OBJECTIVE:To synthesize the evidence on the associations between vegetarian and vegan diets (VVDs) and eating disorder (ED) symptoms compared with omnivorous diets across the lifespan. METHOD:Following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 Guidelines, we searched PubMed, Scopus, Cochrane Library, PsycINFO, and Web of Science Databases up to May 1, 2026, with no language or date restrictions. Random effects models with the Hartung-Knapp-Sidik-Jonkman method were used to estimate pooled effect sizes (standardized mean difference [SMD] with 95% confidence interval [CIs]). RESULTS:We included 24 cross-sectional studies with a total of 25,223 participants (67.7% female; mean age range: 14.9-49.6 years). ED symptoms did not differ significantly between participants who followed VVDs and those following omnivorous diets in analyses including all eligible studies (SMD = 0.07; 95% CI: -0.04 to 0.19; I2 = 80.3%; 95% prediction interval: -0.44 to 0.59). Results were unchanged when analyses were restricted to adult populations. No significant differences in ED symptoms were observed according to diet type (p = 0.524), measurement scale (p = 0.392), or geographic region (p = 0.633). In analyses restricted to adults, sex significantly moderated the pooled estimates (p = 0.028), with studies including a higher proportion of females reporting lower ED symptom scores among individuals following VVDs compared with omnivores. DISCUSSION:ED symptom levels do not appear to differ significantly between individuals following VVDs and those following omnivorous diets. Longitudinal studies accounting for dietary quality, duration of adherence, dietary motivations, and psychosocial factors are also needed to clarify this association.

PURPOSE:This randomized controlled trial investigated the effects of a supervised progressive resistance training (RT) program conducted over 2 yr on cardiac structure and function in older women. METHODS:Sixty-four physically independent older women (≥60 yr) were recruited for this investigation. Participants were randomly assigned to either a training group (TG, n = 33) or a control group (CG, n = 31). The RT program was conducted over 2 yr, in three sessions per week, on nonconsecutive days, and included eight whole-body exercises performed in three sets of 8-12 repetitions. Echocardiographic assessments were performed both before and after a 2-yr period by an experienced echocardiographer who was blinded to the participant's status and group assignment. RESULTS:A group-by-time interaction was found ( P < 0.05) for the left ventricular mass index (TG = -5.5% vs CG = +11%), septal thickness (TG = -3.8% vs CG = +7.3%), posterior wall thickness (TG = -2.8% vs CG = +13.6%), left ventricular end-diastolic volume (TG = -9.0% vs CG = +20.0%), left ventricular end-systolic volume (TG = -7.8% vs CG = +23.3%), left atrial volume index (TG = -7.1% vs CG = +28,1%), the left ventricular ejection fraction (TG = -1.0% vs CG = -4.9%), the E'/E septal (TG = -11.0% vs CG = +22.1%), the E septal (TG = +14.9% vs CG = -19.2%), and the E lateral (TG = +12.7% vs CG = -22.8%). CONCLUSIONS:Our results suggest that a 2-yr follow-up of the RT intervention may improve both the cardiac morphological and functional parameters in older women.

Introduction: Mental disorders, particularly depression and anxiety, represent a leading source of morbidity and disability in young adults, a group increasingly exposed to cumulative psychological processes and environmental stressors. Although evidence links healthy dietary patterns with improved mental health symptoms, the specific contribution of nut consumption (rich in anti-inflammatory, antioxidant, and neuroprotective compounds) remains insufficiently examined in this population. Current evidence also lacks robust data on the dose-response effects of nut consumption and mechanistic pathways involving biomarkers relevant to brain function and mental health. The Nuts4Brain-RCT will investigate the impact of a 6-month mixed-nut consumption intervention on mental health symptoms, cognitive functioning, sleep quality, overall well-being, health-related quality of life, and biochemical brain function mediators in young adults. Methods and analysis: A 6-month, randomized, single-blinded, three-arm, dose-response, parallel-group clinical trial will be conducted with 135 university students aged 18-24 years from the University of Castilla-La Mancha, Cuenca, Spain. The participants will be randomly assigned in a 1:1:1 ratio to one of three groups: (1) a control group maintaining their habitual diet while avoiding nut consumption; (2) a 30 g/day mixed-nut consumption group; or (3) a 60 g/day mixed-nut consumption group. The nut consumption intervention will include unsalted, unroasted walnuts, almonds, hazelnuts, and pistachios. The primary outcomes will include depressive (BDI-II) and anxiety (GAD-7) symptoms, perceived stress (PSS-10), cognitive performance (NIH Toolbox), and plasma brain-derived neurotrophic factor (BDNF). Assessments will take place at baseline and at 3 (intermediate), 6 (end of intervention) and 12 months (follow-up). Repeated-measures mixed-effects models will be applied to estimate the effects of nut consumption and dosage on mental health outcomes. Ethics and dissemination: The study adheres to the principles of the Declaration of Helsinki and the Singapore Statement on Research Integrity and obtained approval from the Clinical Research Ethics Committee of the Virgen de la Luz Hospital, Cuenca, Spain (REG: 2025/E0125). The findings will be disseminated through high-impact open-access peer-reviewed publications, presentations at scientific conferences, and social media platforms. Trial registration: ClinicalTrials.gov. Identifier: NCT07292610.

In COPD, most studies have examined sleep characteristics in isolation, and limited evidence exists regarding sleep phenotypes and their impact on clinical outcomes. To prospectively investigate the impact of sleep phenotypes on several relevant clinical outcomes in individuals with COPD. Based on sleep nighttime assessed at baseline by both objective and subjective methods, individuals were classified into different sleep phenotypes: ‘short sleep’ and ‘high propensity to sleep + average sleep’. Furthermore, in a prospective cohort, individuals were assessed at baseline and after 12 months for lung function, body composition, peripheral muscle strength, functional capacity, daily physical activity (PA) and symptoms of dyspnea, anxiety, and depression. Twenty-nine individuals with COPD were analyzed. In both subjective and objective assessments, the ‘short sleep’ phenotype showed worsening in more outcomes when compared to the other phenotype, with significant worsening in FEV1 (p = 0.038), dyspnea (p = 0.020), light-intensity PA as

Background/Objectives: Evidence on the associations between adherence to different plant-based diet indices and depression in young adults remains limited. This study aimed to analyze the associations of overall, healthy, and unhealthy plant-based diet indices with depressive symptoms in university students. Methods: A cross-sectional study was conducted in 2023 with self-reported data from university students in Cuenca, Spain. Adherence to the overall plant-based diet index (PDI) and to the healthy (hPDI) and unhealthy (uPDI) plant-based diet indices were calculated using data from a 137-item food-frequency questionnaire. Mild-to-severe depression was defined as a Beck Depression Inventory II score > 13 points. Linear and logistic regression models were adjusted for sociodemographic and lifestyle-related confounders. Results: A total of 392 students (mean age: 20.9 ± 2.4 years; 70.4% female) were included. The prevalence of mild-to-severe depression was 36.0%. Higher hPDI and overall PDI scores were associated with lower depressive symptom scores, whereas uPDI scores showed a positive but non-significant association after full adjustment. In logistic regression analyses, high adherence to the hPDI was associated with lower odds of mild-to-severe depression (OR = 0.51; 95% CI: 0.28-0.95; p-for-trend = 0.030). In contrast, higher uPDI adherence was associated with greater odds of depression, although the association was attenuated after adjustment for lifestyle-related variables. Conclusions: Greater adherence to a healthy plant-based diet was associated with lower depressive symptoms and lower odds of mild-to-severe depression among university students. These findings highlight the importance of plant food quality, rather than plant-based diets per se, in relation to depression in young adults.

Cardiorespiratory fitness (CRF) is a strong indicator of overall physical health, but its relevance for mental and neurocognitive health across the life course remains unclear. Here we synthesize evidence from cohort studies examining the associations between CRF and the risk of mental and neurocognitive disorders across all age groups in the general population. Twenty-seven studies comprising 4,007,638 individuals were included. Compared with low CRF, high CRF was associated with a reduced risk of depression (hazard ratio (HR) = 0.64; 95% confidence interval (CI), 0.56-0.74), all-cause dementia (HR = 0.61; 95% CI: 0.55-0.68) and psychotic disorders (HR = 0.71; 95% CI: 0.65-0.77) in adults. A one metabolic equivalent of task (1 MET; 3.5 ml kg-1 min-1) higher level of CRF was associated with lower risks of depression (HR = 0.95; 95% CI: 0.92-0.98) and all-cause dementia (HR = 0.81; 95% CI: 0.67-0.98). Overall certainty of evidence ranged from very low to moderate. These findings suggest that CRF may be a useful marker for identifying adults at increased risk of depression, dementia and psychotic disorders, highlighting the need for further large-scale longitudinal studies.

Background: Adolescence is a sensitive period during which sleep undergoes substantial change, increasing vulnerability to sleep disturbances and their health consequences. Psychological inflexibility (PI) and experiential avoidance (EA), operationalized through the Acceptance and Action Questionnaire-II (AAQ-II), have been associated with poorer sleep among adults; however, evidence in adolescents remains scarce. This study examined the association between PI, EA, and sleep-related problems in a representative sample of Spanish adolescents. Methods: A cross-sectional analysis was conducted using data from 623 adolescents (aged 12-17 years; 56.7% girls) from the Eating Healthy and Daily Life Activities (EHDLA) study, conducted in the Valle de Ricote (Murcia, Spain) during 2021-2022. PI and EA were assessed with the Spanish-validated AAQ-II; sleep-related problems were screened using the BEARS (B = Bedtime problems, E = Excessive daytime sleepiness, A = Awakenings during the night, R = Regularity and duration of sleep, S = Snoring) questionnaire across five domains. Generalized linear models were adjusted for sex, age, socioeconomic status, physical activity, sedentary behavior, body mass index (BMI) z-score, energy intake, and sleep duration. Results: Higher AAQ-II scores were significantly associated with increased probabilities of bedtime problems (+0.9% per point; 95% confidence interval [CI]: 0.6-1.1%), excessive daytime sleepiness (+1.0%; 95% CI: 0.7-1.2%), nocturnal awakenings (+0.7%; 95% CI: 0.5-1.0%), and problems with sleep regularity and duration (+0.8%; 95% CI: 0.5-1.1%). Each additional AAQ-II point increased the probability of reporting any sleep-related problem by 1.2% (95% CI: 0.9-1.5%; p < 0.001). Corresponding adjusted odds ratios ranged from 1.04 to 1.06 per point. No significant association was found for snoring. Conclusions: In this cross-sectional study, psychological inflexibility and experiential avoidance were positively associated with several sleep-related problems among adolescents. Longitudinal and intervention studies are warranted before causal or clinical recommendations can be made.

Background/Objectives: Adherence to the Mediterranean diet (MedDiet) has been associated with numerous health benefits, yet it is often suboptimal among university students. Its relationship with academic performance (AP), an outcome with potential long-term implications, has not been quantitatively synthesized in this population. This study aimed to synthesize the available evidence on the associations between MedDiet adherence and AP in university students. Methods: A systematic review and meta-analysis followed PRISMA 2020 and MOOSE guidelines (PROSPERO: CRD42024526903). PubMed, Web of Science, Scopus, and the Cochrane Library were searched from inception to 6 August 2026. AP was examined through objective (grade point average, mean academic grade, or university entrance scores) and subjective measures (academic self-concept or perceived academic progress). Standardized mean differences (SMDs) were pooled using random-effects models. Subgroup, meta-regression, and sensitivity analyses were performed. Methodological quality was appraised with the NIH tool, and certainty of evidence with GRADE. Results: Twelve cross-sectional studies were included (10,931 students; study-level mean ages: 19.0–25.1 years; 56.7% female). A positive association was observed in the primary analysis of objective AP measures (10 studies; SMD = 0.49; 95% CI: 0.04 to 0.94; I2 = 98.2%) and for subjective measures (3 studies; SMD = 0.42; 95% CI: 0.14 to 0.71; I2 = 0.0%). The certainty of the evidence was very low. Conclusions: Higher MedDiet adherence may be associated with better AP in university students. However, considerable between-study heterogeneity and very low certainty of the evidence limit confidence in the pooled estimates. Further high-quality longitudinal and intervention studies are needed.

OBJECTIVES:To synthesize the available evidence on the effects of animal-assisted therapy on core symptom dimensions (including positive, negative, and general symptoms), specific symptom domains (including depression, anhedonia, anxiety, stress) and cognitive functioning in patients with psychotic spectrum disorders. METHODS:A systematic review and meta-analysis were conducted in accordance with the PRISMA and Cochrane Handbook for Systematic Reviews of Interventions guidelines. The PubMed, Cochrane Library, Web of Science and PsycINFO databases were searched from inception to June 2025 with no language restrictions. Experimental follow-up studies implementing animal-assisted therapy in patients with psychotic disorders were included. Pooled standardized mean differences (SMDs) with 95 % confidence intervals (CIs) were estimated using a random effects model. Heterogeneity was assessed with the I² statistic. RESULTS:A total of 12 studies (10 randomized controlled trials, a quasi-experimental controlled trial and a pre-post study) involving 408 patients (mean age range: 37.0-55.3 years; 32.6 % women) were included. Compared with control conditions, patients receiving animal-assisted therapy (predominantly dog-assisted) showed significantly greater pre-post improvements in negative symptoms (SMD = -0.51, 95 % CI: -0.95, -0.07; I2 = 45.2 %; n = 6). No significant effects were found for positive symptoms (SMD = -0.68, 95 % CI: -1.68, 0.32; I2 = 83.8 %; n = 6) or general symptoms (SMD = -0.08, 95 % CI: -0.86, 0.69; I2 = 72.5 %; n = 4). Sensitivity analyses restricted to dog-assisted interventions yielded similar effect estimates. Anxiety symptoms showed reductions but could not be synthesized quantitatively. CONCLUSION:Animal-assisted therapy may help alleviate symptoms in patients with psychotic disorders, particularly by reducing negative symptoms. Further randomized controlled trials are needed to confirm these findings and clarify their clinical significance.

To summarize the evidence on the global experience of dental caries among Indigenous children and adolescents worldwide using decayed, missing, and filled teeth indices for deciduous (dmft) and permanent (DMFT) dentitions. A systematic review of the PubMed, SciELO, Embase, and Scopus databases was conducted. The search included studies with primary data on dmft and DMFT in Indigenous populations worldwide published until February 9, 2026. The pooled means (95

OBJECTIVE:To synthesize the evidence on the associations between vegetarian and/or vegan diets (VVDs) and symptoms of orthorexia nervosa (ON) compared with omnivorous diets in the adult population. METHOD:Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines, we conducted a systematic review and meta-analysis. We searched the MEDLINE/PubMed, Embase/Scopus, PsycINFO, and Web of Science databases up to June 17, 2025, with no language or date restrictions. Random effects models with the Sidik-Jonkman method were used to estimate pooled effect sizes. RESULTS:The meta-analysis included 26 cross-sectional studies with a total of 23,783 participants (72.0% female; mean age range: 19.6-51.0 years). Adults who followed VVDs had moderately higher ON symptoms compared to omnivores (standardized mean differences using Cohen's d index = 0.46; 95% confidence interval [CI]: 0.33, 0.60; inconsistency index [I 2] = 81.0%). Additionally, categorical data revealed that VVD adherents were approximately twice as likely to report ON symptoms as omnivores (odds ratio = 1.99; 95% CI: 1.21-3.25; I 2 = 92.8%). Vegetarians and vegans were similarly associated with ON symptoms compared with omnivorous (p = 0.855). DISCUSSION:Adherence to VVD is associated with higher ON symptoms in young and middle-aged adults. However, these results should be interpreted with caution due to high heterogeneity and the low overall methodological quality of the exclusively cross-sectional studies included. Higher-quality longitudinal studies using validated assessment tools are needed to establish clearer causal relationships and inform clinical screening and intervention strategies.

Background/objectives: recent studies have suggested that components typical of the Mediterranean diet (MedDiet) are associated with depression and anxiety prevention. In this sense, the main objective of this study was to analyse the associations between adherence to the MedDiet and depression and anxiety symptoms and to examine whether this relationship is mediated by lean mass and the muscle strength index (MSI). Methods: a cross-sectional study (based on data obtained from the Nuts4Brain-Z study) was conducted from 2023–2024, involving 428 university students, aged 18–30 years, from a Spanish public university. Depression was assessed using the Beck Depression Inventory (BDI-II), and anxiety was assessed via the General Anxiety Disorder-7 (GAD-7) tool. Adherence to the MedDiet was assessed using the MEDAS questionnaire. Lean mass was assessed via bioimpedance, and MSI was measured via a dynamometer. ANCOVA models were used to test the mean differences in depression and anxiety scores using MEDAS categories (low adherence < 9 points vs high adherence ≥ 9 points). Serial multiple mediation models, adjusted for the main confounders, were used to explore the role of lean mass and MSI in the relationships between adherence to the MedDiet and depression and anxiety symptoms. Results: university students with high adherence to the MedDiet exhibited lower scores for depression and anxiety symptoms (p < 0.05) than did students with low adherence to the MedDiet. The mediation analysis preliminarily revealed that both lean mass and MSI acted as mediators of the relationships between adherence to the MedDiet and depression and anxiety. Conclusion:adherence to the MedDiet in university students per se does not appear to have a direct effect on depression and anxiety symptoms because these associations are partially (for depression) or entirely (for anxiety) explained by lean mass and MSI.

Objetivo: Verificar as associações entre a preocupação com a imagem corporal e a presença de sintomas depressivos, má qualidade do sono e utilização de medicamentos para emagrecer entre de estudantes universitários. Materiais e Métodos: Trata-se de um estudo transversal com estudantes de cursos de graduação de uma universidade pública do sul do Brasil. O instrumento de pesquisa foi constituído por um questionário semiestruturado, disponibilizado de forma online aos participantes. A coleta de dados ocorreu entre os meses de abril e junho de 2019. A variável independente foi a satisfação com a imagem corporal e as variáveis dependentes foram o indicativo de depressão, qualidade do sono e consumo de medicamentos para emagrecer. Para a análise de dados, foi aplicada a regressão logística bruta e ajustada. Resultados: Os resultados do estudo indicam que estudantes universitários com preocupação moderada ou alta com a forma corporal apresentam maiores chances de má qualidade de sono (OR=2,39; IC95% 2,00-2,86; p<0,001), de indicativo de depressão (OR= 3,97; IC95% 3,31-4,76; p<0,001) e de utilização de medicamentos para emagrecer (OR= 6,47; IC95% 4,76-8,80; p<0,001), em relação àqueles com muito baixa ou baixa preocupação com a forma corporal. Na estratificação por sexo não foram observadas diferenças quando comparadas às relações da população geral, exceto para a qualidade do sono, a qual perdeu significância estatística entre o sexo masculino. Conclusão: Os achados do presente estudo apontam que estudantes universitários com moderada a alta preocupação com a forma corporal apresentam maiores chances para distúrbios do sono, sintomas depressivos e utilização de medicamentos para emagrecer.

ABSTRACT Background and Aims Disordered eating behaviors (DEBs) in adolescence are influenced by family structure and dynamics, including parental supervision, emotional support, and exposure to neglect or abuse. This study examined the associations between adolescents' relationships with parents or guardians, including indicators of neglect and abuse, and the prevalence of DEBs. Methods This cross‐sectional study assessed DEBs and family relationship indicators, including the frequency of shared meals, parental awareness of adolescents' free‐time activities, emotional understanding, and experiences of physical or sexual assault. Data were obtained from the 2019 National School‐Based Health Survey, a representative sample of 95,367 Brazilian students aged 13–17 years. Poisson regression models estimated adjusted prevalence ratios (PRs) and 95% confidence intervals (CIs), stratified by sex. Results Fully adjusted analyses revealed that girls were significantly more likely to report DEBs when living with neither parent (PR = 1.34; 95% CI: 1.03–1.75) or never having family meals (PR = 2.36; 95% CI: 1.96–2.84). DEBs were more prevalent in both sexes when their parents did not supervise their school attendance or were unaware of their free‐time activities and when their parents provided limited emotional support. Furthermore, reporting experiencing parental physical aggression or sexual abuse within the past year was also associated with a higher prevalence of DEBs (p‐value < 0.05). Conclusions The findings suggest that parental neglect is associated with an increased likelihood of DEBs in adolescents and that experiences of parental aggression and sexual abuse may further compound this potential risk. These results underscore the importance of family‐based prevention strategies in addressing adolescent eating disorders.

AIMS:Young people are consuming less healthy diets such as Mediterranean diet (MedDiet), which is associated with an increased risk of chronic diseases, including obesity. This systematic review aimed to synthesize the literature concerning the prevalence and trends of adherence to the (MedDiet) in a young Spanish population (aged 2-24 years) from 2004 to 2023. DATA SYNTHESIS:The present review included observational studies and final assessments of longitudinal studies to assess the prevalence or trend in adherence to the MedDiet using the Mediterranean Diet Quality Index for Children and Adolescents (KIDMED) in three categories (low (≤3), medium (4-7), and high (≥8)). Subgroup analyses were conducted by sex, age group (2-12 years and 12-24 years), and four time periods. A total of 70 studies (n = 84,281) were included. Overall, the pooled prevalence estimate of high adherence to the MedDiet in the young Spanish population (aged 2-24 years) was 38 % (95 % CI: 34-41), the prevalence of medium adherence to the MedDiet was 51 % (95 % CI: 47-54), and low adherence to the MedDiet was 11 % (95 % CI: 9-13). From 2011-2014 to 2019-2023, there was a decrease in high adherence to the MedDiet and an increase in low adherence to the MedDiet. Finally, meta-regression analyses revealed a nonsignificant negative association between the total KIDMED score and body mass index (BMI), age, and data collection year. Variables such as, socioeconomic status and parental education level have not been including in this study. CONCLUSIONS:These results will facilitate a more comprehensive understanding of the importance of reinforcing initiatives to enhance adherence to the MedDiet in young populations, such as increasing education interventions.

Purpose:The aim of the present study was to analyse the associations of family meals and social eating behaviour (SEB) with experiential avoidance (EA) in adolescents from Spain. Methods:This cross-sectional study involved 617 adolescents (aged 12-17 years, 56.7% females) from the Eating Habits and Daily Life Activities study from Valle de Ricote (Region of Murcia, Spain). Variables were analysed using visual techniques including Shapiro-Wilk test and density and quantile-quantile plots. Continuous data were displayed using medians and IQRs, while categorical data was shown as percentages. The frequency of family meals was assessed by asking participants to indicate how many times their family had shared a meal together during the previous week. SEB was self-reported by the adolescents through responses to three statements. To measure EA, we used the Acceptance and Action Questionnaire-II (AAQ-II). Generalised linear models were employed to ascertain the associations of family meals or SEB with EA. Results:For each further point in SEB, a lower estimated marginal mean (M) of the AAQ-II was observed (-0.86 points, 95% CI -1.39 to -0.33, p=0.001). In terms of family meal status, the highest AAQ-II score was found in those with low family meal status (M=20.1, 95% confidence interval [CI] 18.1 to 22.2), followed by participants with medium family meal status (M=19.2, 95% CI 17.0 to 21.4) and those with high family meal status (M=18.8, 95% CI 16.1 to 21.0). Significant differences were observed between participants with high SEB status and their counterparts with medium SEB (p=0.004) or low SEB (p<0.001). Conclusions:This research revealed a significant relationship between SEB and EA and a non-significant relationship between the frequency of family meals and EA. Promoting positive social eating environments and increasing family meal participation could help reduce the prevalence of EA and its negative consequences in adolescents.

Objective:The aim of the present study was to examine the relationships of social network (SN) use and SN addictive behaviors with self-esteem in Spanish adolescents. The use of specific social media platforms and their associated addictive behaviors related to self-esteem were also evaluated. Methods:This cross-sectional study used secondary data from the Eating Healthy and Daily Life Activities (EHDLA) project, which included a representative sample of adolescents aged 12-17 years from the Valle de Ricote in the Region of Murcia, Spain. The sample consisted of 632 adolescents. Addiction and SN use were assessed via the Short Social Media Addiction Scale, and self-esteem was assessed via the Rosenberg Self-Esteem Scale. Generalized linear regression analyses with Gaussian distributions were conducted to calculate unstandardized beta coefficients (B) and their 95% confidence intervals (CIs). Sociodemographic, lifestyle, and anthropometric data were included as covariates. Results:In terms of SN use, Instagram was the most accepted, in contrast to Facebook, which was the least used. The most notable addictive behaviors toward SN use included salience (i.e., when using SNs is the major concern and the priority motivation) and tolerance (i.e., when increasing use is desired). Furthermore, self-esteem levels decreased as adolescent's addiction levels increased. In the adjusted model, an increase in each addictive behavior was associated with a significant decrease in self-esteem (B = -0.699; 95% CI -0.890 to -0.508; p < 0.001). Individually, there was a negative and significant association between Twitter use and self-esteem (B = -0.356; 95% CI -0.695 to -0.017; p = 0.040). With respect to addictive behaviors toward SNs, mood modification showed the strongest negative association with self-esteem (B = -2.580; 95% CI -3.192 to -1.968; p < 0.001), followed by conflict (B = -1.410; 95% CI -2.147 to -0.673; p < 0.001), relapse (B = -1.350; 95% CI -1.999 to -0.701; p < 0.001), tolerance (B = -0.928; 95% CI -1.596 to -0.260; p = 0.007), salience (B = -0.892; 95% CI -1.623 to -0.161; p = 0.017), and finally, withdrawal behaviors (B = -0.170; 95% CI -1.905 to -0.435; p = 0.002), all of which were significantly negatively associated with self-esteem in adolescents. Conclusions:SN use and SN addictive behaviors could significantly affect adolescent's self-esteem. The findings suggest that the use of Twitter and certain addictive behaviors, such as tolerance, salience, mood modification, relapse, withdrawal, or conflict are particularly linked to lower self-esteem. These results highlight the need to develop strategies aimed at promoting healthy engagement with SN platforms and fostering adolescent's psychological well-being.

ObjectiveThe current study aims to provide a comprehensive analysis of the relationships between social network (SN) use, messaging apps use, and addictive behaviors related to SNs, and sleep-related problems in a sample of Spanish adolescents.MethodsThis was a cross-sectional study using data from the Eating Healthy and Daily Life Activities (EHDLA) project, which involved adolescents aged 12–17 years from three secondary schools in Valle de Ricote (Region of Murcia, Spain). A sample of 632 adolescents was studied. The use of SN (i.e., Facebook, Twitter, Instagram, Snapchat or TikTok) or messaging applications (i.e., WhatsApp) was assessed via a scale including one item for each SN, in which adolescents were asked what type of SN they used and the usage profile of each SN. The Short Social Networks Addiction Scale-6 Symptoms (SNAddS-6S) was used to determine SN addictive behaviors. Generalized linear regression analyses with a negative binomial distribution were performed to determine the associations of SN use or SN addictive behaviors with sleep-related problems. These analyses were adjusted for age, sex, body mass index, socioeconomic level, physical activity, sedentary behavior, and adherence to the Mediterranean diet.ResultsHigher SN use was related to greater presence of sleep-related problems [prevalence ratio (PR) = 1.04; 95% confidence interval (CI) 1.01–1.07; p = 0.015]. Additionally, the higher the score on the addictive behaviors toward SN use scale was, the more sleep-related problems were identified (PR = 1.15; 95% Cl 1.09 to 1.21; p < 0.001). Specifically, only the use of Twitter was significantly associated with sleep-related problems (PR = 1.10; 95% Cl 1.01 to 1.21; p = 0.035). In terms of addictive behaviors related to SN use, mood modification, relapse, withdrawal, and conflict were significantly associated with sleep-related problems (mood modification: PR = 1.58; 95% CI 1.36 to 1.84; p < 0.001; relapse: PR = 1.24; 95% CI 1.07 to 1.43; p = 0.004; withdrawal: PR = 1.28; 95% CI 1.08 to 1.51; p = 0.004; conflict: PR = 1.19; 95% CI 1.01 to 1.39; p = 0.037).ConclusionOur results suggest a relationship between SN use, SN addictive behaviors, and sleep-related problems in adolescents. These cross-sectional results should be confirmed in longitudinal and intervention studies.

Background: Children and adolescents with obesity have altered serum copper (Cu) and zinc (Zn) levels, which are associated with oxidative stress, inflammation, and health outcomes. The inclusion of cashew nuts in an adequate diet may provide health benefits and help improve the mineral status of individuals with obesity. Objective: To evaluate the effects of cashew nut consumption on biomarkers of Cu and Zn status in adolescents with obesity. Methods: This was a randomized controlled trial conducted in adolescents. The participants were divided into a control group (CON) and a cashew nut group (CASN). The CASN group received 30 g/day of roasted cashew nuts for 12 weeks, and both groups received nutritional counseling during the study. Anthropometric, dietary, and biochemical parameters (Zn, Cu, and superoxide dismutase (SOD)) were assessed at the baseline and at the end of the study. Association tests, within-group and between-group mean comparisons, and analyses of variation between study periods (Δ T12-T0) were performed. Results: The sample consisted of 81 adolescents who completed the intervention period, resulting in 54 in the CASN group and 27 in the CON group. After the intervention, the CASN group presented a decrease in plasma Cu (p = 0.004) and an increase in SOD (p = 0.030). Both groups showed an increase in plasma Zn (p < 0.050) and a decrease in the Cu/Zn ratio (p < 0.001). CASN had a negative effect on the Cu concentration, which was significantly different from that of CON (p = 0.004). Conclusions: The consumption of cashew nuts for 12 weeks reduced plasma Cu levels in adolescents with obesity. Nutritional counseling may have contributed to the increase in plasma Zn levels in all the study participants.

CONTEXT:Emerging evidence suggests the quality of plant-based diets may play a pivotal role in the primary prevention of certain nonfatal diseases. However, its impact on mental and neurocognitive health conditions remains to be elucidated. OBJECTIVE:To synthesize the available evidence on the cross-sectional and prospective associations of adherence to overall, healthy, and unhealthy plant-based diets with mental and neurocognitive health outcomes in the general adult population (aged ≥18 years). DATA SOURCES:The PubMed, Scopus, and Web of Science databases were searched from inception through March 13, 2024. Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analyses of Observational Studies in Epidemiology guidelines were followed for this study. DATA EXTRACTION:Random-effects meta-analyses were performed using the Sidik-Jonkman estimator. Pooled odds ratios (ORs) and risk ratios (RRs) with their 95% CIs were estimated for cross-sectional and prospective associations between the highest (vs lowest) adherence to plant-based diets and the likelihood of adverse mental and neurocognitive health outcomes (ie, anxiety, depression, psychological distress, cognitive decline, and dementia). DATA ANALYSES:A total of 23 studies involving 709 703 adults (mean age range: 31.4-102.3 years; 52.8% female) were included. The highest (vs lowest) adherence to healthy plant-based diets was significantly associated with a lower likelihood of anxiety (OR = 0.67; 95% CI, 0.46-0.96), depression (OR = 0.74; 95% CI, 0.57-0.96), and psychological distress (OR = 0.51; 95% CI, 0.39-0.65) in cross-sectional studies and with a lower risk of cognitive decline (RR = 0.74; 95% CI, 0.64-0.85), dementia (RR = 0.85; 95% CI, 0.76-0.96), and depression (RR = 0.77; 95% CI, 0.67-0.88) in cohort studies. Conversely, greater adherence to unhealthy plant-based diets was significantly associated with an increased likelihood of anxiety and depression. When the data were subjected to a standardized effect size correction (Hedges g) to mitigate potential biases, the results remained consistent. CONCLUSION:High-quality plant-based diets could play an important role in the primary prevention of mental and neurocognitive health conditions. SYSTEMATIC REVIEW REGISTRATION:PROSPERO registration no. CRD42024524053.