OBJECTIVE:Temperament-Based Treatment with Supports (TBT-S) is an intensive treatment for patients with eating disorders (EDs) integrating neurobiological insights and family dimensions with the involvement of supports. Previous studies report high acceptability among both patients and their supports, and improvements in clinical outcomes and family functioning. The present study investigated acceptability and short-term outcomes of TBT-S intervention as adjunctive to ongoing, specialised treatment for anorexia nervosa (AN) in late adolescent and young adult patients and their supports. METHOD:Thirty-two patients (mean age = 21.44, SD = 4.72), 29 mothers, and 22 fathers participated in eight TBT-S interventions in Greece. ED symptomatology, patients' and supports' psychological distress, and supports' emotional and behavioural responses were assessed immediately before and after participation in TBT-S intervention. Also, acceptability of TBT-S intervention was assessed. RESULTS:TBT-S intervention was found to be highly acceptable among patients and their supports. Patients reported significant reductions in ED restraint symptomatology and depression. Mothers displayed significant reductions in depression, stress, criticism, and accommodating and enabling behaviours. Conversely, fathers displayed significant increases in depression and anxiety. CONCLUSIONS:TBT-S intervention demonstrated high acceptability among patients and supports, and was associated with several short-term outcomes as adjunctive to ongoing treatment for AN.

Grounded in the field of nutrition anthropology, the present manuscript introduces 3 core pillars of the traditional Mediterranean lifestyle: cheerful frugality, belongingness, and purpose in life. These foundational components are integral to Mediterranean culture and have historically shaped food selection, eating, and consumption patterns, depicting the harmonious human-nature-human coexistence. Specifically, the proposed core pillars highlight the role of alignment with natural rhythms in fostering cheerful frugality, the contribution of belongingness to social cohesion, and the influence of spirituality and religiosity in cultivating purpose in life. Together, these 3 pillars form a dynamic system that induces dispositional mindfulness, supporting and enhancing the salutogenic effect of the traditional Mediterranean lifestyle - beyond foods alone. Dispositional mindfulness emerges as the key tool that directs the interaction of these 3 pillars toward the traditional Mediterranean diet characteristic of moderation. Building upon this triptych and the crucial role of dispositional mindfulness, the manuscript proposes a roadmap to moderation, grounded in the ancient Greek concepts of autarkeia - self-sufficiency, and enkrateia - self-control. Within this perspective, autarkeia reframes frugality as cheerfulness, belongingness as meaningful connection, and purpose in life as a stable psychological resource. In this sense, mindfulness is suggested as a coping strategy for stressful situations with contemporary relevance for health-promoting lifestyles as the key tool for moderation.

Background: The popularity of vegan diets (strictly vegetarian) has increased globally. However, the evidence regarding their impact on cardiovascular disease (CVD) risk remains inconclusive. The aim of this study was to conduct an umbrella meta-analysis that synthesizes the available meta-analyses on the effect of vegan diets on cardiovascular health markers. Methods: A comprehensive search of PubMed and Scopus identified meta-analyses evaluating the association between vegan diets and cardiovascular risk factors. Inclusion criteria mandated a clear focus on vegan diets and inclusion of a control group comprising omnivorous or mixed dietary patterns. A random-effects model was applied, and heterogeneity was assessed using the I ² and Cochran’s Q-statistic. Publication bias was evaluated using funnel plots and Egger’s regression test. Results: Nine eligible meta-analyses used both observational studies and clinical trials encompassing diverse hard (i.e., CVD events) and soft (i.e., risk markers) endpoints were included. A vegan diet was inversely associated with body mass index (pooled β = −1.67 kg/m 2 , P < 0.01, I 2 = 0.00%), waist circumference (pooled β = −4.90 cm, P < 0.01, I 2 = 45.64%), fasting glucose (−0.30 mg/dL, P < 0.01, I 2 = 21.75%), glycated hemoglobin (pooled β = −0.20%, P = 0.01, I 2 = 80.16%), both systolic (pooled β = −1.65 mmHg, P = 0.05, I 2 = 77.00%) and diastolic blood pressure (pooled β = −1.25 mmHg, P = 0.01, I 2 = 68.40%), and also C-reactive protein (pooled β = −0.54 mg/L, P < 0.01, I 2 = 0.00%). No significant associations were found with total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels. Substantial publication bias and heterogeneity were noted in several outcomes. Conclusions: Vegan diets appear to be favorably associated with surrogate markers of cardiovascular health, such as adiposity, glycemia, blood pressure, and inflammatory status.

Cardiovascular disease (CVD) has a multifactorial origin, involving a range of genetic and environmental factors that have been extensively studied over recent decades. Behavioral aspects, namely dietary habits, physical activity, sleep patterns, smoking behavior, and mental health conditions, including depression, anxiety, post-traumatic stress-related disorders, are modifiable cardiovascular disease risk factors. Therefore, they represent key targets for CVD prevention and health promotion. The aim of this position is to highlight the importance of behavioral factors and positive well-being in the preventive CVD interventions and to propose strategies for effectively addressing these factors within the context of Greece. It reflects the views of the current board of the Hellenic Atherosclerosis Society Working Group (WG) on Lifestyle, Psychosocial Factors, and Atherosclerosis. Lifestyle and well-being should be a high priority for healthcare policy-makers in Greece; it requires coordinated action among multiple stakeholders, including scientific and healthcare professional societies, and the implementation of interventions to improve guideline adherence, such as community health literacy initiatives and financial incentives linked to the food market or insurance systems. The role of this WG is to actively contribute to this important task.

Background/Objectives: The COVID-19 pandemic has led to detrimental effects on diverse aspects of the mental and physical health of the general population worldwide. The elderly are more susceptible to COVID-19 infection compared to younger age groups. In this aspect, the purpose of the current survey is to evaluate the effect of the COVID-19 pandemic on the interrelationships among the sociodemographic and anthropometric characteristics, depressive behavior, quality of life, cognition status, physical activity and nutritional status of older adults. Methods: The present study constitutes a comparative, cross-sectional study of 4162 older adults (mean age ± standard deviation: 72.13 ± 8.1 years and 75.22 ± 8.2 years in the pre- and post-COVID-19 periods, respectively, and a male/female ratio of almost 1:1). We used validated questionnaires to assess depression, cognition function, quality of life, physical activity and nutritional status of the elderly in the pre-Covid and post-Covid periods. Relevant questionnaires were also used for collecting sociodemographic data, while anthropometric data were measured using standard protocols. Results: The present study finds that the COVID-19 pandemic influenced, in an independent manner, residence location, smoking status, overweight/obesity and abdominal obesity, depressive behavior, quality of life, cognition behavior, physical activity levels and nutritional status of the elderly. The COVID-19 pandemic was also related to employment and living status as well as family economic status. Nevertheless, the above three relationships were insignificant in the multivariate analysis. Conclusions: The COVID-19 pandemic exerted deleterious effects on several aspects of the mental and physical health of the elderly, which appeared to strongly persist in the post-Covid period. Future prospective population-based and well-organized surveys should be conducted to establish whether there is a causality long-term effect of the COVID-19 pandemic on diverse aspects of the mental and physical health of the elderly.

By conducting a narrative review of the scientific literature, the authors of this study sought to verify whether there were sufficient data to answer the following question: “Can wine positively or negatively influence the incidence and severity of disorders associated with gastrointestinal (GI) diseases?”. In this review, most of the studies considered tested different alcoholic beverages (other than wine), not always reporting in the conclusions the possible difference in the extent of symptoms. Although alcohol certainly plays a central role in influencing the oesophageal and gastric environment, no studies evaluating the role of alcohol as such were included, since the aim of the review was to understand whether wine can be moderately consumed by patients with gastrointestinal diseases. The analysis of studies selected from the main reference databases indicates that even moderate wine consumption can be a source of discomfort in subjects with the GI diseases included in this review (gastritis and gastroesophageal disease, gastrointestinal motility, inflammatory bowel disease, irritable bowel syndrome, and microscopic colitis). This does not mean that a certain percentage of patients cannot tolerate moderate amounts of alcoholic beverages; however, discussion with the family doctor or specialist is essential to identify the correct diet in which to include or exclude the consumption of wine. One of the limitations of this review is the low number of studies available, at least for some of the pathologies considered. It is important to emphasise, however, that some selected epidemiological studies, which include many subjects (even over 100,000), can provide useful information from a scientific point of view.

Background: There has been recent evidence to suggest that people who suffer from eating disorders (EDs) or other eating behavior disturbances, such as emotional eating (EE), are particularly vulnerable post-COVID-19. This narrative literature review aims to comprehensively analyze and scrutinize the existing clinical studies regarding the effects of the COVID-19 pandemic on people with EDs or EE. Moreover, due to the COVID-19 pandemic, it is very important to find out whether a person’s emotional state may lead them to wrongly confront their emotional behavior with food consumption. Methods: A thorough search of several databases (PubMed, Scopus, Web of Science, Public Library of Science, Google Scholar, CINAHL Complete, PsycINFO, and Academic Search Complete) was performed to identify available clinical studies on the COVID-19 pandemic published between 2020 and 2024 using relevant keywords. Results: There is substantial evidence that the COVID-19 pandemic exerted negative effects on persons suffering from EDs, including those who are symptomatic, those who are in remission, and those with an EE behavior. Characteristically, people diagnosed with anorexia nervosa (AN), bulimia nervosa (BN), or binge eating disorder (BED) showed considerable symptomatic worsening after the first wave of the COVID-19 pandemic. Clinical studies investigating the effects of the COVID-19 pandemic on persons suffering from EE have also clearly demonstrated that their mood disturbances negatively affected their eating behaviors. These studies have also shown that vulnerable people were at greater risk of EE development and progression during the COVID-19 pandemic. Conclusion: The COVID-19 pandemic seems to have exerted a significant deleterious effect on people who have a history of suffering from EDs or EE. The COVID-19 pandemic has been related to the frequency of dysfunctional eating behaviors, thus decreasing therapeutic intervention efficiency in people with EDs as well as in those with disturbed eating behaviors such as EE. In this aspect, further clinical studies are strongly recommended to investigate the exact effects of the COVID-19 pandemic as well as to explore their potential long-term deleterious complications in the post-pandemic period. Public strategies and policies should be applied to provide special healthcare for this group of patients.

Background/objectives: Dietary habits are a significant predictor of hypertension (HTN). We aimed to evaluate the long-term association between adherence to the Mediterranean diet and HTN incidence. Subjects/methods: This was a prospective study among 1415 non-hypertensive adults (44% men, age: 41 +/- 13 years) followed up for 20 years. Anthropometric, lifestyle, and clinical parameters were evaluated at baseline. Adherence to the Mediterranean diet was evaluated both at baseline and 10 years through the MedDietScore (range: 0-55, higher values indicate greater adherence). Results: At the 20-year follow-up, 314 new HTN cases were recorded. HTN incidence was 35.5%, 22.5%, and 8.7% in the lowest, middle, and upper tertile of baseline MedDietScore, respectively (p < 0.001). For each 1-point increase in baseline MedDietScore, the 20-year HTN risk decreased by 7% [relative risk (RR): 0.925, 95% confidence interval (CI): 0.906, 0.943], and this effect remained significant after adjustment for age, sex, and baseline lifestyle and clinical confounders, i.e., body mass index, physical activity, smoking, systolic and diastolic blood pressure, family history of HTN, and presence of hypercholesterolemia and diabetes mellitus (RR: 0.973, 95%CI: 0.949, 0.997). In a similar multiadjusted model, compared to subjects who were consistently away from the Mediterranean diet (in the lowest MedDietScore tertile both at baseline and 10 years), only those who were consistently close (in the middle and upper MedDietScore tertiles both at baseline and 10 years) exhibited a 47% lower 20-year HTN risk. Conclusion: A high adherence to the Mediterranean diet, particularly when longitudinally sustained, is associated with lower incidence of HTN.

Background/Objectives Scientific evidence suggests that substituting non-fermented with fermented dairy products may confer cardiovascular health benefits. The role of fermented in relation to non-fermented dairy products on 20-year fatal/non-fatal cardiovascular disease (CVD) incidence was examined. Subjects/Methods In 2001-2002, n = 3042 free-of-CVD men and women from Attica, Greece, were recruited. Dietary assessment was based on a validated semi-quantitative food frequency questionnaire. CVD evaluation was performed in three follow-up time points at 5, 10 and 20 years, in n = 1988 participants (718 cases). Results Participants reported >2 servings/day of fermented dairy products had 1.5 times lower risk to develop CVD compared with their lower level of consumption. Multi-adjusted analysis revealed similar cardioprotective properties per 1 serving increase in dairy consumption of fermented dairy products (Hazard Ratio (HR) = 0.82, 95% Confidence Interval (95%CI) (0.58, 0.95)) as well as when the ratios of fermented:total dairy products (0.90, (0.53, 0.95)) and fermented:non-fermented dairy products (0.74, (0.39, 0.92)) were >= 0.76 and >= 2.5, respectively. The associations were more evident in case of impaired inflammation status. Replacing 1 serving of non-fermented with 1 equivalent serving of fermented dairy products reduced CVD risk (0.74, (0.53, 0.92)). Substitution of low-fat with whole-fat yogurt increased CVD risk (1.35, (1.02, 1.58)). Replacing cheese (any kind) with low-fat yogurt reduced CVD risk (all HRs<1) while with whole-fat yogurt no significance was observed. Conclusions Shift of guidelines to a daily pattern of dairy intake yet with an inclination towards emphasizing the consumption of fermented products is recommended.

(1) Background: Cardiometabolic disease progression can be delayed if patients engage in healthy lifestyle behaviors, adherence to which is highly influenced by psychosocial factors. The present study aimed at investigating the association of self-efficacy with the adherence level to healthy lifestyle behaviors among patients with cardiometabolic diseases in Greece. (2) Methods: 1988 patients (1180 females) with cardiometabolic diseases participated. Anthropometric, demographic, socioeconomic, clinical, and lifestyle characteristics were recorded. Patients were also asked to evaluate their efficacy to comply with healthy lifestyle behaviors. (3) Results: The majority exhibited unhealthy lifestyle behaviors. A subgroup demonstrated elevated self-efficacy in maintaining healthy habits despite facing diverse psychosocial challenges. Individuals with higher educational attainment, socioeconomic status, and rural/semi-urban residency had significantly elevated self-efficacy. Those with heightened self-efficacy exhibited significantly lower BMI and reduced prevalence of certain health conditions. Self-efficacy significantly influenced adherence to the Mediterranean diet, physical activity engagement, and smoking cessation, even in challenging circumstances. (4) Conclusions: This study represented an innovative approach in examining the role of self-efficacy in shaping health behaviors and outcomes within a Greek population. By integrating specific psychosocial circumstances into the analysis, valuable insights were provided into the contextual factors influencing self-efficacy and adherence to healthy lifestyle behaviors.

The Mediterranean dietary pattern (MDP) and Japanese dietary pattern (JDP) have received increasing attention from the scientific community and media, predominantly due to their association with increased longevity and health. Although similarities between the two dietary patterns are evident, a detailed comparison between them is still relatively unexplored. This narrative review aimed to explore the similarities and differences between the MDP and JDP in terms of longevity while also reflecting on the adoption of these diets by other populations outside their regions of origin. Both dietary patterns are plant-based, minimally processed, and sustainable for their respective regions and have been shown to significantly prolong life expectancy in different populations. Nevertheless, these dietary patterns also differ in terms of macronutrient ratios, food preparation and consumption and individual cultural characteristics of each population. Additionally, both dietary patterns are part of broader lifestyle patterns, which include other behaviors, such as abstaining from smoking, engaging in regular physical activity, having low stress levels and a sense of community, spirituality/religiousness and purpose. The promotion of these two dietary patterns should be implemented in other regions after considering cultural and socio-economical characteristics.

This review critically assesses scientific literature in order to determine whether alcoholic beverages can positively or negatively affect the incidence and severity of immune-mediated disorders, including autoimmune diseases. Few scientific studies explore the association between alcoholic beverages and the immune system, in contrast to the extensive literature dedicated to the cardiovascular system. Because wine is the most investigated product in this review, it does not take into account studies that evaluate the role of alcohol itself without specifying the beverages included (e.g., wine, spirits and beer). The analysis of the data regarding the diseases reviewed here (allergies, celiac disease, the common cold and COVID-19, chronic inflammation bowel diseases, type 1 diabetes, dermatitis herpetiformis, multiple sclerosis, psoriasis, rheumatoid arthritis, systemic lupus erythematosus and thyroid disorders) revealed that, in principle (although with differences between the various pathologies), moderate consumption of wine does not negatively affect the risk of development or the progression of immune-mediated diseases. In some cases, the effect is mainly attributable to the alcohol itself, in others the wine is responsible for a more favourable trend compared to other alcoholic beverages. This review was limited by the scarcity of available papers, so that new prospective studies on the association between wine consumption and immune-mediated diseases should also be specifically designed to draw more solid conclusions.

Background/Objectives: Home isolation measures during the COVID-19 lockdown periods may have influenced individuals' lifestyles. The COVEAT study aimed to identify differences in children's and their parents' dietary behavior, children's body weight and parental body mass index (BMI) between two lockdown periods implemented in Greece. Methods: In total, 61 participants (children 2-18 years and their parents) completed questionnaires about their lifestyle, body weight and height, and family socio-demographic data, during both lockdown periods (LDs) implemented in Greece (LD1 in March-May 2020; LD2 in December 2020-January 2021). Results: No significant differences in parents' BMI and fluctuations in children's/adolescents' body weight and BMI were observed in LD2 compared to LD1. Regarding dietary behavior, in LD2 fewer parents were found to have dinner and prepared home meals and more families reported to order fast food. Furthermore, a significant decrease in the consumption of fresh and prepacked juices and an increase in fast-food consumption were observed for children/adolescents in LD2 compared to LD1. Conclusions: The findings of the COVEAT study indicate that each lockdown period had a different impact on children's/adolescents' and their parents' dietary behavior, with less favorable changes observed in LD2, suggesting that the implementation of additional lockdowns may have had a negative impact on individuals' lifestyles.

Background: Mediterranean diet (MD) constitutes a commonly examined dietary model. It includes a plethora of bioactive ingredients with strong antioxidant, anti-inflammatory, antithrombotic and anticancer properties. Several substantial studies support strong evidence that MD can exert preventing actions against human morbidity and mortality, promoting human well-being and quality of life. The present study aims to evaluate whether childhood MD compliance may be associated with socio-demographic, anthropometric, and lifestyle factors in children at the age of 6–9 years. Methods: This is a cross-sectional survey on 3875 children aged 6–9 years old with their matched mothers. Qualified questionnaires were used to evaluate and collect by one-to-one interviews with trained professionals the above data. Results: Elevated MD adherence was observed only in 22.2% of the enrolled children, while 37.5% of children maintained intermediate MD adherence and 40.3% of children adopted lower MD levels. Children MD compliance was related at an independent manner with maternal education level, childhood anthropometric factors such as Body Mass Index (BMI), Waist circumference to Height ratio (WtHR), quality of life, and exclusively breastfeeding behaviors after adjusting for several possible confounders (p ˂ 0.05). Conclusions: Elevated MD adherence of children aged 6–9 years old showed a lower obesity of overweight/obesity, including abdominal obesity. A higher maternal educational status and adopting exclusively breastfeeding practices were associated with greater levels of children’s MD adherence, promoting their quality of life and well-being. Based on the present results, future prospective surveys need to be performed to evaluate if there is a causality relation concerning this topic.

Background: In recent decades, the incidence of depression has gradually increased in the general population globally. Depression is also common during gestation and could result in detrimental gestational complications for both the mother and the fetus. The survey presented aimed to evaluate whether pregnant women’s perinatal depression could be associated with socio-demographic, anthropometry and lifestyle factors, and perinatal and postnatal outcomes. Methods: This is a cross-sectional survey conducted on 5314 pregnant women. Socio-demographic and lifestyle factors were recorded by relevant questionnaires via face-to-face interviews. Anthropometric parameters were measured by qualified personnel. Perinatal depressive symptomatology status was evaluated by Beck’s Depression Inventory (BDI-II) questionnaire. Results: Depressive symptoms throughout gestation were found in 35.1% of the enrolled women. Perinatal depression was significantly associated with lower educational and economic level, pre-pregnancy regular smoking and reduced levels of Mediterranean diet adherence levels, a higher prevalence of gestational diabetes and preterm birth, as well as a higher incidence of delivering by caesarean section and abnormal childbirth weight. Perinatal depression was also significantly associated with a higher prevalence of maternal postpartum depression and lower prevalence of exclusive breastfeeding practices, as well as with a higher incidence of childhood asthma. Conclusions: Pregnant women’s perinatal depression appears to be associated with various socio-demographic, anthropometry, and lifestyle characteristics and with a higher frequency of several adverse pregnancy complications. The present findings emphasize the importance of pregnant women’s perinatal mental health, highlighting the need to develop and apply public strategies and policies for psychological counseling and support of future mothers to minimize probable risk factors that may trigger perinatal depression. Novel well-organized, follow-up surveys of enhanced validity are highly recommended to establish more definitive conclusions.

BACKGROUND:The present study aimed to investigate the association between vegetable consumption, in total as well as per type/category, and 10-year type-2 diabetes mellitus (T2DM) incidence.METHODS:The ATTICA study was conducted during 2001-2012 in 3042 apparently healthy adults living in Athens area, Greece. A detailed biochemical, clinical, and lifestyle evaluation was performed; vegetable consumption (total, per type) was evaluated through a validated semi-quantitative food frequency questionnaire. After excluding those with no complete information of diabetes status or those lost at the 10-year follow-up, data from 1485 participants were used for the current analysis.RESULTS:After adjusting for several participants' characteristics, including overall dietary habits, it was observed that participants consuming at least 4 servings/day of vegetables had a 0.42-times lower risk of developing T2DM (hazard ratio [HR] = 0.42; 95% confidence interval [CI] = 0.29-0.61); the benefits of consumption were greater in women (HR = 0.29; 95% CI = 0.16-0.53) compared to men (HR = 0.56; 95% CI = 0.34-0.92). Only 33% of the sample consumed vegetables 4 servings/day. The most significant associations were observed for allium vegetables in women and for red/orange/yellow vegetables, as well as for legumes in men.CONCLUSIONS:The intake of at least 4 servings/day of vegetables was associated with a considerably reduced risk of T2DM, independently of other dietary habits; underlying the need for further elaboration of current dietary recommendations at the population level.

The adoption of healthy nutritional habits constitutes one of the most important determinants of healthy growth and development in childhood. Few studies in Greece have examined children’s diet quality using diet indices. The present study aimed to assess the diet quality of a large cohort of children and adolescents with overweight or obesity. Study participants (n = 1335), aged 2–18, were recruited through the Out-patient Clinic for the Prevention and Management of Overweight and Obesity in Childhood and Adolescence, Aghia Sophia Children’s Hospital, Athens, Greece. Anthropometric, socio-demographic, and behavioral data were collected using standard methods and equipment. The Diet Quality Index (DQI), which includes four subcomponents (i.e., dietary diversity, dietary quality, dietary equilibrium, and meal index), was calculated to assess each subject’s diet quality. According to the results of this study, children’s total DQI score was 63.1%. It was observed that 66.7% of the children had at least moderate diet quality (total DQI ≥ 59.34%). Boys had higher values of the total DQI and certain components of the DQI (i.e., dietary equilibrium score and meal index) compared to girls. Three out of ten children with overweight/obesity had poor diet quality (i.e., DQI ≤ 59.33). Younger children (2–5 years old) were found to have the lowest values of dietary equilibrium compared to older children (6–9 and 12–18 years old). Moreover, boys had higher values of the total DQI score and of specific components of this index (i.e., dietary equilibrium and meal index) compared to girls. Children living in urban areas had higher values in the dietary quality score compared to those living in rural areas. Children with overweight had higher values of the dietary quality score and the total DQI score compared to children with obesity. The present study highlighted that children and adolescents with overweight or obesity have poor diet quality. Multilevel and higher intensity interventions should be designed specifically for this group to achieve tangible outcomes.

Nutrition therapy aims to prevent weight loss and its health consequences in patients with cancer. The aim of this study was to assess Greek patients' adherence to the ESPEN guidelines for oncology patients and its prospective effect on their body weight (BW) and nutritional status. In total, 152 patients with cancer were recruited from the Attikon University Hospital, Greece, and provided data in 2019 (baseline) and 2020 (follow-up) (drop-out rate = 28.3%). Nutritional status was assessed with the PG-SGA questionnaire. Patients were categorized based on whether they adhered at least to the minimum ESPEN-recommended intakes of energy (≥25 kcal/kg/day) or protein (≥1.0 g/kg/day) or not. On average, patients did not adhere to ESPEN guidelines for energy and protein intake. Most patients meeting the minimum recommendations had an improvement of their nutritional status at follow-up and increased their BW compared to those not meeting them. All patients with head, neck, and spinal cancer who met the minimum recommendations for energy intake improved their nutritional status at follow-up. This study showed that consuming at least the minimum amounts of protein and energy recommended by ESPEN may prevent from weight loss and improve nutritional status; however, the exact amounts need to be personalized.

The aim of the present work was two-fold. Firstly, to evaluate the association between the consumption of ultra-processed beverages (UPB) on preadolescents' likelihood of being obese. Secondly, to investigate the potential impact of family and school environmental stressors on this unhealthy lifestyle habit. A cross-sectional study was conducted among 1718 Greek preadolescents and their parents, during the school years 2014 to 2016. Parental and child characteristics were collected anonymously, through self-administered and validated questionnaires. Among others, UPB consumption (soft and flavored drinks) was recorded, classifying children as low, moderate, or high consumers, while anthropometric characteristics [height, body weight, Body Mass Index (BMI)] were also recorded. Almost seven out of ten preadolescents were classified as at least moderate UPB consumers, while approximately three out of ten were classified as high UPB consumers. Higher UPB consumption was associated with significantly higher levels of BMI, while preadolescents living in a more stressful family and school environment were found to consume significantly higher amounts of UPB. Stakeholders should implement programs that raise awareness among parents and teachers about the sources of stress in preadolescence as a potential "triggering factor" of unhealthy dietary preferences.

Summary Purpose Malnutrition constitutes an important complication of cancer. Nutritional status is associated with the progression of malignant neoplasms. This study aimed to assess the nutritional status of patients with cancer using objective and subjective assessment methods. Materials and methods The following validated questionnaires were used to assess the nutritional status of 152 patients with cancer recruited in Attica, Greece: Patient-Generated Subjective Global Assessment (PG-SGA), Nutritional Risk Screening-2002 (NRS-2002), Simplified Nutritional Appetite Questionnaire (SNAQ). Geriatric nutritional risk index (GNRI) was calculated, handgrip strength (HGS) test was carried out, and the arm circumference (MUAC) and triceps skinfold thickness (TSF) were measured. Results Based on the PG-SGA assessment, 54.9% of the individuals were severely malnourished. Imminent risk was observed in 83.6% (NRS-2002) and 48.7% of participants were at increased risk of a 5% reduction in body weight within the next 6‑months (SNAQ). Severely malnourished patients experienced significant weight reduction in the 6 months prior to recruitment and had lower HGS and TSF. MUAC was similar within the PG-SGA categories. High risk for malnutrition was estimated for geriatric patients (GNRI: 46.45 [IQR: 5.17]). Malnourishment, based on PG-SGA, was positively associated with percent weight loss within the past 6 months and negatively associated with body mass index (BMI), hemoglobin (Hgb), HGS, and MUAC (all p ≤ 0.05). Conclusion The present study highlighted a high risk of malnutrition in patients with cancer. Poor nutritional status was positively associated with weight loss, Hgb, and MUAC and negatively associated with BMI, HGS, and TSF.