Nutrients

17 pages, 686 KiB

Open AccessArticle

by Torsten Bohn, Marta Despotovic, Farhad Vahid and Ralph Rühl

Nutrients 2024, 16(23), 4004; https://doi.org/10.3390/nu16234004 (registering DOI) - 22 Nov 2024

Background: A new vitamin concept, termed vitamin A5, an umbrella term for vitamin A derivatives being direct nutritional precursors for 9-cis-13,14-dihydroretinoic acid and further induction of RXR-signaling, was recently identified with global importance for mental health and healthy brain and nerve [...] Read more.

Background: A new vitamin concept, termed vitamin A5, an umbrella term for vitamin A derivatives being direct nutritional precursors for 9-cis-13,14-dihydroretinoic acid and further induction of RXR-signaling, was recently identified with global importance for mental health and healthy brain and nerve functions. Dietary recommendations in the range of 1.1 (0.5–1.8) mg vitamin A5 / day were suggested by an international expert consortium. The ensuing question arises as to the current daily dietary intake amounts in Western civilization. Methods: Addressing this answer included calculating the intake based on known amounts of vitamin A5 in frequently consumed food items of the human diet that are high in this vitamin, as well as the known daily dietary intake amounts of those selected food components in Westernized countries. Results: Regarding food items, amounts of vitamin A5 in the form of provitamin A5 (i.e., 9-cis-beta-carotene (9CBC)), the predominant form in the diet, were found to range from 0.1 to 39 µg 9CBC / g for individual fruits and vegetables, with the highest concentrations being in leafy vegetables. The average intake amounts of vitamin A5 in adults of the general population following a Western lifestyle in Europe averaged 0.9, with a range from 0.5 (for Austria) to 1.3 (for Italy) mg 9CBC/day. Furthermore, based on our calculations, large parts, i.e., approximately two-thirds, of the population are low, even too low (<1.1 mg/day), in daily vitamin A5 intake. Conclusion: In addition to the importance of nudging the population toward a regrettably non-well-accepted higher intake of fruits and vegetables, an additional fortification and supplementation of vitamin A5 could be considered, similar to other micronutrients that are low in a Westernized diet. Full article

(This article belongs to the Section Micronutrients and Human Health)

24 pages, 1067 KiB

Open AccessReview

Relationship Between Dietary Nutrient Intake and Autophagy—Related Genes in Obese Humans: A Narrative Review

by Martyna Bednarczyk, Nicola Dąbrowska-Szeja, Dariusz Łętowski, Sylwia Dzięgielewska-Gęsiak, Dariusz Waniczek and Małgorzata Muc-Wierzgoń

Nutrients 2024, 16(23), 4003; https://doi.org/10.3390/nu16234003 (registering DOI) - 22 Nov 2024

Abstract

Obesity is one of the world’s major public health challenges. Its pathogenesis and comorbid metabolic disorders share common mechanisms, such as mitochondrial or endoplasmic reticulum dysfunction or oxidative stress, gut dysbiosis, chronic inflammation and altered autophagy. Numerous pro-autophagy dietary interventions are being investigated [...] Read more.

Obesity is one of the world’s major public health challenges. Its pathogenesis and comorbid metabolic disorders share common mechanisms, such as mitochondrial or endoplasmic reticulum dysfunction or oxidative stress, gut dysbiosis, chronic inflammation and altered autophagy. Numerous pro-autophagy dietary interventions are being investigated for their potential obesity-preventing or therapeutic effects. We summarize current data on the relationship between autophagy and obesity, and discuss various dietary interventions as regulators of autophagy-related genes in the prevention and ultimate treatment of obesity in humans, as available in scientific databases and published through July 2024. Lifestyle modifications (such as calorie restriction, intermittent fasting, physical exercise), including following a diet rich in flavonoids, antioxidants, specific fatty acids, specific amino acids and others, have shown a beneficial role in the induction of this process. The activation of autophagy through various nutritional interventions tends to elicit a consistent response, characterized by the induction of certain kinases (including AMPK, IKK, JNK1, TAK1, ULK1, and VPS34) or the suppression of others (like mTORC1), the deacetylation of proteins, and the alleviation of inhibitory interactions between BECN1 and members of the Bcl-2 family. Significant health/translational properties of many nutrients (nutraceuticals) can affect chronic disease risk through various mechanisms that include the activation or inhibition of autophagy. The role of nutritional intervention in the regulation of autophagy in obesity and its comorbidities is not yet clear, especially in obese individuals. Full article

(This article belongs to the Section Nutrigenetics and Nutrigenomics)

13 pages, 290 KiB

Open AccessSystematic Review

Does the Ketogenic Diet Mediate Inflammation Markers in Obese and Overweight Adults? A Systematic Review and Meta-Analysis of Randomized Clinical Trials

by Mariangela Rondanelli, Clara Gasparri, Martina Pirola, Gaetan Claude Barrile, Alessia Moroni, Ignacio Sajoux and Simone Perna

Nutrients 2024, 16(23), 4002; https://doi.org/10.3390/nu16234002 - 22 Nov 2024

Abstract

Background/Objectives. The ketogenic diet has emerged as a potential treatment strategy for reducing inflammation. The purpose of this meta-analysis and systematic review is to look into how a ketogenic diet affects inflammatory biomarkers in persons who are overweight or obese. Methods. [...] Read more.

Background/Objectives. The ketogenic diet has emerged as a potential treatment strategy for reducing inflammation. The purpose of this meta-analysis and systematic review is to look into how a ketogenic diet affects inflammatory biomarkers in persons who are overweight or obese. Methods. We conducted an extensive search of Web of Science, PubMed, Scopus, and Google Scholar to find pertinent studies reporting changes in inflammatory biomarkers such as C-reactive protein (CRP), the erythrocyte sedimentation rate, and cytokines after a ketogenic diet. Results. Seven randomized controlled trials involving 218 overweight or obese individuals who followed a ketogenic or control diet over 8 weeks to 2 years were included in the review, and five of those were considered for the meta-analysis. The primary outcomes were CRP and IL-6 levels. The results reported significant decreases after treatment for CRP (mean of −0.62 mg/dL (95% CI: −0.84, −0,40), and a slight, but not statistically significant, reduction in IL-6 (mean of −1.31 pg/mL (95% CI: −2.86, 0.25). Conclusions. The ketogenic diet could contribute to modulating inflammation in obese and overweight subjects. Full article

(This article belongs to the Special Issue Clinical Impact of Ketogenic Diet)

10 pages, 1088 KiB

Open AccessArticle

Keto Analogues in Patients with Chronic Kidney Disease with or Without Kidney Transplantation

by Patrícia Kleinová, Tímea Blichová, Karol Graňák, Andrej Kollár, Matej Vnučák and Ivana Dedinská

Nutrients 2024, 16(23), 4001; https://doi.org/10.3390/nu16234001 - 22 Nov 2024

Abstract

Background: Keto analogues in combination with a (very) low-protein diet significantly reduces the progression to end-stage kidney disease. The question of their benefit and safety for kidney transplant recipients remains. This study aimed to show the renoprotective effect and safety of the use [...] Read more.

Background: Keto analogues in combination with a (very) low-protein diet significantly reduces the progression to end-stage kidney disease. The question of their benefit and safety for kidney transplant recipients remains. This study aimed to show the renoprotective effect and safety of the use of this method in patients with chronic kidney disease and a kidney transplantation. Materials: This was a retrospective monocentric study conducted by the transplant nephrology department in Martin, in which patients with chronic kidney disease, with or without kidney transplant therapy, who received a low-protein diet and supplementation with keto analogues were included (n = 59). The changes in their glomerular filtration rate, proteinemia, calcaemia, weight, and glycaemia and the side effects associated with a low-protein diet and keto analogue use were studied in the patients with chronic kidney disease with or without kidney transplantation. Results: The kidney transplant recipients had a significantly more advanced stage of chronic kidney disease (p = 0.0001) than the non-transplanted patients at the time of the prescription of the keto analogues (p = 0.0001). Furthermore, the kidney transplant recipients had a significantly longer follow-up period (p = 0.0001), with a difference of 27 months within subgroups. During the observed period, we recorded a decrease in glomerular filtration, but without statistical significance. In our group, we did not confirm a significant occurrence of adverse effects associated with a low-protein diet and keto analogues. Conclusion: Keto analogues reduce the progression of chronic kidney disease and stabilise glomerular filtration in patients with chronic kidney disease. Based on our analysis, treatment with keto analogues is effective and safe for kidney transplant recipients after kidney transplantation. Full article

(This article belongs to the Special Issue Nutrition and Metabolism in Chronic Kidney Diseases)

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17 pages, 444 KiB

Open AccessArticle

Gender-Specific Malnutrition and Muscle Depletion in Gastric and Colorectal Cancer: Role of Dietary Intake in a Jordanian Cohort

by Nahla Al-Bayyari, Marah Hailat and Ana Baylin

Nutrients 2024, 16(23), 4000; https://doi.org/10.3390/nu16234000 - 22 Nov 2024

Abstract

Objectives: This study aimed to assess malnutrition and muscle mass depletion risk in gastrointestinal cancer patients, exploring the differences between gastric and colorectal cancer, with a focus on gender0specific variations and dietary intake. It also examined whether muscle depletion mediates the relationship between [...] Read more.

Objectives: This study aimed to assess malnutrition and muscle mass depletion risk in gastrointestinal cancer patients, exploring the differences between gastric and colorectal cancer, with a focus on gender0specific variations and dietary intake. It also examined whether muscle depletion mediates the relationship between dietary intake and malnutrition risk. Methods: A sample of 100 Jordanian pre-operative gastrointestinal cancer patients (60 male, 40 female) with gastric or colorectal cancer were assessed for malnutrition risk using the malnutrition universal screening tool (MUST) and for muscle depletion using fat-free mass index (FFMI) and mid-upper arm muscle area (MUAMA). Results: The study found that 80% (95% CI: 0.708–0.873) of patients were at high risk of malnutrition, with over 60% experiencing severe muscle loss. Gastric cancer patients showed higher, though not statistically significant, malnutrition risk (90.2% vs. 72.9%) and muscle depletion compared to colorectal cancer patients. Advanced cancer stages were associated with significantly higher risk of malnutrition and muscle depletion. Significant gender-specific differences in muscle depletion via FFMI (p = 0.012) and via MUAMA (p = 0.028) were also noted, especially in females with gastric cancer. Additionally, males exhibited a significantly higher malnutrition risk (p < 0.001) based on cancer stage. Patients’ dietary intake was significantly (p < 0.001) below the recommended levels for energy, protein, carbohydrates, fiber, and essential fatty acids, which was associated with higher malnutrition risk, muscle depletion, low BMI (<18.5 kg/m²), and significant weight loss (>10%). Low dietary intake was strongly linked to increased malnutrition risk and muscle depletion, with muscle loss partially mediating (b = 0.4972, p < 0.0001) the relationship between poor dietary intake and malnutrition risk. Additionally, higher muscle mass was protective against malnutrition (OR = 16.0, 95% CI: 1.706–150.507), and cancer type was a significant predictor of malnutrition risk (OR = 14.4, 95% CI: 1.583–130.867). Conclusions: Malnutrition risk and significant muscle loss are common in GI cancer patients, highlighting the urgent need for tailored nutrition care plans and lifestyle modifications. Full article

(This article belongs to the Section Nutritional Epidemiology)

22 pages, 12321 KiB

Open AccessArticle

Impact of Kiwifruit Consumption on Cholesterol Metabolism in Rat Liver: A Gene Expression Analysis in Induced Hypercholesterolemia

by Abdolvahab Ebrahimpour Gorji, Anna Ciecierska, Hanna Leontowicz, Zahra Roudbari and Tomasz Sadkowski

Nutrients 2024, 16(23), 3999; https://doi.org/10.3390/nu16233999 - 22 Nov 2024

Abstract

Background/Objectives: Cholesterol is vital in various bodily functions, such as maintaining cell membranes, producing hormones, etc. However, imbalances, like hypercholesterolemia, can lead to diseases such as cancer, kidney disease, non-alcoholic fatty liver disease, and cardiovascular conditions. This study explores the impact of kiwifruit [...] Read more.

Background/Objectives: Cholesterol is vital in various bodily functions, such as maintaining cell membranes, producing hormones, etc. However, imbalances, like hypercholesterolemia, can lead to diseases such as cancer, kidney disease, non-alcoholic fatty liver disease, and cardiovascular conditions. This study explores the impact of kiwifruit consumption, specifically Actinidia arguta cultivar Geneva and Actinidia deliciosa cultivar Hayward, on cholesterol and lipid metabolism in rat liver. Methods: Rats were divided into groups: a 1% cholesterol control group (Ch), a 5% Geneva kiwifruit-supplemented group (ChGENE), and a 5% Hayward kiwifruit-supplemented group (ChHAYW). Gene expression was analyzed using Gene Spring v.14. Gene ontology, pathway analysis, miRNA, and transcription factor prediction were performed using DAVID, Reactome, and miRNet. In addition, we used Agilent Literature Search software to gain further insights. Results: Statistical analysis identified 72 genes in ChGENE-Ch and 2 genes in ChHAYW-Ch comparison. Key genes involved in cholesterol metabolism pathways, including PCSK9, SCD1, SLC27A5, HMGCR, and DHCR24, showed lower expression in the kiwifruit-supplemented groups. The genes mentioned above showed lower expression in the kiwifruit-supplemented group, probably contributing to the liver lipid level reduction. Further analysis identified miRNA-26a, miRNA-29a/b/c, miRNA-33a/b, and miRNA-155 targeting hub genes. Conclusions: Our findings suggest that dietary supplementation with kiwifruit, particularly the Geneva cultivar, reduces fat accumulation in the liver of rats with hypercholesterolemia, likely through downregulation of critical genes involved in cholesterol metabolism. These studies highlight the potential of kiwifruit as a part of a dietary strategy to manage cholesterol levels. Full article

(This article belongs to the Special Issue Healthy Diet to Prevent Cardiovascular Disease)

16 pages, 1527 KiB

Open AccessReview

Food Functional Factors in Alzheimer’s Disease Intervention: Current Research Progress

by Rong-Zu Nie, Huo-Min Luo, Ya-Ping Liu, Shuang-Shuang Wang, Yan-Jie Hou, Chen Chen, Hang Wang, Hui-Lin Lv, Xing-Yue Tao, Zhao-Hui Jing, Hao-Kun Zhang and Pei-Feng Li

Nutrients 2024, 16(23), 3998; https://doi.org/10.3390/nu16233998 - 22 Nov 2024

Abstract

Alzheimer’s disease (AD) is a complex multifactorial neurodegenerative disease. With the escalating aging of the global population, the societal burden of this disease is increasing. Although drugs are available for the treatment of AD, their efficacy is limited and there remains no effective [...] Read more.

Alzheimer’s disease (AD) is a complex multifactorial neurodegenerative disease. With the escalating aging of the global population, the societal burden of this disease is increasing. Although drugs are available for the treatment of AD, their efficacy is limited and there remains no effective cure. Therefore, the identification of safe and effective prevention and treatment strategies is urgently needed. Functional factors in foods encompass a variety of natural and safe bioactive substances that show potential in the prevention and treatment of AD. However, current research focused on the use of these functional factors for the prevention and treatment of AD is in its initial stages, and a complete theoretical and application system remains to be determined. An increasing number of recent studies have found that functional factors such as polyphenols, polysaccharides, unsaturated fatty acids, melatonin, and caffeine have positive effects in delaying the progression of AD and improving cognitive function. For example, polyphenols exhibit antioxidant, anti-inflammatory, and neuroprotective effects, and polysaccharides promote neuronal growth and inhibit inflammation and oxidative stress. Additionally, unsaturated fatty acids inhibit Aβ production and Tau protein phosphorylation and reduce neuroinflammation, and melatonin has been shown to protect nerve cells and improve cognitive function by regulating mitochondrial homeostasis and autophagy. Caffeine has also been shown to inhibit inflammation and reduce neuronal damage. Future research should further explore the mechanisms of action of these functional factors and develop relevant functional foods or nutritional supplements to provide new strategies and support for the prevention and treatment of AD. Full article

(This article belongs to the Section Nutrition and Public Health)

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9 pages, 896 KiB

Open AccessArticle

Establishment of a Rapid and Precise Nutritional Screening Method for Convalescent Rehabilitation Patients: A Preliminary Study

by Kozue Okamoto, Miho Kogirima, Yoshiro Tsuji, Shinsuke Ishino and Hiromasa Inoue

Nutrients 2024, 16(23), 3997; https://doi.org/10.3390/nu16233997 - 22 Nov 2024

Abstract

Background/Objectives: Malnutrition significantly hinders recovery in patients undergoing convalescent rehabilitation. Proper nutritional management can improve rehabilitation outcomes. This study aimed to develop a novel nutritional screening method (J-Method) specifically in patients undergoing convalescent rehabilitation and compare it with the widely used Mini Nutritional [...] Read more.

Background/Objectives: Malnutrition significantly hinders recovery in patients undergoing convalescent rehabilitation. Proper nutritional management can improve rehabilitation outcomes. This study aimed to develop a novel nutritional screening method (J-Method) specifically in patients undergoing convalescent rehabilitation and compare it with the widely used Mini Nutritional Assessment Short Form (MNA-SF). Methods: We developed the J-Method for convalescent rehabilitation settings and compared its results with that of the MNA-SF. The J-Method comprised six items derived from various nutritional screening methods and obtained solely from medical records, without patient interviews. Data from 148 patients aged > 65 years with cerebrovascular diseases admitted to a convalescent rehabilitation ward (CRW) were collected. Nutritional status was evaluated using the J-Method and MNA-SF, after which the results were compared. Results: It is possible that the J-Method more precisely identified patients as malnourished than did the MNA-SF (J-Method: MNA-SF = 36/148 (24.3%): 111/148 (75.0%)). In detail, 75 (50.4%) were classified as having malnutrition by the MNA-SF but as non-malnutrition by the J-Method; however, no patients were in the opposite scenario. In addition, the results of nutritional screening using the J-Method identified patients in need of nutritional management intervention and suggested that to improve the rehabilitation effect, nutritional management should be initiated in an acute hospital before admission to a CRW. Conclusions: The J-Method may be more effective than the MNA-SF for nutritional screening in convalescent rehabilitation settings, as it provides a more accurate assessment of malnutrition without requiring patient interviews. Full article

(This article belongs to the Special Issue Endocrinology, Diabetes, and Clinical Nutrition)

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27 pages, 3828 KiB

Open AccessReview

Review of the Relationships Between Human Gut Microbiome, Diet, and Obesity

by Ondřej Patloka, Tomáš Komprda and Gabriela Franke

Nutrients 2024, 16(23), 3996; https://doi.org/10.3390/nu16233996 - 22 Nov 2024

Abstract

Obesity is a complex disease that increases the risk of other pathologies. Its prevention and long-term weight loss maintenance are problematic. Gut microbiome is considered a potential obesity modulator. The objective of the present study was to summarize recent findings regarding the relationships [...] Read more.

Obesity is a complex disease that increases the risk of other pathologies. Its prevention and long-term weight loss maintenance are problematic. Gut microbiome is considered a potential obesity modulator. The objective of the present study was to summarize recent findings regarding the relationships between obesity, gut microbiota, and diet (vegetable/animal proteins, high-fat diets, restriction of carbohydrates), with an emphasis on dietary fiber and resistant starch. The composition of the human gut microbiome and the methods of its quantification are described. Products of the gut microbiome metabolism, such as short-chain fatty acids and secondary bile acids, and their effects on the gut microbiota, intestinal barrier function and immune homeostasis are discussed in the context of obesity. The importance of dietary fiber and resistant starch is emphasized as far as effects of the host diet on the composition and function of the gut microbiome are concerned. The complex relationships between human gut microbiome and obesity are finally summarized. Full article

(This article belongs to the Special Issue Nutrition and Gut Microbiota-Immune System Interplay in Chronic Diseases)

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14 pages, 2040 KiB

Open AccessArticle

Lipidomic Signature of Healthy Diet Adherence and Its Association with Cardiometabolic Risk in American Adults

by Loni Berkowitz, Guadalupe Echeverría, Cristian Salazar, Cristian Faúndez, Christopher L. Coe, Carol Ryff and Attilio Rigotti

Nutrients 2024, 16(23), 3995; https://doi.org/10.3390/nu16233995 - 22 Nov 2024

Abstract

Background: The aim of this study was to identify the blood lipidomic profile associated with a healthy eating pattern in a middle-aged US population sample and to determine its relationship with metabolic disorders and cardiovascular risk (CVR). Methodology: Self-reported information about diet and [...] Read more.

Background: The aim of this study was to identify the blood lipidomic profile associated with a healthy eating pattern in a middle-aged US population sample and to determine its relationship with metabolic disorders and cardiovascular risk (CVR). Methodology: Self-reported information about diet and blood samples were obtained from 2114 adult participants in the Midlife in the United States study (MIDUS). Food intake data were used to design a Healthy Diet Index (MIDUS-HEI) and to evaluate the predictive value by examining its association with health variables. The associated lipid signature (HEI-LS) was constructed using Lasso regression, from lipidomic data (LC/MS). Associations between HEI-LS, cardiometabolic biomarkers, and estimated CVR were assessed using multiple linear regression. Results: MIDUS-HEI score was a robust indicator of dietary quality and inversely associated with body mass index (p < 0.001) and metabolic syndrome (p = 0.012). A lipidomic signature comprising 57 distinct lipid species was highly correlated with the MIDUS-HEI score (r = 0.39, p < 10⁻¹⁶). It was characterized by lower levels of saturated fatty acid and adrenic acid (n-6) and higher levels of docosahexaenoic acid (n-3). Healthier HEI-LS scores were strongly associated with better cardiometabolic indicators and lower estimated CVR (OR 0.89 CI 95% 0.87–0.91). Conclusions: The MIDUS-HEI effectively assessed dietary quality, confirming the link between poor diet quality and metabolic disorders in American population. Lipidomic profiling offered an objective assessment of dietary patterns and provided insights into the relationship between diet quality, metabolic responses, and CVR. This approach supports precision nutrition strategies for at-risk populations. Full article

(This article belongs to the Special Issue Dietary Fatty Acids and Metabolic Health)

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19 pages, 1091 KiB

Open AccessReview

Ketogenic Diet and Neuroinflammation: Implications for Neuroimmunometabolism and Therapeutic Approaches to Refractory Epilepsy

by Daniela Guerreiro, Anabela Almeida and Renata Ramalho

Nutrients 2024, 16(23), 3994; https://doi.org/10.3390/nu16233994 - 22 Nov 2024

Abstract

Refractory epilepsy, characterized by seizures that do not respond to standard antiseizure medications, remains a significant clinical challenge. The central role of the immune system on the occurrence of epileptic disorders has been long studied, but recent perspectives on immunometabolism and neuroinflammation are [...] Read more.

Refractory epilepsy, characterized by seizures that do not respond to standard antiseizure medications, remains a significant clinical challenge. The central role of the immune system on the occurrence of epileptic disorders has been long studied, but recent perspectives on immunometabolism and neuroinflammation are reshaping scientific knowledge. The ketogenic diet and its variants have been considered an important medical nutrition therapy for refractory epilepsy and may have a potential modulation effect on the immune system, specifically, on the metabolism of immune cells. In this comprehensive review, we gathered current evidence-based practice, ketogenic diet variants and interventional ongoing clinical trials addressing the role of the ketogenic diet in epilepsy. We also discussed in detail the ketogenic diet metabolism and its anticonvulsant mechanisms, and the potential role of this diet on neuroinflammation and neuroimmunometabolism, highlighting Th17/Treg homeostasis as one of the most interesting aspects of ketogenic diet immune modulation in refractory epilepsy, deserving consideration in future clinical trials. Full article

(This article belongs to the Special Issue Impacts of Micronutrients on Immune System and Inflammatory Diseases)

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14 pages, 1017 KiB

Open AccessArticle

Overweight Prevalence Changes Before and After COVID-19 in Spain: The PESCA Program Longitudinal Outcomes 2018–2021

by F. Zarate-Osuna, C. Quesada-González, A. G. Zapico and M. González-Gross

Nutrients 2024, 16(23), 3993; https://doi.org/10.3390/nu16233993 - 21 Nov 2024

Abstract

Background: Overweight prevalence in Spain reached critical levels before the COVID-19 pandemic, which likely exacerbated this issue. The PESCA (Programa Escolar de Salud Cardio-vascular) program is a multicomponent school-based intervention, launched in 2018 with the aim of tackling this health problem and reducing [...] Read more.

Background: Overweight prevalence in Spain reached critical levels before the COVID-19 pandemic, which likely exacerbated this issue. The PESCA (Programa Escolar de Salud Cardio-vascular) program is a multicomponent school-based intervention, launched in 2018 with the aim of tackling this health problem and reducing overweight rates in youth. Objectives: (1) To analyze the efficacy of the PESCA program intervention on body composition, overweight prevalence, physical activity (PA)/sport practice, resting time, and screentime before COVID-19 and (2) to evaluate the impact of COVID-19 and the associated lockdown measures on these parameters in the studied sample. Methods: This longitudinal study included 207 children and adolescents from schools in Madrid (aged 2.82 to 15.84 years; 44.4% girls), with measurements taken at three time points: two before COVID-19 and one after its onset. Overweight prevalence, body fat percentage diagnosis, physical activity, resting time, and screentime were assessed. Cochran’s Q test and repeated-measures ANOVA were used to compare outcomes across the three assessment time points. Results: Overweight prevalence remained stable among children in the PESCA program before COVID-19 (17.87% to 19.81%). However, a significant increase was observed from point 2 to point 3, post-COVID-19 onset (19.81% to 26.57%). Similarly, healthy body composition significantly deteriorated from 63.16% at point 2 to 52.48% at point 3. PA/sport practice prevalence significantly increased until COVID-19 onset (80.19% to 91.22%) but declined thereafter (91.22% to 79.10% from point 2 to point 3). Although the differences were small, resting time significantly decreased post-COVID-19 onset (from 10.18 h at point 2 to 9.96 h at point 3), with no changes in the first period. Non-academic screentime showed a similar pattern: stable before COVID-19 and significantly increased after its onset (1.61 h at point 1; 1.70 h at point 2; 2.29 h at point 3). Conclusions: The PESCA program positively impacted PA/sport practice prevalence and may have provided some protection against overweight and related variables during the pre-COVID period. However, health authorities’ restrictions and lockdown policies during COVID-19 negatively affected the health and lifestyle variables studied, offsetting previous improvements. Full article

(This article belongs to the Special Issue Healthy Nutrition and Lifestyle: The Role of the School)

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18 pages, 1360 KiB

Open AccessArticle

Attitudes and Beliefs of Primary Care Physicians and Nurses in Spain Toward Vegan Diets

by Nuria Trujillo-Garrido, Eduardo Sánchez-Sánchez and María J. Santi-Cano

Nutrients 2024, 16(23), 3992; https://doi.org/10.3390/nu16233992 - 21 Nov 2024

Abstract

Background: As dietary habits shift in response to environmental concerns and health awareness, understanding healthcare professionals’ perceptions of vegan diets is crucial. Objectives: This study aimed to identify the beliefs and attitudes of primary care doctors and nurses in Spain towards vegan diets. [...] Read more.

Background: As dietary habits shift in response to environmental concerns and health awareness, understanding healthcare professionals’ perceptions of vegan diets is crucial. Objectives: This study aimed to identify the beliefs and attitudes of primary care doctors and nurses in Spain towards vegan diets. Methods: A questionnaire-based, observational, cross-sectional study was conducted among 208 healthcare professionals. Results: 87% of participants followed an omnivorous diet, while only 3.4% identified as lacto-ovo-vegetarian (LOV) or vegan. Statistically significant differences were observed by sex, with women more likely to agree that livestock farming contributes to global warming (27.3% and 28.0% vs. 17.0% and 12.8%, respectively; p = 0.02). Additionally, women were more inclined to consider vegan diets suitable for vulnerable groups, such as pregnant women and children, when adequately supplemented (24.8% and 17.4% vs. 10.6% and 10.6%, respectively; p = 0.030). Healthcare professionals who followed a LOV or vegan diet were more likely to disagree with the notion that vegan diets do not provide the necessary macronutrients and micronutrients compared to omnivores (strongly disagree 19.9%, 56.3%, 85.7%; p = 0.001 for omnivores, flexitarians, and LOVs/vegans, respectively). Conclusions: Current nutrition training may not meet the needs of doctors and nurses. Furthermore, it is implied that some professionals’ attitudes towards vegan diets may be more influenced by personal beliefs than by scientific literature. These findings can inform future clinical guidelines and support a more evidence-based approach to dietary counselling for vegan populations. Full article

(This article belongs to the Special Issue Advances in Sustainable Healthy Diets)

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10 pages, 1893 KiB

Open AccessArticle

Prevalence and Associated Risk Factors for Hypovitaminosis D in Patients Scheduled for Primary Total Knee Arthroplasty in Germany

by Tizian Heinz, Miledi Hoxha, Philip Mark Anderson, Axel Jakuscheit, Manuel Weißenberger, Martin Lüdemann, Dominik Rak, Maximilian Rudert and Konstantin Horas

Nutrients 2024, 16(23), 3991; https://doi.org/10.3390/nu16233991 - 21 Nov 2024

Abstract

Objective: Several studies have reported a high prevalence of hypovitaminosis D in orthopedic patients. The purpose of this prospective observational study was to report on the prevalence of hypovitaminosis D in patients scheduled for elective primary total knee arthroplasty (TKA) and its associated [...] Read more.

Objective: Several studies have reported a high prevalence of hypovitaminosis D in orthopedic patients. The purpose of this prospective observational study was to report on the prevalence of hypovitaminosis D in patients scheduled for elective primary total knee arthroplasty (TKA) and its associated risk factors. Methods: In this monocentric cohort study, 25(OH) vitamin D serum levels were measured in 687 consecutive patients undergoing primary total knee arthroplasty (TKA) over a period of twelve months. Vitamin D levels were classified into deficiency (<20 ng/mL), insufficiency (20–29 ng/mL), and sufficiency (≥30 ng/mL). The study assessed the association of vitamin D levels with demographic and clinical factors, including age, sex, BMI, smoking status, and season of measurement. Statistical analyses included chi-square tests, correlation analyses, and multiple linear regression to identify significant predictors of vitamin D levels. Results: The cohort had a mean age of 67.70 ± 8.95 years and a mean BMI of 31.00 ± 5.71 kg/m². Collectively, 33.9% of patients were vitamin D deficient, a further 32.9% were insufficient, and only 33.2% were sufficient. Vitamin D levels varied significantly with the season and were associated with obesity and smoking. Specifically, there was a small significant inverse correlation between BMI and vitamin D levels (r = −0.17, p < 0.01). Furthermore, regular nicotine abuse was linked to lower vitamin D levels (r = 0.14, p < 0.01). Multiple linear regression analysis reveals that age, BMI, nicotine abuse, and season were small significant predictors of preoperative vitamin D levels (R² = 0.15, adjusted R² = 0.12). A total of 121 (17.61%) patients reported routine vitamin D intake prior to surgery. Supplementing patients had a significantly higher mean serum vitamin D level and a significant reduction in the mean length of in-hospital stay (p < 0.01). Conclusions: The prevalence of vitamin D insufficiency and deficiency in patients undergoing elective primary TKA is alarmingly high. In ongoing efforts to optimize the efficacy and outcome of the TKA procedure, orthopedic surgeons should be advised to strongly implement the role of perioperative vitamin D levels in their routine practice. Full article

(This article belongs to the Special Issue Therapeutic Use and Challenges of Vitamin D)

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12 pages, 1005 KiB

Open AccessArticle

Weizmannia coagulans BC99 Improves Strength Performance by Enhancing Protein Digestion and Regulating Skeletal Muscle Quality in College Students of Physical Education Major

by Li Cao, Minghan Guo, Yiqing Zhou, Jie Zhang, Shanshan Tie, Xuan Li, Pingping Tian, Ying Wu and Shaobin Gu

Nutrients 2024, 16(23), 3990; https://doi.org/10.3390/nu16233990 - 21 Nov 2024

Abstract

Background: The dietary proteins are one of the most important factors determining health conditions in humans. The sufficient digestion and absorption of dietary proteins in the digestive tract has positive effects on performance and recovery in sportspeople and athletes. Improving protein digestibility is [...] Read more.

Background: The dietary proteins are one of the most important factors determining health conditions in humans. The sufficient digestion and absorption of dietary proteins in the digestive tract has positive effects on performance and recovery in sportspeople and athletes. Improving protein digestibility is a strategy for maintaining health status and optimal performance in sport and exercise activities. Objectives: The aim of the present study is to verify whether Weizmannia coagulans BC 99 (BC99) can increase muscle mass and strength. Methods: This randomized double-blind, controlled trial assigned 72 male college students to receive probiotics (n = 36, 20.25 ± 1.03 years; 179.00 ± 5.94 cm; 73.55 ± 8.73 kg, protein powder with BC99) or the placebo (n = 36, 20.19 ± 0.79 years; 179.25 ± 5.16 cm; 73.61 ± 8.24 kg, protein powder) for 12 weeks. At the baseline and final stages of the study, strength tests and body composition assessment were performed. Blood and stool samples were taken at the end of the 12-week intervention, and digestive enzymatic activity of stool samples, biochemical parameters, amino acids and hormone level of plasma were analyzed. Results: BC99 administration significantly improved strength performance, skeletal muscle mass, activity of pepsin and trypsin, the concentrations of branched chain amino acids and essential amino acids, reduced activities of creatine kinase and lactic dehydrogenase and urea nitrogen (BUN) level and increased testosterone and glucagon-like peptide-1 level in male college students. Conclusions: Therefore, BC99 supplementation can be an important nutritional strategy to improve strength performance, body composition, protein digestion and body metabolism in healthy young males. Full article

(This article belongs to the Section Proteins and Amino Acids)

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20 pages, 1943 KiB

Open AccessArticle

Designing Front-of-Package Labels to Inform Consumers and Encourage Healthier Food Choices in Bangladesh: A Qualitative Study

by Lindsey Smith Taillie, Ahmad Khairul Abrar, Ummay Afroza, Jubaida Akhtar, Violet Noe, Nicole Ide, Nora Abdel-Gawad and Sohel Reza Choudhury

Nutrients 2024, 16(23), 3989; https://doi.org/10.3390/nu16233989 - 21 Nov 2024

Abstract

Background/Objectives: Front-of-package labeling (FOPL) policies are a useful strategy to inform consumers about foods high in nutrients of concern, but little is known about what type of label works best in Bangladesh, a country with increasing levels of unhealthy food intake and diet-related [...] Read more.

Background/Objectives: Front-of-package labeling (FOPL) policies are a useful strategy to inform consumers about foods high in nutrients of concern, but little is known about what type of label works best in Bangladesh, a country with increasing levels of unhealthy food intake and diet-related diseases. Methods: We conducted 10 focus groups with men and women in rural and urban Bangladesh (n = 76). Using a semi-structured discussion guide, we asked consumers for their perceptions of the healthfulness of nutrients and foods, two common FOPLs (a color-coded guideline daily allowance [GDA] label and a warning label), and different visual elements of the warning label (e.g., shape, icon, text). Results: Participants understood the health harms of sugar and salt consumption but were less clear on saturated fat. Both FOPLs were perceived as helpful for identifying unhealthy foods, but the warning labels were perceived as easier to understand and more likely to influence behaviors than the GDA. Regarding the design of warning labels, participants perceived warning devices, holding straps, and octagonal shapes as effective but had mixed reactions to which icons or textual statements were most effective. Conclusions: FOPLs are likely to facilitate Bangladeshi consumers’ ability to identify unhealthy products. Further research is needed to understand the impact on food choices as well as the most effective design in this population. Full article

(This article belongs to the Section Nutritional Policies and Education for Health Promotion)

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24 pages, 1038 KiB

Open AccessReview

Dietary and Nutritional Interventions for the Management of Endometriosis

by Nour Abulughod, Stefanie Valakas and Fatima El-Assaad

Nutrients 2024, 16(23), 3988; https://doi.org/10.3390/nu16233988 - 21 Nov 2024

Abstract

Endometriosis is a chronic, complex, systemic inflammatory condition that impacts approximately 190 million girls and women worldwide, significantly impacting their quality of life. The effective management of endometriosis requires a multi-disciplinary and holistic approach, one that includes surgical and medical management, such as [...] Read more.

Endometriosis is a chronic, complex, systemic inflammatory condition that impacts approximately 190 million girls and women worldwide, significantly impacting their quality of life. The effective management of endometriosis requires a multi-disciplinary and holistic approach, one that includes surgical and medical management, such as a laparoscopy and a chronic medical management plan, as well as dietary, nutritional, and lifestyle adjunct interventions, such as pelvic pain physiotherapy and acupuncture. There is growing evidence to support the role of dietary and nutritional interventions in the adjunct management of endometriosis-related pain and gastrointestinal symptoms. However, the implementation of these interventions is often not regulated, as patients with endometriosis often adopt self-management strategies. Diet and nutrition can modulate key players integral to the pathophysiology of endometriosis, such as, but not limited to, inflammation, estrogen, and the microbiome. However, it is unclear as to whether diet plays a role in the prevention or the onset of endometriosis. In this review, we discuss three key players in the pathogenesis of endometriosis—inflammation, estrogen, and the microbiome—and we summarize how diet and nutrition can influence their mechanisms, and consequently, the progression and manifestation of endometriosis. There is a major need for evidence-based, non-invasive adjunct management of this debilitating disease, and diet and nutritional interventions may be suitable. Full article

(This article belongs to the Section Nutrition in Women)

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16 pages, 322 KiB

Open AccessArticle

Correlates of Overweight and Obesity in German Primary School Children

by Anna Reißner, Olivia Wartha, Jens Dreyhaupt and Susanne Kobel

Nutrients 2024, 16(23), 3987; https://doi.org/10.3390/nu16233987 - 21 Nov 2024

Abstract

Background/Objectives: Childhood obesity is a consistent public health issue, which often persists into adulthood. This study determined risk factors of childhood obesity and associated comorbidities in German school children. Methods: Data of 1956 primary school children (7.1 ± 0.6 years) were analysed. Anthropometrics [...] Read more.

Background/Objectives: Childhood obesity is a consistent public health issue, which often persists into adulthood. This study determined risk factors of childhood obesity and associated comorbidities in German school children. Methods: Data of 1956 primary school children (7.1 ± 0.6 years) were analysed. Anthropometrics were taken on site, other (health) parameters were assessed using a parental questionnaire. Binary logistic regression models were calculated, controlling for age, gender, family education level, and migration background. Results: Father’s physical illness (OR 1.092 [1.177; 3.073], p = 0.009) and a child’s chronic illness (OR 1.687 [1.077; 2.644], p = 0.022), maternal and paternal overweight (OR 2.180 [1.492; 3.185]; OR 2.494 [1.547; 4.022], p < 0.001, respectively), as well as maternal and paternal smoking (OR 1.942 [1.306; 2.889]; OR 1.972 [1.334; 2.917], p = 0.001, respectively) were significantly associated with the child being overweight. Also associated with the child being overweight were physical activity, regular screen media use (OR 0.605 [0.408, 0.896], p = 0.012; OR 2.029 [1.306; 3.152], p = 0.002, respectively), the mother and/or father thinking their child is too fat (OR 2.213 [1.504; 3.258], p < 0.001; OR 1.537 [1.048; 2.253], p = 0.028), the father’s physical inactivity (OR 1.69 [1.133; 2.521], p = 0.010), and if the child has not been breastfed (OR 1.632 [1.056; 2.521], p = 0.027), the mother smoked during pregnancy (OR 1.992 [1.224; 3.246], p = 0.006) as well as if the mother and/or father admonished their child about their weight (OR 25.521 [14.578; 44.680]; OR 19.448 [11.865; 31.877], p < 0.001, respectively). Children of unemployed mothers and in low-income households had an increased risk of being overweight (OR 4.811 [1.642; 14.096], p = 0.004; OR 2.203 [1.360; 3.568], p = 0.001, respectively). Conclusions: This study shows that parental health, lifestyle, and social behaviours matter in determining childhood obesity. Understanding those is essential to promoting a healthy lifestyle. Full article

(This article belongs to the Special Issue Effects of Nutrition and Physical Activity Lifestyle Interventions on Childhood Obesity)

13 pages, 1639 KiB

Open AccessArticle

The Mediating Effect of Eating Behaviors on Interoception, Self-Regulation and Weight Status Among College Students

by Shanté Jeune, Paulo Graziano, Adriana Campa and Catherine Coccia

Nutrients 2024, 16(23), 3986; https://doi.org/10.3390/nu16233986 - 21 Nov 2024

Abstract

Background/Objectives: Obesity among college students has been consistently high in the recent decades. Regulatory processes such as interoception and self-regulation have been studied to identify specific health behaviors that lead to weight gain. Reduced interoception and self-regulation may lead to increased body mass [...] Read more.

Background/Objectives: Obesity among college students has been consistently high in the recent decades. Regulatory processes such as interoception and self-regulation have been studied to identify specific health behaviors that lead to weight gain. Reduced interoception and self-regulation may lead to increased body mass index (BMI), however, various eating styles may indirectly affect this relationship. It is proposed that poor interoception and self-regulation can increase the incidence of maladaptive eating styles, such as emotional or external eating, which may indirectly contribute to weight gain. Conversely, eating styles like cognitive restraint and intuitive eating may indicate an opposing indirect effect, exhibiting eating behaviors likely to maintain optimal weight status. To date, it is unknown which eating styles mediate the relationship between interoception and self-regulation on BMI. Additionally, study variables were examined throughout time to identify any potential influences throughout a typical semester. Methods: There were 104 female participants who completed the study measures. Participants were primarily identified as Hispanic (75.1%), mean age = 23.39 (SD = 6.312), and mean BMI = 25.45 (SD = 5.48) at baseline. Preliminary statistics and longitudinal mediation analyses were conducted to examine the relationships among eating styles, interoception, self-regulation, and BMI. Results: Intuitive eating was the only eating style that was found to be a significant mediator among both interoception and self-regulation, and BMI. It is theorized that these regulation skills occur more commonly among college females who intuitively eat, thus accurately explaining the associations with BMI. Conclusions: The study has provided foundational evidence on the indirect effect of eating behaviors on one’s relationship with interoception and self-regulation on BMI and can be useful in future interventions regarding college students and their associated risk for obesity. Full article

(This article belongs to the Special Issue Eating Behaviors and Eating Disorders: Prevention, Clinical Characterization, and Treatment)

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