Nutrition (Burbank, Los Angeles County, Calif.)[JOURNAL]
Sun
200 papers
Fecal iron quantification in a randomized controlled trial of Lactiplantibacillus plantarum ATCC 202195 in newborns in Dhaka, Bangladesh.
Khan AZ, Roy AK, Qamar H … +9 more , Pell LG, O'Callaghan KM, Sarker SA, Mahmud AA, Haque R, Akter S, Sultana S, Roth DE, Raqib R
Nutrition · 2026 Sep · PMID 42066676 · Publisher ↗
BACKGROUND: Probiotics may enhance host iron bioavailability, offering a strategy to address iron deficiency. Fecal iron may be a useful noninvasive biomarker of such effects in infants. OBJECTIVE: To examine the use of...
BACKGROUND: Probiotics may enhance host iron bioavailability, offering a strategy to address iron deficiency. Fecal iron may be a useful noninvasive biomarker of such effects in infants. OBJECTIVE: To examine the use of fecal iron quantification in a randomized placebo-controlled trial (RCT) of neonatal administration of Lactiplantibacillus plantarum ATCC 202195 (LP202195), with or without fructooligosaccharide (FOS), in Dhaka, Bangladesh. METHODS: Fecal iron quantification using atomic absorption spectrometry (AAS) was optimized using standards and reference materials, and pilot-tested using pooled stool aliquots (n = 32) from an observational cohort of young infants in Bangladesh (aged 0-64 days). The optimized AAS assay was then applied to individual stool samples collected at 14 days of age (n = 307) in a RCT in which newborns aged 0-4 days were randomly allocated to one of five groups: placebo, 1- or 7-day regimens of LP202195, with or without FOS. Serum ferritin was measured at 2 months postnatal age (n = 251). Effects of the 1- and 7-day LP202195 regimens were estimated using linear regression and expressed as mean percent differences relative to placebo, with 95% confidence intervals (95% CI). RESULTS: The optimized AAS fecal iron assay had acceptable accuracy (91%-99%), precision (within- and between-run coefficients of variation <10%), and recovery (93%-112%), with a reportable range of 0.2 to 80 mg Fe per 100 g dry stool. In pooled samples from the observational cohort, fecal iron varied with age and feeding status. In the RCT, fecal iron concentrations did not significantly differ following 1-day (% difference = 9.8%, 95% CI: -19%, 49%; P = 0.54) or 7-days (% difference= -6.1%, 95% CI: -31%, 28%; P = 0.69) of LP202195 administration, versus placebo (geometric mean concentration = 4.3 mg Fe/100 g dry stool (95% CI: 3.3, 5.6; n = 53). Inferences were unchanged when groups were disaggregated by FOS co-administration (P > 0.05 for all). Similarly, there were no effects of LP202195 on serum ferritin at 2 months of age (P > 0.05 for all). CONCLUSIONS: Fecal iron quantification by AAS was valid and feasibly implemented in a trial of neonatal administration of L. plantarum ATCC 202195. However, the assay is resource-intensive and may not be more informative than conventional measures of iron status when studying the effects of probiotics/synbiotics on iron bioavailability. CLINICAL TRIAL REGISTRY: ClinicalTrials.gov identifier: NCT05180201.
Agreement and reliability among muscle strength and physical performance assessments for sarcopenia diagnosis in patients on maintenance dialysis.
Morais DM, Trombim IC, Silva MZC … +2 more , Caramori JCT, Vogt BP
Nutrition · 2026 Sep · PMID 42066675 · Publisher ↗
BACKGROUND: Screening and diagnosing sarcopenia is crucial in dialysis patients since sarcopenia has been associated with adverse outcomes in this population. However, the sarcopenia diagnosis may be different according...
BACKGROUND: Screening and diagnosing sarcopenia is crucial in dialysis patients since sarcopenia has been associated with adverse outcomes in this population. However, the sarcopenia diagnosis may be different according to the strength or physical performance tests used for its diagnosis. Therefore, this study aimed to evaluate the agreement and reliability between different measures of muscle strength and physical performance in dialysis patients. METHODS: Cross-sectional analysis by which patients on hemodialysis and peritoneal dialysis were enrolled. The sit-to-stand test and handgrip strength (HGS) were performed to evaluate muscle strength. The 4m-gait speed test and Short Physical Performance Battery (SPPB) were performed to evaluate physical performance. Low muscle strength and low physical performance were defined according to consensus from the European Working Group on Sarcopenia in Older People (EWGSOP2). RESULTS: One-hundred ninety patients were enrolled, median age 58.5 (49.5-68.0), 57.4% male. HGS was negatively correlated with sit-to-stand test (r = -0.263; P = 0.001). Cohen kappa coefficient (κ) shows fair reliability between the classification of HGS (κ = 0.258; P < 0.001), and there was 60.0% of agreement. Gait speed was negatively correlated with SPPB score (r = -0.824; P < 0.001). There was moderate reliability between the classification of these tests (κ = 0.702; P < 0.001), with 85.3% of agreement. CONCLUSION: There were differences in the classification of parameters of muscle strength and physical performance for sarcopenia diagnosis according to EWGSOP2 in maintenance dialysis patients, leading to variations in the prevalence of sarcopenia within the same criteria.
Advancing digital nutrition assessment: Development and evaluation of the UK eNutriFFQv2.0.
Weech M, Fallaize R, Franco RZ … +5 more , Sutton R, Fotiou M, Robertson N, Hwang F, Lovegrove JA
Nutrition · 2026 Sep · PMID 42066674 · Publisher ↗
BACKGROUND: Digital dietary assessment tools are highly beneficial for nutrition research and personalized interventions. OBJECTIVE: This paper describes the development and evaluation of eNutriFFQv2.0, an updated online...
BACKGROUND: Digital dietary assessment tools are highly beneficial for nutrition research and personalized interventions. OBJECTIVE: This paper describes the development and evaluation of eNutriFFQv2.0, an updated online food frequency questionnaire designed to reflect current diets in the United Kingdom (UK). Updates included modernized food lists based on recent UK population surveys, food composition tables, and food portion photos to improve accuracy and user experience. METHODS: To assess reproducibility, UK adults completed the FFQ twice, 14 days apart; validity was evaluated against a 3-d weighed food record in a sub-sample. Multiple statistical methods were used. After excluding participants with unfeasible energy intakes, 87 participants completed the reproducibility and 53 the evaluation. RESULTS: The final eNutriFFQv2.0 captured 164 items and estimated intake for 56 nutrients and 6 food groups. Agreement with the WFR was acceptable to good for 25 out of the 29 nutrients analyzed (weighted kappa 0.21-0.77), with ≤10% misclassification into opposite quartiles for most nutrients. Bland-Altman plots showed good agreement for energy (176 kcal/d higher in FFQ1) and macronutrient estimates. Reproducibility was good for 24 out of the 29 nutrients analyzed (weighted kappa 0.58-0.85) with <5% misclassification. Mean bias for estimates of carbohydrate, fat, and protein was small (0.0-0.7). Energy estimates were 209 kcal/d (10.7%) higher in the first compared with the second completion of the FFQ. CONCLUSIONS: These findings demonstrate that eNutriFFQv2.0 is a valid and reliable tool for assessing nutrient intake in UK adults, offering a practical, scalable solution for research and public health in the context of digital health and personalized dietary interventions.
Exploring the prevalence and determinants of stunting among children under 5 in Ethiopia: A cross-sectional analysis of the 2019 Ethiopia Mini Demographic and Health Survey.
Merera AM, Huluka TY, Wordofa EA
Nutrition · 2026 Aug · PMID 42066636 · Publisher ↗
OBJECTIVES: Malnutrition is a critical global health issue impacting children's growth, with nearly 45% of child deaths associated with undernourishment. The 2019 Ethiopia Mini Demographic and Health Survey reported a st...
OBJECTIVES: Malnutrition is a critical global health issue impacting children's growth, with nearly 45% of child deaths associated with undernourishment. The 2019 Ethiopia Mini Demographic and Health Survey reported a stunting prevalence of about 37% among children under 5, positioning Ethiopia among the countries with the highest stunting prevalence. This study aimed to identify risk factors for stunting among children under 5 in Ethiopia. METHODS: A cross-sectional study was conducted from March 21 to June 28, 2019, enrolling 5126 children aged 0 to 59 mo through a stratified two-stage cluster sampling method. Binary logistic regression was used to identify factors associated with stunting, including variables with P values less than 0.2 from bivariate analysis in the multivariable analysis. Variables with P values less than 0.05 indicated significance. RESULTS: The prevalence of stunting among children under 5 in Ethiopia was 36.9%. Tigray had the highest prevalence of stunting (49%), whereas Addis Ababa had the lowest (9.6%). Multivariable logistic regression revealed several risk factors: rich households (adjusted odds ratio [AOR], 0.451, 95% confidence interval [CI], 0.123-0.931), middle-income households (AOR, 0.625, 95% CI, 0.345-0.725), mothers with secondary and higher education (AOR, 0.336, 95% CI, 0.252-0.937), primary education (AOR, 0.781, 95% CI, 0.231-0.872), child still breastfeeding (AOR, 0.261, 95% CI, 0.165-0.742), rural residence (AOR, 2.105, 95% CI, 1.415-3.471), and vitamin A supplementation (AOR, 0.841, 95% CI, 0.126-0.963). Other significant factors included child age, number of children under 5, vaccination status, water source, birth interval, and region. CONCLUSIONS: Stunting remains a significant issue in Ethiopia, influenced by factors such as household wealth, maternal education, place of residence, and health practices. Policymakers must address these determinants to enhance nutritional outcomes in Ethiopia.
Specific Nutrition Evaluation for Advanced Chronic Liver Disease: Validation through psychometrics analysis.
Arruda MR, Cunha CM, Batista ACV … +8 more , Boulhosa RSDSB, Garcêz LS, Lyra AC, Romeiro FG, Pereira KG, Cavalcante LN, de Jesus RP, de Oliveira LPM
Nutrition · 2026 Aug · PMID 42066635 · Publisher ↗
OBJECTIVES: Validated instruments specifically designed to assess the nutritional status of individuals with chronic liver disease (CLD) are scarce. The purpose of this study was to evaluate the psychometric properties o...
OBJECTIVES: Validated instruments specifically designed to assess the nutritional status of individuals with chronic liver disease (CLD) are scarce. The purpose of this study was to evaluate the psychometric properties of the Specific Nutrition Evaluation for Advanced Chronic Liver Disease (SNE-ACLD) instrument and establish cut-off points for the nutritional assessment of individuals with CLD. METHODS: Hospitalized individuals with CLD were evaluated by SNE-ACLD and different nutritional assessment tools. Initial evidence of structural construct validity was assessed using principal component analysis; reliability using Cronbach's alpha; cut-off points were determined using cluster analysis. Criterion validity, in which the appendicular muscle mass index was adopted as a reference for concurrent validity using ROC curve; and Cox regression to assess the one-year mortality risk for predictive validity. RESULTS: Two hundred participants were evaluated, of which 75.0% were male, 50.5% were elderly, and 80.8% were classified as Child-Pugh B or C. Principal component analysis demonstrated that SNE-ACLD has four components that explain 69.9% of the total variance of the construct. Cronbach's alpha of 0.70 indicated a good interrelationship between the items. The established cut-off points classified the participants into four groups: without malnutrition, mild, moderate, or severe malnutrition. The SNE-ACLD showed concurrent validity with an AUC of 0.714 and predictive validity, with severely malnourished participants presenting one-year mortality risk almost five times higher (HR = 4.98; 95% CI: 2.42-10.2) than those without severe malnutrition. CONCLUSIONS: SNE-ACLD effectively addresses the domains of the malnutrition construct in this public, presenting evidence of both internal and external validity.
Evaluation of the predictive capacity of metabolic syndrome severity scores and anthropometric indicators in a Spanish working cohort.
Zafrilla-Sánchez S, Molina-Luque R, Molina-Recio G … +3 more , Alcaide-Leyva JM, Rodríguez MG, Romero-Saldaña M
Nutrition · 2026 Aug · PMID 42060960 · Publisher ↗
INTRODUCTION: Metabolic syndrome (MetS) comprises cardiometabolic risk factors linked to higher morbidity and mortality. Traditional binary definitions, such as the Harmonised Definition, enable diagnosis but may underes...
INTRODUCTION: Metabolic syndrome (MetS) comprises cardiometabolic risk factors linked to higher morbidity and mortality. Traditional binary definitions, such as the Harmonised Definition, enable diagnosis but may underestimate risk progression. Severity scores like MetS-Z and MetSSS aim to quantify burden more precisely. OBJECTIVES: To assess the predictive capacity of MetS-Z and MetSSS severity scores for MetS incidence in a Spanish working cohort and compare them with classic anthropometric indicators. METHODS: A longitudinal study (2006-2019) included 630 municipal workers from Córdoba, Spain, free of MetS at baseline. Participants underwent periodic health examinations. Variables were classified using international guidelines and the Harmonised Definition. Predictive ability was evaluated through survival analysis, Cox regression, and ROC curves. RESULTS: Over a mean follow-up of 9.1 years (5728 worker-years), 65 new MetS cases occurred, with an incidence density of 11.3 per 1000 worker-years (95% CI: 8.8-14.5). Incidence was higher in men (13.1) than women (8.0). Among anthropometric indicators, waist-to-height ratio (WHtR) had the highest discriminatory capacity (AUC = 0.82), followed by BMI and waist circumference (both AUC = 0.80). In multivariate Cox models, the best-performing model (AUC = 0.74) included age, BMI, leukocytes, eosinophils, and MetS-Z. The MetS-Z score was independently associated with MetS incidence (HR = 3.2; 95% CI: 1.8-5.7). CONCLUSIONS: MetS incidence in this occupational cohort was lower than in the general Spanish population. WHtR was the strongest anthropometric predictor, while BMI showed greater robustness in adjusted models. The MetS-Z score added independent predictive value, supporting its use as a continuous marker of cardiometabolic risk in occupational health.
Dual burden of malnutrition in institutionalized children: Insights from a Pakistani orphanage.
Shoukat A, Fatima M, Bashir F … +2 more , Fatima B, Shahid K
Nutrition · 2026 Aug · PMID 42054971 · Publisher ↗
BACKGROUND: The dual burden of malnutrition, involving both undernutrition and overnutrition, is a significant challenge. Children in institutional care are a vulnerable group, yet their nutritional status in Pakistan is...
BACKGROUND: The dual burden of malnutrition, involving both undernutrition and overnutrition, is a significant challenge. Children in institutional care are a vulnerable group, yet their nutritional status in Pakistan is understudied. OBJECTIVES: The aim of this study was to assess the dual burden of malnutrition in a Pakistani orphanage by determining the prevalence of under and overnutrition, evaluating dietary patterns, and exploring associated lifestyle factors. METHODS: A descriptive cross-sectional study was conducted with 30 male children (aged 10-16 years) at an orphanage in Lahore. Data were collected via a structured questionnaire (assessing socio-demographics, dietary habits, psychosocial factors, and physical activity), 24-hour dietary recall, and anthropometric measurements. Nutritional status was classified using WHO BMI-for-age z-scores. Dietary patterns were categorized as "Balanced" or "Unbalanced" based on predefined food frequency criteria. Data were analyzed using descriptive statistics, with exploratory inferential analyses (Fisher's Exact Test, Kruskal-Wallis H test) conducted cautiously due to the small sample size. RESULTS: The study revealed a clear dual burden: 56.7% of children were of normal weight, while 36.7% exhibited overnutrition (30.0% overweight, 6.7% obese) and 6.7% were underweight. Dietary patterns were nearly evenly split (46.7% balanced versus 53.3% unbalanced), with high frequencies of packaged snack (≥2/d: 36.7%) and sweetened beverage (daily: 40%) consumption. Psychosocial and lifestyle factors were generally favorable, with most children reporting no emotional eating triggers (90%), regular sleep (96.7%), and high physical activity levels (93.3% moderately/highly active). No statistically significant associations were found between physical activity and nutritional status in this small sample. CONCLUSIONS: This study confirms the presence of the DBM within a Pakistani orphanage, with overnutrition being more prevalent than undernutrition. While the institution provides food security and promotes physical activity, poor diet marked by high intake of processed snacks and sugary drinks emerges as a key concern. Findings highlight the need for institutional nutritional strategies that focus on diet quality alongside calorie provision and suggest the importance of larger-scale research to inform targeted interventions for this vulnerable population.
Food insecurity and sarcopenia among community-dwelling older adults from southern Brazil.
Engracio BDS, Bielemann RM, Tomasi E … +3 more , Demarco FF, Gonzalez MC, Santos LP
Nutrition · 2026 Aug · PMID 42054970 · Publisher ↗
OBJECTIVES: To investigate the association between food insecurity and sarcopenia among community-dwelling older adults in Pelotas, Brazil. METHODS: This cross-sectional study included 607 individuals from the "Como Vai?...
OBJECTIVES: To investigate the association between food insecurity and sarcopenia among community-dwelling older adults in Pelotas, Brazil. METHODS: This cross-sectional study included 607 individuals from the "Como Vai?" cohort, a population-based study of older adults, with data from the 2024 wave. Sarcopenia was defined according to the EWGSOP2 consensus, incorporating measures of muscle strength, muscle mass, and physical performance. Food insecurity was assessed using the 5-item version of the Brazilian Household Food Insecurity Scale (EBIA). Poisson regression models were used to estimate crude and adjusted prevalence ratios (PRs) for the association between food insecurity and sarcopenia. RESULTS: The prevalence of food insecurity was 17.2%. Sarcopenia and severe sarcopenia were observed in 11.7% and 9.1% of participants, respectively. No significant association was found between food insecurity and either sarcopenia or severe sarcopenia. However, when EBIA scores were analyzed categorically, individuals with higher scores (3-5 points) showed a higher prevalence of sarcopenia (PR = 2.25; 95% CI: 1.02-4.95) and severe sarcopenia (PR = 3.23; 95% CI: 1.31-7.93), independently of potential confounders. CONCLUSIONS: Elevated scores on the food insecurity scale were associated with increased prevalence of sarcopenia and severe sarcopenia, suggesting that the severity of food deprivation may adversely affect muscle health in older adults.
Mediterranean diet for the primary prevention of cardiometabolic diseases: evidence from a systematic review and meta-analysis featured in the Italian National Guidelines "La Dieta Mediterranea".
Muscogiuri G, Maiorino MI, Paolini B … +28 more , Aversano F, Buscemi C, Cappiello I, Caruso I, Ceriani E, Chimienti M, Cicero FAG, Cintoni M, Desideri G, D'Eusebio C, Medea G, Patti MC, Randazzo C, Troiano E, Vitale M, Zimmitti S, Veronese N, Gianfredi V, Volpe M, Maggi S, Onder G, Silano M, Nucci D, Zanetti M, Casirati A, Leonardi F, Fontana L, Mediterranean Diet Guideline Group
Nutrition · 2026 Aug · PMID 42048757 · Publisher ↗
OBJECTIVES: The Mediterranean diet (MD) is widely recognized for its potential health benefits, yet the extent and certainty of its association with metabolic outcomes remains incompletely understood. The aim of this sys...
OBJECTIVES: The Mediterranean diet (MD) is widely recognized for its potential health benefits, yet the extent and certainty of its association with metabolic outcomes remains incompletely understood. The aim of this systematic review and meta-analysis was to evaluate the relationship between adherence to the MD and the risk or prevalence of cardiometabolic disorders in the general population, with a focus on its role in primordial and primary prevention. METHODS: This review followed PRISMA 2020 and MOOSE guidelines. A systematic search of PubMed/MEDLINE, Scopus, Embase, and the Cochrane Library was conducted through February 28, 2024. Eligible studies examined adherence to the MD in relation to the risk or prevalence of metabolic disorders. Study quality was assessed using the Newcastle-Ottawa Scale, and evidence certainty was rated with the NUTRI-GRADE framework. Pooled effect estimates were calculated using a random-effects model and reported as risk ratios (RR), hazard ratios (HR), or odds ratios (OR), as appropriate. RESULTS: Sixty studies comprising over 1.1 million participants were included. Higher MD adherence was consistently associated with a reduced risk of T2DM (RR: 0.96; 95% CI: 0.95-0.97), supported by moderate to high certainty of evidence. Similar inverse associations were observed for overweight (OR: 0.94; 95% CI: 0.91-0.97) and adult obesity (OR: 0.95; 95% CI: 0.93-0.97). The PREDIMED randomized trial further demonstrated a 20% reduction in diabetes incidence with MD intervention. Evidence for metabolic syndrome (RR: 0.98; 95% CI: 0.98-0.99) and hyperuricemia (OR: 0.43; 95% CI: 0.25-0.75) was suggestive of protective effects, though with lower certainty. Associations with hypercholesterolemia and hypertriglyceridemia were inconsistent and inconclusive. CONCLUSIONS: Adherence to the Mediterranean diet is associated with a lower risk of several metabolic disorders, particularly T2DM and obesity in adults. These findings support the inclusion of the MD in public health strategies for metabolic disease prevention. Further high-quality longitudinal and interventional studies are warranted to clarify its effects on other metabolic outcomes.
Metabolic, adherence, and sustainability outcomes of plant-based low-carbohydrate and ketogenic diets: A systematic review of clinical evidence.
Mazzola G, Rondanelli M, Cabrini C … +1 more , Perna S
Nutrition · 2026 Aug · PMID 42048756 · Publisher ↗
Plant-based adaptations of low-carbohydrate (PB-LCD) and ketogenic diets (PB-KD) have emerged as nutritional models aiming to combine metabolic efficacy, nutritional adequacy, and environmental sustainability within a On...
Plant-based adaptations of low-carbohydrate (PB-LCD) and ketogenic diets (PB-KD) have emerged as nutritional models aiming to combine metabolic efficacy, nutritional adequacy, and environmental sustainability within a One Health framework. These regimens may align human and planetary health goals, especially in long-term therapeutic contexts such as GLUT1 deficiency or drug-resistant migraine, where ketogenic approaches are established. However, evidence on the integration of plant-based principles into carbohydrate-restricted diets remains limited, particularly regarding sustainability and long-term feasibility. To critically assess the effects of PB-LCD and PB-KD on metabolic outcomes, adherence, and sustainability indicators in adults with overweight, obesity, or metabolic disorders. A systematic search of PubMed/MEDLINE, Embase, Cochrane Library, Web of Science, and Google Scholar (January 2000-March 2025) identified randomized controlled trials testing predominantly plant-based low-carbohydrate diets. Methodological quality was assessed with the Cochrane RoB 2 tool, and evidence certainty was graded using GRADE. Primary outcomes were body composition, glycemic and lipid profiles; secondary outcomes included adherence and sustainability measures. Seven RCTs (n = 976; duration 4-52 wk) were included. Both PB-LCD and PB-KD significantly reduced body weight (-5 to -7 kg), LDL-cholesterol, and HbA1c, with effects comparable or superior to control diets. GRADE certainty was moderate for weight and lipid parameters and moderate-to-low for glycemic control. Adherence was high in controlled settings but declined in free-living conditions. PB-LCDs showed better long-term feasibility, whereas PB-KDs induced stronger short-term effects but required supervision. Only one study quantified greenhouse gas emissions (-0.63 kg CO₂/d). Sustainability evidence was very low. PB-LCDs and PB-KDs are clinically effective, nutritionally safe, and potentially sustainable models for metabolic improvement, though long-term integrative trials are needed.
Efficacy of Mediterranean diet for the primary prevention of oncological diseases: A systematic review and meta-analysis featured in the Italian National Guidelines "La Dieta Mediterranea".
Brunello A, Nucci D, Veronese N … +18 more , Laviano A, Fontana L, Volpe M, Maggi S, Onder G, Silano M, Zanetti M, Casirati A, Alonzo E, Fichera M, Crudele L, Giussani C, Misotti A, Paolini B, Ragusa FS, Trestini I, Gianfredi V, Mediterranean Diet Guideline Group
Nutrition · 2026 Aug · PMID 42044540 · Publisher ↗
BACKGROUND: The Mediterranean diet (MD), characterized by high consumption of plant-based foods, olive oil, moderate intake of fish and poultry, and limited red and processed meats, has been associated with various healt...
BACKGROUND: The Mediterranean diet (MD), characterized by high consumption of plant-based foods, olive oil, moderate intake of fish and poultry, and limited red and processed meats, has been associated with various health benefits, but its role in cancer prevention remains under debate. METHODS: This review was conducted in accordance with PRISMA 2020 and MOOSE guidelines. A comprehensive search of PubMed/MEDLINE, Scopus, Embase, and Cochrane Library was performed up to February 28, 2024. Study quality was assessed using the Newcastle-Ottawa Scale, and the certainty of evidence was evaluated with the NUTRIGRADE approach. Pooled effect sizes were computed using a random-effects model and expressed as risk ratios (RR), hazard ratios, or odds ratios, as appropriate. RESULTS: A total of 126 studies, including more than 8 million participants, across all included studies, were included. High adherence to the MD, as one point increase in the adherence, was significantly associated with a modest reduced risk of several site-specific cancers, including head and neck (RR = 0.88, 95% CI 0.78-0.98), oral cavity (RR = 0.83, 95% CI 0.73-0.95), stomach (RR = 0.93, 95% CI 0.88-0.97), liver/gallbladder (RR = 0.94, 95% CI 0.93-0.96), colorectal (RR = 0.95, 95% CI 0.92-0.98), bladder (RR = 0.96, 95% CI 0.92-0.995), and breast cancer (RR = 0.95, 95% CI 0.92-0.98). Higher adherence was also associated with lower cancer-related mortality (RR = 0.97, 95% CI 0.96-0.99). Certainty of evidence was rated as moderate for the main outcomes. CONCLUSIONS: Greater adherence to the MD is associated with a lower risk of several site-specific cancers and reduced cancer mortality. These findings support the promotion of the MD as a preventive dietary strategy within public health policies.
Effects of the Brazilian Cardioprotective Diet and mixed nuts on adipokines in post myocardial infarction: A randomized clinical trial.
Weschenfelder C, de Quadros AS, Bersch-Ferreira ÂC … +4 more , Machado RHV, Santos RHN, de Abreu-Silva EO, Marcadenti A
Nutrition · 2026 Aug · PMID 42035518 · Publisher ↗
OBJECTIVES: Adipokines play a role in the pathophysiology of ischemic heart diseases, and nut-rich diets are often recommended after myocardial infarction (MI). However, their effects on adipokines in secondary cardiovas...
OBJECTIVES: Adipokines play a role in the pathophysiology of ischemic heart diseases, and nut-rich diets are often recommended after myocardial infarction (MI). However, their effects on adipokines in secondary cardiovascular prevention are not well established. This study evaluated the effect of adding mixed nuts to the Brazilian Cardioprotective Diet (DICA Br) on adipokines and diet quality in post-MI patients. METHODS: This subanalysis of the DICA-NUTS trial included 170 patients randomized to two groups: DICA group (DICA Br alone; n = 85) and DICA-NUTS group (DICA Br + 30 g/day of peanuts, cashews, and Brazil nuts; n = 85). Leptin, resistin, progranulin (pg/mL), adiponectin (ng/mL), leptin/adiponectin and resistin/adiponectin ratios were measured at baseline and after 16 weeks. Diet quality was assessed using the New BALANCE Dietary Index (NBDI). RESULTS: The DICA-NUTS group showed increased leptin levels post-intervention (269.6 pg/mL [95% CI 104.6; 434.6], P < 0.001), but no between-group differences were observed for any adipokines. Both groups improved diet quality (NBDI): +20% [95% CI 4; 38] in DICA-NUTS and +27% [95% CI 10; 45] in DICA, with no significant differences. In patients who gained weight (n = 82) or had <10% to no NBDI improvement (n = 44), leptin and leptin/adiponectin ratios increased regardless of nut intake (P < 0.001). CONCLUSIONS: Adding 30 g/day of mixed nuts to DICA Br did not alter adipokines after 16 weeks in post-MI. Diet quality improved in both groups but remained at about 50% of the ideal score.
Undernutrition impacts on cognitive performance trajectories in older adults: The collaborative PROMED-COG pooled cohorts study.
Ravelli A, Prinelli F, Noale M … +10 more , Conti S, Devita M, Ceolin C, Brennan L, de Groot LCPGM, McEvoy CT, Maggi S, Sergi G, Trevisan C, PROMED-COG Consortium
Nutrition · 2026 Aug · PMID 42035517 · Publisher ↗
OBJECTIVES: The aim of this retrtospective study was to investigate the association between undernutrition and the trajectories of neurocognitive aging. METHODS: We used harmonized data from two population-based longitud...
OBJECTIVES: The aim of this retrtospective study was to investigate the association between undernutrition and the trajectories of neurocognitive aging. METHODS: We used harmonized data from two population-based longitudinal studies: the Progetto Veneto Anziani and the Italian Longitudinal Study on Aging. Both studies included a baseline and two follow-up evaluations over 9 y. Undernutrition was defined according to the Global Leadership Initiative on Malnutrition criteria, and cognitive function was assessed using the Mini-Mental State Examination. RESULTS: The analytical sample comprised 3852 individuals (46% female) aged 65 to 96 y. During follow-up, growth mixture modeling identified three Mini-Mental State Examination score trajectories. Trajectory 1 (4.8% of participants) was characterized by a steep decline, trajectory 2 (22.1% of participants) by a gradual decrease, and trajectory 3 (73.1% of participants) by high scores that remained nearly stable throughout the follow-up period. Overall, 540 participants (14.1%) had undernutrition, with a prevalence significantly higher in trajectory 1 (26.9%) than in trajectory 2 (17.3%) or trajectory 3 (12.2%). Baseline undernutrition was associated with a higher probability of belonging to the rapidly decreasing trajectory 1 (odds ratio, 1.71, 95% confidence interval, 1.06-2.77, reference, trajectory 3), a finding driven mainly by the phenotypic Global Leadership Initiative on Malnutrition criteria. CONCLUSIONS: Undernutrition is associated with steeper cognitive decline in older adults, particularly when phenotypic signs are present. However, given the potential bidirectional relationship between cognitive status and undernutrition, reverse causation cannot be ruled out entirely. Nevertheless, our findings underscore the importance of assessing nutritional status in advanced age, as it represents a modifiable factor that may delay or prevent cognitive decline.
Efficacy of Mediterranean Diet in pregnancy: A systematic review and meta-analysis featured in the Italian National Guidelines "La Dieta Mediterranea".
Scarpato E, Nucci D, Veronese N … +13 more , Volpe M, Maggi S, Onder G, Silano M, Zanetti M, Lisso F, Maiorino MI, Morlando A, Pira C, Salatto A, Serra MR, Gianfredi V, Lezo A
Nutrition · 2026 Aug · PMID 42035516 · Publisher ↗
Maternal nutritional status and dietary patterns represent key determinants of pregnancy outcomes and long-term health of the offspring, through metabolic, epigenetic, and developmental programming mechanisms. Mediterran...
Maternal nutritional status and dietary patterns represent key determinants of pregnancy outcomes and long-term health of the offspring, through metabolic, epigenetic, and developmental programming mechanisms. Mediterranean Diet (MD) has been widely acknowledged as a model of healthy eating, with anti-inflammatory and cardiometabolic benefits, and evidence on the impact of MD during pregnancy on maternal/infant outcomes is growing. The present systematic review and meta-analysis evaluates the association between adherence to MD during pregnancy and maternal and neonatal health outcomes. This review was conducted in accordance with PRISMA 2020 and MOOSE guidelines. A comprehensive search of PubMed/MEDLINE, Scopus, Embase, and Cochrane Library was performed up to February 28, 2024. Study quality was assessed using the Newcastle-Ottawa Scale, and the certainty of evidence was evaluated with the NUTRIGRADE approach. Pooled effect sizes were computed using a random-effects model and expressed as risk ratios (RR), hazard ratios (HR), or odds ratios (OR), as appropriate. Thirty-three studies (19 RCTs and 14 observational; >180 000 pregnant women) were included. Higher MD adherence was associated with lower risk of gestational diabetes mellitus (cohorts: OR 0.93, 95% CI 0.91-0.96; RCTs: RR 0.74, 95% CI 0.63-0.88), preterm delivery (cohorts: OR 0.96, 95% CI 0.92-0.99; RCTs: RR 0.45, 95% CI 0.05-0.84), low neonatal weight (cohorts: OR 0.96, 95% CI 0.91-1.00; RCTs: RR 0.61, 95% CI 0.42-0.88) and fetal growth alterations (RR 0.93, 95% CI 0.87-0.995). Evidence for pre-eclampsia was inconsistent, with significant associations in cohorts but not in RCTs. No significant effects were found for caesarean section, fetal death, neonatal asthma, or childhood obesity. NUTRIGRADE indicated moderate-to-high certainty for gestational diabetes, preterm delivery and low neonatal weight, and low certainty for other outcomes. Adherence to MD during pregnancy is associated with reduced risk of gestational diabetes, preterm birth and abnormal fetal growth. Given its safety and broader cardiometabolic benefits, the MD represents a suitable dietary pattern in pregnancy, although further high-quality trials with diverse populations and standardized MD metrics are warranted.
Exploring the links between nutrition, gut microbiome, and neurodevelopmental disorders.
Chatzinikolaou R, Rouskas K, Argiriou A
Nutrition · 2026 Aug · PMID 42034943 · Publisher ↗
Neurodevelopmental disorders (NDDs), such as autism spectrum disorder (ASD), emerge during early childhood, affecting cognitive and behavioral health and motor development. While genetic factors contribute to the onset o...
Neurodevelopmental disorders (NDDs), such as autism spectrum disorder (ASD), emerge during early childhood, affecting cognitive and behavioral health and motor development. While genetic factors contribute to the onset of ASD, recent studies highlight the significant role of environmental factors, particularly nutrition, in influencing the severity and manifestation of symptoms, primarily through the gut microbiome. This review explores how dietary imbalances, such as the consumption of ultra-processed foods, disrupt gastrointestinal health and microbiome composition, which in turn impact neurodevelopmental outcomes. It further explores the gut-brain axis and how early-life exposures, along with dietary and environmental factors, play a significant role in shaping brain development. The review concludes by underscoring the potential of a deeper understanding of these interactions to pave the way for more effective interventions aimed at improving developmental outcomes in children with ASD and other related NDDs. Key findings reveal that specific gut microbiota imbalances, such as a reduction in Bifidobacterium, are commonly associated with ASD. Additionally, dietary patterns like the Mediterranean and ketogenic diets show promise in supporting cognitive function and promoting neurodevelopment. Maternal nutrition, stress, and epigenetic factors during early life are also shown to influence brain development, contributing to gut dysbiosis, neuroinflammation, and the development of NDDs. To enhance our understanding of NDDs, future research should focus on large-scale longitudinal studies, maternal nutrition, and integrative multi-omics approaches.
Chronic kidney disease and cognitive impairment: The role of diet and gut microbiota.
Milovanova LY, Nezhdanov KS, Milovanova SY … +6 more , Druzhinin DS, Zakharov VV, Kosivtsova OV, Braga VI, Volkov AV, Moiseev SV
Nutrition · 2026 Aug · PMID 42034942 · Publisher ↗
Several important milestones have been achieved in recent years in the area of slowing the progression of chronic kidney disease (CKD). Consequently, additional facets of reducing quality of life (QoL) in CKD patients ha...
Several important milestones have been achieved in recent years in the area of slowing the progression of chronic kidney disease (CKD). Consequently, additional facets of reducing quality of life (QoL) in CKD patients have emerged, including progressive cognitive impairment (CI) in up to 50% of patients. Accumulating evidence suggests that gut microbiome dysregulation may promote CI in a paradigm of kidney-brain-gut axis. Systemic inflammation, oxidative stress, uremic toxins and increased intestinal permeability ("leaky gut") are key components of the kidney-brain-gut axis dysfunction. Correcting this cross-stalk through dietary changes may improve brain function and prevent further kidney damage. Beneficial nutritional guidelines include plant-based (Mediterranean style) low-protein diet, substitution of animal protein with soy isolate, ketoanalogues of essential amino acids supplementation, modification of the gut microbiota through prebiotics, probiotics, synbiotics and metabiotics. Although being a subject of debate, there are many worthwhile areas for research in kidney-brain-gut axis dysfunction. In this review, we aimed to address knowledge gaps in studies of CI in CKD patients in the context of the kidney-brain-gut axis.
Role of social capital in improving diet of pregnant women in Southern Ethiopia: A non-randomized cluster controlled study.
Tariku Y, Fekadu A, Baye K
Nutrition · 2026 Aug · PMID 42030578 · Publisher ↗
BACKGROUND: Inadequate dietary intake among pregnant women is a major public health challenge in Ethiopia. Although nutrition interventions exist, they often overlook dietary diversity and face sustainability issues. Thi...
BACKGROUND: Inadequate dietary intake among pregnant women is a major public health challenge in Ethiopia. Although nutrition interventions exist, they often overlook dietary diversity and face sustainability issues. This study evaluated a community-based intervention designed to improve dietary diversity for pregnant women in Southern Ethiopia by leveraging the women's development army (WDA) platform. METHODS: A non-randomized, cluster-controlled study with two parallel arms was conducted across North and South kebeles (clusters), which were assigned to either an intervention or control group. The intervention group received a program delivered through the existing WDA network, which provided modest monthly financial support (400 ETB) and targeted nutrition education. The control group received standard care. The primary outcome was the proportion of women meeting the minimum dietary diversity for women. RESULTS: A total of 372 pregnant women were enrolled (intervention: 179; control: 193). Cluster-level analysis showed that women in the intervention group had a 60% higher odds of achieving minimum adequate dietary diversity (odds ratio: 1.60; 95% confidence interval: 1.32, 1.93). This improvement was primarily driven by increased consumption of pulses, dairy, and other vegetables. CONCLUSIONS: The findings demonstrate that a community-centered intervention using the WDA as a delivery platform to combine financial support and nutrition education improved dietary diversity among pregnant women. This model effectively addresses key barriers to affordability and knowledge, offering a sustainable, community-owned approach to enhancing maternal nutrition.
Rewiring the brain: Ketogenic diet and gut microbiota in nervous system development.
Jędrusik J, Setkowicz Z
Nutrition · 2026 Aug · PMID 42030577 · Publisher ↗
The ketogenic diet (KD), a high-fat and low-carbohydrate dietary approach, has a well-established therapeutic role, particularly in epilepsy treatment. Recently, its use has expanded beyond clinical practice, gaining pop...
The ketogenic diet (KD), a high-fat and low-carbohydrate dietary approach, has a well-established therapeutic role, particularly in epilepsy treatment. Recently, its use has expanded beyond clinical practice, gaining popularity as a general health and lifestyle choice for healthy people. However, despite its long-standing history, KD exposure during early developmental periods remains unclear. This review summarizes current research on the impact of maternal KD intake on offspring brain development, physiology, and behavior, highlighting the potential mediating role of gut microbiota in neurodevelopment. Emerging evidence suggests that maternal KD may significantly influence brain development, maturation and behavior on numerous levels, possibly linking brain abnormalities, microbiota alterations and behavioral deficits. Nonetheless, lack of conclusive findings underlies the need for further research to assess its safety and long-term effects on the developing nervous system.
Dietary therapy intervention reduces C-reactive protein in individuals diagnosed with hypertension.
Silva MAA, Carraro JCC, Vieira RAL … +2 more , Mendonça RD, do Amaral JF
Nutrition · 2026 Aug · PMID 42030576 · Publisher ↗
INTRODUCTION: The inflammatory process in hypertension is a complex response, with C-reactive protein (CRP) being the inflammatory marker with the most robust literature. Studies suggest that diet and lifestyle play an i...
INTRODUCTION: The inflammatory process in hypertension is a complex response, with C-reactive protein (CRP) being the inflammatory marker with the most robust literature. Studies suggest that diet and lifestyle play an important role in blood pressure control, making it a key nutritional therapy. OBJECTIVE: To investigate the effect of dietary intervention and motivational nutritional intervention on CRP modulation in patients diagnosed with hypertension. METHODS: Controlled intervention study with users of primary health care (PHC) in the municipality of Ouro Preto, Minas Gerais, Brazil, diagnosed with hypertension. Participants were randomized in a 1:1 ratio into the diet therapy group (DG), with care based on diet therapy for hypertension, and the motivational interview group (MIG), with care based on the theories of motivational interviewing. Data were collected at the beginning and at the end of the 6-mo span between the different interventions. The outcome variable was CRP, and the explanatory variables were sociodemographic, biochemical, and anthropometric data. RESULTS: The dietary intervention led to a reduction in CRP (-0.26 mg/L). The decrease was significant in participants who did not consume tobacco (-0.26 mg/L), alcohol (-0.58 mg/L), and those with normal urea (-0.26 mg/L), and microalbuminuria (-0.26 mg/L). CONCLUSION: The diet therapy intervention was more effective than motivational interviewing in reducing CRP levels in individuals diagnosed with hypertension.
Economic evaluations of the Mediterranean diet: a systematic review.
Morsella A, Veronese N, Gianfredi V … +13 more , Limongi F, Saverio Ragusa F, Nucci D, Maggi S, Silano M, Randazzo C, Romiti GF, Lezo A, Rossi L, Volpe M, Zanetti M, Onder G, Mediterranean Diet Guidelines Group
Nutrition · 2026 Aug · PMID 42030575 · Publisher ↗
CONTEXT: The Mediterranean diet (MD) is widely recognized for its health benefits and increasing relevance in health system planning and dietary policy. Understanding the costs and cost-effectiveness of MD adherence is c...
CONTEXT: The Mediterranean diet (MD) is widely recognized for its health benefits and increasing relevance in health system planning and dietary policy. Understanding the costs and cost-effectiveness of MD adherence is critical for informing public health policy and dietary interventions. OBJECTIVE: This systematic review summarizes the evidence on the economic implications of the MD, distinguishing between studies assessing health outcome-based cost-effectiveness and those examining the monetary costs of adhering to the MD for households. METHODS: This review was conducted in accordance with PRISMA 2020. We searched PubMed/MEDLINE, Embase, Scopus, and the Cochrane Library to February 2024. Data extraction and quality assessment followed standardized protocols using CHEC-Extended and Newcastle-Ottawa tools. RESULTS: Of 6,733 screened records, 24 studies met inclusion criteria and were included. Studies were grouped into: (A) economic evaluations (cost-effectiveness, cost-utility, cost-benefit, cost-of-illness - 13 studies) and (B) cost analyses of MD adherence (11 studies). Group A studies, conducted primarily from health system perspectives, found MD interventions generally cost-effective, particularly in cardiovascular prevention, despite higher initial dietary costs. Several reported favorable incremental cost-effectiveness ratio. Group B studies, adopting a societal perspective, consistently showed that greater MD adherence is associated with higher food costs, with a disproportionate impact on low-income populations. CONCLUSIONS: MD is a cost-effective intervention from a health system perspective, with potential for substantial long-term savings. However, economic barriers at the household level may limit uptake. Future evaluations should integrate environmental co-benefits and equity considerations to fully capture the MD's public health value.
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