Search Results (306)

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

Given the rising global population of older adults and their association with edentulism and the use of complete removable prostheses [CRP], it is imperative to pursue solutions for issues such as the relationship between poor diets and masticatory deficiency. Objective: To examine the research on the efficacy of dietary counseling in enhancing mastication and nutrition in older adults with CRP. Methods: A systematic literature review was performed in the PubMed, Trip, and Web of Science databases. Results: 812 results were retrieved from the databases, from which 6 clinical studies that fulfilled the qualifying criteria were selected. The selected studies reported reduced nutrition in patients with CRP due to impaired masticatory function. Research suggests that employing basic dietary guidelines or simplified nutritional recommendations enhances the masticatory function of patients with CRP, thereby ensuring sufficient nutritional intake. Conclusion: Dietary counseling improves nutritional intake and masticatory function in patients with CRP. This would allow simple dietary advice to be given to patients with total prostheses in clinical practice. Further randomized clinical trials are recommended to increase the available evidence. Full article

Background/Objectives: This systematic review aims to identify diets related to weight gain in pregnant women diagnosed with gestational diabetes mellitus (GDM). Methods: This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and its protocol was registered on the International Prospective Register of Systematic Reviews (CRD42023432322). The searches used the medical subject headings in the PubMed/MEDLINE, Web of Science, Scopus, and EMBASE databases. Studies were selected, and data were extracted by three researchers. The Newcastle–Ottawa Scale (NOS) and the Joanna Briggs Institute (JBI) tool were used to assess methodological quality. Results: Six articles were included, most of them of the cohort type, with nutritional strategies lasting 2–15 weeks for overweight/obese women, based on the “macronutrient-adjusted diet” and “calorie-adjusted diet”. Only one study addressed dietary counseling in weight management, and none considered the dietary pattern. The gestational weight gain was 4.91–13.8 kg, and a lower weight gain was found in all studies that used the “macronutrient-adjusted diet” nutritional strategy. However, it did not meet the gestational weight gain targets. Conclusions: Despite the limited number of studies examining the impact of nutritional strategies on weight gain in women with GDM, some research suggests that diets focused on macronutrient adjustment may lead to less weight gain but are not adequate. Therefore, future studies are needed to evaluate which type of nutritional strategies ensure weight gain control during pregnancy. Full article

Dietary interventions during chemotherapy hold promise for clinical and supportive care outcomes. We systematically investigated the feasibility, safety, and efficacy of nutritional counseling conducted during chemotherapy. Studies prospectively implemented nutrition counseling during chemotherapy. Articles were identified from three databases—EMBASE, Cochrane Library, and SCOPUS—from inception to 1 October 2024. Feasibility, safety, and efficacy of outcome data were extracted. Among 44 publications, 39 studies recruited 98 ± 80 participants (range 15–360); 38/39 (97%) were randomized controlled trials. One-third (31%) were among patients with breast cancer. Interventions were divided into individualized nutritional counseling (n = 21), nutrition counseling plus exercise (n = 13), and nutrient-specific dietary patterns (n = 10). Many had goals to achieve established nutrition guidelines. Feasibility was high based on attendance at counseling sessions, retention, and/or food log analysis. Overall, there were minimal adverse events related to the interventions. Many studies showed between-group differences favoring the intervention group for body weight (8/24, gain or loss, according to goals), nutritional status (8/9), quality of life (3/10 without and 6/9 with exercise), cancer-related fatigue (7/10), chemotherapy tolerance (6/11), and treatment responses (3/13). In conclusion, nutritional interventions were feasible and safe for patients undergoing chemotherapy and demonstrated preliminary efficacy to improve nutritional status, fatigue, chemotherapy tolerance, and other outcomes. Full article

Background: Lung cancer (LC) patients are prone to suffer from malnutrition. Malnutrition negatively affects patients’ response to therapy, increases the incidence of treatment-related side effects, and decreases survival. Early identification of LC patients who are malnourished or at risk of malnutrition can promote recovery and improve prognosis. Objective: This study aimed to assess the risk and nutritional status of lung cancer patients who are hospitalised, as well as to evaluate the impact of nutritional intervention on the risk of malnutrition. Methods: From January 2022 to December 2023, 53 LC patients hospitalised in a pulmonology department had their nutritional risk (initial and final) and nutritional status (initial) assessed. All were selected for nutritional intervention. Nutrition counselling was the first intervention option, along with dietary changes with/without oral nutritional supplements. Results: At the time of hospitalisation, 90.6% of the patients were at nutritional risk, 45.3% were classified as moderately malnourished, and 35.8% were classified as severely underweight. After the hospitalisation, 73.6% were at nutritional risk at the time of discharge, suggesting a statistically significant decrease in the number of patients with nutritional risk. Conclusions: Most LC patients hospitalised presented an altered nutritional status. Our study suggests that a nutritional intervention must be implemented to reduce malnutrition risk, which may impact prognosis. The comprehensive nutritional problems experienced by LC patients require nutritional assessment and improved individually tailored nutritional support. Full article

Emerging evidence underscores the pivotal role of the gut microbiota in regulating emotional and behavioral responses via the microbiota–gut–brain axis. This study explores associations between pediatric obstructive sleep apnea (OSA), emotional distress (ED), and gut microbiome alterations before and after OSA treatment. Sixty-six children diagnosed with OSA via polysomnography participated, undergoing adenotonsillectomy alongside routine educational sessions. ED was assessed using the OSA-18 questionnaire, categorizing participants into high ED (scores ≥ 11, 52%) and low ED (scores < 11, 48%) groups. Gut microbiome analysis revealed significant diversity differences, with high ED linked to a reduced Shannon index (p = 0.03) and increased beta diversity (p = 0.01). Three months post-treatment, significant improvements were observed in OSA symptoms, ED scores, and gut microbiome alpha diversity metrics among 55 participants (all p < 0.04). Moreover, changes in the relative abundances of Veillonella, Bifidobacterium, Flavonifractor, and Agathobacter, as well as ultra-low frequency power and low frequency power of sleep heart rate variability, were independently associated with ED score alterations. These findings underscore the gut microbiome’s critical role in the emotional and behavioral symptoms associated with pediatric OSA, suggesting that microbiome-targeted interventions could complement traditional treatments for ED reduction and emphasizing the need for further research. Full article

Recent insights into the influence of nutrition on immune system components have driven the development of dietary strategies targeting the prevention and management of major metabolic-inflammatory diseases. This review summarizes the bidirectional relationship between nutrition and immunocompetence, beginning with an overview of immune system components and their functions. It examines the effects of nutritional status, dietary patterns, and food bioactives on systemic inflammation, immune cell populations, and lymphoid tissues, as well as their associations with infectious and chronic disease pathogenesis. The mechanisms by which key nutrients influence immune constituents are delineated, focusing on vitamins A, D, E, C, and B, as well as minerals including zinc, iron, and selenium. Also highlighted are the immunomodulatory effects of polyunsaturated fatty acids as well as bioactive phenolic compounds and probiotics, given their expanding relevance. Each section addresses the implications of nutritional and nutraceutical interventions involving these nutrients within the broader context of major infectious, metabolic, and inflammatory diseases. This review further underscores that, while targeted nutrient supplementation can effectively restore immune function to optimal levels, caution is necessary in certain cases, as it may increase morbidity in specific diseases. In other instances, dietary counseling should be integrated to ensure that therapeutic goals are achieved safely and effectively. Full article

Background/Objectives: Thus far, no studies have examined the relationship between fruit and vegetable (F and V) intake, urinary metabolite quantities, and weight change. Therefore, the aim of the current study was to explore changes in urinary metabolomic profiles during and after a 10-week weight loss intervention where participants were prescribed a high F and V diet (7 servings daily). Methods: Adults with overweight and obesity (n = 34) received medical nutrition therapy counselling to increase their F and V intakes to national targets (7 servings a day). Data collection included weight, dietary intake, and urine samples at baseline at week 2 and week 10. Urinary metabolite profiles were quantified using ¹H NMR spectroscopy. Machine learning statistical approaches were employed to identify novel urine-based metabolite biomarkers associated with high F and V diet patterns at weeks 2 and 10. Metabolic changes appearing in urine in response to diet were quantified using Metabolite Set Enrichment Analysis (MSEA). Results: Energy intake was significantly lower (p = 0.02) at week 10 compared with baseline. Total F and V intake was significantly higher at week 2 and week 10 (p < 0.05). In total, 123 urinary metabolites were quantified. At week 10, 21 metabolites showed significant changes relative to baseline. Of these, 11 metabolites also significantly changed at week 2. These overlapping metabolites were acetic acid, dimethylamine, choline, fumaric acid, glutamic acid, L-tyrosine, histidine, succinic acid, uracil, histamine, and 2-hydroxyglutarate. Ridge Classifier and Linear Discriminant Analysis provided best prediction accuracy values of 0.96 when metabolite level of baseline was compared to week 10. Conclusions: Urinary metabolites quantified represent potential candidate biomarkers of high F and V intake, associated with a reduction in energy intake. Further studies are needed to validate these findings in larger population studies. Full article

Introduction: The impact of multidisciplinary supervised cardiac rehabilitation programs on reducing the risk of having heart problems in the future is well documented. However, little is known about nurse-led post-coronary heart disease (post-CHD). Purpose: Our aim was to evaluate the effectiveness of an educational and counseling-structured nurse-led post-CHD support program by assessing the prediction of psychological, behavioral and dietary variables in relation to adherence to a care plan in a single hospital in Athens (Greece). Method: A prospective follow-up comparative approach in a single group of CHD patients was applied. The structured nurse-led program included eight topics (management of anxiety, physical activity, dietary habits, weight control, smoking cessation, alcohol moderation, family engagement and adherence to a care plan). Participants received tailored nursing interventions focused on psychological and behavioral needs and dietary habits by a CHD-specialized nurse based on patients’ medical prescriptions and/or instructions. A modified clinical assessment questionnaire by the European Society of Cardiology was applied to identify pre–post clinical baseline measurements. A nurse-led post-coronary Heart Disease Support Program was evaluated by assessing the predictivity (effect) of specific interventions on adherence to a care plan by employing a logistic regression beta coefficient (Generalized Estimating Equations model). Results: The sample consisted of 275 patients (66.2% male), with a mean age of 68.5 ± 12.5 years old. CHD patients presented significantly lower anxiety rates (54.27 [1st m] vs. 49.63 [2nd m], p < 0.05). In addition, significant differences were observed between the first and the second measurements of total cholesterol (163.27 [1rst m] vs. 134.44 [2nd m], p < 0.001), BMI (obesity) (33.69 [1rst m] vs. 32.79 [2nd m], p < 0.001), smoking (42.18 [1rst m] vs. 22.55 [2nd m], p < 0.001) and adherence to a care plan (78.90 [1rst m] vs. 89.10 [2nd m], p < 0.001). A Generalized Estimating Equations model revealed that participants with higher levels of anxiety showed significantly lower adherence to a care plan (beta −0.10, p < 0.001) and those with family history of CHD (beta −0.71, p = 0.04) in comparison to those with no CHD history. No significant differences were observed in the predictive variables of smoking (beta 0.08, p = 0.69), alcohol consumption (beta 0.09, p = 0.79) and family engagement (beta −0.11, p = 069) with respect to adherence to a care plan, even after adjusting for age, sex and history of CHD. Conclusion: Our findings indicate that the nurse-led post-CHD support program was found to be partially feasible and effective in our single-group study, emphasizing the need for effective training and retention strategies to enhance the specialization of nurses providing post-CHD care and support. Full article

Background and objectives: We aimed to assess the body composition and dietary intake of female patients attending one of the Polish infertility clinics. Additionally, we evaluated if there were any relationships between dietary intake and body composition parameters. Methods: The study involved 51 women who met the inclusion criteria. For the nutritional assessment, we used 3-day dietary records. Weight, height, waist and hip circumferences, and body composition were assessed. The participants were divided into three groups, with low (I, n = 12), normal (II, n = 27), and high (III, n = 12) fat tissue content, and then compared in terms of dietary intake. Results: The lowest protein intake per kilogram of body weight was observed in group III (p < 0.001). In group I, we reported the highest consumption of plant protein in general (p = 0.03) and per kg of body weight (p < 0.001). Higher protein intake per kg body mass was associated with lower values of BMI (r = −0.681; p < 0.001), fat mass (r = −0.641; p < 0.001), waist–hip ratio (r = −0.391; p = 0.005), and abdominal fat index (r = −0.653; p < 0.001). Conclusions: Our findings suggest that targeted nutritional counseling focused on optimizing protein intake and emphasizing plant-based sources may improve body composition and potentially support fertility outcomes in women undergoing infertility treatment. Full article

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

Background/objectives: Smoking increases the risk for multiple lifestyle-related diseases. In Japan, consumption of heated tobacco products (HTPs), a novel cigarette type, is rising. However, no studies have yet compared dietary habits among HTP smokers. This study assessed food and nutrient intake and alcohol consumption by smoking status (non-smokers, cigarette smokers, HTP smokers). Methods: This cross-sectional study included 237 HTP smokers, 242 cigarette smokers, and 178 non-smokers (50% each male and female). The Brief Self-Administered Diet History Questionnaire was administered as a nutritional survey, and smokers were asked about their smoking status, including smoking history and the number of puffs smoked per day. Results: A significantly higher intake of meat was seen in HTP smokers than in cigarette smokers (p = 0.038), and HTP smokers showed the lowest intake of vitamin D in all groups. HTP and cigarette smokers had a lower intake of certain vitamins, minerals, and dietary fiber compared with non-smokers. The rate of habitual drinkers (at least one drink a month) and their alcohol consumption (g/day) were significantly lower in non-smokers (58%, 1.3 g) than in HTP smokers (67%, 4.8 g) and cigarette smokers (70%, 7.1 g) (p = 0.031). Additionally, after adjusting for sex and smoking status in a multiple regression analysis, the number of puffs was a significant contributor to alcohol intake in HTP smokers (β = 0.296, p < 0.001). Conclusions: This study identified significant dietary, nutritional, and alcohol consumption differences based on smoking status, underscoring the need to consider both diet and smoking type in nutritional counseling and smoking cessation guidance. Full article

Background: The effectiveness of telehealth in managing obesity in Saudi patients is still under investigation. This study compared the effectiveness of telehealth and in-person obesity management programs for adults. Methods: This clinical trial involved 62 adults, 29 receiving in-person intervention at the clinic and 33 receiving telehealth via videoconference calls. Anthropometric measurements, biochemical parameters, and dietary and lifestyle habits were assessed at baseline and after 12 weeks. Patients have been educated about goal-setting, healthy eating behaviors, personalized meal plans, and increasing physical activity levels. Results: It showed that 45% and 49% of the in-person and telehealth groups lost more than 5% of their initial body weight. Weight, % body fat, and waist circumference were significantly reduced in the in-person and telehealth groups (p < 0.001). No significant differences between the groups were found in the parameters mentioned above. Within-group analysis showed that light physical activity levels improved in both groups significantly (p < 0.001), and the moderate physical activity level improved significantly among the telehealth group (p < 0.039). No significant differences were observed between the groups regarding physical activity level, blood pressure measurement, and biochemical markers, except for the RBC blood level (p = 0.026). The telehealth group had significantly higher attendance rates for counseling sessions (97% vs. 75% for the in-person group, p < 0.01). Participants’ dropout rates were higher for the in-person group 21%, compared to the telehealth group 13%. Telehealth participants’ satisfaction regarding the benefits of the obesity management program in losing weight was higher at 87% compared to the in-person group at 76%. Conclusions: In conclusion, applying a telehealth obesity management program can support patients struggling with obesity who may have limited access to traditional healthcare services, while ensuring that telehealth care replicates the quality of in-person care. Full article

Background/Objectives: Carbohydrate counting is recommended to improve glycemic control in type 1 diabetes (T1D), but the most effective educational methods are unclear. Despite its benefits, many individuals struggle with mastering carbohydrate counting, leading to inconsistent use and suboptimal glycemic outcomes. This study aimed to compare the effectiveness of two group-based programs with individual dietary counseling (standard care) for glycemic control. Methods: The trial was a randomized, controlled, open-label, parallel-group design. Adults with T1D on multiple daily insulin injections (MDIs) and with glycated hemoglobin A1c (HbA1c) 53–97 mmol/mol were randomly assigned (1:1:1) to basic (BCC), advanced carbohydrate counting (ACC), or standard care. Primary outcomes were the changes in HbA1c or mean amplitude of glycemic excursions (MAGEs) in BCC and ACC versus standard care after six months. Equivalence testing was performed to compare BCC and ACC. Results: Between November 2018 and August 2021, 63 participants were randomly assigned to BCC (N = 20), ACC (N = 21), or standard care (N = 22). After 6 months, HbA1c changed by −2 mmol/mol (95% CI −5 to 0 [−0.2%, −0.5 to 0]) in BCC, −4 mmol/mol (−6 to −1 [−0.4%, −0.6 to −0.1]) in ACC, and −3 mmol/mol (−6 to 0 [−0.3%, −0.6 to 0]) in standard care. The estimated difference in HbA1c compared to standard care was 1 mmol/mol (−3 to 5 [0.1%, −0.3 to 0.5]); p = 0.663 for BCC and −1 mmol/mol (−4 to 3 [−0.1%, −0.4 to 0.3]); p = 0.779 for ACC. For MAGEs, changes were −0.3 mmol/L (−1.5 to 0.8) in BCC, −0.0 mmol/L (−1.2 to 1.1) in ACC, and −0.7 mmol/L (−1.8 to 0.4) in standard care, with differences of 0.4 mmol/L (−1.1 to 1.9); p = 0.590 for BCC and 0.7 mmol/L (−0.8 to 2.1); p = 0.360 for ACC versus standard care. An equivalence in effect between BCC and ACC was found for HbA1c, but not for MAGEs. Conclusions: Group-based education in BCC and ACC did not demonstrate a clear advantage over individualized dietary counseling for overall glycemic control in adults with T1D. Healthcare providers should consider flexible, patient-centered strategies that allow individuals to choose the format that best suits their learning preferences when selecting the most suitable dietary educational approach. Full article

A decade of research on gluten-related disorders (GRDs) is reviewed in this study, with a particular emphasis on celiac disease (CD) and non-celiac gluten sensitivity (NCGS). GRDs are triggered by the ingestion of gluten and gluten-like proteins found in wheat, barley, and rye. These proteins lead to intestinal damage in celiac disease, an autoimmune condition characterized by villous atrophy and a variety of gastrointestinal and extraintestinal symptoms. More enigmatic and less understood, NCGS involves symptoms similar to CD but without the immunological reaction or intestinal damage. Recent years have seen advances in the understanding of GRDs, particularly in connection to how intestinal microbiota influences disease progression and patient outcomes. The gluten-free diet (GFD) is still the standard therapy recommended for GRDs despite significant challenges, as discussed in this article. Precise diagnostic methods, patient education and dietary counseling are critical for improving patients’ quality of life. The purpose of this review is to provide a more clear and up-to-date understanding of GRDs, and to help further research on this important topic. Full article