Nutrients

14 pages, 710 KiB

Open AccessEditor’s ChoiceArticle

The Geriatric Nutritional Risk Index (GNRI) as a Prognostic Biomarker for Immune Checkpoint Inhibitor Response in Recurrent and/or Metastatic Head and Neck Cancer

by Markus Haas, Alexander Lein, Thorsten Fuereder, Faris F. Brkic, Julia Schnoell, David T. Liu, Lorenz Kadletz-Wanke, Gregor Heiduschka and Bernhard J. Jank

Nutrients 2023, 15(4), 880; https://doi.org/10.3390/nu15040880 - 09 Feb 2023

Cited by 9 | Viewed by 2132

Abstract

Malnutrition is a frequent comorbidity in head and neck cancer patients and has been shown to impair immunotherapy response in other cancer types. The geriatric nutritional risk index (GNRI) assesses malnutrition using the patient’s ideal weight, actual weight, and serum albumin. The aim [...] Read more.

Malnutrition is a frequent comorbidity in head and neck cancer patients and has been shown to impair immunotherapy response in other cancer types. The geriatric nutritional risk index (GNRI) assesses malnutrition using the patient’s ideal weight, actual weight, and serum albumin. The aim of this study was to evaluate the prognostic relevance of malnutrition as determined by the GNRI for the response to immunotherapy in recurrent and/or metastatic head and neck squamous cell carcinoma (R/M HNSCC). A total of 162 patients with R/M HNSCC who received immune checkpoint inhibitors were included. The associations between the GNRI and progression-free survival (PFS), overall survival (OS), and the disease control rate (DCR) were computed. Univariable analysis showed worse PFS for GNRI ≤ 98 (p < 0.001), ECOG performance status (PS) ≥ 2 (p = 0.012), and enteral (p = 0.009) and parenteral (p = 0.015) nutritional supplementation, and worse OS for GNRI < 92 (p < 0.001), ECOG PS ≥ 2 (p < 0.001), and enteral (p = 0.008) and parenteral (p = 0.023) nutritional supplementation. In our multivariable model, GNRI ≤ 98 (p = 0.012) and ECOG PS ≥ 2 (p = 0.025) were independent prognostic factors for PFS. For OS, GNRI < 92 (p < 0.001) and ECOG PS ≥ 2 (p < 0.001) were independent prognostic factors. A GNRI ≤ 98 was significantly associated with a lower DCR compared to a GNRI > 98 (p = 0.001). In conclusion, our findings suggest that the GNRI may be an effective predictor for response to immunotherapy in R/M HNSCC. Full article

(This article belongs to the Section Clinical Nutrition)

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11 pages, 287 KiB

Open AccessEditor’s ChoiceArticle

The Effects of Eight Weeks’ Very Low-Calorie Ketogenic Diet (VLCKD) on Liver Health in Subjects Affected by Overweight and Obesity

by Roberta Rinaldi, Sara De Nucci, Fabio Castellana, Martina Di Chito, Vito Giannuzzi, Endrit Shahini, Roberta Zupo, Luisa Lampignano, Giuseppina Piazzolla, Vincenzo Triggiani, Raffaele Cozzolongo, Gianluigi Giannelli and Giovanni De Pergola

Nutrients 2023, 15(4), 825; https://doi.org/10.3390/nu15040825 - 06 Feb 2023

Cited by 10 | Viewed by 5755

Abstract

Very low-calorie ketogenic diets (VLCKD) are widely employed in successful weight-loss strategies. Herein, we evaluated the efficacy and safety of a VLCKD on non-alcoholic fatty liver disease (NAFLD) and parameters commonly associated with this condition in overweight and obese subjects who did not [...] Read more.

Very low-calorie ketogenic diets (VLCKD) are widely employed in successful weight-loss strategies. Herein, we evaluated the efficacy and safety of a VLCKD on non-alcoholic fatty liver disease (NAFLD) and parameters commonly associated with this condition in overweight and obese subjects who did not take any drugs. This prospective, real-life study included thirty-three participants who followed a VLCKD for 8 weeks. NAFLD was diagnosed using transient elastography (FibroScan). Data on anthropometric measurements, bioimpedance analysis, and biochemical assays were gathered both before and after the dietary intervention. BMI (kg/m²) (from 33.84 ± 6.55 to 30.89 ± 6.38, p < 0.01), waist circumference (cm) (from 106.67 ± 15.51 to 98.64 ± 16.21, p < 0.01), and fat mass (Kg) (from 38.47 ± 12.59 to 30.98 ± 12.39, p < 0.01) were significantly lower after VLCKD. CAP (db/m), the FibroScan parameter quantifying fatty liver accumulation, showed a significant reduction after VLCKD (from 266.61 ± 67.96 to 223 ± 64.19, p < 0.01). After VLCKD, the fatty liver index (FLI), a benchmark of steatosis, also revealed a significant decline (from 62.82 ± 27.46 to 44.09 ± 31.24, p < 0.01). Moreover, fasting blood glucose, insulin, triglycerides, total cholesterol, LDL-cholesterol, ALT, γGT, and FT3 blood concentrations, as well as insulin resistance (quantified by HOMAIR) and systolic and diastolic blood pressure levels, were significantly lower after VLCKD (p < 0.01 for all the parameters). By contrast, HDL-cholesterol, 25 (OH) vitamin D, and FT4 blood concentrations were higher after VLCKD (p < 0.01 for all parameters). The variation (δ) of CAP after VLCKD did not show a correlation with the δ of any other parameter investigated in this study. We conclude that VLCKD is a helpful approach for NAFLD independent of changes in factors commonly associated with NAFLD (obesity, fat mass, insulin resistance, lipids, and blood pressure) as well as vitamin D and thyroid hormone levels. Full article

(This article belongs to the Special Issue The Role of Ketogenic Diet in Human Health and Diseases)

15 pages, 546 KiB

Open AccessEditor’s ChoiceReview

Epigenetics in Obesity and Diabetes Mellitus: New Insights

by Rosario Suárez, Sebastián P. Chapela, Ludwig Álvarez-Córdova, Estefanía Bautista-Valarezo, Yoredy Sarmiento-Andrade, Ludovica Verde, Evelyn Frias-Toral and Gerardo Sarno

Nutrients 2023, 15(4), 811; https://doi.org/10.3390/nu15040811 - 04 Feb 2023

Cited by 13 | Viewed by 5491

Abstract

A long-term complication of obesity is the development of type 2 diabetes (T2D). Patients with T2D have been described as having epigenetic modifications. Epigenetics is the post-transcriptional modification of DNA or associated factors containing genetic information. These environmentally-influenced modifications, maintained during cell division, [...] Read more.

A long-term complication of obesity is the development of type 2 diabetes (T2D). Patients with T2D have been described as having epigenetic modifications. Epigenetics is the post-transcriptional modification of DNA or associated factors containing genetic information. These environmentally-influenced modifications, maintained during cell division, cause stable changes in gene expression. Epigenetic modifications of T2D are DNA methylation, acetylation, ubiquitylation, SUMOylation, and phosphorylation at the lysine residue at the amino terminus of histones, affecting DNA, histones, and non-coding RNA. DNA methylation has been shown in pancreatic islets, adipose tissue, skeletal muscle, and the liver. Furthermore, epigenetic changes have been observed in chronic complications of T2D, such as diabetic nephropathy, diabetic retinopathy, and diabetic neuropathy. Recently, a new drug has been developed which acts on bromodomains and extraterminal (BET) domain proteins, which operate like epigenetic readers and communicate with chromatin to make DNA accessible for transcription by inhibiting them. This drug (apabetalone) is being studied to prevent major adverse cardiovascular events in people with T2D, low HDL cholesterol, chronic kidney failure, and recent coronary events. This review aims to describe the relationship between obesity, long-term complications such as T2D, and epigenetic modifications and their possible treatments. Full article

(This article belongs to the Special Issue Insulin Resistance and Related Diseases: From Pathophysiology to Clinical Management)

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17 pages, 347 KiB

Open AccessEditor’s ChoiceReview

Effects of Vitamin D on Cardiovascular Risk and Oxidative Stress

by Guilherme Renke, Bernardo Starling-Soares, Thomaz Baesso, Rayssa Petronio, Danilo Aguiar and Raphaela Paes

Nutrients 2023, 15(3), 769; https://doi.org/10.3390/nu15030769 - 02 Feb 2023

Cited by 19 | Viewed by 6234

Abstract

Introduction: Vitamin D has been primarily studied as an important factor influencing bone and calcium metabolism. Metabolites of vitamin D are essential for whole-body calcium homeostasis, maintaining serum calcium levels within a narrow range by regulating this process in the bones and gut. [...] Read more.

Introduction: Vitamin D has been primarily studied as an important factor influencing bone and calcium metabolism. Metabolites of vitamin D are essential for whole-body calcium homeostasis, maintaining serum calcium levels within a narrow range by regulating this process in the bones and gut. Nevertheless, its deficiency is also related to increased risk of type 2 diabetes mellitus (T2DM), metabolic syndrome (MS), and cardiovascular disease (CVD)—with increased visceral adipose tissue and body mass index (BMI), as well as the frequently associated hypercholesterolemia. It has been reported that vitamin D levels are inversely related to cardiovascular (CV) risk in men and women. However, the effects of vitamin D on distinct outcomes in women and the dose of supplementation needed to improve clinical endpoints have not been established. 25-Hydroxyvitamin D [25(OH)D] reduces systemic inflammatory mediators in CVD and favors the release of anti-inflammatory cytokines from the immune system. In addition, 25(OH)D can be primarily converted into calcitriol (1,25-dihydroxycholecalciferol [1,25(OH)2D]) in the kidneys through the action of the 1-α-hydroxylase enzyme. Calcitriol, through the downregulation mechanism of renin expression, renin–angiotensin–aldosterone system (RAAS) activity, and its interaction with the vitamin D receptor, can bring CV benefits. The calcitriol form also lowers parathyroid hormone (PTH) levels by indirectly causing a reduction in aldosterone and mineralocorticoid synthesis. Elevated plasma aldosterone is related to endothelial dysfunction and CVD in hypovitaminosis D status. Conclusion: Vitamin D supplementation may benefit certain risk groups, as it improves metabolic variables, reducing oxidative stress and CV outcomes. More studies are needed to define interventions with vitamin D in men and women. Full article

(This article belongs to the Special Issue Vitamins and Human Health)

14 pages, 1017 KiB

Open AccessEditor’s ChoiceSystematic Review

Association between Food, Beverages and Overweight/Obesity in Children and Adolescents—A Systematic Review and Meta-Analysis of Observational Studies

by Dorthe Dalstrup Jakobsen, Lea Brader and Jens Meldgaard Bruun

Nutrients 2023, 15(3), 764; https://doi.org/10.3390/nu15030764 - 02 Feb 2023

Cited by 11 | Viewed by 4327

Abstract

A healthy diet is essential to prevent childhood obesity, however, adherence to a healthy diet is challenging. The aim of this study was to give a comprehensive overview of the literature investigaating associations between food and beverages and overweight/obesity in children and adolescents [...] Read more.

A healthy diet is essential to prevent childhood obesity, however, adherence to a healthy diet is challenging. The aim of this study was to give a comprehensive overview of the literature investigaating associations between food and beverages and overweight/obesity in children and adolescents in order to identify dietary risk factors. A systematic search was performed in four databases and observational studies were included. Meta-analysis was performed using the random effect model. Sixty records met inclusion criteria and 14 different food or beverage categories were identified. A higher intake of sugar-sweetened beverages increased the odds of overweight/obesity by 1.20 (p < 0.05) (n = 26) and higher intake of fast food increased the odds of overweight/obesity by 1.17 (p < 0.05) (n = 24). Furthermore, higher intake of meat (OR 1.02, p < 0.05 (n:7)) and refined grains (OR 1.28, p < 0.05 (n:3)) was associated with an increased risk of overweight/obesity. In contrast, higher intake of whole grain (OR 0.86, p = 0.04 (n:5)) and more surprisingly sweet bakery (OR 0.59, p < 0.05 (n:3)) was associated with a decreased risk of overweight/obesity. In conclusion, a higher intake of sugar-sweetened beverages and a higher intake of fast food was identified as the primary dietary risk factors for overweight/obesity. Future research is needed to strengthen the generalizability of these results. Full article

(This article belongs to the Section Pediatric Nutrition)

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10 pages, 278 KiB

Open AccessEditor’s ChoiceReview

Human Milk Oligosaccharides and Infant Neurodevelopment: A Narrative Review

by Paige K. Berger, Margaret L. Ong, Lars Bode and Mandy B. Belfort

Nutrients 2023, 15(3), 719; https://doi.org/10.3390/nu15030719 - 31 Jan 2023

Cited by 12 | Viewed by 3624

Abstract

The objective of this narrative review was to synthesize the literature on human milk oligosaccharides (HMOs) and neurodevelopmental outcomes in human milk-fed infants. We conducted a scoping review of the literature indexed in PubMed reporting observational or interventional studies on HMO exposure in [...] Read more.

The objective of this narrative review was to synthesize the literature on human milk oligosaccharides (HMOs) and neurodevelopmental outcomes in human milk-fed infants. We conducted a scoping review of the literature indexed in PubMed reporting observational or interventional studies on HMO exposure in relation to psychometric measures in infants. Studies were characterized based on study design and definitions of HMO exposure and neurodevelopmental outcomes. Six studies were identified; all were observational in design, and five were conducted in full-term infants. Sample sizes ranged from 35–659 infants. HMOs were defined as individual concentrations or relative abundances assessed at 1 and/or 6 months of age. Studies accounted for differences in HMO exposure based on maternal secretor status. Neurodevelopmental outcomes were assessed between 6 and 24 months of age and included four domains. Studies in full-term infants reported that total and individual fucosylated and sialylated HMOs were positively associated with cognitive, language, and motor skill domains between 18 and 24 months of age, while the single study in preterm infants reported no statistically significant findings in the full cohort. The presence of a maternal secretor did not consistently alter the associations between HMO exposure and neurodevelopmental outcomes. Emerging evidence from observational studies suggests that HMO exposure may be beneficial for neurodevelopment in infants. Full article

(This article belongs to the Special Issue Human Milk Feeding: Health and Nutrition for Term and Preterm Newborns—What’s New?)

18 pages, 464 KiB

Open AccessEditor’s ChoiceReview

Modern Diets and the Health of Our Planet: An Investigation into the Environmental Impacts of Food Choices

by Kiera A. Dixon, Malia K. Michelsen and Catherine L. Carpenter

Nutrients 2023, 15(3), 692; https://doi.org/10.3390/nu15030692 - 30 Jan 2023

Cited by 13 | Viewed by 14231

Abstract

Popular modern diets are often seen as a panacea for improving health and promoting weight reduction. While there is a large body of literature reporting the health benefits of popular diets, few studies have described their planetary benefits. Our investigation aims to evaluate [...] Read more.

Popular modern diets are often seen as a panacea for improving health and promoting weight reduction. While there is a large body of literature reporting the health benefits of popular diets, few studies have described their planetary benefits. Our investigation aims to evaluate the simultaneous impacts of six popular diets within the United States on both human and planetary health. Using carbon footprint databases and representative meal plans, the environmental and health-related impacts of the Standard American, Mediterranean, vegan, paleo, keto, and climatarian diets are compared using the currently available literature. Results indicate that diets that exhibit lower carbon footprints also have positive effects on human health. The diets found to have the lowest environmental impacts were the vegan, climatarian, and Mediterranean diets. These low-carbon-footprint diets can likely be attributed to a reduced reliance on ruminant meat (cattle and sheep) and processed food consumption, while diets with high carbon footprints are more dependent on ruminant meat and saturated fat. Moderate consumption of meats such as chicken, pork, and fish in conjunction with an emphasis on locally grown fruits and vegetables can be maintained without adversely affecting the planetary carbon footprint and with the added benefit of promoting good health. Thus, making simple substitutions within each individual’s diet can be advertised as an effective approach to collectively lower the environmental impact in tandem with improving health and longevity. Full article

(This article belongs to the Section Nutritional Epidemiology)

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27 pages, 776 KiB

Open AccessEditor’s ChoiceReview

Understanding NAFLD: From Case Identification to Interventions, Outcomes, and Future Perspectives

by Daniel Clayton-Chubb, William Kemp, Ammar Majeed, John S. Lubel, Alex Hodge and Stuart K. Roberts

Nutrients 2023, 15(3), 687; https://doi.org/10.3390/nu15030687 - 29 Jan 2023

Cited by 13 | Viewed by 3281

Abstract

While non-alcoholic fatty liver disease (NAFLD) is a prevalent and frequent cause of liver-related morbidity and mortality, it is also strongly associated with cardiovascular disease-related morbidity and mortality, likely driven by its associations with insulin resistance and other manifestations of metabolic dysregulation. However, [...] Read more.

While non-alcoholic fatty liver disease (NAFLD) is a prevalent and frequent cause of liver-related morbidity and mortality, it is also strongly associated with cardiovascular disease-related morbidity and mortality, likely driven by its associations with insulin resistance and other manifestations of metabolic dysregulation. However, few satisfactory pharmacological treatments are available for NAFLD due in part to its complex pathophysiology, and challenges remain in stratifying individual patient’s risk for liver and cardiovascular disease related outcomes. In this review, we describe the development and progression of NAFLD, including its pathophysiology and outcomes. We also describe different tools for identifying patients with NAFLD who are most at risk of liver-related and cardiovascular-related complications, as well as current and emerging treatment options, and future directions for research. Full article

(This article belongs to the Special Issue Liver Disease, Lifestyle and Cardiovascular Risk)

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15 pages, 383 KiB

Open AccessEditor’s ChoiceReview

The Assessment of the Risk of Malnutrition (Undernutrition) in Stroke Patients

by Olivia Di Vincenzo, Maria Luisa Eliana Luisi, Paola Alicante, Giada Ballarin, Barbara Biffi, Chiara Francesca Gheri and Luca Scalfi

Nutrients 2023, 15(3), 683; https://doi.org/10.3390/nu15030683 - 29 Jan 2023

Cited by 14 | Viewed by 3721

Abstract

Malnutrition is common in stroke patients, as it is associated with neurological and cognitive impairment as well as clinical outcomes. Nutritional screening is a process with which to categorize the risk of malnutrition (i.e., nutritional risk) based on validated tools/procedures, which need to [...] Read more.

Malnutrition is common in stroke patients, as it is associated with neurological and cognitive impairment as well as clinical outcomes. Nutritional screening is a process with which to categorize the risk of malnutrition (i.e., nutritional risk) based on validated tools/procedures, which need to be rapid, simple, cost-effective, and reliable in the clinical setting. This review focuses on the tools/procedures used in stroke patients to assess nutritional risk, with a particular focus on their relationships with patients’ clinical characteristics and outcomes. Different screening tools/procedures have been used in stroke patients, which have shown varying prevalence in terms of nutritional risk (higher in rehabilitation units) and significant relationships with clinical outcomes in the short- and long term, such as infection, disability, and mortality. Indeed, there have been few attempts to compare the usefulness and reliability of the different tools/procedures. More evidence is needed to identify appropriate approaches to assessing nutritional risk among stroke patients in the acute and sub-acute phase of disease or during rehabilitation; to evaluate the impact of nutritional treatment on the risk of malnutrition during hospital stay or rehabilitation unit; and to include nutritional screening in well-defined nutritional care protocols. Full article

(This article belongs to the Special Issue Nutrition in Post-stroke Subjects during Rehabilitation)

11 pages, 276 KiB

Open AccessEditor’s ChoiceReview

Current Nutritional Therapies in Inflammatory Bowel Disease: Improving Clinical Remission Rates and Sustainability of Long-Term Dietary Therapies

by Elizabeth A. Reznikov and David L. Suskind

Nutrients 2023, 15(3), 668; https://doi.org/10.3390/nu15030668 - 28 Jan 2023

Cited by 9 | Viewed by 4273

Abstract

Inflammatory Bowel Disease (IBD) includes a spectrum of chronic immune-mediated intestinal diseases thought to be related to the complex interaction between the host immune system and the intestinal microbiome. Research supports the use of nutritional therapy in IBD; however, it is not routinely [...] Read more.

Inflammatory Bowel Disease (IBD) includes a spectrum of chronic immune-mediated intestinal diseases thought to be related to the complex interaction between the host immune system and the intestinal microbiome. Research supports the use of nutritional therapy in IBD; however, it is not routinely used in clinical practice. This literature review seeks to advance the understanding of diet and its effect in IBD with a focus on both Crohn’s Disease (CD) and Ulcerative Colitis (UC). The contribution of diet to the development and treatment of IBD cannot be overstated. In both pediatric as well as adult IBD, nutritional interventions have been shown to improve clinical symptoms as well as inflammatory burden. The impact of dietary intervention is best exemplified through the use of Exclusive Enteral Nutrition (EEN) in CD. EEN and clinical research on exclusionary whole food diets—Crohn’s Disease Exclusion Diet (CDED), Specific Carbohydrate Diet (SCD), low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet, and Mediterranean Diet—are discussed within this review. Current clinical literature supports the elimination of detrimental components and the incorporation of low processed whole foods in the diet. Additional prospective and longitudinal dietary studies on sustainable and long-term dietary options, along with a deeper understanding of the mechanism, are needed to further advance the role of nutritional interventions in IBD. Full article

(This article belongs to the Special Issue Inflammatory Bowel Diseases (IBDs) and Diet: New Highlights and Triggers)

38 pages, 1540 KiB

Open AccessEditor’s ChoiceReview

New Advances in Metabolic Syndrome, from Prevention to Treatment: The Role of Diet and Food

by Donatella Ambroselli, Fabrizio Masciulli, Enrico Romano, Giuseppina Catanzaro, Zein Mersini Besharat, Maria Chiara Massari, Elisabetta Ferretti, Silvia Migliaccio, Luana Izzo, Alberto Ritieni, Michela Grosso, Caterina Formichi, Francesco Dotta, Francesco Frigerio, Eleonora Barbiera, Anna Maria Giusti, Cinzia Ingallina and Luisa Mannina

Nutrients 2023, 15(3), 640; https://doi.org/10.3390/nu15030640 - 26 Jan 2023

Cited by 29 | Viewed by 8381

Abstract

The definition of metabolic syndrome (MetS) has undergone several changes over the years due to the difficulty in establishing universal criteria for it. Underlying the disorders related to MetS is almost invariably a pro-inflammatory state related to altered glucose metabolism, which could lead [...] Read more.

The definition of metabolic syndrome (MetS) has undergone several changes over the years due to the difficulty in establishing universal criteria for it. Underlying the disorders related to MetS is almost invariably a pro-inflammatory state related to altered glucose metabolism, which could lead to elevated cardiovascular risk. Indeed, the complications closely related to MetS are cardiovascular diseases (CVDs) and type 2 diabetes (T2D). It has been observed that the predisposition to metabolic syndrome is modulated by complex interactions between human microbiota, genetic factors, and diet. This review provides a summary of the last decade of literature related to three principal aspects of MetS: (i) the syndrome’s definition and classification, pathophysiology, and treatment approaches; (ii) prediction and diagnosis underlying the biomarkers identified by means of advanced methodologies (NMR, LC/GC-MS, and LC, LC-MS); and (iii) the role of foods and food components in prevention and/or treatment of MetS, demonstrating a possible role of specific foods intake in the development of MetS. Full article

(This article belongs to the Section Nutrition and Metabolism)

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16 pages, 856 KiB

Open AccessEditor’s ChoiceArticle

Expert Consensus on Morphofunctional Assessment in Disease-Related Malnutrition. Grade Review and Delphi Study

by José Manuel García-Almeida, Cristina García-García, María D. Ballesteros-Pomar, Gabriel Olveira, Juan J. Lopez-Gomez, Virginia Bellido, Irene Bretón Lesmes, Rosa Burgos, Alejandro Sanz-Paris, Pilar Matia-Martin, Francisco Botella Romero, Julia Ocon Breton, Ana Zugasti Murillo and Diego Bellido

Nutrients 2023, 15(3), 612; https://doi.org/10.3390/nu15030612 - 25 Jan 2023

Cited by 10 | Viewed by 3190

Abstract

Disease-related malnutrition (DRM) affects approximately a third of hospitalized patients and is associated with an increased risk of morbimortality. However, DRM is often underdiagnosed and undertreated. Our aim is to evaluate the prognostic value of morphofunctional tools and tests for nutritional assessment in [...] Read more.

Disease-related malnutrition (DRM) affects approximately a third of hospitalized patients and is associated with an increased risk of morbimortality. However, DRM is often underdiagnosed and undertreated. Our aim is to evaluate the prognostic value of morphofunctional tools and tests for nutritional assessment in clinical practice. A systematic literature review was conducted to identify studies relating to the morphofunctional assessment of nutritional status and mortality or complications. Evidence was evaluated using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) method. Twelve GRADE recommendations were made and divided into seven topics: food intake and nutrient assimilation, anthropometry, biochemical analysis, hand grip strength, phase angle, muscle imaging, and functional status and quality of life. From these recommendations, 37 statements were developed and scored in a two-survey Delphi method by 183 experts. A consensus was reached on accepting 26/37 statements. Surveys had high internal consistency and high inter-rater reliability. In conclusion, evidence-based recommendations were made on the prognostic value of morphofunctional assessment tools and tests to assess malnutrition, most of which were found to be feasible in routine clinical practice, according to expert opinions. Full article

(This article belongs to the Section Nutrition Methodology & Assessment)

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21 pages, 6629 KiB

Open AccessFeature PaperEditor’s ChoiceReview

The Alignment of Recommendations of Dietary Guidelines with Sustainability Aspects: Lessons Learned from Italy’s Example and Proposals for Future Development

by Laura Rossi, Marika Ferrari and Andrea Ghiselli

Nutrients 2023, 15(3), 542; https://doi.org/10.3390/nu15030542 - 20 Jan 2023

Cited by 10 | Viewed by 9957

Abstract

The main objective of this paper is to describe the process of the inclusion of sustainability in the Italian Dietary Guidelines (IDGs). In the IDGs’ sustainability chapter, particular emphasis was put on the selection of foods, recommending a plant-based diet with a large [...] Read more.

The main objective of this paper is to describe the process of the inclusion of sustainability in the Italian Dietary Guidelines (IDGs). In the IDGs’ sustainability chapter, particular emphasis was put on the selection of foods, recommending a plant-based diet with a large quota of vegetable proteins. Advice was also given on the selection of local seasonal products, with low growth input, such as fertilizers, artificial light and heating. Reduction of animal food was recommended, to be substituted with lower impact foods (poultry, milk, eggs and Mediterranean fish including aquaculture). Food waste was largely addressed. Recommendations were made for food purchase planning, food storage and the reuse of leftovers as strategies to reduce waste and save money. The IDGs sustainability recommendations were related to the 16 guiding principles of a sustainable healthy diet and their contribution to the achievement of the Sustainable Developing Goals was provided. The inclusion of sustainability in dietary guidelines requires a multidisciplinary approach to cover the wide range of aspects of a sustainable diet. In the IDGs, it was possible to show that practical recommendations for improving sustainability behavior can be passed on to consumers. Methodological aspects for developing recommendations are not definitive. Full article

(This article belongs to the Special Issue Sustainable Nutrition and Human Health as Part of Sustainable Development)

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22 pages, 1288 KiB

Open AccessEditor’s ChoiceReview

Effect of the Ketogenic Diet on the Prophylaxis and Treatment of Diabetes Mellitus: A Review of the Meta-Analyses and Clinical Trials

by Damian Dyńka, Katarzyna Kowalcze, Filip Ambrozkiewicz and Agnieszka Paziewska

Nutrients 2023, 15(3), 500; https://doi.org/10.3390/nu15030500 - 18 Jan 2023

Cited by 9 | Viewed by 8602

Abstract

The exponentially growing frequency of diagnosing diabetes mellitus means that a verification of the previous dietetic approach to treating the disease seems justified. The simultaneous growth of interest in the ketogenic diet and the development of knowledge in this field have contributed to [...] Read more.

The exponentially growing frequency of diagnosing diabetes mellitus means that a verification of the previous dietetic approach to treating the disease seems justified. The simultaneous growth of interest in the ketogenic diet and the development of knowledge in this field have contributed to the increasingly frequent application of the ketogenic diet in diabetes treatment. This paper also deals with that issue; its aim includes an extensive analysis of the influence of the ketogenic diet on the prophylaxis and treatment of diabetes. The paper has been prepared based on a wide, meticulous analysis of the available literature on the subject. Among other findings, a favorable effect of that nutrition model has been demonstrated on the values of glycated hemoglobin, glucose, insulin, or other metabolic parameters in diabetes patients. The effect of the ketogenic diet on the pharmacotherapy of type 1 and type 2 diabetes has been presented and compared with the standard nutritional management plan recommended for that disease. Further research is needed in this field, especially studies with a long follow-up period. The discussed articles report interesting therapeutic advantages to the ketogenic diet in comparison with standard diets. Full article

(This article belongs to the Special Issue Nutritional Support for Chronic Disease)

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23 pages, 4982 KiB

Open AccessFeature PaperEditor’s ChoiceReview

Bioactivity and Digestibility of Microalgae Tetraselmis sp. and Nannochloropsis sp. as Basis of Their Potential as Novel Functional Foods

by Samuel Paterson, Pilar Gómez-Cortés, Miguel Angel de la Fuente and Blanca Hernández-Ledesma

Nutrients 2023, 15(2), 477; https://doi.org/10.3390/nu15020477 - 16 Jan 2023

Cited by 17 | Viewed by 4934

Abstract

It is estimated that by 2050, the world’s population will exceed 10 billion people, which will lead to a deterioration in global food security. To avoid aggravating this problem, FAO and WHO have recommended dietary changes to reduce the intake of animal calories [...] Read more.

It is estimated that by 2050, the world’s population will exceed 10 billion people, which will lead to a deterioration in global food security. To avoid aggravating this problem, FAO and WHO have recommended dietary changes to reduce the intake of animal calories and increase the consumption of sustainable, nutrient-rich, and calorie-efficient products. Moreover, due to the worldwide rising incidence of non-communicable diseases and the demonstrated impact of diet on the risk of these disorders, the current established food pattern is focused on the consumption of foods that have functionality for health. Among promising sources of functional foods, microalgae are gaining worldwide attention because of their richness in high-value compounds with potential health benefits. However, despite the great opportunities to exploit microalgae in functional food industry, their use remains limited by challenges related to species diversity and variations in cultivation factors, changes in functional composition during extraction procedures, and limited evidence on the safety and bioavailability of microalgae bioactives. The aim of this review is to provide an updated and comprehensive discussion on the nutritional value, biological effects, and digestibility of two microalgae genera, Tetraselmis and Nannochloropsis, as basis of their potential as ingredients for the development of functional foods. Full article

(This article belongs to the Special Issue Role of Food Digestion and Digestive System in the Nutritional, Functional and Health Properties of Food Bioactives)

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16 pages, 1131 KiB

Open AccessEditor’s ChoiceReview

Plant-Based Meat Alternatives: Technological, Nutritional, Environmental, Market, and Social Challenges and Opportunities

by Giulia Andreani, Giovanni Sogari, Alessandra Marti, Federico Froldi, Hans Dagevos and Daniela Martini

Nutrients 2023, 15(2), 452; https://doi.org/10.3390/nu15020452 - 15 Jan 2023

Cited by 40 | Viewed by 20388

Abstract

There is a growing awareness that fostering the transition toward plant-based diets with reduced meat consumption levels is essential to alleviating the detrimental impacts of the food system on the planet and to improving human health and animal welfare. The reduction in average [...] Read more.

There is a growing awareness that fostering the transition toward plant-based diets with reduced meat consumption levels is essential to alleviating the detrimental impacts of the food system on the planet and to improving human health and animal welfare. The reduction in average meat intake may be reached via many possible ways, one possibility being the increased consumption of plant-based meat alternatives (PBMAs). For this reason, in recent years, hundreds of products have been launched on the market with sensory attributes (i.e., taste, texture, appearance, and smell) similar to their animal counterparts; however, these products have often a long list of ingredients and their nutritional values are very different from animal meat. The present review aims to highlight the main opportunities and challenges related to the production and consumption of PBMAs through an interdisciplinary approach. Aspects related to the production technology, nutritional profiles, potential impacts on health and the environment, and the current market and consumer acceptance of PBMAs are discussed. Focusing on the growing literature on this topic, this review will also highlight research gaps related to PBMAs that should be considered in the future, possibly through the collaboration of different stakeholders that can support the transition toward sustainable plant-based diets. Full article

(This article belongs to the Special Issue Beyond Meat: Alternative Sources of Proteins to Feed the World)

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33 pages, 2354 KiB

Open AccessEditor’s ChoiceReview

Neuroprotective Effects of Agri-Food By-Products Rich in Phenolic Compounds

by Alejandro Rojas-García, Álvaro Fernández-Ochoa, María de la Luz Cádiz-Gurrea, David Arráez-Román and Antonio Segura-Carretero

Nutrients 2023, 15(2), 449; https://doi.org/10.3390/nu15020449 - 14 Jan 2023

Cited by 9 | Viewed by 3660

Abstract

Neurodegenerative diseases are known for their wide range of harmful conditions related to progressive cell damage, nervous system connections and neuronal death. These pathologies promote the loss of essential motor and cognitive functions, such as mobility, learning and sensation. Neurodegeneration affects millions of [...] Read more.

Neurodegenerative diseases are known for their wide range of harmful conditions related to progressive cell damage, nervous system connections and neuronal death. These pathologies promote the loss of essential motor and cognitive functions, such as mobility, learning and sensation. Neurodegeneration affects millions of people worldwide, and no integral cure has been created yet. Here, bioactive compounds have been proven to exert numerous beneficial effects due to their remarkable bioactivity, so they could be considered as great options for the development of new neuroprotective strategies. Phenolic bioactives have been reported to be found in edible part of plants; however, over the last years, a large amount of research has focused on the phenolic richness that plant by-products possess, which sometimes even exceeds the content in the pulp. Thus, their possible application as an emergent neuroprotective technique could also be considered as an optimal strategy to revalorize these agricultural residues (those originated from plant processing). This review aims to summarize main triggers of neurodegeneration, revise the state of the art in plant extracts and their role in avoiding neurodegeneration and discuss how their main phenolic compounds could exert their neuroprotective effects. For this purpose, a diverse search of studies has been conducted, gathering a large number of papers where by-products were used as strong sources of phenolic compounds for their neuroprotective properties. Finally, although a lack of investigation is quite remarkable and greatly limits the use of these compounds, phenolics remain attractive for research into new multifactorial anti-neurodegenerative nutraceuticals. Full article

(This article belongs to the Special Issue Neuroprotection with Bioactive Compounds)

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15 pages, 771 KiB

Open AccessEditor’s ChoiceReview

Interlinkages between Climate Change and Food Systems: The Impact on Child Malnutrition—Narrative Review

by Carlo Agostoni, Mattia Baglioni, Adriano La Vecchia, Giulia Molari and Cristiana Berti

Nutrients 2023, 15(2), 416; https://doi.org/10.3390/nu15020416 - 13 Jan 2023

Cited by 14 | Viewed by 7445

Abstract

The pandemics of obesity, undernutrition, and climate change represent severe threats to child health. They co-occur; interact with each other to produce sequelae at biological, psychological, or social levels; and share common underlying drivers. In this paper, we review the key issues concerning [...] Read more.

The pandemics of obesity, undernutrition, and climate change represent severe threats to child health. They co-occur; interact with each other to produce sequelae at biological, psychological, or social levels; and share common underlying drivers. In this paper, we review the key issues concerning child diet and nutritional status, focusing on the interactions with climate and food systems. Inadequate infant and young child feeding practices, food insecurity, poverty, and limited access to health services are the leading causes of malnutrition across generations. Food system industrialization and globalization lead to a double burden of malnutrition, whereby undernutrition (i.e., stunting, wasting, and deficiencies in micronutrients) coexists with overweight and obesity, as well as to harmful effects on climate. Climate change and the COVID-19 pandemic are worsening child malnutrition, impacting the main underlying causes (i.e., household food security, dietary diversity, nutrient quality, and access to maternal and child health), as well as the social, economic, and political factors determining food security and nutrition (livelihoods, income, infrastructure resources, and political context). Existing interventions have the potential to be further scaled-up to concurrently address undernutrition, overnutrition, and climate change by cross-cutting education, agriculture, food systems, and social safety nets. Several stakeholders must work co-operatively to improve global sustainable nutrition. Full article

(This article belongs to the Special Issue Feeding Practice and Infant and Young Child Health)

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17 pages, 1177 KiB

Open AccessEditor’s ChoiceReview

Serum 25-Hydroxyvitamin D and Cancer Risk: A Systematic Review of Mendelian Randomization Studies

by Thomas Lawler and Shaneda Warren Andersen

Nutrients 2023, 15(2), 422; https://doi.org/10.3390/nu15020422 - 13 Jan 2023

Cited by 9 | Viewed by 8407

Abstract

Epidemiological studies suggest that higher serum 25-hydroxyvitamin D is associated with lower risk for several cancers, including breast, prostate, colorectal, and lung cancers. To mitigate confounding, genetic instrumental variables (IVs) have been used to estimate causal associations between 25-hydroxivtamin D and cancer risk [...] Read more.

Epidemiological studies suggest that higher serum 25-hydroxyvitamin D is associated with lower risk for several cancers, including breast, prostate, colorectal, and lung cancers. To mitigate confounding, genetic instrumental variables (IVs) have been used to estimate causal associations between 25-hydroxivtamin D and cancer risk via Mendelian randomization (MR). We provide a systematic review of 31 MR studies concerning 25-hydroxyvitamin D and cancer incidence and mortality identified from biomedical databases. MR analyses were conducted almost exclusively in European-ancestry populations and identified no statistically significant associations between higher genetically predicted 25-hydroxyvitamin D and lower risk for total cancer or colorectal, breast, prostate, lung, or pancreatic cancers. In recent studies including ≥80 genetic IVs for 25-hydroxyvitamin D, null associations were reported for total cancer (odds ratio [95% confidence interval] per 1-standard deviation increase: 0.98 [0.93–1.04]), breast (1.00 [0.98–1.02]), colorectal (0.97 [0.88–1.07]), prostate (0.99 [0.98–1.01]), and lung cancer (1.00 [0.93–1.03]). A protective association was observed for ovarian cancer in the Ovarian Cancer Association Consortium (0.78 [0.63–0.96] per 20 nmol/L increase, p-trend = 0.03), but not in the UK Biobank (1.10 [0.80–1.51]). Null associations were reported for other tumor sites (bladder, endometrium, uterus, esophagus, oral cavity and pharynx, kidney, liver, thyroid, or neural cells). An inconsistent protective association for cancer-specific mortality was also observed. Results from MR analyses do not support causal associations between 25-hydroxyvitamin D and risk for cancer incidence or mortality. Studies including non-White populations may be valuable to understand low 25-hydroxyvitamin D as a modifiable risk factor in populations with a higher risk of common cancers, including African ancestry individuals. Full article

(This article belongs to the Special Issue Role of Vitamin D in Chronic Diseases)

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13 pages, 986 KiB

Open AccessEditor’s ChoiceArticle

Nutritional Quality of Plant-Based Meat and Dairy Imitation Products and Comparison with Animal-Based Counterparts

by Alexandra Katidi, Konstantina Xypolitaki, Antonis Vlassopoulos and Maria Kapsokefalou

Nutrients 2023, 15(2), 401; https://doi.org/10.3390/nu15020401 - 12 Jan 2023

Cited by 20 | Viewed by 5386

Abstract

While consumers are increasingly adopting plant-based meat and dairy imitation products, the nutritional quality and adequacy of those foods to act as a substitute is still under discussion. The Greek Branded Food Composition Database (HelTH) was expanded to map currently available meat and [...] Read more.

While consumers are increasingly adopting plant-based meat and dairy imitation products, the nutritional quality and adequacy of those foods to act as a substitute is still under discussion. The Greek Branded Food Composition Database (HelTH) was expanded to map currently available meat and dairy imitations in Greece. Their main ingredient used, nutritional composition, and promotion as a healthy, nutritious food were described, and their overall nutritional quality using the Nutri-Score algorithm was evaluated. A total of n = 421 plant-based imitations were analyzed, made primarily of wheat or wheat mixes (83.5%) for meat imitations and grain (19.8%) or vegetable oil (17.1%) for dairy imitations. All meat imitations were high in protein and fiber, while, for dairy, only yogurts carried a protein content claim (80.9%). Imitation sausages, milk, and yogurt products had lower total fat and saturated fat content compared to their animal-based counterparts. All dairy imitations had lower protein content than animal-based dairy. The nutritional quality of imitation cheeses was graded as D–E, under the Nutri-Score system, compared to A–C for the animal-based cheese. Plant-based imitations have variable composition based on their main ingredient, and the substitution of specific food groups with plant-based alternatives may not support an equivalent or improved diet. Full article

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

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13 pages, 1424 KiB

Open AccessEditor’s ChoiceArticle

Assessing the Hepatic Safety of Epigallocatechin Gallate (EGCG) in Reproductive-Aged Women

by Hiba Siblini, Ayman Al-Hendy, James Segars, Frank González, Hugh S. Taylor, Bhuchitra Singh, Ainna Flaminia, Valerie A. Flores, Gregory M. Christman, Hao Huang, Jeremy J. Johnson and Heping Zhang

Nutrients 2023, 15(2), 320; https://doi.org/10.3390/nu15020320 - 09 Jan 2023

Cited by 12 | Viewed by 3331

Abstract

A similar abstract of the interim analysis was previously published in Fertility and Sterility. EPIGALLOCATECHIN GALLATE (EGCG) FOR TREATMENT OF UNEXPLAINED INFERTILITY ASSOCIATED WITH UTERINE FIBROIDS (PRE-FRIEND TRIAL): EARLY SAFETY ASSESSMENT. Uterine fibroids are the most common cause of unexplained infertility in reproductive-aged [...] Read more.

A similar abstract of the interim analysis was previously published in Fertility and Sterility. EPIGALLOCATECHIN GALLATE (EGCG) FOR TREATMENT OF UNEXPLAINED INFERTILITY ASSOCIATED WITH UTERINE FIBROIDS (PRE-FRIEND TRIAL): EARLY SAFETY ASSESSMENT. Uterine fibroids are the most common cause of unexplained infertility in reproductive-aged women. Epigallocatechin gallate (EGCG), a green tea catechin, has demonstrated its ability to shrink uterine fibroids in prior preclinical and clinical studies. Hence, we developed an NICHD Confirm-funded trial to evaluate the use of EGCG for treating women with fibroids and unexplained infertility (FRIEND trial). Prior to embarking on that trial, we here conducted the pre-FRIEND study (NCT 04177693) to evaluate the safety of EGCG in premenopausal women. Specifically, our aim was to assess any adverse effects of EGCG alone or in combination with an ovarian stimulator on serum liver function tests (LFTs) and folate level. In this randomized, open-label prospective cohort, participants were recruited from the FRIEND-collaborative clinical sites: Johns Hopkins University, University of Chicago, University of Illinois at Chicago, and Yale University. Thirty-nine women, ages ≥18 to ≤40 years, with/without uterine fibroids, were enrolled and randomized to one of three treatment arms: 800 mg of EGCG daily alone, 800 mg of EGCG daily with clomiphene citrate 100 mg for 5 days, or 800 mg of EGCG daily with Letrozole 5 mg for 5 days. No subject demonstrated signs of drug induced liver injury and no subject showed serum folate level outside the normal range. Hence, our data suggests that a daily dose of 800 mg of EGCG alone or in combination with clomiphene citrate or letrozole (for 5 days) is well-tolerated and is not associated with liver toxicity or folate deficiency in reproductive-aged women. Full article

(This article belongs to the Special Issue Nutraceuticals for Women’s Reproductive Health and Disorders)

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12 pages, 526 KiB

Open AccessEditor’s ChoiceArticle

Increased Intake of Omega-3 Polyunsaturated Fatty Acids Is Associated with Reduced Odds of Low Hand Grip Strength in Korean Adults

by Yoonjin Shin and Eugene Chang

Nutrients 2023, 15(2), 321; https://doi.org/10.3390/nu15020321 - 09 Jan 2023

Cited by 9 | Viewed by 2635

Abstract

Nutritional status is thought to be one of the modifiable risk factors for muscle health. This study investigates the association between dietary omega-3 polyunsaturated fatty acids (PUFA) intake and hand grip strength (HGS) in Korean adults. The cross-sectional analysis was performed on 18,278 [...] Read more.

Nutritional status is thought to be one of the modifiable risk factors for muscle health. This study investigates the association between dietary omega-3 polyunsaturated fatty acids (PUFA) intake and hand grip strength (HGS) in Korean adults. The cross-sectional analysis was performed on 18,278 participants aged ≥19 years enrolled in the Korea National Health and Nutrition Examination Survey from 2016–2019. Omega-3 PUFA consumption was positively linked to the dietary intake of nuts, fish, and shellfish in Korean adults. After adjusting for potential confounders, the results showed that increased omega-3 PUFA intake was associated with a decreased risk of low HGS (odds ratio (OR) for upper quartile (Q4) compared to Q1, men: OR = 1.42 (95% CI: 1.17–1.72), women: OR = 1.61 (1.37–1.89)). This inverse association was reported in people who did no resistance exercise or had an insufficient protein intake. In contrast, this association was not evident in adults who did resistance exercise or had sufficient protein intake. Furthermore, participants with hypertension or type 2 diabetes showed stronger associations between dietary omega-3 PUFA intake and HGS compared with other subgroups. These results suggest that dietary omega-3 PUFA intake positively related with HGS in Korean adults. Full article

(This article belongs to the Special Issue Potential Benefits of Dietary Fat in Chronic Diseases)

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12 pages, 618 KiB

Open AccessEditor’s ChoiceArticle

Oral Bioavailability and Metabolism of Hydroxytyrosol from Food Supplements

by Cecilia Bender, Sarah Strassmann and Christian Golz

Nutrients 2023, 15(2), 325; https://doi.org/10.3390/nu15020325 - 09 Jan 2023

Cited by 9 | Viewed by 2435

Abstract

Table olives and olive oils are the main dietary sources of hydroxytyrosol (HT), a natural antioxidant compound that has emerged as a potential aid in protection against cardiovascular risk. Bioavailability studies with olive oils showed that HT is bioavailable from its free form [...] Read more.

Table olives and olive oils are the main dietary sources of hydroxytyrosol (HT), a natural antioxidant compound that has emerged as a potential aid in protection against cardiovascular risk. Bioavailability studies with olive oils showed that HT is bioavailable from its free form and from conjugated forms such as oleuropein and its aglycone. Still, its low dietary intake, poor bioavailability, and high inter-individual variability after absorption through the gastrointestinal tract hamper its full benefits. In a randomized, controlled, blinded, cross-over study, we investigated the impact of HT metabolism and bioavailability by comparing two olive-derived watery supplements containing different doses of HT (30.58 and 61.48 mg of HT/dosage). Additionally, HT-fortified olive oil was used in the control group. To this aim, plasma and urine samples were evaluated in 12 healthy volunteers following the intake of a single dose of the supplements or fortified olive oil. Blood and urine samples were collected at baseline and at 0.5, 1, 1.5, 2, 4, and 12 h after intake. HT and its metabolites were analyzed using UHPLC-DAD-MS/MS. Pharmacokinetic results showed that dietary HT administered through the food supplements is bioavailable and bioavailability increases with the administered dose. After intake, homovanillic acid, HT-3-O-sulphate, and 3,4-dihydroxyphenylacetic acid are the main metabolites found both in plasma and urine. The maximum concentrations in plasma peaked 30 min after intake. As bioavailability of a compound is a fundamental prerequisite for its effect, these results promise a good potential of both food supplements for protection against oxidative stress and the consequent cardiovascular risk. Full article

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

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44 pages, 2374 KiB

Open AccessEditor’s ChoiceReview

Phytoestrogens and Health Effects

by Marie-Chantal Canivenc-Lavier and Catherine Bennetau-Pelissero

Nutrients 2023, 15(2), 317; https://doi.org/10.3390/nu15020317 - 09 Jan 2023

Cited by 16 | Viewed by 7883

Abstract

Phytoestrogens are literally estrogenic substances of plant origin. Although these substances are useful for plants in many aspects, their estrogenic properties are essentially relevant to their predators. As such, phytoestrogens can be considered to be substances potentially dedicated to plant–predator interaction. Therefore, it [...] Read more.

Phytoestrogens are literally estrogenic substances of plant origin. Although these substances are useful for plants in many aspects, their estrogenic properties are essentially relevant to their predators. As such, phytoestrogens can be considered to be substances potentially dedicated to plant–predator interaction. Therefore, it is not surprising to note that the word phytoestrogen comes from the early discovery of estrogenic effects in grazing animals and humans. Here, several compounds whose activities have been discovered at nutritional concentrations in animals and humans are examined. The substances analyzed belong to several chemical families, i.e., the flavanones, the coumestans, the resorcylic acid lactones, the isoflavones, and the enterolignans. Following their definition and the evocation of their role in plants, their metabolic transformations and bioavailabilities are discussed. A point is then made regarding their health effects, which can either be beneficial or adverse depending on the subject studied, the sex, the age, and the physiological status. Toxicological information is given based on official data. The effects are first presented in humans. Animal models are evoked when no data are available in humans. The effects are presented with a constant reference to doses and plausible exposure. Full article

(This article belongs to the Special Issue Dietary Phytoestrogens and Health)

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21 pages, 1328 KiB

Open AccessEditor’s ChoiceSystematic Review

Whole Dietary Patterns, Cognitive Decline and Cognitive Disorders: A Systematic Review of Prospective and Intervention Studies

by Rebecca F. Townsend, Danielle Logan, Roisin F. O’Neill, Federica Prinelli, Jayne V. Woodside and Claire T. McEvoy

Nutrients 2023, 15(2), 333; https://doi.org/10.3390/nu15020333 - 09 Jan 2023

Cited by 9 | Viewed by 3409

Abstract

Dementia prevalence is a global public health concern. Adherence towards a healthy dietary pattern (DP) may reduce the risk of cognitive decline and dementia. This narrative systematic review aimed to synthesise prospective and intervention study data to evaluate the impact of a-posteriori [...] Read more.

Dementia prevalence is a global public health concern. Adherence towards a healthy dietary pattern (DP) may reduce the risk of cognitive decline and dementia. This narrative systematic review aimed to synthesise prospective and intervention study data to evaluate the impact of a-posteriori and a-priori derived DPs on cognitive ageing, from cognitive decline to incident dementia. Ninety-three studies were included: 83 prospective studies and 10 randomised controlled trials (RCT). Most prospective studies (77%) examined a-priori DPs, with the Mediterranean diet examined most frequently. A total of 52% of prospective and 50% of RCTs reported a protective relationship between ‘healthy’ DPs and global cognitive decline. Overall, 59% of prospective studies reported positive associations between healthy DPs and risk of cognitive disorder. Incident cognitive disorder was examined by only one intervention study (subgroup analysis) which reported a beneficial effect of a low-fat diet on risk of probable dementia in women. Unhealthy DPs were examined less frequently (n = 17; 21%), with 41% of these studies reporting associations between adherence and poorer cognitive outcomes. Overall, there were mixed results for healthy and unhealthy DPs on cognition, likely due to between-study heterogeneity. Standardisation of diet exposure and cognitive outcome measurement would help to reduce this. Future research would benefit from investigating effects of culturally appropriate DPs on individual cognitive domains and incident cognitive disorders in diverse and high-risk populations. Full article

(This article belongs to the Special Issue Nutrition and Aging - Featured Perspectives on Health and Metabolism)

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25 pages, 1638 KiB

Open AccessEditor’s ChoiceReview

Role of Vitamin D Deficiency in the Pathogenesis of Cardiovascular and Cerebrovascular Diseases

by Éva Pál, Zoltán Ungvári, Zoltán Benyó and Szabolcs Várbíró

Nutrients 2023, 15(2), 334; https://doi.org/10.3390/nu15020334 - 09 Jan 2023

Cited by 28 | Viewed by 5804

Abstract

Deficiency in vitamin D (VitD), a lipid-soluble vitamin and steroid hormone, affects approximately 24% to 40% of the population of the Western world. In addition to its well-documented effects on the musculoskeletal system, VitD also contributes importantly to the promotion and preservation of [...] Read more.

Deficiency in vitamin D (VitD), a lipid-soluble vitamin and steroid hormone, affects approximately 24% to 40% of the population of the Western world. In addition to its well-documented effects on the musculoskeletal system, VitD also contributes importantly to the promotion and preservation of cardiovascular health via modulating the immune and inflammatory functions and regulating cell proliferation and migration, endothelial function, renin expression, and extracellular matrix homeostasis. This brief overview focuses on the cardiovascular and cerebrovascular effects of VitD and the cellular, molecular, and functional changes that occur in the circulatory system in VitD deficiency (VDD). It explores the links among VDD and adverse vascular remodeling, endothelial dysfunction, vascular inflammation, and increased risk for cardiovascular and cerebrovascular diseases. Improved understanding of the complex role of VDD in the pathogenesis of atherosclerotic cardiovascular diseases, stroke, and vascular cognitive impairment is crucial for all cardiologists, dietitians, and geriatricians, as VDD presents an easy target for intervention. Full article

(This article belongs to the Special Issue Dietary Interventions against Age-Related Vascular Pathologies)

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26 pages, 1458 KiB

Open AccessEditor’s ChoiceReview

Gut Microbial-Derived Short Chain Fatty Acids: Impact on Adipose Tissue Physiology

by Karolline S. May and Laura J. den Hartigh

Nutrients 2023, 15(2), 272; https://doi.org/10.3390/nu15020272 - 05 Jan 2023

Cited by 10 | Viewed by 3878

Abstract

Obesity is a global public health issue and major risk factor for pathological conditions, including type 2 diabetes, dyslipidemia, coronary artery disease, hepatic steatosis, and certain types of cancer. These metabolic complications result from a combination of genetics and environmental influences, thus contributing [...] Read more.

Obesity is a global public health issue and major risk factor for pathological conditions, including type 2 diabetes, dyslipidemia, coronary artery disease, hepatic steatosis, and certain types of cancer. These metabolic complications result from a combination of genetics and environmental influences, thus contributing to impact whole-body homeostasis. Mechanistic animal and human studies have indicated that an altered gut microbiota can mediate the development of obesity, leading to inflammation beyond the intestine. Moreover, prior research suggests an interaction between gut microbiota and peripheral organs such as adipose tissue via different signaling pathways; yet, to what degree and in exactly what ways this inter-organ crosstalk modulates obesity remains elusive. This review emphasizes the influence of circulating gut-derived short chain fatty acids (SCFAs) i.e., acetate, propionate, and butyrate, on adipose tissue metabolism in the scope of obesity, with an emphasis on adipocyte physiology in vitro and in vivo. Furthermore, we discuss some of the well-established mechanisms via which microbial SCFAs exert a role as a prominent host energy source, hence regulating overall energy balance and health. Collectively, exploring the mechanisms via which SCFAs impact adipose tissue metabolism appears to be a promising avenue to improve metabolic conditions related to obesity. Full article

(This article belongs to the Special Issue Modulation of Host Physiology and Pathophysiology by the Gut Microbiome)

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23 pages, 1097 KiB

Open AccessEditor’s ChoiceReview

Gut Microbiota and Time-Restricted Feeding/Eating: A Targeted Biomarker and Approach in Precision Nutrition

by Falak Zeb, Tareq Osaili, Reyad Shakir Obaid, Farah Naja, Hadia Radwan, Leila Cheikh Ismail, Hayder Hasan, Mona Hashim, Iftikhar Alam, Bismillah Sehar and MoezAllslam Ezzat Faris

Nutrients 2023, 15(2), 259; https://doi.org/10.3390/nu15020259 - 04 Jan 2023

Cited by 10 | Viewed by 5922

Abstract

Each individual has a unique gut microbiota; therefore, the genes in our microbiome outnumber the genes in our genome by about 150 to 1. Perturbation in host nutritional status influences gut microbiome composition and vice versa. The gut microbiome can help in producing [...] Read more.

Each individual has a unique gut microbiota; therefore, the genes in our microbiome outnumber the genes in our genome by about 150 to 1. Perturbation in host nutritional status influences gut microbiome composition and vice versa. The gut microbiome can help in producing vitamins, hormones, and other active metabolites that support the immune system; harvest energy from food; aid in digestion; protect against pathogens; improve gut transit and function; send signals to the brain and other organs; oscillate the circadian rhythm; and coordinate with the host metabolism through multiple cellular pathways. Gut microbiota can be influenced by host genetics, medications, diet, and lifestyle factors from preterm to aging. Aligning with precision nutrition, identifying a personalized microbiome mandates the provision of the right nutrients at the right time to the right patient. Thus, before prescribing a personalized treatment, it is crucial to monitor and count the gut flora as a focused biomarker. Many nutritional approaches that have been developed help in maintaining and restoring an optimal microbiome such as specific diet therapy, nutrition interventions, and customized eating patterns. One of these approaches is time-restricted feeding/eating (TRF/E), a type of intermittent fasting (IF) in which a subject abstains from food intake for a specific time window. Such a dietary modification might alter and restore the gut microbiome for proper alignment of cellular and molecular pathways throughout the lifespan. In this review, we have highlighted that the gut microbiota would be a targeted biomarker and TRF/E would be a targeted approach for restoring the gut-microbiome-associated molecular pathways such as hormonal signaling, the circadian system, metabolic regulators, neural responses, and immune-inflammatory pathways. Consequently, modulation of the gut microbiota through TRF/E could contribute to proper utilization and availability of the nutrients and in this way confer protection against diseases for harnessing personalized nutrition approaches to improve human health. Full article

(This article belongs to the Section Nutrition and Metabolism)

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12 pages, 670 KiB

Open AccessEditor’s ChoiceArticle

Waist Circumference Is an Essential Factor in Predicting Insulin Resistance and Early Detection of Metabolic Syndrome in Adults

by José Ignacio Ramírez-Manent, Andrés Martínez Jover, Caroline Silveira Martinez, Pilar Tomás-Gil, Pau Martí-Lliteras and Ángel Arturo López-González

Nutrients 2023, 15(2), 257; https://doi.org/10.3390/nu15020257 - 04 Jan 2023

Cited by 11 | Viewed by 2831

Abstract

Background: Metabolic syndrome (Met-S) is considered one of the most important health problems of the 21st century. It includes a group of metabolic disorders that increase the risk of cardiovascular diseases such as overweight and obesity, elevated lipid profile and blood pressure and [...] Read more.

Background: Metabolic syndrome (Met-S) is considered one of the most important health problems of the 21st century. It includes a group of metabolic disorders that increase the risk of cardiovascular diseases such as overweight and obesity, elevated lipid profile and blood pressure and insulin resistance (IR). Based on the information mentioned above in which there seems to be a relationship between IR and Met-S, the objective of this work was twofold: on the one hand, to assess the relationship between the values of different insulin resistance risk scales and Met-S determined with three different scales, and on the other, to determine whether any of the components of Met-S predispose more to the appearance of IR. Methods: A descriptive cross-sectional study of 418,343 workers. Waist circumference was measured and evaluated together with six formulas to assess the insulin resistance index. Categorical variables were evaluated by calculating the frequency and distribution of each one. For quantitative variables, mean and standard deviation were determined, and Student’s t-test was applied, while for qualitative variables, the chi-square test was performed. The usefulness of the different risk scales for insulin resistance for predicting metabolic syndrome was evaluated using ROC curves, the area under the curve (AUC), as well as their cut-off points for sensitivity, specificity, and the Youden index. Results: People with metabolic syndrome applying any criteria had higher values in the IR risk scales. The different IR scales made it possible to adequately classify people with metabolic syndrome. Of the three definitions of Met-S, the one that showed the greatest relationship with IR was IDF. Conclusions: Most risk scales for insulin resistance enable the presence of metabolic syndrome to be adequately classified, finding the best ones if the International Diabetes Federation (IDF) criteria are applied. Of the elements included in the Met-S, the one that seems to increase the risk of presenting IR the most is waist circumference; hence, the Met-S definition that is most related to IR is that of the IDF, which is the only one of the three in which a high value of waist circumference is necessary to be able to diagnose Met-S. Waist circumference can be considered the central essential component for detecting insulin resistance and, therefore, the early detection of metabolic syndrome. Full article

(This article belongs to the Topic Metabolism and Health)

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30 pages, 4143 KiB

Open AccessEditor’s ChoiceReview

Treatment of Dyslipidemia through Targeted Therapy of Gut Microbiota

by Brandon Flaig, Rachel Garza, Bhavdeep Singh, Sevag Hamamah and Mihai Covasa

Nutrients 2023, 15(1), 228; https://doi.org/10.3390/nu15010228 - 02 Jan 2023

Cited by 11 | Viewed by 4364

Abstract

Dyslipidemia is a multifaceted condition with various genetic and environmental factors contributing to its pathogenesis. Further, this condition represents an important risk factor for its related sequalae including cardiovascular diseases (CVD) such as coronary artery disease (CAD) and stroke. Emerging evidence has shown [...] Read more.

Dyslipidemia is a multifaceted condition with various genetic and environmental factors contributing to its pathogenesis. Further, this condition represents an important risk factor for its related sequalae including cardiovascular diseases (CVD) such as coronary artery disease (CAD) and stroke. Emerging evidence has shown that gut microbiota and their metabolites can worsen or protect against the development of dyslipidemia. Although there are currently numerous treatment modalities available including lifestyle modification and pharmacologic interventions, there has been promising research on dyslipidemia that involves the benefits of modulating gut microbiota in treating alterations in lipid metabolism. In this review, we examine the relationship between gut microbiota and dyslipidemia, the impact of gut microbiota metabolites on the development of dyslipidemia, and the current research on dietary interventions, prebiotics, probiotics, synbiotics and microbiota transplant as therapeutic modalities in prevention of cardiovascular disease. Overall, understanding the mechanisms by which gut microbiota and their metabolites affect dyslipidemia progression will help develop more precise therapeutic targets to optimize lipid metabolism. Full article

(This article belongs to the Special Issue Endocrinology and Metabolic Diseases in Human Health)

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16 pages, 804 KiB

Open AccessEditor’s ChoiceReview

Update on Anti-Inflammatory Molecular Mechanisms Induced by Oleic Acid

by Consuelo Santa-María, Soledad López-Enríquez, Sergio Montserrat-de la Paz, Isabel Geniz, María Edith Reyes-Quiroz, Manuela Moreno, Francisca Palomares, Francisco Sobrino and Gonzalo Alba

Nutrients 2023, 15(1), 224; https://doi.org/10.3390/nu15010224 - 01 Jan 2023

Cited by 24 | Viewed by 8865

Abstract

In 2010, the Mediterranean diet was recognized by UNESCO as an Intangible Cultural Heritage of Humanity. Olive oil is the most characteristic food of this diet due to its high nutraceutical value. The positive effects of olive oil have often been attributed to [...] Read more.

In 2010, the Mediterranean diet was recognized by UNESCO as an Intangible Cultural Heritage of Humanity. Olive oil is the most characteristic food of this diet due to its high nutraceutical value. The positive effects of olive oil have often been attributed to its minor components; however, its oleic acid (OA) content (70–80%) is responsible for its many health properties. OA is an effective biomolecule, although the mechanism by which OA mediates beneficial physiological effects is not fully understood. OA influences cell membrane fluidity, receptors, intracellular signaling pathways, and gene expression. OA may directly regulate both the synthesis and activities of antioxidant enzymes. The anti-inflammatory effect may be related to the inhibition of proinflammatory cytokines and the activation of anti-inflammatory ones. The best-characterized mechanism highlights OA as a natural activator of sirtuin 1 (SIRT1). Oleoylethanolamide (OEA), derived from OA, is an endogenous ligand of the peroxisome proliferator-activated receptor alpha (PPARα) nuclear receptor. OEA regulates dietary fat intake and energy homeostasis and has therefore been suggested to be a potential therapeutic agent for the treatment of obesity. OEA has anti-inflammatory and antioxidant effects. The beneficial effects of olive oil may be related to the actions of OEA. New evidence suggests that oleic acid may influence epigenetic mechanisms, opening a new avenue in the exploration of therapies based on these mechanisms. OA can exert beneficial anti-inflammatory effects by regulating microRNA expression. In this review, we examine the cellular reactions and intracellular processes triggered by OA in T cells, macrophages, and neutrophils in order to better understand the immune modulation exerted by OA. Full article

(This article belongs to the Special Issue The Role of Nutraceuticals in Immune Function)

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14 pages, 550 KiB

Open AccessEditor’s ChoiceReview

Saturated Fatty Acid Chain Length and Risk of Cardiovascular Disease: A Systematic Review

by Monica Perna and Susan Hewlings

Nutrients 2023, 15(1), 30; https://doi.org/10.3390/nu15010030 - 21 Dec 2022

Cited by 24 | Viewed by 7241

Abstract

The purpose of this systematic review was to evaluate the impact of saturated fatty acid chain lengths on the development of cardiovascular disease (CVD). The importance of replacement macronutrients is also discussed. PubMed, CINAHL, and Cochrane library were searched for relevant prospective cohort [...] Read more.

The purpose of this systematic review was to evaluate the impact of saturated fatty acid chain lengths on the development of cardiovascular disease (CVD). The importance of replacement macronutrients is also discussed. PubMed, CINAHL, and Cochrane library were searched for relevant prospective cohort studies that measured SFA chain length via diet analysis through October of 2020. A second updated PubMed search was conducted from October 2020 to 7 August 2022. Five prospective cohort studies were added. All studies used food frequency questionnaires to assess dietary intake. For all five added studies, the main sources of saturated fat were palmitic and steric acid from meat and cheese. Most studies discovered an association with increased risk of CVD and long-chain saturated fatty acid intake, as well as a neutral (potentially beneficial) association with short- and medium-chain saturated fatty acids. Isocaloric substitutions were associated with a higher risk for CVD when saturated fats were replaced with refined carbohydrates and protein from meat, but a reduced or neutral impact when relaced with plant-based protein, unsaturated fat, or complex carbohydrates. When examining the impact of diet on CVD risk, it is critical to consider the macronutrient replacing saturated fat as well as the saturated fat chain length, whole foods, and diet patterns on CVD risk. The studies included in this review suggest that LCSFA (C12–18) may increase the risk for CVD development, while SCFA and MCFA (C4–-C10) may be more beneficial or neutral. Full article

(This article belongs to the Section Lipids)

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48 pages, 1563 KiB

Open AccessEditor’s ChoiceReview

Short Chain Fatty Acid Metabolism in Relation to Gut Microbiota and Genetic Variability

by Guilherme Ramos Meyers, Hanen Samouda and Torsten Bohn

Nutrients 2022, 14(24), 5361; https://doi.org/10.3390/nu14245361 - 16 Dec 2022

Cited by 26 | Viewed by 5023

Abstract

It is widely accepted that the gut microbiota plays a significant role in modulating inflammatory and immune responses of their host. In recent years, the host-microbiota interface has gained relevance in understanding the development of many non-communicable chronic conditions, including cardiovascular disease, cancer, [...] Read more.

It is widely accepted that the gut microbiota plays a significant role in modulating inflammatory and immune responses of their host. In recent years, the host-microbiota interface has gained relevance in understanding the development of many non-communicable chronic conditions, including cardiovascular disease, cancer, autoimmunity and neurodegeneration. Importantly, dietary fibre (DF) and associated compounds digested by the microbiota and their resulting metabolites, especially short-chain fatty acids (SCFA), were significantly associated with health beneficial effects, such as via proposed anti-inflammatory mechanisms. However, SCFA metabolic pathways are not fully understood. Major steps include production of SCFA by microbiota, uptake in the colonic epithelium, first-pass effects at the liver, followed by biodistribution and metabolism at the host’s cellular level. As dietary patterns do not affect all individuals equally, the host genetic makeup may play a role in the metabolic fate of these metabolites, in addition to other factors that might influence the microbiota, such as age, birth through caesarean, medication intake, alcohol and tobacco consumption, pathogen exposure and physical activity. In this article, we review the metabolic pathways of DF, from intake to the intracellular metabolism of fibre-derived products, and identify possible sources of inter-individual variability related to genetic variation. Such variability may be indicative of the phenotypic flexibility in response to diet, and may be predictive of long-term adaptations to dietary factors, including maladaptation and tissue damage, which may develop into disease in individuals with specific predispositions, thus allowing for a better prediction of potential health effects following personalized intervention with DF. Full article

(This article belongs to the Special Issue Nutrigenetics, Nutrigenomics, and Precision Nutrition in Complex Diseases)

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42 pages, 996 KiB

Open AccessEditor’s ChoiceReview

Animal- and Plant-Based Protein Sources: A Scoping Review of Human Health Outcomes and Environmental Impact

by Luca Ferrari, Stefan-Alexandru Panaite, Antonella Bertazzo and Francesco Visioli

Nutrients 2022, 14(23), 5115; https://doi.org/10.3390/nu14235115 - 01 Dec 2022

Cited by 18 | Viewed by 13463

Abstract

Dietary proteins are indispensable to human nutrition. In addition to their tissue-building function, they affect body composition and regulate various metabolic pathways, as well as satiety and immune system activity. Protein use can be examined from a quantitative or qualitative viewpoint. In this [...] Read more.

Dietary proteins are indispensable to human nutrition. In addition to their tissue-building function, they affect body composition and regulate various metabolic pathways, as well as satiety and immune system activity. Protein use can be examined from a quantitative or qualitative viewpoint. In this scoping review, we compare animal- and plant-based protein sources in terms of their effects on human health and the environment. We conclude that the consumption of vegetable protein sources is associated with better health outcomes overall (namely, on the cardiovascular system) than animal-based product use. The healthier outcomes of vegetable protein sources dovetail with their lower environmental impact, which must be considered when designing an optimal diet. Indeed, the health of the planet cannot be disjointed from the health of the human being. Future research will clarify the mechanisms of action underlying the health effects of plant-based protein sources when compared with animal sources, fostering better agronomic practices and influencing public health in a direction that will benefit both the planet and its inhabitants. Full article

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

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20 pages, 825 KiB

Open AccessEditor’s ChoiceReview

Nongenomic Activities of Vitamin D

by Michał A. Żmijewski

Nutrients 2022, 14(23), 5104; https://doi.org/10.3390/nu14235104 - 01 Dec 2022

Cited by 25 | Viewed by 4714

Abstract

Vitamin D shows a variety of pleiotropic activities which cannot be fully explained by the stimulation of classic pathway- and vitamin D receptor (VDR)-dependent transcriptional modulation. Thus, existence of rapid and nongenomic responses to vitamin D was suggested. An active form of vitamin [...] Read more.

Vitamin D shows a variety of pleiotropic activities which cannot be fully explained by the stimulation of classic pathway- and vitamin D receptor (VDR)-dependent transcriptional modulation. Thus, existence of rapid and nongenomic responses to vitamin D was suggested. An active form of vitamin D (calcitriol, 1,25(OH)₂D₃) is an essential regulator of calcium–phosphate homeostasis, and this process is tightly regulated by VDR genomic activity. However, it seems that early in evolution, the production of secosteroids (vitamin-D-like steroids) and their subsequent photodegradation served as a protective mechanism against ultraviolet radiation and oxidative stress. Consequently, direct cell-protective activities of vitamin D were proven. Furthermore, calcitriol triggers rapid calcium influx through epithelia and its uptake by a variety of cells. Subsequently, protein disulfide-isomerase A3 (PDIA3) was described as a membrane vitamin D receptor responsible for rapid nongenomic responses. Vitamin D was also found to stimulate a release of secondary massagers and modulate several intracellular processes—including cell cycle, proliferation, or immune responses—through wingless (WNT), sonic hedgehog (SSH), STAT1-3, or NF-kappaB pathways. Megalin and its coreceptor, cubilin, facilitate the import of vitamin D complex with vitamin-D-binding protein (DBP), and its involvement in rapid membrane responses was suggested. Vitamin D also directly and indirectly influences mitochondrial function, including fusion–fission, energy production, mitochondrial membrane potential, activity of ion channels, and apoptosis. Although mechanisms of the nongenomic responses to vitamin D are still not fully understood, in this review, their impact on physiology, pathology, and potential clinical applications will be discussed. Full article

(This article belongs to the Special Issue A Commemorative Issue in Honor of Centennial of the Discovery of Vitamin D-The Central Role of Vitamin D in Physiology)

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26 pages, 1494 KiB

Open AccessEditor’s ChoiceReview

The Role of Ketogenic Diet in the Treatment of Neurological Diseases

by Damian Dyńka, Katarzyna Kowalcze and Agnieszka Paziewska

Nutrients 2022, 14(23), 5003; https://doi.org/10.3390/nu14235003 - 24 Nov 2022

Cited by 33 | Viewed by 16501

Abstract

Over a hundred years of study on the favourable effect of ketogenic diets in the treatment of epilepsy have contributed to a long-lasting discussion on its potential influence on other neurological diseases. A significant increase in the number of scientific studies in that [...] Read more.

Over a hundred years of study on the favourable effect of ketogenic diets in the treatment of epilepsy have contributed to a long-lasting discussion on its potential influence on other neurological diseases. A significant increase in the number of scientific studies in that field has been currently observed. The aim of this paper is a widespread, thorough analysis of the available scientific evidence in respect of the role of the ketogenic diet in the therapy of neurological diseases such as: epilepsy, Alzheimer’s disease (AD), Parkinson’s disease (PD), multiple sclerosis (MS) and migraine. A wide range of the mechanisms of action of the ketogenic diet has been demonstrated in neurological diseases, including, among other effects, its influence on the reduction in inflammatory conditions and the amount of reactive oxygen species (ROS), the restoration of the myelin sheath of the neurons, the formation and regeneration of mitochondria, neuronal metabolism, the provision of an alternative source of energy for neurons (ketone bodies), the reduction in glucose and insulin concentrations, the reduction in amyloid plaques, the induction of autophagy, the alleviation of microglia activation, the reduction in excessive neuronal activation, the modulation of intestinal microbiota, the expression of genes, dopamine production and the increase in glutamine conversion into GABA. The studies discussed (including randomised controlled studies), conducted in neurological patients, have stressed the effectiveness of the ketogenic diet in the treatment of epilepsy and have demonstrated its promising therapeutic potential in Alzheimer’s disease (AD), Parkinson’s disease (PD), multiple sclerosis (MS) and migraine. A frequent advantage of the diet was demonstrated over non-ketogenic diets (in the control groups) in the therapy of neurological diseases, with simultaneous safety and feasibility when conducting the nutritional model. Full article

(This article belongs to the Special Issue Nutritional Support for Chronic Disease)

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18 pages, 5845 KiB

Open AccessEditor’s ChoiceArticle

Once-Weekly Subcutaneous Semaglutide Improves Fatty Liver Disease in Patients with Type 2 Diabetes: A 52-Week Prospective Real-Life Study

by Sara Volpe, Giuseppe Lisco, Margherita Fanelli, Davide Racaniello, Valentina Colaianni, Domenico Triggiani, Rossella Donghia, Lucilla Crudele, Roberta Rinaldi, Carlo Sabbà, Vincenzo Triggiani, Giovanni De Pergola and Giuseppina Piazzolla

Nutrients 2022, 14(21), 4673; https://doi.org/10.3390/nu14214673 - 04 Nov 2022

Cited by 22 | Viewed by 4905

Abstract

Background. Nonalcoholic fatty liver disease (NAFLD) is commonly observed in patients with type 2 diabetes (T2D). Semaglutide, a glucagon-like peptide 1 receptor agonist, may have a therapeutic role by targeting common mechanisms involved in the pathophysiology of T2D and NAFLD. The study aimed [...] Read more.

Background. Nonalcoholic fatty liver disease (NAFLD) is commonly observed in patients with type 2 diabetes (T2D). Semaglutide, a glucagon-like peptide 1 receptor agonist, may have a therapeutic role by targeting common mechanisms involved in the pathophysiology of T2D and NAFLD. The study aimed to assess the effectiveness of Semaglutide on NAFLD in patients with T2D. Methods. Forty-eight patients were treated with subcutaneous Semaglutide in add-on to metformin for 52 weeks. After the baseline visit (T0), follow-up was scheduled quarterly (T3, and T6) and then at 12 months of therapy (T12). During each visit, body composition was analyzed by phase-sensitive bio-impedance, and NAFLD was diagnosed and staged by Ultrasound (US) imaging. Surrogate biomarkers of NAFLD were also calculated and followed over time. Results. A significant decrease in anthropometric and glucometabolic parameters, insulin resistance, liver enzymes, and laboratory indices of hepatic steatosis was observed during treatment. Similarly, fat mass and visceral adipose tissue (VAT) decreased over time more than skeletal muscle and free-fat mass. US-assessed VAT thickness and the 12-point steatosis score also declined at T3 up to T12. Liver steatosis improved in most patients (70%), showing a reduction by at least one class in the semiquantitative US staging. Conclusion. Besides glucose control and body composition improvements, Semaglutide was effective in ameliorating the clinical appearance and severity of NAFLD in T2D patients. Full article

(This article belongs to the Section Nutrition and Diabetes)

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20 pages, 1104 KiB

Open AccessEditor’s ChoiceReview

Diet in the Prevention of Alzheimer’s Disease: Current Knowledge and Future Research Requirements

by Oliwia Stefaniak, Małgorzata Dobrzyńska, Sławomira Drzymała-Czyż and Juliusz Przysławski

Nutrients 2022, 14(21), 4564; https://doi.org/10.3390/nu14214564 - 30 Oct 2022

Cited by 31 | Viewed by 9167

Abstract

Alzheimer’s disease is a progressive brain disease that is becoming a major health problem in today’s world due to the aging population. Despite it being widely known that diet has a significant impact on the prevention and progression of Alzheimer’s disease, the literature [...] Read more.

Alzheimer’s disease is a progressive brain disease that is becoming a major health problem in today’s world due to the aging population. Despite it being widely known that diet has a significant impact on the prevention and progression of Alzheimer’s disease, the literature data are still scarce and controversial. The application of the principles of rational nutrition for the elderly is suggested for Alzheimer’s disease. The diet should be rich in neuroprotective nutrients, i.e., antioxidants, B vitamins, and polyunsaturated fatty acids. Some studies suggest that diets such as the Mediterranean diet, the DASH (Dietary Approaches to Stop Hypertension) diet, and the MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diet have a beneficial effect on the risk of developing Alzheimer’s disease. Full article

(This article belongs to the Section Nutritional Epidemiology)

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20 pages, 987 KiB

Open AccessEditor’s ChoiceReview

Vitamin D and the Central Nervous System: Causative and Preventative Mechanisms in Brain Disorders

by Xiaoying Cui and Darryl W. Eyles

Nutrients 2022, 14(20), 4353; https://doi.org/10.3390/nu14204353 - 17 Oct 2022

Cited by 30 | Viewed by 3989

Abstract

Twenty of the last one hundred years of vitamin D research have involved investigations of the brain as a target organ for this hormone. Our group was one of the first to investigate brain outcomes resulting from primarily restricting dietary vitamin D during [...] Read more.

Twenty of the last one hundred years of vitamin D research have involved investigations of the brain as a target organ for this hormone. Our group was one of the first to investigate brain outcomes resulting from primarily restricting dietary vitamin D during brain development. With the advent of new molecular and neurochemical techniques in neuroscience, there has been increasing interest in the potential neuroprotective actions of vitamin D in response to a variety of adverse exposures and how this hormone could affect brain development and function. Rather than provide an exhaustive summary of this data and a listing of neurological or psychiatric conditions that vitamin D deficiency has been associated with, here, we provide an update on the actions of this vitamin in the brain and cellular processes vitamin D may be targeting in psychiatry and neurology. Full article

(This article belongs to the Special Issue A Commemorative Issue in Honor of Centennial of the Discovery of Vitamin D-The Central Role of Vitamin D in Physiology)

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10 pages, 475 KiB

Open AccessEditor’s ChoiceReview

Evolving Concepts on Inflammatory Biomarkers and Malnutrition in Chronic Kidney Disease

by Fredzzia Graterol Torres, María Molina, Jordi Soler-Majoral, Gregorio Romero-González, Néstor Rodríguez Chitiva, Maribel Troya-Saborido, Guillem Socias Rullan, Elena Burgos, Javier Paúl Martínez, Marina Urrutia Jou, Carles Cañameras, Josep Riera Sadurní, Anna Vila and Jordi Bover

Nutrients 2022, 14(20), 4297; https://doi.org/10.3390/nu14204297 - 14 Oct 2022

Cited by 30 | Viewed by 4166

Abstract

While patient care, kidney replacement therapy, and transplantation techniques for chronic kidney disease (CKD) have continued to progress, the incidence of malnutrition disorders in CKD appears to have remained unchanged over time. However, there is now a better understanding of the underlying pathophysiology [...] Read more.

While patient care, kidney replacement therapy, and transplantation techniques for chronic kidney disease (CKD) have continued to progress, the incidence of malnutrition disorders in CKD appears to have remained unchanged over time. However, there is now a better understanding of the underlying pathophysiology according to the disease background, disease stage, and the treatment received. In CKD patients, the increased production of proinflammatory cytokines and oxidative stress lead to a proinflammatory milieu that is at least partially responsible for the increased morbidity and mortality in this patient population. New insights into the pathogenic role of innate immunity and the proinflammatory cytokine profile, characterized, for instance, by higher levels of IL-6 and TNF-α, explain some of the clinical and laboratory abnormalities observed in these patients. In this article, we will explore currently available nutritional–inflammatory biomarkers in distinct CKD populations (hemodialysis, peritoneal dialysis, transplantation) with a view to evaluating their efficacy as predictors of malnutrition and their involvement in the common proinflammatory process. Although there is a direct relationship between inflammatory-nutritional status, signs and symptoms [e.g., protein-energy wasting (PEW), anorexia], and comorbidities (e.g., atheromatosis, atherosclerosis), we are in need of clearly standardized markers for nutritional-inflammatory assessment to improve their performance and design appropriate bidirectional interventions. Full article

(This article belongs to the Special Issue Relevant Nutritional, Biochemical and Molecular Disorders in CKD)

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14 pages, 279 KiB

Open AccessEditor’s ChoiceArticle

The Prevalence of Hyperuricemia and Its Correlates among Adults in China: Results from CNHS 2015–2017

by Wei Piao, Liyun Zhao, Yuxiang Yang, Hongyun Fang, Lahong Ju, Shuya Cai and Dongmei Yu

Nutrients 2022, 14(19), 4095; https://doi.org/10.3390/nu14194095 - 02 Oct 2022

Cited by 22 | Viewed by 2922

Abstract

This study aimed to investigate the prevalence of hyperuricemia (HUA) and associated risk factors in Chinese adults aged 18 to 59 years. All the data were collected from the China Nutrition and Health Surveillance during the period 2015–2017, which adopted a stratified, multistage, [...] Read more.

This study aimed to investigate the prevalence of hyperuricemia (HUA) and associated risk factors in Chinese adults aged 18 to 59 years. All the data were collected from the China Nutrition and Health Surveillance during the period 2015–2017, which adopted a stratified, multistage, random sampling method on a national scale. A total of 52,627 participants aged 18 years or older were included in this study. The definition of hyperuricemia was 420 μmol/L for male and 360 μmol/L for female. The Rao–Scott chi-square test was used to compare the differences in prevalence between or among the subgroups. A weighted two-level multivariate survey-logistic regression was used to detect the correlations between HUA and demographic, physical, lifestyle and metabolic factors. The total prevalence of HUA was 15.1%, and that was higher in male, current smokers, higher BMI and less physical activities subgroups, and also in noninfectious chronic diseases (NCDs) subgroups. The subgroups of non-vegetarian diet, insufficient vegetable intakes and excessive red meat and alcohol intakes had significantly higher HUA prevalence. After introducing all the variables in the survey-logistic regression, gender, age, BMI, physically active, hypertension, diabetes mellitus, bean and nut intake, vegetable intake, red meat intake, alcohol consumption and vegetarian were associated with HUA. Among the significant variables, age and physical active served as a protective factor, and BMI showed to be a risk factor for HUA. Hypertension and dyslipidemia could increase the risk for HUA, while diabetes mellitus was shown a negative association with it. For dietary factors, vegetarian diet, sufficient beans and nuts and vegetables intake could lower the risk of HUA, but more alcohol could increase the risk of HUA. Dietary factor played a key role in HUA. It suggested that the intervention of dietary factor should receive more attention to ameliorate the high prevalence of HUA in China. Full article

(This article belongs to the Special Issue Dietary Intake and Health throughout the Life Cycle)

21 pages, 745 KiB

Open AccessEditor’s ChoiceSystematic Review

What Are the Effects of Vitamin A Oral Supplementation in the Prevention and Management of Viral Infections? A Systematic Review of Randomized Clinical Trials

by Alessandra Sinopoli, Susanna Caminada, Claudia Isonne, Maria Mercedes Santoro and Valentina Baccolini

Nutrients 2022, 14(19), 4081; https://doi.org/10.3390/nu14194081 - 01 Oct 2022

Cited by 18 | Viewed by 3874

Abstract

Vitamin A (VA) deficiency is associated with increased host susceptibility to infections, but evidence on its role in the prevention and management of viral infections is still lacking. This review aimed at summarizing the effects of VA supplementation against viral infections to support [...] Read more.

Vitamin A (VA) deficiency is associated with increased host susceptibility to infections, but evidence on its role in the prevention and management of viral infections is still lacking. This review aimed at summarizing the effects of VA supplementation against viral infections to support clinicians in evaluating supplemental treatments. PubMed, Scopus, and Web of Science were searched. Randomized clinical trials comparing the direct effects of VA oral supplementation in any form vs. placebo or standard of care in the prevention and/or management of confirmed viral infections in people of any age were included. A narrative synthesis of the results was performed. The revised Cochrane Risk-Of-Bias tool was used to assess quality. Overall, 40 articles of heterogeneous quality were included. We found data on infections sustained by Retroviridae (n = 17), Caliciviradae (n = 2), Flaviviridae (n = 1), Papillomaviridae (n = 3), Pneumoviridae (n = 4), and Paramyxoviridae (n = 13). Studies were published between 1987 and 2017 and mostly conducted in Africa. The findings were heterogeneous across and within viral families regarding virological, immunological, and biological response, and no meaningful results were found in the prevention of viral infections. For a few diseases, VA-supplemented individuals had a better prognosis and improved outcomes, including clearance of HPV lesions or reduction in some measles-related complications. The effects of VA oral supplementation seem encouraging in relation to the management of a few viral infections. Difference in populations considered, variety in recruitment and treatment protocols might explain the heterogeneity of the results. Further investigations are needed to better identify the benefits of VA administration. Full article

(This article belongs to the Special Issue Vitamins and Human Health)

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19 pages, 1191 KiB

Open AccessEditor’s ChoiceArticle

Nutritional Composition and Estimated Iron and Zinc Bioavailability of Meat Substitutes Available on the Swedish Market

by Inger-Cecilia Mayer Labba, Hannah Steinhausen, Linnéa Almius, Knud Erik Bach Knudsen and Ann-Sofie Sandberg

Nutrients 2022, 14(19), 3903; https://doi.org/10.3390/nu14193903 - 21 Sep 2022

Cited by 23 | Viewed by 24564

Abstract

Transition towards plant-based diets is advocated to reduce the climate footprint. Health implications of a diet composed of meat substitutes are currently unknown, and there are knowledge gaps in their nutritional composition and quality. Samples of available meat substitutes were bought in two [...] Read more.

Transition towards plant-based diets is advocated to reduce the climate footprint. Health implications of a diet composed of meat substitutes are currently unknown, and there are knowledge gaps in their nutritional composition and quality. Samples of available meat substitutes were bought in two convenience stores in the city of Gothenburg, Sweden, and were included in the study. Meat substitutes (n = 44) were analyzed for their contents of dietary fiber, fat, iron, zinc, phytate, salt, total phenolics and protein, as well as for their amino acid and fatty acid composition. Bioavailability of iron and zinc was estimated based on the phytate:mineral molar ratio. We found large variations in the nutritional composition of the analyzed meat substitutes. Amino acid profiles seemed to be affected by processing methods. Mycoprotein products were rich in zinc, with a median content of 6.7 mg/100 g, and had very low content of phytate, which suggests mycoprotein as a good source of zinc. Degradability of fungal cell walls might, however, pose as a potential aggravating factor. None of the products could be regarded as a good source of iron due to very high content of phytate (9 to 1151 mg/100 g) and/or low content of iron (0.4 to 4.7 mg/100 g). Phytate:iron molar ratios in products with iron contents >2.1 mg/100 g ranged from 2.5 to 45. Tempeh stood out as a protein source with large potential due to low phytate content (24 mg/100 g) and an iron content (2 mg/100 g) close to the level of a nutrition claim. Producers of the products analyzed in this study appear to use nutritional claims regarding iron that appear not in line with European regulations, since the iron is in a form not available by the body. Meat substitutes analyzed in this study do not contribute to absorbed iron in a relevant manner. Individuals following mainly plant-based diets have to meet their iron needs through other sources. Salt and saturated fat were high in certain products, while other products were more in line with nutritional recommendations. Further investigation of the nutritional and health effects of protein extraction and extrusion is needed. We conclude that nutritional knowledge needs to be implemented in product development of meat substitutes. Full article

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

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16 pages, 1773 KiB

Open AccessEditor’s ChoiceArticle

Vitamin D Supplementation Does Not Influence SARS-CoV-2 Vaccine Efficacy or Immunogenicity: Sub-Studies Nested within the CORONAVIT Randomised Controlled Trial

by David A. Jolliffe, Giulia Vivaldi, Emma S. Chambers, Weigang Cai, Wenhao Li, Sian E. Faustini, Joseph M. Gibbons, Corinna Pade, Anna K. Coussens, Alex G. Richter, Áine McKnight and Adrian R. Martineau

Nutrients 2022, 14(18), 3821; https://doi.org/10.3390/nu14183821 - 16 Sep 2022

Cited by 20 | Viewed by 3198

Abstract

Vitamin D deficiency has been reported to associate with the impaired development of antigen-specific responses following vaccination. We aimed to determine whether vitamin D supplements might boost the immunogenicity and efficacy of SARS-CoV-2 vaccination by conducting three sub-studies nested within the CORONAVIT randomised [...] Read more.

Vitamin D deficiency has been reported to associate with the impaired development of antigen-specific responses following vaccination. We aimed to determine whether vitamin D supplements might boost the immunogenicity and efficacy of SARS-CoV-2 vaccination by conducting three sub-studies nested within the CORONAVIT randomised controlled trial, which investigated the effects of offering vitamin D supplements at a dose of 800 IU/day or 3200 IU/day vs. no offer on risk of acute respiratory infections in UK adults with circulating 25-hydroxyvitamin D concentrations <75 nmol/L. Sub-study 1 (n = 2808) investigated the effects of vitamin D supplementation on the risk of breakthrough SARS-CoV-2 infection following two doses of SARS-CoV-2 vaccine. Sub-study 2 (n = 1853) investigated the effects of vitamin D supplementation on titres of combined IgG, IgA and IgM (IgGAM) anti-Spike antibodies in eluates of dried blood spots collected after SARS-CoV-2 vaccination. Sub-study 3 (n = 100) investigated the effects of vitamin D supplementation on neutralising antibody and cellular responses in venous blood samples collected after SARS-CoV-2 vaccination. In total, 1945/2808 (69.3%) sub-study 1 participants received two doses of ChAdOx1 nCoV-19 (Oxford–AstraZeneca); the remainder received two doses of BNT162b2 (Pfizer). Mean follow-up 25(OH)D concentrations were significantly elevated in the 800 IU/day vs. no-offer group (82.5 vs. 53.6 nmol/L; mean difference 28.8 nmol/L, 95% CI 22.8–34.8) and in the 3200 IU/day vs. no offer group (105.4 vs. 53.6 nmol/L; mean difference 51.7 nmol/L, 45.1–58.4). Vitamin D supplementation did not influence the risk of breakthrough SARS-CoV-2 infection in vaccinated participants (800 IU/day vs. no offer: adjusted hazard ratio 1.28, 95% CI 0.89 to 1.84; 3200 IU/day vs. no offer: 1.17, 0.81 to 1.70). Neither did it influence IgGAM anti-Spike titres, neutralising antibody titres or IFN-γ concentrations in the supernatants of S peptide-stimulated whole blood. In conclusion, vitamin D replacement at a dose of 800 or 3200 IU/day effectively elevated 25(OH)D concentrations, but it did not influence the protective efficacy or immunogenicity of SARS-CoV-2 vaccination when given to adults who had a sub-optimal vitamin D status at baseline. Full article

(This article belongs to the Special Issue The Effect of Vitamin D on Respiratory Disease)

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35 pages, 1446 KiB

Open AccessEditor’s ChoiceReview

Metabolism and Bioavailability of Olive Bioactive Constituents Based on In Vitro, In Vivo and Human Studies

by Theodora Nikou, Maria Eleni Sakavitsi, Evangelos Kalampokis and Maria Halabalaki

Nutrients 2022, 14(18), 3773; https://doi.org/10.3390/nu14183773 - 13 Sep 2022

Cited by 21 | Viewed by 2860

Abstract

Consumption of olive products has been established as a health-promoting dietary pattern due to their high content in compounds with eminent pharmacological properties and well-described bioactivities. However, their metabolism has not yet been fully described. The present critical review aimed to gather all [...] Read more.

Consumption of olive products has been established as a health-promoting dietary pattern due to their high content in compounds with eminent pharmacological properties and well-described bioactivities. However, their metabolism has not yet been fully described. The present critical review aimed to gather all scientific data of the past two decades regarding the absorption and metabolism of the foremost olive compounds, specifically of the phenylalcohols hydroxytyrosol (HTyr) and tyrosol (Tyr) and the secoiridoids oleacein (Olea), oleocanthal (Oleo) and oleuropein (Oleu). A meticulous record of the in vitro assays and in vivo (animals and humans) studies of the characteristic olive compounds was cited, and a critical discussion on their bioavailability and metabolism was performed taking into account data from their gut microbial metabolism. The existing critical review summarizes the existing knowledge regarding the bioavailability and metabolism of olive-characteristic phenylalchohols and secoiridoids and spotlights the lack of data for specific chemical groups and compounds. Critical observations and conclusions were derived from correlating structure with bioavailability data, while results from in vitro, animal and human studies were compared and discussed, giving significant insight to the future design of research approaches for the total bioavailability and metabolism exploration thereof. Full article

(This article belongs to the Special Issue Featured Reviews on Phytochemicals and Human Health)

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17 pages, 1281 KiB

Open AccessEditor’s ChoiceArticle

Maternal Vitamin B₁₂ Deficiency Detected by Newborn Screening—Evaluation of Causes and Characteristics

by Anna T. Reischl-Hajiabadi, Sven F. Garbade, Patrik Feyh, Karl Heinz Weiss, Ulrike Mütze, Stefan Kölker, Georg F. Hoffmann and Gwendolyn Gramer

Nutrients 2022, 14(18), 3767; https://doi.org/10.3390/nu14183767 - 13 Sep 2022

Cited by 15 | Viewed by 3004

Abstract

Vitamin B₁₂ deficiency, mostly of maternal origin in newborns, is a well-treatable condition but can cause severe neurologic sequelae in infants. Early detection of vitamin B₁₂ deficiency allows the pre-symptomatic treatment of affected children. This evaluation assesses the characteristics of maternal [...] Read more.

Vitamin B₁₂ deficiency, mostly of maternal origin in newborns, is a well-treatable condition but can cause severe neurologic sequelae in infants. Early detection of vitamin B₁₂ deficiency allows the pre-symptomatic treatment of affected children. This evaluation assesses the characteristics of maternal vitamin B₁₂ deficiency detected by newborn screening. In a prospective single-center study, a systematic screening strategy for vitamin B₁₂ deficiency using a combination of two second-tier strategies was applied. In addition to confirmatory diagnostics in children, the systematic work-up of vitamin B₁₂ status was also performed for their mothers. Maternal characteristics were assessed including ethnic origin, diet, and vitamin supplementation during pregnancy. For affected mothers, a work-up by internal medicine was recommended. In total, 121 mother–infant couples were analyzed. 66% of mothers adhered to a balanced diet including meat. The cause of maternal vitamin B₁₂ deficiency was unknown in 56% of cases, followed by dietary causes in 32%, and organic causes in 8%. All mothers following a vegan diet and most mothers with a vegetarian diet took vitamin preparations during pregnancy, whereas only 55.8% of mothers with a balanced diet took folic acid or other vitamins. Maternal vitamin B₁₂, folic acid, and homocysteine levels were significantly correlated with the child’s folic acid levels, and with homocysteine, methylmalonic, and methylcitric acid levels in first and second NBS dried blood spots. Most children had normal blood counts and showed normocytosis. Although 36.7% of mothers showed anemia, only one presented with macrocytosis. Adherence to vitamin supplementation in pregnancy is low despite the recommendation for supplementation of folic acid. Ideally, the evaluation of mothers for vitamin B₁₂ levels and appropriate therapy should be initiated in early pregnancy. In infants detected through newborn screening, the multidisciplinary assessment and therapy of both children and mothers should be performed. Full article

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

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25 pages, 1250 KiB

Open AccessEditor’s ChoiceReview

Recent Advances in the Neuroprotective Properties of Ferulic Acid in Alzheimer’s Disease: A Narrative Review

by Silvia Di Giacomo, Ester Percaccio, Marco Gullì, Adele Romano, Annabella Vitalone, Gabriela Mazzanti, Silvana Gaetani and Antonella Di Sotto

Nutrients 2022, 14(18), 3709; https://doi.org/10.3390/nu14183709 - 08 Sep 2022

Cited by 19 | Viewed by 2839

Abstract

Alzheimer’s disease (AD) is a progressive degenerative disorder of the central nervous system, characterized by neuroinflammation, neurotransmitter deficits, and neurodegeneration, which finally leads to neuronal death. Emerging evidence highlighted that hyperglycemia and brain insulin resistance represent risk factors for AD development, thus suggesting [...] Read more.

Alzheimer’s disease (AD) is a progressive degenerative disorder of the central nervous system, characterized by neuroinflammation, neurotransmitter deficits, and neurodegeneration, which finally leads to neuronal death. Emerging evidence highlighted that hyperglycemia and brain insulin resistance represent risk factors for AD development, thus suggesting the existence of an additional AD form, associated with glucose metabolism impairment, named type 3 diabetes. Owing to the limited pharmacological options, novel strategies, especially dietary approaches based on the consumption of polyphenols, have been addressed to prevent or, at least, slow down AD progression. Among polyphenols, ferulic acid is a hydroxycinnamic acid derivative, widely distributed in nature, especially in cereal bran and fruits, and known to be endowed with many bioactivities, especially antioxidant, anti-inflammatory and antidiabetic, thus suggesting it could be exploited as a possible novel neuroprotective strategy. Considering the importance of ferulic acid as a bioactive molecule and its widespread distribution in foods and medicinal plants, the aim of the present narrative review is to provide an overview on the existing preclinical and clinical evidence about the neuroprotective properties and mechanisms of action of ferulic acid, also focusing on its ability to modulate glucose homeostasis, in order to support a further therapeutic interest for AD and type 3 diabetes. Full article

(This article belongs to the Special Issue Plant Polyphenols and Human Health: Novel Findings for Future Therapeutic Developments)

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11 pages, 674 KiB

Open AccessEditor’s ChoiceArticle

Exclusive Breastfeeding for at Least Four Months Is Associated with a Lower Prevalence of Overweight and Obesity in Mothers and Their Children after 2–5 Years from Delivery

by Maria Mantzorou, Dimitrios Papandreou, Georgios K. Vasios, Eleni Pavlidou, Georgios Antasouras, Evmorfia Psara, Zainab Taha, Efthymios Poulios and Constantinos Giaginis

Nutrients 2022, 14(17), 3599; https://doi.org/10.3390/nu14173599 - 31 Aug 2022

Cited by 28 | Viewed by 3566

Abstract

Introduction: Obesity is a current public health concern. Higher body weight is influenced by genetic and environmental parameters, and their interplay and is associated with a greater risk for several chronic diseases. Breastfeeding has been suggested as a preventive measure against obesity, which [...] Read more.

Introduction: Obesity is a current public health concern. Higher body weight is influenced by genetic and environmental parameters, and their interplay and is associated with a greater risk for several chronic diseases. Breastfeeding has been suggested as a preventive measure against obesity, which can further reduce long-term negative health outcomes for both women and children. Aim: The aim of the present study was to evaluate the role of breastfeeding on maternal and childhood overweight and obesity. Materials and Methods: This is a cross-sectional study conducted on 2515 healthy mothers and their children, aged 2–5 years, enrolled from nine different Greek rural and urban regions. Validated, standardized questionnaires were administrated that included anthropometric indices, socio-demographic characteristics of mothers and children, as well as breastfeeding practices. Results: Overall, 68% of participated women exclusively breastfed their children for at least 4 months. Mothers that exclusively breastfed showed a significantly lower prevalence of overweight and obesity after 2–5 years from delivery (p < 0.0001). Children that had exclusively been breastfed showed a significantly lower prevalence of overweight and obesity at the age of 2–5 years (p < 0.0001). Using multivariate regression analysis, exclusive breastfeeding for at least 4 months was associated with a two-fold lower risk for maternal and childhood overweight and obesity after 2–5 years from delivery, independent from maternal age, educational and economic status, and smoking habits (p < 0.0001). Conclusion: Exclusive breastfeeding for at least 4 months had a positive effect on childhood overweight and obesity, also contributing beneficially to post-natal maternal weight control. The beneficial effects of breastfeeding should be communicated to future and new mothers, while supportive actions for all mothers to initiate and continue breastfeeding their offspring should be implemented. Full article

(This article belongs to the Special Issue Feeding Practice and Infant and Young Child Health)

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11 pages, 287 KiB

Open AccessEditor’s ChoiceReview

Iodine and Iodine Deficiency: A Comprehensive Review of a Re-Emerging Issue

by Adrienne Hatch-McChesney and Harris R. Lieberman

Nutrients 2022, 14(17), 3474; https://doi.org/10.3390/nu14173474 - 24 Aug 2022

Cited by 51 | Viewed by 8626

Abstract

Iodine is a mineral nutrient essential for the regulation of a variety of key physiological functions including metabolism and brain development and function in children and adults. As such, iodine intake and status within populations is an area of concern and research focus. [...] Read more.

Iodine is a mineral nutrient essential for the regulation of a variety of key physiological functions including metabolism and brain development and function in children and adults. As such, iodine intake and status within populations is an area of concern and research focus. This paper will review recently published studies that focus on the re-emerging issue of iodine deficiency as a global concern and declining intake among populations in developed countries. Historically, the implementation of salt-iodization programs worldwide has reduced the incidence of iodine deficiency, but 30% of the world’s population is still at risk. Iodine nutrition is a growing issue within industrialized countries including the U.S. as a result of declining iodine intake, in part due to changing dietary patterns and food manufacturing practices. Few countries mandate universal salt iodization policies, and differing agriculture and industry practices and regulations among countries have resulted in inconsistencies in supplementation practices. In the U.S., in spite of salt-iodization policies, mild-to-moderate iodine deficiency is common and appears to be increasing. European countries with the highest incidence of deficiency lack iodization programs. Monitoring the iodine status of at-risk populations and, when appropriate, public health initiatives, appear to be warranted. Full article

(This article belongs to the Topic Metabolism and Health)

23 pages, 4295 KiB

Open AccessEditor’s ChoiceReview

The Dark Side of Iron: The Relationship between Iron, Inflammation and Gut Microbiota in Selected Diseases Associated with Iron Deficiency Anaemia—A Narrative Review

by Ida J. Malesza, Joanna Bartkowiak-Wieczorek, Jakub Winkler-Galicki, Aleksandra Nowicka, Dominika Dzięciołowska, Marta Błaszczyk, Paulina Gajniak, Karolina Słowińska, Leszek Niepolski, Jarosław Walkowiak and Edyta Mądry

Nutrients 2022, 14(17), 3478; https://doi.org/10.3390/nu14173478 - 24 Aug 2022

Cited by 22 | Viewed by 11120

Abstract

Iron is an indispensable nutrient for life. A lack of it leads to iron deficiency anaemia (IDA), which currently affects about 1.2 billion people worldwide. The primary means of IDA treatment is oral or parenteral iron supplementation. This can be burdened with numerous [...] Read more.

Iron is an indispensable nutrient for life. A lack of it leads to iron deficiency anaemia (IDA), which currently affects about 1.2 billion people worldwide. The primary means of IDA treatment is oral or parenteral iron supplementation. This can be burdened with numerous side effects such as oxidative stress, systemic and local-intestinal inflammation, dysbiosis, carcinogenic processes and gastrointestinal adverse events. Therefore, this review aimed to provide insight into the physiological mechanisms of iron management and investigate the state of knowledge of the relationship between iron supplementation, inflammatory status and changes in gut microbiota milieu in diseases typically complicated with IDA and considered as having an inflammatory background such as in inflammatory bowel disease, colorectal cancer or obesity. Understanding the precise mechanisms critical to iron metabolism and the awareness of serious adverse effects associated with iron supplementation may lead to the provision of better IDA treatment. Well-planned research, specific to each patient category and disease, is needed to find measures and methods to optimise iron treatment and reduce adverse effects. Full article

(This article belongs to the Special Issue Physiology and Pathophysiology of Iron Metabolism)

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