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The United Nations Organization (UNO) has proposed achieving specific Sustainable Development Goals (SDGs), including poverty, hunger, health, education, equality, climate change, and the need for sustainable development, while protecting the planet Earth from environmental degradation. The expert group of the International College of Nutrition aims to emphasize the merits of sustainable diets and traditional plant based foods for the primordial prevention of cardio-metabolic Diseases (CMDs) and other chronic diseases in this review, to achieve these goals. A narrative review was conducted to identify articles related to cardiovascular diseases (CVDs), obesity, diabetes, and cancer, using databases from the World Health Organization (WHO), Google Scholar, MEDLINE (PubMed), Web of Science, and EBSCO, along with additional secondary sources and a search of grey literature. Opinions of experts were also sought, and views of all authors were obtained as outlined in this document. It seems that education, in particular health education and motivation, apart from cultural factors, are crucial for achieving total health, and the SDGs of the UNO. The prevalence of unhealthy behaviours and risk factors for most of the CMDs and other chronic diseases is rapidly increasing in low- and middle-income countries, due to the ongoing economic development, leading to rapid changes in diet and lifestyle. There is some decline in cardiovascular disease (CVD) mortality in high-income countries due to education and learning of preventive strategies, resulting in a reduction in mortality due to these diseases. However, CMDs and cancer remain the significant causes of morbidity and mortality. During and after World War II, food scarcity persisted from 1940 to 1965 in most countries, accompanied by a low risk of cardiovascular disease (CVD) and diabetes. The rapid increase in industrialization and urbanization has been linked to environmental degradation on planet Earth, a decline in fertile, healthy soil, and sustainable, functional farming practices, resulting in a decrease in the production of nutritious foods. These alterations in food availability are associated with an increased production of unhealthy, energy rich foods and Western-type dietary patterns, which in turn increased the risk of non-communicable diseases (NCDs). The health of the planet and its people is at risk. There is a deterioration in the global standard of natural systems that support life on Earth, which is exacerbating energy, food, and water insecurity, and increasing the risk of disease, disaster, displacement, and conflict. Recent advice about the safe corridor on the planet can enhance research on planetary boundaries and Earth-system aspects of the SDGs. It appears that poverty, lack of education, and inadequate health education and motivation, possibly due to ineffective policies by national and local governments, are significant determinants of the increased risk of these diseases. In urban areas of lower and middle-income countries, as well as in immigrant populations in high-income countries, CMDs and other chronic diseases are significantly higher than they are in some of the high-income populations. Improvements in soil and the promotion of functional farming, along with an emphasis on the food industry, are urgently needed to support plant-based, low-animal food traditional food diets. Traditional foods are feasible and affordable in every country. The use of high-protein substitutes for animal-derived foods, such as soybean products such as tofu and tempe, millets, beans, lentils, peas (400 g/day), green vegetables, fruits, and nuts (400 g/day), as well as vegetable oils, low-fat dairy products, and culinary spices, with low meat (sea-foods) may be beneficial in promoting health and preventing NCDs. Health education and promotion of healthier lifestyles and behaviours during the preconception period, in utero life, and the postnatal development and infancy stages may lead to healthy eating patterns, contributing to primordial prevention of NCDs. A wild-type omega-6/3 diet rich in flavonoids, folate, and other nutrients, along with other interventions may mitigate epigenetic risk variations at the individual level across all subgroups, from the preconception period to the elderly stages. These findings may necessitate revisions to the existing guidelines proposed for sustainable functional farming and sustainable plant based diets. Eating 400 g/day of vegetable, fruits, and nuts and another 400 g/day of whole grains, with spices (20-50 g/day) and meat as condiment (50 g/day), along with 30-50 g/day of vegetable oils, can prevent CMDs and other chronic diseases, and promote health to serve the SDGs of the UNO. Cohort studies and randomized trial in each country may be necessary to confirm the role of our advice in the prevention of diseases.
The 2023 iteration of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) estimated prevalence, incidence, and health burden for 375 diseases and injuries, including 12 mental disorders. We assess past, current, and emerging trends in the prevalence and burden of mental disorders across sexes and age groups, for 21 regions, 204 countries and territories, and by Socio-demographic Index (SDI) quintile, from 1990 to 2023. Mental disorders included in GBD 2023 were anxiety disorders, major depressive disorder, dysthymia, bipolar disorder, schizophrenia, autism spectrum disorders, conduct disorder, attention-deficit hyperactivity disorder, anorexia nervosa, bulimia nervosa, idiopathic developmental intellectual disability, and a residual category of other mental disorders. A literature review identified epidemiological data for each disorder. These were analysed via a Bayesian meta-regression to estimate prevalence by disorder, sex, age, location, and year. Disorder-specific prevalence was multiplied by disability weights representing the severity of health loss associated with each disorder to estimate years lived with disability (YLDs). Deaths due to anorexia nervosa were assessed with a Cause of Death Ensemble modelling strategy to estimate deaths by sex, age, location, and year, and then multiplied by the standard life expectancy at age of death to estimate years of life lost (YLLs). YLDs equalled disability-adjusted life-years (DALYs) for all mental disorders except anorexia nervosa (the only mental disorder considered as an underlying cause of death in GBD), for which DALYs represented the sum of YLDs and YLLs. We presented prevalence, deaths, YLDs, YLLs, and DALYs as counts, age-specific rates per 100 000 population, and age-standardised rates per 100 000 population. We estimated 1·17 billion (95% uncertainty interval 1·06-1·31) prevalent cases of mental disorders globally in 2023, equivalent to an age-standardised prevalence rate of 14 210·7 cases (12 849·5-15 940·1) per 100 000 population. These estimates represented a 95·5% (75·0-121·2) increase in prevalent cases and 24·2% (11·4-41·4) increase in age-standardised prevalence rate between 1990 and 2023. All mental disorders showed increases in prevalent cases between 1990 and 2023, while notable increases were seen in age-standardised prevalence rates for anxiety disorders, major depressive disorder, dysthymia, anorexia nervosa, bulimia nervosa, schizophrenia, and conduct disorder. There were an estimated 171 million (127-228) DALYs due to mental disorders globally across sex and age in 2023, equivalent to an age-standardised DALY rate of 2070·5 DALYs (1519·1-2750·5) per 100 000 population. Mental disorders contributed to 6·1% (4·8-7·6) of all-cause DALYs in 2023, making them the fifth leading cause of global DALYs (up from 12th in 1990). DALYs were almost entirely composed of YLDs. Mental disorders were the leading cause of YLDs in 2023 (up from second in 1990), explaining 17·3% (14·8-20·6) of all-cause global YLDs. Leading causes of mental disorder DALYs were anxiety disorders (ranked 11th among the 304 diseases and injuries at Level 4 of the GBD cause hierarchy), major depressive disorder (15th), and schizophrenia (41st). Globally in 2023, mental disorder age-standardised DALY rates were higher among females (2239·6 [1643·7-3014·1] per 100 000) than among males (1900·2 [1399·8-2510·8] per 100 000), and peaked in the 15-19 years age group (2617·3 [1850·6-3696·8] per 100 000). All locations showed increased mental disorder DALY rates in 2023 compared with 1990, ranging across countries and territories from 1302·4 (952·7-1683·7) per 100 000 in Viet Nam to 3555·8 (2661·9-4715·0) per 100 000 in the Netherlands. Across SDI quintiles, DALY rates ranged from 1853·0 (1352·1-2469·3) per 100 000 for middle SDI to 2184·1 (1606·1-2890·3) per 100 000 for high SDI. A significant health burden was imposed by mental disorders in all countries and territories in 2023, irrespective of the health resources available. In some instances, this burden has increased over time and is unevenly distributed across populations. Stronger surveillance systems, particularly in low-income and middle-income countries, are required. Additionally, we need more coordinated and inclusive policies to reduce the burden through early treatment and prevention, tailored to sex and age differences across locations. Responding to the mental health needs of our global population, especially those most vulnerable, is an obligation, not a choice. Gates Foundation, Queensland Health, and University of Queensland.
Background/Objectives: South Korea has experienced a rapid transition from widespread food insecurity and undernutrition to a comprehensive and institutionalized nutrition policy system. This study aimed to examine the historical evolution of Korean nutrition policy and nutrition education from the 1960s to the present and to explore its implications for global nutrition governance and nutrition-related Official Development Assistance (ODA). Methods: A narrative review was conducted using historical documents, government reports, nutrition policies, national health plans, legislation, and previous academic studies related to Korean nutrition policy and nutrition education. Results: Korean nutrition policy evolved through several developmental phases, including an aid-dependent relief period, a state-led food security and school feeding expansion phase, a preventive health and nutrition education phase, and a stage of legal and institutional consolidation. More recently, policies have shifted toward evidence-based, equity-oriented, and life-course approaches. Korea has also expanded its nutrition policy experience through ODA initiatives by supporting institutional development, workforce training, community-based nutrition education, and adaptable nutrition management systems in developing countries. Conclusions: Korea's experience demonstrates how long-term governmental commitment, legislation, surveillance systems, and nutrition education can contribute to national nutrition improvement during rapid socioeconomic transition. These findings may provide useful insights for countries facing the double burden of malnutrition and seeking sustainable and adaptive nutrition policy systems.
Sustained policy-driven changes to the availability and promotion of healthier food and drinks in foodservice outlets are essential to support population health over time. Limited research has explored whether why and how healthy food retail practices become easier or more challenging to maintain over time. This study aimed to explore food retailer (managers, staff, and volunteers) and implementation support practitioner (e.g. dietitians and health promotion practitioners) experiences with and perspectives on the (i) feasibility of, (ii) key determinants of, and (iii) strategies for sustaining healthy food retail practices in a range of Australian public settings (e.g. healthcare facilities). Semi-structured interviews were conducted with 17 participants (nine practitioners and eight retailers) representing food outlets with experience sustaining healthy food retail practices in sport and recreation centres, schools, and healthcare facilities across six Australian jurisdictions. Interviews were thematically analyzed, using primarily a deductive approach informed by the Integrated Sustainability Framework, sustainment-explicit Expert Recommendations for Implementing Change glossary, and marketing mix theory. Key determinants of sustainment (Theme 1) were related to 'intervention-context fit and outlet capacity'; 'people and processes driving sustainment'; and 'top-down leadership and systemic support'. Multiple interconnected strategies to support sustainment (Theme 2) were identified, including 'iterative, evaluative, and adaptive strategies to support fit and fidelity'; 'engagement and behaviour-focused strategies to build capacity and demand'; and 'embedding healthy food retail within organizational governance and policy systems'. Sustaining healthy food retail practices in public settings is a dynamic process, requiring consistent alignment between inner and outer context, support systems, and engagement with key actors.
Ultra-processed foods (UPFs) have increasingly displaced traditional diets globally and have become a significant public health concern, particularly in relation to cardiovascular (CV) diseases. UPFs are defined as food products primarily composed of cheap industrial ingredients, additives, and neo-formed compounds, often with little to no nutritional value. These foods are highly processed and contain additives that can have harmful effects on health. While traditional dietary guidelines have long emphasized the importance of limiting animal-derived fats and promoting the intake of fruits, vegetables, and unsaturated fats, recent evidence suggests that the extent and nature of food processing are also key factors in the relationship between diet and health. Studies over the past decade have highlighted that the consumption of UPFs is associated with increased CV risk, often independent of the overall diet quality. Despite growing evidence linking UPF consumption to major CV risk factors (e.g. hypertension, dyslipidaemia, obesity) and adverse CV outcomes, the role of food processing in CV health remains underrecognized in cardiology. Current dietary counselling in clinical practice tends to overlook the potential adverse impact of UPFs, with patients not receiving comprehensive nutritional guidance. This European Society of Cardiology (ESC) clinical consensus statement, developed by a multidisciplinary group of European experts, is conceived to increase awareness among clinicians about the CV risks associated with UPFs. Starting from a comprehensive review of current evidence, it provides practical, actionable advice to help the general cardiologists incorporate UPF-related assessment and counselling into their routine care. The statement also proposes a stepwise framework focused on CV prevention, including tools designed to enhance patient communication and engagement. Moreover, it discusses these clinical advices within wider strategic and policy frameworks, therefore supporting a more integrated, food-centred approach to improve CV health.
Camel milk is increasingly recognized as a premium functional food, attributed to its rich nutraceutical compounds. Recent research has concentrated on the nanoscale extracellular vesicles derived from camel milk (CM-EVs), which exhibit distinctive properties. This review examines the methodologies for isolating and characterizing CM-EVs, alongside their potential health benefits in functional foods and nutraceuticals. CM-EVs have the capacity to safeguard functional proteins, noncoding RNAs, and bioactive lipids from degradation within the gastrointestinal tract, rendering them particularly suitable for incorporation into infant formulas, adult dietary supplements, and nutraceuticals targeting chronic inflammatory and metabolic disorders. Preclinical models indicate that CM-EVs can mitigate oxidative stress, enhance intestinal barrier integrity, and modulate gut microbiota, thereby contributing to the reduction in colonic injury and inflammation. Nonetheless, the majority of these findings are derived from laboratory and animal studies, highlighting a substantial deficiency in human clinical trials. Critical research gaps remain, necessitating further investigation into the elucidation of molecular mechanisms, assessment of long-term safety, evaluation of bioavailability, and compatibility with dairy processing techniques. This review underscores the significance of CM-EVs as bioactive food components and delineates research priorities, such as standardizing isolation methods, investigating food matrix integration, and providing translational evidence for their application in nutrition and preventive medicine.
This article presents the results of the modified Delphi study conducted by the GLIM Risk of Malnutrition Working Group to develop a consensus-based conceptual definition of "risk of malnutrition", as first step in revising the GLIM screening procedure. Focus groups with nutritional care experts and patient/older adult representatives, and a literature exploration informed 46 statements on risk of malnutrition. Malnutrition experts (n = 112) evaluated these statements, using a five-point Likert scale. Statements with ≥75% agreement were accepted; those with ≥75% disagreement and/or neutrality were rejected. Remaining statements were marked "undecided" and re-evaluated in later rounds. In three questionnaire rounds (response rates 63%, 59%, and 54%), 26 statements were ultimately accepted to shape the conceptual definition of "risk of malnutrition". The GLIM Working Group and patient/older adult representatives reviewed the pre-final professional and layperson versions. Risk of malnutrition was defined as: A dynamic state, with or without unintentional weight loss, in which an individual has one or more risk factors, that is, nutrition impact symptoms, and/or disease-related, physical, psychological, social, demographic, and economic risk factors, that may result in malnutrition and may negatively impact clinical outcomes. In the layperson version, sentences were simplified to aid comprehension. GLIM has developed the first global (professional and layperson) conceptual definition of risk of malnutrition. This definition will guide future nutritional screening recommendations and a more preventive malnutrition approach. It also implies that screening tools covering "risk of malnutrition" should no longer be validated against signs or the diagnosis of malnutrition.
Prostate cancer (PCa) is among the most frequently diagnosed malignancies in aging men and remains a major public health concern, highlighting the need for effective and safe preventive strategies. Annona crassiflora Mart. seed extract (ASE) was evaluated using the transgenic adenocarcinoma of the mouse prostate (TRAMP) model. Animals were divided into control and ASE-treated groups evaluated from 8-12 to 12-16 weeks of age. Control groups received the vehicle (water containing 10% DMSO), whereas ASE-treated groups received 100 mg/kg body weight of ASE. The preservation of hepatic histoarchitecture and normal body weight gain demonstrated that ASE was well tolerated and did not show hepatotoxic effects. ASE treatment increased the frequency of healthy prostatic epithelium in early prostate lesions (predominantly low-grade prostatic intraepithelial neoplasia (LGPIN)) and late prostate lesions (high-grade prostatic intraepithelial neoplasia (HGPIN) and well-differentiated adenocarcinoma (WDAC)) of PCa. Furthermore, ASE reduced HGPIN incidence in the ASE 12-16 group, showing a lower incidence of WDAC. In addition, ASE reduced androgen receptor (AR) protein levels as well as cytoplasmic and nuclear AR localization in late prostate lesions (HGPIN and WDAC) of PCa. ASE also induced apoptosis through multiple pathways, including upregulation of BID, BAD, and BAX, activation of caspase-8, caspase-9, and caspase-3, and downregulation of BCL-2, BCL-xL, and MCL-1. Thus, ASE promotes a pro-apoptotic environment unfavorable to tumor survival. Taken together, these results reinforce the potential of ASE to modulate prostatic homeostasis, indicating a promising strategy with chemopreventive effects and potential as an adjuvant therapy against PCa.
The COVID-19 pandemic and accompanying social distancing measures might have caused adverse health consequences. We aimed to describe changes in participants' self-rated health and mental health (depression, anxiety, and stress), and investigate factors associated with them. We collected data from the German National Cohort (NAKO). We first described changes in participants' self-rated health and mental health from the baseline examination (1 to 6 years earlier) to the early phase of the COVID-19 pandemic. We then applied the multinomial logistic regression model (self-rated health) and the quantile regression model (mental health) to investigate the potential factors associated with the health status and changes. After a median of 3.1 [2.1, 4.1] years from baseline to the early pandemic phase (N = 91,809), 39.3% of participants with good health and 69.7% with less good health status at baseline reported better health. However, the percentage of participants with high depression, anxiety, and stress scores (≥ 10) increased from 6.2%, 4.1%, and 4.3% to 8.6%, 5.6%, and 10.1%, respectively. In the multivariable models, we found that being younger, being male, highly educated, being employed, having higher life satisfaction at baseline, being more physically active, drinking heavily, and experiencing improved anxiety symptoms were associated with improved self-rated health. In contrast, smoking and having mental health disorders were all associated with worse self-rated health. Our results showed that being younger, being female, smoking, drinking heavily, and drinking more since baseline were associated with higher depression scores. Having had a coronavirus test was associated with worse self-rated health and more severe anxiety and stress. During the early COVID-19 pandemic, many participants experienced improvements in self-rated health but suffered deterioration in mental health and physical activity engagement. Female participants, those who were physically inactive, and those with pre-existing mental disorders were more likely to report poorer health.
Precision nutrition informed by genetic profiling has been proposed to improve public health outcomes; however, long-term, community-based evidence remains limited. This study evaluated the long-term health and economic impacts of the Sakado Folate Project. Since 2006, residents participating in the Sakado Folate Project received gene-guided nutritional counseling focused on folate intake and related lifestyle factors. Target genes included methylenetetrahydrofolate reductase (MTHFR), angiotensinogen (AGT), adrenoreceptor B3 (ADRB3), and uncoupling protein 1 (UCP1); Δ5-fatty acid desaturase (FADS1) was incorporated later. Biochemical markers, genetic polymorphisms, and health indicators were monitored longitudinally. Population-level health outcomes and per-capita medical expenditure data were compared with regional and national statistics. In program participants (n = 888), folate status and biochemical indicators improved: 76.1% achieved the serum folate target (≥9.5 ng/mL) and 55.3% achieved the serum total homocysteine target (≤7 μmol/L). Healthier lifestyle behaviors were observed across 99,565 Sakado residents, with the city recording the highest proportion of individuals actively attempting lifestyle improvement (31%) of all districts in the region. Disease prevalence was lower in Sakado City than in Saitama Prefecture overall, at standardized prevalence ratios of 52% for stroke and 86% for cerebral infarction. Per-capita medical expenditure was also lower in Sakado City (¥337,800) than the national average (¥392,044) in 2021. Long-term implementation of a community-based, gene-guided nutritional intervention may improve population health outcomes and reduce healthcare expenditures. Integrating nutrigenomics into public health strategies alongside community education and food environment improvements may contribute to sustainable healthcare systems in aging societies.
Background/Objectives: Nutrition literacy (NL) is an important determinant of healthy dietary behaviors, particularly among population groups at increased cardiovascular risk. This study aimed to describe NL and adherence to the Mediterranean diet (MD), and to describe their association, among women aged 45-70 years living in socioeconomically disadvantaged neighborhoods in Florence (Italy). Methods: A cross-sectional study was conducted within the Joint Action on Cardiovascular Diseases and Diabetes (JACARDI). This study represents the second step of Phase 1 of the Optimising Health Literacy and Access (Ophelia) process. Women were recruited in a primary health care setting using a convenience sample. NL was assessed using the Italian-adapted version of the Nutrition Literacy Assessment Instrument (NLit-IT) and the adherence to the MD using MEDI-LITE. Results: Questionnaires filled in by 143 women were included in the analysis. Most participants (63.6%) had "possibility of poor NL". Regarding the MD, 60.8% showed moderate and 9.1% low adherence. A positive correlation was observed between total NLit-IT and MEDI-LITE scores (rho = 0.214; p = 0.011). In logistic regression analysis, an increase in the NLit-IT total score was associated with a higher possibility of having a moderate/high adherence to the MD (OR 1.157). Only the subscale "Food Label and Numeracy" of NLit-IT emerged as an independent predictor of moderate/high adherence to the MD (OR 1.416). Conclusions: These preliminary findings suggest a possible association between NL and adherence to the MD. Further longitudinal and interventional studies are needed to confirm these results and inform tailored nutrition education interventions.
Non-communicable diseases are a growing public health challenge, shaped not only by biological predispositions but also by geo-demographic, socioeconomic, psychological, and lifestyle factors. A comprehensive understanding of these determinants is essential for developing targeted public health strategies. This study aimed to examine the multifactorial determinants of individual health status by analyzing geo-demographic, socio-economic, behavioral, psychological, and lifestyle variables. Data were collected from 4,010 participants (age: 37.2 ± 15.4 years; 59.5% female) across 10 Mediterranean and neighboring countries using the multinational MEDIET4ALL e-survey. Health status was categorized as healthy, at-risk, or with diseases. Multinomial logistic regression, Quade's Rank ANCOVA and series of multiple regression models were conducted. Collectively, around 25% of respondents declared to be at-risk of or with known disease. BMI emerged as the strongest negative predictor of health status (β = -0.145), with both obesity and underweight significantly increasing the odds of being at risk (OR = 1.8 and 5.2, respectively) and having diseases (OR = 2.2 and 11.9, respectively). Other significant negative predictors included psychological distress (notably anxiety, β = -0.091), insomnia (β = -0.084), alcohol consumption (β = -0.053), and prolonged sitting time (β = -0.037). Conversely, life satisfaction was the strongest significant protective factor (β = 0.066), followed by higher education, better sleep quality, and adherence to the Mediterranean Diet and lifestyle (β = 0.034 to 0.050). Socio-economic disparities, including employment status (β = -0.045) and living environment (β = -0.031), also significantly influenced health outcomes with rural environment and employed individual showing lower odd ratios of being at-risk and/or having diseases (p < 0.001). Furthermore, individuals residing in Mediterranean regions, females, married or cohabiting individuals, and non-smokers exhibited significantly lower odds of being at-risk or having diseases (p < 0.05). While gender remained a significant predictor in the final refined comprehensive regression model (β = -0.049), marital status lost significance, suggesting that its protective effect may be mediated by psychological well-being and health-related behaviors. These findings highlight the complex interplay of lifestyle, mental health, and socio-environmental factors in determining health outcomes, while emphasizing the urgent need for multi-level public health interventions, including policies promoting physical activity, healthy eating, mental well-being, and equitable healthcare access. Future research should employ longitudinal designs to establish causal relationships and guides preventive strategies.
Nutritional deficiencies affecting the immune and haematopoietic systems represent a well-known global public health challenge: only the iron deficiency anaemia affects 1.62 billion individuals, especially in vulnerable populations. However, the protective effect that nutrition might give on disorders of these systems is still poorly understood. This umbrella review aims to synthesise the available evidence on the effectiveness of nutritional interventions in the primary prevention of blood and immune disorders, with a focus on the role of essential micronutrients and bioactive compounds. The protocol for this review was registered on PROSPERO (registration number 535785). A systematic search was conducted on PubMed, Web of Science, Embase and Cochrane until April 2024, using MeSH terms and keywords related to nutritional interventions, preventive effects and immune and haematopoietic system disorders. The search strategy followed the PRISMA guidelines for umbrella reviews. Two independent review teams performed the screening and data extraction, while a third reviewer resolved any disputes. Methodological quality was assessed using the JBI Critical Appraisal Checklist, risk of bias was analysed using the tools ROBINS-E for non-experimental studies, ROBIS for systematic reviews and RoB 2 for RCTs. The quality of evidence was assessed according to the GRADE approach. Of the 1028 articles identified, 13 met the inclusion criteria after systematic screening. Considering specific infection rates, vitamin D supplementation showed a significant protective effect (OR 0.88, 95% CI 0.81-0.96), with particular efficacy in deficient subjects (< 25 nmol/L). Zinc showed significant preventive efficacy (RR 0.68, 95% CI 0.58-0.80), especially in nasal formulations. Multiple micronutrient interventions demonstrated synergistic effects in reducing iron deficiency (RR 0.44, 95% CI 0.32-0.60) and vitamin A deficiency (RR 0.42, 95% CI 0.28-0.62). The methodological quality of the included studies was high, with JBI scores ranging from 9.5 to 11/11, indicating a solid evidence base. The evidence supports the effectiveness of nutritional interventions in boosting the immune system, with particular relevance for vitamin D and zinc supplementation. The multiple micronutrient approach emerges as a promising strategy, especially in more-at-risk populations. Both individualised approaches and public health interventions are recommended. Future research should focus on optimising nutrient combinations and identifying predictive biomarkers of response for the primary prevention of blood and immune disorders.
The consumption of beverages has rapidly increased in Korea in recent years. However, such data on sugar-sweetened beverages (SSBs), which are one of the major dietary risks for cardiometabolic diseases, are very limited. This study evaluated SSBs consumption by sex and age group as well as SSBs types among Koreans. We included 17,084 participants (≥3 years) from the 2020－2022 Korea National Health and Nutrition Examination Surveys. Based on 24 h dietary recall data, SSBs were assessed as daily consumption (g/d and servings/d) and categorized as soft drinks, fruit drinks and juices, sweetened coffees, and other sweetened beverages. These analyses were also conducted separately with only SSBs consumers (n=8,404). The mean daily consumption of SSBs in the total study population was 96.5 g/d [standard error (SE)=2.4; mean intake=0.9 servings/d]. Among SSBs consumers, the mean consumption was 192.7 g/d (SE=4.2; mean intake=1.7 servings/d). Adolescents and young adults consumed more SSBs compared to other age groups. SSBs consumption differed by age group and beverage type, with fruit drinks and juices being most popular among children; soft drinks and other sweetened beverages among adolescents and young adults, and sweetened coffee among adults. Energy intake from SSBs was 74.2 and 75.9 kcal/d in adolescents and young adults, respectively; ∼20% of total daily sugar and ∼4% of total daily energy intake was from SSBs. This study found that the types and amounts of SSBs consumed vary by age group, with adolescents and young adults showing particularly higher consumption, highlighting the need for age-specific intervention strategies.
Food insecurity remains a major public health challenge in Guamote Canton, Ecuador, particularly in areas characterized by high levels of poverty and limited educational attainment. This study examined the association between household income, educational level, and food insecurity in Guamote Canton. A cross-sectional survey based on the Latin American and Caribbean Food Security Scale (ELCSA) was administered to 368 households, allowing food insecurity to be classified into four categories: food security, mild insecurity, moderate insecurity, and severe insecurity. An Ordinal Logistic model was applied to identify the socioeconomic factors associated with food insecurity. The results showed that household income and educational level were significantly associated with lower probabilities of food insecurity (β = -0.639, p = 0.001; β = -0.366, p = 0.008, respectively). Gender, Area of residence, and Access to nutrition information were also significantly associated with food insecurity. Households located in rural areas and those headed by women were more likely to experience moderate or severe food insecurity. Overall, the findings highlight the importance of improving income opportunities, educational attainment, and structural living conditions, which may contribute to lower levels of food insecurity.
This randomized, double-blind, placebo-controlled clinical trial evaluated the efficacy and safety of fermented oyster extract (FGO) as a functional food ingredient for promoting growth in children with idiopathic short stature (ISS). In total, 80 children aged 6－9 years with height below the 25th percentile for age and gender per the Korean National Growth Charts, 2017, were included. They were randomly assigned to receive either 500 mg/d FGO or a matched placebo for 24 weeks. The primary outcome was a change in height while standing; secondary outcomes included growth rate, height standard deviation score (height-SDS), bone age (BA), and levels of growth-related hormones and bone metabolism markers. In the intention-to-treat analysis, mean height gain at 24 weeks was 3.22±0.71 and 2.38±0.74 cm in the FGO and placebo groups (P<0.001). Growth rate, height-SDS, BA, serum insulin-like growth factor-1, and urinary deoxypyridinoline increased significantly in the FGO group compared with the placebo group (P<0.05). In contrast, growth hormone and insulin-like growth factor-binding protein-3 levels did not vary between groups. No serious adverse events or clinically meaningful laboratory abnormalities were observed; however, two events of mild rash, possibly related to FGO, led to one drop-out. These findings suggest that standardized FGO may safely augment linear growth and bone metabolism in children with ISS. This product could be developed as a marine-derived functional food for pediatric growth support, although more long-term and multicenter studies are warranted to confirm the generalizability of these effects and FGO durability.
The transition to university is a critical life stage characterized by increased autonomy, identity exploration, and new social and environmental influences. During this period, university students often exhibit low adherence to dietary guidelines. Among the determinants influencing healthy eating, cooking self-efficacy, the central construct of Social Cognitive Theory (SCT), is consistently associated with improved diet quality and is a frequent target of health interventions. However, no validated instrument exists to assess this construct among university students in Spain. Therefore, the goal was to develop and provide preliminary evidence of the Spanish Cooking Self-Efficacy Questionnaire (SCSEQ), a concise SCT-based instrument tailored to Mediterranean university settings. A 32-item questionnaire was developed through a review of existing instruments assessing cooking self-efficacy. Face validity was evaluated with Spanish food and nutrition experts (n = 12) to assess the clarity and pertinence of the initial items. The revised Spanish Cooking Self-Efficacy Questionnaire (SCSEQ) was then pilot-tested with Spanish university students (n = 73) from four Catalan universities. Exploratory factor analysis (EFA) was conducted to identify the underlying factor structure and detect problematic items. Internal consistency reliability was assessed using McDonald's ω, and test-retest reliability over a two-week interval was evaluated using Pearson correlations. Face validity indicated overall clarity and adequacy. Four items were excluded and recombined, two items were added, and nine items were rewritten based on experts' feedback. After pilot testing, the questionnaire overall demonstrated high internal consistency (ω = 0.9). Items were reviewed based on factor loadings, item redundancy, theoretical relevance, and their contribution to scale-level internal consistency. EFA suggested a two-factor structure with good internal consistency (ω = 0.88 and ω = 0.82) and test-retest reliability (ICC = 0.91, 95% CI [0.80, 0.96]). Three items with weak loadings were excluded. The final version consisted of 25 items and 2 subscales. The SCSEQ showed favorable preliminary psychometric properties.
Blood cancers, including leukemia, lymphoma, and myeloma, are complex malignancies influenced by genetic, environmental, and epigenetic factors. Among these, epigenetic modifications play a crucial role in cancer initiation and progression. This review explores the interplay between dietary patterns, epigenetic mechanisms, and blood cancer development, highlighting the potential of diet-based interventions in cancer prevention and therapy. A growing body of evidence suggests that dietary habits significantly impact epigenetic modifications such as DNA methylation and histone modifications, which regulate gene expression. Phytochemicals, including curcumin, resveratrol, quercetin, and epigallocatechin gallate (EGCG), exhibit promising epigenetic modulation in blood cancer. These compounds influence DNA methyltransferases (DNMTs) and histone deacetylases (HDACs), restoring normal epigenetic patterns and reactivating silenced tumor suppressor genes (TSGs). Individual variability in dietary response, bioavailability of bioactive compounds, and the complexity of epigenetic interactions necessitate further research in nutri-epigenomics. Future directions should focus on personalized nutrition strategies and clinical trials to validate the efficacy of dietary approaches in blood cancer prevention and therapy. In conclusion, diet plays a pivotal role in epigenetic regulation, influencing the risk and progression of blood cancer. Understanding the molecular mechanisms underlying dietary epigenetic modifications may open new avenues for preventive and therapeutic strategies.
The stamens of Crocus sativus L., often discarded as floral waste, are rich in flavonoids and phenolics. This study investigated their toxicological safety, antigenotoxic potential, and molecular mechanisms of protection against cyclophosphamide (CP)-induced genotoxicity. Hydroethanolic and hydromethanolic extracts were prepared, and acute oral toxicity was assessed in mice following the Organization for Economic Co-operation and Development guideline 423. Genotoxicity and its amelioration were evaluated in rat and mouse leukocytes by employing the alkaline comet assay. Oxidative stress markers, including superoxide dismutase activity, as well as malondialdehyde and glutathione levels, in hepatic and renal tissues were quantified. In parallel, nine major metabolites were identified in the extracts and were molecularly docked with key enzymes involved in CP bioactivation (CYP2B6), aldehyde detoxification (ALDH1A1), DNA repair (OGG1), and oxidative stress regulation (Keap1-Kelch domain; Protein Data Bank ID: 7K2A). The extracts were non-toxic up to 4,000 mg/kg and did not exhibit any genotoxicity. Pre-treatment with extracts (200 mg/kg body weight) significantly attenuated CP-induced DNA damage and restored antioxidant enzyme levels. Docking results supported these observations: rutin demonstrated a high affinity for CYP2B6 (-11.2 kcal/mol) and favorable binding to 7K2A (-9.7 kcal/mol); catechin gallate bound tightly to ALDH1A1 (-10.0 kcal/mol) and OGG1 (-9.2 kcal/mol). These findings suggest reduced CP activation, but enhanced detoxification and DNA repair. In conclusion, the extracts of C. sativus stamens are safe and possess robust antioxidant and antigenotoxic properties, confirmed by molecular docking. These findings highlight their potential as natural protective agents against chemotherapy-induced genotoxicity.
To investigate socio-economic disparities in the association between dietary diversity and type 2 diabetes (T2D). Prospective secondary analysis study of 10,363 incident cases of T2D over 12 years and a random sub-cohort of 13,937 individuals in the EPIC-InterAct case-cohort study. We used baseline self-reported diet data (1991-1998) to construct scores for diversity between food groups (range: 0-5) and diversity within subtypes of vegetables (0-4), and plant protein sources (0-5). Prentice-weighted Cox regressions estimated multivariable-adjusted hazard ratios (HR) and 95% confidence intervals of incident T2D for each diversity score stratified by education, employment, and marital status. Overall group differences were evident for education in the association between plant-protein diversity and incident T2D (p for group effect = 0.04). University-educated participants consuming three plant-protein subtypes had 35% lower T2D incidence (HR 0.65 [95% CI: 0.45, 0.95]). Greater vegetable diversity (3-4 subtypes vs 0-1) was associated with 61%, 22% and 18% lower T2D incidence for, respectively, those who were single, had primary education or were employed. Total diet diversity (5 food groups versus ≤ 3) was associated with 43%, 30%, 20% and 15% lower T2D incidence for, respectively, those who were single, employed, had primary education or were married. Education modified the association between plant-protein diversity and T2D onset in European adults, and certain socioeconomic groups specifically benefited from higher diversity reducing T2D risk. Promoting diet diversity overall may support T2D prevention across populations, while tailored messages of plant-protein diversity may improve relevance and equity in nutrition and diabetes.