Frontiers in Nutrition最新文献

Background: With the acceleration of global population aging, psychological health issues among elderly hospitalized patients have become increasingly prominent. Death anxiety, as a key psychological experience of existential threat, is associated with psychological adaptation challenges in older adults and may be related to health behavior intentions. Nutrition awareness is a critical factor in promoting rehabilitation and healthy aging; however, the associations between death anxiety and nutrition awareness, as well as potential psychological pathways, remain understudied.

Objective: This study aims to examine the associations among death anxiety, future time perspective, and nutrition awareness, while identifying group heterogeneity through latent profile analysis.

Methods: This study employed a cross-sectional design, recruiting elderly hospitalized patients (N = 557) from three tertiary Grade-A hospitals in Hangzhou and Chongqing, China. Measurements were conducted using the Death Anxiety Scale, Future Time Perspective Scale, and Nutrition Awareness Scale. Data analyses included descriptive statistics, correlation analysis, structural equation modeling, and latent profile analysis.

Results: Death anxiety was significantly and positively associated with both future time perspective and nutrition awareness. Future time perspective demonstrated a significant indirect effect in the relationship between death anxiety and nutrition awareness, suggesting a partial mediation pattern. Latent profile analysis identified three distinct subgroups: "low death anxiety-low future time perspective," "moderate death anxiety-moderate future time perspective," and "high death anxiety-high future time perspective," with the latter group demonstrating the highest levels of nutrition awareness.

Conclusion: Under the moderating influence of future time perspective, death anxiety can be transformed into a positive psychological driver for health-promoting behaviors. Enhancing future orientation and sense of life meaning in elderly patients can convert anxious emotions into motivation for health management, providing a scientific basis for individualized psychological-nutritional interventions.

Objective: To construct and validate a risk prediction model for refeeding syndrome (RFS) in patients with severe acute pancreatitis (SAP), identify high-risk individuals before overt electrolyte abnormalities occur, and provide decision support for the timing of enteral nutrition initiation and early personalized intervention.

Methods: A retrospective cohort study was conducted on SAP patients admitted to Xuzhou Medical University Affiliated Hospital (XYFY) between September 2018 and September 2025. Patients were divided into RFS and Non-RFS groups based on the development of RFS after initiating enteral nutrition. Clinical data differences between groups were compared, least absolute shrinkage and selection operator (LASSO) regression was used for feature selection, and six machine learning (ML) algorithms were applied to build prediction models. Model performance was evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curves. SHapley Additive exPlanations (SHAP) analysis was performed to interpret the contribution of key features.

Results: Seven predictive features were identified for model construction. The gradient boosting machine (GBM) model exhibited good generalization ability, with area under the curve (AUC) values of 0.851 (95% CI: 0.809-0.894) in the training set and 0.762 (95% CI: 0.672-0.852) in the testing set. Calibration curves confirmed consistency between predicted probabilities and actual outcomes, while decision curves demonstrated favorable net benefits across different clinical decision thresholds. SHAP analysis ranked feature importance as follows: serum potassium (K), serum sodium (Na), serum calcium (Ca), gastrointestinal decompression, blood urea nitrogen (BUN), diabetes mellitus (DM) history, and diuretic use.

Conclusion: The GBM model effectively predicts RFS risk in SAP patients after initiating enteral nutrition.

Background: Liver function is foundational to human health. While numerous herbal extracts have individually been shown to improve liver function, there are relatively few studies on combinations of herbal ingredients that may have synergistic effects. In addition, capsule fatigue is a common problem when aiming to incorporate multiple ingredients to support liver health. With these gaps in mind, the goal of this study was to evaluate the safety and efficacy of a highly purified plant-based nutraceutical containing organic herbal extracts of turmeric, dandelion, milk thistle, and ginger on liver function parameters.

Methods: A randomized, placebo-controlled clinical trial was conducted to evaluate the efficacy of this nutraceutical liquid formula. Healthy adults were randomized 1:1 to receive the nutraceutical product or placebo (both 60 mL) twice daily for 180 days. The primary endpoint was change in liver function tests (alanine aminotransferase [ALT], aspartate aminotransferase [AST], alanine phosphatase [ALP], gamma-glutamyl transferase [GGT]) from baseline to end of study. Safety was also evaluated. The primary endpoint was compared between study arms via analysis of covariance.

Results: In total, 130 participants enrolled in the trial; 65 were randomized to each group. Mean improvements in ALT, AST, ALP, and GGT were significantly greater with the nutraceutical product than placebo (p ≤ 0.001). No adverse events were reported.

Discussion: Supplementation with this liquid nutraceutical formula improved the liver enzyme profile of healthy individuals, suggesting that it may mitigate a trend toward higher liver enzyme levels over time in a convenient manner that fosters compliance.

Clinical trial registration: https://ctri.nic.in/Clinicaltrials/login.php, CTRI/2023/06/054492.

Introduction: Caloric restriction facilitates weight loss and metabolic improvement, in part by altering the gut microbiota. However, its influence via the tongue coating microbiota and gut microbiota remains largely unexplored.

Methods: To address this gap, we conducted a single-center, prospective, controlled study from 23 April to 5 July 2021, enrolling 48 participants with a body mass index (BMI) ≥ 24 kg/m². Participants were assigned to either a 7-day modified fasting group (550 kcal/day, n = 35) or a control group (n = 13) based on their personal preference.

Results: In the fasting group, body weight decreased by 4.0 ± 1.6 kg (p < 0.01), BMI decreased by 1.51 ± 0.58 (p < 0.01), significantly, accompanied by marked improvements in blood glucose and lipid profiles (p < 0.05). 16S rRNA sequencing of tongue coating and fecal samples revealed distinct microbial alterations between groups. In the tongue microbiota, Haemophilus was reduced, while Prevotella and Actinomyces were enriched, along with suppression of nucleotide synthesis and glycolysis pathways. In the gut microbiota, Bacteroides decreased, and Clostridia increased, with significant upregulation of gluconeogenesis and branched-chain amino acid biosynthesis pathways (p < 0.05). Notably, specific taxa such as Haemophilus and Granulicatella were positively correlated with body weight and BMI (r > 0.4, p < 0.05).

Discussion: These findings suggest that MFT improves metabolic outcomes by reshaping the taxonomic composition and possible functional capabilities of the tongue coating and gut microbiota in overweight and obese individuals. However, these findings should be interpreted in the context of the limitations of the study, including its non-randomized design and the preliminary nature of the gut microbiome analysis due to a small sample size.

Clinical trial registration: http://www.chictr.org.cn/, identifier ChiCTR2100047532.

Natural aging involves an imbalance in gut bacteria, changes in metabolism, and mild ongoing inflammation. The integrated impact of chitosan oligosaccharide (COS) on microbiota-metabolite-immune interactions in a physiological (non-accelerated) aging context remains unclear. In this study, male C57BL/6J mice (young control; aged vehicle; aged +COS from 10 to 18 months) underwent longitudinal assessment including 16S rRNA profiling, untargeted serum metabolomics, multiplex cytokine measurement, and colonic p53 and p21 immunohistochemistry. The results showed that COS was associated with restructuring of gut community composition, with reduced Firmicutes (67.07% to 32.93%) and increased Bacteroidota (15.29% to 31.22%), alongside marked enrichment of Muribaculaceae (to 52.83%). Discriminant metabolites (VIP > 1 and FDR-adjusted) mapped predominantly to propionate (propanoate) and amino acid-linked pathways. Integrative correlation analysis connected Muribaculaceae with propionate-associated and aromatic amino acid-related metabolites and selected cytokines (including CCL20). COS mitigated age-associated body weight gain and was accompanied by reduced p53 and p21 immunoreactivity in brain and kidney, consistent with attenuation of stress associated senescence signaling. Long-term COS supplementation in naturally aged mice is associated with coordinated shifts in a putative Muribaculaceae-propionate-immune axis and concurrent down-regulation of both p53 and p21. These associative findings warrant mechanistic validation through targeted short-chain fatty acid quantification, receptor signaling assays, microbiota transfer, and functional aging endpoints to clarify causality and translational potential.

Background: Celiac disease (CD) is a chronic immune-mediated enteropathy triggered by gluten ingestion in genetically predisposed individuals and is increasingly diagnosed in childhood. Growing evidence suggests an association between CD and metabolic syndrome (MetS), potentially mediated by chronic inflammation, intestinal dysbiosis, oxidative stress, and micronutrient deficiencies. In addition, although a gluten-free diet (GFD) is essential for intestinal recovery, its frequent reliance on ultra-processed, energy-dense products may adversely affect metabolic health, particularly in pediatric patients.

Objective: This narrative review aims to examine the relationship between CD and MetS, with a specific focus on pediatric populations, by analyzing shared pathophysiological mechanisms, the metabolic impact of a GFD, and preventive nutritional strategies to reduce long-term cardiometabolic risk.

Methods: A narrative review was performed using PubMed and Scopus databases, focusing on studies published in the past 15 years. Search terms included "Celiac Disease," "Metabolic Syndrome," "Child," "Adolescent," "Risk Factors," and "Prevention." Among 229 identified papers, 43 were selected after critical appraisal. Evidence was synthesized on epidemiology, mechanisms, dietary effects, and preventive strategies.

Results: Studies indicate that MetS prevalence in CD ranges from 3 to 11% at diagnosis and may rise to 14-29% after 1 year on a GFD, particularly in adults. In children, complete MetS is rare, though isolated components, central adiposity, dyslipidemia, and hypertension, are increasingly observed. Mechanistically, gluten-induced barrier disruption, inflammation, dysbiosis, and nutritional imbalances contribute to systemic metabolic alterations. Adherence to a Mediterranean-style GFD emphasizing whole, naturally gluten-free foods reduces cardiometabolic risk.

Conclusion: CD and MetS share interconnected inflammatory and metabolic pathways. While GFD remains essential for CD management, it necessitates tailored nutritional guidance and metabolic monitoring. Early lifestyle-based interventions-promoting balanced diet quality, micronutrient adequacy, and physical activity, offer key opportunities to prevent metabolic complications in children with CD.

Vascular cognitive impairment (VCI), a cognitive disorder arising from cerebrovascular pathology, currently lacks effective targeted therapies. Dysfunction of the blood-brain barrier (BBB) represents a pivotal event in VCI pathogenesis, characterized by tight junction degradation, neuroinflammation, and oxidative stress. Phytochemicals-including polyphenols, flavonoids, and polysaccharides-demonstrate promising multi-target potential in ameliorating VCI by preserving BBB integrity, mitigating neuroinflammation and oxidative stress, exerting neuroprotective effects, and modulating the gut-brain axis. However, the clinical translation of these compounds is currently impeded by low bioavailability and limited BBB permeability. Prioritizing the development of targeted delivery systems is essential to enhance the therapeutic efficacy and clinical utility of phytochemicals in the prevention and treatment of VCI.

Background: Sustainable sports nutrition is increasingly recognized as a means of enhancing the athlete's performance while reducing negative environmental impacts, however, empirical data in the context of adolescent athletes is limited.

Objectives: This study examined sport nutrition knowledge, environmental awareness, and sustainable dietary behaviors among adolescent athletes, and their associated with motivation and sports participation.

Methods: A mixed-methods design was used to examine sustainable nutrition behaviors and their motivational, contextual, and social determinants. A total of 312 athletes were invited to participate, and 120 completed a structured survey (response rate: 38%). Measures included a modified Sport Nutrition Knowledge Questionnaire, a validated environmental awareness subscale (α > 0.78), and a composite Sustainable Practice Score (SPS; α = 0.81).

Results and discussion: Quantitative analyses showed that 78% of the participants reported moderate awareness of the environmental impact of food choices, and 62% had adopted at least one sustainable dietary practice. SPS was positively correlated with sports nutrition knowledge (r = 0.39, p < 0.001) and environmental awareness (r = 0.46, p < 0.001). Regression analyses indicated that sustainable nutrition practices significantly predicted motivation (β = 0.32, p < 0.01) and participation frequency (β = 0.29, p < 0.01), with environmental awareness moderating both relationships. Qualitative findings highlighted perceived physiological benefits, social influences, and structural barriers as a key theme influencing adoption.

Conclusion: In general, adolescent athletes demonstrated developing and context-dependent sustainable dietary behaviors shaped by nutrition knowledge, environmental awareness, and socio-cultural influences. Enhancing sustainability-oriented educational interventions within youth sport settings may support both performance-related outcomes and the development of environmental responsibility.

[This corrects the article DOI: 10.3389/fnut.2025.1677196.].