Frontiers in Nutrition最新文献

Background: Malnutrition remains a major public health concern in Mali, particularly in rural districts where food insecurity, limited dietary diversity, and inadequate infant and young child feeding (IYCF) practices persist. The Koulikoro Region continues to experience malnutrition levels above the national average. To strengthen community-level prevention and early detection, the Ministry of Health and partners implemented Nutrition Support Groups (NSGs), facilitated by relais communautaires. Despite their scale-up, evidence on NSG functionality and effectiveness in rural settings, including Dioila Health District, remains limited.

Objective: To assess caregiver participation in NSGs, examine self-reported changes in feeding practices, and review recovery outcomes for moderate and severe acute malnutrition using routine health facility records.

Methods: A cross-sectional study was conducted in Dioila District between August and September 2024. Caregiver knowledge and practices were assessed using a pre-tested questionnaire, while NSG attendance registers and health facility records provided data on participation and recovery. Descriptive statistics summarized variables, and chi-square and t-tests explored associations between NSG participation and caregiver outcomes.

Results: A total of 227 caregivers from 37 villages participated in the study. NSG attendance was high (91%), and satisfaction with activities reached 78%. Frequent attendees demonstrated significantly higher nutrition knowledge scores (mean = 75.4 vs. 65.0; t = 5.23, p = 0.0002) and better feeding practices (χ ² = 15.67, p = 0.0001) compared with infrequent participants. Self-reported behavior changes included improved complementary feeding (42%), increased dietary diversity (28%), and enhanced hygiene practices (17%). Health facility records indicated strong recovery outcomes, with 99.86% for moderate acute malnutrition (MAM) and 97.86% for severe acute malnutrition (SAM). Reported challenges included limited funding, volunteer fatigue, and occasional community resistance.

Conclusion: NSGs in Dioila Health District are effective community-based platforms for improving caregiver knowledge, promoting positive feeding practices, and supporting early detection of malnutrition. While facility-based recovery outcomes are strong, sustainability challenges remain. Strengthening supervision mechanisms, ensuring consistent support for community volunteers, and improving referral linkages with health facilities are critical to enhance the effectiveness and long-term sustainability of NSGs in rural Mali.

Objective: To examine whether a concise, clinic-feasible Patient Inflammatory Diet Score (PIDS) relates to prevalent pancreatic cancer and cardiovascular disease (CVD) in a hospital population, and to explore associations with systemic inflammation.

Methods: We conducted a cross-sectional study among 401 adults (≥40 years) attending cardiology, gastroenterology, or oncology services (2018-2022). A 10-12-min questionnaire captured sociodemographics, lifestyle, and habitual intake of pro- and anti-inflammatory food groups to derive the PIDS (quartiles). Pancreatic cancer and CVD were ascertained from de-identified electronic records; high-sensitivity C-reactive protein (hsCRP) indexed systemic inflammation. Robust Poisson models estimated prevalence ratios (PRs) across PIDS quartiles with prespecified adjustments and subgroup/sensitivity analyses.

Results: Pancreatic cancer was present in 24 participants (6.0%); CVD in 111 (27.7%). Relative to Q1, fully adjusted PRs for pancreatic cancer were 0.81 (95% CI 0.32-2.06), 0.94 (0.39-2.27), and 1.09 (0.45-2.65) for Q2-Q4 (p-trend = 0.79); the per-SD estimate was 1.03 (0.81-1.31). PIDS showed no material association with prevalent CVD (Q4 vs. Q1, PR 1.08; 0.76-1.54; p-trend = 0.61). Correlation with hsCRP was weak (ρ = 0.09; p = 0.08), and findings were consistent across sex, age, and BMI strata, alternative PIDS categorizations, exclusion of hsCRP > 10 mg·L^-1, and restriction to participants without CVD. No synergistic effects were observed for joint PIDS-CVD categories.

Conclusion: In this pragmatic clinical setting, a brief, food-based inflammatory diet score did not discriminate cross-sectional differences in pancreatic-cancer prevalence or CVD, nor did it correlate meaningfully with hsCRP. These null findings bound plausible effect sizes and support the need for larger, prospective studies with richer dietary phenotyping and biomarker integration.

Aging is accompanied by a progressive decline in immune function, known as immunosenescence, and by a chronic low-grade inflammatory state, termed inflammaging. Both conditions contribute to increased susceptibility to infections, reduced vaccine responses, and the development of age-related diseases. Emerging evidence suggests that intermittent fasting (IF), a dietary pattern that alternates between periods of fasting and feeding, may influence pathways associated with immune aging across mid-life and older adulthood. This review explores how IF may exert immunoregulatory effects through metabolic remodeling, cellular stress responses, and inflammatory signaling. Preclinical and human studies indicate that IF attenuates pro-inflammatory cytokine production, enhances autophagy, and improves immune cell function, potentially delaying immunosenescence and reducing inflammaging in middle-aged and older populations. Additionally, IF may protect against neuroinflammation and cognitive decline by reducing oxidative stress, activating AMPK-SIRT1 and ketone signaling via β-hydroxybutyrate (BHB), enhancing neuroplasticity, upregulating brain-derived neurotrophic factor, and suppressing pro-inflammatory cytokines, inflammation, and frailty in the aging brain. However, most evidence comes from short- to medium-term studies in selected, relatively healthy populations, with benefits often similar to those of continuous calorie restriction, and there is limited data on long-term safety, adverse effects, and outcomes in frail older adults. By reducing oxidative stress and inflammaging, IF may mitigate frailty in older adults or delay its progression when initiated earlier. By integrating insights from immunometabolism and gerontology, this review highlights the potential role of IF as a non-pharmacological strategy to promote healthy immune aging and support functional outcomes in older adults. However, evidence in frail older adults remains limited, and randomized trials in this population are warranted. Future research should directly compare IF with isocaloric non-fasting regimens, include long-term follow-up, and carefully characterize safety and adherence in high-risk groups before IF can be routinely recommended for immune aging.

Ovarian aging is the process of decline in ovarian reserve, endocrine function with age, leading to reduced fertility and increased risk of various related diseases. In recent years, medicine food homology (MFH) species have attracted much attention for their potential to delay ovarian aging due to their dietary and medicinal values. In this review, we have focused on the intervention of MFH species and active ingredients on ovarian aging, with an emphasis on the molecular mechanisms involved in antioxidant, anti-inflammatory, apoptosis inhibitory, balance of autophagy, maintenance of genome stability, mitochondrial function protective and estrogen-like effects through multiple signaling pathways (e.g., PI3K/Akt, Nrf2/HO-1, SIRT1/mTOR, Nrf2/ARE, etc.). Possessing the characteristics of multi-pathway and multi-target effects, MFH species and active ingredients provide new ideas for the research and development of health food and functional preparations. High-quality clinical studies are still needed for verification.

Objective: To systematically identify, review, and synthesize the best available evidence on the rational use of parenteral nutrition (PN) in hospitalized adult oncology patients, and to develop a practice-oriented framework encompassing decision-making, prescribing, review, compounding, administration, and monitoring, and quality management.

Methods: PIPOST-based questions were developed to guide the review. Following the "5S" evidence-pyramid model, searches were performed in a top-down manner across system-level resources, guideline repositories, synthesis databases, and primary literature databases, including UpToDate, BMJ Best Practice, NICE, ESPEN, CSPEN, ASPEN, Chinese Certified Dietitian, Cochrane, JBI, PubMed, Embase, Web of Science, CINAHL, CNKI, Wanfang, and SinoMed. Eligible evidence types included clinical decision resources, clinical practice guidelines, systematic reviews and meta-analyses, expert consensus statements, and evidence summaries related to parenteral nutrition for hospitalized adult cancer patients. Study selection, quality appraisal, and data extraction were conducted independently by two trained reviewers, and any disagreements were resolved through discussion or adjudication by a third reviewer. Evidence items were regraded using the JBI pre-grading framework and synthesized thematically. The search covered all databases from their inception to 13 August 2025.

Results: A total of 2,248 records were retrieved. Eighteen documents met the inclusion criteria and were included: one system-level clinical decision resource, four clinical practice guidelines, nine expert consensus statements, and four systematic reviews. From these sources, 46 discrete evidence items were distilled and organized into five domains: individualized nutritional decision-making, PN prescribing and review, PN preparation and compounding, PN administration and monitoring, safety assessment and quality management.

Conclusion: Parenteral nutrition for hospitalized cancer patients should be implemented within a multidisciplinary Nutrition Support Team (NST) framework and embedded within institutional quality management systems. Structured, individualized care plans should be developed based on the best available evidence. Given variability in institutional resources, staff competencies, and evidence across tumor subgroups, key quality indicators should be specified, and routine audits should be conducted during local implementation. The ultimate goal is to improve nutritional status, clinical outcomes, and the efficiency of healthcare resource utilization among hospitalized cancer patients.

Patients with irritable bowel syndrome experience abdominal pain and stool habit disturbances, and often also extraintestinal symptoms, such as fatigue. The disorder is linked to gut dysbiosis, and manipulation of the microbiota is considered a possible treatment strategy. This randomised, double-blinded, placebo-controlled study aimed to investigate the effects of the probiotic strain Bifidobacterium breve, Bif195™ (DSM 33360) (Bif195), on symptoms and gut microbiome composition in patients with diarrhoea-predominant irritable bowel syndrome. Sixty-one patients with moderate-severe disease activity were allocated to 8 weeks of treatment with either Bif195 or placebo (1:1), followed by 8 weeks of follow-up. The primary outcome was a change in symptom scores measured by the validated questionnaire, IBS-symptom severity scale. Secondary and explorative outcomes were the effects of Bif195 on intestinal symptoms, quality of life, fatigue, and the gut microbiota. Modulation of the transepithelial electrical resistance (TEER) of Caco-2 cells by Bif195 was investigated in vitro as a model of barrier integrity. The results showed no effect of Bif195 on primary or secondary outcomes; however, Bif195 lowered fatigue scores compared to placebo. Significantly increased TEER readings in vitro indicated enhanced barrier integrity, suggesting GI permeability as a mechanism for further clinical exploration.

Clinical trial registration: clinicaltrials.gov, identifier NCT04808271.

Background: Autosomal-dominant polycystic kidney disease (ADPKD) is a common hereditary form of chronic kidney disease with limited pharmacological treatment options. Emerging evidence suggests that metabolic interventions, including ketogenic dietary strategies and reducing lithogenic risk, may positively influence disease progression.

Objectives: This study evaluated real-world outcomes from the Ren-Nu™ program, a remotely administered educational program for individuals with ADPKD that combines the use of a medical food with nutrition and lifestyle changes, including a very-low-carbohydrate ketogenic diet and reduction of renal lithogenic stressors. Ren-Nu™ was launched in 2021 as a collaboration between scientists and nutrition experts from the University of California Santa Barbara and Santa Barbara Nutrients, Inc, and dietitians from Kidney Nutrition Institute.

Methods: Data from 103 ADPKD participants who completed the Ren-Nu™ program between 2021 and 2023 were analyzed in this longitudinal, baseline- controlled evaluation. The 3-month intervention included structured dietary education, regular dietitian and nutritionist support, and supplementation with KetoCitra^®, a medical food providing beta-hydroxybutyrate (BHB), citrate, minerals, and alkali base. Primary outcomes included estimated glomerular filtration rate (eGFR), body mass index (BMI), anti-hypertensive medication usage, and self-reported symptom burden. Safety was assessed through routine metabolic biomarkers.

Results: Participants demonstrated high adherence to nutritional ketosis, leading to a significant improvement in BMI. Renal function significantly improved, showing an eGFR increase of 6.3% (from 58.4 to 61.6 ml/min/1.73 m2; P < 0.001). There was a notable decrease in anti-hypertensive medication use and significant reductions in self-reported kidney pain and headaches. Safety markers, including lipid profiles, electrolytes, and acid-base balance, remained stable throughout the intervention.

Conclusion: Use of KetoCitra^® supported by nutrition and lifestyle changes in the Ren-Nu™ program demonstrates feasibility, safety, and clinically meaningful improvements in metabolic health, renal function,  and quality.

Introduction: This study aimed to assess the diet quality of Turkish athletes and confirm the validity and reliability of the Athlete Diet Index (ADI), which is the only index designed to assess diet quality in athletes. The ADI assesses three primary domains: basic athlete nutrition, nutrition for exercise performance, and personal dietary practices.

Methods: The final Turkish version of the ADI, developed through forward-backward translation (n = 5 + 2), expert review (n = 10), and a pilot study (n = 15), was administered to 151 professional athletes. Construct validity was examined by assessing the association between ADI scores and 2-day food record scores. Test-retest reliability was evaluated by readministering the ADI to 44 athletes after 3 weeks.

Results: All assessments were conducted face-to-face. The ADI demonstrated strong validity (r = 0.798, p < 0.001) and good test-retest reliability (ICC = 0.79, 95% CI). Diet quality did not differ by age, sex, or individual versus team sport (p > 0.05); however, athletes competing in weight-category sports had significantly lower diet quality than non-weight-category athletes (p = 0.01).

Conclusion: The ADI is valid and reliable tool for evaluating the diet quality of Turkish athletes and can be confidently used in both research and applied sports nutrition settings.

Background: Ultra-processed foods (UPFs) account for approximately 38% of the adult diet, corresponding with a global increase in the prevalence of mental illnesses. Understanding the relationship between UPF consumption and mental health is crucial for public health and clinical practice.

Objectives: To uncover the association between consumption of ultra-processed food (UPF), dysregulated lipid metabolism, and increased risk of mental illnesses, including depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), eating disorders (ED), and food addiction (FA). In addition, this review explores the potential biological and behavioral mechanisms that may underlie these associations for each disorder.

Methods: Following the PRISMA extension for scoping reviews guideline, a comprehensive search was conducted across PubMed, Web of Science, and EMBASE databases. The retrieved records, screened using Covidence, included English-language studies published between 2020 and 2025 that involved participants without significant comorbidities. Relevant data on associations and proposed mechanisms were extracted and synthesized using a narrative approach.

Results: UPF consumption was associated with dysregulated lipid metabolism and increased risk of Anxiety, Depression, ADHD, Autism, ED, and FA. Dose-dependent increases in risk were identified in all mental illnesses except for autism. Proposed mechanisms for all these increased risks included systemic low-grade inflammation, alterations in neuronal signaling, particularly dopamine and serotonin signaling pathways, and the influence of UPF additives on neurochemical regulation.

Conclusion: There is a strong association between UPF consumption, disrupted lipid metabolism and increased risk of mental disorder in populations without significant comorbidities. Diets rich in minimally processed foods appear protective. The findings support the potential of public health initiatives aimed at reducing UPF consumption to mitigate the mental health burden. Future studies should focus on mechanistic pathways, UPF and minimally processed food consumption patterns to provide evidence for targeted dietary and policy interventions that improve health outcomes.

Objectives: This study aimed to investigate the knowledge, attitudes, and practices (KAP) regarding nutrition among patients diagnosed with malignant tumors.

Methods: A cross-sectional survey was conducted from 16 October 2023 to 30 April 2024, in author's hospital. Demographic information and KAP were collected through structured questionnaires.

Results: The study analyzed 535 patients. Males were 370 (69.16%), and 213 (39.81%) reported nutritional supplement use. The mean (±SD) scores were 10.88 ± 6.02 for knowledge, 15.46 ± 3.15 for attitude, and 33.13 ± 5.19 for practice. In multivariable analyses, primary school education or below (β = -2.626, 95% CI: -4.593 to -0.659, p = 0.009), diagnosis of oesophageal, gastric cardia, or stomach cancer (β = -1.865, 95% CI: -3.278 to -0.452, p = 0.010), colorectal cancer (β = -1.670, 95% CI: -3.299 to -0.041, p = 0.045), and the use of nutritional supplements (β = 1.850, 95% CI: 0.813 to 2.888, p < 0.001) were associated with knowledge scores. Knowledge scores (β = 0.110, 95% CI: 0.066 to 0.154, p < 0.001), being a homemaker (β = -1.660, 95% CI: -2.834 to -0.486, p = 0.006), and the use of nutritional supplements (β = 0.558, 95% CI: 0.019 to 1.096, p = 0.042) were positively associated with attitude scores. For practice, only higher knowledge scores were independently associated with better nutritional practices (β = 0.359, 95% CI: 0.291 to 0.428, p < 0.001). Structural equation modeling showed that knowledge directly influenced attitudes (β = 0.194; p = 0.002) and practices (β = 0.546; p = 0.009).

Conclusion: Patients diagnosed with malignant tumors exhibited inadequate knowledge and negative attitudes, although the practice was proactive, there was still room for improvement on specific practice. Targeted, multidisciplinary, and continuous nutritional education may be considered to support better nutritional awareness, patient-centered care, and overall quality of life.