Nutrition reviews最新文献

Diabetes is a chronic, lifelong metabolic disorder characterized by elevated blood glucose levels. The role of diet and nutrition in the entire life cycle of metabolic diseases, particularly type 2 diabetes (T2D), is pivotal and represents the primary modifiable factors in combating the onset and progression of diabetes. The previous association between a high-sugar diet and diabetes risk has been well established. However, there is now evidence suggesting that a shift towards reduced carbohydrate intake and increased dietary fat may be linked to higher morbidity and mortality rates in patients with diabetes. This review investigated the effects of dietary fats and carbohydrates on the onset and progression of T2D and its associated complications (microvascular and macrovascular) and fatal events by reviewing several clinical studies and animal experiments. A lack of controlled trials comparing high-sugar and high-fat diets (HFDs) in clinical studies hinders us from drawing consistent conclusions. The majority of animal studies demonstrated a greater impact from HFDs compared with higher-sugar diets. There are several diets for treating diabetes that restrict fat intake below the upper limit of the dietary guidelines, and people with diabetes or abnormal glucose tolerance seem more able to tolerate low-fat, high-carbohydrate, low-calorie diets. Due to various factors, including the types of carbohydrates and fats, caloric intake, cognition, population age, and study design, it is difficult to conclusively determine which ratio of dietary components is more likely to contribute to diabetes, microvascular and macrovascular complications, or mortality events. Animal experiments may provide a systematic approach for simulating the effects of dietary fats and carbohydrates across the entire diabetes life cycle. Nevertheless, care must be taken when generalizing the findings from animal models to human contexts. Consequently, there is still a need for more high-quality, large, prospective controlled research to elucidate the role of dietary structure with different fat to carbohydrate ratios across the life cycle of diabetes. Meanwhile, studies should analyze relevant interactions, including potential effect modification factors.

This scoping review synthesized the evidence on double-duty actions targeted at adolescents to address the double burden of malnutrition (DBM). Adolescents face unique challenges related to the DBM, including both undernutrition and overweight, obesity, or diet-related noncommunicable diseases (NCDs). Understanding effective strategies for addressing these issues is critical. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. We examined studies from MEDLINE, Embase, CENTRAL, CINAHL, and Google Scholar on double-duty actions, defined as an array of interventions, programs, and policies that aim to simultaneously reduce the risk or burden of both undernutrition (including wasting, stunting and micronutrient deficiency) and overweight, obesity or diet-related NCDs. The evidence was analyzed through narrative synthesis. Our comprehensive search of the published and gray literature identified 17 publications representing 16 studies. These included 5 cluster randomized controlled trials, 2 evaluation studies, and 10 quasi-experimental studies conducted across 10 countries, mainly in sub-Saharan Africa and Asia. The interventions varied in duration from 1 month to 5 years and incorporated multi-component approaches, such as physical activity promotion, school feeding programs, nutrition education, and water, sanitation, and hygiene (WASH) activities. While 2 studies effectively reduced both undernutrition and overweight, 9 were DBM-neutral, 4 were potentially beneficial, and 2 had potential DBM-harmful outcomes. Thirteen multi-component interventions showed improved nutritional indicators, particularly in anemia and dietary diversity, with strong engagement from the school community contributing to successful outcomes. This review emphasizes the need for multifaceted interventions to address the DBM among adolescents. The included studies showed that school-based, multi-component strategies, including physical activity promotion and nutrition education, can improve nutritional outcomes. However, variations in effectiveness highlighted the complexity of the DBM, requiring re-design of strategies to address common drivers of multiple forms of malnutrition through context-specific approaches that engage multiple sectors and local communities. Ongoing evaluation and adaptation of strategies to attain optimal nutritional status are key to success.

Context: Baby-led weaning (BLW) is a popular approach for introducing solid foods, supporting infant autonomy, sensory development, and family mealtimes. Despite potential benefits, concerns remain about its safety and nutritional adequacy. Further evidence is needed to clarify its effects on infant health.

Objective: This systematic review compared BLW and traditional spoon-feeding (TSF) on growth, choking risk, and iron deficiency in infants aged 6-12 months.

Data sources: PubMed, CINAHL, Cochrane Library Plus, BioMed Central, and Google Scholar were searched from September 2022 to March 2023.

Data extraction: Titles, abstracts, and full texts were screened, and methodological quality and risk of bias were assessed using the JBI (Joanna Briggs Institute) checklist and Cochrane Handbook. Due to the limited number of studies, no meta-analysis was performed; instead, a hybrid synthesis of effect estimates and vote counting by direction was conducted, supported by box-and-whisker and harvest plots.

Data analysis: Four randomized clinical trials were selected from 359 publications. Dogan et al reported lower overweight prevalence with BLW (0%, 10.4 ± 0.9 kg) compared with TSF (17%, 11.1 ± 0.5 kg; P < .001), whereas Taylor et al found no difference (BLW vs TSF, 10.3% vs 6.4%; P > .05). Choking risk was similar across studies (Dogan et al: BLW [n = 2] vs TSF [n = 3]; Fangupo et al: overall, 35%; no group difference; P > .20). Hemoglobin levels also showed no significant differences (Dogan et al: BLW vs TSF, 12.28 ± 0.48 vs 12.24 ± 0.41 g/dL; Daniels et al: BLW vs TSF, 11.6 ± 0.89 vs 11.7 ± 0.84 g/dL; P > .05).

Conclusion: Current evidence suggests that BLW does not increase choking risk or compromise iron status compared with TSF. Its effect on growth remains limited. BLW may be considered a safe and nutritionally adequate complementary feeding method; however, these findings should be interpreted cautiously. Caregiver education on choking prevention and timely iron-rich foods is essential for safety and nutrition adequacy.

Systematic review registration: PROSPERO registration no. CRD42023402900.

Context: Bisphenol A (BPA) is a chemical found in polycarbonate plastics that can disrupt the endocrine system of humans and animals. Because human exposure to BPA is ubiquitous, due to its high-volume production and use, research into methods of mitigating its toxicity is considered imperative.

Objective: The objective of this study thus was to summarize current knowledge of the effects of probiotics on BPA toxicity and of methods of restoring the overall health of organisms exposed to it.

Data sources: An electronic search of the literature was undertaken using the PubMed, The Cochrane Library, Scopus, and Web of Science databases to identify all relevant articles. Gray literature was also screened. The search process ended on March 31, 2025.

Data extraction: The following data were extracted from each intervention study: type of animal model, number of animals, BPA exposure, daily dose and type of probiotic supplementation, placebo, and other treatment intervention. The following details for experimental animals was also recorded: health status, mean age, main outcomes (changes in BPA toxicity; BPA content in stool, blood, saliva, or urine; decreased oxidative stress and endocrine disruption; changes in metabolic parameters such as insulin, lipid profile, and liver parameters).

Data analysis: A total of 404 studies were identified using the databases. Five in vivo and 7 in vitro articles met the inclusion criteria and were included in the final analysis. Probiotic bacteria, especially Lactobacillus plantarum, Bacillus subtilis, L. acidophilus, Lactococcus lactis, and Lactobacillus reuteri have potential applications in the bioremediation of BPA.

Conclusion: This review provides information on whether probiotics may play a role in effectively relieving the outcomes of BPA exposure; therefore, the aim was achieved. The findings provide valuable insights for the development of intervention strategies and could have practical applications in food formulation and probiotic supplementation.

Systematic review registration: PROSPERO registration No. CRD42023470061.

Nutrition recommendation systems (NRSs), which integrate user data with nutritional knowledge to generate individualized advice, have emerged as promising digital tools. However, challenges remain in design, implementation, and clinical applicability. We conducted this review to map the development, characteristics, and technological aspects of NRS, and to identify existing gaps in application and evaluation. To provide a comprehensive overview, we included both peer-reviewed literature and non-peer-reviewed sources, thereby reflecting the breadth of existing innovations beyond academic research. We systematically searched bibliographic databases, patent repositories, and software stores. From all identified NRSs, we extracted publication year, topic, interface users, input variables, system-generated output, and target population. For NRSs reported in peer-reviewed studies, we further collected detailed data on author affiliations, system characteristics, evaluation strategies, artificial intelligence techniques, and recommendation algorithms. Results were synthesized and presented in visual formats. The protocol for this study was registered on the Open Science Framework (doi: 10.17605/OSF.IO/VF7NB). A total of 878 NRSs were identified, with 43.4% released after 2022. Systems mainly targeted general people or the population with overweight and were based on general information (eg, dietary habits, exercise types). Among all of the 49 NRSs published in academic studies, only 4 involved nutritionists, and nearly half relied on public surveys without documented data procedures or quality control. Most NRSs focused on nutrition advice (53.1%) as a primary output. Evaluation relied primarily on internal test sets (22.4%). Accuracy (34.7%) was primarily metric. Convolutional Neural Networks (14.3%) and Random Forests (14.3%) were the top smart techniques; most models were non-self-updating. Content-based filtering (30.6%) dominated recommendation algorithms, with the latest proposed algorithm dating to 2014. Current nutrition recommendation systems lack personalization, standardized evaluation, and nutrition expert involvement. Most systems rely on general data and outdated algorithms, limiting their clinical relevance and applicability. Enhancing individualization, ensuring data transparency, and fostering interdisciplinary collaboration are critical to improving the effectiveness and reliability of future systems.

Hashimoto thyroiditis (HT) is an autoimmune thyroid disorder characterized by chronic inflammation and hypothyroidism. The current scientific understanding indicates that the development of HT is influenced by a combination of genetic and environmental factors. Nevertheless, oxidative stress (OS) and dysregulated immune processes play a substantial role in HT pathogenesis. Reactive oxygen species (ROS) play a critical role in thyroid hormone synthesis by facilitating iodide oxidation. Since thyroid hormones influence mitochondrial activity and regulate ROS production, the thyroid gland is particularly vulnerable to OS and disruptions in homeostasis. Research indicates that, in HT, the oxidative balance shifts toward a pro-oxidative state. Excessive levels of ROS disrupt cellular homeostasis and induce inflammation, leading to structural and functional damage of thyroid tissue. These processes play a substantial role in the pathogenesis and progression of HT. Among the various environmental factors that can be modulated, dietary nutrients are considered one of the most promising and underappreciated clinical tools in this process. The primary aim was to explore the potential role of dietary interventions in protecting thyroid function, supporting the immune response, and alleviating OS in individuals with HT. According to the literature data, proper nutrition in HT should include sufficient amounts of anti-inflammatory components. These emphasize the role of mono- and polyunsaturated fatty acids (such as omega-3, omega-6), polyphenols, whey protein, soy protein, and isoflavones. Moreover, a well-balanced and varied diet rich in antioxidants, including vitamins C and E, selenium, zinc, and polyphenols, may help reduce OS in HT, simultaneously modulating the immunological processes. Additionally, it is essential to ensure an adequate intake of micronutrients, including iodine, iron, selenium, and vitamins, especially vitamin D, to support thyroid homeostasis. Adopting a balanced and nutrient-rich diet, along with specific dietary patterns, may be beneficial in managing the symptoms and improving the overall well-being of individuals with HT.

Context: Chronic non-communicable diseases (NCDs) are the leading global causes of morbidity, mortality, and escalating health care costs, driven largely by unhealthy lifestyles in an aging population.

Objective: The Mediterranean Diet (MD), traditionally associated with healthy longevity, is increasingly recognized for its preventative and therapeutic benefits across many NCDs.

Data sources: Using the NUTRIGRADE methodology, a multidisciplinary panel of clinical, methodological, and public health experts conducted a comprehensive systematic review across 9 health domains and one economic domain.

Data extraction: Data were extracted from multiple databases without date restrictions, assessing outcomes such as disease incidence and prevalence, mortality rates of nutrition-related NCDs, quality of life indicators, and relevant biochemical markers. Evidence was critically appraised and synthesized to formulate evidence-based recommendations.

Data analysis: A total of 84 evidence-based recommendations were developed. The MD was found to significantly reduce all-cause mortality in the general population and cardiovascular morbidity and mortality, particularly in high-risk individuals. High-quality evidence supports the protective role of the MD against myocardial infarction, stroke, atrial fibrillation, and peripheral arterial disease. In oncological evidence, MD adherence has been found to be linked to a lower incidence of several cancer types and improved survival outcomes. Additional benefits include reduced incidence and progression of cognitive decline, type 2 diabetes, metabolic syndrome, and obesity, and improved pregnancy outcomes. The strength of recommendations varied by outcome and target population, with many supported by robust evidence.

Conclusions: The MD is a scientifically supported dietary intervention with broad preventive and therapeutic benefits. Its integration into clinical practice, public health strategies, and policy initiatives is strongly recommended to promote health and reduce the global health care burden.

Noncommunicable diseases (NCDs) pose substantial global health challenges, frequently driven by lifestyle behaviors such as unhealthy diet and physical inactivity. Adolescence represents a pivotal period for intervention, since habits during this stage often persist into adulthood. This review evaluates psychoeducational interventions aimed at enhancing dietary and physical activity (PA) behaviors among adolescents. A comprehensive literature search in PubMed and PsycINFO identified 19 studies (15 interventional studies and 4 systematic reviews), analyzing school-based interventions targeting healthy adolescents aged 12-18. These studies employed psychoeducational strategies within the school setting, utilizing diverse resources and involving both individual and group activities. While certain studies reported significant improvements in reducing unhealthy food consumption, increasing PA rates, and enhancing nutritional knowledge, the long-term evidence for such dietary and PA habit changes being sustained, as well as for improvement in youths' attitudes towards a healthy lifestyle, varied widely across studies. This variability reflects differences in study design, measures of success, intervention intensity and duration, participant adherence, socio-demographic profiles, and engagement strategies. Notably, peer interactions and family involvement, especially parental support, emerged as critical components in enhancing motivation and fostering behavioral change. The findings underscore the promising role of school settings for behavioral interventions, stressing the necessity for tailored, engaging strategies that take into consideration adolescent autonomy, social influences, peer dynamics, and family support to optimize health behavior outcomes.

Systematic review registration: Open Science Framework identifier osf.io/98n7r.

Context: The combination of vitamin D supplementation and exercise has gained attention for its potential to improve body composition and muscular strength.

Objective: In this systematic review and meta-analysis we aimed to determine whether combining vitamin D supplementation with exercise is more effective than exercise alone in improving body composition and muscular strength in adults.

Data sources: We systematically searched PubMed, Web of Science, and Scopus up to April 1, 2024.

Data extraction: Studies evaluating vitamin D supplementation combined with exercise versus exercise-only controls were included. Outcomes assessed were 25-hydroxyvitamin D [25(OH)D], body weight (BW), body mass index (BMI), fat mass (FM), body fat percentage (BFP), fat-free mass (FFM), and muscular strength (handgrip, leg press, and knee extension). Weighted mean differences (WMDs) were calculated. Fractional polynomial modeling was used to assess nonlinear associations between vitamin D dose (IU/wk), intervention duration, and outcomes.

Data analysis: A total of 28 studies with 1675 participants were included. Vitamin D combined with exercise significantly increased 25(OH)D levels compared to exercise alone (WMD, 34.11 nmol/L; P = .001). Subgroup analyses showed significant increases in 25(OH)D levels in both healthy and unhealthy adults. No significant effects were observed for BW, BMI, FM, BFP, FFM, or leg press strength (all P > .05). A modest but significant improvement was found in knee extension strength (WMD, 4.36 kg; P = .039). Additionally, handgrip strength improved significantly in older adults and in those receiving higher vitamin D doses.

Conclusion: Vitamin D supplementation combined with exercise increases 25(OH)D levels but does not improve body composition more than exercise alone. Overall, muscular strength was not significantly affected; however, modest improvements were observed in knee extension strength and handgrip strength, particularly in older adults and those receiving higher vitamin D doses.

Systematic review registration: PROSPERO registration No. CRD42024548619.