Pub Date : 2025-10-08DOI: 10.1016/j.nut.2025.112989
Angela Silva de Almeida Brito M.Sc., Janielly Vilela dos Santos Gonçalves M.Sc., Gilcilene Oliveira Gadelha Ph.D., Suleima Pedroza Vasconcelos Ph.D.
Introduction
Psychomotor performance is critical for professionals with high cognitive demands, such as police officers. Nutritional factors have been suggested to influence attention and reaction time. This study aimed to assess the association between caloric and macronutrient intake and psychomotor performance in shift-working police officers.
Methods
This cross-sectional study included 22 military police officers from Rio Branco, Acre, Brazil. Dietary intake was assessed using 24-hour dietary recalls, and psychomotor performance was measured with the Psychomotor Vigilance Test (PVT). Spearman correlation coefficients were calculated between caloric and macronutrient intake and psychomotor performance variables: mean reaction time (MRT) and number of attention lapses (NL).
Results
During the day shift, significant positive correlations were found between caloric intake and NL (r = 0.630; P = 0.004) and MRT (r = 0.565; P = 0.012), as well as between protein intake and NL/MRT at shift start (r = 0.543; P = 0.016 / r = 0.600; P = 0.007) and shift end (r = 0.529; P = 0.020 / r = 0.544; P = 0.016). Although psychomotor performance declined during night shifts, no significant correlations were observed between performance and caloric or macronutrient intake during these shifts.
Conclusions
Higher caloric and protein intake was associated with poorer psychomotor vigilance performance during day shifts. No significant associations were detected between performance parameters and intake of other macronutrients.
心理运动表现对于具有高认知要求的专业人员，如警察来说是至关重要的。营养因素被认为会影响注意力和反应时间。本研究旨在评估倒班警察的热量和常量营养素摄入与精神运动表现之间的关系。方法：本横断面研究包括22名来自巴西阿克里巴布兰科的宪兵。通过24小时饮食回顾评估饮食摄入量，并通过精神运动警觉性测试（PVT）测量精神运动表现。计算热量和常量营养素摄入与精神运动表现变量：平均反应时间（MRT）和注意力缺失次数（NL）之间的Spearman相关系数。结果：白班时，热量摄入与NL （r = 0.630; P = 0.004）、MRT （r = 0.565; P = 0.012）、蛋白质摄入与NL/MRT （r = 0.543; P = 0.016 / r = 0.600; P = 0.007）、轮班结束（r = 0.529; P = 0.020 / r = 0.544; P = 0.016）呈正相关。尽管精神运动表现在夜班期间有所下降，但在夜班期间的表现与热量或常量营养素摄入之间没有显著的相关性。结论：较高的热量和蛋白质摄入与白班期间较差的精神运动警觉性表现有关。在性能参数和其他常量营养素的摄入量之间没有发现显著的关联。
{"title":"Association between caloric and macronutrient intake and the psychomotor performance of military police officers working shifts","authors":"Angela Silva de Almeida Brito M.Sc., Janielly Vilela dos Santos Gonçalves M.Sc., Gilcilene Oliveira Gadelha Ph.D., Suleima Pedroza Vasconcelos Ph.D.","doi":"10.1016/j.nut.2025.112989","DOIUrl":"10.1016/j.nut.2025.112989","url":null,"abstract":"<div><h3>Introduction</h3><div>Psychomotor performance is critical for professionals with high cognitive demands, such as police officers. Nutritional factors have been suggested to influence attention and reaction time. This study aimed to assess the association between caloric and macronutrient intake and psychomotor performance in shift-working police officers.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 22 military police officers from Rio Branco, Acre, Brazil. Dietary intake was assessed using 24-hour dietary recalls, and psychomotor performance was measured with the Psychomotor Vigilance Test (PVT). Spearman correlation coefficients were calculated between caloric and macronutrient intake and psychomotor performance variables: mean reaction time (MRT) and number of attention lapses (NL).</div></div><div><h3>Results</h3><div>During the day shift, significant positive correlations were found between caloric intake and NL (r = 0.630; <em>P = 0.</em>004) and MRT (r = 0.565; <em>P = 0.</em>012), as well as between protein intake and NL/MRT at shift start (r = 0.543; <em>P = 0.</em>016 / r = 0.600; <em>P = 0.</em>007) and shift end (r = 0.529; <em>P = 0.</em>020 / r = 0.544; <em>P = 0.</em>016). Although psychomotor performance declined during night shifts, no significant correlations were observed between performance and caloric or macronutrient intake during these shifts.</div></div><div><h3>Conclusions</h3><div>Higher caloric and protein intake was associated with poorer psychomotor vigilance performance during day shifts. No significant associations were detected between performance parameters and intake of other macronutrients.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"142 ","pages":"Article 112989"},"PeriodicalIF":3.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145550044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-04DOI: 10.1016/j.nut.2025.112984
Gianfranco Alicandro , Laura Zazzeron , Valentina Visciola , Anna Bulfamante , Arianna Biffi , Fabiola Corti , Andrea Gramegna , Francesco Blasi , Valeria Daccò
Background
The highly effective CFTR modulator elexacaftor/tezacaftor/ivacaftor therapy has revolutionized the care of cystic fibrosis (CF) leading to significant improvement in patient outcomes. However, data on long-term evolution of nutritional outcomes are limited.
Methods
We conducted a prospective study to evaluate changes in nutritional outcomes in people with CF (pwCF), including weight, body mass index (BMI), fat absorption and fat-soluble vitamin levels. Study outcomes were measured before treatment initiation and after 12 and 24 mo. Mean changes and 95% confidence intervals (CI) were obtained using generalized estimating equations.
Results
A total of 84 patients with a median age of 19.9 y (range: 12–32) were enrolled. At the 24-mo follow-up visit, weight increased by 4.7 kg (95% CI: 3.5, 6.0) and BMI increased by 0.40 standard deviation scores (95% CI: 0.27, 0.53). The prevalence of overweight and obesity increased from 4.8% to 10.7%. After 24 mo of ETI therapy, levels of vitamin A and E, as well as international normalized ratio (used as a marker of vitamin K status) were lower than baseline values, while vitamin D did not appreciably change.
Conclusions
ETI has primarily led to significant improvements in the nutritional status of pwCF, resulting in increased BMI. However, a shift from the traditional hypercaloric and high fat diet to a balanced, healthy diet is essential to avoid excessive weight gain. Additionally, our findings underscore the need for ongoing monitoring of fat-soluble vitamin levels and adherence to supplementation.
{"title":"Nutritional outcomes in people with cystic fibrosis receiving elexacaftor/tezacaftor/ivacaftor: A 24-mo real-world study","authors":"Gianfranco Alicandro , Laura Zazzeron , Valentina Visciola , Anna Bulfamante , Arianna Biffi , Fabiola Corti , Andrea Gramegna , Francesco Blasi , Valeria Daccò","doi":"10.1016/j.nut.2025.112984","DOIUrl":"10.1016/j.nut.2025.112984","url":null,"abstract":"<div><h3>Background</h3><div>The highly effective CFTR modulator elexacaftor/tezacaftor/ivacaftor therapy has revolutionized the care of cystic fibrosis (CF) leading to significant improvement in patient outcomes. However, data on long-term evolution of nutritional outcomes are limited.</div></div><div><h3>Methods</h3><div>We conducted a prospective study to evaluate changes in nutritional outcomes in people with CF (pwCF), including weight, body mass index (BMI), fat absorption and fat-soluble vitamin levels. Study outcomes were measured before treatment initiation and after 12 and 24 mo. Mean changes and 95% confidence intervals (CI) were obtained using generalized estimating equations.</div></div><div><h3>Results</h3><div>A total of 84 patients with a median age of 19.9 y (range: 12–32) were enrolled. At the 24-mo follow-up visit, weight increased by 4.7 kg (95% CI: 3.5, 6.0) and BMI increased by 0.40 standard deviation scores (95% CI: 0.27, 0.53). The prevalence of overweight and obesity increased from 4.8% to 10.7%. After 24 mo of ETI therapy, levels of vitamin A and E, as well as international normalized ratio (used as a marker of vitamin K status) were lower than baseline values, while vitamin D did not appreciably change.</div></div><div><h3>Conclusions</h3><div>ETI has primarily led to significant improvements in the nutritional status of pwCF, resulting in increased BMI. However, a shift from the traditional hypercaloric and high fat diet to a balanced, healthy diet is essential to avoid excessive weight gain. Additionally, our findings underscore the need for ongoing monitoring of fat-soluble vitamin levels and adherence to supplementation.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"142 ","pages":"Article 112984"},"PeriodicalIF":3.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145409013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-04DOI: 10.1016/j.nut.2025.112980
Jose M Quintana PhD , Nere Larrea MSc , Josune Martin PhD , Inmaculada Bolinaga BS , Cristina Sarasqueta PhD , Amaia Perales BS , Natalia-Covadonga Iglesias MD , Alfredo Yoldi MD , Yolanda Garcia MD , the REDISSEC-Malnutrition Research Group
Background/Objectives
Our goal was to study the association between the Global Leadership Initiative on Malnutrition (GLIM) categories of gastrointestinal cancer patients and treatment outcomes.
Subjects/Methods
Prospective cohort study of patients with esophageal, gastric, pancreatic, colon or rectal cancers, in which nutritional status was assessed by GLIM at three hospitals. Sociodemographic, clinical, nutritional parameters (changes in weight, calf circumference and handgrip-strength from admission to discharge) and treatment outcomes (mortality up to 12 months, occurrence of infectious complications, length of hospital stay, readmissions at 90 days) were recorded. Logistic, survival regression or generalized multilevel linear multivariable models were used depending on the outcome variable.
Results
Of the 519 patients included, 283 (54.53%) were categorized as having no malnutrition, 122 (23.51%) as moderate and 114 (21.97%) as severe malnutrition. The multivariate analysis showed no difference between GLIM categories in 30-day mortality, 90-day readmission or infectious complications. Differences were found in 90-day mortality between those with moderate and severe malnutrition compared to the group with no malnutrition; in mortality at up to one year, differences were found between patients with severe malnutrition and those with no malnutrition. There were no differences between the groups with moderate or severe malnutrition and those with no malnutrition in either length of hospital stay or change in nutritional parameters between admission and discharge.
Conclusion
In this sample, GLIM classification was found to be related to outcomes in 90-day and one-year mortality but not to other clinical parameters or changes in nutritional parameters.
{"title":"Impact of GLIM-criteria-defined malnutrition on outcomes in gastrointestinal cancer patients","authors":"Jose M Quintana PhD , Nere Larrea MSc , Josune Martin PhD , Inmaculada Bolinaga BS , Cristina Sarasqueta PhD , Amaia Perales BS , Natalia-Covadonga Iglesias MD , Alfredo Yoldi MD , Yolanda Garcia MD , the REDISSEC-Malnutrition Research Group","doi":"10.1016/j.nut.2025.112980","DOIUrl":"10.1016/j.nut.2025.112980","url":null,"abstract":"<div><h3>Background/Objectives</h3><div>Our goal was to study the association between the Global Leadership Initiative on Malnutrition (GLIM) categories of gastrointestinal cancer patients and treatment outcomes.</div></div><div><h3>Subjects/Methods</h3><div>Prospective cohort study of patients with esophageal, gastric, pancreatic, colon or rectal cancers, in which nutritional status was assessed by GLIM at three hospitals. Sociodemographic, clinical, nutritional parameters (changes in weight, calf circumference and handgrip-strength from admission to discharge) and treatment outcomes (mortality up to 12 months, occurrence of infectious complications, length of hospital stay, readmissions at 90 days) were recorded. Logistic, survival regression or generalized multilevel linear multivariable models were used depending on the outcome variable.</div></div><div><h3>Results</h3><div>Of the 519 patients included, 283 (54.53%) were categorized as having no malnutrition, 122 (23.51%) as moderate and 114 (21.97%) as severe malnutrition. The multivariate analysis showed no difference between GLIM categories in 30-day mortality, 90-day readmission or infectious complications. Differences were found in 90-day mortality between those with moderate and severe malnutrition compared to the group with no malnutrition; in mortality at up to one year, differences were found between patients with severe malnutrition and those with no malnutrition. There were no differences between the groups with moderate or severe malnutrition and those with no malnutrition in either length of hospital stay or change in nutritional parameters between admission and discharge.</div></div><div><h3>Conclusion</h3><div>In this sample, GLIM classification was found to be related to outcomes in 90-day and one-year mortality but not to other clinical parameters or changes in nutritional parameters.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"142 ","pages":"Article 112980"},"PeriodicalIF":3.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-03DOI: 10.1016/j.nut.2025.112988
Rie Akamatsu DrPH , Keiko Otake PhD
Objective
This study examined whether paying visual attention to meals—by following a simple and non-burdensome instruction—could enhance eating pleasure in individuals with low eating pleasure, as measured by epicurean eating tendency (EET) scores, and whether increased EET could be sustained after the intervention.
Methods
A randomized controlled trial was conducted online in Japan’s Kanto region (Nov–Dec 2023) among 536 men aged 20-64 with low EET scores. The intervention group (n = 360) followed a 5-d lunch color-counting task and reported increased meal awareness. The control group included 176 participants. EET scores were measured before, immediately after, and 2 and 4 wk postintervention, using per-protocol set analysis.
Results
Data from 116 (32.2%) intervention and 126 (71.6%) control participants were analyzed. Median baseline scores were 21.0 in both groups (P = 0.051). After the intervention (post-survey 1), the intervention group scored higher (25.0) than the control group (22.0, P < 0.001). Two weeks later (post-survey 2), scores slightly declined in both groups (24.0 and 20.0), but the intervention group maintained a significant increase from baseline (P < 0.001), whereas the control group did not (P = 0.089). Scores in the intervention group remained stable at post-survey 3 (24.0, P = 1.000).
Conclusion
Given prior evidence linking higher EET to healthier eating behaviors, this simple 5-d lunch color-counting task may help increase and sustain EET. Future studies should explore further methods to enhance EET in populations with low eating pleasure.
{"title":"Counting meal colors enhances eating pleasure related to favorable dietary behaviors: A randomized controlled trial in adult men","authors":"Rie Akamatsu DrPH , Keiko Otake PhD","doi":"10.1016/j.nut.2025.112988","DOIUrl":"10.1016/j.nut.2025.112988","url":null,"abstract":"<div><h3>Objective</h3><div>This study examined whether paying visual attention to meals—by following a simple and non-burdensome instruction—could enhance eating pleasure in individuals with low eating pleasure, as measured by epicurean eating tendency (EET) scores, and whether increased EET could be sustained after the intervention.</div></div><div><h3>Methods</h3><div>A randomized controlled trial was conducted online in Japan’s Kanto region (Nov–Dec 2023) among 536 men aged 20-64 with low EET scores. The intervention group (<em>n</em> = 360) followed a 5-d lunch color-counting task and reported increased meal awareness. The control group included 176 participants. EET scores were measured before, immediately after, and 2 and 4 wk postintervention, using per-protocol set analysis.</div></div><div><h3>Results</h3><div>Data from 116 (32.2%) intervention and 126 (71.6%) control participants were analyzed. Median baseline scores were 21.0 in both groups (<em>P</em> = 0.051). After the intervention (post-survey 1), the intervention group scored higher (25.0) than the control group (22.0, <em>P</em> < 0.001). Two weeks later (post-survey 2), scores slightly declined in both groups (24.0 and 20.0), but the intervention group maintained a significant increase from baseline (<em>P</em> < 0.001), whereas the control group did not (<em>P</em> = 0.089). Scores in the intervention group remained stable at post-survey 3 (24.0, <em>P</em> = 1.000).</div></div><div><h3>Conclusion</h3><div>Given prior evidence linking higher EET to healthier eating behaviors, this simple 5-d lunch color-counting task may help increase and sustain EET. Future studies should explore further methods to enhance EET in populations with low eating pleasure.</div></div><div><h3>Registry Number</h3><div>jRCT1030230414</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"142 ","pages":"Article 112988"},"PeriodicalIF":3.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145418623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carbohydrate counting is a recommended approach for achieving glycemic control in individuals with type 1 diabetes (T1D). This study aimed to compare the accuracy of carbohydrate content estimations for traditional Turkish fast foods made by artificial intelligence (AI) models and dietitian.
Methods
Children and adolescents with T1D were pretested to identify the 12 most preferred Turkish fast-food items. Standardized recipes were developed for these meals, and the meals were photographed under standardized angular and lighting conditions. The photos were then uploaded to AI applications (ChatGPT-4.0, DeepSeek, Gemini, and CarbManager) and each model was prompted to estimate the carbohydrate content of the respective food items. Dietitians were asked to estimate the carbohydrate content based on these photographs.
Results
Of the dietitians in the study (n = 40), 50% had postgraduate education, and 17.5% of those providing carbohydrate counting education (n = 20, 50.0%) had been doing so for more than 7 y. No significant difference was found between the carbohydrate estimates of dietitians who provided and those who did not provide carbohydrate counting training (P > 0.05). The intraclass correlation coefficient (ICC) between the AI models was 0.3554 (95% confidence interval [CI]: 0.0974–0.6801), indicating low reliability. The highest agreement with the estimates of dietitians who provided carbohydrate counting training (ICC = 0.417, 95% CI: 0.247–0.685) and those who did not (ICC = 0.307, 95% CI: 0.163–0.578) was observed with ChatGPT.
Conclusions
AI models can assist individuals with diabetes and healthcare professionals in estimating the carbohydrate content of foods, and consequently, can make a significant contribution to diabetes self-management.
{"title":"Carbohydrate counting in traditional Turkish fast foods for individuals with type 1 diabetes: Can artificial intelligence models replace dietitians?","authors":"Volkan Özkaya , Erdal Eren , Şebnem Özgen Özkaya , Güven Özkaya","doi":"10.1016/j.nut.2025.112986","DOIUrl":"10.1016/j.nut.2025.112986","url":null,"abstract":"<div><h3>Objectives</h3><div>Carbohydrate counting is a recommended approach for achieving glycemic control in individuals with type 1 diabetes (T1D). This study aimed to compare the accuracy of carbohydrate content estimations for traditional Turkish fast foods made by artificial intelligence (AI) models and dietitian.</div></div><div><h3>Methods</h3><div>Children and adolescents with T1D were pretested to identify the 12 most preferred Turkish fast-food items. Standardized recipes were developed for these meals, and the meals were photographed under standardized angular and lighting conditions. The photos were then uploaded to AI applications (ChatGPT-4.0, DeepSeek, Gemini, and CarbManager) and each model was prompted to estimate the carbohydrate content of the respective food items. Dietitians were asked to estimate the carbohydrate content based on these photographs.</div></div><div><h3>Results</h3><div>Of the dietitians in the study (<em>n</em> = 40), 50% had postgraduate education, and 17.5% of those providing carbohydrate counting education (<em>n</em> = 20, 50.0%) had been doing so for more than 7 y. No significant difference was found between the carbohydrate estimates of dietitians who provided and those who did not provide carbohydrate counting training (<em>P</em> > 0.05). The intraclass correlation coefficient (ICC) between the AI models was 0.3554 (95% confidence interval [CI]: 0.0974–0.6801), indicating low reliability. The highest agreement with the estimates of dietitians who provided carbohydrate counting training (ICC = 0.417, 95% CI: 0.247–0.685) and those who did not (ICC = 0.307, 95% CI: 0.163–0.578) was observed with ChatGPT.</div></div><div><h3>Conclusions</h3><div>AI models can assist individuals with diabetes and healthcare professionals in estimating the carbohydrate content of foods, and consequently, can make a significant contribution to diabetes self-management.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"142 ","pages":"Article 112986"},"PeriodicalIF":3.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145418624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-03DOI: 10.1016/j.nut.2025.112985
Andrea Devecchi , Lorenzo Stacchini , Daniele Nucci , Maria Regina Ferrando , Elisa Proietti , Martina Moretton , Elena Formisano , Alessandro Leone , Vincenza Gianfredi
Objective
This study examined regional disparities in food security and food safety knowledge and behavior among Italian adults.
Methods
Between January and June 2024, we conducted a cross-sectional anonymous online survey targeting Italian residents aged ≥18. The sample size was calculated a priori assuming a 50% prevalence, 95% confidence, and 3% margin of error, yielding a target of 1067 participants. Validated Italian versions of the Food Security Survey Module (It-FSSM) and the Food Safety Knowledge and Behavior Questionnaire (It-FSKB) were employed to assess participants’ knowledge and behaviors. Sociodemographic data, including age, sex, body mass index (BMI), educational level, physical activity, smoking habits, and food apps usage, were collected. Multinomial logistic regression—adjusted for age, sex, BMI, and educational level—was used to evaluate regional differences.
Results
Among 1752 participants (70.4% women; mean age: 36.01 ± 13.84 y), those in the South area and Islands were significantly less likely to report high food safety knowledge (relative risk ratio [RRR] = 0.66; 95% confidence interval [CI]: 0.54–0.82; P = 0.000) and high food safety behaviors (RRR = 0.64; 95% CI: 0.52–0.79; P < 0.001), and more likely to experience moderate food insecurity (RRR = 1.64; 95% CI: 1.00–2.69; P = 0.048) compared to participants to the North. Participants in the Center were over twice likely than those in the North to report high food security versus very low (RRR = 2.72; 95% CI: 1.15–6.43; P = 0.023) and were also 30% less likely to use food delivery apps rarely rather than not at all (RRR = 0.70; 95% CI: 0.50–0.97; P = 0.034).
Conclusions
This study highlights significant regional disparities, with the South area and Islands facing the greatest challenges. These findings provide evidence to guide targeted public health interventions and policies promoting food safety and security across Italy.
目的研究意大利成年人在食品安全和食品安全知识和行为方面的地区差异。方法在2024年1月至6月期间，我们对年龄≥18岁的意大利居民进行了横断面匿名在线调查。样本量是先验计算的，假设患病率为50%，置信度为95%，误差幅度为3%，目标为1067名参与者。采用经过验证的意大利版食品安全调查模块（It-FSSM）和食品安全知识与行为问卷（It-FSKB）来评估参与者的知识和行为。收集了社会人口统计数据，包括年龄、性别、体重指数（BMI）、教育水平、体育活动、吸烟习惯和食品应用程序使用情况。采用多项logistic回归（调整了年龄、性别、BMI和教育水平）来评估地区差异。结果在1752名参与者中（70.4%为女性，平均年龄36.01±13.84岁），南方地区和岛屿地区的食品安全知识（相对风险比[RRR] = 0.66, 95%可信区间[CI]: 0.54-0.82, P = 0.000）和食品安全行为（RRR = 0.64, 95% CI: 0.52-0.79, P < 0.001）的比例显著低于北方地区，而中度食品不安全（RRR = 1.64, 95% CI: 1.00-2.69, P = 0.048）的比例显著低于北方地区。中心的参与者报告高食品安全的可能性是北方的两倍多，而不是非常低（RRR = 2.72; 95% CI: 1.15-6.43; P = 0.023），很少使用送餐app的可能性比根本不使用的可能性低30% （RRR = 0.70; 95% CI: 0.50-0.97; P = 0.034）。本研究突出了显著的地区差异，南部地区和岛屿面临最大的挑战。这些发现为指导有针对性的公共卫生干预措施和政策提供了证据，以促进意大利各地的食品安全和保障。
{"title":"Exploring regional inequities in food safety practices and food security in Italy: A cross-sectional study","authors":"Andrea Devecchi , Lorenzo Stacchini , Daniele Nucci , Maria Regina Ferrando , Elisa Proietti , Martina Moretton , Elena Formisano , Alessandro Leone , Vincenza Gianfredi","doi":"10.1016/j.nut.2025.112985","DOIUrl":"10.1016/j.nut.2025.112985","url":null,"abstract":"<div><h3>Objective</h3><div>This study examined regional disparities in food security and food safety knowledge and behavior among Italian adults.</div></div><div><h3>Methods</h3><div>Between January and June 2024, we conducted a cross-sectional anonymous online survey targeting Italian residents aged ≥18. The sample size was calculated a priori assuming a 50% prevalence, 95% confidence, and 3% margin of error, yielding a target of 1067 participants. Validated Italian versions of the Food Security Survey Module (It-FSSM) and the Food Safety Knowledge and Behavior Questionnaire (It-FSKB) were employed to assess participants’ knowledge and behaviors. Sociodemographic data, including age, sex, body mass index (BMI), educational level, physical activity, smoking habits, and food apps usage, were collected. Multinomial logistic regression—adjusted for age, sex, BMI, and educational level—was used to evaluate regional differences.</div></div><div><h3>Results</h3><div>Among 1752 participants (70.4% women; mean age: 36.01 ± 13.84 y), those in the South area and Islands were significantly less likely to report high food safety knowledge (relative risk ratio [RRR] = 0.66; 95% confidence interval [CI]: 0.54–0.82; <em>P</em> = 0.000) and high food safety behaviors (RRR = 0.64; 95% CI: 0.52–0.79; <em>P</em> < 0.001), and more likely to experience moderate food insecurity (RRR = 1.64; 95% CI: 1.00–2.69; <em>P</em> = 0.048) compared to participants to the North. Participants in the Center were over twice likely than those in the North to report high food security versus very low (RRR = 2.72; 95% CI: 1.15–6.43; <em>P</em> = 0.023) and were also 30% less likely to use food delivery apps rarely rather than not at all (RRR = 0.70; 95% CI: 0.50–0.97; <em>P</em> = 0.034).</div></div><div><h3>Conclusions</h3><div>This study highlights significant regional disparities, with the South area and Islands facing the greatest challenges. These findings provide evidence to guide targeted public health interventions and policies promoting food safety and security across Italy.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"142 ","pages":"Article 112985"},"PeriodicalIF":3.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145418629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-02DOI: 10.1016/j.nut.2025.112983
Yasmina Ahmad Uzhir, Zalilah Mohd Shariff, Nurzalinda Zalbahar
The use of linear programming (LP) to develop complementary food recommendations (CFRs) is gaining interest due to its ability to produce low-cost population-specific food-based recommendations (FBRs). This review aimed to identify the components of LP models commonly used in developing CFRs and summarize the evidence on the use of LP-developed CFRs as an intervention strategy. The databases PubMed, Science Direct, Scopus, Cochrane Library, Web of Science, and Google Scholar were searched for relevant articles. LP was used in twenty-six studies to develop CFRs for young children and in three studies LP-developed CFRs were applied to improving complementary feeding. The objective function varied across studies, such as to maximize nutrient content, minimize cost, minimize deviation between observed and modeled diets, and minimize multiple nutrient deficiencies. All studies applied nutritional and acceptability constraints. Individual intervention studies showed that LP-developed CFRs can improve children’s nutrient intake and feeding practices, as well as mother’s nutrition knowledge. Various applications of LP have been used to develop optimal infant diets. However, LP-developed CFRs as a nutrition intervention strategy have been used in only a few studies. Further robust research is needed to test LP-developed CFRs.
利用线性规划（LP）制定辅食建议（CFRs）正引起人们的兴趣，因为它能够产生低成本的针对特定人群的基于食物的建议（FBRs）。本综述旨在确定通常用于发展cfr的LP模型的组成部分，并总结使用LP发展的cfr作为干预策略的证据。检索PubMed、Science Direct、Scopus、Cochrane Library、Web of Science和谷歌Scholar等数据库查找相关文章。在26项研究中，LP被用于开发幼儿CFRs，在3项研究中，LP开发的CFRs被用于改善辅食喂养。不同研究的目标功能各不相同，例如最大化营养含量，最小化成本，最小化观察和模拟饮食之间的偏差，以及最小化多种营养缺乏症。所有研究均采用营养和可接受性约束。个体干预研究表明，lp开发的CFRs可以改善儿童的营养摄入和喂养方式，以及母亲的营养知识。LP的各种应用已被用于开发最佳的婴儿饲料。然而，lp开发的CFRs作为营养干预策略仅在少数研究中使用。需要进一步强有力的研究来测试lp开发的CFRs。
{"title":"Application of linear programming in the development of complementary feeding recommendations: A systematic review","authors":"Yasmina Ahmad Uzhir, Zalilah Mohd Shariff, Nurzalinda Zalbahar","doi":"10.1016/j.nut.2025.112983","DOIUrl":"10.1016/j.nut.2025.112983","url":null,"abstract":"<div><div>The use of linear programming (LP) to develop complementary food recommendations (CFRs) is gaining interest due to its ability to produce low-cost population-specific food-based recommendations (FBRs). This review aimed to identify the components of LP models commonly used in developing CFRs and summarize the evidence on the use of LP-developed CFRs as an intervention strategy. The databases PubMed, Science Direct, Scopus, Cochrane Library, Web of Science, and Google Scholar were searched for relevant articles. LP was used in twenty-six studies to develop CFRs for young children and in three studies LP-developed CFRs were applied to improving complementary feeding. The objective function varied across studies, such as to maximize nutrient content, minimize cost, minimize deviation between observed and modeled diets, and minimize multiple nutrient deficiencies. All studies applied nutritional and acceptability constraints. Individual intervention studies showed that LP-developed CFRs can improve children’s nutrient intake and feeding practices, as well as mother’s nutrition knowledge. Various applications of LP have been used to develop optimal infant diets. However, LP-developed CFRs as a nutrition intervention strategy have been used in only a few studies. Further robust research is needed to test LP-developed CFRs.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"142 ","pages":"Article 112983"},"PeriodicalIF":3.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145418619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.nut.2025.112982
Fulian Zhao M.D. , Ruojing Wang M.D. , Chengbin Zhu M.D. , Chang Zhang Ph.D. , Tianzhi Ni M.D. , Qijuan Zang M.D. , Yali Feng M.D. , Mengmeng Zhang M.D. , Li Zhu M.D. , Yage Zhu M.D. , Juan Du M.D. , Zhe Jiao M.D. , Chenxia Li M.D. , Taotao Yan M.D. , Yingli He Ph.D. , Yuchao Wu M.D. , Yingren Zhao Ph.D. , Yuan Yang Ph.D.
Background
Sarcopenia is the progressive loss of muscle mass that worsens the clinical outcomes of cirrhosis. Here, we aimed to investigate the changes in skeletal muscle index (ΔSMI) over an intermediate period of time to comprehensively elucidate its prognostic value for long-term mortality in cirrhosis.
Materials and Methods
This ambispective cohort study included patients with cirrhosis who underwent abdominal computed tomography (CT) between January 2012 and December 2021. SMI was obtained from annual CT scans at the third lumbar vertebra. The effect of the first 3 y of the annual rate of change in SMI (∆SMI/yr%) was calculated and its prognosis at the next long-term follow-up was analyzed.
Results
Overall, 384 patients who underwent at least two CT examinations during the first 3 y were enrolled. Here, 120 men (31.3%) and 44 women (11.5%) had sarcopenia at baseline. At an average follow-up of 71.52 mo, 257 (66.9%) patients were with liver transplantation (LT)-free. Sarcopenia defined status at 1 to 3 y tended to be a prognostic factor. Patients with a change in sarcopenia status from normal to sarcopenic had worse outcomes in terms of LT-free survival. Based on Cox and competing risk model analyses, ∆SMI/yr% was independently associated with poor survival. When separated by a cutoff of ∆SMI/yr% −2.08 derived from the receiver operating characteristic (ROC) analysis, ∆SMI/yr% < −2.08 was not associated with age, but it did significantly discriminate the patients with decompensation, bacterial infection, and severe liver dysfunction (P value < 0.05).
Conclusions
SMI/yr% performs as an effective index for predicting poor long-term outcomes in patients with cirrhosis, independent of age. Early short-term monitoring of SMI could guide clinical decision-making regarding nutritional interventions in cirrhosis.
{"title":"Impact of year-to-year changes in skeletal muscle mass on the prediction of long-term survival in patients with liver cirrhosis","authors":"Fulian Zhao M.D. , Ruojing Wang M.D. , Chengbin Zhu M.D. , Chang Zhang Ph.D. , Tianzhi Ni M.D. , Qijuan Zang M.D. , Yali Feng M.D. , Mengmeng Zhang M.D. , Li Zhu M.D. , Yage Zhu M.D. , Juan Du M.D. , Zhe Jiao M.D. , Chenxia Li M.D. , Taotao Yan M.D. , Yingli He Ph.D. , Yuchao Wu M.D. , Yingren Zhao Ph.D. , Yuan Yang Ph.D.","doi":"10.1016/j.nut.2025.112982","DOIUrl":"10.1016/j.nut.2025.112982","url":null,"abstract":"<div><h3>Background</h3><div>Sarcopenia is the progressive loss of muscle mass that worsens the clinical outcomes of cirrhosis. Here, we aimed to investigate the changes in skeletal muscle index (ΔSMI) over an intermediate period of time to comprehensively elucidate its prognostic value for long-term mortality in cirrhosis.</div></div><div><h3>Materials and Methods</h3><div>This ambispective cohort study included patients with cirrhosis who underwent abdominal computed tomography (CT) between January 2012 and December 2021. SMI was obtained from annual CT scans at the third lumbar vertebra. The effect of the first 3 y of the annual rate of change in SMI (∆SMI/yr%) was calculated and its prognosis at the next long-term follow-up was analyzed.</div></div><div><h3>Results</h3><div>Overall, 384 patients who underwent at least two CT examinations during the first 3 y were enrolled. Here, 120 men (31.3%) and 44 women (11.5%) had sarcopenia at baseline. At an average follow-up of 71.52 mo, 257 (66.9%) patients were with liver transplantation (LT)-free. Sarcopenia defined status at 1 to 3 y tended to be a prognostic factor. Patients with a change in sarcopenia status from normal to sarcopenic had worse outcomes in terms of LT-free survival. Based on Cox and competing risk model analyses, ∆SMI/yr% was independently associated with poor survival. When separated by a cutoff of ∆SMI/yr% −2.08 derived from the receiver operating characteristic (ROC) analysis, ∆SMI/yr% < −2.08 was not associated with age, but it did significantly discriminate the patients with decompensation, bacterial infection, and severe liver dysfunction (<em>P</em> value < 0.05).</div></div><div><h3>Conclusions</h3><div>SMI/yr% performs as an effective index for predicting poor long-term outcomes in patients with cirrhosis, independent of age. Early short-term monitoring of SMI could guide clinical decision-making regarding nutritional interventions in cirrhosis.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"142 ","pages":"Article 112982"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145418622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-30DOI: 10.1016/j.nut.2025.112976
Yuanhao Tong M.D. , Huayu Li Ph.D. , Yang Cheng M.D. , Hongmei Wang Ph.D. , Min Mao M.D., Ph.D.
Background
The progression of sarcopenia is closely associated with inflammation. However, systematic data is currently limited linking sarcopenia to inflammatory-related indices, especially neutrophil percentage-to-albumin ratio (NPAR).
Objective
The study was designed to investigate the correlation between inflammatory-related indices and sarcopenia.
Subjects and methods
Data on sarcopenia were obtained from the 2011–2018 period of the National Health and Nutrition Examination Survey (NHANES). The correlation between inflammatory-related indices and sarcopenia was investigated by adjusting for confounders using multivariate logistic regression models, restricted cubic splines (RCS) regression, and subgroup analysis. To evaluate prediction performance, we conducted the random forest method and plotted receiver operating characteristic (ROC) curves. The area under the curve (AUC) was applied to gauge accuracy.
Results
After adjusting for confounding variables, a greater incidence of sarcopenia was correlated with increased levels of NPAR and systemic immune-inflammation index (SII). The risk of sarcopenia was higher among individuals in the highest quartile of NPAR (OR = 1.70, 95% CI: 1.17–2.47) and SII (OR = 1.62, 95% CI: 1.11–2.37) than those in the lowest quartiles. Neutrophil-to-lymphocyte ratio (NLR) and SII exhibited a nonlinear association with sarcopenia in the RCS model. The results of the random forest revealed that, among all indexes, NPAR exhibited the highest predictive value for sarcopenia. ROC analysis for the NPAR showed an AUC of 0.784.
Conclusion
Inflammatory-related indices have a strong correlation with an increased incidence of sarcopenia in Americans, suggesting that they may be employed to predict sarcopenia in clinical practice. Among those indices, NPAR represents the most promising with the highest predictive performance. More future research should be done to validate its efficiency in clinical practice.
{"title":"Novel inflammatory-related indices for screening sarcopenia: Insights from a population-based study","authors":"Yuanhao Tong M.D. , Huayu Li Ph.D. , Yang Cheng M.D. , Hongmei Wang Ph.D. , Min Mao M.D., Ph.D.","doi":"10.1016/j.nut.2025.112976","DOIUrl":"10.1016/j.nut.2025.112976","url":null,"abstract":"<div><h3>Background</h3><div>The progression of sarcopenia is closely associated with inflammation. However, systematic data is currently limited linking sarcopenia to inflammatory-related indices, especially neutrophil percentage-to-albumin ratio (NPAR).</div></div><div><h3>Objective</h3><div>The study was designed to investigate the correlation between inflammatory-related indices and sarcopenia.</div></div><div><h3>Subjects and methods</h3><div>Data on sarcopenia were obtained from the 2011–2018 period of the National Health and Nutrition Examination Survey (NHANES). The correlation between inflammatory-related indices and sarcopenia was investigated by adjusting for confounders using multivariate logistic regression models, restricted cubic splines (RCS) regression, and subgroup analysis. To evaluate prediction performance, we conducted the random forest method and plotted receiver operating characteristic (ROC) curves. The area under the curve (AUC) was applied to gauge accuracy.</div></div><div><h3>Results</h3><div>After adjusting for confounding variables, a greater incidence of sarcopenia was correlated with increased levels of NPAR and systemic immune-inflammation index (SII). The risk of sarcopenia was higher among individuals in the highest quartile of NPAR (OR = 1.70, 95% CI: 1.17–2.47) and SII (OR = 1.62, 95% CI: 1.11–2.37) than those in the lowest quartiles. Neutrophil-to-lymphocyte ratio (NLR) and SII exhibited a nonlinear association with sarcopenia in the RCS model. The results of the random forest revealed that, among all indexes, NPAR exhibited the highest predictive value for sarcopenia. ROC analysis for the NPAR showed an AUC of 0.784.</div></div><div><h3>Conclusion</h3><div>Inflammatory-related indices have a strong correlation with an increased incidence of sarcopenia in Americans, suggesting that they may be employed to predict sarcopenia in clinical practice. Among those indices, NPAR represents the most promising with the highest predictive performance. More future research should be done to validate its efficiency in clinical practice.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"142 ","pages":"Article 112976"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145401534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Authors’ response to comment re. “Food insecurity is associated with obesity and abdominal obesity among older adults: A cross-sectional analysis of ELSA study”","authors":"Vincenza Gianfredi MD, PhD, Daniele Nucci MSc, Nicola Veronese MD","doi":"10.1016/j.nut.2025.112977","DOIUrl":"10.1016/j.nut.2025.112977","url":null,"abstract":"","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"142 ","pages":"Article 112977"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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