Nutrition and Health

Artificial intelligence (AI) is increasingly applied in nutrition science to support clinical decision-making, prevent diet-related diseases such as obesity and type 2 diabetes, and improve nutrition care in both preventive and therapeutic settings. By analyzing diverse datasets, AI systems can support highly individualized nutritional guidance. We focus on machine learning applications and image recognition tools for dietary assessment and meal planning, highlighting their potential to enhance patient engagement and adherence through mobile apps and real-time feedback. Despite these advantages, challenges persist. AI-driven recommendations depend heavily on data quality and algorithm transparency, and biases may arise from unbalanced datasets that underrepresent certain populations or dietary patterns. These challenges can be mitigated through validated data sources, explainable AI systems, and mandatory professional oversight. We emphasize an approach that integrates AI responsibly within nutritional practice. It underscores the importance of ethical standards, interdisciplinary collaboration, and equitable access to ensure safe and effective implementation.

Background: The health belief model (HBM) provides a theoretical framework to understand and predict health-related behaviors. Numerous studies have shown that HBM-based nutrition education programs are effective in inducing the adoption of healthy dietary behaviors, which is an effective way to prevent diet-related chronic diseases. However, little is known about reviews of existing findings pertaining to the HBM and nutrition education, aiming to highlight the need for a validated HBM-based practical tool that can be adapted and used by program managers or related specialists when developing, implementing, and evaluating nutrition education programs. Aim: This study aims to review the application of the HBM in nutrition education and highlight the need for an HBM-based practical tool that can be consistently used in nutrition education programs. Methods: We searched articles published between 2014 and 2025, which were related to the HBM and nutrition education, using Google Scholar, PubMed, EBSCO, and Taylor & Francis databases. Twelve articles were selected for this review after applying the inclusion and exclusion criteria. Results: Across all the studies reviewed, HBM constructs were consistently shown to be significant predictors of positive dietary behavior changes (p < 0.05). All the articles reviewed indicated that the use of the HBM-based approach is an effective way to improve the effectiveness of nutrition education programs. Conclusion: The HBM can be used to assess and identify the HBM behavioral gaps of individuals, groups, or communities at the beginning of nutrition education programs, which can be subsequently addressed to induce the adoption of healthy dietary behaviors.

Background: Time-restricted eating/feeding (TRE/TRF) and physical exercise are promising nonpharmacological strategies to improve gut microbiota composition, diversity, and functionality. Aim: This review examines the independent and potential synergistic effects of TRE/TRF and various exercise modalities on gut microbiota, with a focus on underlying mechanisms and associated health outcomes. Methods: A comprehensive literature search was conducted using databases such as PubMed, Scopus, and Web of Science for articles published between 2015 and 2024. Keywords included terms related to intermittent fasting, TRE, TRF, physical exercise, and gut microbiota. Eligible studies involved human or animal models and examined primary outcomes, including gut microbiota diversity, composition, and metabolic outcomes. Results: The TRE/TRF has been shown to positively influence microbial diurnal rhythms, enhance microbial diversity, and increase beneficial bacteria such as Akkermansia muciniphila. Exercise, particularly aerobic and resistance training, enhances both α- and β-diversity, stimulates the proliferation of short-chain fatty acid producing and anti-inflammatory bacteria such as Bifidobacterium and Roseburia, and improves gut barrier integrity. However, findings from human studies remain heterogeneous and are influenced by intervention timing, participant characteristics, and dietary patterns. Limited evidence exists on the combined effects of TRE/TRF and exercise, but preliminary data suggest potential synergistic benefits, particularly in improving microbial diversity and metabolic outcomes. Conclusion: The TRE/TRF and exercise represent promising, nonpharmacological strategies for enhancing gut microbiota and supporting metabolic health. While individual effects are supported by robust preclinical and clinical evidence, research on their combined impact remains scarce.

The interaction between exercise modalities and time-restricted eating/feeding (TRE/TRF) on gut microbiota.

Background: There are no studies that have systematically reviewed the currently available evidence on the influence of vitamin E-supplementation on orthodontic tooth movement (OTM). Aim: The objective of this systematic review is to assess the influence of vitamin E-supplementation on OTM. Methods: Indexed databases were searched without time and language restrictions up to and including October 2025. Original studies addressing the focused question “Does vitamin E-supplementation affect OTM?” were included. Different combinations (Boolean operators) of keywords were used, and independent reviewers screened the studies for eligibility. The Risk of bias (RoB) and quality of studies were assessed using the Systematic Review Centre for Laboratory Animal Experimentation tool and Grading of Recommendations, Assessment, Development, and Evaluation analysis, respectively. Disagreements were resolved via discussion. Summary: Four studies performed on animal models were included. The magnitude of the orthodontic forces administered ranged from 10 g to 50 g. The route and dosage of vitamin E-supplementation varied between studies. One study showed no influence of vitamin E-supplementation on OTM; and three reported that vitamin E-supplementation increases OTM. Three studies reported that vitamin E-supplementation increases osteoblast activity and one reported that vitamin E-supplementation increases osteoclastic activity. Prior sample-size-estimation was performed in none of the studies. All studies had an unclear RoB and a low overall certainty of evidence. Since a limited number of preclinical studies, characterized by a high RoB and a low certainty of evidence fulfilled the eligibility criteria, the influence of vitamin E-supplementation on OTM remains inconclusive. Further well-designed, blinded, and power-adjusted randomized controlled trials with standardized vitamin E-supplementation related parameters are needed.

Background: The novel food compass score (FCS) may ease food choices and policy actions. Aim: To assess the correlations of FCS with key nutrients in hospital meals. Methods: A 14-day hospital menu was recorded and analyzed with the USDA database and published FCS values. Results: The menu FCS was 40.6 ± 3.7 (mean ± standard deviation). Fish, vegetable, chicken, and egg-based meals had the highest FCS, while pork/beef meals had the lowest FCS. The FCS was positively related to vitamins (vitamin C, thiamine, B6, folate, pantothenic acid, vitamin E, vitamin D, vitamin A, carotenoids), choline and minerals (calcium, magnesium, phosphorus, potassium, sodium, copper, and manganese) and negatively associated with zinc, niacin, and animal protein. Moreover, the FCS was positively related to portions of cheese, fish, vegetables, and eggs and negatively to portions of poultry, refined grains, and margarine. Conclusion: The FCS may help in designing healthier nutrient-dense hospital menus.

Background: Coronavirus disease 2019 emerged in China in December 2019 as a disease spreading from person to person by rapid droplet transmission, and which eventually evolved into a pandemic. Aim: This study aims to examine the psychosocial state, nutritional awareness, and physical activity level of municipal employees who provided services under changing working conditions during the coronavirus disease 2019 pandemic. Methods: A total of 220 employees working in two different municipalities in Istanbul were included in this study during March and April of 2021. For data collection, a questionnaire form was used. The form consisted of questions about the demographics and nutritional awareness of individuals, the Coronavirus-19 Phobia Scale, and the International Physical Activity Questionnaire (short form). Results: The mean total coronaphobia score was 51.08 ± 14.47 with the mean score for women being significantly higher than that for men (p < 0.05). The mean score obtained by the responses of participants to questions about nutritional awareness during the pandemic was significantly higher than the mean score referring to the period before the pandemic. The examination of the physical activity level of employees revealed that 62.4% of the men and 60% of the women were physically inactive during the pandemic. Conclusion: It was found that the coronaphobia scores of municipal employees during the coronavirus disease 2019 pandemic were at an average level, their nutritional awareness levels increased in general compared to the pre-pandemic period, and municipal employees were mostly inactive physically during the pandemic.

Objective: Recent epidemiological research has found food insecurity to be a growing public health concern among college students. This study investigated food insecurity, mental health, and substance use behaviors among state university undergraduate students. Study Design: Cross-sectional survey. Methods: This was a secondary data analysis of the Student Health Survey. Undergraduate participants (n = 589) completed the paper-based survey, which had an 84% response rate overall. Results: Approximately 38.5% of students were considered food insecure, 24.8% experiencing low food security, and 13.8% experiencing very low food security. Having a diagnosis of depression, experience of depressive symptoms, and marijuana use in the past 30 days were associated with food insecurity. Conclusion and Implications: Food insecurity is a serious health concern for college students. The results of this study indicate collocating food security and counseling services may enhance existing student resources to better support students facing food and nutrition insecurity, substance use, and depression.

Introduction: Hispanic men have one of the highest consumptions of sugar-sweetened beverages in the United States. Frequent sugar-sweetened beverage consumption has been associated with higher incidence of cardiovascular disease through altered vascular function. Cardiovascular disease is the second leading cause of death in the Hispanic population. The purpose of this study is to assess the difference in vascular function between Hispanic men and non-Hispanic men and whether this difference is attributed to ethnic predisposition (i.e. ethnicity) or other risk factors, such as sugar-sweetened beverage consumption. Method: Reactive hyperemia forearm blood flow of 11 Hispanic males and 11 non-Hispanic males was measured via venous occlusion plethysmography. Interview-administered questionnaires gathered anthropometric, medical, dietary, and physical activity data for participants. Results: No significant differences were found in peak or total reactive hyperemia forearm blood flow between matched pairs (p = 0.924). Significant differences were also not observed in dietary factors, sugar-sweetened beverage consumption (p = 0.693), or physical activity (0.720). Conclusion: No statistical differences in body composition, dietary intake, physical activity, and vascular function were observed between Hispanic and non-Hispanic males. Environmental and lifestyle factors may play a larger role than ethnicity in the development of cardiovascular disease. Recruitment based on ethnicity alone yielded a population that was similar regarding SSB consumption and vascular function.

Background: Important changes in lifestyle habits, especially diet, typically occur during the transitional period between high school and college and some of these changes may increase the risk of inflammation. Aim: The purpose of this study was to investigate the relationship between lifestyle factors and inflammation in college students. Methods: Students enrolled in a southeastern university participated in this cross-sectional study. Participants completed online questionnaires for assessment of demographics, supplement and dietary intake, sleep quality, and perceived stress. Body composition was measured during a clinic visit via air displacement plethysmography and blood and urine were collected for measurement of C-reactive protein (CRP) and cortisol, respectively. Analysis of variance was used to examine associations between tertiles of CRP levels and lifestyle variables and a linear regression model was fit to investigate whether there were any significant predictors of CRP levels. Results: Analysis included data for 83 participants for whom serum CRP levels and diet intake were available. Approximately 68% of the participants were female; mean age and body mass index (BMI) were 24 years and 23.4 kg/m², respectively. Alcohol intake was significantly associated with increasing CRP levels (P = 0.017). No other dietary variables or lifestyle characteristics such as sleep quality, perceived stress, or BMI were associated with tertiles of CRP. The best model to predict CRP levels included urinary cortisol, aerobic exercise duration, alcohol, and vitamin E intake (adjusted R²=0.27). Conclusion: Alcohol and vitamin E intake were found to be associated with increased CRP levels.

Background: Education may improve hiker safety on trails. Aim: To investigate the impact of an educational video on hiker fluid selection and fluid consumption in a hot environment. Methods: Quasi-experimental field study at hiking trails in which the intervention group (INT) viewed a three-minute hydration education video, whereas the control group (CON) did not. Before the hike, all hikers were asked if they wanted to select extra fluid, which was provided by the research team. Results: A total of n = 97 hikers participated in the study, with n = 56 in INT (32 male) and n = 41 in CON (25 male). Despite absolute differences in environmental conditions, the differences fell within the same WBGT category. The total amount of fluid brought to the trails by participants was different between INT: 904 (503–1758) mL and CON: 1509 (880–2176) mL (P = 0.006), but participants in the INT group selected extra fluid (41%; n = 23) significantly more often when compared with participants in the CON group (7%; n = 3; P < 0.001). As a result, there was no difference in the amount of fluid brought on the trail between INT: 1047 (611–1936) mL and CON: 1509 (932–2176) mL (P = 0.069), nor for fluid consumption between INT: 433 (289–615) mL/h and CON: 489 (374–719) mL/h (P = 0.18). Conclusions and Implications: A 3-min educational video may encourage hikers to select additional fluid before the start of their hike but does not appear to increase fluid intake.

Background and aim: In India, total vitamin B12 (Vit B12) and its active form (active B12) have not been studied in mother’s blood and cord blood. We hypothesized that total and active B12 levels are sufficiently maintained in cord blood despite low levels in mothers. Methods: Two hundred term pregnant mother's blood and cord blood was collected and analyzed for total Vit B12 (radioimmunoassay method) and active B12 levels (enzyme-linked immunosorbent assay). Mean values of constant or continuous variables (hemoglobin (Hb), packed cell volume (PCV), mean corpuscular volume (MCV), white blood cells (WBC), and Vit B12) were compared in mother's blood and newborn cord blood using Student's t-test and multiple comparisons within the groups were carried out with ANOVA. Spearman's correlation (Vit B12) and multivariable backward regression analyses (height, weight, education, body mass index (BMI) and Hb, PCV, MCV, WBC, and Vit B12 levels) were also performed. Results: Total Vit 12 deficiency was highly prevalent at 89% and active B12 deficiency was 36.7% in mothers. Cord blood showed total Vit B12 deficiency prevalence of 53% and active B12 deficiency being 9.3%. Total Vit B12 (p<0.001) and active B12 (p<0.001) levels were significantly higher in cord blood when compared to mother's blood. In multivariate analysis, higher total and active B12 levels in mother's blood predicted higher levels of total and active B12 levels in cord blood. Conclusion: Our study showed higher prevalence of total and active Vit B12 deficiency in mothers compared to cord blood thus indicating their transfer to fetus irrespective of mother's status. Maternal Vit B12 levels affected cord blood Vit B12 levels.

Background: Asian Americans (AA) young adults face a growing non-communicable disease burden linked with poor dietary behaviors. Family plays a significant role in shaping the diet of AA young adults, although little is known on the specific types of family structures most associated with different dietary behaviors. Aim: This analysis explores the changes in dietary behaviors across different AA young adult family structural characteristics. Methods: Nationwide data of 18–35-year-old self-identified Asians surveyed in the 2015 National Health Interview Survey (NHIS) was analyzed. Family structure was measured through family size, family health, and family members in one's life. The Dietary Screener Questionnaire (DSQ) measured the average intake of 10 food and nutrient groups. Published dietary guidelines were used to calculate the number of dietary recommendations met. Results: 670 AA young adults with dietary data were analyzed (26.1% Asian Indian, 26.1% Chinese, 19.3% Filipino, 28.5% other Asian). Participants had an average family size of 2.3. In weighted analyses, 19% of AA young adults met none of the examined dietary recommendations, and only 14% met 3–4 guidelines. Living with a child was associated meeting more dietary recommendations (adjusted odds ratio [AOR]: 1.22; 95%CI: 1.05, 1.42). The adjusted association between living with an older adult and lower odds of meeting dietary recommendations approached significance (AOR: 0.70; 95%CI: 0.49, 1.00). Conclusions: Findings revealed the important role of children and older adults in influencing the diet of AA young adults. Further mixed-methods research to disentangle mechanisms behind the influence of family structure on diet is warranted.

Objective: Understanding the impact of stress on emotional and external eating behaviors and the psychological and the associated metabolic factors can help in designing subsequent interventions to protect health. In particular, psychological trait-like construct related to eating has been shown to be an important target for intervention. Methods and measures: This study aimed to investigate the biochemical variables associated with a decrease in emotional and external eating behaviors due to 12-week ketogenic diet (12KD) in 35 adult participants (12 males) with obesity. Results: Absolute changes in emotional and external eating were independent of changes in body mass, nutritional intake, and Δ cortisol, but were predicted with increases in serum β-hydroxybutyrate (BHB) and decreases in serum peripheral neuropeptide Y (pNPY) (all p’s < 0.050). Decrease in pNPY was also associated with an increase in BHB but was independent of anthropometrical changes, Δ fasting glucose, and Δ insulin. Conclusion: The reductions in emotional and external eating behaviors in participants with obesity were uniquely predicted by an increase in BHB and a decrease in pNPY after 12KD. In ketosis, emotional and external eating dropped independently of body mass change. Change in pNPY predicted changes in emotional and external eating. The role of BHB in modulating eating behavior should be further explored.

Background: Dietary behaviours of adolescence are concerning, and this may impact long-term well-being. Aim: This study examined the socio-ecological determinants of dietary behaviours in a national prospective cohort study of English adolescents. Methods: Latent class analysis was used to identify the typologies of eight dietary behaviours: fruit, vegetable, breakfast, sugar-sweetened beverages, artificial-sweetened beverages, fast-food, bread, and milk from 7402 adolescents aged 13–15 years (mean 13.8 ± 0.45 years) (50.3% female and 71.3% white ethnicity) participating in the U.K. Millennium Cohort Study (sixth survey). Multinomial logistic regression and path analysis predicted associations between personal characteristics, individual, influential others, social environment and physical environment determinants and three distinct diet typologies: (1) healthy, (2) less-healthy and (3) mixed, (reference category = mixed). Results: Within Path analysis, the magnitudes of coefficients were small to moderate suggesting a relatively weak relationship between the variables. Model 1 reported adolescents within the less-healthy compared to mixed typology had lower levels of physical activity (β = 0.074, 95% CI = −0.115, −0.033), and have siblings (β = 0.246, 95% CI = 0.105, 0.387). Model 2 reported adolescents within the healthy compared to mixed typology had lower screen time (β = 0.104, 95% CI = 0.067, 0.141), and lower social media usage (β = 0.035, 95% CI = 0.024, 0.046). Conclusion: This study highlights the importance of considering multiple dietary determinants. These findings are likely to be useful in supporting the development of multi-faceted interventions. They emphasise the need to move away from investigating silo behaviours on individual diet components and a step towards more systems thinking to improve adolescent eating behaviours.

Background: Research into disordered eating (DE), shame and self-compassion (SC) has poorly represented men, general populations and non-Western communities. Aim: To explore associations between these variables in an international community sample of men and women. Methods: An online exploratory sequential mixed methods cross-sectional survey assessed levels of (quantitative Phase 1) and perceptions of (qualitative Phase 2) eating behaviours, external shame and body image shame (BIS) and SC. Results: Phase 1: Nearly 60% of our 142 survey participants were male (82/142) and about one-third were from India (43/142). About one-third of people (41/142) had a high-level concern regarding dieting, body weight, or eating (based on Eating Attitudes Test scores), and they had significantly higher levels of external shame, BIS and (SC-related) self-judgement and overidentification – compared to the 101/142 participants with low concern. Men had healthier levels of study outcomes than women. Phase 2: Four key themes were identified using inductive thematic analysis of the responses of 55 survey participants: (T1) DE as a Psychological Issue, (T2) DE as a Social Issue, (T3) The Vicious Cycle of Shame and (T4) Seeking Help. Conclusion: In participants in Phase 1 of our study – who were mostly male – DE behaviours were related to more external shame and body image-specific shame, and to less SC. Men had healthier levels of study variables than women. In Phase 2, participants talked about a vicious cycle of pathological eating and shame.

Background: Malnutrition is a major global public health issue, especially for under five children and their mothers. Objective: This study examined the relationships between socio-economic and demographic characteristics and under- and over-nutrition in mothers and children of Bangladesh. Method: Using the Nationally representative Bangladesh Demographic and Health Survey (2017–18) data, we performed the multiple logistic regression analysis to assess the relationships between key outcome variables and predictors. The analysis included 8321 children aged 0–59 months and 7800 mothers aged 15–49 years. Findings: The prevalence of stunting, wasting, and overweight among children under five was 30.72%, 8.44%, and 2.21% respectively. About 2.74% of the children were both stunted and wasted, while 0.56% of the children were both stunted and overweight. The prevalence of underweight and overweight among mother was 14.09% and 26.35% respectively. Children who are stunted are significantly associated with the mother's BMI status, mothers’ education, fathers’ education, and wealth index, while children who are wasted are significantly associated with the mother's BMI status and the child's sex. A child's sex and birth order are significantly associated with children being overweight. Mother's age, mother's education, father's education, place of residence and wealth index are significant determinants for mothers being underweight, whereas mother's age, mother's occupation, father's education, father's occupation, place of residence and wealth index are significant determinants for mothers being overweight. Conclusion: In addition to essential nutrition interventions, it is vital to address the basic social-economic and demographic determinants.

Purpose: To analyze the association between dietary patterns and dyslipidemia in adolescents. Methods: This is a cross-sectional study conducted with 363 adolescents of both genders, aged 17–18 years, from public schools in Sao Luis, in the state of Maranhão, Brazil. Adolescents with alteration in at least one of the following conditions were considered to have dyslipidemia: total cholesterol (TC), low-density lipoprotein (LDL-c), high-density lipoprotein (HDL-c), triglycerides (TG), Castelli I and II Indices, and non-HDL-c. Food consumption was assessed through the food frequency questionnaire, and dietary patterns were identified using the principal component analysis. The directed acyclic graph was elaborated to select the variables that were controlled in the analysis of the effect of dietary patterns on dyslipidemias, and the final sample of the study was weighted by the inverse probability of selection for these variables, using a doubly robust method. Results: Adolescents were 17.3 ± 0.5 years, mostly women (55.6%), brown (66.6%), with one to three minimum wages (38.3%), and maternal education from 8 to 12 years (46.4%). Three dietary patterns were identified: Western, Healthy, and Traditional. Most adolescents had dyslipidemia, and inadequate HDL-c levels were the main dyslipidemia found (44.9%). There was no significant difference in the occurrence of dyslipidemia among the three dietary patterns identified (healthy: −0.015; CI: −0.11; 0.08; p = 0.773; traditional: 0.04; CI: −0.06; 0.13; p = 0.542; Western: −0.064, CI: −0.16; 0.03; p = 0.201). Conclusions: The prevalence of dyslipidemia is high among adolescents from one city in a poor Brazilian region, but it was not explained by the dietary patterns identified in this study.

Background and aim: To evaluate the validity and user satisfaction of a digital photo-based dietary assessment tool as an alternative to the hand-written paper record method that assists researchers during the pandemic. This study compared nutrient intake and users’ satisfaction with methods between a digital photo-based dietary assessment tool, known as the Nutrinote Gama app, and food weighing as the gold standard. Methods: Fifty college students majoring in food and nutrition (90% were women; median age, 21 years) took pictures of their foods and beverages before and after consumption and then uploaded them to the Nutrinote Gama application. Trained nutritionists evaluated plate wastes, and nutritional content was revealed on the Nutrinote Gama application. Parallel to the photo-based method, they kept a weight dietary record and sent it to the researcher. A questionnaire was used to assess participants’ satisfaction. Results: No statistical differences (p = 0.89) were observed in the measurement of energy intake between Nutrinote Gama (mean ± standard deviation [SD] = 582.8 ± 131) and food weighing (mean ± SD = 566.1 ± 133). No statistical differences (p = 0.59) were also observed in the measurement of protein, fat (p = 0.434), and carbohydrate (p = 230). The energy, protein, fat, and carbohydrate intakes estimated from the two methods were significantly correlated (r = 0.86, 0.870, 0.811, 0.738, respectively). Over 70% of participants were satisfied with the photo-based record. Conclusion: The results indicate that this digital photo-based dietary assessment tool is valid and user-friendly to estimate nutrient intake.