Nutrients最新文献

{"title":"Dietary Tryptophan Allocation in Depression: Serotonin-Kynurenine Balance, Microbial Indole Pathways, and Inflammatory Phenotypes.","authors":"Bernard Kordas","doi":"10.3390/nu18162716","DOIUrl":"10.3390/nu18162716","url":null,"abstract":"<p><p>Depression is defined by clinical symptoms, but its biology varies considerably among patients. In this review, dietary tryptophan allocation describes the routes taken by tryptophan after intestinal absorption. Some is incorporated into proteins. Some enters serotonin and melatonin synthesis or the kynurenine pathway, while gut bacteria convert another fraction into indole compounds. Brain availability also depends on the circulating free pool and competition with other large neutral amino acids. This term does not imply a new biochemical pathway. It allows these known processes to be considered in relation to inflammation, metabolism, the gut microbiota, medication use, and current disease state. Recent meta-analyses indicate that peripheral tryptophan is lower in depression. They do not show a consistent increase in the kynurenine-to-tryptophan ratio, and findings from cerebrospinal fluid vary between studies. Human multiomics studies have associated microbial and metabolite profiles with cognition and response to treatment, although the evidence remains largely correlational. Changes in kynurenine, 3-hydroxykynurenine, and quinolinic acid are more apparent in inflammatory subgroups than in unselected samples. Modern evidence for L-tryptophan monotherapy is sparse. Trials of 5-hydroxytryptophan and interventions directed at the gut microbiota have also produced mixed results. Studies should characterize participants and sampling conditions more carefully. Diet and competition among amino acids need to be recorded. Albumin concentration, medication exposure, and disease state also affect interpretation. Considering these variables together may improve biomarker analyses and support trials in more biologically homogeneous groups. Dietary tryptophan allocation is proposed for these research purposes, not for clinical diagnosis or routine supplementation.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 16","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary Aluminium Exposure and Human Health: Sources, Bioavailability, Toxicokinetics, and Health Risk Assessment.","authors":"Łukasz Kogut, Czesław Puchalski, Julia Jastrzębska, Grzegorz Zaguła","doi":"10.3390/nu18162719","DOIUrl":"10.3390/nu18162719","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Aluminium is a widespread environmental element and food contaminant to which the general population is continuously exposed, primarily through diet and drinking water. Although gastrointestinal absorption is generally low, bioavailability varies according to chemical form, food matrix, and interactions with dietary components. Prolonged exposure can nevertheless result in gradual tissue accumulation. This review summarises current evidence on dietary aluminium exposure, factors influencing its bioavailability, toxicokinetics, biological effects, gut microbiota interactions, and population-level health risk. <b>Methods</b>: A comprehensive narrative literature review was conducted using publications retrieved from PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar. Original research articles, review papers, and reports issued by international organisations were critically evaluated with particular emphasis on dietary sources, drinking water, food additives, food contact materials, gastrointestinal absorption, toxicokinetics, biological mechanisms, gut microbiota, and health risk assessment. <b>Results</b>: Food represents the principal source of aluminium exposure in the general population, while drinking water usually contributes a smaller but continuous fraction of total oral intake. Dietary exposure varies substantially between populations and is influenced by food composition, processing practices, the use of aluminium-containing additives, and migration from food contact materials. Aluminium bioavailability is modified by chemical speciation and dietary constituents, including citrate, phosphates, silicates, phytates, polyphenols, and essential minerals. Despite limited absorption, prolonged exposure can lead to gradual aluminium accumulation, particularly in bone tissue and the central nervous system. Proposed biological mechanisms include oxidative stress, mitochondrial dysfunction, disruption of mineral homeostasis, and inflammatory signalling. Emerging evidence also indicates that aluminium may alter the gut microbiota, impair intestinal barrier integrity, and influence the gut-brain axis. Population exposure assessments show considerable regional variation, with some groups approaching or exceeding established tolerable weekly intake values. <b>Conclusions</b>: Dietary aluminium exposure represents a relevant issue in nutritional toxicology and food safety. Although current evidence does not establish that typical dietary exposure directly causes chronic disease, long-term exposure, differences in bioavailability, and the possibility of elevated intake in selected population groups justify continued monitoring and further prospective human studies. Future research should integrate dietary intake, aluminium speciation, nutritional status, biomarkers of internal exposure, and long-term health outcomes to improve risk assessment and support effective exposure-reduction strategies.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 16","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13517020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Mood- and Stress-Relief Dietary Supplements and Over-the-Counter Medications in Relation to Physician Trust, Hypothetical Help-Seeking Preferences, and Communication-Related Attitudes: A Cross-Sectional Survey.","authors":"Aleksandra Brzozowska, Jakub Grabowski, Maciej Brosz","doi":"10.3390/nu18162726","DOIUrl":"10.3390/nu18162726","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Dietary supplements (DSs) and over-the-counter (OTC) medications for mood improvement and stress relief are widely used, but little is known about how their use relates to coping preferences, trust in physicians, and communication with doctors. This exploratory cross-sectional study compared users and non-users of such products in Poland. <b>Methods:</b> Data were collected between October 2024 and May 2025 and included 798 adults recruited through a mixed-mode convenience sampling strategy (636 online and 162 in person). Participants were classified as current users (CUs; <i>n</i> = 184), past users (PUs; <i>n</i> = 297), or never-users (NUs; <i>n</i> = 317). The outcomes included hypothetical future coping strategies (under an assumption of unlimited resources), trust in physicians using an author-translated adaptation of the Trust in Doctors in General (T-DiG) scale and three-category communication-related attitudes. Multivariable models were adjusted for age, gender, education, medical or health science background, and recruitment mode. <b>Results:</b> Overall, 60.3% of respondents reported current or past use. Compared with NUs, both CUs and PUs had higher adjusted odds of selecting future DS/OTC use (CUs: aOR = 5.60, 95% CI 3.44-9.14, <i>p</i> < 0.001; PUs: aOR = 2.44, 95% CI 1.52-3.93, <i>p</i> < 0.001). PUs also had higher adjusted odds of selecting psychotherapy (aOR = 1.50, 95% CI 1.04-2.17, <i>p</i> = 0.031; overall <i>p</i> = 0.018). Product-use status was associated with selected items of T-DiG: communication competency (overall <i>p</i> = 0.031) and global trust (overall <i>p</i> < 0.001). Compared with NUs, CUs had lower adjusted scores on both subscales (aMD = -0.19, 95% CI -0.33 to -0.04, <i>p</i> = 0.010 and aMD = -0.40, 95% CI -0.59 to -0.21, <i>p</i> < 0.001, respectively). Overall product-group effects were also observed for the first two communication items: CUs had lower relative risk ratios than NUs for discussing product-related doubts first with their physician (RRR = 0.52, 95% CI 0.35-0.78, <i>p</i> = 0.001) and for feeling free to raise such doubts (RRR = 0.57, 95% CI 0.36-0.92, <i>p</i> = 0.022). <b>Conclusions:</b> Product-use status showed selective associations with hypothetical coping preferences, physician trust, and communication-related attitudes rather than a uniform pattern of reluctance to seek professional support. Current use was most strongly associated with lower trust and less favorable product-related communication attitudes. Given the cross-sectional design and hypothetical nature of the coping outcomes, these findings do not establish causality, temporal ordering, or actual healthcare-seeking behavior.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 16","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Hydration Rounds Versus a Socially Assistive Robot to Promote Fluid Intake in Institutionalized Older Adults: A Quasi-Experimental Study.","authors":"Cristina Vallès-Carvajal, Laia Selva-Pareja, Olga Masot, Maria Falcón-Villaitodo, Carla Camí, Teresa Botigué","doi":"10.3390/nu18162715","DOIUrl":"10.3390/nu18162715","url":null,"abstract":"<p><p><b>Background:</b> Several strategies have been proposed to promote hydration among institutionalized older adults, including systematic hydration rounds and, more recently, the use of Socially Assistive Robots (SAR). However, their implementation in nursing homes remains limited. <b>Objective:</b> To compare changes in fluid intake over a one-month period among residents exposed to two hydration-promotion strategies and to identify baseline characteristics associated with fluid intake. <b>Methods:</b> A quasi-experimental study was conducted in a nursing home. Residents were assigned to either a systematic hydration rounds intervention with manual recording or a SAR-supported multicomponent educational intervention including reminders, positive reinforcement, and digital intake monitoring. Fluid intake was monitored for one month and analyzed using adjusted mixed-effects linear regression models. <b>Results:</b> Residents in the systematic hydration rounds group showed higher fluid intake throughout follow-up. In the longitudinal analysis, assignment to the SAR-supported group was independently associated with lower fluid intake during follow-up (β = -354.24 mL/day; <i>p</i> < 0.001), after adjustment for baseline fluid intake and functional dependence. No significant differences were observed in intake trajectories between strategies. Dysphagia was independently associated with lower fluid intake, whereas diabetes was associated with higher fluid intake. <b>Conclusions:</b> Residents assigned to the systematic hydration rounds group showed higher fluid intake during follow-up. Dysphagia was associated with lower fluid intake, highlighting the need to adapt hydration-promotion strategies to residents' swallowing-related needs. Although the SAR-supported intervention was not associated with higher fluid intake, the findings suggest that technological tools for hydration promotion and monitoring require adequate integration into routine clinical practice.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 16","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary Intake as an Undermeasured Potential Mediator: The Ethical Case for Complete and Transparent Dietary Reporting in GLP-1 Receptor Agonist Trials.","authors":"Jessica N Strosahl, Thomas R Ziegler, Rani H Singh","doi":"10.3390/nu18162722","DOIUrl":"10.3390/nu18162722","url":null,"abstract":"<p><p>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are transforming obesity management, yet landmark trials often incompletely measure and report a central mediator of response: dietary intake. Because GLP-1RAs promote weight loss primarily by suppressing appetite and reducing energy consumption, capturing changes in dietary intake is essential to interpreting efficacy, safety, and translation into clinical care. This perspective argues that failure to measure and report comprehensive dietary intake raises concerns under four core bioethical principles. It undermines autonomy by limiting evidence for shared decision-making across the treatment continuum. It challenges non-maleficence because inadequate energy, protein, and micronutrient intake may contribute to lean mass loss and nutrient deficiencies, particularly in vulnerable populations. It weakens beneficence because failing to report a measurable mediator diminishes the scientific value of research requiring substantial investment and participant burden. It raises justice concerns because the equitable distribution of assessment burden and access to resulting nutritional care cannot be evaluated without transparent reporting. To meet the ethical and scientific obligations of clinical research, future trials should preregister dietary intake as a key secondary or safety endpoint. Investigators should report total energy, macronutrient, and micronutrient distribution at baseline and serial follow-up alongside dietary assessment methods, food composition databases, and assessor training. Journal editors, funders, and regulatory bodies should support development of consensus-based, nutrition-specific reporting recommendations aligned with CONSORT principles and encourage preregistration of dietary trial endpoints. Registered dietitian nutritionists should be prospectively integrated into GLP-1RA trial teams from design through data interpretation. Advancing the standard of obesity care requires that the research community look beyond the scale and ground clinical translation in the nutritional context in which pharmacotherapy operates.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 16","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Credibility of Social Media Narratives About GLP-1 Receptor Agonists and Acceptance of Integrated Obesity Care: Implications for Nutrition and Lifestyle Support.","authors":"Tomasz Żurawski, Anna Bartosiewicz","doi":"10.3390/nu18162718","DOIUrl":"10.3390/nu18162718","url":null,"abstract":"<p><p><b>Background/Objectives:</b> GLP-1 receptor agonists are an established component of obesity treatment that should complement nutritional and lifestyle interventions. Social media narratives may shape public understanding and acceptance of these therapies. This study examined whether exposure to GLP-1-related narratives and their perceived credibility were associated with perceptions of obesity pharmacotherapy. <b>Methods:</b> An anonymous cross-sectional online survey was conducted among Polish-speaking adults aged ≥ 18 years who used social media at least weekly and reported exposure to GLP-1-related content within the preceding 3 months. Five exploratory composite scores assessed narrative exposure, perceived credibility, perceptions of communication, attitudes toward obesity pharmacotherapy, and GLP-1 treatment evaluation. Associations were examined using univariable and multivariable linear regression. <b>Results:</b> The final sample comprised 279 participants (84.6% women; mean age, 38.14 ± 8.58 years). In adjusted models, greater perceived narrative credibility was associated with less favorable GLP-1 treatment evaluations (<i>B</i> = -0.311, 95% CI: -0.359 to -0.263; <i>p</i> < 0.001) and greater endorsement of negative pharmacotherapy-related statements (<i>B</i> = 0.401, 95% CI: 0.350 to 0.453; <i>p</i> < 0.001). Greater narrative exposure was associated with more favorable GLP-1 treatment evaluations (<i>B</i> = 0.072, 95% CI: 0.026 to 0.118; <i>p</i> = 0.002) and more negative perceptions of social media communication (<i>B</i> = 0.235, 95% CI: 0.161 to 0.309; <i>p</i> < 0.001). <b>Conclusions:</b> Greater perceived credibility of GLP-1-related narratives was associated with less favorable perceptions of obesity pharmacotherapy, but the cross-sectional design precludes conclusions about direction or causality. The findings highlight the importance of evidence-based communication that supports critical evaluation of treatment-related claims and presents pharmacotherapy, nutrition, and lifestyle support as complementary components of comprehensive obesity care.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 16","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Parenting Strategies and Daughters' Perceived Weight Teasing as Predictors of Restrictive Eating Behaviors.","authors":"Norma Olvera, Molly R Matthews-Ewald, Tamal J Roy, Rhonda Scherer, Weihua Fan, Consuelo Arbona","doi":"10.3390/nu18162717","DOIUrl":"10.3390/nu18162717","url":null,"abstract":"<p><p><b>Background/Objective</b>: Restrictive eating behaviors during early adolescence may increase the risk of disordered eating, yet little is known about modifiable family and social factors influencing these behaviors. This study investigated associations between maternal parenting strategies, weight teasing, and restrictive eating behaviors among 168 Hispanic mother-daughter dyads. <b>Methods</b>: Mothers and daughters independently completed surveys assessing demographic and acculturation characteristics, and their height and weight were objectively measured. Mothers also completed the parenting strategies measures, while daughters completed the weight teasing and restrictive eating behaviors measures. <b>Results</b>: Descriptive analyses indicated that 66.1% of mothers and 98.9% of daughters were classified in either the overweight or obese categories. Hierarchical multiple regression analyses showed that greater use of maternal limit-setting strategies was associated with lower levels of restrictive eating behaviors in daughters (<i>β</i> = -0.213, <i>p</i> = 0.017), whereas more frequently perceived weight teasing was associated with greater restrictive eating behaviors (<i>β</i> = 0.404, <i>p</i> < 0.001). The final model was statistically significant, <i>F</i>(8, 126) = 5.139, <i>p</i> < 0.001, explaining 19.8% of the variance in daughters' restrictive eating behaviors. <b>Conclusions</b>: These findings suggest that interventions that strengthen supportive parenting strategies and reduce weight stigma may help prevent restrictive eating behavior in this population.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 16","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Bacteria: The Emerging Role of the Gut Virome and Mycobiome in Celiac Disease.","authors":"Aurelio Seidita, Mirco Pistone, Federica Latteri, Francesca Di Stefano, Pasquale Mansueto, Sonia Giardina, Gabriele Spagnuolo, Alessandro Termini, Salvatore Maestri, Alessandra Giuliano, Salvatore Accomando, Carola Buscemi, Francesca Mandreucci, Antonio Carroccio","doi":"10.3390/nu18162721","DOIUrl":"10.3390/nu18162721","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Celiac disease (CeD) is a complex autoimmune enteropathy triggered by gluten intake in genetically predisposed individuals. While the bacterial microbiome has been extensively studied in CeD, the role of the gut virome and mycobiome is less well defined. Emerging evidence suggests that viruses and fungi may influence mucosal immunity, intestinal permeability and gluten tolerance, acting as potential environmental cofactors in the onset of this disease. <b>Methods:</b> A narrative review of the literature was conducted to summarize current knowledge of the composition, development and function of the gut virome and mycobiome and to explore their potential involvement in CeD pathogenesis. <b>Results:</b> The gut virome shows high interindividual variability and dynamic maturation early in life. Multiple studies have associated early <i>enterovirus</i> or <i>parechovirus</i> infections with an increased risk of celiac autoimmunity, supporting a virus-gluten \"double hit\" model. Viral dysbiosis in CeD has been reported to include an enrichment of <i>human polyomavirus 2 (JC polyomavirus)</i> and of specific enterobacterial phages. The mycobiome, although less abundant, also displays disease-associated alterations: cross-sectional mycobiome studies have reported higher relative abundance of <i>Saccharomyces</i>, <i>Candida</i>, and <i>Tricholomataceae</i> and lower relative abundance of <i>Pichia</i> and <i>Pneumocystis</i> taxa in children with CeD. <b>Conclusions:</b> Current evidence, although preliminary, supports associations between selected viral exposures and CeD-related immune alterations, whereas current phageome and mycobiome findings mainly describe cross-sectional compositional differences. These data do not establish temporal direction or causality, and further longitudinal and mechanistic investigations are required before preventive or therapeutic implications can be considered.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 16","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148830178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Preliminary Validation of a Multidimensional Questionnaire on Nutrition Knowledge, Food Composition Knowledge, and Dietary Habits in Medical Students.","authors":"Ana Presa-Carrera, Eva Luyufeng Yáñez-Izquierdo, Carlos Enrique Adán-Failde, Juan Manuel Vázquez-Lago","doi":"10.3390/nu18162720","DOIUrl":"10.3390/nu18162720","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Nutrition is an important component of disease prevention and clinical care, yet nutrition training in medical education is often limited and may not adequately prepare future physicians for dietary counselling. Valid assessment tools are therefore needed to identify specific educational gaps and guide curriculum improvement. Unlike general nutrition knowledge instruments, the present questionnaire was specifically developed for medical students and integrates factual nutrition knowledge, applied food composition knowledge, and dietary habits within a multidimensional assessment framework. This study aimed to develop and preliminarily validate a multidimensional questionnaire assessing nutrition knowledge, food composition knowledge, and dietary habits in medical students. <b>Methods</b>: A cross-sectional psychometric validation study with a mixed-methods approach was conducted at the University of Santiago de Compostela, Spain. The instrument was developed by the research team using the revised General Nutrition Knowledge Questionnaire by Kliemann et al. as a conceptual reference and was subsequently adapted to the educational context and expected baseline knowledge of medical students. Face validity was examined through student focus groups, and content validity was established by an expert panel. The initial questionnaire included 61 analyzable items across three domains. Internal consistency was evaluated using Cronbach's alpha, construct validity by exploratory factor analysis with Promax rotation, and sensitivity analysis was performed to refine the scale. <b>Results</b>: A total of 150 medical students from all six academic years participated (mean age 21.26 years). The initial instrument showed high overall internal consistency with a Cronbach's alpha = 0.824. After excluding 15 low-performing items, the final 46-item version demonstrated improved reliability (alpha = 0.849). Domain-specific reliability was moderate for general nutrition knowledge (alpha = 0.632) and acceptable for food composition knowledge (alpha = 0.751) and dietary habits (alpha = 0.776). The revised structure produced interpretable components with potential utility for educational diagnosis. <b>Conclusions</b>: The refined questionnaire showed preliminary psychometric validity as a multidimensional assessment tool for medical students. Its potential value lies in providing a framework for future assessment of nutrition-related educational needs rather than in directly producing curricular or behavioral change. Independent multicenter and cross-cultural validation is required before broader use can be recommended.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 16","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Discharge of Very Preterm Infants with Home Nasogastric Tube Feeding Is Not Associated with Increased Parental HADS Anxiety or Depression Scores.","authors":"Rahel Schuler, Lea Woitschitzky, Burkhard Brosig, Beate Priewasser, Edda Hofstätter, Harald Ehrhardt, Walter A Mihatsch","doi":"10.3390/nu18162728","DOIUrl":"10.3390/nu18162728","url":null,"abstract":"<p><p><b>Background:</b> Early discharge with home nasogastric (NGT) feeding has been associated with favorable infant outcomes and high parental satisfaction. However, its impact on parental mental health has been insufficiently studied. We aimed to evaluate symptoms of anxiety and depression in mothers and fathers of very preterm infants discharged with or without NGT feeding. <b>Methods:</b> This prospective cohort study was conducted at a German tertiary perinatal center between October 2020 and May 2024. A total of 238 preterm infants with a birth weight ≤ 1500 g and/or a postmenstrual age (PMA) ≤ 32 weeks were included; 131 were discharged with full oral feeding and 107 with NGT feeding. Symptoms of anxiety and depression were assessed in mothers and fathers using the Hospital Anxiety and Depression Scale (HADS-D) at discharge and at three months corrected age (CA). A total of 201 parent-infant dyads were included. HADS-D assessments were completed by 155 mothers and 135 fathers at discharge and by 121 mothers and 119 fathers at three months CA. <b>Results:</b> At discharge, depression and anxiety scores did not differ between parents of infants discharged with and without NGT feeding. At three months CA, mothers of infants discharged on full oral feeding had higher depression and anxiety scores than mothers of infants discharged with NGT feeding (4.95 ± 3.62 vs. 3.18 ± 2.89; <i>p</i> ≤ 0.01 and 6.42 ± 3.85 vs. 4.79 ± 3.72; <i>p</i> = 0.04), and clinically significant depression scores (≥8) were more frequent (23.53% vs. 10.45%; <i>p</i> = 0.04). Similarly, fathers in the non-tube-feeding group had higher depression scores at 3 months CA (4.78 ± 3.74 vs. 3.48 ± 2.72; <i>p</i> = 0.04), with a trend towards a greater proportion showing clinically significant depression scores (24.14% vs. 13.11%; <i>p</i> = 0.12. <b>Conclusions:</b> Early discharge of very preterm infants with home NGT feeding was not associated with increased parental psychological distress at discharge and at 3 months CA. Across the outcomes, parental distress tended to be lower at 3 months CA with NGT feeding at discharge. However, as no NGT × time interaction was statistically significant after correction for multiple testing, these group differences should be interpreted as exploratory in nature.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 16","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}