Nutrients最新文献

{"title":"<i>Panax ginseng</i> C.A. Mey. as Multi-Target Regulators of Vascular Homeostasis: Pharmacological Mechanisms and Therapeutic Perspectives.","authors":"Yudan Wang, Haiyan Hao, Rui Tan, Zhe Shi, Qinhui Tuo","doi":"10.3390/nu18162729","DOIUrl":"10.3390/nu18162729","url":null,"abstract":"<p><p>Cardiovascular and cerebrovascular diseases (CVDs) are closely associated with disturbances in vascular homeostasis, including endothelial dysfunction, abnormal vascular remodeling, inflammation, oxidative stress, thrombosis, barrier disruption, and dysregulated angiogenesis. Ginsenosides, the major bioactive saponins of <i>Panax ginseng</i> C.A. Mey., have been reported to modulate several of these processes. This review integrates structural, pharmacokinetic, bioinformatic, and experimental evidence to evaluate the vascular actions of representative ginsenosides. Preclinical studies indicate partially overlapping effects on endothelial integrity, vascular tone, permeability, inflammatory and oxidative responses, hemostasis, remodeling, and angiogenesis. Structural differences and biotransformation may contribute to variation in exposure and pharmacological profiles. However, most evidence derives from isolated compounds tested in heterogeneous cell and animal models, direct comparisons or combination studies are limited, and several in vitro concentrations exceed plasma levels reported after oral ginseng administration. The proposed multi-target network should therefore be regarded as hypothesis-generating rather than evidence of coordinated restoration of vascular homeostasis. Future studies should emphasize exposure-relevant experimental designs, comparative assessment of individual ginsenosides and defined combinations, and pharmacokinetic-target engagement relationships.</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/PMC13516309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831075","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":"Nutritional Status, Dietary Intake and Immunosuppressive Therapy in Kidney Transplant Recipients: Differences Between Early and Late Post-Transplant Period-A Cross-Sectional Pilot Study.","authors":"Aleksandra Anna Kajdas, Dorota Szostak-Węgierek, Krzysztof Krasuski, Dorota Miszewska-Szyszkowska, Magdalena Durlik","doi":"10.3390/nu18162725","DOIUrl":"10.3390/nu18162725","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background/objectives: &lt;/strong&gt;Kidney transplantation is associated with profound metabolic and nutritional changes, particularly across different post-transplant periods. This study aimed to evaluate differences in nutritional status, dietary intake, and immunosuppressive therapy between recipients in the early and late post-transplant period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This cross-sectional pilot study presents an analysis of baseline data obtained from a prospective cohort of 38 kidney transplant recipients divided into early (≤1 year post-transplantation; &lt;i&gt;n&lt;/i&gt; = 15) and late (&gt;1 year post-transplantation; &lt;i&gt;n&lt;/i&gt; = 23) post-transplant groups. Nutritional status was assessed using anthropometric and laboratory measurements, bioelectrical impedance analysis (BIA), and Nutritional Risk Screening 2002 (NRS-2002). Dietary intake was assessed using the Food Frequency Questionnaire-6 (FFQ-6) and a 3-day dietary record. Information regarding immunosuppressive therapy was obtained from medical records and verified at routine clinic visits.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The groups did not differ significantly with respect to sociodemographic characteristics, comorbidities, anthropometric measurements, body composition, and nutritional risk. No significant differences were observed in body weight, body mass index (BMI), body composition parameters, or most laboratory measurements. Early post-transplant recipients exhibited significantly higher non-high-density lipoprotein (non-HDL) cholesterol concentrations (153.3 ± 37.5 vs. 111.1 ± 50.8 mg/dL; &lt;i&gt;p&lt;/i&gt; = 0.040), higher tacrolimus trough concentrations (11.2 ± 5.2 vs. 4.6 ± 1.1 ng/mL; &lt;i&gt;p&lt;/i&gt; = 0.0001), and lower serum magnesium concentrations (1.64 ± 0.13 vs. 1.94 ± 0.15 mg/dL; &lt;i&gt;p&lt;/i&gt; = 0.009) than late post-transplant recipients. No statistically significant differences were observed for most assessed dietary habits, except for the more frequent addition of sugar to beverages among the early post-transplant group (&lt;i&gt;p&lt;/i&gt; = 0.048). Qualitative assessment of 3-day dietary records showed a tendency toward more regular meals and greater dietary variety among early post-transplant recipients. This group also received significantly higher tacrolimus trough concentrations and higher prednisone-equivalent and mycophenolate doses than recipients in the late post-transplant period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this pilot study, the observed differences between early and late post-transplant recipients concerned primarily immunosuppressive exposure and selected metabolic parameters, while no statistically significant differences were identified for most measures of nutritional status or dietary intake. Given the small sample size and the exploratory nature of the study, these findings should be considered preliminary and hypothesis-generating rather than confirmatory. Larger, adequately powered prospective studies are needed to validate these observations and ","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/PMC13516085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831337","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":"Reproducibility of a 69-Item School Children's Food Frequency Questionnaire (69-Item SCh-FFQ) and Diet Quality Scores Among Polish Children Aged 7-9 Years.","authors":"Kamila Sobaś, Joanna Kowalkowska, Edyta Suliga, Lidia Wadolowska","doi":"10.3390/nu18162712","DOIUrl":"10.3390/nu18162712","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Reliable dietary assessment tools are essential for evaluating dietary habits and diet quality in children. The aim of this study was to assess the reproducibility of a 69-item School Children's Food Frequency Questionnaire (69-item SCh-FFQ) and the diet quality scores among Polish children aged 7-9 years. <b>Methods</b>: The reproducibility study was conducted among 77 children. The 69-item SCh-FFQ was administered twice (test and retest). Data on food consumption frequency were used to evaluate two diet quality scores: the pro-Healthy Diet Index (pHDI) and the non-Healthy Diet Index (nHDI). The reproducibility of the 69-item SCh-FFQ and the diet quality scores was evaluated using comparisons of mean values, cross-classification analysis, Cohen's kappa statistic, Spearman's rank correlation coefficient, intraclass correlation coefficient (ICC), and Bland-Altman analysis. <b>Results</b>: No significant differences were observed between test and retest of the FFQ for mean values of the pHDI (2.9 ± 1.8 vs. 2.8 ± 1.9 points; <i>p</i> = 0.124) or the nHDI (4.3 ± 1.5 vs. 4.2 ± 1.5 points; <i>p</i> = 0.611). Total agreement for the classification of children into categories of the diet quality scores reached 81.8% for pHDI and 75.3% for nHDI, with low gross misclassification rates (1.3% and 0.0%, respectively). Cohen's kappa statistic indicated moderate to good agreement (κ = 0.68 for pHDI and κ = 0.51 for nHDI). For all food items, total agreement ranged from 66.2% to 94.8%, while the kappa statistic ranged from 0.56 to 0.81. Strong correlations and good agreement were observed between repeated measurements for both pHDI (r = 0.748, ICC = 0.778; <i>p</i> < 0.001) and nHDI (r = 0.783, ICC = 0.752; <i>p</i> < 0.001). Bland-Altman analysis demonstrated good agreement and no evidence of proportional bias. <b>Conclusions</b>: The 69-item SCh-FFQ demonstrated satisfactory reproducibility for assessing food consumption frequency and diet quality scores in children aged 7-9 years. Therefore, this questionnaire is a promising tool for future epidemiological studies among early school-aged children, although its utility should be confirmed in further validation studies using an appropriate reference method.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 16","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148830585","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":"The Effectiveness of Oral Nutrition Supplementation on Growth Indicators, Dietary Intake, Appetite, and Health Outcomes Among Underweight Preschool Children in Urban Area of Kuala Lumpur, Malaysia: A Multi-Centre Community-Based Randomised Controlled Trial.","authors":"Abdul Hakim Abdul Wahid, Nur Hana Hamzaid, Haslina Abdul Hamid, Rosnah Sutan, Zahara Abdul Manaf","doi":"10.3390/nu18162714","DOIUrl":"10.3390/nu18162714","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Undernutrition remains a public health concern among preschool children in Malaysia. Although oral nutritional supplementation (ONS) globally has been recommended to improve nutritional status, evidence from community-based randomised controlled trials among underweight Malaysian preschool children remains limited. This study evaluated the effectiveness of ONS on growth, dietary intake, appetite, and common illnesses among underweight preschool children in Kuala Lumpur, the capital city of Malaysia. <b>Methods</b>: A multi-centre, community-based, cluster-randomised controlled trial was conducted among underweight preschool children aged 4-6 years from 16 government-subsidised preschools. Participants were assigned to receive ONS plus nutrition education (ONS + NE) or nutrition education alone (NE only) for 90 days. Anthropometric measurements, dietary intake, appetite, attainment of catch-up growth, and parent-reported common illnesses were assessed. Between-group differences were analysed using analysis of covariance adjusted for baseline values. <b>Results</b>: Ninety-six underweight preschool children were randomised to ONS plus nutrition education (ONS + NE, <i>n</i> = 56) or nutrition education alone (NE only, <i>n</i> = 40). Compared with the NE group, children receiving ONS + NE demonstrated significantly greater improvements in weight-for-age z-scores at day 60 and day 90 (<i>p</i> < 0.05). The ONS + NE group also achieved significantly higher catch-up growth attainment at day 60 (116.6 ± 38.5% vs. 99.1 ± 17.4%; <i>p</i> = 0.029) and day 90 (114.6 ± 37.2% vs. 95.5 ± 23.8%; <i>p</i> = 0.021). In addition, significantly higher energy, macronutrients, selected micronutrient intakes, and appetite scores were observed in the ONS + NE group (all <i>p</i> < 0.05). <b>Conclusions</b>: ONS combined with nutrition education improved weight-related growth, dietary adequacy, catch-up growth energy achievement, and appetite among underweight preschool children. ONS may serve as an effective community-based strategy for nutritional rehabilitation in this population. Trial registration: ISRCTN15093638.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 16","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831228","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 Bone Health: Exploring the \"Heart-Brain-Bone\" Axis Modulated by Lipid-Soluble Nutrients (Omega-3, Vitamin D3, and Vitamin K2).","authors":"Shih-Chin Fang, Meng-Kai Huang, Hsieh-Tsung Ethan Shen, Bo-Xiang Benjamin Zhang, Ting-Hsuan Collette Chao, Chung-Che Wu","doi":"10.3390/nu18162711","DOIUrl":"10.3390/nu18162711","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Population aging is driving a convergent rise in three disorders historically managed in isolation: cardiovascular disease, neurocognitive decline, and osteoporotic bone loss. Mechanistic data indicate that these systems are coupled through shared regulators of calcium trafficking, inflammation resolution, vascular integrity, and inflammaging. On this basis, a \"Heart-Brain-Bone\" axis has been proposed; it should be understood as an integrative conceptual framework that organizes evidence drawn from three separate studies, not as a validated physiological entity with agreed diagnostic criteria or demonstrated modifiability. Three lipid-soluble nutrients-long-chain omega-3 polyunsaturated fatty acids (EPA/DHA), vitamin D3 (cholecalciferol), and vitamin K2 (menaquinone-7 [MK-7])-act on overlapping nodes of this network.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We performed a structured narrative review. PubMed/MEDLINE, Embase, the Cochrane Library, and Web of Science were searched from database inception to 25 June 2026 using predefined term blocks for each nutrient, each organ domain, and each candidate mechanism, and the search was updated on 7 August 2026. Records were screened against prespecified inclusion and exclusion criteria by two authors independently, with disagreements resolved by a third. The strength of evidence for each nutrient-organ relationship was graded with an explicitly defined four-level scheme ((-) to (+++)) applied separately to preclinical, observational, randomized and meta-analytic evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Vitamin K2-dependent gamma-carboxylation of matrix Gla protein (MGP) and osteocalcin has been proposed to influence whether calcium is incorporated into the bone matrix or deposited in the arterial wall, offering a candidate mechanistic account of the \"calcium paradox\" associated with isolated vitamin D3 supplementation; EPA/DHA-derived specialized pro-resolving mediators may support resolution of endothelial and neuronal inflammation; and bone-, vascular- and brain-derived signals (osteocalcin, FGF23, the neurovascular unit) interconnect the three organs. These mechanisms are biologically plausible but remain insufficiently confirmed in humans. The clinical evidence is heterogeneous, formulation- and population-dependent, and comprises positive, neutral and null results: cardiovascular omega-3 trials are discordant (REDUCE-IT, which used icosapent ethyl [an EPA ethyl ester], positive; VITAL/STRENGTH/ASCEND null, predominantly in lower-risk or replete cohorts); cognitive trials are largely null or subgroup-dependent (MAPT, DO-HEALTH, VITAL); and MK-7 improves surrogate bone and calcification biomarkers and slowed coronary artery calcification in one recent randomized imaging trial (VitaK-CAC), whereas combined MK-7 plus vitamin D3 did not slow aortic valve or coronary calcification in AVADEC and MK-7 did not reduce bone loss in early menopausal women. Recognized safety signals in","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 16","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148830296","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":"Vitamin C as a Potential Geroprotector: Interactions with Aging Hallmarks and Implications for Healthy Longevity.","authors":"Diána Bodó, Ferenc Jójárt, Rebeka Jójárt, Dezső Csupor, Barbara Tóth","doi":"10.3390/nu18162704","DOIUrl":"10.3390/nu18162704","url":null,"abstract":"<p><p>Vitamin C (L-ascorbic acid) is an essential micronutrient with established roles in antioxidant defense, epigenetic regulation, collagen synthesis, redox signaling, immune modulation, and cellular stress responses. This narrative review critically evaluates the potential role of vitamin C as a modulator of the hallmarks of aging. Although mechanistic studies suggest that vitamin C influences gene expression, inflammatory regulation, mitochondrial function, and cellular stress adaptation, the available evidence remains heterogeneous and is derived predominantly from in vitro and preclinical models, whereas human data are largely observational with limited interventional confirmation. Accordingly, vitamin C should be regarded as a context-dependent modulator of cellular resilience, with potential relevance under conditions of deficiency, inflammation, or increased oxidative stress rather than as a general anti-aging agent. Future studies integrating biomarkers of biological aging with clinically meaningful healthspan outcomes are needed to determine whether these mechanistic observations translate into measurable benefits during human aging.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 16","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13517069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148830528","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":"Resveratrol and Curcumin in Stroke Therapy: From Experimental Evidence to Clinical Perspectives.","authors":"Mikołaj Grabarczyk, Aleksandra Szychowska, Weronika Szczepańska, Ewa Smolińska, Andrzej Glabinski, Piotr Szpakowski","doi":"10.3390/nu18162713","DOIUrl":"10.3390/nu18162713","url":null,"abstract":"<p><p>Stroke remains one of the leading causes of death and long-term neurological disability worldwide, while currently available therapeutic strategies are limited by narrow treatment windows and incomplete neuroprotection. In this context, plant-derived polyphenols have attracted increasing attention as potential adjunctive agents because of their multimodal biological activity. This review focuses on resveratrol and curcumin, two of the most extensively investigated polyphenols, and evaluates their potential role in the prevention and treatment of ischaemic and haemorrhagic stroke. Evidence from in vitro studies, animal models, and early clinical trials indicates that both compounds may attenuate key mechanisms involved in stroke-related brain injury, including oxidative stress, neuroinflammation, mitochondrial dysfunction, apoptosis, autophagy dysregulation, blood-brain barrier disruption, and microglial activation. Emerging evidence further suggests that interactions with the gut microbiota and modulation of the gut-brain axis may contribute to their biological effects by influencing intestinal barrier integrity, microbial metabolite production, systemic inflammation, and vascular risk. Preclinical studies show that resveratrol and curcumin can reduce infarct volume, limit cerebral oedema, preserve neuronal viability, promote angiogenesis and neurogenesis, and improve neurological and cognitive outcomes. Their beneficial effects have been reported both when administered before stroke onset and after cerebral injury, suggesting potential relevance for both prevention and post-stroke therapy. However, interpretation of these findings requires consideration of the translational limitations of experimental stroke models, which do not fully reproduce the heterogeneity, comorbidities, age profile, and variable reperfusion patterns characteristic of human stroke. Although commonly used models such as middle cerebral artery occlusion provide important mechanistic and therapeutic insights, preclinical efficacy should therefore not be regarded as a direct predictor of clinical benefit. Resveratrol and curcumin may also complement established and emerging treatment strategies, including thrombolysis, endovascular interventions, antihypertensive therapy, and stem cell-based approaches. Nevertheless, their clinical translation remains limited by poor solubility, low bioavailability, rapid metabolism, and insufficient clinical evidence. Novel formulations, including nanoparticles, exosome-based delivery systems, and structurally modified analogues, may help overcome these barriers by improving brain targeting and therapeutic efficacy. Overall, resveratrol and curcumin represent promising but still investigational candidates for adjunctive stroke therapy, requiring further well-designed clinical trials to define their optimal dosing, timing, safety, and clinical value.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 16","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148830645","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":"Clinical Utility and Patient-Level Analysis of IDDSI Level 1 (Slightly Thick) in Oropharyngeal Dysphagia: A Strategy to Mitigate Over-Thickening and Support Hydration.","authors":"Jae Woo Kim, Seung Yoon Choi, Ji Woo Lee, Seong Ho Jang, Seung Hoon Han, Jae Hyeon Park, Yeo Joon Yun","doi":"10.3390/nu18162703","DOIUrl":"10.3390/nu18162703","url":null,"abstract":"<p><p><b>Background/Objectives:</b> The International Dysphagia Diet Standardisation Initiative (IDDSI) introduced Level 1 (slightly thick) as a new intermediate consistency between thin liquid (Level 0) and mildly thick (Level 2). Although over-thickening is associated with reduced hydration and impaired medication absorption, the specific clinical utility of Level 1 has not been quantified. We aimed to determine the clinical benefit of Level 1 and identify the proportion of dysphagia patients for whom Level 1 is the minimum sufficient consistency. <b>Methods:</b> We retrospectively analyzed 163 consecutive patients undergoing a videofluoroscopic swallowing study (VFSS) in a single rehabilitation department, including a pre-specified stroke subgroup (<i>n</i> = 87). A de-escalation protocol was used (IDDSI Level 3 → 2 → 1 → 0) with stepwise bolus volumes (2-3 mL followed by 5 mL at each consistency), and testing was discontinued at thinner consistencies once aspiration (Penetration-Aspiration Scale [PAS] ≥ 6) was observed. PAS values at untested thinner levels following aspiration were imputed (assigned an assumed value reflecting the expected clinical outcome) as 8 in the primary analysis. We quantified Level 1 effectiveness using absolute risk reduction (ARR), relative risk reduction (RRR), and number needed to treat (NNT). <b>Results:</b> In paired analyses, Level 1 reduced aspiration versus Level 0 by 12.0 percentage points (RRR 31.5%, NNT 8.4) in the full cohort and 13.7 percentage points (RRR 38.5%, NNT 7.3) in the stroke subgroup. Incremental escalation from Level 1 to Level 2 yielded only modest additional benefit (incremental NNT 18.4 and 38.5). Patient-level classification identified 13.7% (full) and 16.5% (stroke) of patients as \"Level 1-sufficient\", defined as unsafe on thin liquid but safe on Level 1. <b>Conclusions:</b> IDDSI Level 1 provides substantial aspiration protection compared to thin liquid (NNT ≈ 7-8) with diminishing returns from further escalation, supporting Level 1 as a clinically useful and underutilized first-line thickened liquid option that may help avoid the nutritional and hydration drawbacks of over-thickening.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 16","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148830871","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":"Quality of Life and Gluten-Free Diet Adherence in Adult Patients with Celiac Disease: A Cross-Sectional Questionnaire Study.","authors":"Zuzanna Zając, Aleksandra Kołtuniuk","doi":"10.3390/nu18162701","DOIUrl":"10.3390/nu18162701","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Celiac disease is a chronic autoimmune enteropathy whose only established treatment is a strict, lifelong gluten-free diet (GFD). Beyond physical symptoms, the disease and its dietary management affect emotional, social, and economic functioning. &lt;b&gt;&lt;i&gt;Objectives:&lt;/i&gt;&lt;/b&gt; This study aimed to assess health-related quality of life (HRQoL) in adult patients with celiac disease and to identify factors associated with their daily functioning and adherence to the GFD. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; A cross-sectional survey was conducted between February and March 2026 among 101 adults with a self-reported diagnosis of celiac disease made by a gastroenterologist, recruited through online support groups. Data were collected using an author-designed sociodemographic questionnaire, the Gastrointestinal Quality of Life Index (GIQLI), and the Celiac Dietary Adherence Test (CDAT). Analyses (Mann-Whitney U and Kruskal-Wallis tests, repeated-measures ANOVA, Spearman correlations with false-discovery-rate correction, and multivariable linear and logistic regression with prespecified sensitivity analyses) were performed in R 4.5.2, with α = 0.05. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; The most frequently reported difficulties were eating away from home, the high cost of the GFD, and limited product availability; the most common symptoms after inadvertent gluten exposure were abdominal pain, bloating, fatigue, diarrhea, and headache. HRQoL was lowest in the emotional and physical domains. Better dietary adherence was significantly correlated with higher HRQoL across the total score and all domains except the social domain, whose weak internal consistency in this sample (α = 0.57) precludes substantive interpretation (total GIQLI: ρ = -0.50; &lt;i&gt;p&lt;/i&gt; &lt; 0.001), and in the multiple regression, adherence remained the strongest independent correlate of HRQoL (β = -0.36; adjusted R&lt;sup&gt;2&lt;/sup&gt; = 0.41). Longer time on the diet was independently associated with better adherence (adjusted OR = 0.55 per duration category; &lt;i&gt;p&lt;/i&gt; = 0.017). In a small vocational education subgroup (&lt;i&gt;n&lt;/i&gt; = 8), poorer adherence and lower HRQoL were observed relative to participants with higher education, though only the HRQoL difference survived correction for multiple testing (FDR-adjusted &lt;i&gt;p&lt;/i&gt; = 0.011 vs. 0.060 for adherence); given the size of this subgroup, this comparison is exploratory and hypothesis-generating. Higher HRQoL was also associated with milder symptoms, better-rated medical care, greater product availability, and higher household income. &lt;b&gt;&lt;i&gt;Conclusions&lt;/i&gt;&lt;/b&gt;: In this sample, HRQoL scores were lowest in the emotional and physical domains; because the design was cross-sectional and included no comparison group, these data characterize the distribution of HRQoL within the sample and do not establish that celiac disease reduces HRQoL. Dietary adherence was the strongest correlate of patient functioning, alongside symptom burden, self-rated quality of medica","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 16","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148830595","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 Diet During Pregnancy and Offspring Health: Current Evidence on Dietary Patterns, Microbiota, and Developmental Programming.","authors":"Dana-Teodora Anton-Păduraru, Dana Elena Mîndru, Codruta Olimpiada Iliescu Haliţchi, Ana Simona Bocec, Olivia Simona Dorneanu, Felicia Trofin, Mioara Florentina Trandafirescu, Lucia Maria Sur, Cătălina Elena Mărgineanu, Paula Popovici, Cosmin Diaconescu, Alina Costina Luca","doi":"10.3390/nu18162710","DOIUrl":"10.3390/nu18162710","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Maternal nutrition is an important exogenous factor which, together with other factors, may play a fundamental role in ensuring the well-being of the pregnant woman and in the development of the offspring, with long-term effects on health. Therefore, this narrative review aims to synthesize current evidence on how maternal dietary patterns and nutrient intake during pregnancy affect maternal well-being, pregnancy outcomes, fetal growth, and the short- and long-term health of the child, while addressing research gaps, and implications for antenatal nutrition guidance. Literature Search Strategy and Study Selection: A comprehensive literature search was performed using the electronic databases PubMed and Google Scholar. The selection and curation of articles were guided by the central research question: \"How does maternal diet during pregnancy influence maternal health and offspring outcomes?\" <b>Results:</b> The analysis of the literature reveals that the overall maternal dietary pattern is more important than the isolated intake of nutrients in determining the course of pregnancy and the long-term health of the offspring. <b>Conclusions:</b> The present review pointed out that maternal nutrition is not merely energy support for pregnancy, but a factor in fetal programming with a long-term impact on the child, in line with the Developmental Origins of Health and Disease (DOHaD) concept, and may act as an epigenetic and metabolic influence with potential transgenerational effects. Optimizing the diet in the periconceptional period and during pregnancy represents an accessible and effective form of preventive intervention, but it requires personalized recommendations and structured nutritional education begun as early as the preconception period.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 16","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148830727","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}