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PubMed2026

Effect of a PROtein-enriched MEDiterranean diet and EXercise (PROMED-EX) on nutritional status and cognitive performance in older adults at risk of undernutrition and cognitive decline: the PROMED-EX randomized controlled trial.

BACKGROUND: Undernutrition in older adults is associated with adverse health outcomes including cognitive decline, yet evidence for effective preventive strategies is limited. OBJECTIVES: The objective of this study was to investigate effects of a protein-enriched Mediterranean diet, with and without exercise, on nutritional status and cognitive performance in "at risk" community-dwelling older adults. METHODS: A total of 105 participants (69% female; aged 67.7 &#xb1; 6.1 y) at risk of undernutrition and cognitive decline were randomized to 1 of 3 groups: 1) PROMED-EX (personalized dietary counseling plus home-based exercise); 2) PROMED (personalized dietary counseling only); or 3) CON (healthy eating leaflet). The primary outcome was change in nutritional status at 6 mo, measured by the Mini Nutritional Assessment (MNA; 0-30 points). Secondary outcomes included neurocognitive test battery (NTB) z-score, PROMED diet quality score (0-14), physical performance, and health-related quality of life. Analyses followed an intention-to-treat approach using linear regression to assess between-group differences in 6-mo outcomes. RESULTS: At baseline, the mean MNA score was 22.5 &#xb1; 2.3. After 6 mo, nutritional status improved significantly in both intervention groups compared with CON: mean differences in MNA were 2.7 [95% confidence interval (CI): 1.3, 4.2] for PROMED and 2.9 (95% CI: 1.5, 4.3) for PROMED-EX (both P < 0.001). Cognitive function also improved, with NTB z-score differences of 0.3 (95% CI: 0.1, 0.5; P = 0.01) in PROMED and 0.2 (95% CI: 0.0, 0.4; P = 0.02) in PROMED-EX compared with CON. Diet quality scores significantly increased with mean differences of 4.0 (95% CI: 2.9, 5.0) for PROMED and 3.9 (95% CI: 2.8, 4.9) for PROMED-EX compared with CON (both P < 0.001). Despite low adherence to exercise, additional benefits were observed for physical performance and quality of life. CONCLUSIONS: Dietary intervention improved nutritional status in community-dwelling older adults at risk of undernutrition. Correcting undernutrition could help to slow cognitive decline and promote physical health and quality of life during aging. This study was registered at clinicaltrials.gov as NCT05166564.

Humans↗
PubMed2026

Adherence to the Mediterranean diet and incident cardiovascular outcomes among older adults.

AIM: The present study examined the prospective associations between adherence to the Mediterranean (MED) diet, its individual components, and incident cardiovascular disease (CVD) among community-dwelling older adults. METHODS: Data were obtained from the English Longitudinal Study of Ageing (ELSA). Participants aged &#x2265;65 years without hypertension at baseline (Wave 9, 2018-2019) were followed through Wave 11 (2023-2024). Adherence to the MED diet was assessed using the Medi-Lite score. Incident hypertension, myocardial infarction, and stroke were identified through self-reported physician diagnoses. Logistic regression analyses were performed to examine the prospective associations between MED diet adherence, individual dietary components, and cardiovascular outcomes, adjusting for age, sex, and caloric intake. RESULTS: A total of 338 participants (74.6 &#xb1; 6.2 years; 56.6% women) were included. During follow-up, the incidence of hypertension, myocardial infarction, and stroke was 12.4%, 2.6%, and 2.6%, respectively. No statistically significant associations were detected between overall MED diet adherence and incident hypertension (OR = 0.992, 95% CI = 0.586-1.679), myocardial infarction (OR = 1.422, 95% CI = 0.381-5.302), or stroke (OR = 0.808, 95% CI = 0.360-1.811). Likewise, none of the individual MED diet components was significantly associated with incident CVD outcomes. CONCLUSION: In conclusion, no statistically significant associations were detected between adherence to the MED diet and incident CVD among community-dwelling older adults in England. However, given the relatively low number of cardiovascular events, particularly myocardial infarction and stroke, these findings should be interpreted with caution. Further studies with longer follow-up periods and larger numbers of CVD events are warranted to provide more precise estimates and further clarify these associations.

diet pattern↗
PubMed2026

Multi-Omic Insights Into Mediterranean Diet-Associated Microbiota.

This study aimed to evaluate the gut microbiota and mycobiota composition, depending on the Mediterranean diet (MD) adherence, using metataxonomics. Combining metagenomics and metatranscriptomics, we also investigate the gene expression level in the bacterial community. Two groups of healthy subjects greatly differing in adherence were selected. Significant differences in microbiota composition were observed between individuals with high adherence (HAMD; mean 10.5&#xa0;+/-&#xa0;0.9 points) and low adherence (LAMD; 5.23&#xa0;+/-&#xa0;83 points). Notably, the olive oil, vegetable, and fruit consumption presented an important discriminant power between groups. Saccharomyces, Penicillium, and Candida were the most abundant genera. Mycobiota richness was higher in LAMD than in HAMD. Aspergillus was identified as a biomarker for LAMD, whereas Yarrowia, a potential probiotic, was a biomarker for HAMD. Metatranscriptomics indicated that Bacillota was the most metabolically active phylum in the gut microbiota. The low-abundant genus, Methanobrevibacter, showed high transcriptional activity, contributing to the crucial methanogenesis process. Gene expression analyses further highlighted functional differences. Overall, HAMD microbiota presented increased metabolic activity, protein synthesis, and cellular mobility. Overexpression of flagellin and urease genes may enhance immune response in HAMD. Further metatranscriptomic studies are necessary to deepen our understanding of intestinal microbiota transcriptional programs and their interactions with the diet and human health.

Humans↗
PubMed2026

Diet and sleep among college student populations: a systematic review.

College students are at-risk for both poor diet and poor sleep. We aimed to systematically review the evidence regarding associations between diet and sleep health within this population. A comprehensive electronic search was conducted in PubMed, Embase, Scopus, Web of Science, and PsycINFO from the earliest possible date through February 6, 2026. A total of 57 studies representing 44 countries were retained; most were cross-sectional. There were 22 studies that examined dietary patterns in relation to sleep, generally showing that healthier diet patterns, including the Mediterranean Diet, were related to better sleep quality. Among 20 studies that examined individual foods or nutrients, there was evidence that fruits, vegetables, dairy, protein, and lower intake of sugar-sweetened beverages were linked to better sleep health, although some findings were mixed. Finally, 15 studies related meal timing to sleep quality, showing that breakfast skipping and later last meals were associated with poor sleep health. Overall, these studies reveal robust cross-sectional associations between diet and sleep among college students, but more longitudinal studies and randomized controlled trials are needed to evaluate directionality. Moreover, a key direction for future study is consideration of sleep and nutrition situated within the unique contexts of college settings and academic schedules.

Humans↗
PubMed2025

Mediterranean and standard American diet consumption in psychosis and non-psychosis affective disorders groups: Symptoms and cognition.

UNLABELLED: Research supports an association between diet and health, and emerging evidence suggests that diet is associated with neuropsychiatric symptoms. However, no human study has examined an anti-inflammatory diet across rigorously defined psychiatric diagnoses and its associations with symptom severity and cognition. As inflammation is implicated in mental illness, we investigated adherence to the Mediterranean diet (MD), an anti-inflammatory diet, and the standard American diet (SAD), and examined cross-sectional relationships with psychiatric symptoms and cognition. METHOD: Participants included 54 individuals with psychotic disorders, 30 with non-psychosis affective disorders and 40 healthy controls. Participants underwent diagnostic interviews, PANSS symptom ratings, and MATRICS cognitive assessments. The self-report GBAQ was used to assess adherence to the MD versus SAD. RESULTS: The psychosis group was significantly more likely to consume the SAD than healthy controls (p&#xa0;=&#xa0;0.007), with MD adherence predicting better working memory (r&#xa0;=&#xa0;0.461, p&#xa0;<&#xa0;0.001). In the non-psychosis affective disorders group, MD adherence predicted slower processing speed (r&#xa0;=&#xa0;-0.376, p&#xa0;=&#xa0;0.049). In the non-psychosis affective disorders group, MD predicted reduced PANSS General Psychopathology scale (r&#xa0;=&#xa0;-0.449, p&#xa0;=&#xa0;0.013), as well as the Activation (r&#xa0;=&#xa0;-0.362, p&#xa0;=&#xa0;0.049), and Dysphoric Mood factors (r&#xa0;=&#xa0;-0.403, p&#xa0;=&#xa0;0.027). DISCUSSION: This first-of-its kind study identified poor dietary choices in persons with psychosis, showing significantly lower symptoms and better cognition in association with the MD in transdiagnostic analyses. It supports the study of dietary interventions for prevention and treatment of psychiatric conditions.

Humans↗
PubMed2026

Multiomics: the intersection of personalized nutrition in cardiometabolic diseases.

BACKGROUND: Cardiometabolic diseases are among the leading causes of increasing morbidity and mortality worldwide. However, current population-based dietary recommendations do not sufficiently account for biological differences between individuals and therefore do not have the same effect on everyone. The multiomic approach, which incorporates genomic, epigenomic, transcriptomic, proteomic, metabolomic, and microbiome data, facilitates more accurate classification of disease risk and selection of appropriate nutritional interventions by mapping food-disease relationships across different biological layers. METHODS: Through a narrative synthesis of the current literature, we focused on evidence from multiomic studies to assess their ability to guide personalized nutrition strategies based on individual genetic, metabolic, and microbiome characteristics in cardiometabolic diseases. RESULTS: Recent evidence indicates that metabolomic markers have been reported to provide predictive value in addition to classic risk indicators and to increase the predictive power of models when combined with genetic data. Microbiome research shows that glycemic and lipemic responses can be predicted using algorithms based on gut microbiota. Recent clinical studies show that personalized nutrition plans, which evaluate the microbiome and clinical characteristics together, improve continuous glucose monitoring-based glycemic control, glycated hemoglobin levels, and triglycerides more than the classic Mediterranean diet. CONCLUSION: This review summarizes the current multiomic evidence, discusses the methodological and practical challenges in this field, and highlights future priorities. The integration of digital biomarkers obtained from wearable technologies with multiomic systems and artificial intelligence-supported models, when developed in accordance with ethical and equitable access principles, has the potential to support the transition from the discovery phase to patient-centered clinical applications.

Humans↗
PubMed2026

Dietary approaches for glycemic management in type 1 diabetes: A systematic review of Mediterranean and low-carbohydrate diets.

BACKGROUND/OBJECTIVES: Specific dietary approaches for better management of type 1 diabetes (T1D) have not been thoroughly investigated. We conducted a systematic review to evaluate the Mediterranean and low-carbohydrate diets for glycemic management in people with T1D. METHODS: We examined longitudinal studies (cohort studies and clinical trials) including individuals with T1D who followed low-carbohydrate diets (<26% calories from carbohydrates and/or <130&#x202f;g of carbohydrates per day) and/or a Mediterranean diet, while hemoglobin A1c (HbA1c) and/or time in range (TIR) were measured. Additional eligibility criteria included publication in English and availability of a full-text primary research article. Non-longitudinal studies, abstracts, and studies published in languages other than English were excluded. Results were synthesized narratively, and the GRADEpro Guideline Development Tool was used to assess article quality. RESULTS: A total of 565 studies were identified from PubMed, the Web of Science, and citation chasing. After removal of duplicates and further evaluation, 22 studies (6 cohort studies and 16 clinical trials; total n&#x202f;=&#x202f;3284) were included in this review. The search was initially completed in May 2024, and updated February 2026. Low-carbohydrate diets were associated with better glycemic management when compared to usual diets or baseline glycemic parameters. Studies using CGM were overall underpowered. The impact of Mediterranean diets was less clear, but generally appeared to be less effective at improving glycemic management than low-carbohydrate diets. DISCUSSION: Although structured dietary interventions for T1D hold promise for improving glycemic outcomes, further research is needed to determine exactly which dietary intervention is most beneficial for this population. The evidence provided by included studies is limited by small sample sizes and short durations; better powered, longer-term studies are required to inform clinical recommendations.

Humans↗
PubMed2025

Consumption of traditional Sardinian fermented milk promotes changes in the rat gut microbiota composition and functions.

BACKGROUND: Fermented milk products are part of the staple diet for many Mediterranean populations. Most of these traditional foods are enriched with lactobacilli and other lactic acid bacteria, as well as with metabolites resulting from lactose fermentation. Currently, there is very little scientific knowledge on how dietary supplementation with fermented milk affects the composition of the gut microbiota and its metabolic activities. RESULTS: We integrated 16&#xa0;S rRNA gene-based taxonomic profiling with metaproteomics-based functional analysis to investigate gut microbiota changes in rats exposed to an 8-week dietary supplementation with casu axedu, a traditional fermented milk produced within rural communities in Sardinia (Italy). Several microbial taxa showed a significantly increased abundance at the end of the dietary treatment, including Phascolarctobacterium, Prevotella, Blautia glucerasea, and Lactococcus lactis, while Bacteroides dorei and Helicobacter rodentium were decreased compared to the control rats. Metaproteomic analysis highlighted a striking reshaping of the Prevotella proteome in agreement with its blooming in casu axedu-fed animals, suggesting an increase of the glycolytic activity through the Embden-Meyerhof-Parnas pathway over the Entner-Doudoroff pathway. Moreover, an increased production of enzymes involved in succinate biosynthesis was observed, which in turn significantly boosted the abundance of Phascolarctobacterium and its production of propionate. Fermented milk consumption also promoted microbial synthesis of branched chain essential amino acids L-valine and L-leucine. Finally, metaproteomic data indicated a reduction of bacterial virulence factors and host inflammatory markers, suggesting that the consumption of casu axedu can have beneficial effects on the gut mucosa health. CONCLUSIONS: Our integrated multi-omics approach reveals that dietary supplementation with the traditional Sardinian fermented milk, casu axedu, induces significant shifts in the rat gut microbiota composition and function, characterized by the enrichment of beneficial taxa and metabolic pathways associated with improved gut health and reduced inflammation.

Animals↗
PubMed2026

Nutrition and longevity - diet in centenarians.

BACKGROUND: Nutrition plays a central role in the biological mechanisms that shape aging, health span, and longevity. Micronutrients&#x2014;including vitamins, trace elements, and polyphenols&#x2014;support genomic stability, mitochondrial integrity, and antioxidant defense, while dietary patterns rich in plant-based foods modulate inflammation, metabolic regulation, and epigenetic processes. Centenarian populations consuming Mediterranean, Okinawan, Nordic, and Nicoyan diets offer a natural model for understanding how nutrient-rich, minimally processed foods, moderate caloric intake, and balanced lifestyles interact with molecular pathways to extend functional life. MAIN BODY: This review synthesizes current evidence on how micronutrients influence DNA repair, oxidative stress reduction, and mitochondrial protection, particularly through the actions of vitamins C and E, niacin-dependent PARP activity, folate-mediated methylation, and metal cofactors involved in antioxidant enzymes. Plant-based diets rich in fiber and polyphenols enhance microbial diversity and promote beneficial taxa such as Akkermansia and Bifidobacterium, supporting gut barrier integrity and immune balance. Caloric restriction and intermittent fasting activate nutrient-sensing pathways, including AMPK and sirtuins, reduce mTOR activity, and stimulate autophagy, collectively improving cellular resilience. Findings from centenarian regions highlight the convergence of lifestyle, nutrition, and cultural practices that reduce systemic inflammation, maintain metabolic flexibility, and support healthy aging trajectories. CONCLUSIONS: Diet emerges as a decisive modifiable determinant of lifespan and health span. The convergence of molecular nutrition, microbiome composition, and traditional dietary habits underlies the exceptional longevity observed in centenarian populations. Future research should integrate nutrigenomics, metabolomics, and microbiome profiling to clarify causal mechanisms and guide precision nutrition strategies for aging societies.

Humans↗
PubMed2026

"Not flying solo": phylogenetic identification and life-cycle insights of larval cestodes in the European flying squid Todarodes sagittatus (Cephalopoda: Ommastrephidae).

The European flying squid Todarodes sagittatus Lamarck is a widely distributed ommastrephid cephalopod in the Northeast Atlantic and Mediterranean Sea, yet its parasite fauna remains poorly documented in the&#xa0;Mediterranean Sea. In this study, two cestode larvae species infecting T. sagittatus from the Algerian coast (Western Mediterranean) were investigated using an integrative approach combining morphological observations and molecular analyses. A total of 63 squids were examined for parasitic infection. Cestodes in plerocercoid stage were detected in 31 individuals (prevalence of 46%), primarily located within the gastrointestinal tract, including the stomach, intestine, and caecum. Morphological features of the larvae were consistent with members of the order Phyllobothriidea but did not allow identification to the species level. Molecular analysis of the D1-D3 region of the 28S rDNA revealed two distinct larval lineages belonging to the genus Crossobothrium Linton, 1889. One lineage showed 100% sequence identity with the adult cestode Crossobothrium dohrnii (Oerley, 1885), a parasite of hexanchid sharks, confirming the identity of these larvae as plerocercoids of C. dohrnii. The second lineage clustered within the Crossobothrium clade but could not be assigned to a known species and is therefore referred to as Crossobothrium sp. The occurrence of these larvae in T. sagittatus, together with ecological data on squid diet and predator-prey relationships, suggests that this cephalopod acts as an intermediate or paratenic host in the life cycle of hexanchid cestodes. Infection likely occurs through predation on crustaceans acting as first intermediate hosts, while transmission to definitive hosts occurs when infected squids are consumed by sharks. These findings provide the first molecular identification of cestode larvae from T. sagittatus in the Mediterranean and highlight the important role of ommastrephid squids in the trophic transmission of elasmobranch parasites in pelagic ecosystems.

Crossobothrium↗
PubMed1979

The nutritional value and quality of squid (Illex illecebrosus) meal as source of dietary protein for broiler chicken.

1. Squid meal (SqM), produced by grinding and drying the whole squid (Illex illecebrosus) common to the northeast Atlantic and Mediterranean, contained 645 g protein/kg and appeared limiting with respect to lysine, methionine and cystine. 2. Although a comparison of the essential amino acid profiles of SqM with other protein concentrates indicated that SqM was higher than fish meal and soya-bean meal but lower than casein or whole-egg protein, these teported for evaluating protein quality of SqM. It was based on the direct chromatographic determination, of its collagen content, from the amounts of 5-hydroxylysine or 5-hydroxyproline present, and elastin, from the amounts of desmosine or iso-desmosine present. This method can also be routinely used to assess the connective tissue content and protein quality of animal protein supplements such as fish, meat-and-bone meals. 4. A nutritional evaluation of SqM as a source of protein for poultry was carried out using 320 male and 320 female Cobb chicks fed from 1-d-old to 48 d, a control diet containing 50 g/kg fish meal or test diets containing 50 g, 100 g or 150 g SqM/kg. 5. Feeding of SqM at a rate of up to 100 g/kg diet resulted in optimum biological response and monetary returns.

Amino Acids↗
PubMed1976

Feeding families and children--1776 to 1976. A bicentennial study.

The food heritage which Americans enjoy today owes its great diversity to the influences of many ethnic groups--the native Indians, Franciscan friars in California, Mexican-Americans, the British, the French, the Creoles, and later, northern Europeans and those of Mediterranean stock. Geography and climate in different parts of our large country and religious beliefs have also played a part in the development of our present-day, varied cuisine. In our colonial and pioneer days, most people raised their own food, but as our nation has become industrialized and urbanized, we find that now only 7 per cent of our population produces the food for our entire nation, and our consumers generally buy their food in stores. Even as late as the beginning of the twentieth century, infant feeding practices could be considered unscientific and primitive. Only in recent years have knowledge of metabolism and the rapid increase in nutritional science permitted progress in infant feeding. Problems of feeding families remain, nevertheless--different than in the early days of our nation--and their solution challenges American ingenuity.

Agriculture↗