Ultra-processed food (UPF) intake may influence outcomes in long-term cancer survivors. This study examined the relationship between post-diagnostic UPF consumption and mortality and assessed whether chronic disease biomarkers explain this association. We longitudinally analysed 802 men and women with a previous cancer diagnosis (any site) recruited in the Moli-sani Study (2005-2010). Food intake data was collected at baseline, and assessed an average of 8.4 years after diagnosis. UPF was defined according to the Nova classification and calculated as a weight ratio. The Mediterranean Diet Score (MDS) was used to assess overall diet quality. Inflammatory, metabolic, and cardiovascular biomarkers were analysed as potential explanatory factors on the basis of change-in-estimate. During a median follow-up of 14.6 years, a total of 281 deaths occurred. Multivariable (including the MDS)-adjusted HRs of higher UPF consumption for all-cause and cancer mortality, were 1.48 (95%CI 1.07-2.03 for highest vs. lowest third) and 1.57 (95%CI 1.00-2.47), respectively. Taken together, inflammation markers and resting heart rate levels attenuated the associations of UPF with all-cause mortality by approximately 40%. Higher consumption of UPFs after cancer diagnosis was associated with increased all-cause and cancer mortality rates, irrespective of diet quality. Part of these associations was explained by elevated levels of inflammation markers and resting heart rate. These findings contribute to the growing body of evidence linking UPFs to adverse health outcomes in cancer survivors. Further research is needed to identify specific mechanisms underlying this relationship and to explore potential dietary interventions for improving long-term survival.

Inflammatory arthritis is a term used to describe a diverse group of rheumatic disorders involving the inflammation and hyperproliferation of synovial joints and systemic manifestations. Oleacein (OLA) is one of the most abundant secoiridoids in extra virgin olive oil, the principal source of fat in the Mediterranean diet, which has been shown to exhibit beneficial effects. The objective of the study was to explore the antioxidant and anti-inflammatory effects induced by OLA in a human cell line of synovial cells (SW982), as well as to evaluate its possible role as an epigenetic modulator through the regulation of DNA methylation. Sulforhodamine B assay was utilised to assess cell viability. The levels of inflammatory marker production (MMP-1, MMP-3, TNF-α, IL-1β, IL-6, and PGE2) were evaluated by ELISA, and IL-8 gene expression was analysed by RT-qPCR. The expression of pro-inflammatory enzymes, including COX-2 and mPGES-1, and signaling pathways (MAPK, NF-κB, Keap1/Nrf-2/HO-1 and inflammasome) were evaluated by western blotting. In addition, global DNA methylation was analysed by ELISA, and we studied the gene expression of DNMT1/3A enzymes by RT-qPCR. OLA exhibited anti-inflammatory and antioxidant effects through the regulation of key inflammatory signaling pathways such as inflammasome, MAPK, NF-κB, and the Keap1/Nrf-2/HO-1 axis. In addition, it reduced the production and expression of pro-inflammatory markers (COX-2, mPGES-1, MMP-1, MMP-3, IL-8, IL-6, TNF-α and PGE2) and regulated IL-1β-induced changes in DNA methylation modulating DNMT1 and DNMT3 gene expression and global DNA methylation. These results show OLA as a promising epigenetic regulator of the inflammatory response in rheumatic diseases.

Effects of maternal Mediterranean diet on fetal cardiac function in high-risk pregnancies: a secondary analysis of the IMPACT BCN randomized trial.

Efficacy of Mediterranean diet in musculoskeletal disorders: A systematic review and meta-analysis for primary and tertiary prevention featured in the Italian National Guidelines "La Dieta Mediterranea".

Efficacy of Mediterranean diet for the prevention of neurological diseases: A systematic review and meta-analysis featured in the Italian National Guidelines "La Dieta Mediterranea".

Exploring the multiple mechanisms of Hydroxytyrosol in treating obesity.

Mediterranean diet for the management of pre-existing metabolic diseases: Evidence from a systematic review and meta-analysis featured in the Italian national guidelines "La Dieta Mediterranea".

Nutritional composition of diets for inducing and maintaining remission in inflammatory bowel diseases: from bedside to plate.

The growing prevalence of metabolic syndrome (MS) is a major public health issue. The traditional Maya milpa diet (MayDiet) offers a promising alternative to the Mediterranean diet (MetDiet) due to its similar therapeutic benefits. This study evaluated 24 MayDiet foods (fruits, vegetables, tubers, leaves and seeds) to assess their bioactive compounds (BC) and their effects on key therapeutic targets for MS: antidiabetic, antihypertensive and antilipidemic activities. Multivariate analysis of variance (ANOVA) and machine learning were used to analyze the results. The studied foods exhibited high concentrations of BC. The ranges were 7.44-123.74 μg gallic acid equivalents mg-1 for total phenols, 2.72-16.13 μg catechin mg-1 for total flavonoids, 8.20-142.93 μg naringenin mg-1 for flavanones and dihydroflavonols, 0.12-9.40 μg quillaja saponin mg-1 for total saponins, 9.71-75.83 μg tannic acid mg-1 for hydrolysable tannins and 3.60 μg atropine mg-1 for total alkaloids. Mentha spicata exhibited the highest concentrations of phenols, flavonoids, tannins and alkaloids, while Cucumis sativus led in flavanones and dihydroflavonols, and Sechium edule in saponins. Multivariate ANOVA showed Averrhoa carambola, Capsicum chinense, Beta vulgaris, Mentha spicata and Bixa orellana as the most potent foods against MS. Machine learning analysis highlighted leaves and seeds as the most potent food groups, with the highest biological potential due to their high flavonoid content. MayDiet, due to its diversity of BC-rich foods and biological activities, suggests therapeutic benefits comparable to MetDiet. Therefore, it represents a promising approach against MS. © 2025 Society of Chemical Industry.

Food neophobia correlates with motor cortex excitability in response to disgust-related stimuli.

Mood disorders, such as depression and anxiety, represent a growing public health problem and have historically been addressed from a neurochemical perspective, overlooking the role of nutrition and the intestinal ecosystem. In this regard, current scientific evidence supports that the gut microbiota may be involved in emotional regulation through the gut–brain axis. This study corresponds to a bibliographic review with a qualitative approach and descriptive design, in which a systematic search was conducted in scientific databases such as PubMed, Scopus, ScienceDirect, Web of Science, and Google Scholar. Original articles, systematic reviews, and meta-analyses published within the last five years addressing gut microbiota, nutrition, and mental health were selected. The findings demonstrated that the gut microbiota plays a key role in regulating the gut–brain axis by participating in the production of neurotransmitters such as serotonin and gamma-aminobutyric acid, as well as in immunological and inflammatory processes. In addition, dysbiosis (microbial imbalance) was found to be associated with depressive and anxiety symptoms. Finally, healthy dietary patterns, such as the Mediterranean diet, along with probiotic and prebiotic supplementation, were shown to positively influence mental health through the modulation of the intestinal microbiome. In conclusion, a balanced diet may be considered a complementary therapeutic strategy to improve emotional well-being through the maintenance of a healthy gut microbiota.

Existing guidelines lack comprehensive recommendations for stroke prevention. This network meta-analysis aimed to evaluate the comparative efficacy of non-pharmacological interventions in preventing total stroke and fatal stroke in high-risk adults. We pooled only randomized controlled trials (RCTs). Relative risks (RRs), 95% confidence intervals (CIs), and P-scores were computed to compare and rank the efficacy of interventions in preventing stroke. 50 RCTs with 673624 participants were pooled in this study. Compared with the control group, Exercise + Education may decrease stroke risk (RR=0.23; 95% CI: 0.07 - 0.73; low strength of evidence (SOE)), followed by Exercise (RR=0.40; 95% CI: 0.28 - 0.57; moderate SOE), Mediterranean diet (RR=0.70; 95% CI: 0.50 - 0.97; low SOE), and Vitamin B6 combined with B12 and folic acid (Vitamin B6 + B12 + folic acid) (RR=0.86; 95% CI: 0.77 - 0.95; moderate SOE). Only Salt substitute showed significantly reduced fatal stroke risk (RR = 0.78; 95% CI: 0.68 - 0.90; high SOE). Exercise + Education (low SOE) and Exercise alone (moderate SOE) showed short-term benefits, while Salt substitute had long-term effects on reducing stroke risk (high SOE). Carotid endarterectomy (moderate SOE) and vitamin C (high SOE) were significantly effective in preventing ischemic stroke; and Salt substitute (high SOE) showed significantly reduced hemorrhagic stroke risk. Vitamin B6 + B12 + folic acid may lower hemorrhagic stroke, fatal hemorrhagic stroke, and transient ischemic attack risks (moderate SOE). Future studies should prioritize high-quality RCTs with large sample sizes, different follow-up durations and specific stroke types to confirm the efficacy of these non-pharmacological interventions.

Adolescence is a critical period for brain development, during which dietary patterns may influence neuropsychological functioning. To examine cross-sectional associations and determine if baseline adherence to the Mediterranean diet (MD) and ultra-processed food (UPF) consumption is associated with changes in adolescent neuropsychological outcomes over 6months. This study represents a secondary analysis of the WALNUTs Smart-Snack Trial. We evaluated 653 adolescents (aged 12-16years) from Barcelona at baseline and at 6-month follow-up. All dietary data used for these analyses were collected at the baseline timepoint only. MD adherence was measured with the KIDMED index and UPF consumption was assessed using a food frequency questionnaire and classified using the NOVA system. Cognitive domains were assessed at both time points using standardised computer-based tasks: attention (alerting, orienting, executive control) with the Attention Network Test; working memory (4-back) with the N-back task; fluid intelligence with the Primary Mental Abilities-Revised; decision-making with the Roulettes Task; and emotion recognition with the Emotion Recognition Task. Behavioural outcomes were also evaluated at both time points using the self-reported Strengths and Difficulties Questionnaire and teacher-reported Attention-Deficit/Hyperactivity Disorder-DSM-IV scales. Associations were examined using multivariable generalised linear models. To further validate UPF consumption estimations, polyphenol biomarkers were measured in urine in a subsample of 257 participants. Greater adherence to the MD was cross-sectionally linked to fewer behavioural problems and higher scores of executive functioning, while higher UPF consumption was associated with poorer emotion recognition, reduced alerting attention, less advantageous decision-making, more behavioural problems and internalising symptoms. Longitudinally, higher UPF consumption was associated with more internalising symptoms and less advantageous decision-making, whereas MD adherence showed no associations. Greater MD adherence appears associated with more favourable behavioural and cognitive profiles. In contrast, higher UPF consumption seems to be associated with less favourable profiles across multiple neuropsychological domains in adolescents. However, the limited longitudinal evidence points to complex relationships that warrant further investigation. Overall, these findings highlight the importance of promoting healthier dietary habits during adolescence.

Objective: The aim of this study was to evaluate and compare the dietary habits, diet quality, and mental well-being of university students in different countries. Material and Methods: The descriptive general characteristics, disease status, dietary habits, smoking status, and alcohol consumption status of the students were recorded. In addition, the Mediterranean Dietary Adherence Scale (MEDAS) was used to assess diet quality, the Short Physical Activity Assessment Tool was used to assess physical activity levels, and the Warwick-Edinburgh Mental Well-Being Scale was used to assess mental well-being. Results: 58% of the students in Turkey and 69.9% of the students in Bosnia and Herzegovina had a normal BMI. The percentage of students in Turkey and Bosnia and Herzegovina with high adherence to the Mediterranean diet ranged from 20.3% to 32.5%. The mental well-being scores of students in the two countries were similar, with averages of 51.7±9.3 in Turkey and 51.2±8.8 in Bosnia and Herzegovina. Conclusion: Since university represents a critical transitional stage to adulthood, it is important to promote and support healthy behaviors during this period. Therefore, adopting and implementing nutrition and health education programs, along with increasing students' physical activity levels, is recommended to reduce the prevalence of overweight and obesity amonguniversity students and to improve their dietary habits. Keywords: Dietary habits, mental well-being, Mediterranean diet, different countries.

Validation of a Brief and Very Brief Screener to Assess Overall Diet Quality in a Southeastern US Sample.

Carotid intima-media thickness (CIMT), measured by ultrasound, is a validated marker of subclinical atherosclerosis and an early predictor of cardiovascular and cerebrovascular disease. Increasing evidence links vascular aging and oxidative stress to cognitive decline, particularly among older adults and individuals with neurodegenerative disorders. Dietary antioxidants and polyphenols-abundant in fruits, vegetables, olive oil, tea, and red wine-exert protective effects on vascular and brain health through anti-inflammatory, antioxidant, and endothelial-supportive mechanisms. This narrative review synthesizes current evidence on the influence of dietary antioxidants and polyphenols on ultrasound-measured CIMT and cognitive function, with emphasis on aging and early neurodegenerative disease. A narrative review of clinical trials, cohort studies, and mechanistic investigations published between 2000 and 2024 was conducted. Studies exploring antioxidant-rich diets and individual polyphenols (e.g., resveratrol, epigallocatechin gallate, punicalagin) and their effects on CIMT, oxidative stress, neuroinflammation, and cognitive outcomes were included. Evidence from randomized controlled and observational studies shows that polyphenol-rich interventions-such as the Mediterranean diet and pomegranate juice-are associated with reductions in CIMT and improvements in cognitive domains, including memory, attention, and executive function. These benefits are mediated through reduced oxidative stress, suppression of pro-inflammatory cytokines, improved lipid metabolism, and enhanced nitric oxide bioavailability. Some studies also demonstrate favorable changes in brain imaging biomarkers and cerebrovascular perfusion. Dietary antioxidants and polyphenols show potential to mitigate vascular aging and cognitive decline. These nutritional strategies may serve as safe, cost-effective adjuncts in preventing atherosclerosis and neurodegenerative disorders. However, further long-term, high-quality studies are needed to define optimal doses, formulations, and personalized dietary approaches.

Over the past decade, emerging evidence has shed light on the role of the gut microbiota in the interface between diet and brain health. Olive oil, particularly virgin olive oil, a key component and major fat source in the Mediterranean diet, has exhibited widespread healthful benefits, including improvements in gut microbiota and cognitive health. Despite insights from preclinical studies into the relationship between virgin olive oil consumption, gut microbiota, and cognitive function, human research in this area remains limited. Therefore, our study aims to investigate the interplay between total olive oil consumption and its subtypes, gut microbiota, and changes in cognitive function in older adults who were cognitively healthy at baseline but at high risk of cognitive decline. In this prospective cohort study, we assessed a total of 656 participants aged 55 to 75y (mean age 65.0 ± 4.9y, 47.9% women) with overweight/obesity and metabolic syndrome who provided stool samples and completed a validated semi-quantitative food frequency questionnaire at baseline and a comprehensive battery of neuropsychological tests at baseline and at a 2-y follow-up. Results from the multivariable linear regression models showed that higher consumption of virgin olive oil was associated with improved cognitive function over a 2-y follow-up, and a more diverse gut microbiota overall structure at baseline. Conversely, increased consumption of common olive oil is linked to lower alpha diversity of the microbial communities, and accelerated cognitive decline. Mediation analysis suggests that gut microbiota and particularly the Adlercreutzia, may serve as a mediator taxon in the association between virgin olive oil consumption and positive changes in general cognitive function. Higher consumption of virgin olive oil was associated with cognitive preservation, possibly mediated by favorable alterations in gut microbiota composition. Our study provides novel insights into the complex interplay between different types of olive oil consumption, gut microbiota, and changes in cognitive function. These findings underscore the potential of microbiota-targeted dietary strategies to promote cognitive health in aging populations, though further high-quality and clinical cohort studies are required. Video Abstract.

The Mediterranean diet exerts beneficial effects on cardiovascular health, though many of its underlying mechanisms remain undefined. While omega-3/6 polyunsaturated fatty acids (PUFAs) present in this dietary pattern may influence cardiac inflammatory conditions, their specific roles in heart diseases require further investigation. Independent single nucleotide polymorphisms associated with omega-3/6 PUFAs and 3 cardiac inflammatory diseases were identified through the IEU Open Genome-Wide Association Study database. Mendelian randomization (MR) analysis was employed to assess potential causal relationships between PUFAs and endocarditis, myocarditis, and pericarditis. The primary analytical approach utilized inverse variance weighting (IVW), complemented by weighted median and MR-Egger methods. Sensitivity analyses included Cochran Q test, MR-pleiotropy residual sum and outlier, MR-Egger regression, and leave-one-out analysis to evaluate heterogeneity and potential pleiotropic effects. IVW analysis revealed a positive causal association between omega-6 PUFAs and myocarditis risk (P-IVW = .013). No statistically significant genetic associations were observed between omega-6 PUFAs and endocarditis or pericarditis. Similarly, omega-3 PUFAs showed no significant causal relationships with any of the 3 inflammatory cardiac conditions. Sensitivity analyses confirmed the absence of horizontal pleiotropy across all findings. This MR study identifies omega-6 fatty acids as a significant class of PUFAs potentially contributing to myocarditis pathogenesis. These findings highlight the need for further investigation into the pro-inflammatory properties of specific PUFAs in cardiac pathophysiology.

Background/Objectives: The increasing prevalence of overweight and obesity in adolescents represents a major global health concern. Adolescent weight gain frequently shows additional metabolic risk factors, including insulin resistance, hypertension, and dyslipidemia, whose co-occurrence defines the metabolic syndrome (MetS). Adherence to a healthy dietary pattern, such as the Mediterranean Diet (MD), has been shown to reduce the metabolic risk among adolescents. Skin carotenoid score has emerged as an objective and non-invasive indicator of MD adherence; however, its relationship with a cluster of metabolic parameters which characterize the MetS, including the triglyceride levels, diastolic blood pressure, and waist circumference, remains poorly explored. Here, we investigated the role of skin carotenoid score as an early biomarker of metabolic syndrome risk in adolescents. Methods: A sample of 634 healthy adolescents underwent anthropometric and clinical measurements, blood sample collection, and evaluation of the MD adherence by the Mediterranean Diet Quality Index for Children and Adolescents (KIDMED) questionnaire and the skin carotenoid levels by the Veggie Meter®. Student's t-test, chi-square test, Pearson correlation, and the multivariable linear regression model were used for analyses. Results: Participants had a mean BMI Z-score of 0.02 ± 1.01; the metabolic serum profile and the cardiovascular parameters were within the normal range. Mean KIDMED and skin carotenoid scores were 5.21 ± 2.56 and 357 ± 96.58, respectively. Skin carotenoids were positively associated with height (p = 0.02), while they were inversely associated with weight (p = 0.008), BMI Z-score (p < 0.0001), diastolic blood pressure (p = 0.013), and triglycerides (p = 0.003). Moreover, the carotenoid score was positively associated with male gender and KIDMED score and negatively associated with waist circumference and triglyceride levels in multivariable regression analyses. Conclusions: Our results suggested the potential application of skin carotenoid score as a complementary biomarker for the early identification of adolescents at increased metabolic risk.

The gut microbiota, a diverse community of trillions of microorganisms residing in the human gastrointestinal tract, plays a pivotal role in maintaining host nutrition, immunity, and metabolic function. Emerging research highlights its significant influence on the development and progression of various diseases, including obesity, type 2 diabetes, inflammatory bowel disease (IBD), and neuropsychiatric disorders. This narrative review aimed to synthesize recent findings (2020–2025) on the relationship between gut microbiota, diet, and health outcomes. A comprehensive search of databases such as PubMed, Scopus, and Google Scholar identified 110 peer-reviewed studies examining the functional roles of gut microbes, dietary interventions, and therapeutic strategies. The findings emphasize that microbial diversity and composition are influenced by factors such as diet, age, medication, birth mode, and lifestyle. High-Fiber diets, such as the Mediterranean diet, promote beneficial microbes like Bifidobacterium and Lactobacillus, while Western diets are associated with dysbiosis and chronic inflammation. Therapeutic approaches including probiotics, prebiotics, synbiotics, and faecal microbiota transplantation (FMT) demonstrated varying success in modulating gut flora to improve health. Dysbiosis was notably linked to metabolic disorders, cognitive decline, immune dysfunction, and gastrointestinal diseases. In conclusion, the gut microbiota acts as a key mediator between diet and health, influencing disease onset and therapeutic response. Personalized nutrition, combined with targeted microbial modulation, offers promising avenues for disease prevention and management. Future research should focus on standardized methods, long-term clinical trials, and multi-omics approaches to unlock the full therapeutic potential of the gut microbiome.