Family-based therapy is the main evidence-based outpatient treatment for children and adolescents with eating disorders. In this context, nutritional education and family guidance can be carried out using different strategies, including calorie counting, exchange lists, and visual models and resources such as the Plate-by-Plate Approach®. The objectives of this study were to develop a visual resource adapted to the Mediterranean diet pattern and the eating and gastronomic habits of Spain, and to evaluate the energy and macro- and micronutrient contribution, as well as the methodology's nutritional quality, using models such as the Plate-by-Plate Approach® as a reference. The MedPlate Method™ was designed as a graphical tool that accounts for meals being distributed on a single plate or two plates. Different recipes and menus were developed according to cultural preferences, and their composition and nutritional quality were analyzed using specialized software. The results show that the MedPlate Method™ allows for meeting energy intake requirements and the recommended intakes for most nutrients. Further studies are needed to evaluate and validate the usefulness of the MedPlate Method™, a new nutritional education tool designed to help professionals and serve as a guide for family members and caregivers of eating disorder patients who are metabolically stable and not at risk of refeeding syndrome.

Low-grade chronic inflammation (LGCI) is a shared biological pathway for noncommunicable diseases (NCDs) and clinical manifestations, including atherosclerotic cardiovascular disease, type 2 diabetes, obesity-related complications, some cancers, and neurodegenerative conditions. Diet is a powerful modulator of inflammatory status. This summary article synthesizes mechanistic and clinical evidence linking LGCI to NCDs, with emphasis on the role of the Mediterranean dietary pattern (MedDiet) and outlines pragmatic prescription guidelines within precision and personalized nutrition bases. Meta-analytic evidence indicates that MedDiet interventions reduce interleukin(IL)-6 and IL-1β, with a trend toward lower C-reactive protein. The Mediterranean diet promotes beneficial shifts in gut microbiota (gut microbiome) composition, increasing short-chain fatty acid production and supporting epithelial barrier integrity, which contributes to its anti-inflammatory effects. Taken together, these data endorse the Mediterranean Diet as a primary cardiometabolic protective approach, emphasizing the importance of integrating straightforward, equity-focused strategies to translate biological potential into measurable benefits at the population level.

Gut microbiota in pathogenesis and therapeutic potentials in rheumatoid arthritis.

Gestational weight gain (GWG) is associated with complications for both offspring and pregnant women, and GWG is closely related to maternal dietary intake and nutritional habits. The aim of the present study was to evaluate and analyze the association between maternal dietary patterns and nutrient intake, considering the GWG in pregnant women. This is a retrospective cross-sectional study with a descriptive-correlational methodology whose sample consists of 306 pregnant women from the city of Melilla (Spain). The total GWG (kg) was obtained by subtracting pre-pregnancy weight from weight before delivery. Dietary intake was assessed using a validated food frequency questionnaire (FFQ) and a 24-hour recall. Confounder-adjusted regression models were established to show associations between dietary patterns and GWG and associations between dietary patterns and nutrient adequacy. A negative association was found between the Mediterranean pattern and the GWG (adjusted β= -0.008, 95% CI: -0.076, 0.039) and a direct correlation between the western pattern and the GWG (adjusted β = 0.086, 95% CI: -0.075, -0.082) was found. The Mediterranean dietary pattern showed moderate evidence of meeting an adequate intake of dietary fiber and vitamins B12, D, and E (p < 0.05). This pattern is associated with adequate GWG during pregnancy and better nutrient adequacy. Given the relevance of food in this physiological stage, promoting healthy eating based on a Mediterranean dietary pattern through health education is considered essential.

Perinatal depression is a common disorder that can manifest during pregnancy and the postpartum period, severely affecting both the mother and the baby. Dietary factors have been associated with an increased risk of perinatal depression. We analyzed the association between adherence to certain dietary patterns before and during pregnancy and postpartum and perinatal depression. A scoping review of the available literature was conducted reporting the main findings following the PRISMA 2020 statement. The search strategy was last reproduced in December 2024 in MEDLINE, Web of Science and Scopus databases. The methodological quality of the studies was evaluated using the Newcastle-Ottawa Scale and the Revised Cochrane risk-of-bias tool for randomized trials. The protocol has been published on OSF (https://doi.org/10.17605/OSF.IO/AV8TP). 11 studies (6 cohort studies, 4 cross-sectional studies, and 1 randomized clinical trial) conducted in various countries were included in the mapping review. These studies evaluated the dietary intake of the participants at different times during the perinatal period and identified several dietary patterns. 9/11 studies showed a significant inverse association between adherence to the Mediterranean Diet or healthy patterns, characterized by high intake of vegetables, fruits, fish and seafood and perinatal depression. In contrast, 4/11 studies showed that adherence to Western dietary patterns and the consumption of ultra-processed foods was associated with higher risk of perinatal depression. Adherence to healthy dietary patterns may be negatively associated with perinatal depression. Conversely, Western diet and the intake of ultra-processed and pro-inflammatory foods are directly associated with a higher risk of perinatal depression.

Background/Objectives: Physical activity and sedentary behaviour represent related yet distinct movement behaviours with potentially different behavioural, psychosocial, and lifestyle correlates. However, multinational evidence examining these behaviours within the Mediterranean lifestyle framework remains limited. This study investigated correlates of physical activity and sedentary behaviour among adults from Mediterranean and neighbouring countries participating in the MEDIET4ALL survey. Methods: Data were collected from 4010 adults (37.2 ± 15.4 years; 59.5% female) across 10 Mediterranean and neighbouring countries using a standardized multilingual e-survey. Physical activity was assessed using the short International Physical Activity Questionnaire (IPAQ-SF; MET-min/week), and sedentary behaviour was assessed by daily sitting time. Hierarchical multiple linear regression analyses were conducted separately for physical activity and sedentary behaviour. Exploratory bootstrapped mediation analyses examined whether life satisfaction (SLSQ) or social participation (SSPQ) mediated associations between MEDLIFE dietary dimensions and sitting time. Results: Higher physical activity was associated with more rural living environments, lower body mass index, more favourable smoking status, higher alcohol consumption, stronger adherence to Mediterranean dietary habits, longer sleep latency, higher stress, and greater social participation (β ≈ 0.05–0.11), whereas female sex, longer sleep duration, and higher anxiety were associated with lower physical activity (β = −0.04 to −0.23); the positive association with alcohol consumption should be interpreted cautiously in light of potential residual confounding. By contrast, sedentary behaviour was positively associated with higher education, higher body mass index, and more favourable smoking-status (β ≈ 0.04–0.09) and inversely associated with better self-reported health status, Mediterranean dietary consumption patterns, life satisfaction, and social participation (β = −0.04 to −0.07). Mediation analyses showed significant but small-magnitude indirect effects for the pathways linking MEDLIFE dietary consumption patterns and MEDLIFE dietary habits with sitting time through social participation (indirect β = −0.0032 and −0.0045, respectively), which should be interpreted with caution, whereas no significant indirect effects were observed through life satisfaction. Conclusions: Physical activity and sedentary behaviour are associated with different, though partially overlapping, lifestyle and psychosocial correlates within the MEDIET4ALL framework. Social participation may represent a modest behavioural pathway linking Mediterranean dietary dimensions with lower sitting time. Given the cross-sectional design, these findings should be interpreted as associative rather than causal, but they nonetheless reinforce the importance of integrated and context-sensitive lifestyle promotion strategies.

Diet represents a promising yet complex component of prostate cancer prevention and care, with the potential to influence cancer control and cardiometabolic outcomes. Previous studies suggest that plant-based and Mediterranean dietary patterns may be associated with the lower risk of prostate cancer progression among patients with nonmetastatic disease or those on active surveillance. Dietary interventions are also thought to mitigate metabolic toxicity from androgen deprivation therapy, including effects on lipid profiles, blood pressure, body composition, and glucose metabolism, although findings remain heterogeneous. Despite these suggestive findings, definitive conclusions about the role of diet in prostate cancer development and progression remain elusive. Much of the existing evidence comes from observational studies or trials with small sample sizes, reliance on intermediate endpoints, imprecise diet assessment, adherence challenges, and limited funding. Consequently, positioning diet as a standalone therapy risks overstating its benefits. We propose a more pragmatic framework in which dietary interventions are evaluated as complementary to standard prostate cancer treatments, with an emphasis on clinically meaningful endpoints, rigorous study designs, and adequately powered trials. Future research should prioritize adequately powered studies that assess the role of diet in improving disease outcomes, metabolic health, and quality of life, thereby better defining its place within evidence-based prostate cancer management. See related article by Hua et al., Cancer Epidemiol Biomarkers Prev 2026;35:438-46.

Biochemical pathways linking adiposity, diet, and endometrial carcinogenesis.

This study aimed to investigate MASLD prevalence from the general adult population, using validated noninvasive tools (NITs). We hypothesized that higher adherence to the Mediterranean diet, is inversely associated with the presence of MASLD. The study included Hellenic National Nutrition and Health Survey (HNNHS) participants with available biomarkers (N = 1022, 38.1% males). MASLD presence was indirectly assessed through the Liver Fat Score (LFS) while metabolic dysfunction-associated steatohepatitis (elevated metabolic markers consistent with steatohepatitis risk) was differentiated using the index of nonalcoholic steatohepatitis (NASH-ION). Multiple logistic regression models were performed to evaluate associations between MASLD and various factors. Estimated MASLD prevalence was 17.3% (n = 155). Among these individuals, 56.3% indicated the presence of elevated metabolic markers, consistent with steatohepatitis risk. Each one-point increase in MedDietScore was associated with 6% lower odds of MASLD without steatohepatitis (OR: 0.94, 95% CI: 0.90-0.99). Overweight and obesity significantly increased the odds of MASLD in all age groups: 19-39.9 years (OR: 4.79, 95% CI: 3.07-7.28), 40-59.9 years (OR: 3.54, 95% CI: 2.05-6.13), and 60+ years (OR: 5.41, 95% CI: 2.64-11.07) although Mediterranean diet adherence appeared to attenuate MASLD risk. High physical activity also decreased likelihood in this age group only (OR: 0.33, 95% CI: 0.15-0.74). The lower prevalence of MASLD with higher Mediterranean diet adherence, especially in younger persons without steatohepatitis highlights the necessity of advocating Mediterranean dietary patterns within public health initiatives to mitigate the prevalence of MASLD in Greece. However, the high presence of metabolic markers likely reflects the high sensitivity of the screening tool used, underscoring a significant underlying metabolic burden (e.g., insulin resistance and obesity) rather than histologically confirmed severe liver disease.

Mediterranean diet (MedDiet) is central to metabolic dysfunction-associated steatotic liver disease (MASLD) management; however, evidence in non-Mediterranean populations is limited. This study examined the association between MedDiet adherence and MASLD, hospitalisation and mortality in a non-Mediterranean population. This longitudinal study included 119536 UK Biobank adults with at least one 24-hour dietary recall and available sociodemographic and clinical data. Diet quality was assessed using the Modified-Mediterranean Diet Score (M-MedDietScore). MASLD was determined by fatty liver index (FLI) at baseline and by liver imaging in a subgroup. Hospitalisation and mortality data were obtained from linked records, with MASLD outcomes identified using International Classification of Diseases, 10th Revision codes. Binary logistic regression and Cox proportional hazard models estimated Odds Ratio (OR) for MASLD and hazard ratio (HR) for hospitalisation and mortality. Each five-unit increase in M-MedDietScore was associated with 19 % lower OR of MASLD as identified by FLI and confirmed in the imaging sub-analysis in a multivariate adjusted Model 2. Higher adherence to the MedDiet was associated with lower HR of hospitalisation due to liver-related, CVD, diabetes, respiratory and renal disease (all P < 0·05). During a median follow-up of 9·7 years, 5552 deaths occurred. Higher MedDiet adherence was associated with lower HR of all-cause, CVD and extrahepatic cancer mortality and lower all-cause mortality risk in those with MASLD (HR: 0·94, 95 % CI: 0·90, 0·98). Higher adherence to the MedDiet was associated with lower odds of MASLD and with reduced MASLD-related hospitalisations and mortality and lower all-cause mortality in those with MASLD. These findings support the role of MedDiet in reducing hepatic and cardiovascular burden in non-Mediterranean population.

Dietary guidelines represent foundational instruments of public health governance, influencing clinical practice, food assistance programs, school meal standards, and food system policies. The release of the Dietary Guidelines for Americans (DGA) 2025-2030 provides an opportunity to reassess how evolving nutrition science is translated into policy in a context characterized by high burdens of obesity and cardiometabolic disease. This review presents a comparative qualitative policy analysis of the 2025-2030 DGA and the Italian Dietary Guidelines for Healthy Eating (2018), aiming to identify structural differences and explore potential policy implications. The analysis examines governance mandates, macronutrient targets, protein sourcing, treatment of ultra-processed foods, alcohol guidance, sustainability integration, and cultural framing. Although both countries draw upon a largely shared body of scientific evidence and converge on core dietary principles, notable divergences emerge in policy emphasis and communication strategies. The DGA 2025-2030 adopt a more prescriptive approach focused on chronic disease prevention, with greater emphasis on protein intake, and explicit reference to ultra-processed foods, while sustainability remains outside the policy scope. In contrast, Italian guidelines are framed within a Mediterranean dietary pattern, emphasize plant-based protein sources and integrate environmental sustainability, food waste reduction, and cultural dimension. These differences may reflect national epidemiological and institutional contexts and variations in policy priorities. This policy review identifies policy trade-offs in guideline development and proposes actionable recommendations to enhance coherence between public health priorities, environmental sustainability, and implementation feasibility in future revisions.

Background/objectivesCardiometabolic diseases are a major global health concern, and their development are linked to suboptimal dietary patterns and adverse gastrointestinal (GI) health outcomes and symptoms. Mediterranean dietary patterns are associated with reduced cardiometabolic disease risk and improved quality of life (QoL). The potential impact of the Mediterranean diet on GI symptoms is an important area of inquiry that requires elucidation. This study aimed to evaluate whether a New Zealand-adapted Mediterranean diet (NZMedDiet) affects GI symptom severity in adults at increased cardiometabolic risk, explore the influence of participant characteristics on symptoms, and assess the association between GI symptoms and health-related QoL.MethodsThis secondary analysis used data from a randomized controlled trial of a 12-week NZMedDiet and behavioral intervention in adults with increased cardiometabolic risk. Associations were assessed between the gastrointestinal symptom rating scale (GSRS), the 36-Item Short-Form Survey (SF-36)(assessing QoL), and the NZMedDiet, alongside participant characteristics.ResultsA total of 200 participants were enrolled (mean age 49.9 ± 10.9 years; 62% women), with women reporting significantly higher baseline GI symptom severity scores on average across all GSRS domains except reflux (p < 0.05). Māori participants reported higher baseline indigestion and abdominal pain scores compared with New Zealand Europeans (p < 0.01). Compared with controls, participants in the NZMedDiet group had lower GSRS domain scores, with the largest between-group estimated mean difference observed for abdominal pain being −0.27 (95% CI: −0.48 to −0.06; p = 0.01). Moderate associations were observed between GSRS domains and quality-of-life measures, particularly between abdominal pain and the general health domain (rs = −0.25; p < 0.001).ConclusionThe NZMedDiet had a positive impact on GI symptom severity scores and was well tolerated in participants with increased cardiometabolic risk. Improvements in GSRS domains were correlated with moderate improvements in QoL measurements.Clinical trial registrationhttps://www.anzctr.org.au/Default.aspx, identifier ACTRN12622000906752 and https://www.isrctn.com/, identifier ISRCTN89011056.

Hyperuricemia-defined as serum urate above 6.8 mg/dL-is increasingly recognized as a risk marker and amplifier of chronic kidney disease (CKD) progression and cardiovascular disease (CVD), rather than merely a precursor to gout. In CKD, impaired renal urate clearance is exacerbated by environmental toxins, including airborne pollutants and heavy metals (lead, cadmium, arsenic), which disrupt tubular function and downregulate urate transporters (ABCG2, OAT1/3, URAT1). Dietary factors such as high-purine foods, fructose-rich beverages, and alcohol promote urate overproduction and reduce excretion, whereas DASH and Mediterranean dietary patterns are associated with lower serum urate and reduced cardiovascular risk. This narrative review synthesizes current evidence from PubMed, Scopus, and Google Scholar on hyperuricemia in CKD, with a focus on environmental and dietary triggers and their cardiovascular implications. Priority was given to high-level evidence, including systematic reviews, meta-analyses, randomized controlled trials, and large cohort studies, alongside mechanistic and preclinical data. Mechanistically, uric acid promotes systemic inflammation, endothelial dysfunction, and oxidative stress via xanthine oxidase, contributing to microvascular and macrovascular injury. Genetic polymorphisms in urate transporters modulate susceptibility but represent non-modifiable risk factors. Observational studies consistently link elevated serum urate with adverse CKD and CVD outcomes; however, randomized trials of xanthine oxidase inhibitors have yielded conflicting results regarding clinical benefit. An integrated approach is required to manage hyperuricemia in CKD. Lifestyle strategies, including reducing dietary fructose, limiting alcohol, and adopting plant-forward diets, may lower serum urate, while mitigating environmental exposures may help preserve renal function. Pharmacotherapy should be individualized based on comorbidities and risk profiles. Despite supportive mechanistic and observational evidence, randomized trials remain inconclusive, highlighting the need for further research to clarify the cardiovascular impact of urate-lowering therapies and their role in CKD populations. A comprehensive, multidisciplinary approach may help reduce risk factors associated with CKD progression and cardiovascular disease.

Diet is a major modifiable determinant of gastrointestinal (GI) health, influencing disease risk and progression through coordinated effects on the gut microbiome, immune regulation, epithelial barrier integrity, oxidative balance, and epigenetic mechanisms. This narrative review synthesizes epidemiological, mechanistic, and clinical evidence from the past decade to examine bidirectional relationships between dietary patterns and seven common GI disorders: celiac disease, irritable bowel syndrome (IBS), Crohn's disease, ulcerative colitis, Helicobacter pylori-associated gastritis, peptic ulcer disease, and lactose intolerance. Western dietary patterns, characterized by high intake of ultra-processed foods and saturated fats and low fiber consumption, are consistently associated with microbial dysbiosis, impaired barrier function, and enhanced inflammatory signaling. In contrast, Mediterranean and plant-forward dietary patterns show protective associations across multiple GI conditions. Mechanistically, diet influences GI pathophysiology largely through microbiome-derived metabolites, particularly short-chain fatty acids, which regulate epithelial homeostasis, immune tolerance, and inflammatory pathways. Condition-specific dietary strategies remain clinically important. Gluten exclusion is essential in celiac disease, low- fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) approaches provide evidence-based symptom control in IBS, and exclusive enteral nutrition or targeted exclusion diets support remission induction in Crohn's disease. Selected probiotics and emerging postbiotics may provide adjunctive benefits in specific contexts. Despite growing evidence, dietary research remains limited by methodological heterogeneity and interindividual variability. Precision nutrition approaches integrating microbiome profiling and artificial intelligence represent a promising translational direction. Overall, dietary patterns-rather than isolated nutrients-form the foundation of GI dietary therapy.

Objective: This study aimed to evaluate the association between adherence to the Mediterranean dietary pattern and periodontal health, with particular emphasis on inflammatory modulation and clinical periodontal outcomes. Methodology: A comprehensive narrative synthesis of the scientific literature was conducted, focusing on observational studies, clinical investigations, and experimental research that examined dietary patterns and periodontal parameters. Electronic databases were systematically searched using keywords related to Mediterranean diet, periodontitis, systemic inflammation, and oral health. Studies addressing nutritional components, inflammatory biomarkers, and periodontal clinical indices were included. Data were qualitatively analyzed to identify consistent biological mechanisms and clinical trends linking dietary habits to periodontal health. Results: The Mediterranean diet demonstrated a consistent association with improved periodontal status. Higher adherence to this dietary pattern was correlated with reduced gingival inflammation, lower probing depth, and decreased bleeding on probing. These clinical benefits were accompanied by reduced levels of systemic inflammatory markers, such as C-reactive protein and pro-inflammatory cytokines. The anti-inflammatory and antioxidant properties of key dietary components, particularly fruits, vegetables, olive oil, whole grains, and omega-3-rich fish, appear to play a central role in modulating host immune responses and oxidative stress, thereby influencing periodontal tissue stability. Conclusion: The findings suggest that the Mediterranean diet exerts a protective effect on periodontal health by attenuating systemic and local inflammatory pathways. Incorporating dietary counseling into periodontal prevention and management strategies may represent a valuable adjunctive approach. Future longitudinal and interventional studies are warranted to further clarify causality and establish standardized dietary recommendations in periodontal care.

Obesity has emerged as a major global health issue, affecting multiple organ systems. Within the central nervous system obesity causes a series of disruptions that can significantly affect neurological function. Identifying obesity as a modifiable risk factor presents opportunities for preventive and therapeutic strategies that may significantly diminish neurological sequelae. This narrative review aims to summarize current evidence on how obesity contributes to different neurological diseases and focusing on biological mechanisms linking obesity to these conditions, outlines the characteristic clinical presentations of obesity-related neurological diseases across different age groups and potential therapeutic strategies. This narrative review integrates findings from comprehensive search of PubMed, EMBASE, and Cochrane Library to investigate how obesity and metabolic syndrome relate to a broad spectrum of neurological disorders. After screening 1,950 records, 48 studies were included supplemented by nine manually identified articles. Obesity triggers a range of biological changes in the nervous system such as increased oxidative stress, persistent low‑grade inflammation, disruption of the blood–brain barrier, and impaired mitochondrial function. Together, these changes raise the risk of several neurological problems, including cognitive decline, Alzheimer’s disease, stroke, faster progression of multiple sclerosis, greater epilepsy‑related complications, transformation of episodic into chronic migraine, idiopathic intracranial hypertension, and various peripheral neuropathies. The impact of body mass index on neurological health differs across diseases and age groups with obesity in midlife representing a high risk. Lifestyle‑based strategies especially Mediterranean or ketogenic dietary patterns, regular physical activity and weight reduction show encouraging potential in reducing these neurological risks. Obesity is a modifiable contributor to many neurological disorders. Identifying at‑risk individuals early and adopting healthier daily habits, following tailored diets and managing weight effectively may help lessen the neurological consequences of obesity. Continued research is essential to clarify underlying mechanisms and refine treatment strategies for different patient groups.

BackgroundSjogren’s syndrome (SS) is a multifaceted clinical condition characterized by various features, including ocular dryness (OD), dry mouth, arthralgia, and fatigue, which plays a substantial role in shaping the clinical presentation of the disease and has detrimental effects on quality of life. Recent research has acknowledged the advantages of the Mediterranean diet (MD) for its positive impact on various autoimmune diseases. This study aims to investigate the effect of Mediterranean diet on Sjogren disease using two validated scores: the Ocular Surface Disease Index (OSDI) score and the Eular Sjogren’s Syndrome Patient Reported Index (ESSPRI).MethodsThis was a cross-sectional observational study of previously diagnosed patients of Sjogren Syndrome using the ACR EULAR 2016 criteria. Patients were recruited from the archives of a tertiary university hospital. Data were collected through a telephone questionnaire, including demographic and disease data, the Ocular Surface Disease Index (OSDI) score to evaluate the OD severity, the Mediterranean Diet Adherence Screener (MEDAS) score to determine adherence to the MD and the Eular Sjogren’s Syndrome Patient Reported Index (ESSPRI). The primary outcome of the study, the association between OSDI/ESSPRI and MEDAS scores, was evaluated using Spearman’s correlation coefficient.ResultsThe study comprised 75 patients with a mean age of 50.1 ± 13.3 years. There were 88% women among the patients. The median scores were 5.0 for the ESSPRI (IQR 3.0–6.7), 25.0 for the OSDI (IQR 10.4–40.6), and 8.0 for the MEDAS (IQR 4.5–11.0). The Spearman correlation analysis revealed a significant negative correlation between MEDAS and OSDI (ρ = −0.78, p < 0.001). None of the covariates were statistically significant in the ESSPRI model, whereas treatment exhibited 2 a positive correlation with OSDI (β = +6.44, 95% CI 0.84 to 12.03; p = 0.025), likely indicating confounding by indication.ConclusionThe study results suggest that higher adherence to a Mediterranean dietary pattern was consistently associated with lower symptom burden. This approach may serve as a complementary strategy with multiple health benefits, alongside conventional treatment options.

Obesity and prediabetes are overlapping global epidemics. This systematic review synthesises evidence on gene-diet interactions in adults with obesity, prediabetes, or related cardiometabolic risks. It evaluates Mediterranean and DASH dietary patterns, macronutrient quality, and energy restriction across both single-variant and polygenic score approaches. PubMed was searched for English language papers published in the last 5 years (last run: 31 October 2025). Fewer than 200 studies were retained after excluding those lacking explicit statistical testing for gene-diet interactions or relevant endpoints. Evidence supports restricting saturated fat and preserving carbohydrate quality as general baseline targets, with associations heterogeneous by genotype. Effect modification was observed: healthy dietary patterns were associated with lower risk in high polygenic-risk strata (OR~0.53) but little or no benefit in low-risk groups. TCF7L2 variants were associated with macronutrient thresholds (e.g., protein > 18%, carbohydrate < 48%) affecting visceral adiposity, while APOA2 variants showed genotype-dependent inflammation, including paradoxical increases in markers with higher dietary antioxidant capacity. Interpretation was limited by underpowered interaction tests, multiplicity, and uneven ancestry representation (e.g., unique SLC16A11 and CREBRF signals). While anti-inflammatory dietary substitutions improve biomarkers irrespective of some variants (e.g., TCF7L2), genotype-informed nutrition appears to yield the largest absolute risk reduction in high-risk populations. Clinical implementation should therefore combine baseline diet-quality guidance with targeted strategies for genotype-specific response patterns (e.g., APOA2 antioxidant heterogeneity and TCF7L2 carbohydrate thresholds), rather than rely on uniform recommendations alone. Future progress requires preregistered, genotype-stratified trials and locally trained polygenic scores to address ancestry-specific genetic architecture.

The associations between dietary patterns and major eye diseases remain incompletely understood. This study conducted a cross-sectional analysis of 4241 participants from the 2005-2008 National Health and Nutrition Examination Survey. Eye diseases were assessed using fundus photography and self-reported information, while dietary patterns were evaluated based on two 24-h dietary recalls. Survey-weighted logistic regression and restricted cubic spline models were applied with adjustment for complex sampling design and relevant covariates, alongside subgroup and dietary component-specific analyses. In fully adjusted models, higher HEI-2020 scores were associated with lower odds of retinopathy and composite eye disease outcomes with or without cataract surgery. Similarly, greater adherence to the DASH was inversely associated with retinopathy and composite eye disease outcomes. Mediterranean diet adherence was also associated with reduced odds of retinopathy, and a non-linear association was observed between Mediterranean diet adherence and cataract risk. Subgroup analyses indicated effect modification by age, body mass index, alcohol consumption, and hyperlipidemia status. Whole grains, total vegetables, and nuts emerged as protective dietary components, whereas refined grains were identified as a potential risk factor. In conclusion, higher adherence to HEI-2020, DASH, and Mediterranean dietary patterns was associated with a lower prevalence of selected major eye diseases. These findings reflect associations rather than causation, and prospective studies and randomized trials are needed to clarify temporal and causal relationships.

Polycystic ovary syndrome is a common endocrine and metabolic disorder affecting women of reproductive age and is strongly associated with insulin resistance and increased lifetime risk of type 2 diabetes mellitus. Growing evidence indicates that lifestyle interventions represent the cornerstone of dual management targeting both reproductive and metabolic dysfunction. This systematic study synthesizes contemporary evidence on dietary modification, structured physical activity, behavioral therapy, and sleep optimization in women with polycystic ovary syndrome at risk of diabetes. Evidence from international guidelines, systematic reviews, meta-analyses, and interventional studies demonstrates that low glycemic index diets, Mediterranean dietary patterns, caloric restriction, and combined aerobic-resistance exercise significantly improve insulin sensitivity, glycemic control, body composition, and cardiometabolic markers. Behavioral reinforcement and long-term adherence strategies further enhance metabolic outcomes. Early risk screening and implementation of structured lifestyle programs are essential to prevent progression from insulin resistance to impaired glucose tolerance and overt diabetes. Integrated, multidisciplinary management offers the most sustainable benefit for dual control of polycystic ovary syndrome and diabetes risk.