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The Mediterranean Diet (MedDiet) is considered an Intangible Cultural Heritage by UNESCO; it is also the world's most evidence-based eating pattern for promoting health and longevity. This study aims to investigate consumer segmentation based on consumption patterns and identify barriers to adherence to MedDiet. Data were collected in 2020 by telephonic survey based on PREDIMED, using a quota sampling technique by socio-demographic variables, such as gender, age, and regional representation of the Portuguese population. The final sample was composed of a total of 1000 respondents. The main results show that regardless of the awareness of the MedDiet (62%), Portugal witnessed a loss of the traditional MedDiet, with the exception of the stand-out statistic that 95% of respondents still use of olive oil as the main culinary fat. Five segments were identified: (1) MedDiet lifestyle followers (11%), (2) olive oil lovers (20%), (3) low-sugar diet foods seekers (11%), (4) healthy and balanced diet seekers (28%), and (5) low-fat diet foods seekers (30%). The main barriers to adhering to the MedDiet include lack of knowledge about the MedDiet, education level, financial comfort, and specific food preference, which by segment are: (1) being passionate about soda drinks, (2) an excess of sweets, (3) low level of pasta consumption, and a (5) lack of fruit, vegetables, and legumes. Segment (4) holds a leading position in MedDiet adherence. The main obstacle to consuming fish is its high price, taste, and challenges in cooking it. When it comes to bread and oleaginous nuts, the belief that these foods are "fattening" reduces consumption. Results help to tailor education strategy and increase adherence to the Mediterranean lifestyle. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the needs and preferences of sports volunteers regarding nutritional education, with particular emphasis on the availability of educational materials and expectations towards event organizers. The methodology was grounded in a qualitative approach, employing detailed individual interviews (IDIs) with seventeen volunteers (n = 17) who were actively involved in various sporting events, including races, triathlons, and athletic competitions at local, national, and international levels. This sample size was justified as it was sufficient to achieve data saturation, meaning no new significant themes emerged after these interviews. The results indicate that most participants feel a lack of access to reliable information about nutrition, with 70% (n = 12) indicating a need for educational materials, which limits their ability to make informed dietary decisions. Volunteers expect event organizers to provide educational materials and prefer a variety of practical forms of education, such as interactive workshops and accessible online resources. While the volunteers expressed a desire for improved nutritional education, further investigation is needed to establish a direct link between this education and potential enhancements in their performance and well-being. For this reason, greater attention should be paid to the nutritional education of volunteers, which is a key element of their preparation to work in high-stress and physically intense conditions. [ABSTRACT FROM AUTHOR]

Nutrition plays a key role in maintaining health and physical condition, particularly for active individuals, including athletes. It can therefore be assumed that individuals performing physically demanding tasks during the organization of sporting events, such as volunteers, should also pay attention to their nutrition. While the importance of diet for athletes has been widely studied, the impact of nutrition on sports volunteers remains under-researched. Volunteers often have to cope with varying degrees of physical and mental exertion, which may affect their nutritional needs. A qualitative study was conducted using in-depth individual interviews (IDIs) with 17 sports volunteers who had experience in organizing various sporting events. Participants were purposefully selected based on specific inclusion criteria, which included active involvement in sports volunteering (with a minimum of two years of experience in volunteer activities) as well as volunteering experience at sports events of various scales. The interviews aimed to understand the eating habits, dietary awareness, and impact of nutrition on health and physical fitness. The data were transcribed and subjected to thematic analysis, focusing on coding responses and identifying recurring themes. Most participants did not place much importance on their diet, making random food choices due to a busy lifestyle and lack of time. Only a few volunteers consciously adjusted their diet when they had knowledge of the physically demanding tasks they were expected to perform during their volunteer work. The majority of volunteers relied on less reliable sources of nutritional information, such as blogs or social media, rather than credible sources of knowledge. This study revealed that many individuals involved in sports volunteering are unaware of the impact of diet on their fitness and health. There is a need for nutritional education for this group to improve their awareness of the importance of a balanced diet in the context of increased physical activity. It is also advisable to provide better nutritional conditions during sporting events and to promote the use of professional sources of information about healthy eating. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is a prevalent chronic autoimmune disease with a high impact on global health, affecting millions of adults and resulting in significant morbidity and mortality. Achieving optimal blood glucose levels is crucial for diabetes management to prevent acute and long-term complications. Carbohydrate counting (CC) is widely used by patients with type 1 diabetes to adjust prandial insulin bolus doses based on estimated carbohydrate content, contributing to better glycemic control and improved quality of life. However, accurately estimating the carbohydrate content of meals remains challenging for patients, leading to errors in bolus insulin dosing. This review explores the current limitations and challenges in CC accuracy and emphasizes the importance of personalized educational programs to enhance patients' abilities in carbohydrate estimation. Existing tools for assessing patient learning outcomes in CC are discussed, highlighting the need for individualized approaches tailored to each patient's needs. A comprehensive review of the relevant literature was conducted to identify educational programs and assessment tools dedicated to training diabetes patients on carbohydrate counting. The research aims to provide insights into the benefits and limitations of existing tools and identifies future research directions to advance personalized CC training approaches. By adopting a personalized approach to CC education and assessment, healthcare professionals can empower patients to achieve better glycemic control and improve diabetes management. Moreover, this review identifies potential avenues for future research, paving the way for advancements in personalized CC training and assessment approaches and further enhancing diabetes management strategies. [ABSTRACT FROM AUTHOR]

Extra-uterine growth restriction (EUGR) is a common complication and a known risk factor for impaired development in very-low-birth-weight (VLBW) neonates. We report a population of 288 patients with no or with low-grade MRI lesions scanned at a term equivalent age (TEA) born between 2012 and 2018. Griffiths Mental Development Scale II (GMDS II) at 2 and 3 years, preterm complications and weight growth were retrospectively analyzed. EUGR was defined for weight z-score ˂ 10 percentile at TEA, 6 and 12 months of correct age or as z-score decreased by 1-point standard deviation (SDS) from birth to TEA and from TEA to 6 months. Multivariate analysis showed that a higher weight z-score at 6 months is protective for the global developmental quotient (DQ) at 2 years (OR 0.74; CI 95% 0.59–0.93; p = 0.01). EUGR at 6 months was associated with worse locomotor, personal/social, language and performance DQ at 2 years and worse language and practical reasoning DQ at 3 years. In conclusion, a worse weight z-score at 6 months of age seems to be an independent risk factor for significantly reduced GMDS in many areas. These results suggest that we should invest more into post-discharge nutrition, optimizing family nutritional education. [ABSTRACT FROM AUTHOR]

Nutrition education is a long-term process that should cover various population groups. A special focus should be placed on children, adolescents and their parents. The aim of this research was to find out the opinions of parents of primary school pupils aged 7–12 on their expectations towards school education in the areas of food and nutrition, addressed to both pupils and their parents. The research was conducted among 101 parents of primary school pupils with the use of the Focus Group Interview (FGI) method. It demonstrated that what is most needed are hands-on activities relating to basic theoretical issues. While parents see the need for nutrition education for their children, educating pupils in this area is of interest to only some of the respondents for whom nutrition aspects are quite important. All parents would like formal nutrition education at school, but at the same time, they do not want classes to take up too much of their children's time, due to the already excessive number of school subjects. It seems appropriate to include everyone in regard to nutrition education, regardless of their declared interest in this issue. The need for consistent presentation of educational content addressed to teachers and parents is very important, so that they can, in a uniform way, shape the attitudes towards food and nutrition of children and adolescents. [ABSTRACT FROM AUTHOR]

The early introduction of effective nutritional educational programs is pivotal for instilling sustainable healthy behaviors. The present work aims to present a best practice example of a nutrition and overall lifestyle school-based training program, the Nutritional Adventures ("Diatrofoperipeteies"). Conducted during 2020–2022 in Greek primary schools, this synchronous, online educational initiative included two 1-school-hour activities with a nutrition instructor. Additionally, schools were randomly assigned to supplementary "at-home" supported-by-parents or "in-class" supported-by-educators educational activities. In total, n = 12,451 students of 84 primary schools participated. Parent-completed questionnaires were selected in the recruitment and post-intervention phase (40% participation rate); overall, the working sample was n = 1487 students. In the post-intervention phase, a significant increase in Mediterranean diet adherence was observed (KIDMED score: mean increment = 0.25 units; p < 0.001), particularly fruit and vegetable consumption. Time spent on physical activity increased, while screen time decreased. Students' total quality of life significantly improved (PedsQL; mean increment = 1.35 units; p < 0.001), including on all of its subscales (physical, emotional, social, and school function). Supplementary educational activities that were supported by educators rather than parents yielded a more favorable impact on students' lifestyle and quality of life. The Nutritional Adventures program can be regarded as a successful initiative in primary schools, yielding immediate advantages that extend beyond promoting healthy dietary habits. [ABSTRACT FROM AUTHOR]

The inadequate lifestyle associated with university life may have a negative impact on various cardiometabolic factors. The aim of this study was to evaluate the effect of a one-year nutrition education course on cardiometabolic parameters in undergraduate health science students. During the 2021–22 academic year, 1.30 h nutrition sessions were conducted twice a week. Capillary blood samples were collected and centrifuged to measure cardiometabolic and inflammatory biomarkers in serum. The sample studied consisted of 49 students: 20.4% male and 79.6% female. The nutritional intervention resulted in changes in dietary patterns, with increased consumption of vegetables, nuts and legumes. After the course, females showed an increase in HDL-cholesterol levels (p = 0.007) and no change in LDL-cholesterol levels (p = 0.189). On the other hand, males showed significant changes in HDL-cholesterol (p = 0.001) and LDL-cholesterol (p = 0.043) levels. The atherogenic index was also significantly reduced (p < 0.001) in both males (p = 0.009) and females (p = 0.002). Differences were also observed in the increase in vitamin D levels in both males and females, although the magnitude of the increase was greater in the men (Δ = 7.94, p = 0.016 in men vs. Δ = 4.96, p = 0.001 in women). The monocyte-to-HDL ratio (MHR) showed a significant reduction, although these differences were only significant in males. Students with low vitamin D levels had higher LDL-cholesterol values (p = 0.01) and atherogenic index (p = 0.029). Adjusted linear regression analysis showed a significant association between post-course vitamin D MHR (β = −0.42, IC: −0.29, −0.06, p < 0.01). These findings suggest the importance of including nutrition education programs during the university stage for the prevention of long-term health problems. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare the effects of nutritional supplement drinks (NSDs) and nutritional education (NE) on the nutritional status and physical performance of older nursing home residents who were at risk of malnutrition. This study was a clustered, randomized, parallel, multi-center clinical trial, with 107 participants more than 65 years old and at risk of malnutrition recruited from several nursing homes in this study. Participants were divided into two groups: an NE group (n = 50) and an NSD group (n = 57). The NE group was given NE by a dietitian, while the NSD group was provided with two packs of NSD except receiving NE (Mei Balance, Meiji Holdings, Tokyo, Japan) per day as a snack between meals and before bed. Anthropometric data, blood pressure, nutritional status, blood biochemical biomarkers, and physical performance were measured before and after 12-week interventions. After 12 weeks of NE combined with NSD intervention, body weight, body-mass index, the mini nutritional assessment-short form (MNA-SF) score, walking speed, and SF-36 questionnaire score were improved in older nursing home residents at risk of malnutrition. [ABSTRACT FROM AUTHOR]

The treatment for celiac disease (CD) involves a strict gluten-free diet, which can be challenging and lead to questions for patients. Pinpointing these uncertainties can enable the creation of efficient educational resources. In this study, a questionnaire was specifically designed to gain insights into the knowledge, concerns, and needs of individuals with CD and their supporters. The questionnaire was distributed through the Instagram social network and received adequate responses from 300 participants, 258 (86%) being female and 152 (50.7%) falling in the age range of 25–44 years. The concerns of individuals with celiac disease and celiac supporters were rated on a 1–4 scale, with a mean score of 3.5 indicating significant concern. A total of 255 (85%) of all participants expressed that their principal concern was the social limitations they faced, such as difficulties in eating out and sharing food with others. Every participant evaluated their overall disease knowledge, averaging at 2.92 out of 4, indicating a reasonable level of awareness. When asked if they believed that improving general knowledge about CD in the general population would enhance their quality of life, the vast majority responded affirmatively. This finding underscores the importance of not only educating individuals with CD but also reaching out to the wider population, especially those who have a direct impact on the daily lives of individuals with CD, such as family members, friends, and food service providers. [ABSTRACT FROM AUTHOR]

Background: The years spent at university represent a critical period that can influence both the quality of lifestyle and the eating habits of subsequent adulthood, and also, in the long term, the health of the individual. The aim of this study was to investigate the lifestyle of university students living away from home. Methods: Each subject recruited for the study was given a questionnaire to obtain general information, eating habits and physical activity levels before (T0) and after six month of training seminars (T1). Blood pressure, body composition and questionnaire responses were investigated. Results: The main findings of this study are a significant decrement in blood pressure; an increment in physical activity practice; an increased number of subjects who pay attention to the calorific value of food and also an improvement in BIA parameters. Conclusions: In conclusion, this study demonstrated the challenges that university students face in leading a healthy lifestyle and caring for their nutritional needs, particularly when they are away from their families. No intervention specifically targets young adults, even though much emphasis is placed on the promotion of a healthy lifestyle based on a varied and balanced diet and sufficient exercise. Our study showed that it is possible to improve lifestyle through educational events aimed at making students aware of the health risks deriving from unhealthy lifestyles. [ABSTRACT FROM AUTHOR]

For patients with celiac disease (CeD), a lifelong gluten-free diet is not a voluntary lifestyle choice—it is a necessity. The key end points in clinical follow-up are symptom resolution, the normalization of weight, prevention of overweight, seroconversion, and negation or minimization of increased long-term morbidity. For the latter, a surrogate endpoint is mucosal healing, which means the normalization of histology to Marsh 0–1. Ideally, celiac follow-up care includes a multidisciplinary approach, effective referral processes, improved access that leverages technological advances, and following guidelines with the identification of measurable quality indicators, ideally informed by evidence-based research. Face-to-face CeD care and telemedicine are considered the standards for this process, although published data are insufficient. Guidelines and statements on diagnosis are readily available. However, data are lacking on optimal clinic visit intervals and outcomes and quality indicators such as improvement of symptoms, function and quality of life, survival and disease control, and how to most effectively use healthcare resources. The results of future research should provide the basis for general recommendations for evidence-based standards of quality of care in CeD. [ABSTRACT FROM AUTHOR]

As in adults, childhood obesity is associated with several metabolic disorders; however, there is little information regarding complex obesity-derived complications such as hepatic steatosis or endothelial dysfunction at early ages. Therefore, the objective of the present study was to analyze the effect of a nutritional and physical exercise program on obesity comorbidities in the form of subclinical atherosclerosis and non-alcoholic fatty liver in young children. A total of 148 children completed the study. For nine months (one academic year), children carried out a nutritional and physical activity program of 3 h/week. Anthropometric, clinical, liver ultrasound and carotid intima-media thickness (cIMT) parameters were evaluated. Our results showed that the program significantly improved anthropometrical parameters, especially regarding BMI and body fat (p < 0.001 and p = 0.004, respectively). The effect on metabolic parameters was limited, although a significant reduction on triglycerides was observed (p = 0.009). The education program had a great influence on the echogenic parameters, since the percentage of children with light steatosis decreased from 35% to 4% at the end of the study. In addition, cIMT also decreased significantly in both groups, although there was no statistically significant differences between groups. In conclusion, detection of early complications of obesity through sonographic parameters may allow early intervention, as in the present study, to prevent obesity co-morbidities in children. [ABSTRACT FROM AUTHOR]

Background: Hemodialysis patients are at high risk of muscle loss as a result of aging and disease, and combined with inadequate dietary intake. The Healthy Eating Index for HemoDialysis patients (HEI-HD) was developed to assess the dietary quality of hemodialysis patients. The purposes of this study were to examine the effects of different nutritional education models using HEI-HD-based education on dietary quality and muscle mass in hemodialysis patients. Methods: A quasi-experimental study was conducted from May 2019 to April 2021, with four groups, including no course for patients and nurses (Non-C), course for nurses (CN), course for patients (CP), and course for patients and nurses (CPN). The courses were delivered by registered dietitians. The data of 94 patients were collected and analyzed at baseline, after 2 months of intervention, and 2 months follow-up, including demographics, body composition, 3-day dietary records, and hemodialysis dietary knowledge. The HEI-HD index score was calculated. Results: Patients aged 58.3 ± 10.1 years. The dietary quality change in the CPN group was improved as compared with the Non-C group (−3.4 ± 9.5 vs. 3.0 ± 5.5, 0.04). The skeletal muscle mass of the Non-C group at intervention was also significantly lower than baseline, but the CPN group was not. Conclusions: The HEI-HD-based nutritional education for both patients and nurses showed a positive effect on improving the dietary quality and maintaining muscle mass in hemodialysis patients. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) is the most common complication in hemodialysis patients. Nutritional education provided by dietitians could improve overall dietary quality and dietary fat quality to reduce the risk of CVD. However, no studies have investigated the relationship between dietary fat quality (using the hypocholesterolemic/hypercholesterolemic ratio, or the h/H) and CVD risk factors in hemodialysis patients. The aim of this study was to examine the association between the h/H and CVD risk factors, and further explore how nutritional education intervention models could improve dietary fat quality and CVD risk factors in hemodialysis patients. A quasi-experimental design was conducted from May 2019 to April 2021 on four groups, including 'no course for patients and nurses' as the non-C group, a "course for nurses" as the CN group, a "course for patients" as the CP group, and a "course for patients and nurses" as the CPN group. Nutritional education booklets based on a healthy eating index for hemodialysis patients were developed and provided to patients and nurses. Data of 119 patients were collected at baseline, intervention, and follow-up periods, including patients' basic information, blood biochemical data, dietary content, and calculated h/H. The results showed that the h/H was negatively correlated with body mass index (BMI) and positively correlated with high-density lipoprotein cholesterol (HDL-C). Compared with the non-C group, the CPN group was significantly higher in the h/H as well as HDL-C, and significantly lower in serum total cholesterol. In conclusion, the h/H was found to predict CVD risk factors, which helps in improving dyslipidemia. Nutritional education for both patients and nurses showed a beneficial impact on reducing CVD risks in hemodialysis patients. [ABSTRACT FROM AUTHOR]

In adolescence, the body requires sufficient amounts of adequate nutrients. This is especially important in the case of young athletes, for whom a nutrition plan should be as significant as a proper training plan. The aim of the study was a 17-week follow-up of the effects of individual and group nutrition intervention on changes in eating habits and selected biochemical parameters. 46 young soccer players aged 12–17 from the Soccer Academy in Northeastern Poland completed the study. One group received only individual recommendations, while the other additionally received group nutrition education. As a result of the dietary education, teenagers from the latter group consumed less saccharose (44 g vs. 39.2 g) in favor of digestible carbohydrates (266 g vs. 273 g) and dietary fiber (19.7 g vs. 22.2 g), further emphasizing the health-promoting profile of diets. The amount of fluid consumed (33% vs. 48% above 2 L of water a day) and the habits of the peri-workout hydration routine were also improved. Many of the participants (41%) reported faster regeneration while 26% experienced an overall better well-being. The short-term intervention produced positive results, but nevertheless it is the implementation of long-term dietary improvement schemes involving parents and coaches that should be the direction of future approaches. [ABSTRACT FROM AUTHOR]

GDM is a multifactorial disease, so there is controversy regarding the mechanisms involved in its pathogenesis. We speculate whether lifestyle and eating habits influenced the appearance and pathogenesis of GDM. To explore this issue, the aim of the present study was to analyze maternal diet and lifestyle characteristics in early pregnancy and their influence on the development of GDM. The study included 103 pregnant women who completed a questionnaire on nutritional knowledge, lifestyle and eating habits. Perinatal and biochemical outcomes as well as pregestational lifestyle and eating habits were compared between normoglycemic women and those who developed GDM. The results obtained showed that women who developed GDM had erroneous knowledge regarding nutrition. Consumption of white bread (p = 0.018), added sugars (p = 0.037), legumes (p = 0.025), fish (p = 0.014), butter (p = 0.010) and the performance of less physical activity (p = 0.024) correlated with glucose intolerance in pregnant women. In conclusion, we found a relationship between dietary and lifestyle habits at the beginning of pregnancy and the later diagnosis of GDM. [ABSTRACT FROM AUTHOR]

Consumer education, including nutrition education, understood as a process based on scientific principles, is becoming a very effective element in influencing the health of the population in the modern world. This work is based on direct research carried out in 2016–2018 in the form of a questionnaire interview among patients—consumers of educational services in spa treatment facilities. The research sample was N = 1000 (600 people were tested with the use of PAPI (Paper and Pencil Interview), and 400 people with the use of CAWI (Computer-Assisted Web Interview)) and concerned a representative group of spa patients in Poland. In addition, as a supplement, a direct survey was conducted in the form of a Computer-Assisted Telephone Interview with managers of spa treatment facilities (N = 50). Consumers of spa treatment services differ from each other, and types can be distinguished based on their professional activity status and the type of entity that pays for their stay in the spa, and, using cluster analysis, the status of professional activity in relation to their education level. The nutritional education system is based on highly specialized medical personnel. At the same time, it does not use the available assessment tools based on proven monitoring and evaluation indicators. Health education, which also includes nutritional education, apart from disease prevention, is the basic tool for health promotion in spa treatment conditions, enabling the introduction of a permanent change in the patients' lifestyles, the additional advantages of which are low costs and relatively high efficiency. In the course of the study, several useful patient profiles were also distinguished, thanks to which it is possible to select dedicated educational methods for selected groups of recipients. [ABSTRACT FROM AUTHOR]

Nutrition education is a long-term process that should cover various population groups. A special focus should be placed on children, adolescents and their parents. The aim of this research was to find out the opinions of parents of primary school pupils aged 7-12 on their expectations towards school education in the areas of food and nutrition, addressed to both pupils and their parents. The research was conducted among 101 parents of primary school pupils with the use of the Focus Group Interview (FGI) method. It demonstrated that what is most needed are hands-on activities relating to basic theoretical issues. While parents see the need for nutrition education for their children, educating pupils in this area is of interest to only some of the respondents for whom nutrition aspects are quite important. All parents would like formal nutrition education at school, but at the same time, they do not want classes to take up too much of their children's time, due to the already excessive number of school subjects. It seems appropriate to include everyone in regard to nutrition education, regardless of their declared interest in this issue. The need for consistent presentation of educational content addressed to teachers and parents is very important, so that they can, in a uniform way, shape the attitudes towards food and nutrition of children and adolescents.

Basketball is a team sport, with many fans and practitioners worldwide from all ages and levels. In all cases, players accumulate high levels of fatigue, and there is also limited time to recover between games or practices. In particular, nutrition plays a key role in optimizing performance and recovery. However, it is typical to observe erroneous nutritional behaviors among basketball players. It has been theorized that these behaviors are influenced by habits acquired based on the individual's knowledge. Therefore, the main aim of this study was to conduct a descriptive research of the sports nutrition knowledge and practices in a sample of Spanish basketball players, from athletes under 18 years old (n = 69) to nonprofessional (n = 14) and professional adult players (n = 21). The sample was comprised of 49 men and 55 women. This was a transversal, cross-sectional, observational and descriptive study. All participants (n = 104) completed an anonymous online survey in order to analyze their sports nutrition knowledge and practices. In view of the obtained results, we can conclude that the knowledge of sport-specific nutrition in players under 18 years old, as well as non-professional and professional adult basketball players, is insufficient through all the categories and levels. The lack of professional support and time management difficulties were identified as some of the main barriers. [ABSTRACT FROM AUTHOR]

Basketball is a team sport, with many fans and practitioners worldwide from all ages and levels. In all cases, players accumulate high levels of fatigue, and there is also limited time to recover between games or practices. In particular, nutrition plays a key role in optimizing performance and recovery. However, it is typical to observe erroneous nutritional behaviors among basketball players. It has been theorized that these behaviors are influenced by habits acquired based on the individual's knowledge. Therefore, the main aim of this study was to conduct a descriptive research of the sports nutrition knowledge and practices in a sample of Spanish basketball players, from athletes under 18 years old ( n = 69) to nonprofessional ( n = 14) and professional adult players ( n = 21). The sample was comprised of 49 men and 55 women. This was a transversal, cross-sectional, observational and descriptive study. All participants ( n = 104) completed an anonymous online survey in order to analyze their sports nutrition knowledge and practices. In view of the obtained results, we can conclude that the knowledge of sport-specific nutrition in players under 18 years old, as well as non-professional and professional adult basketball players, is insufficient through all the categories and levels. The lack of professional support and time management difficulties were identified as some of the main barriers.

The growing popularity of health education on social media indicates the need for its appropriate evaluation. This paper aims to present the potential of the Kirkpatrick Model (KM) with New World Kirkpatrick Model (NWKM) additions to evaluate the nutritional education provided by dieticians via Instagram. Instagram profiles of ten dieticians providing nutritional education for their followers were analyzed in March and April 2021. The study sample included profiles of both macro- and micro-influencers. The analyzed quantitative data included Instagram Engagement Rate and the number of likes and comments per post. The qualitative analysis of the comments was performed following the theoretical framework provided by the KM and NWKM. Collected data showed followers' satisfaction, commitment, and relevance of the presented content, fulfilling the Level 1 of NWKM. Level 2 of NWKM was represented by 4 out of 5 dimensions (knowledge, attitude, confidence, commitment). No comments were found only for skills. Both Levels 3 (Behavior) and 4 (Results) of the KM were met. However, the use of the NWKM for them seems limited. The KM can be used to evaluate nutritional education on social media. The NWKM additions seem applicable mostly for Levels 1 and 2. [ABSTRACT FROM AUTHOR]

Adolescent high-performance gymnasts are considered to be at risk for low energy intake. The aim of the present study was to determine the effects of implementing a nutritional education program during the sports season on the nutritional status and nutrition knowledge of the female artistic gymnasts from the Technification Center of the Balearic Islands (n = 24; age, 14.1 ± 2.3 years). A quasi-experimental intervention design was applied, which consisted of implementing a nutritional education program of seven sessions given during eight months. Measurements of nutritional intake, nutrition knowledge, and anthropometric parameters, as well as hematological and biochemical blood parameters, were performed. Gymnasts reported low energy and carbohydrate intakes, with significant increases during the study (energy, 28.3 ± 1.4 vs. 32.8 ± 1.4 kcal kg−1, p = 0.015, carbohydrate 3.2 ± 0.2 vs. 3.9 ± 0.2 g kg−1, p = 0.004). The average values for parameters such as hemoglobin, ferritin, lipoprotein, and vitamin C and E levels in the plasma were within normal ranges. Low intakes of most of the food groups were observed during the study, with similar initial and final values. Nutrition knowledge did not change as a result of the study (28.0 ± 1.7 vs. 31.1 ± 1.3, p = 0.185). In conclusion, gymnasts reported low energy intakes. However, blood markers and most of the anthropometrical parameters measured were within normal ranges. The nutrition education program implemented did not produce significant improvements in the dietary habits or nutritional knowledge of gymnasts. [ABSTRACT FROM AUTHOR]

Currently, there are several methodological models that have broken into different disciplines of knowledge with the aim of making the teaching/learning process more dynamic, active and participatory for students. This is the case of Flipped Classroom, which is based on a mixed approach between e-learning and face-to-face teaching, as well as gamification, which bases its didactic principles on the recreational components of the games. Within this context, the aim of this research is to observe what effect the application of Flipped Classroom and gamification has in the development of motivation, autonomy and self-regulation towards learning through a didactic unit on healthy habits and diet in 202 students of 6th grade of Primary School from four different schools (public and state-subsidized) in the city of Granada (Spain). For this purpose, a methodological design was used with pre-test and post-test to check the effects of the experience on the students. The findings obtained showed that the application of these methods promoted an increase in students' motivation, as well as in their autonomy and self-regulation when facing the contents of the subject. For this reason, it is advocated that there is a need to continue promoting a quality and innovative educational practice according to the figure of the student today. [ABSTRACT FROM AUTHOR]

Following a gluten-free diet (GFD) is the only treatment for celiac disease. This diet must ensure the absence of gluten but also needs to be nutritionally balanced. Dietitians working in this field cannot properly evaluate energy and nutrient intake of celiac people because dietary programs available on the market do not contain the nutritional composition of gluten-free products (GFP). Here we present a new GFD evaluation software that contains more than 700 gluten-free rendered foodstuffs and their macronutrient composition. Apart from diet evaluation and design, the software represents a tool for nutritional education as well, since it shows diet appropriacy and indicates how to promote balanced self-care. Moreover, anthropometric and biochemical data or symptoms presence and diet adherence can be recorded and evaluated. This open free software, can be downloaded in its app format for mobiles and tablets. Software evaluation indicated its correct functionality and the importance of assessing a GFD with GFP instead of with their gluten-containing analogues. Thus, this software represents an essential e-Health tool, not only for proper GFD evaluation, but also for improving life quality of celiac and gluten sensitive people. [ABSTRACT FROM AUTHOR]

This study aimed to create an easy tool to identify healthier choices for meal assembly in food services (self-service restaurants) and to allow consumers to compose their plates to make healthier choices. It is an interventional study, and the first step was setting healthy food parameters to design a rating scale. The first evaluation criterion was based on energy density (ED) and sodium content (SC) using "traffic light" color in the dishes' nameplates; the second criterion was based on food groups; the third criterion was based on ingredients of the meals. After using the classification, we assessed the rating scale in a food service and we evaluated the strategy with its consumers. To evaluate the effect of the nutritional intervention, we developed a multiple-choice-questionnaire with eight questions to measure the impact on consumer food choices quantitatively. The dish nameplate allows identification of healthier choices regarding SC and/or ED by colors; ingredients that compose the dish; the food group and the serving size, helping the identification of the amount of food to compose the meal. Banners helped consumers to understand the information. After four weeks, all the consumers (n = 1000) received questionnaires regarding their comprehension of the classification. The questionnaire presented an ICC of 0.71. Most of the preparations (61%) were inadequate based on ED and/or SC at the studied food service. A total of 556 consumers returned questionnaires, and 86.3% of them observed the rating scale as a nutritional strategy. Almost 55% (n = 261) of consumers reported changes in food choice after reading the dishes nameplates. The items with greater impact on consumer change in eating behavior were the use of colors as an indicator of nutritional quality, portion size information and ingredients list. Almost 25% of the consumers that changed their eating behavior noticed more than three items presented on the nameplate. [ABSTRACT FROM AUTHOR]