Mediterranean Journal of Nutrition and Metabolism

Plant-based nutraceuticals and therapeutics have emerged as promising natural interventions to enhance athletic performance, support recovery, and promote long-term health benefits. Compounds from herbs, vegetables, fruits, seeds, legumes, and other plant parts are rich in antioxidants such as polyphenols, flavonoids, and carotenoids, as well as essential micronutrients that collectively modulate oxidative stress, inflammation, immune response, and metabolic functions during physical exertion and injury.

This review evaluates findings from clinical research involving athletes, along with traditional knowledge from indigenous communities that utilise plant-based remedies to manage sports injuries, muscle fatigue, and recovery.

A literature search was performed using PubMed, Scopus, Web of Science, and Google Scholar for studies published between 1999 and 2025, with a focus on the last 10 years, using keywords related to plant-based nutraceuticals, Sports, Athletic performance, Sports injury, Sports supplements and Adaptogens. Only English language human studies publications involving athletes or physically active individuals were included.

Various human studies have widely documented their roles in reducing exercise-induced / sports-induced muscle damage, accelerating tissue repair and improving endurance capacity. Plant-derived compounds such as Curcumin, Quercetin, Catechins, Resveratrol and Allicin exhibit the capacity to improve muscle strength, reduce fatigue and enhance recovery. Additionally, various adaptogens help in the regulation of stress hormones and improve physical resilience under high training loads. Traditional and indigenous knowledge supports these findings, particularly for managing sports injuries and recovery.

Plant-based nutraceuticals offer effective, safe, and multifunctional support for athletic performance and recovery. Their integration into sports nutrition holds strong potential to improve performance and injury management after standardized clinical investigations.

Mediterranean diet (MD) is linked to improved health outcomes in children and adolescents. While prior research suggests that individual components of the MD, such as omega-3 fatty acids, may improve cognitive function and behavior in individuals with special educational needs (SEN), it is not known the association between adhering to MD and the symptomatology of SEN.

To systematically identify and evaluate the association between adherence to the MD and the diagnosis, symptomatology, and/or well-being of children and adolescents diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive-Compulsive Tics Disorder (OCTD), conditions classified as SEN.

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search was carried out on MEDLINE, Scopus, and Web of Science, from February to June 2024. Studies were included according to the following criteria: studies written in English or Portuguese; participants ≤19 years old; evaluation of MD using specific scores; and SEN diagnosis and/or symptomatology/well-being. This systematic review was also registered at PROSPERO as CRD42024527230.

Six studies were included, investigating two specific conditions within the SEN umbrella: ADHD (five studies) and OCTD (one study). Studies found that higher adherence to the MD was associated with reduced symptoms of OCTD and ADHD. Also, a lower likelihood of ADHD diagnosis or having ADHD was associated with children and adolescents adhering more to MD.

This systematic review suggests that higher adherence to the MD is linked to lower prevalence and symptom severity of ADHD and OCTD in children and adolescents with SEN. However, future research is needed to confirm these results.

Recent advancements in cancer therapy still lack complementary treatments that substantially enhance the effectiveness of existing anti-cancer agents. A promising emerging strategy is the fine-tuning of nutrients, with a combinatory approach likely achieving superior results.

Here, the study aimed to evaluate the efficacy of a novel nutritional regimen that combines the ketogenic diet (KD) and high-dose vitamin C (VitC) as an adjuvant cancer therapy.

Syngrafts were established using triple-negative breast cancer EMT-6 cells in BALB/c mice. Five experimental groups were created: one received doxorubicin (DOX) alone, while the others received DOX with KD, high-dose VitC, or both. Treatments were administered over 14 days.

Both KD and high-dose VitC individually enhanced the response to DOX, as reflected by favorable changes in cancer-associated markers, while their combination did not provide additional benefit. Specifically, KD positively influenced tumor proliferative signaling, angiogenesis, hypoxic response, anti-tumor immunity, and glucose metabolism, evidenced by reductions in insulin-like growth factor-1, vascular endothelial growth factor, hypoxia-inducible factor-1α, and programmed death-ligand 1, as well as decreased activity of pyruvate kinase and glyceraldehyde-3-phosphate dehydrogenase. High-dose VitC primarily targeted tumor replicative potential by reducing telomerase reverse transcriptase levels and may have inhibited metastasis by increasing tumor collagen content. However, neither the individual use of KD and high-dose VitC nor their combination enhanced DOX efficacy in reducing tumor volume or weight.

The combined nutritional approach, comprising KD and high-dose VitC, did not show significant advantages over the individual use of each in enhancing the tumor-inhibitory effects of DOX or modulating the tested cancer-associated markers. These findings highlight the need for further research to optimize dosing, treatment schedules, and mechanistic understanding of the combined therapy.

The prevalence of low quality of life (QoL) remains high among older adults. Understanding the relationship between protein consumption, handgrip strength, fall risk, and QoL is crucial. This study aimed to analyze the association between these variables among older residents of a nursing home.

A cross-sectional design was used for this study with a sample size of 56 subjects. Protein intake data were collected using the Visual Comstock method. Handgrip strength (HGS) was measured using a CAMRY handgrip dynamometer, and fall risk was assessed using the Timed Up and Go Test (TUGT). QoL was evaluated using the EQ-5D-5L, which comprises five domains. The associations between variables were analyzed using Spearman's correlation with a significance level of p < 0.05.

56 elderly subjects, with an average age of 70.82 ± 8 years, were involved in this study at a nursing home in Surabaya, Indonesia. The majority of subjects had insufficient protein intake (80.4%), low muscle strength (92.9%), and a high risk of falling (66.1%). 44.6% of the elderly were found to have a low QoL. Protein intake, HGS, and fall risk were significantly associated with overall QoL with coefficient correlation 0.346, 0.385, and −0.821, respectively. Both Fall risk and HGS showed significant associations with mobility, self-care, and daily activity, Meanwhile, the significant association were found between protein intake and mobility (p = 0.044) and daily activities (p = 0.029).

The findings show significant associations between fall risk, protein intake, and HGS with the QoL of the elderly, particularly in specific domains. These results highlight that improving variables is important for enhancing the overall QoL of older adults.

Timely identification of lactose intolerance is crucial to prevent secondary complications. This study aimed to assess the diagnostic accuracy of three commonly used methods for detecting lactose malabsorption (LM): the lactose hydrogen breath test (LHBT), the lactose tolerance test (LTT), and the genetic test (GT).

Patients diagnosed with irritable bowel syndrome underwent fasting and post-lactose (20 g) evaluations, including measurements of breath hydrogen, blood glucose, and genotyping for the C/T-13910 polymorphism associated with lactase persistence in European populations. A sustained increase of breath hydrogen ≥20 ppm above baseline, a failure of plasma glucose to rise >20 mg/dL from fasting levels, and the presence of the C/T-13910 variant were defined as positive for LHBT, LTT, and GT, respectively.

One hundred and eight patients (age 39 ± 14 years, 17 males) were enrolled. Eighty-eight had symptoms after lactose ingestion. Of these, 88 (100%) were LHBT and 69 (78%) were LTT positive. Of a subgroup of 33 patients undergoing GT, 27 presented symptoms and 25 tested positive. Sensitivity and specificity were 100% and 85% for LHBT, 78% and 48% for LTT, and 93% and 83% for GT. Conclusions: With observation times greater than 4 h, LHBT had higher sensitivity and specificity than LTT and GT.

Psychotropic medications are known to induce significant metabolic side effects, including weight gain and visceral fat accumulation, which are major risk factors for cardiovascular and metabolic diseases. This study aimed to assess the effectiveness of a personalized dietary intervention, supported by targeted physical activity and nutraceutical supplementation, in mitigating weight-related adverse effects, among hospitalized psychiatric patients treated with antipsychotic and/or antidepressant drugs.

A cohort of 50 patients was initially enrolled; 44 patients with a BMI > 25 proceeded with the full intervention protocol, which included a Mediterranean-style dietary plan, structured exercise under kinesiologist supervision, and supplementation with branched-chain amino acids (HYDROXIRAM^®) and phytosomal or micellar curcumin. Anthropometric and bioelectrical impedance measurements were used to monitor Body Mass Index (BMI), Fat Mass Index (FMI), and Fat-Free Mass Index (FFMI) over six follow-up visits.

Despite a high dropout rate, significant reductions in BMI and FMI were observed among patients who completed the program, with minimal loss of lean body mass. Results suggest that a multidisciplinary, individualized intervention can effectively reduce fat accumulation while preserving muscle mass in this patient population.

The findings support the implementation of integrated nutritional strategies to enhance both physical, and psychiatric outcomes, in individuals with mental health disorders undergoing pharmacological treatment.