The importance of digital tools for dietary assessment has increased in recent years, both commercially and scientifically. In the field of nutrition research, the digitization of dietary assessment methods presents many opportunities and risks. One of the main challenges is ensuring scientific quality while maintaining good usability. In this context, an evaluation tool was developed based on the guidelines of the European Food Safety Authorization (EFSA; 2009 and 2014), complemented by the usability aspect of health-related applications. This was followed by a literature search concerning the available dietary assessment tools, which were analyzed according to the evaluation criteria. Eight applications were included in the study after reviewing the inclusion and exclusion criteria for the digital tools. A total of thirty-eight requirements in eight main categories were defined for the evaluation, which the best possible dietary assessment tool should meet. The evaluation showed that none of the tested tools currently meet all the defined requirements or categories. The aspects of usability and the accuracy of data collection showed a positive correlation, suggesting a direct link between the two categories and providing an important approach for future developments.

Eating disorders are primarily associated with women and an obsession with thinness. Recent research and social media content show that men are also concerned about their body image, striving for a muscular and athletic physique. To investigate eating disorder tendencies among male content creators with a mesomorphic body type (N = 26), a social media analysis was conducted on Instagram and TikTok over four weeks. Published content and profiles were screened using ICD-11 diagnostic criteria for anorexia nervosa, which were then adapted to take account of gender differences. A total of 2,985 posts were recorded, of which 69% were classified as relevant to diet, exercise and body content. Six content creators (23%) met the ICD-11 diagnostic criteria for anorexia nervosa, while gender-specific adaptations identified 15 individuals (58%) with tendencies toward an eating disorder. The profile analysis shows that gender-specific adaptation of the diagnostic criteria with regard to the pursuit of muscularity can facilitate the additional recognition of eating disorder-related behaviours in males. Male children and adolescents should be educated at an early stage to avoid critical behaviour patterns and the internalisation of utopian beauty ideals.

Background: After being developed in the 1920s, the ketogenic diet fell into disuse, only to make a comeback at the end of the 20th century. In addition to its original use in the treatment of epilepsy, research on the ketogenic diet is now focusing on many other indications. Methods: Based on a systematic literature analysis according to the PRISMA guidelines, an overview of the current research on specific topics in the last five years (2019 to August 2024) was compiled. Results: A total of 290 trials were included. In total, 32 topics were analyzed, most of which were related to overweight and obesity, as well as exercise and epilepsy. The articles included 1981 authors from 47 countries, who published their results from intervention and observational studies in 153 journals. In total, 227 studies lasted less than six months, while 61 studies lasted more than six months. Conclusions: The results and the increasing amount of research underline the growing scientific attention and potential of the ketogenic diet to offer new therapeutic and individual preventive approaches. These trends indicate that the ketogenic diet remains an important international research topic.

The ketogenic diet is used worldwide to treat various diseases, especially drug-resistant epilepsies. Medium-chain triglycerides or medium-chain fatty acids, primarily the major ketogenic compound caprylic acid (C8; C8:0), can significantly support ketogenesis. This review examines the effects of concurrent carbohydrate intake on C8-induced ketogenesis. A systematic literature search (PubMed and Web of Science) with subsequent data extraction was performed according to PRISMA guidelines and the Cochrane Handbook. Studies investigating the metabolic response to C8-containing MCT interventions with carbohydrate intake were included. The studies did not include a ketogenic diet. Three intervention groups were created. The quality of the studies was assessed using the RoB II tool, and the meta-analysis was performed using the Cochrane RevMan software. A total of 7 trials, including 4 RCTs, met the inclusion criteria. Ketone production was lower when C8 was combined with carbohydrates compared to MCT intake alone. The lower C8 dose group (11 g) did not show a significantly lower ketogenic effect than the higher dose group (19 g). Forest plot analysis showed heterogeneous data. The data suggest a non-linear relationship between C8, carbohydrate intake and ketone production. Further studies are needed to investigate the influence of different carbohydrates on C8-induced ketogenesis. Limitations include heterogeneous intervention conditions, such as different types of dispersions, caffeine intake, limited number of studies and variability in study design.

Although medium-chain triglycerides (MCT) stimulate and carbohydrates inhibit ketone body synthesis, their quantitative interaction in humans is not well defined. This randomised, controlled, double-blind crossover study investigated how increasing glucose doses affects C8-MCT-induced ketone body synthesis after overnight fasting. Eleven healthy young woman (22.5 ± 1.9 years) received a constant dose of tricaprylin (99% C8; 0.2 g/kg bodyweight) combined with increasing glucose doses (0.2–0.6 g/kg bodyweight). In additional interventions, both C8-MCT and glucose were increased in parallel. Plasma β-hydroxybutyrate (βHB), glucose, and insulin were measured for up to 300 min post-dose. Indirect calorimetry in a subset and side effects were monitored. C8-MCT significantly increased βHB concentrations at low and medium glucose doses compared with control, but not at highest glucose dose. When both substrates were increased equally (1:1 ratio), ketone body synthesis increased. βHB was negative correlated with increasing glucose dosing at constant C8-MCT dosing, while parallel increases in both substrates showed a positive moderate correlation between βHB and C8-MCT doses. No dose-dependent side effects occurred. Overall, ketone body synthesis declines with rising glucose intake. It remains unclear whether a C8-MCT: glucose ratio of 1:3 represents a metabolic cut-off or whether glucose intake becomes excessive due to linear effects. Trial registration This study was prospectively registered in the German Clinical Trials Register (DRKS ID DRKS00035373 https//www.bfarm.de/EN/BfArM/Tasks/GermanClinicalTrialsRegister/_node.html ).

Introduction: Medium-chain triglycerides (MCTs) are widely used in clinical and nutritional contexts due to their rapid metabolism and therapeutic potential. However, concerns regarding their tolerability persist, particularly with respect to gastrointestinal side effects. This systematic review examines the occurrence and characteristics of side effects following oral MCT consumption. Methods: In accordance with the PRISMA guidelines and the Cochrane Handbook, a systematic literature search was conducted in PubMed and Web of Science. Studies reporting side effects following oral, gastric or enteral MCT administration were included. Data on study design, population characteristics, MCT formulation, dosage, and reported side effects were extracted and synthesized. Side effects were analyzed quantitatively or qualitatively in studies using non-standard reporting formats. Risk of bias was assessed using the RoB 2 tool for randomized studies and the ROBINS-I tool for non-randomized studies. Results: Thirty three studies comprising 1,100 participants were included. Gastrointestinal symptoms were the most frequently reported side effects, particularly diarrhea, abdominal pain, discomfort, and nausea. While these symptoms were often described as mild, moderate to severe reactions and dropouts due to side effects were not uncommon, especially at higher doses. Substantial heterogeneity in study design, dosing strategies, and reporting practices limited comparability. Temporal aspects of side effects and long-term tolerability were insufficiently investigated, and evidence regarding the influence of MCT composition and co-administration strategies on tolerability remained inconclusive. A high proportion of studies reported industry involvement, and risk-of-bias assessment indicated that 26.3% (RoB 2)-−78.6% (ROBINS-I) of the included studies were at high/serious risk of bias. Conclusions: Gastrointestinal side effects represent a consistent and clinically relevant limitation of MCT use. Standardized methodologies and targeted research are needed to better understand and mitigate these effects, thereby improving the safety and applicability of MCT-based interventions.