The exposome encompasses all endogenous and exogenous exposure individuals encounter throughout their lives, including biological, chemical, physical, psychological, relational, and socioeconomic factors. It examines the duration and intensity of these types of exposure and their complex interactions over time. This interdisciplinary approach involves various scientific disciplines, particularly toxicology, to understand the long-term effects of toxic exposure on health. Factors like air pollution, racial background, and socioeconomic status significantly contribute to diseases such as metabolic, cardiovascular, neurodegenerative diseases, infertility, and cancer. Advanced analytical methods measure contaminants in biofluids, food, air, water, and soil, but often overlook the cumulative risk of multiple chemicals. An exposome analysis necessitates sophisticated tools and methodologies to understand health interactions and integrate findings into precision medicine for better disease diagnosis and treatment. Chronic exposure to environmental and biological stimuli can lead to persistent low-grade inflammation, which is a key factor in chronic non-communicable diseases (NCDs), such as obesity, cardiometabolic disorders, cancer, respiratory diseases, autoimmune conditions, and depression. These NCDs are influenced by smoking, unhealthy diets, physical inactivity, and alcohol abuse, all shaped by genetic, environmental, and social factors. Dietary patterns, especially ultra-processed foods, can exacerbate inflammation and alter gut microbiota. This study investigates the exposome’s role in the prevention, development, and progression of NCDs, focusing on endogenous and exogenous factors.

Little is known about the changes in body composition (BC) in people with overweight or obesity. The aim of this study was to assess the differences in BC patterns in this population based on gender and age. A total of 2844 Italian adults of mixed gender and a body mass index (BMI) of ≥25 kg/m² underwent a BC assessment by means of dual-energy X-ray absorptiometry (DXA). The sample was categorized into three age groups: ‘young’ (20–39 years), ‘middle’ (40–59 years), and ‘older’ (60–80 years) adults, after being matched by body weight and BMI. Males showed higher total body fat percentage (BF%) and a lower total lean mass (LM), progressively from the young to the middle to the older age groups, while females showed similar values for these total compartments between the three age groups. However, in both genders, participants in the middle and older groups were more likely to have a higher trunk fat percentage by +1.23% to +4.21%, and lower appendicular lean mass (ALM) by −0.81 kg to −2.63 kg with respect to the young group, indicating expression of major central adiposity and sarcopenia. While our findings underscore the limitations of BMI to detect these differences between age groups, the identification of new tools suitable for this aim is greatly needed in this population. Moreover, further investigation that clarifies the impact of these differences in BC patterns between gender and age groups on health outcomes is also required.

Adherence to the Mediterranean diet (MedDiet) has long been associated with several health benefits, including a reduced risk of heart disease, diabetes, and obesity. The MedDiet is characterized by a high consumption of foods such as fruits, vegetables, whole grains, fish, and olive oil, along with a moderate intake of red meat and red wine with meals. Some studies report significant differences between men and women in susceptibility to obesity, with women at a higher prevalence of obesity than men. One unexplored aspect, however, concerns the sex difference in MedDiet adherence, which could be influenced by various factors, such as health perceptions, food preferences, and cultural influences. The aim of this study is to assess the effectiveness and impact of MedDiet adherence in men and women, with a focus on its influence on health and well-being, as well as its ability to promote sex equity in healthcare outcomes. Moreover, we aim to measure the overall health improvements in men and women participating in a MedDiet program, including changes in body composition and overall quality of life. This study highlights that the MedDiet is associated with more significant body weight loss in women, although their increase in MedDiet adherence was lower than in men. Trial registration: NCT01890070. Registered 24 June 2013.

The human exposome, including dietary exposures such as pesticides, additives, and environmental contaminants, plays a critical role in shaping the gut microbiota (GM) and long-term health outcomes. While the Mediterranean Diet is known for its health-promoting effects, the role of food quality, specifically organic vs. conventional products, in modulating GM within this dietary pattern remains underexplored. The aim of this study was to evaluate (1) whether an Italian Mediterranean Organic Diet (IMOD) confers additional benefits compared to an Italian Mediterranean non-Organic Diet (IMnOD), and (2) the impact of IMOD and IMnOD versus a free diet (No Diet) on GM and anthropometric parameters. A randomized, controlled trial was conducted on 39 healthy subjects. Eligible subjects were divided into the following groups: (1) 4 weeks No Diet, (2) 4 weeks IMOD, and (3) 4 weeks IMnOD. Microbiota profiling (16S rRNA sequencing), body composition (BIA), and dietary adherence (MEDAS, FFQ) were evaluated. Distinct microbial shifts following both IMOD and IMnOD compared to No Diet were revealed. Several taxa previously associated with short-chain fatty acid (SCFA) biosynthesis (i.e., Anaerobutyricum hallii, Anaerostipes hadrus, and Dorea longicatena) were increased after both Mediterranean Diet interventions, while Parabacteroides distasonis showed a specific increase in the IMOD group. No significant changes in body weight or composition were observed. These findings suggest that adherence to a Mediterranean Diet, regardless of food source, reshapes the gut microbiota, while organic food intake may influence specific microbial trajectories. Our results support the relevance of food quality in dietary interventions.

Background: Evidence on non-restrictive MIND pattern interventions in Alzheimer’s (ALZ) disease remains limited. Methods: In an observational case–control study, 60 participants (ALZ, n = 30; cognitively healthy controls, n = 30) completed baseline (T0) and follow-up (T1) after structured MIND counseling. Adherence was assessed via the MEDAS questionnaire. Stool samples (16S rRNA profiling) were taken and anthropometry and cognitive/functional measures were recorded at T0/T1. Results: In the ALZ group, MEDAS improved as adherence to the Mediterranean diet increased (increasing the use of vegetables ≥ 2/day, p < 0.01; and lowering butter adoption ≤ 1/day, p = 0.02), with a shift from low to moderate/high adherence; in controls, baseline Mediterranean diet adherence was already high, and changes in MEDAS categories were modest (low adherence from 13.8% to 3.6%, high adherence from 37.9% to 50.0%), with no statistically significant overall change (p = 0.39). Regarding gut microbiota (GM), in the ALZ group, alpha diversity increased significantly and Bray–Curtis PCoA separated T0 from T1. Species-level analysis showed increases in SCFA-linked taxa (e.g., Anaerobutyricum hallii, Blautia luti, Eubacterium coprostanoligenes) and reductions in dysbiosis/mucin-degrading taxa (e.g., Mediterraneibacter torques, M. gnavus, Agathobacter rectalis). Between-group Δ(T1 − T0) comparisons at the genus level indicated larger positive shifts in ALZ for Anaerobutyricum, Oscillibacter, Faecalicatena, Romboutsia, Mediterraneibacter, and Blautia, and more negative Δ for Gemmiger, Subdoligranulum, Bifidobacterium, Clostridium, and Collinsella. sPLS-DA showed partial separation (first two components ≈ 9% variance). Conclusions: A structured, non-restrictive MIND intervention was feasible, improved dietary adherence, and accompanied higher diversity and compositional remodeling of the GM in ALZ’s disease. Larger randomized mechanistic studies are warranted.