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.

Background: Young adulthood represents a critical period for the emergence of early metabolic disturbances, potentially influenced by dietary shifts toward convenience and ultra-processed foods. However, evidence linking dietary patterns and cooking practices with objective metabolic biomarkers in Romanian university students remains limited. Methods: This cross-sectional study included 693 students aged 18–24 years at the Victor Babeș University of Medicine and Pharmacy, Romania (June–July 2025). Dietary habits, food preferences, and cooking practices were assessed using a structured online questionnaire, while anthropometric and biochemical data were obtained from university health records. The primary outcome was glycated hemoglobin (HbA1c), a marker of average blood glucose levels over the previous 2–3 months. Prediabetes was defined as HbA1c 5.7–6.4%. Dietary patterns were identified using k-means clustering based on fast-food consumption frequency, main meal of the day, fruit and vegetable intake frequency, and predominant cooking method. Multivariable regression models assessed associations between dietary variables and glycemic or lipid outcomes. Results: Prediabetes prevalence was 21.1% (diabetes: 1.4%). Three dietary patterns were identified: health-conscious (prediabetes 15.4%), mixed (20.0%), and fast-food oriented (27.3%; χ² p = 0.003). Fast-food consumption frequency was independently associated with higher prediabetes risk (OR = 1.78 per category; 95% CI 1.38–2.30; p < 0.001) and higher HbA1c levels (β = 0.147; p < 0.001), while fruit and vegetable intake showed an inverse association with HbA1c (β = −0.109; p < 0.001). A dose–response relationship was observed between fast-food frequency and both HbA1c and prediabetes prevalence (p-trend < 0.001). An interaction between high-temperature cooking methods and frequent fast-food consumption was observed for HbA1c (p = 0.023). BMI and sex were the strongest predictors of lipid outcomes, although fast-food intake was associated with higher triglyceride levels (p = 0.034). Conclusions: Among Romanian university students, dietary patterns characterized by frequent fast-food consumption were associated with higher HbA1c levels and greater prediabetes prevalence. A high-temperature cooking method was associated with higher glycemic levels when combined with frequent fast-food intake. These findings suggest that early dietary behaviors during university years may be relevant for metabolic risk profiles in young adults.

Background/Objectives: Current menopause assessment instruments primarily evaluate vasomotor, somatic, and urogenital symptoms, with limited attention to oral, sensory, and integrated psychological domains. Evidence that oral tissues are estrogen-responsive suggests that oral symptoms may represent an important but underrecognized component of menopausal burden. This study aimed to develop and provide initial psychometric validation of the Multidimensional Menopausal Burden Questionnaire (MMBQ-44), a 44-item instrument integrating systemic, oral, and psychological symptoms. Methods: A cross-sectional validation study was conducted in 308 women aged 45–65 years (perimenopausal n = 66, menopausal n = 40, postmenopausal n = 202). The MMBQ-44 combined items from the Menopause Rating Scale (MRS), Xerostomia Inventory (XI), Oral Health Impact Profile-14 (OHIP-14), and psychological measures derived from the PHQ-9, GAD-7, and HADS. Instrument development included expert review, cognitive interviewing, and field testing. Psychometric evaluation assessed item performance, internal consistency, factor structure, discriminant validity, and known-groups validity. Exploratory factor analysis used principal axis factoring with promax rotation, with factor retention determined by parallel analysis. Results: Internal consistency was good to excellent across domains (Cronbach’s α: 0.813–0.941; McDonald’s ω: 0.864–0.953). All corrected item–total correlations exceeded 0.30. The questionnaire showed strong factorability (KMO = 0.931; Bartlett’s χ² = 9006.2, p < 0.001). Parallel analysis identified four factors explaining 48.6% of total variance. Psychological and OHIP domains emerged clearly, whereas several MRS and XI items cross-loaded onto related factors. Most HTMT ratios were below 0.85, supporting discriminant validity. Floor effects were observed for OHIP (37.0%) and XI (23.4%). Known-groups validity was modest, with OHIP scores differing significantly across menopausal stages. Conclusions: The MMBQ-44 demonstrates strong reliability and acceptable construct validity as an integrative screening instrument for menopausal burden. Further confirmatory studies and refinement of oral symptom items are warranted.

Background/Objectives: Disorders of Gut–Brain Interaction (DGBIs), particularly irritable bowel syndrome (IBS), are frequently underdiagnosed in clinical practice, contributing to a substantial hidden burden of disease. This study aimed to quantify this “symptomatic iceberg” by comparing the prevalence of formal IBS diagnoses with a broader symptom-based case definition in a clinical cohort. Methods: We conducted a cross-sectional analysis of 194 adult subjects from a gastroenterology clinic in Western Romania. Data on demographics, clinical diagnoses, self-reported symptoms, and eating behaviors were collected. For the case–control analysis, patients with confirmed organic gastrointestinal pathology or incomplete data were excluded. The final analytical sample consisted of 52 patients classified as having a functional DGBI phenotype and 84 asymptomatic controls without organic disease, while 58 were excluded from the analysis. Results: While only 4.4% (95% CI: 2.0–9.3%) of the cohort (N = 136) had a formal IBS diagnosis, 47.8% (95% CI: 39.6–56.1%) met criteria for an IBS-compatible symptom cluster, yielding an underdiagnosis ratio of 10.8. Neuro-vegetative symptoms such as sweating (19.1%) and dizziness (11.8%) were highly prevalent. In the case–control analysis, patients with a functional DGBI phenotype had a significantly higher mean BMI compared to controls (28.15 ± 6.49 vs. 24.47 ± 4.60 kg/m²; p = 0.001). DGBI cases were less likely to report regular snacking behavior (OR = 0.36; 95% CI: 0.18–0.74; p = 0.009), suggesting behavioral adaptation. A sensitivity analysis excluding participants with CRP > 10 mg/L (n = 98) confirmed the robustness of these associations, indicating that minor systemic inflammation did not bias the primary findings.

Background/Objectives: The transition toward healthier and more sustainable diets has increased the need for reformulated bakery and confectionery products formulated with alternative ingredients. However, validated instruments for assessing consumer acceptance of these products remain limited. This study aimed to develop and psychometrically validate a multidimensional assessment framework integrating food choice motives, green (environmental) values, health consciousness, perceived nutritional value, willingness to pay a premium, and purchase intention. Methods: A cross-sectional survey was conducted among 504 consumers in Romania using an online questionnaire. The instrument was developed by adapting established scales and by developing a new Perceived Nutritional Value scale. Dimensionality was evaluated using exploratory (EFA) and confirmatory (CFA) factor analyses. Temporal stability was assessed in an independent test–retest subsample (n = 30; 14-day interval), and the proposed conceptual model was evaluated using Partial Least Squares Structural Equation Modeling (PLS-SEM) with 5000 bootstrap resamples. Robustness was examined through a sensitivity analysis excluding respondents younger than 18 years (N = 441). Results: EFA (KMO = 0.933) and CFA (CFI = 0.965, TLI = 0.959, RMSEA = 0.061, SRMR = 0.033) supported the proposed six-factor structure. All constructs demonstrated excellent internal consistency (Cronbach’s α: 0.898–0.938), convergent validity (AVE: 0.790–0.889), discriminant validity (HTMT < 0.77), and good-to-excellent test–retest reliability (ICC: 0.82–0.91). Perceived nutritional value was positively and significantly associated with both willingness to pay and purchase intention, and willingness to pay partially mediated the association between perceived nutritional value and purchase intention. The structural model explained 46.1% of the variance in purchase intention; all hypothesized relationships were supported, and the findings remained stable in the sensitivity analysis. Conclusions: The proposed framework demonstrated good psychometric performance and provides a theory-informed measurement framework for assessing consumer acceptance of reformulated bakery and confectionery products. It may support future nutrition research, consumer studies, and the evaluation of food reformulation strategies aimed at promoting healthier and more sustainable dietary choices.

Background: The transition to university life is characterized by substantial changes in eating behaviors, sleep–wake organization, and lifestyle patterns. Chrononutrition-related behaviors, including meal timing and caloric distribution across the day, may influence metabolic health independently of dietary quantity, yet prospective evidence in university students remains limited. This study aimed to evaluate BMI trajectories during the first academic year and to identify chrononutrition-related behaviors associated with BMI change and clinically significant weight gain in young adults. Methods: This prospective observational study included 921 university students aged 18–24 years. BMI was assessed at university entry and after one academic year, and BMI change (Diff_BMI) was calculated. Chrononutrition-related variables included meal frequency, identity of the main meal, breakfast habits, and late eating. Multivariable linear and logistic regression models were used to evaluate independent associations between chrononutrition-related behaviors, BMI change, and clinically significant weight gain (Diff_BMI > +1 kg/m²). Results: Mean Diff_BMI was −0.45 ± 1.07 kg/m² (95% CI −0.52 to −0.38; p < 0.001). Overall, 48.2% of participants showed BMI reduction, 38.7% remained weight-stable, and 13.1% experienced BMI increases; clinically significant weight gain occurred in 7.2% of the cohort. In multivariable analysis, having dinner as the main meal (vs. lunch) was independently associated with greater BMI gain (β = +0.22 kg/m²; p = 0.004). Male sex was associated with lower BMI gain and lower odds of clinically significant weight increase. Breakfast skipping showed an inverse association with BMI change, whereas meal frequency and late eating were not independently associated with BMI trajectory after adjustment. Conclusions: The temporal distribution of caloric intake, particularly late eating patterns and shifting the principal meal toward later hours of the day, appears more strongly associated with BMI trajectory during the transition to university life than meal frequency alone. These findings support the relevance of chrononutrition-oriented strategies targeting meal timing and circadian eating behaviors in university students.