https://www.um.edu.mt/library/oar/handle/123456789/1122 Previously known as Department of Food Studies and Environmental Health 2026-04-16T21:25:55Z https://www.um.edu.mt/library/oar/handle/123456789/145572 Title: A study of factors affecting fruit and vegetable consumption and a retail assessment in selected districts in Malta Abstract: Background: Fruit and vegetable (FV) consumption is a foundation of a healthy diet, with the World Health Organization and Food and Agriculture Organisation of the United Nations jointly recommending at least 400 g (roughly five portions) per day to reduce non-communicable disease risk. In Malta, over one in four adults live with obesity and only ~12 % meet the five-a-day intake. This study aimed to assess FV intakes and drivers, particularly barriers, among adults aged 18-65 years in Malta and explore the local FV retail environment across two selected districts. Methods: The study included two phases. The first phase consisted of a 33-question, cross-sectional, anonymised survey, which was adapted, translated and piloted for Malta, then distributed online via Google Forms using convenience sampling Questions covered FV consumption, local retail environment perceptions and socio-demographic characteristics. The second phase focused on the assessment of FV retail outlets selected in two selected districts, the Northern Harbour and South Eastern districts. This assessment included measuring the number of retail outlets in 4 different localities, mapping their locations using Geographic Information Systems (GIS), and collecting data on the quality and cost of selected FV in eleven conveniently selected outlets within 4 different localities. Results: Data from 315 respondents (mean age 44.5 years; 72.4 % female; mean BMI 26.4 kg/m2) were analysed using Chi-square or Fisher-Freeman-Halton exact tests, Spearman’s correlations and cross-tabulations. Mean daily intake was 1.7 fruit and 1.8 vegetable portions. Around 51.0% of participants were classified in the overweight and obese ranges. Fruit intake increased with age (p < .05) and decreased with higher BMI (p < .05). Cost barriers were significant among lower-income households (p = .001), non-EU nationals (44.4 %, p < .001) and younger adults (p < .001). Larger households consumed more vegetables (p=0.003), but no significant associations were found between consumption frequency and gender, education or taste preferences (p >.05). Regarding shopping habits, 64.7 % of respondents travelled to purchase FV by car, while 44.8 % went on foot. Main desired improvements to better FV intake included lower prices (57.5 %), better quality (37.5 %) and more variety (28.4 %). Comparing the two selected districts, tests showed no difference in FV intake (p>.20). Quality and price assessments revealed that visual defects, °Brix and pH influenced retail prices across multiple crops (p<0.05). Spatial analyses confirmed that there was good availability of FV outlets in two most populated towns of selected districts and most participants lived within a 5-minute walk of an FV outlet. Discussion: FV intake in Malta remains relatively low, particularly among younger, lower-income and non-EU groups, similar consumption across districts. Affordability emerged as the primary barrier. Targeted interventions, such as subsidies for vulnerable pockets and community-tailored educational campaigns, are needed to boost FV consumption and reduce chronic disease risk. Description: M.Sc.(Melit.) 2025-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/142952 Title: The role of fermented foods in managing food allergies in children and adults : a systematic review Authors: Hyseni, Bahtir; Papadimitriou, Konstantinos; Issa, Aline; Nur Tonay, Ayşe; Gündüz Ergün, Burcu; Gonzalez-Domenech, Carmen Maria; Arranz, Elena; Luzha Pula, Endra; Erem, Erenay; Garcia-Gutierrez, Enriqueta; Bouchaud, Gregory; Szajewska, Hania; Kalkan Yıldırım, Hatice; Ender Künili, İbrahim; Markiewicz, Lidia; Caruana Grech Perry, Mario; Kilic-Akyilmaz, Meral; Halim El Jalil, Mounaim; Merabti, Ryma; Mojsova, Sandra; Karagül Yüceer, Yonca; Gulsunoglu-Konuskan, Zehra; Akpınar, Aslı; Karakaş-Budak, Barçın; Chassard, Christophe; Pracer, Smilja; Vergères, Guy; Bavaro, Simona Lucia Abstract: Introduction: Fermented foods are among the oldest foods produced, and several different health benefits are attributed to their consumption even in the absence of concrete clinical evidence. To address this gap, this systematic review focuses on the effects of the consumption of fermented foods on food allergies. Methods: This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the relevant European Food Safety Authority guidelines. A systematic search strategy was established and registered in a study protocol in Open Science Framework. Scopus, MEDLINE, and Cochrane Library were searched with specific strings targeting human studies focusing on Fermented food and food allergies. Inclusion and exclusion criteria were defined based on the People Intervention Comparison Outcome elements. The Cadima tool was used to perform screening and selection of articles. A standard template was used for data extraction. Risk of bias assessment was performed using the Risk of Bias 2.0 Tool, Risk of Bias in Non-randomized Studies - of Interventions, or Newcastle– Ottawa Scale protocols. Additionally, a narrative section was written based on the European Food Safety Authority guidelines for the mechanism of action and product characteristics for evidence support. Results: From a total of 558 initial records, 10 studies were finally selected. Fermented foods evaluated were fermented soy products, baked goods, fruit-based beverages, vinegar-treated foods, oat-based drinks, and dairy products (yogurt, cheese). In several studies, a reduced allergenicity was reported that was related to fermentation-mediated hydrolysis of allergenic proteins of gluten or soy. Additional mechanisms were related to anti-allergic immunomodulatory effects or favorable shifts in gut microbiota composition. In one case, fermented food consumption led to aggravation of the allergic response, presumably due to the compounds generated during soy fermentation. Risk of bias assessment revealed that most studies were performed with important methodological limitations. Conclusion: While fermented foods hold promise in reducing food allergenicity and promoting tolerance, current evidence is limited to draw solid conclusions. Rigorous, well-designed human clinical trials, complemented by mechanistic studies in vitro and in vivo, are needed to clarify the role of fermented foods as dietary or even clinical tools to combat food allergies. 2025-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/142939 Title: Characterising irritable bowel syndrome : an exploratory cross-sectional study Authors: Galea, Heather; Caruana Grech Perry, Mario; Jones, Petra Abstract: Background: Irritable Bowel Syndrome (IBS) is a prevalent functional gastrointestinal disorder influenced by cultural, dietary and psychosocial factors. Locally relevant tools are needed to better understand the experiences and management behaviours of Maltese individuals living with IBS. Objective: To develop and content-validate a culturally relevant questionnaire and characterise a sample of Maltese patients living with Irritable Bowel Syndrome (IBS). Methodology: A cross-sectional quantitative design was used. Consenting Maltese adults meeting the Rome IV criteria for IBS were recruited via social media and outpatient gastroenterology and dietetic clinics across Malta. A 30-item culturally adapted questionnaire was systematically developed, content-validated and administered. Collected variables included demographics, lifestyle behaviours, psychological comorbidities, symptom severity, diagnosis status, information sources, dietary triggers and treatments used. Descriptive statistics summarised cohort characteristics, while inferential analyses examined associations between symptom severity and demographic or clinical variables (p < 0.05), with effect sizes calculated. Results: The sample (N = 130) was predominantly female (90.8%), most commonly aged 36 - 45 years, with a mean BMI of 27.5 ± 6.8 kg/m². Participants reported moderate symptom severity and high rates of psychological comorbidities. Food was the most frequently reported trigger (78.5%), particularly dairy (45%) and vegetables, fruit, beans and legumes (39%). Pharmacological treatments were widely used (85.4%) and online sources were the predominant information channel (80.8%). No significant associations were identified between symptom severity and demographic or clinical factors. Conclusion: This study describes a symptom-aware Maltese cohort actively engaging in IBS self-management. The prominence of food-related triggers, moderate symptom severity and psychological comorbidities underscores the need for multidisciplinary, personalised, evidence-based care, including dietetic and psychological support. The validated questionnaire offers a culturally grounded tool for future research and clinical assessment in Malta. 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/142937 Title: Peas, natural resources for a sustainable future : a multifaceted review of nutritional, health, environmental, and market perspectives Authors: Nikolic, Nada Cujic; Mutavski, Zorana; Šavikin, Katarina; Živkovic, Jelena; Pavlovic, Suzana; Jones, Petra; Copperstone, Claire; Aytar, Erdi Can; Aydin, Betül; Van Bavegem, Evelien; Kunili, Ibrahim Ender; Özmen, Özge; Kü¸sümler, Aylin Seylam; Unal, Derya Ozalp; Gunduz, Selin; Lara, Szymon Wojciech; Akin, Meleksen; Orahovac, Amil; Balázs, Bálint; Mileševic, Jelena; Sîrbu, Alexandrina; Negrão, Sonia; Knez, Marija Abstract: The pea (Pisum sativum L.) is an emerging pillar in plant-based nutrition and sustainable food systems due to its high-quality proteins, diverse bioactive compounds, and agroecological benefits. This review provides an updated synthesis of the nutritional composition, health-promoting properties, and environmental relevance of peas, emphasizing recent scientific findings. Pea seeds typically contain 20%−40% protein, 45%−55% starch, and 10%−15% dietary fiber, alongside essential micronutrients such as vitamin C (40–60 mg/100 g), folate (60–70 μg/100 g), vitamin K (30–45 μg/100 g), iron (1.5– 2.0 mg/100 g), and manganese (0.4–0.6 mg/100 g). Their storage proteins, primarily legumin and vicilin, offer high digestibility and amino acid profiles compatible with human requirements, supporting their rapidly growing use in protein isolates and meat- and dairy-alternative products. Peas represent a valuable source of phenolic acids, flavonoids, and saponins, which contribute to notable antioxidant (50–120 μmol Trolox/g) and anti-inflammatory activities demonstrated in preclinical studies. Compared with other legumes, peas exhibit a lower glycemic index (35–45), making them suitable for metabolic health applications. Agronomically, pea cultivation enhances soil fertility through biological nitrogen fixation (up to 150 kg N/ha), supporting reduced fertilizer inputs and improved crop rotation performance, aligning with circular economy and climate-resilience strategies. Despite these advantages, global consumption and breeding innovation remain insufficient to meet the rising demand for alternative proteins. Future opportunities include improving protein extraction technologies, valorizing processing side-streams, and exploring underutilized phytochemicals to strengthen the nutritional and sustainability profile of pea-based food systems. 2026-01-01T00:00:00Z