https://www.um.edu.mt/library/oar/handle/123456789/144 2026-06-28T04:33:49Z https://www.um.edu.mt/library/oar/handle/123456789/147724 Title: The flavour of sustainability : Mediterranean aromatic plants as enablers of nutrient-dense and low-salt gastronomy Authors: Jones, Petra; Blundell, Renald; Spiteri, Melania Abstract: Transitioning to sustainable, plant-forward diets, such as the Planetary Health Diet is a global priority; however, the palatability gap remains a formidable barrier, as consumers often perceive low-sodium, plant-centric diets as sensory-deficient. While aromatic herbs could bridge this gap, the current literature rarely integrates their sensory, ecological, phytochemical, and cultural dimensions. This narrative review explores how Mediter- ranean aromatic plants indigenous to the Maltese Islands function as sensory and molecular catalysts to bridge this gap. Through a thematic synthesis (2005–2026) integrating ethnob- otanical evidence with molecular nutrition and sensory science, the Maltese archipelago is examined as a small-island ecological model. Chronic abiotic stressors, including high salinity and intense solar exposure, induce phytochemical priming, significantly enhancing secondary metabolites like polyphenols and terpenoids. These compounds establish a folk–medicine bridge, where traditional culinary practices align with modern biochemical validation. These bioactives demonstrate a capacity to modulate the NF-κB inflamma- tory axis, mitigate systemic inflammaging, and support the gut–microbiome–brain axis. Furthermore, these aromatics serve as translational tools for EAT-Lancet 2025 targets by fa- cilitating cross-modal sensory compensation for sodium reduction and improving nutrient bioaccessibility via the culinary entourage effect. The TASTE-MED framework positions culinary nutrition as a vital translational bridge, asserting that flavour is a prerequisite for dietary sustainability and aligning individual molecular resilience with broader planetary health goals. 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/147711 Title: National and subnational analysis of self-reported diabetes mellitus and health inequalities in Europe Authors: Soares Andrade, Carlos Alexandre; Mahrouseh, Nour; Kovács, Nóra; Cuschieri, Sarah; Chen-Xu, José; Varga, Orsolya Abstract: Diabetes mellitus (DM) has been a major public health concern with increased epidemiologic and economic burden in Europe. We aimed to estimate self-reported national and subnational DM prevalence and inequalities in individuals aged 50 years and over in 13 European countries between 2010 and 2019. Microdata were extracted from waves 4 (2010/2011), 5 (2013), 6 (2015), 7 (2017/2018) and 8 (2019) of the Survey of Health, Ageing and Retirement in Europe (SHARE) database. The analysis was conducted at both national and subnational levels, comprising 13 European countries. Health inequalities were assessed using the gini coefficient (GC) and concentration index (CI). Socioeconomic risk factors were included in the inequality analysis (urbanization, income, and educational level) in addition to multilevel regression model. The prevalence of DM decreased from 11% in wave 4 to 10.6% in wave 8, with the lowest recorded in Switzerland at 5.9% in wave 5 and the highest observed in Czechia at 16.7% in wave 8. DM prevalence varied widely subnationally, ranging from 2.1% in wave 8 Zentralschweiz (Switzerland) to 28.5% in wave 8 in Střední Čechy in Czechia. The GC demonstrated an increase from 21.9% (95% CI 17.0, 24.5) in wave 4 to 22.5% (95% CI 19.4,25.2) in wave 8, with Switzerland exhibiting the highest coefficient in wave 8 [30.1% (95% CI 7.9, 41.7)]. The CIs for income and educational level at national level were consistently low and mostly negative. The education and income CI ranged from [− 0.0182 (95% CI – 0.0242, − 0.0122) to − 0.0010 (95% CI − 0.0021, − 0.0001)] and [− 0.0278 (95% CI − 0.0411, −0.0166) to − 0.0018 (95% CI – 0.0032, – 0.0005)] across waves 4 and 8, respectively. The CI for urbanization displayed both negative and positive values, but most were not statistically significant (p > 0.05). Inequalities exist in the self-reported prevalence of DM both nationally and subnationally, with elevated rates observed among individuals with lower educational and income levels. Addressing these significant health inequalities calls for the development of prevention programs and policies by the European countries and subnational regions, specifically tailored to prioritize and support vulnerable groups. 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/147709 Title: Are future doctors ready for the post-pandemic obesity surge? A mixed-methods pilot study Authors: Sant, Desiree’; Cuschieri, Andrea; Cuschieri, Sarah Abstract: Obesity is a global epidemic, posing intricate health dilemmas with wide-reaching ramifications. Despite its rising prevalence, obesity often receives inadequate attention in medical training, which is hypothesized to influence obesity management. The study aimed to evaluate medical students’ readiness in addressing obesity, which is especially relevant in a country with significant high obesity rates. A cross-sectional pilot study was carried out by disseminating a mixed-methods anonymous questionnaire among pre-clinical and clinical students studying at the University of Malta. Quantitative data was analyzed through descriptive and inferential statistical analysis, while qualitative responses were subject to thematic assessment. One hundred and eighty-nine students were recruited, and the majority expressed dissatisfaction with curricular education on obesity, especially clinical students who reported a perceived lack of essential theoretical and practical skills (82.65%, 95% CI [73.69–89.56]). Less pre-clinical students perceived receiving sufficient education on obesity and obesity management students (33.3% and 43.33%, respectively) compared to their clinical counterparts (67.68% and 53.54% respectively), which highlights a potential curriculum gap. Qualitative analysis revealed discontent with teaching methods and demonstrated the need for a more holistic approach to obesity education. This study highlights an urgent need to integrate holistic and comprehensive obesity education within the medical education curriculum that addresses both theoretical understanding and practical skills. 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/147706 Title: The plight of the Monaco microstate in the GBD 2023 study Authors: Wyper, Grant M. A.; Cuschieri, Sarah; Devleesschauwer, Brecht Abstract: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023, although invaluable for global health metrics, presents concerning estimates of life expectancy at birth for Monaco. Monaco is a microstate typically synonymous with world-leading levels of life expectancy at birth, with official sources, such as statistics from the Monaco Government and UN reports, consistently placing Monaco's life expectancy among the highest globally. The most recent estimate from the Monegasque Demography Observatory for 2022–24 places life expectancy at birth at 87·0 years; however, GBD estimates are substantially lower, at 80·4 years in 2023. This sizable discrepancy demands immediate attention. [excerpt] 2026-01-01T00:00:00Z