{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:12:12Z","timestamp":1788415932285,"version":"build-2803163510"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Blood donor eligibility is essential for donation safety, but it may not fully capture nutritional, metabolic, and lifestyle-related vulnerabilities that can affect donor health over time. As transfusion systems increasingly rely on regular donors, identifying modifiable factors that may support long-term donor health and retention is becoming increasingly relevant. This study aimed to characterize nutritional and lifestyle heterogeneity, peri-donation dietary behaviors, and donation-related outcomes in adult blood donors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional survey used a structured online questionnaire assessing anthropometric characteristics, lifestyle factors, habitual dietary intake, nutrition-related awareness, peri-donation dietary behaviors, self-reported history of iron deficiency, and post-donation symptoms. Dietary profiles were identified using principal component analysis followed by k-means clustering. Multivariable logistic regression models were used to explore factors associated with iron deficiency history and post-donation symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study included 698 adult blood donors. Overweight and obesity affected nearly half of the cohort and were more frequent among men and older donors, whereas women more frequently reported iron deficiency history and post-donation symptoms. Three dietary profiles were identified: Western\/ultra-processed, Mediterranean-like, and mixed beverage-oriented. Younger donors were more frequently represented in less favorable dietary and lifestyle profiles, whereas older donors showed more favorable dietary habits despite a higher prevalence of overweight\/obesity. In multivariable analyses, female sex was independently associated with iron deficiency history (OR 4.62, 95% CI 3.20\u20136.68;\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) and post-donation symptoms (OR 3.07, 95% CI 2.09\u20134.52;\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001), while increasing age was inversely associated with post-donation symptoms (OR 0.73 per 10-year increase, 95% CI 0.64\u20130.84;\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). Dietary pattern membership was not independently associated with either outcome. Peri-donation dietary changes were reported more frequently before donation than after donation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These findings suggest that adult blood donors represent a nutritionally and metabolically heterogeneous population despite donation eligibility. These findings support the potential relevance of structured nutritional counseling, lifestyle-oriented prevention, and recovery-focused recommendations within donor care pathways, although their impact on long-term donor health, continued eligibility, and donor retention should be evaluated in future prospective and interventional studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1903623","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:13:28Z","timestamp":1788412408000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond donor eligibility: nutritional and lifestyle heterogeneity and implications for long-term donor health preservation"],"prefix":"10.3389","volume":"13","author":[{"given":"Elisa","family":"Mazza","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University Magna Gr\u00e6cia","place":["Catanzaro, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Maurotti","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University Magna Gr\u00e6cia","place":["Catanzaro, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvelise","family":"Ferro","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University Magna Gr\u00e6cia","place":["Catanzaro, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca Rita","family":"Noto","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University Magna Gr\u00e6cia","place":["Catanzaro, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmelo","family":"Pujia","sequence":"additional","affiliation":[{"name":"Clinical Nutrition Unit, AOU \u201cRenato Dulbecco\u201d","place":["Catanzaro, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Paone","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University Magna Gr\u00e6cia","place":["Catanzaro, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Sestito","sequence":"additional","affiliation":[{"name":"Clinical Nutrition Unit, AOU \u201cRenato Dulbecco\u201d","place":["Catanzaro, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Moraca","sequence":"additional","affiliation":[{"name":"Clinical Nutrition Unit, AOU \u201cRenato Dulbecco\u201d","place":["Catanzaro, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilda Fatima","family":"Martino","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University Magna Gr\u00e6cia","place":["Catanzaro, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Pujia","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University Magna Gr\u00e6cia","place":["Catanzaro, Italy"]},{"name":"Research Center for the Prevention and Treatment of Metabolic Diseases, University \u201cMagna Gr\u00e6cia\u201d","place":["Catanzaro, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"Montalcini","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University Magna Gr\u00e6cia","place":["Catanzaro, Italy"]},{"name":"Research Center for the Prevention and Treatment of Metabolic Diseases, University \u201cMagna Gr\u00e6cia\u201d","place":["Catanzaro, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"770","DOI":"10.3390\/epidemiologia5040052","article-title":"Voluntary blood donation in modern healthcare: trends, challenges, and opportunities.","volume":"5","author":"Gasparovic Babic","year":"2024","journal-title":"Epidemiologia."},{"key":"B2","volume-title":"Global Status Report on Blood Safety And Availability 2021.","year":"2022"},{"key":"B3","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.tmrv.2016.02.002","article-title":"How can we improve retention of the first-time donor? A systematic review of the current evidence.","volume":"30","author":"Bagot","year":"2016","journal-title":"Transfus Med Rev."},{"key":"B4","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1111\/tme.12249","article-title":"Easy come, easy go. Retention of blood donors.","volume":"25","author":"van Dongen","year":"2015","journal-title":"Transfusion Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1186\/s12913-026-14150-9","article-title":"Forecasting blood supply and demand under population aging: implications and challenges for healthcare resource allocation.","volume":"26","author":"Lin","year":"2026","journal-title":"BMC Health Serv Res."},{"key":"B6","volume-title":"Blood Donor Selection: Guidelines on Assessing Donor Suitability For Blood Donation.","year":"2012"},{"key":"B7","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1111\/trf.16791","article-title":"A methods review of the \u201chealthy donor effect\u201d in studies of long-term health outcomes in blood donors.","volume":"62","author":"Rahman","year":"2022","journal-title":"Transfusion."},{"key":"B8","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1016\/j.tracli.2017.07.001","article-title":"The impact of multiple blood donations on the risk of cardiovascular diseases: insight of lipid profile.","volume":"24","author":"Bani-Ahmad","year":"2017","journal-title":"Transfus Clinique Biologique."},{"key":"B9","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/j.tmrv.2022.04.004","article-title":"Cardiovascular benefits for blood donors? A systematic review.","volume":"36","author":"Quee","year":"2022","journal-title":"Transfus Med Rev."},{"key":"B10","doi-asserted-by":"publisher","first-page":"2400","DOI":"10.3324\/haematol.2019.229450","article-title":"Dietary intake of heme iron is associated with ferritin and hemoglobin levels in dutch blood donors: results from donor insight.","volume":"105","author":"Timmer","year":"2020","journal-title":"Haematologica."},{"key":"B11","doi-asserted-by":"publisher","first-page":"756","DOI":"10.33594\/000000747","article-title":"Optimisation of blood donor nutrition: blood donor health improvement studies.","volume":"58","author":"Kurhaluk","year":"2024","journal-title":"Cell Physiol Biochem."},{"key":"B12","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1146\/annurev.nutr.24.012003.132306","article-title":"New insights into erythropoiesis: the roles of folate, vitamin B12, and iron.","volume":"24","author":"Koury","year":"2004","journal-title":"Annu Rev Nutr."},{"key":"B13","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1111\/j.1741-6892.2004.00435.x","article-title":"The body\u2019s response to blood loss.","volume":"87","author":"Garrioch","year":"2004","journal-title":"Vox Sang."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1656","DOI":"10.1111\/trf.14133","article-title":"Quantification of body iron and iron absorption in the REDS-II donor iron status evaluation (RISE) study.","volume":"57","author":"Kiss","year":"2017","journal-title":"Transfusion."},{"key":"B15","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1016\/j.tracli.2020.08.004","article-title":"Iron-deficiency among blood donors: donors\u2019 opinion on iron supplementation strategy.","volume":"27","author":"Chueca","year":"2020","journal-title":"Transfus Clin Biol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1111\/j.1537-2995.2011.03401.x","article-title":"Iron deficiency in blood donors: the REDS-II donor iron status evaluation (RISE) study.","volume":"52","author":"Cable","year":"2012","journal-title":"Transfusion."},{"key":"B17","doi-asserted-by":"publisher","first-page":"e056316","DOI":"10.1136\/bmjopen-2021-056316","article-title":"Ferritin-guided iron supplementation in whole blood donors: optimal dosage, donor response, return and efficacy (FORTE)-a randomised controlled trial protocol.","volume":"12","author":"Karregat","year":"2022","journal-title":"BMJ Open."},{"key":"B18","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/S0140-6736(24)01085-7","article-title":"Effectiveness of ferritin-guided donation intervals in whole-blood donors in the Netherlands (FIND\u2019EM): a stepped-wedge cluster-randomised trial.","volume":"404","author":"Meulenbeld","year":"2024","journal-title":"Lancet."},{"key":"B19","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1007\/s10877-016-9912-y","article-title":"Modulation of cardiac autonomic tone in non-hypotensive hypovolemia during blood donation.","volume":"31","author":"Yadav","year":"2017","journal-title":"J Clin Monit Comput."},{"key":"B20","doi-asserted-by":"publisher","first-page":"41","DOI":"10.4103\/ajts.ajts_90_21","article-title":"Factors associated with vasovagal reactions in whole blood donors: a case-control study.","volume":"16","author":"Shivhare","year":"2022","journal-title":"Asian J Transfus Sci."},{"key":"B21","doi-asserted-by":"publisher","first-page":"43","DOI":"10.4103\/0973-6247.126690","article-title":"A single-centre study of vasovagal reaction in blood donors: influence of age, sex, donation status, weight, total blood volume and volume of blood collected.","volume":"8","author":"Philip","year":"2014","journal-title":"Asian J Transfus Sci."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1111\/vox.13712","article-title":"Donor knowledge and perceptions regarding donation-induced iron depletion and iron supplementation as a blood service policy.","volume":"119","author":"Karregat","year":"2024","journal-title":"Vox Sang."},{"key":"B23","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1080\/10408399209527576","article-title":"Contributions of heme and nonheme iron to human nutrition.","volume":"31","author":"Carpenter","year":"1992","journal-title":"Crit Rev Food Sci Nutr."},{"key":"B24","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1016\/j.foodchem.2015.10.012","article-title":"The effect of proteins from animal source foods on heme iron bioavailability in humans.","volume":"196","author":"Pizarro","year":"2016","journal-title":"Food Chem."},{"key":"B25","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1111\/j.1750-3841.2011.02184.x","article-title":"Bioactive dietary polyphenols inhibit heme iron absorption in a dose-dependent manner in human intestinal caco-2 cells.","volume":"76","author":"Ma","year":"2011","journal-title":"J Food Sci."},{"key":"B26","doi-asserted-by":"publisher","first-page":"89","DOI":"10.3390\/nu8020089","article-title":"Is higher consumption of animal flesh foods associated with better iron status among adults in developed countries? A systematic review.","volume":"8","author":"Jackson","year":"2016","journal-title":"Nutrients."},{"key":"B27","doi-asserted-by":"publisher","first-page":"427","DOI":"10.4103\/jehp.jehp_250_21","article-title":"Homemade food, alcohol, and body weight: change in eating habits in young individuals at the time of COVID-19 lockdown.","volume":"10","author":"Mazza","year":"2021","journal-title":"J Educ Health Promot."},{"key":"B28","doi-asserted-by":"publisher","first-page":"2641","DOI":"10.3390\/nu13082641","article-title":"The effects of COVID-19 on the eating habits of children and adolescents in italy: a pilot survey study.","volume":"13","author":"Pujia","year":"2021","journal-title":"Nutrients."},{"key":"B29","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1046\/j.1537-2995.2003.00368.x","article-title":"Adverse effects in blood donors after whole-blood donation: a study of 1000 blood donors interviewed 3 weeks after whole-blood donation.","volume":"43","author":"Newman","year":"2003","journal-title":"Transfusion."},{"key":"B30","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1111\/trf.17190","article-title":"The healthy donor effect and survey participation, becoming a donor and donor career.","volume":"63","author":"Brodersen","year":"2023","journal-title":"Transfusion."},{"key":"B31","doi-asserted-by":"publisher","first-page":"e0186662","DOI":"10.1371\/journal.pone.0186662","article-title":"Associations of health status with subsequent blood donor behavior-an alternative perspective on the healthy donor effect from donor insight.","volume":"12","author":"van den Hurk","year":"2017","journal-title":"PLoS One."},{"key":"B32","doi-asserted-by":"publisher","first-page":"96","DOI":"10.2450\/BloodTransfus.1191","article-title":"Donor health beyond donation: cardiovascular risk factors in blood donor populations. A cross-sectional study.","volume":"24","author":"Maric","year":"2025","journal-title":"Blood Transfus."},{"key":"B33","doi-asserted-by":"publisher","first-page":"964","DOI":"10.1017\/S1368980011003405","article-title":"BMI and obesity in US blood donors: a potential public health role for the blood centre.","volume":"15","author":"Murphy","year":"2012","journal-title":"Public Health Nutr."},{"key":"B34","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.blre.2013.12.003","article-title":"The sex difference in haemoglobin levels in adults - mechanisms, causes, and consequences.","volume":"28","author":"Murphy","year":"2014","journal-title":"Blood Rev."},{"key":"B35","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ajog.2023.01.017","article-title":"The relationship between heavy menstrual bleeding, iron deficiency, and iron deficiency anemia.","volume":"229","author":"Munro","year":"2023","journal-title":"Am J Obstet Gynecol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"2279","DOI":"10.1001\/jama.299.19.2279","article-title":"Adverse reactions to allogeneic whole blood donation by 16- and 17-year-olds.","volume":"299","author":"Eder","year":"2008","journal-title":"JAMA."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.1111\/aogs.14890","article-title":"Menstrual blood loss is an independent determinant of hemoglobin and ferritin levels in premenopausal blood donors.","volume":"103","author":"Ekroos","year":"2024","journal-title":"Acta Obstet Gynecol Scand."}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1903623\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:13:29Z","timestamp":1788412409000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1903623\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":37,"alternative-id":["10.3389\/fnut.2026.1903623"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2026.1903623","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,3]]},"article-number":"1903623"}}