Clinical nutrition ESPEN最新文献

{"title":"Co-designed, personalised protein supplementation with whole-food dairy products in a randomised controlled trial: An investigation of success and acceptability in ≥80 years old community-dwelling adults.","authors":"Sussi Friis Buhl, Ilaria Marcella Piccinini, Anne Marie Beck, Anja Serena, Werner Vach, Paolo Caserotti","doi":"10.1016/j.clnesp.2025.06.037","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.06.037","url":null,"abstract":"<p><strong>Background & aims: </strong>Protein malnutrition is associated with loss of muscle mass and physical function in older adults, and specific tailored nutritional interventions may be required. This two-phased randomised controlled trial aimed at evaluating the success of 16-week co-designed personalised protein supplementation intervention with whole-food dairy products in community-dwelling adults 80+ years.</p><p><strong>Methods: </strong>Participants, recruited through a nationally regulated preventive service, were screened for protein malnutrition, with personalised guidance provided if below the cut-point of 1.0 g/kg/day (phase 1: 1-month optimization period). All eligible participants (≥1.0 g/kg/day) were randomly assigned to i) protein supplementation + power training, ii) protein supplementation-only, or iii) control. Protein supplementation included co-design of a supplementation plan with whole-food dairy products to supplement habitual diet (phase 2). Success was evaluated from changes in protein intake (mean (10;90 percentiles) and ≥1.35 g/kg/day cut-point.</p><p><strong>Results: </strong>Of the 92 participants entering the study, 55.4% were protein malnourished with 56,9% reaching eligibility following personal guidance. A total of 38 participants were randomised to phase 2. All receiving protein supplementation increased protein intake (0.24 (0.01;0.63) g/kg/day) compared to 16.7% in the control group (-0.19 (-0.35;-0.07)). However, only 47% of participants in the supplementation groups reached cut-point success criteria (1.35 g/kg/day).</p><p><strong>Conclusion: </strong>Co-designed personalised protein supplementation with whole-food dairy products was successful to increase protein intake in adults 80+ year. Nevertheless, reaching high intake was challenging. Individual nutritional guidance by a nutritional specialist may result in higher level of protein intake among most older adults with habitual low levels of protein intake.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relation between resting energy expenditure and amino acid metabolism in the post-acute phase of catabolic critically ill patients.","authors":"Itai Bendavid, Ilana BenAri, Benjamin Zribi, Raven A Wierzchowska-McNew, Mariëlle P K J Engelen, Nicolaas E P Deutz, Pierre Singer","doi":"10.1016/j.clnesp.2025.06.031","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.06.031","url":null,"abstract":"<p><strong>Introduction: </strong>Post Intensive Care Unit (ICU) acquired weakness is characterized by a massive loss of muscle mass and is generally considered to be multifactorial, secondary to bedridden condition, ubiquitination, increased catabolism, and moderately increased anabolism, and a lack of protein administration. We attended to explore the metabolism of amino acids of long-stayer patients hospitalized for more than 7 days in the ICU, using a stable isotopes technique and correlate the changes observed in the amino acid metabolism to the resting energy expenditure obtained by indirect calorimetry measurement METHODS: Chronically critically ventilated patients were included in the study and matched to healthy volunteers according to age, sex, and BMI. Labeled amino acids were injected, and samples were collected for tracer enrichment and amino acid concentration measurements. Compartment measurement was obtained. In addition, resting energy expenditure was measured by indirect calorimetry, and body composition was measured by bioimpedance. The results were compared to those from normal volunteers.</p><p><strong>Results: </strong>Fourteen ICU patients were matched to 14 normal volunteers and were very comparable. A high catabolism was observed in these long stayers. Most of the plasma levels of amino acids were decreased in the ICU post-acute phase patients compared to healthy volunteers. Only aspartate, taurine, and hydro methyl butyrate significantly increased. The extracellular pool size of amino acids and whole-body amino acid production was significantly increased compared to normal volunteers. Phase angle was lower and REE was correlated to BMI but inversely correlated to citrulline.</p><p><strong>Conclusion: </strong>In chronically critically ill patients, catabolism persists. Resting energy expenditure is in a decrease and is inversely correlated to citrulline. Most of plasma amino acid concentrations are decreased, but whole-body amino acid production is increased.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serial measurement of energy expenditure in critically ill patients - Feasibility and impact on nutrition provision.","authors":"Niklas Prange, Lorenz Weidhase, Bastian Pasieka, Sirak Petros","doi":"10.1016/j.clnesp.2025.06.036","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.06.036","url":null,"abstract":"<p><strong>Background: </strong>Serial indirect calorimetry instead of prediction of energy expenditure is recommended in critically ill patients. However, the feasibility and the challenges associated with it are not systematically investigated. This prospective study was aimed to investigate the course of measured resting energy expenditure in critically ill adult medical patients, the challenges associated with it and factors that significantly impact variations in energy expenditure.</p><p><strong>Method: </strong>Indirect calorimetry was serially performed on critically ill adult medical patients on invasive mechanical ventilation. Data on disease severity, body temperature, vasopressor support and sedation depth as well as nutrition therapy were also recorded.</p><p><strong>Results: </strong>A total of 98 patients (65.3% males) with a mean age of 66.9±13.5 years were included. Their mean Acute Physiology And Chronic Health Evaluation-II score was 31.4± 8.4. There was a total of 600 potential measurement days, out of which indirect calorimetry could be carried out on 452 days (75.3%). There was a stepwise increase in resting energy expenditure during the first 7 days with a quasi-plateau on day 8 and beyond, amounting to an increase in resting energy expenditure by 19.0 ± 28.7%. Daily changes in body temperature and the Richmond Agitation and Sedation Scale showed a significant effect on variations in energy expenditure. The study patients received beginning from day 4 onwards 93.6±34.7% (95% confidence interval 86.1 - 101.1%) of their measured energy expenditure.</p><p><strong>Conclusion: </strong>There is a stepwise increase in resting energy expenditure during the first week of critical care among critically ill adult medical patients. Patient-related factors and logistic challenges should be considered regarding indirect calorimetry. Body temperature and the degree of sedation have a significant impact on variations in energy expenditure.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RELATIONSHIP BETWEEN HOMOCYSTEINE LEVELS AND BONE QUALITY IN HEALTHY ADULTS - A SYSTEMATIC REVIEW AND META-ANALYSIS.","authors":"Deepti K Sharma, Tim Soon Cheok, Manuela Rogers, Victor Yan Zhe Lu, Lucian B Solomon, Boopalan Ramasamy, Peter M Clifton, Stuart A Callary","doi":"10.1016/j.clnesp.2025.06.034","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.06.034","url":null,"abstract":"<p><strong>Background and aims: </strong>Patients with elevated homocysteine (Hcy) levels are associated with an increased risk of fracture. B-vitamin supplementation studies have consistently shown an ability to reduce Hcy levels but have had no or marginal effect on bone mineral density (BMD), which led us to hypothesize that hyperhomocysteinemia may increase fracture risk by altering bone quality outcome measures beyond BMD. The aim of our systematic review was to investigate the association between Hcy and bone quality outcome measures, i.e. bone turnover, bone microarchitecture, collagen crosslinks and micro damage accumulation, in healthy adults.</p><p><strong>Methods: </strong>A systematic search was performed on Pubmed, Embase, and Scopus from the date of inception to 30^th of September^, 2024. Studies were included that had sufficient data to identify the pooled relationship between plasma Hcy and at least one domain of bone quality, such as bone microarchitecture, bone turnover, advanced glycation product (AGE) pentosidine levels, collagen crosslinks, or micro damage accumulation. Studies involving patients who were on medications or had conditions affecting plasma Hcy or bone health were excluded. Osteoporotic patients were included only if they had not been treated.</p><p><strong>Results: </strong>Twenty-seven studies were included in our systematic review. Our meta-analysis found a significant positive correlation between Hcy and osteocalcin [Pearson's coefficient of correlation (r) = 0.39, significance value (p) = 0.023, 95% Confidence Interval (CI) = 0.36 - 0.42]. No significant correlation was observed between Hcy and Procollagen type-1 N propeptide (P1NP), C-terminal telopeptide of type 1 collagen (CTX-1), or Bone-specific alkaline phosphatase (Bone ALP). Additionally, we found a strong positive correlation between Hcy and the AGE serum pentosidine [r = 0.72, p = 0.020, 95% CI = 0.67 - 0.76], a molecule linked to increased non-enzymatic collagen cross-linkage. Further, two studies measured collagen-crosslinking in the bone, and both reported elevated Hcy to be associated with higher non-enzymatic crosslinks and reduced enzymatic crosslinks.</p><p><strong>Conclusion: </strong>Our results suggest that elevated Hcy impacts bone quality outcome measures. The effect is possibly mediated via increased bone turnover and accumulation of non-enzymatic collagen crosslinking, resulting in decreased bone strength. PROSPERO Registration No.: CRD42024595870.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mind the gap: which are the gaps in dysphagia management?","authors":"Carlo Pedrolli","doi":"10.1016/j.clnesp.2025.06.039","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.06.039","url":null,"abstract":"<p><p>dysphagia is underdiagnosed and undertreated; the authors tries to list most important limits at the moment in dysphagia management, together with some proposal to revert the situation.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The predictive role of the geriatric nutritional risk index and modified creatinine index in patients undergoing hemodialysis.","authors":"Takahiro Yajima","doi":"10.1016/j.clnesp.2025.06.038","DOIUrl":"10.1016/j.clnesp.2025.06.038","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of linoleic acid on apolipoprotein B in individuals without previous diagnosis of cardiovascular disease: A Mendelian Randomization study","authors":"Gregory S. Nacarelli ,&nbsp;Tracy Fasolino ,&nbsp;Puya Yazdi ,&nbsp;Vivian Haley-Zitlin ,&nbsp;Stephanie Trammel","doi":"10.1016/j.clnesp.2025.06.008","DOIUrl":"10.1016/j.clnesp.2025.06.008","url":null,"abstract":"<div><h3>Background</h3><div>Apolipoprotein B is an essential causal marker of cardiovascular disease. Studies have attempted to understand the impact of fatty acids on cardiovascular disease risk by measuring changes in apolipoprotein B. Linoleic acid is an omega-6 polyunsaturated fatty acid that has demonstrated effects on cardiovascular disease outcomes.</div></div><div><h3>Objective</h3><div>This study attempts to investigate the causal association of plasma concentrations of linoleic acid with apolipoprotein B via Mendelian Randomization, in addition to confounders of this relationship.</div></div><div><h3>Methods</h3><div>The UK Biobank was used to obtain participant data for omega-6 polygenic risk scores, linoleic acid, and apolipoprotein B concentrations, in addition to confounding variable data. This study excluded individuals with a cardiovascular disease diagnosis or taking cholesterol-lowering medications. Multivariable regression was utilized to identify statistically significant impacts on apolipoprotein B, followed by Mendelian Randomization via two-stage least-squares analysis.</div></div><div><h3>Results</h3><div>Multivariable regression identified a statistically significant association of apolipoprotein B with linoleic acid, monounsaturated fatty acids, saturated fatty acids, age, sex, fasting, BMI, alcohol intake frequency, vigorous exercise, and smoking status. Two-stage least-squares analysis found a statistically significant causal association of genetically predicted linoleic acid on apolipoprotein B concentration (b = 0.23; 95 % CI: 0.207–0.243; p &lt; 0.001), with the first stage of the analysis yielding an eigenvalue of 755.79 and F-statistic of 2796.93 and the second stage of the analysis yielding a statistically significant Wald χ ² value of 27276.48 and R² of 0.62.</div></div><div><h3>Conclusions</h3><div>This study demonstrates a causal association of linoleic acid with apolipoprotein B concentrations. Future studies should evaluate this association and the confounders of this relationship.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 619-625"},"PeriodicalIF":2.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of new bioimpedance equations to estimate skeletal muscle mass percentage in a white, healthy population","authors":"Heliodoro Moya-Amaya ,&nbsp;Daniel Rojano-Ortega ,&nbsp;Antonio Molina-López ,&nbsp;Antonio Jesús Berral-Aguilar ,&nbsp;Alessandro Portolan ,&nbsp;Francisco José Berral-de la Rosa","doi":"10.1016/j.clnesp.2025.06.025","DOIUrl":"10.1016/j.clnesp.2025.06.025","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Skeletal muscle mass (SMM) plays a crucial role in overall health, especially in the aging population, and increased fat deposition elevate the risk of frailty and metabolic disorders. Accurate and accessible SMM assessment is essential for identifying and monitoring these risks. Bioelectrical impedance analysis (BIA) devices, widely used for body composition assessment, provide a non-invasive, practical solution; however, the accuracy of BIA measurements can vary significantly compared to dual-energy X-ray absorptiometry (DXA), particularly across different device types and demographic groups. Given the physiological and lifestyle changes that can influence muscle mass across the adult lifespan, there is a growing need for precise, reliable tools to evaluate SMM in a broad adult population.</div></div><div><h3>Methods</h3><div>We developed novel equations for estimating SMM percentage in a white, healthy population using two different BIA technologies: foot-to-hand device (Akern 101) and hand-to-hand device (TELELAB). These equations were developed to enhance the precision of SMM measurements, calibrating the output to align more closely with DXA values. A sample of 211 individuals (100 women, 111 men) aged 18–65 years was divided into a development group and a validation group to establish and test the predictive reliability of the proposed equations.</div></div><div><h3>Results</h3><div>Bland–Altman analyses revealed minimal fixed bias for both new equations compared to DXA, with substantially reduced mean bias values and lower standard deviations than those observed with use of the original manufacturer's equations.</div></div><div><h3>Conclusions</h3><div>The new equations effectively minimize the overestimation observed when using the manufacturer's equations, demonstrating an average bias close to zero and enhanced consistency across age and ethnic groups. These optimized equations offer a robust, practical solution for accurate SMM assessment in clinical and research settings across diverse adult populations.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 707-714"},"PeriodicalIF":2.9,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply - Letter to the Editor: \"The Metabolic Penalty of Time: Nutritional Vulnerability and Cardiovascular Risk in the Shift Work Economy\".","authors":"Luiz Antônio Alves de Menezes-Júnior","doi":"10.1016/j.clnesp.2025.06.018","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.06.018","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between metabolic dysfunction-associated steatotic liver disease and sarcopenia: A systematic review and meta-analyses","authors":"Ninglin Xia ,&nbsp;Jiwei Wang ,&nbsp;Qian Lu ,&nbsp;Xue Fan ,&nbsp;Zhenzhou Jiang ,&nbsp;Qinwei Yu","doi":"10.1016/j.clnesp.2025.06.027","DOIUrl":"10.1016/j.clnesp.2025.06.027","url":null,"abstract":"<div><h3>Background and aims</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) and Sarcopenia are highly prevalent health conditions in the world. Our objective was designed to quantify the relationship between the diagnosis of sarcopenia, sarcopenia and the risk of MASLD.</div></div><div><h3>Methods</h3><div>Web of Science, PubMed, Embase, and OVID were systematically searched from inception to 10 March, 2024, to identify all relevant studies.</div></div><div><h3>Results</h3><div>63 studies met the inclusion criteria, encompassing 288,583 participants. Our findings revealed that the risk of MASLD increased in subjects with sarcopenia (OR: 1.37, [95%CI 1.23,1.51]). In MASLD patients, the levels of skeletal muscle index (SMI) (SMD: −0.26, [95%CI -0.34, −0.18]) and gait speed (SMD: −0.17, [95%CI -0.27, −0.06]) were lower than in normal individuals. Moreover, a higher risk of MASLD was associated with decreased SMI (OR: 0.73, [95%CI 0.66, 0.79], decreased muscle strength (OR: 0.97, [95%CI 0.93, 1.00]). Additionally, the risk of advanced liver fibrosis (OR: 1.47, [95%CI 1.23,1.71]), mortality rate (RR: 1.15, [95%CI 1.09, 1.20]) and all-cause mortality (HR: 1.30, [95%CI 1.13,1.47]) increased in MASLD patients with sarcopenia.</div></div><div><h3>Conclusion</h3><div>Sarcopenia individuals have higher occurrence risk of MASLD. Meanwhile, the patients with low SMI and low muscle strength have higher occurrence risk of MASLD. Furthermore, sarcopenia individuals have higher occurrence risk of MASLD advanced stages including liver fibrosis or mortality. Our study suggested that clinicians should be vigilant about symptoms of sarcopenia, such as SMI, gait speed and muscle strength in patients with MASLD, detect susceptible populations early, and reduce the risk of poor prognosis.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 679-690"},"PeriodicalIF":2.9,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}