Clinical nutrition ESPEN最新文献

{"title":"A review of the impact of intermittent ramadan fasting on wellbeing, nutrition and physical performance in different sports","authors":"Tehreema Ghaffar,&nbsp;Francesca Ubaldi,&nbsp;Federica Valeriani,&nbsp;Vincenzo Romano Spica","doi":"10.1016/j.clnesp.2025.03.052","DOIUrl":"10.1016/j.clnesp.2025.03.052","url":null,"abstract":"<div><h3>Background</h3><div>Athletes in different sports may experience a change in the physical performance during Ramadan Intermittent Fasting (RIF). The impacts of fasting on performance, coping behaviour and fatigue in athletes have not been fully researched.</div></div><div><h3>Objective</h3><div>To examines the effects of Ramadan Intermittent Fasting (RIF) on the physical performance of athletes in different types of sports. The approaches used to assess effects of intermittent fasting among young athletes have not yet been systematically reviewed.</div></div><div><h3>Method</h3><div>Following PRISMA guidelines, 3 independent searches on different databases to identify all the articles describing effects of RIF on physical performance of athletes with all available articles from 2014 up to April 2024.</div></div><div><h3>Results</h3><div>Among 422 articles identified, 31 studies met eligibility criteria. Fourteen studies reported the effect of Ramadan fasting on individual sports, three studies on combat sports, and fourteen studies on team sports.</div></div><div><h3>Conclusion</h3><div>The RIF negatively effects the physical performance, players coping behavior, nutritional status and fatigue capacities in different sports, although, the negative effects are greater for Handball, Basketball, Volleyball, Football and Swimming although the impact is less negative for Tennis, Badminton, Martial arts and Endurance sports. The athletes who maintain their total energy and macronutrient intake, training load, body composition, sleep length and quality are unlikely to suffer any substantial decrements in performance during Ramadan. Adding other recovery methods could improve performance and reduce the fatigue and muscle soreness experienced with increased game frequency during RIF.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 585-598"},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820920","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":"Serum and urine metabolite correlates of vitamin D supplementation in the Atherosclerosis Risk in Communities (ARIC) study","authors":"Valerie K. Sullivan ,&nbsp;Jingsha Chen ,&nbsp;Lauren Bernard ,&nbsp;Bing Yu ,&nbsp;Erin D. Michos ,&nbsp;Lawrence J. Appel ,&nbsp;Alice H. Lichtenstein ,&nbsp;Casey M. Rebholz","doi":"10.1016/j.clnesp.2025.03.172","DOIUrl":"10.1016/j.clnesp.2025.03.172","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Vitamin D regulates calcium and phosphorus homeostasis, skeletal health, and potentially other aspects of health. There are limitations of existing vitamin D biomarkers. We aimed to discover novel vitamin D biomarkers by investigating serum and urine metabolites associated with vitamin D supplementation.</div></div><div><h3>Methods</h3><div>We examined cross-sectional associations between vitamin D supplementation and serum and urine metabolites in Atherosclerosis Risk in Communities Study participants at visit 5 (2011–2013). Untargeted metabolomic profiling of serum and spot urine samples was performed by Metabolon, Inc. We analyzed associations between vitamin D supplementation and log₂-transformed metabolites using linear regression models adjusted for demographic, lifestyle, and health covariates.</div></div><div><h3>Results</h3><div>Of 5225 participants with serum metabolites analyzed (mean age 76 [SD 5] years, 57 % female, 20 % Black), 45 % reported taking vitamin D supplements. Eighty-two of 933 serum metabolites were associated with vitamin D supplementation (P &lt; 0.05/933). Most were lipids (n = 36). Of 1565 participants with urine metabolites analyzed, one-third (37 %) used vitamin D. Nineteen of 946 urine metabolites were associated with vitamin D supplementation (P &lt; 0.05/946). Most were cofactors and vitamins (n = 12). After adjusting for other supplement use (multivitamin/mineral, omega-3, B and C vitamins), 5 serum metabolites (pro-hydroxy-pro, pyroglutamine, sulfate, creatine, and 2-hydroxypalmitate) and no urine metabolites were significantly associated with vitamin D supplementation.</div></div><div><h3>Conclusions</h3><div>Many serum and urine metabolites were associated with vitamin D supplementation. Five serum metabolites remained associated with vitamin D after adjustment for other dietary supplements, including metabolites of bone collagen degradation, glutathione metabolism, and sphingolipid metabolism. These metabolites may reflect physiological activities of vitamin D and, thus, improve assessment of vitamin D adequacy to achieve functional outcomes. These merit further investigation as potential vitamin D biomarkers.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 523-532"},"PeriodicalIF":2.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794581","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":"Undernutrition in adult hospitalized patients and its impact on the length of stay, a 10-year repeated cross-sectional study analyzing 65,226 stays","authors":"Thierry Chevalier ,&nbsp;Josiane Arnaud ,&nbsp;Jérôme Fauconnier ,&nbsp;Eric Fontaine","doi":"10.1016/j.clnesp.2025.04.001","DOIUrl":"10.1016/j.clnesp.2025.04.001","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>The prevalence of undernutrition in hospitalized patients and its impact on their length of stay (LOS) varies considerably depending on the population studied, the diagnosis criteria or the screening tools used. Previous reports using controlled data have been done on small populations while large cohorts have been studied on unverified declarative data. This study aims at determining the prevalence of undernutrition in a large population using verified anthropometric data and assessing its impact on the LOS.</div></div><div><h3>Methods</h3><div>– For 10 years (2007–2017), a specialized nutritional assessment unit screened inpatients in a tertiary hospital for undernutrition, with the exception of those in emergency and intensive care, orthopedics, pediatrics and maternity wards. Within each unit, screening was carried out every two to three weeks. The diagnosis of undernutrition in adult inpatients was made using body mass index (BMI) (&lt;18.5 kg/m² for age &lt;70 or &lt; 21 kg/m² for age ≥70) or weight loss (weight loss &gt;5 % over a month or &gt;10 % over 6 months). We retrospectively analyzed this database, looking at all adults (&gt;18 years) hospitalized for at least one day. The analysis of the prevalence of undernutrition and its consequence on the LOS was performed on the entire population as well as by sex, age groups and diagnosis-related groups (DRGs). Statistics were performed using the chi-square test, T-test, ANOVA and mixed linear analysis. Age and gender were added as potential confounders, while DRG was included as a random effect.</div></div><div><h3>Results</h3><div>The analysis included data from 65,226 stays. Mean age 65 years (min 18, max 113), 58.2 % male patients. The overall prevalence of undernutrition was 29.77 %, lower in the 40 to 70-year-old group than in the younger and older population. Undernutrition was present in all of the 53 surveyed DRGs, with a prevalence ranging from 12 % to 57.89 %. In the overall population, undernourished patients had a longer LOS than well-nourished patients, with a median increase of 5 days. In 42 of the 53 DRGs, representing 97.57 % of the total population, undernutrition significantly increased the LOS.</div></div><div><h3>Conclusions</h3><div>This large study of the prevalence of undernutrition diagnosed from verified anthropometric data in hospitalized adults does not confirm recent findings obtained from unverified data in hospital databases.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 533-540"},"PeriodicalIF":2.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794711","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":"Perioperative or combined preoperative and postoperative standard nutrition therapy for patients with head and neck or gastrointestinal cancer: A systematic review and meta-analysis","authors":"Masano Sagawa ,&nbsp;Ryota Matsui ,&nbsp;Akihiko Sano ,&nbsp;Makoto Sakai ,&nbsp;Shinichiro Hiraoka ,&nbsp;Isao Tabei ,&nbsp;Takayuki Imai ,&nbsp;Hideo Matsumoto ,&nbsp;Seiji Onogawa ,&nbsp;Norihiro Sonoi ,&nbsp;Shigeyuki Nagata ,&nbsp;Ryo Ogawa ,&nbsp;Shigeki Wakiyama ,&nbsp;Yasuhiro Miyazaki ,&nbsp;Koshi Kumagai ,&nbsp;Rie Tsutsumi ,&nbsp;Takehiro Okabayashi ,&nbsp;Yu Uneno ,&nbsp;Naoki Higashibeppu ,&nbsp;Joji Kotani","doi":"10.1016/j.clnesp.2025.03.170","DOIUrl":"10.1016/j.clnesp.2025.03.170","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Since malnutrition is a risk factor for postoperative complications, preoperative nutritional therapy is recommended to reduce postoperative complications. Few meta-analyses conducted exclusively in cancer patients have shown that perioperative standard nutritional therapy reduces postoperative complications. This study examined whether preoperative or combined preoperative and postoperative standard nutritional therapy reduced postoperative complications in patients with head and neck or gastrointestinal (GI) cancer.</div></div><div><h3>Methods</h3><div>We conducted randomized controlled trials in 1979–2021. Patients who received standard nutritional interventions were classified as the intervention group and those who did not receive any nutritional intervention as controls. The primary outcome was the total number of postoperative complications and infectious complications.</div></div><div><h3>Results</h3><div>In total, 19 studies were included (n = 2047). Of 19 studies, 5 were for upper GI cancer, 8 were for lower GI cancer, 5 were for upper and lower GI cancers, and 1 was for head and neck cancer. Total postoperative and infectious complications were reported in 15 (n = 1762) and 9 (n = 905) studies. The meta-analysis showed that standard nutritional interventions may reduce the total complication rates (RR: 0.78, 95 % CI: 0.65–0.94) and infectious complications (RR: 0.67, 95 % CI: 0.51–0.87). There were no significant differences in subgroup analyses, according to the nutritional therapy timing and nutritional status. The risk of bias was high for random sequence generation, allocation concealment, and participants' and data analysts’ blinding. COE for total postoperative and infectious complications was weak and inconsistent due to the high risk of bias and substantial heterogeneity.</div></div><div><h3>Conclusion</h3><div>Although the present study was inconclusive due to the small number of studies in head and neck cancer, preoperative or combined preoperative and postoperative standard nutrition therapy in patients with GI cancer may significantly reduce the incidence of postoperative complications. Further studies are needed to confirm these findings and to reduce the risk of bias.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 567-577"},"PeriodicalIF":2.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794546","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":"3D assessment of skeletal muscle and adipose tissue for prognosis of hepatocellular carcinoma: a multicenter cohort study.","authors":"Jinxiong Zhang, Shuoling Zhou, Yurong Jiang, Wei Zhao, Weiguo Xu, Jiawei Zhang, Taixue An, Jianfeng Yan, Chongyang Duan, Xiaojun Wang, Sihui Yang, Tao Wang, Dandan Dong, Yuan Chen, Feixiang Zou, Xiangrong Yu, Meiyan Huang, Sirui Fu","doi":"10.1016/j.clnesp.2025.03.168","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.03.168","url":null,"abstract":"<p><strong>Background: </strong>Changes in protein and lipid metabolism could provide additional prognostic information for hepatocellular carcinoma (HCC).This study aimed to explore whether 3D automatic assessment of skeletal muscle and adipose tissue can contribute to the precise prognosis for HCC.</p><p><strong>Methods: </strong>The data of 458 HCC patients from 6 hospitals were divided into training and external validation datasets. Preoperative CT Images were used for this study. First, we tested the stability of the 2D factors. Second, we tested whether standardization for volume assessment was necessary. Third, we compared the clinical (Model^C), skeletal muscle and adipose tissue (Model^NSA), and combined (Model^C-NSA) models by discrimination and calibration to identify the optimal model. Subgroup analysis was performed for the optimal model.</p><p><strong>Results: </strong>For the 16 2D factors, 13 factors were statistically different among the three 2D slices. Standardization of the volume factors was necessary. Among the three models, Model^C-NSA had a higher area under the curve [AUC] than Model^C and Model^NSA, both in the training dataset (0.809 vs. 0.649 vs. 0.797) and the validation dataset (0.770 vs. 0.718 vs. 0.719). For calibration, the performance of Model^C-NSA was similar to those of Model^C and Model^NSA. The performance of Model^C-NSA was not influenced by age (P=0.753), sex (P=0.781), treatments (P=0.504), Barcelona Clinic Liver Cancer stage (P=0.913), or Child-Pugh class (P=0.580).</p><p><strong>Conclusions: </strong>Compared to 2D evaluation, 3D assessment is more stable. 3D automatic assessment of skeletal muscle and adipose tissue can accurately predict progression in patients with HCC.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788008","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":"Maternal sleep and psychological status in the postpartum period are associated with functional protein alterations in breast milk:a mother-infant cohort study","authors":"Celi Yang ,&nbsp;Xiaona Na ,&nbsp;Haibing Yang ,&nbsp;Menglu Xi ,&nbsp;Yucheng Yang ,&nbsp;Yalu Yan ,&nbsp;Sufang Duan ,&nbsp;Ting Li ,&nbsp;Ignatius Man-Yau Szeto ,&nbsp;Ai Zhao","doi":"10.1016/j.clnesp.2025.03.167","DOIUrl":"10.1016/j.clnesp.2025.03.167","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Postpartum sleep disorder and mental disorders are common unpleasant conditions faced by women after delivery, and they have many adverse effects on both mothers and infants. It is unclear whether breast milk composition is affected by maternal sleep, psychological state, diet and gut microbiome. This study aims to explore the effects of these key factors on the functional protein components of breast milk.</div></div><div><h3>Methods</h3><div>With a prospective design, this pilot study included a total of 41 postpartum women. Breast milk and maternal faecal samples collected at 42 days and 3 months postpartum were tested by liquid chromatography-mass spectrometry and 16S RNA sequencing, respectively. Sleep state, psychological state and dietary intake data were also collected from the mothers with validated questionnaires.</div></div><div><h3>Results</h3><div>In the early postpartum period, sleep disorders and depression were associated with a decrease in the functional proteins in breast milk. Disordered sleep was significantly negatively correlated with α-lactalbumin (cor = −0.578, p &lt; 0.001), osteopontin (cor = −0.522, p &lt; 0.01) and κ-casein (cor = −0.451, p &lt; 0.01). Depression was negatively correlated with αs1-casein (cor = −0.422, p &lt; 0.01), β-casein (cor = −0.317, p &lt; 0.05) and casein (cor = −0.318, p &lt; 0.05). In 3 months postpartum, most associations were disappeared. But a positive correlation was observed between β-casein (cor = 0.414, p &lt; 0.01), casein (cor = 0.372, p &lt; 0.05), total protein (cor = 0.376, p &lt; 0.05) and depression, while a positive correlation was found between total protein (cor = 0.357, p &lt; 0.05) and disordered sleep at 3 months postpartum. Faecal microbiome data illustrated that changes in the gut microbiome at early postpartum were associated with sleep disorders/depression, but not with the diet. Furthermore, functional pathway analysis revealed metabolic regulation in the amino acid synthesis and metabolic pathways associated with specific microbes was involved in the reduction of breast milk protein.</div></div><div><h3>Conclusion</h3><div>Sleep disorders/depression could lead to significant changes in breast milk profiles at 42 days postpartum. Maternal gut microbiome might affect breast milk protein composition through regulating amino acid synthesis and metabolic pathways.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 510-522"},"PeriodicalIF":2.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to dietary guidelines and liver cancer risk: Results from two prospective cohort studies","authors":"Jia-Yi Tuo ,&nbsp;Qiu-Ming Shen ,&nbsp;Zhuo-Ying Li ,&nbsp;Dan-Ni Yang ,&nbsp;Yi-Xin Zou ,&nbsp;Yu-Ting Tan ,&nbsp;Hong-Lan Li ,&nbsp;Yong-Bing Xiang","doi":"10.1016/j.clnesp.2025.03.173","DOIUrl":"10.1016/j.clnesp.2025.03.173","url":null,"abstract":"<div><h3>Background and aims</h3><div>Although dietary factors have been extensively investigated as potential risk factors for liver cancer, the evidence is inconclusive. Our study systematically assessed the associations between ten dietary guidelines compliance scores and liver cancer risk among adult people, and found out the dietary patterns for liver cancer prevention.</div></div><div><h3>Methods</h3><div>Participants of 59,844 men and 72,680 women, aged 40–74 years and living in urban Shanghai, were included in two prospective cohort studies conducted between 2002–2006 and 1996–2000, respectively. Dietary intakes were assessed during baseline in-person interviews using validated food-frequency questionnaires, and dietary guideline compliance scores were calculated by adjusting for total energy intake and adapting existing dietary recommendations. Hazards ratios (HRs) with 95 % confidence intervals (CIs) were evaluated by both tertile categories and per standard deviation (SD) increment using Cox proportional hazard regression models to assess the associations between ten dietary guideline compliance scores and liver cancer risk.</div></div><div><h3>Results</h3><div>In the two cohorts, 431 male and 256 female incident liver cancer cases were identified during a mean follow-up of 11.90 and 17.44 years, respectively. There were no statistically significant associations between these ten dietary guidelines and male liver cancer risk (<em>P</em> &gt; 0.05). In contrast, only the modified reversed Empirical Dietary Inflammation Pattern (rEDIP) tended to be associated with the low risk of female liver cancer (HR _{T3 vs. T1} = 0.67, 95 % CI: 0.48–0.92, <em>P</em> _{<em>trend</em>} = 0.016, HR per SD = 0.94, 95 % CI: 0.85–1.03). The inverse associations appeared stronger between rEDIP and liver cancer risk at younger ages (&lt;55 years) in women (HR per SD = 0.91, 95 % CI: 0.84–0.99) compared to the older women (≥55 years). There were suggestive but non-significant inverse associations between the modified Diabetes Risk Reduction Diet (mDRRD) (men: HR per SD = 0.92, 95 % CI: 0.84–1.02; women: HR per SD = 0.97, 95 % CI: 0.84–1.02) and the modified World Cancer Research Fund/American Institute for Cancer Research (mWCRF/AICR) (men: HR per SD = 0.93, 95 % CI: 0.84–1.02; women: HR per SD = 0.91, 95 % CI: 0.80–1.03) and liver cancer incidence. The associations of mDRRD (HR per SD = 0.82, 95 % CI: 0.75–0.98) and mWCRF/AICR (HR per SD = 0.83, 95 % CI: 0.74–0.99) on liver cancer risk were significant in men who ever smoked.</div></div><div><h3>Conclusions</h3><div>Our findings confirm that greater adherence to some healthy dietary patterns (i.e. rEDIP, mDRRD and mWCRF/AICR) is inversely associated with liver cancer risk, especially in certain populations. Future studies are required to confirm these findings and elucidate potential mechanisms.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 599-611"},"PeriodicalIF":2.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788011","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":"Postprandial glycemic effects of lactose-hydrolyzed milk supplemented with mulberry leaf and corn silk extracts in adults with type 2 diabetes: A randomized crossover trial","authors":"You Sun ,&nbsp;Yong Zhang ,&nbsp;Xiaokang Niu ,&nbsp;Yan Liu ,&nbsp;Lingling Xu ,&nbsp;Yifan Wang ,&nbsp;Qi Zhang ,&nbsp;Jingjing He ,&nbsp;Yinghua Liu ,&nbsp;Kaishuai Zhang ,&nbsp;Ran Wang ,&nbsp;Jian He ,&nbsp;Jie Guo","doi":"10.1016/j.clnesp.2025.03.174","DOIUrl":"10.1016/j.clnesp.2025.03.174","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Lactose-hydrolyzed milk is widely used to address lactose intolerance. However, its monosaccharide content may rapidly increase postprandial blood glucose levels and heighten glycemic variability. We aimed to explore the effects of mulberry leaf and corn silk extracts (medicinal and edible homologous materials) and their supplementation in lactose-hydrolyzed milk on postprandial glycemic control in adults with type 2 diabetes.</div></div><div><h3>Methods</h3><div>Eligible participants in this crossover trial were randomized to four interventions, separated by a 7 d washout. Intervention foods were whole-grain bread (50 g carbohydrates) together with water, mulberry leaf and corn silk extracts (MCE), lactose-hydrolyzed milk (LHM), or lactose-hydrolyzed milk supplemented with mulberry leaf and corn silk extracts (LHM-MCE). Continuous glucose monitoring systems were used to collect fasting and postprandial interstitial glucose over 2 h after interventions and to calculate the incremental area under the curve (iAUC). Paired Wilcoxon signed-rank test was used to compare the difference in iAUC, 1-h postprandial glycemic (1h PG), 2h PG, maximum glycemic, and maximum glucose excursion from baseline across interventions.</div></div><div><h3>Results</h3><div>Twenty-eight adults with type 2 diabetes (55 ± 10 years old, fasting blood glucose: 6.93 ± 1.22 mmol/L) completed the trial. MCE was associated with lower levels of maximum glycemic (median of difference [interquartile range]: (−0.9 [−1.9, 0.4], <em>P = 0.025</em>) and maximum glucose excursion from baseline (−0.9 [−1.5, −0.03], <em>P = 0.005</em>) compared to water. LHM-MCE was associated with lower levels of 1h PG (−0.7 [−1.9, 0.4], <em>P = 0.04</em>), maximum glycemic (−0.9 [−2.2, 0.4], <em>P = 0.014</em>), and maximum glucose excursion from baseline (−1.0 [−2.3, −0.4], <em>P = 0.003</em>) compared to LHM.</div></div><div><h3>Conclusions</h3><div>Mulberry leaf and corn silk extracts may benefit postprandial glycemic control and their incorporation into lactose-hydrolyzed milk could be a promising dietary intervention for patients with type 2 diabetes.</div></div><div><h3>Registration number of clinical trial</h3><div>ChiCTR2400086442.</div></div><div><h3>Website</h3><div><span><span>https://www.chictr.org.cn/showproj.html?proj=235132</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 549-554"},"PeriodicalIF":2.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788017","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 Nutritional Characteristics and Experiences of Survivors of Critical Illness After Hospital Discharge: A Multi-Method Narrative Review.","authors":"Josephine M Dudzik, Ethan K Balk, Andrea L Deierlein","doi":"10.1016/j.clnesp.2025.03.171","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.03.171","url":null,"abstract":"<p><strong>Background & aims: </strong>Many survivors of critical illness experience long-term functional, cognitive, and psychological impairments known as post-intensive care syndrome (PICS). Yet, the nutritional recovery experiences of intensive care unit (ICU) survivors after hospital discharge remain underrecognized and poorly understood. The objective of this review was to characterize nutritional indices and nutrition-related outcomes in survivors of critical illness, and to understand the nutritional recovery experience after hospital discharge.</p><p><strong>Methods: </strong>Searches were conducted for eligible quantitative and qualitative studies between June and August 2024 using PubMed, CINAHL Complete, and Scopus electronic databases. Abstracts and full texts were screened against predetermined inclusion and exclusion criteria. Primary research analyzing anthropometric, nutritional, and/or experiential data of adult survivors of critical illness after hospital discharge were included in this review.</p><p><strong>Results: </strong>21 quantitative (n=3054) and 7 qualitative (n=162) studies were included. After hospital discharge, ICU survivors seldom returned to their baseline weight with many having small to modest weight gains in the first months of recovery. Average calorie (18-33.5 calories/kilogram/day) and protein (0.96-1.6 grams/kilogram/day) intakes largely did not meet requirements needed to facilitate recovery, resulting in high rates of malnutrition, ranging from 16.8-63% 3 months after discharge. A multitude of barriers to nutritional recovery were faced in the post-discharge period resulting from persistent physical and functional limitations due to critical illness. Ongoing individualized nutrition monitoring and follow-up from dietetic professionals knowledgeable in post-ICU care has the potential to improve nutrition-related outcomes for survivors yet remains underutilized. Improving the availability and affordability of such services is a key facilitator to improve the nutritional recovery experience for ICU survivors.</p><p><strong>Conclusions: </strong>After hospital discharge, many survivors of critical illness face numerous barriers to nutritional recovery resulting in long-term nutritional complications. Future research efforts should target nutritional characterization, associations between nutritional variables and PICS, and the identification and development of effective nutrition interventions to improve long-term outcomes for survivors of critical illness after hospital discharge.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788020","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 quality of plant-based diets and liver cancer incidence and liver disease mortality in the UK Biobank","authors":"Xiaocong Dong ,&nbsp;Mingjie Zhang ,&nbsp;Jing Shu ,&nbsp;Yunshan Li ,&nbsp;Peishan Tan ,&nbsp;Tianyou Peng ,&nbsp;Jialin Lu ,&nbsp;Yaojun Zhang ,&nbsp;Xiali Zhong ,&nbsp;Aiping Fang","doi":"10.1016/j.clnesp.2025.03.166","DOIUrl":"10.1016/j.clnesp.2025.03.166","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Plant-based diets have been associated with a lower risk of various chronic diseases. However, their role in preventing liver cancer and liver-related death is currently unclear. We aimed to investigate the association between plant-based diets and the risk of liver cancer incidence and liver disease mortality in the UK Biobank.</div></div><div><h3>Methods</h3><div>We included 85,810 males and 101,971 females from the UK Biobank in our analyses. Three plant-based diet indices, including an overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI), and an unhealthful plant-based diet index (uPDI), were created based on 17 food groups using data from at least one 24-hour dietary assessments. Cox proportional hazards models were used to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>During follow-up, 109 males and 68 females developed liver cancer, and 190 males and 108 females died from liver diseases. Overall PDI scores were not associated with liver cancer incidence or liver disease mortality in either males or females. However, higher hPDI scores were linked to a lower risk of liver cancer incidence (HR_{Q5 vs. Q1}: 0.47; 95%CI: 0.26, 0.85; <em>P</em>-trend=0.005) and liver disease mortality (HR_{Q5 vs. Q1}: 0.46; 95%CI: 0.27, 0.77; <em>P</em>-trend=0.011) in males. Higher uPDI scores were associated with an increased incidence of liver cancer (HR_{Q5 vs. Q1}: 1.90; 95%CI: 1.00, 3,63; <em>P</em>-trend=0.038) and a higher risk of liver disease-related deaths (HR_{Q5 vs. Q1}: 2.21; 95%CI: 1.37, 3.57; <em>P</em>-trend &lt;0.001). However, no such associations between hPDI or uPDI and the risk of liver cancer or liver disease mortality were observed in females.</div></div><div><h3>Conclusions</h3><div>Our results suggest that higher adherence to plant-based diets, emphasizing healthful plant-based foods while restricting less healthful plant foods, may protect against liver cancer and liver disease-related deaths in males, but not in females.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788023","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}