Clinical nutrition ESPEN最新文献

{"title":"Corrigendum to \"Navigating complexity: The challenge of reaching consensus on the diagnosis of malnutrition in patients with obesity via a modified delphi study\" [Clin Nutr ESPEN 68 (2025) 591-601].","authors":"Natasha Nalucha Mwala, Jeanne J F A In 't Hulst, Barbara S van der Meij, Emmelyne Vasse, Jos W Borkent, Carliene van Dronkelaar, Patty L M Lakenman, Esmee M Reijnierse, Josje D Schoufour, Peter J M Weijs, Renate M Winkels, Maarten R Soeters, Marian A E de van der Schueren","doi":"10.1016/j.clnesp.2025.07.001","DOIUrl":"10.1016/j.clnesp.2025.07.001","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"822"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616602","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":"Provision of additional oral nutritional supplements to postgastrectomy patients based on regular diet intake to meet their energy requirements reduces body weight loss.","authors":"Hitoshi Harada, Shingo Kanaji, Moe Tsuboi, Saki Nakatani, Satoko Tabuchi, Ikuko Yamamoto, Yutaka Sugita, Taro Ikeda, Yasufumi Koterazawa, Tomoaki Aoki, Yasunori Otowa, Naoki Urakawa, Hironobu Goto, Hiroshi Hasegawa, Kimihiro Yamashita, Takeru Matsuda, Michiko Takahashi, Yoshihiro Kakeji","doi":"10.1016/j.clnesp.2025.07.015","DOIUrl":"10.1016/j.clnesp.2025.07.015","url":null,"abstract":"<p><strong>Background & aims: </strong>Oral nutritional supplements (ONS) administered after gastrectomies can prevent postoperative weight loss. However, the amount of additional energy to be added to energy requirements after gastrectomy is unclear. This study aimed to clarify dietary energy intake and its association with weight loss in postgastrectomy patients.</p><p><strong>Methods: </strong>We performed a single-center, single-arm, open-label, non-randomized clinical trial. Fifty patients with gastric cancer who underwent distal or total gastrectomy were included in this study. Until 3 months postoperatively, the patients continuously consumed ONS and their intake was recorded. Additionally, the patients took photos of their regular diets. Hospital visits were made every 2 weeks to investigate calorie intake (from regular diet plus ONS), physical findings, and nutritional status. The primary endpoint was the percentage of body weight loss (%BWL) at 3 months after gastrectomy.</p><p><strong>Results: </strong>Data were available for 45 patients. %BWL was 7.5 ± 5.1 % at 3 months postoperatively. The group with ONS intake <200 kcal/day tended to show a lower %BWL; however, this was not significant. No correlation was observed between ONS and regular dietary calorie intake. The required calorie intake was 1588 ± 157 kcal/day. Calorie intake from regular diet alone and from regular diet plus ONS were 1330 ± 280 and 1487 ± 300 kcal/day, respectively. The sufficient group, whose total calorie intake met the requirements, had significantly reduced body weight loss, compared with the insufficient group.</p><p><strong>Conclusions: </strong>After gastrectomy, regular diet alone often fails to meet nutritional requirements, and ONS supplementation may reduce %BWL at 3 months postoperatively by correcting energy deficits. This study was registered with the University Hospital Medical Information Network Clinical Trial Registry (UMIN-CTR; UMIN000047451; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000054111).</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"449-457"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616606","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 Reference Intervals for Essential and Toxic Trace Elements in a Healthy Population: A Basis for Nutritional Monitoring and Clinical Intervention.","authors":"Inés Rivas, Marta Miranda, Carlos Herrero-Latorre, Rafael Monte-Secades, Marta López-Alonso","doi":"10.1016/j.clnesp.2025.09.031","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.09.031","url":null,"abstract":"<p><strong>Background & aims: </strong>Trace elements play a crucial role in human metabolism, and both deficiencies and toxic exposures can have significant clinical implications. This study aimed to establish clinically relevant reference intervals for essential and toxic trace elements in serum from a healthy adult population to support nutritional assessment and public health monitoring.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in 501 healthy adults. Serum concentrations of essential [cobalt (Co), copper (Cu), iron (Fe), iodine (I), manganese (Mn), molybdenum (Mo), selenium (Se), zinc (Zn)] and toxic [(arsenic (As), cadmium (Cd), chromium (Cr), lead (Pb), mercury (Hg), nickel (Ni)] trace elements were measured using inductively coupled plasma mass spectrometry (ICP-MS). Reference intervals (2.5th-97.5th percentiles) were calculated following CLSI guidelines, and stratified analyses were performed based on sex and age.</p><p><strong>Results: </strong>Reference intervals were established for each element, revealing significant sex-related differences. Women exhibited higher serum concentrations of Co, Cu, Mo, Cd, and Hg, and lower Fe compared to men. Age-related differences were also observed for several elements, with distinct sex-specific trends particularly for Cu and Hg. While serum levels of most essential elements were within expected physiological ranges, Se concentrations were suboptimal in a considerable proportion of the population, suggesting potential nutritional inadequacy. Toxic element levels remained generally low, indicative of minimal environmental exposure CONCLUSIONS: Essential trace element concentrations were generally adequate within the Northern Spain population, with the notable exception of Se, where a significant proportion exhibits low levels, suggesting a potential benefit from dietary supplementation or intervention. Toxic element concentrations were low corresponding to a basal level of environmental exposure; however, observed variations by age and sex highlight the importance of ongoing monitoring.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225204","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":"Corrigendum to \"Examining commonalities and differences in food groups, nutrients, and diet quality among popular diets\" [Clin Nutr ESPEN 41 (2021) 377-385].","authors":"Gabrielle Turner-McGrievy, Michael D Wirth, Kathleen L Hill, Emma R Dear, James R Hébert","doi":"10.1016/j.clnesp.2025.06.032","DOIUrl":"10.1016/j.clnesp.2025.06.032","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"821"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674012","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":"Survival predictions of different arm circumference classifications in patients under intensive care.","authors":"Jorge Z Silva-Filho, Jarson P Costa-Pereira, Ivan K S Zapanta, Evi C L Brasil, Rodrigo L S Silva, Flávia M Silva","doi":"10.1016/j.clnesp.2025.07.1131","DOIUrl":"10.1016/j.clnesp.2025.07.1131","url":null,"abstract":"<p><strong>Background & aims: </strong>Mid-upper arm circumference (MUAC) is a simple anthropometric measure widely used as a marker of nutritional reserves, in the context of critical illness and other clinical conditions. Although MUAC can be classified using different approaches, few studies have investigated the prognostic value of these classifications in critically ill patients. In this study, we aimed to evaluate the ability of different MUAC classifications approaches to predict survival among patients admitted to the intensive care unit (ICU).</p><p><strong>Methods: </strong>This was a secondary analysis of a cohort study with prospective data collection. Adults of all ages admitted to a general ICU were included. MUAC was measured upon ICU admission and classified using four different approaches: two continuous and two categorical. Continuous measures included (1) absolute MUAC in centimeters (MUAC_cm) and (2) MUAC adequacy percentage (MUAC%), calculated using the 50th percentiles from Frisancho. Categorical classifications were (3) MUAC% based on Blackburn & Thornton criteria, categorized as low (<90 %), adequate (90-110 %), and excess (>110 %), and (4) using the Malnutrition Universal Screening Tool (MUST) cutoff, with low MUAC defined as <23.5 cm. Outcomes of interest were 28-day ICU mortality and in-hospital mortality.</p><p><strong>Results: </strong>A total of 426 patients were included (53.1 % male, median age: 64 years, interquartile range: 53 to 71). Metabolic disorders were the most common cause of ICU admission (49.5 %). Cox regression analysis using continuous variables showed that for each 1 cm decrease in MUAC, the risk of ICU mortality increased by 11 % (HR _adjusted 1.11, 95 % CI 1.01 to 1.20). Furthermore, for each 1 % decrease in MUAC, the risk of ICU mortality increased by 4 % (HR _adjusted 1.04, 95 % CI 1.01 to 1.06). Low MUAC according to the MUST classification was associated with a 3.73-fold increase in the hazard of 28-day ICU mortality and a 2.70-fold increase in the hazard of in-hospital mortality. No significant associations were observed using the Blackburn & Thornton classification.</p><p><strong>Conclusion: </strong>As a continuous variable, MUAC was an independent predictor of 28-day ICU mortality, but not of in-hospital mortality. In contrast, low MUAC classified according to the MUST criterion independently predicted both 28-day ICU and in-hospital mortality. No significant associations were observed using the Blackburn & Thornton classification. These findings highlight the prognostic utility of a simple anthropometric measure; however, they also suggest that different classification methods may yield distinct prognostic implications.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"428-434"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774783","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":"Assessing energy expenditure: Accuracy of predictive equations versus indirect calorimetry in older hospitalized patients at the medical ward.","authors":"Anne Wilkens Knudsen, Sofie Nunez Engelsted, Cecilia Margareta Lund, Cecilie Meldgaard Møller, Charlotte Suetta, Henrik Højgaard Rasmussen, Tina Munk","doi":"10.1016/j.clnesp.2025.07.1118","DOIUrl":"10.1016/j.clnesp.2025.07.1118","url":null,"abstract":"<p><strong>Background & aims: </strong>Indirect calorimetry (IC) is considered the gold standard to measure Resting Energy Expenditure (REE) in clinical practice. However, this method is more time-consuming than using estimates. Therefore, this study aimed to determine 1) the accuracy between estimated and measured energy requirement and 2) if certain patient characteristics were associated with discrepancies between measured and estimated energy requirement.</p><p><strong>Methods: </strong>The patient's measured REE was assessed with IC. To determine Total Energy Expenditure (TEE), an individual level of activity was applied. The measured REE and TEE were compared with the Harris-Benedict (H-B) equation and measured TEE with two weight-based formulas. A variation of ±10 % was regarded as an acceptable value of variation. To explore whether specific variables were related to differences between measurements and estimates, the following variables were recorded: age, Body Mass Index (BMI), body temperature, heart rate, Mean Arterial Pressure (MAP), respiratory rate, p-C-Reactive Protein (p-CRP), B-Leucocytes, and p-Albumin.</p><p><strong>Results: </strong>We included 110 patients (58 % women), mean age 81.5 (±7.6) years. The H-B equation most accurately predicted REE for n = 56 (51 %) and TEE for n = 57 (52 %). The H-B equation tended to underestimate REE n = 35 (32 %) rather than overestimate n = 18 (16 %). Underestimation by the H-B equation was significantly (p < 0.05) associated with having higher p-CRP, heart rate, body temperature, and B-Leucocytes. Including these variables with a significant association in a multiple linear regression model revealed that only 17 % (r² = 0.170) of the variation could be explained by these variables.</p><p><strong>Conclusion: </strong>The H-B equation was most accurate at predicting energy expenditure, however, only in alignment with IC measurements in about half of the patients. Several infectious markers were associated with an increase in REE compared with estimated by the H-B equation.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"458-467"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752594","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":"Addressing nutritional risk and dehydration in vulnerable older adults in the emergency department: A single-arm feasibility study on detection, treatment, and follow-up.","authors":"Martine Kjærsgaard Nielsen, Emma Dalbæk Mejlvang Pedersen, Anne Wilkens Knudsen, Tina Munk, Anne Marie Beck","doi":"10.1016/j.clnesp.2025.07.1125","DOIUrl":"10.1016/j.clnesp.2025.07.1125","url":null,"abstract":"<p><strong>Background and aim: </strong>Dehydration and malnutrition are highly prevalent among older adults in the emergency department (ED). To date, there is no evidence regarding targeted nutrition and hydration interventions initiated directly in the ED setting. The primary aim of the study was to assess the feasibility of such an intervention, defined in terms of eligibility, recruitment rate, retention, representativeness, compliance to and effect of the intervention, and completeness of outcome data collection. This information will help establish the parameters required to design an eventual future definitive randomized controlled trial (RCT).</p><p><strong>Methods: </strong>The study was a feasibility study conducted at the ED and in cooperation with four municipalities. Older patients at nutritional risk (defined by a nutritional risk score of minimum 3 according to NRS 2002) and/or dehydrated (p-osmolarity >295 mmol/L) were provided with individual dietary counselling initiated in the emergency department and followed-up by a dietitian or other health care professionals in the municipalities. Data were collected on eligibility, recruitment, and retention of the older participants and completeness of data collection. Compliance was assessed as change in intake of energy, protein and fluids, self-efficacy, quality of life, prevalence of readmissions, and mortality within 30 days.</p><p><strong>Results: </strong>Of those 326 screened for the study, 314 (96%) were eligible due to either dehydration or nutritional risk. It was possible to recruit more than half (58%) of those invited to participate and the retention rate was high (90%). Completeness of data collection was above 80% for most of those assessed. There was an increase in intake of energy (p = 0.0012), protein (p = 0.0002), and fluid (p = 0.0040), quality of life (p = 0.0007), and self-efficacy (p = 0.0498). The prevalence of readmissions was 19%, and 7% had died.</p><p><strong>Conclusion: </strong>The detection, treatment and follow-up of nutritional risk and dehydration in vulnerable older patients in the ED was proven to be feasible in relation to eligibility, recruitment, and retention. Further, most of the chosen outcomes had a high rate of completeness and hence may be relevant parameters to include in an eventual future RCT. The explorative nature of the study limits firm conclusions; however, the positive findings support the initiation of a definitive RCT.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"468-476"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764683","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":"Reliability and validity of an adherence score sheet to monitor adherence of patients with diabetes to personalised nutrition education.","authors":"Hildegard Strydom, Jane Muchiri, Elizabeth Delport, Zelda White","doi":"10.1016/j.clnesp.2025.07.1128","DOIUrl":"10.1016/j.clnesp.2025.07.1128","url":null,"abstract":"<p><strong>Background: </strong>Dietary management of diabetes relies on the patient's ability to adhere to the nutrition guidelines presented to them by a health care professional. Traditional analysis of dietary intake to monitor adherence can be tedious, and there is a need for a short, easy-to-use tool to measure dietary adherence from food records. This study aimed to determine the reliability and validity of an Adherence Score Sheet (ASS) developed to quantify dietary adherence to personalised nutrition education.</p><p><strong>Methodology: </strong>67 three-day food records of patients with diabetes who received nutrition education were scored using the ASS Adherence scores were given for adhering to glycemic index (GI), glycemic load (GL), protein and fat guidelines, and a total adherence score. Intraclass correlation (ICC) and Bland-Altman plots were used to demonstrate the amount of agreement between ASS from two independent raters (inter-rater reliability) and ASS score from Rater 1 [test method] vs ASS obtained from dietary analysis (DA) program [reference method] for the assessment of concurrent validity.</p><p><strong>Results: </strong>ICC values for the total adherence score showed good agreement (ICC = 0.74) between raters, with subcategories agreement being fair to excellent (ICC ranging from 0.56 to 0.81). The Bland-Altman plots for all 5 categories (GI, GL, protein, fat, and total score) indicated acceptable agreement between Rater 1 and Rater 2. ICC values for all categories indicated excellent validity between Rater 1 and the DA scores. The Bland-Altman plots for validity indicated overall acceptable agreement between Rater 1 and DA for all 5 categories.</p><p><strong>Conclusion: </strong>Our findings reveal that the ASS is a reliable and valid tool to determine and quantify adherence to personalised nutrition education among patients with diabetes.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"442-448"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774782","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":"Comparing indirect calorimetry and predictive equations for energy expenditure - 1 year follow-up of adult hematopoietic stem cell transplanted recipients.","authors":"Anne Marte Gudmundstuen, Per Ole Iversen, Maiju Pesonen, Marianne J Hjermstad, Asta Bye, Geir E Tjønnfjord, Kristin J Skaarud","doi":"10.1016/j.clnesp.2025.09.027","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.09.027","url":null,"abstract":"<p><strong>Background and aims: </strong>Recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT) often undergo body composition changes that may impact their energy expenditure (EE), however, the accurate energy requirements may be difficult to estimate. Indirect calorimetry (IC) is recommended as the gold standard to assess measured energy expenditure (mEE), but its use is resource-demanding and thus rarely applied compared to predictive energy equations. Here we evaluated the agreement between mEE by IC and EE estimated by several predictive energy equations, or the ESPEN recommendation, during 1-year follow-up of adult allo-HSCT recipients.</p><p><strong>Methods: </strong>We examined 117 adult patients with hematological malignancies who received allo-HSCT. mEE was assessed by IC in non-fasting patients before transplantation, and at 3, 6, 9 and 12 months post-allo-HSCT. Agreement between mEE and predictive values using the Harris-Benedict-HB, Mifflin St. Jeor-MSJ, Ireton Jones-IJ equations and the fixed ESPEN recommendation of 25 kcal/kg/day was evaluated using Bland-Altman analysis and accuracy within ± 10%. Changes in mEE over time were analyzed using linear mixed model with age as a covariate.</p><p><strong>Results: </strong>A total of 509 mEE measurements by IC were obtained. HB and MSJ overestimated mEE on average (mean bias: + 2.9 and + 3.8 kcal/kg/day), while IJ, and the fixed ESPEN recommendation underestimated mEE (biases: - 0.7 and - 4.7 kcal/kg/day, respectively). None of the equations or the fixed ESPEN recommendation achieved > 50% accuracy within ± 10% of mEE by IC. IJ had the highest variability and widest limits of agreement. mEE changed significantly over time (p < 0.001), with no significant differences between the initially randomized intervention and control group (p = 0.982). Mean mREE was 24.74 ± 3.80 kcal/kg/day and 31.14 ± 4.91 kcal/kg/day when adjusted for FFM. Age was not significantly associated with mREE (p = 0.198).</p><p><strong>Conclusion: </strong>Our findings indicate that commonly used predictive equations and the fixed ESPEN recommendation showed limited accuracy compared with mEE in allo-HSCT recipients. Only mEE obtained by IC captured longitudinal changes in EE during the first year post-transplantation. mEE by IC varied significantly the first year post-transplant.</p><p><strong>Clinicaltrials: </strong>gov, ID NCT01181076.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211840","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":"Segmental Validation of the 50-kHz Phase Angle as a Valid, Practical Proxy That Closely Approximates the Characteristic-Frequency Phase Angle and Associations With Muscle Function and Body Water: A Cross-Sectional Study.","authors":"Yujiro Asano, Tsukasa Yoshida, Kenji Tsunoda, Keiichi Yokoyama, Yuya Watanabe, Yasuko Yoshinaka, Tomohiro Okura, Misaka Kimura, Yosuke Yamada","doi":"10.1016/j.clnesp.2025.09.030","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.09.030","url":null,"abstract":"<p><strong>Background & aims: </strong>Although phase angle at 50 kHz (PhA50) is widely used, its validity relative to the theoretically correct characteristic-frequency PhA (PhAcf) remains unclear. This study evaluated the validity of the PhA50 by comparing it with the PhAcf and examining its associations with body composition, muscle strength, and physical function.</p><p><strong>Methods: </strong>This cross-sectional study included 1,266 community-dwelling older adults. Bioimpedance spectroscopy (BIS) was used to assess whole-body, thigh, and arm impedance parameters. PhAcf, PhA50, membrane capacitance (Cm), extracellular water (ECW), intracellular water (ICW), total body water (TBW), and ECW/ICW ratio were derived. Muscle strength (grip strength and knee extension) and physical function (Timed Up-and-Go test, 6-meter walk, 5-times chair stand, and vertical jump) were assessed.</p><p><strong>Results: </strong>Characteristic frequency was positively associated with age, whereas PhA50 and PhAcf were negatively associated with age. PhA50 was strongly correlated with PhAcf and ECW/ICW (|r|>0.90), with Cm (|r|>0.70), and with ICW and TBW (|r|>0.40) across segments in both sexes. Both PhA50 and PhAcf were significantly associated with muscle strength and physical function, with no significant differences in the correlation coefficients between the two PhA measures. Thigh PhA (both PhA50 and PhAcf) showed significantly stronger correlations with lower extremity muscle strength and performance than arm PhA.</p><p><strong>Conclusions: </strong>The commonly used PhA50 closely approximates PhAcf and ECW/ICW and reflects Cm, ICW, and TBW. It tracks muscle strength and physical function with similarity to the theoretically optimal yet harder-to-measure PhAcf. These findings support PhA50 as a practical index for clinical nutrition research and potential healthcare screening.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211830","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}