Clinical nutrition ESPEN最新文献

{"title":"Relationship between longitudinal changes in calf circumference and skeletal muscle mass.","authors":"Ryoko Kawakami, Kumpei Tanisawa, Nobuhiro Nakamura, Tomoko Ito, Chiyoko Usui, Yumiko Inoue, Yiwen Chen, Daiki Watanabe, Motohiko Miyachi, Suguru Torii, Taishi Midorikawa, Kaori Ishii, Katsuhiko Suzuki, Shizuo Sakamoto, Mitsuru Higuchi, Koichiro Oka","doi":"10.1016/j.clnesp.2025.05.044","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.05.044","url":null,"abstract":"<p><strong>Background & aims: </strong>Calf circumference serves as a surrogate marker of skeletal muscle mass. However, its ability to reflect changes in skeletal muscle mass remains unclear. This longitudinal study aimed to assess the relationship between changes in calf circumference and appendicular skeletal muscle mass (ASM) and to explore the effects of age and obesity.</p><p><strong>Methods: </strong>The two-wave cohort data of 227 adults aged 40-87 years were analyzed. The maximum calf circumference was measured in a standing position, whereas body composition, including ASM, was measured using dual-energy X-ray absorptiometry. Pearson's correlation coefficient was calculated to assess this relationship.</p><p><strong>Results: </strong>The mean follow-up period was 8.0 ± 0.4 years. The mean changes in calf circumference and ASM (follow-up - baseline value) were -0.1 ± 1.2 cm and -0.7 ± 1.0 kg, respectively. Changes in calf circumference and ASM showed a positive correlation in men and women (r = 0.71 and 0.71, respectively). A 1.0 cm reduction in calf circumference corresponded to a 1.4 and 0.9 kg reduction in ASM for men and women, respectively. As in the primary analysis, subgroup analysis based on age and obesity exhibited similar positive correlations between changes in calf circumference and ASM (r = 0.70, 0.67, 0.69, and 0.72 for middle-aged, older, non-obese, and obese adults, respectively).</p><p><strong>Conclusions: </strong>Longitudinal changes in calf circumference were positively correlated with those in ASM, regardless of age and obesity status. As such, changes in calf circumference could serve as a reliable indicator of variations in skeletal muscle mass.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186719","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":"Unlocking the Fat Factor: How Adiposity Shapes Survival in Colorectal Cancer--A Comprehensive Meta-Analysis.","authors":"Chun Gao, Min Chen, Yi Xin Tong, Li Zhu, Sheng Zhang","doi":"10.1016/j.clnesp.2025.05.038","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.05.038","url":null,"abstract":"<p><strong>Background: </strong>Adipose tissue distribution has been increasingly recognized for its potential impact on clinical outcomes in colorectal cancer (CRC) patients. This study systematically reviews and analyzes the relationship between visceral and subcutaneous adiposity and patient survival outcomes in CRC.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across multiple databases including MEDLINE, PubMed, Google Scholar, Embase, Cochrane Library, and Web of Science, covering publications up to October 2024. Studies were selected based on their examination of the association between adiposity metrics (visceral adipose tissue [VAT], subcutaneous adipose tissue [SAT], VAT/SAT ratio) and overall survival (OS) or disease-free survival (DFS) in CRC patients. Outcomes were measured using hazard ratios (HRs) derived from univariate or multivariate analyses. Meta-analyses were performed using RevMan, pooling hazard ratios with 95% confidence intervals (CIs) using both fixed and random-effects models.</p><p><strong>Results: </strong>A total of 22 studies encompassing 11,954 CRC patients were included in the analysis. The meta-analysis indicated that higher levels of SAT were significantly associated with longer OS (HR: 0.77, p < 0.05) and DFS (HR: 0.61, p < 0.05). In contrast, VAT showed no significant correlation with OS or DFS. No publication bias was detected in the correlation between VAT/SAT and survival outcomes.</p><p><strong>Conclusions: </strong>The findings suggest that elevated subcutaneous adiposity is linked to improved OS and DFS in colorectal cancer patients. These insights highlight the prognostic significance of SAT over VAT in CRC. Further large-scale studies are warranted to corroborate these results and explore the underlying mechanisms.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186721","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":"Decline in the phase angle of older patients before cardiovascular surgery prolongs the postoperative walk acquisition time: a retrospective, observational, single-center study.","authors":"Hiroyuki Takahashi, Junichi Yokota, Masanori Kanazawa, Seisho Takahashi, Takahiro Seki, Hitoshi Kudo, Hiroshi Honjo, Hideaki Endo, Katsuhiko Oda, Yoshiki Sakurada, Eiki Tsushima","doi":"10.1016/j.clnesp.2025.05.042","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.05.042","url":null,"abstract":"<p><strong>Background: </strong>Prolonged postoperative inactivity after cardiovascular surgery is associated with a decline in functional capacity. Early cardiac rehabilitation (CR) is vital for older patients with frailty and sarcopenia. The phase angle (PhA), a marker of skeletal muscle quality measured by bioelectrical impedance analysis (BIA), is associated with physical performance and long-term outcomes; however, its relationship with postoperative rehabilitation progress remains unclear.</p><p><strong>Objectives: </strong>This study investigated the relationship between preoperative PhA and 100-m walking acquisition in older patients.</p><p><strong>Methods: </strong>A retrospective, observational, single-center study was conducted on patients aged ≥ 65 years who underwent elective cardiovascular surgery. The primary outcome was days from surgery to 100-m walking acquisition. Kaplan-Meier survival curves and Cox proportional hazards regression analyses were used to evaluate the relationship between PhA and outcomes.</p><p><strong>Results: </strong>Among 97 patients, the median PhA was 4.9°, dividing them into Low-PhA (< 4.9°, n = 48) and High-PhA (PhA≥ 4.9°, n = 49) groups. The Low-PhA group required significantly more days for 100-m walking acquisition and had lower 100-m walking acquisition rates (log-rank P < 0.001). Cox regression analysis identified preoperative PhA as an independent factor associated with 100-m walking acquisition (HR, 1.519; 95% CI: 1.078-2.140, P = 0.017).</p><p><strong>Conclusions: </strong>A lower preoperative PhA is associated with delayed 100-m walking acquisition in older patients undergoing cardiovascular surgery.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186707","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":"An interdisciplinary intervention improves lifestyle behaviours in women living with obesity and subfertility: a secondary analysis of a randomized controlled trial.","authors":"Audrey St-Laurent, Matea Belan, Farrah Jean-Denis, Marie-France Langlois, Marie-Hélène Pesant, Belina Carranza-Mamane, Karine Duval, Anne-Sophie Morisset, Jean-Patrice Baillargeon","doi":"10.1016/j.clnesp.2025.05.036","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.05.036","url":null,"abstract":"<p><strong>Background & aims: </strong>There are few effective interdisciplinary lifestyle programs aiming to support women with obesity who are seeking fertility treatments. This study aims to determine whether the Obesity-Fertility lifestyle program leads to healthier lifestyle behaviours in women with obesity and subfertility compared to controls.</p><p><strong>Methods: </strong>This is a secondary analysis of an open-label randomized controlled trial whose primary outcome was live birth rate. Women with obesity and subfertility were randomized to the lifestyle (LSG=65) or control (CG=65) groups. The LSG participated in individual and group sessions with a dietitian and a kinesiologist, while the CG received the usual care of the fertility clinic. Data on food consumption, physical activity, sedentary time, and smoking and alcohol use were collected before and 6 months after the intervention. Functional capacity was evaluated with a 6-minute walk test (6MWT). Changes in lifestyle after 6 months were compared between groups with p-values corrected for the outcome baseline data.</p><p><strong>Results: </strong>From January 2012 to September 2016, 130 women were randomized, 85 of whom had data available at 6±1 months (LSG=42 and CG=43). Groups had similar sociodemographic characteristics and lifestyle behaviours at baseline, except for lower prevalence of smoking in LSG (9.5%) vs CG (34.9%) (p=0.005). After 6 months of follow-up, and compared to the CG, women in the LSG significantly improved their intake of whole fruits (+1.1±1.2 vs +0.4±0.8/day, p=0.001), whole grain products (+1.0±1.3 vs +0.04±1.2/day, p<0.001), dairy products (+0.4[0; 0.9] vs -0.1[-0.7; 0.3]/day, p<0.001); breakfast frequency (+1.4±2.6 vs +0.5±1.8/week, p<0.001); proportion of active women (>3 kcal/kg/day: +14.2% vs +2.3%, p=0.003); and time spent in sedentary behaviour (-6.7 vs -0.1h/week, p<0.005). Distance covered during the 6MWT tended to increase more in LSG vs CG (+28.8±42.1 vs +5.5±42.6 metres, p=0.06). No significant difference was found between groups for sleep duration, alcohol consumption and smoking use.</p><p><strong>Conclusion: </strong>After 6 months, the Obesity-Fertility program significantly improved diet quality, physical activity level and sedentary behaviour in women with obesity and subfertility. Such programs can therefore support these women to adopt healthier lifestyle behaviours.</p><p><strong>Clinicaltrials: </strong></p><p><strong>Gov registration number: </strong>NCT01483612.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186706","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 energy-dense oral nutritional supplements on compliance with nutritional support after surgical treatment for gastric cancer: A multicenter phase II study.","authors":"Hiroshi Ichikawa, Masaki Aizawa, Yosuke Kano, Yusuke Muneoka, Takeo Bamba, Sou Hiroi, Hiroto Ueki, Kazuki Moro, Yuki Hirose, Yoshifumi Shimada, Jun Sakata, Hiroshi Yabusaki, Satoru Nakagawa, Yu Koyama, Toshifumi Wakai","doi":"10.1016/j.clnesp.2025.05.041","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.05.041","url":null,"abstract":"<p><strong>Background & aims: </strong>Maintaining compliance with oral nutritional supplements (ONS) is a major problem in patients receiving nutritional support after surgical treatment for gastric cancer. The objective of this multicenter, single-arm phase II study was to test whether nutritional support with energy-dense ONS (1.6 kcal/mL) provides an average caloric intake of 200 kcal/day or more for a greater proportion of patients than that reported in previous studies.</p><p><strong>Methods: </strong>Patients who underwent curative gastrectomy for gastric cancer were enrolled and received nutritional support with energy-dense ONS. ONS was initiated within three days after the start of the postoperative oral diet and continued until three months after surgery. The primary endpoint was the achievement rate (AR), which was defined as the proportion of patients who were able to achieve an average caloric intake of 200 kcal/day or more in nutritional support.</p><p><strong>Results: </strong>Among 45 eligible patients who received nutritional support, 30 were able to achieve an average caloric intake of 200 kcal/day or more, and the AR was 66.7% (95% confidence interval, 53%-100%), which significantly differed from the threshold of 50% (P = 0.018). Grade 3 hypertriglyceridemia and grade 2 diarrhea were observed in one patient each. There were no significant differences in the percentage of body weight (BW) or the skeletal muscle index (SMI) between patients who consumed 200 kcal/day or more and those who consumed less than 200 kcal/day at three and 12 months after surgery.</p><p><strong>Conclusions: </strong>Nutritional support with energy-dense ONS provides an average caloric intake of 200 kcal/day or more in a high proportion of patients after surgical treatment for gastric cancer without causing severe adverse events. However, the significant suppressive effect of energy-dense ONS on BW and SMI loss is not demonstrated. (UMIN-CTR, https://www.umin.ac.jp/ctr/index.htm, study unique identifier: UMIN000045645).</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186709","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 Effect of a Digital Energy- and Protein-Dense Food Concept with a Nutritional Tracker on Dietary Intake in Hospitalized Patients at Nutritional Risk - A one-day Cross-Sectional Study.","authors":"Tina Munk, Signe Frederikke Holmsted, Anne Marie Beck, Lise Laursen, Henrik Højgaard Rasmussen, Anne Wilkens Knudsen","doi":"10.1016/j.clnesp.2025.05.037","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.05.037","url":null,"abstract":"<p><strong>Background & aims: </strong>A one-day cross-sectional study conducted at our hospital in 2019 found low achieved intake of energy and protein requirement among nutritional at-risk patients. Since then, a new energy and protein-dense digital food concept with a nutritional tracker to actively involve patients in their nutrition has been introduced. This study aimed to assess improvements in energy and protein intake, evaluate the performance of nutritional risk screening and documentation, examine hospital length of stay (LOS), prevalence of malnutrition, and rates of mortality and readmission.</p><p><strong>Methods: </strong>A one-day cross-sectional study was performed in September 2023. Patients >18 years and hospitalized for >4 days were enrolled.</p><p><strong>Exclusion criteria: </strong>admission to the intensive, palliative, emergency, or maternal ward. Patients identified as at nutritional risk by the Nutritional Risk Screening tool (NRS-2002) underwent a 24-hour dietary recall to evaluate their nutritional intake and adequacy. Malnutrition was assessed using the criteria of Global Leadership Initiative on Malnutrition (GLIM). Additional data were collected from the electronic medical records.</p><p><strong>Results: </strong>Out of 124 patients (52% female) with a median age of 75 years (Interquartile Range (IQR): 66-83), 81 (65%) were at nutrition risk. Dietary intake was assessed for 69 at-risk patients. Compared to 2019, more patients met 75% of their energy (70% vs. 35%, p < 0.001) and protein (51% vs. 24%, p < 0.001) requirements. Energy and protein intake was documented for 42% of patients but was inaccurate documented. Only 25% were nutritionally screened within 24 hours of admission. Among at-risk patients, 74% (n=58) were diagnosed with malnutrition. LOS was 13 days (IQR: 9-21), with readmission and mortality rates of 39% and 22%, respectively. No significant difference in LOS, readmission and mortality was found between nutritional at-risk and not at-risk patients.</p><p><strong>Conclusions: </strong>The study indicated that actively involving nutritional at-risk patients in their own nutrition effectively increased energy and protein intake. The study revealed significant gaps in nutritional documentation and a high prevalence of malnutrition according to the GLIM criteria.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186720","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":"Fibrous Sheath Technique for Exchanging Tunneled Central Venous Catheters in Intestinal Failure Patients.","authors":"Naoki Hashizume, Akihiro Fujino, Kotaro Tomonaga, Genta Ozeki, Takeshi Saito, Michimasa Fujiogi, Motohiro Kano, Yuki Yamamoto, Tetsuya Ishimaru, Akihiro Yoneda, Yutaka Kanamori","doi":"10.1016/j.clnesp.2025.05.040","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.05.040","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with intestinal failure (IF) are dependent on tunneled central venous catheters (CVC) to provide parenteral nutrition. A method using a fibrous sheath (FS) was developed to preserve the central venous routes while exchanging CVC. We focused on the reduction of punctured catheter insertions for the FS method.</p><p><strong>Methods: </strong>Patients with IF were divided into two groups. The n-FS group was comprised of patients who underwent primary insertion CVC only for the exchange CVC. The FS group was comprised of patients treated using the FS method. Patients diagnosed with CRBSI without septic shock received ethanol lock therapy. Outcomes included CVC durability days during the catheter insertion and primary punctured catheter insertion.</p><p><strong>Results: </strong>Twenty patients with IF were treated. Seven patients were classified into the n-FS group and 13 patients were in FS group. Total number of CVC replacements of n-FS group and FS group were 27 and 43. Eighteen CVC replacements were used by FS method. The overall FS success rate was 100%. The CVC replacements per 1000 days was not significantly different between the two groups. The primary punctured catheter insertion was significantly lower in FS group compared with in n-FS group.</p><p><strong>Conclusion: </strong>Our results suggest that the FS method reduces primary punctured catheter insertion.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186708","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":"Machine-learning modeL based on computed tomography body composition analysis for the estimation of resting energy expenditure: A pilot study.","authors":"Fiorella Palmas, Andreea Ciudin, Jose Melian, Raul Guerra, Alba Zabalegui, Guillermo Cárdenas, Fernanda Mucarzel, Aitor Rodriguez, Nuria Roson, Rosa Burgos, Cristina Hernández, Rafael Simó","doi":"10.1016/j.clnesp.2025.05.031","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.05.031","url":null,"abstract":"<p><strong>Background & aims: </strong>The assessment of resting energy expenditure (REE) is a challenging task with the current existing methods. The reference method, indirect calorimetry (IC), is not widely available, and other surrogates, such as equations and bioimpedance (BIA) show poor agreement with IC. Body composition (BC), in particular muscle mass, plays an important role in REE. In recent years, computed tomography (CT) has emerged as a reliable tool for BC assessment, but its usefulness for the REE evaluation has not been examined. In the present study we have explored the usefulness of CT-scan imaging to assess the REE using AI machine-learning models.</p><p><strong>Methods: </strong>Single-centre observational cross-sectional pilot study from January to June 2022, including 90 fasting, clinically stable adults (≥18 years) with no contraindications for indirect calorimetry (IC), bioimpedance (BIA), or abdominal CT-scan. REE was measured using classical predictive equations, IC, BIA and skeletal CT-scan. The proposed model was based on a second-order linear regression with different input parameters, and the output corresponds to the estimated REE. The model was trained and tested using a cross-validation one-vs-all strategy including subjects with different characteristics.</p><p><strong>Results: </strong>Data from 90 subjects were included in the final analysis. Bland-Altman plots showed that the CT-based estimation model had a mean bias of 0 kcal/day (LoA: -508.4 to 508.4) compared with IC, indicating better agreement than most predictive equations and similar agreement to BIA (bias 53.4 kcal/day, LoA: -475.7 to 582.4). Surprisingly, gender and BMI, ones of the mains variables included in all the BIA algorithms and mathematical equations were not relevant variables for REE calculated by means of AI coupled to skeletal CT scan. These findings were consistent with the results of other performance metrics, including mean absolute error (MAE), root mean square error (RMSE), and Lin's concordance correlation coefficient (CCC), which also favored the CT-based method over conventional equations.</p><p><strong>Conclusions: </strong>Our results suggest that the analysis of a CT-scan image by means of machine learning model is a reliable tool for the REE estimation. These findings have the potential to significantly change the paradigm and guidelines for nutritional assessment.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172616","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":"Low Muscle Mass in Intestinal Transplant Recipients: Prevalence, Outcomes, and Longitudinal Analysis of Body Composition.","authors":"Julie Varkey, Kirsten Mehlig, Antal Bajor, Shilla Khalil, Mihai Oltean, Markus Gäbel, William Bennet, Jonas Varkey","doi":"10.1016/j.clnesp.2025.05.035","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.05.035","url":null,"abstract":"<p><strong>Background: </strong>Intestinal transplantation (ITX) is a life-saving treatment for patients with irreversible intestinal failure. While short-term survival has improved, long-term outcomes remain challenging, and the role of Low Muscle Mass (LMM) in influencing post-transplant outcomes is unclear. This study investigates the prevalence and impact of LMM on long-term survival in adults who underwent ITX, while also examining the longitudinal changes in body composition following transplantation.</p><p><strong>Methods: </strong>This retrospective study included 26 adult patients who underwent ITX from February 2000 to August 2023. Body composition was assessed using Dual-Energy X-ray Absorptiometry (DEXA) scans, focusing on appendicular skeletal muscle mass index (ASMI) as an indicator of LMM. Longitudinal changes in ASMI, body fat percentage, body mass index (BMI), and bone mineral density (BMD) were analyzed using mixed linear regression models. Survival analysis was conducted using Kaplan-Meier curves and Cox proportional hazards regression.</p><p><strong>Results: </strong>Pre-transplant LMM was prevalent in 58% of patients. Patients with LMM were younger (34 years vs. 49 years, p=0.001), with lower BMI (18.8 vs. 23.4, p=0.003) and ASMI (5.1 vs. 6.8, p=0.0003). Over up to 10 years of follow-up, average ASMI change was 0.02 kg/m²/year (-0.06, 0.10), showing positive time trends in patients younger than 40 years and negative trends in older patients (interaction p=0.04). A similar age dependence was seen for BMD (interaction p=0.01). ASMI, BMI, and fat percentage increased from pre-TX to the most recent follow-up, but these changes were not significantly different from zero. Additionally, 5-year mortality and overall survival rates did not significantly differ by pre-TX LMM status.</p><p><strong>Conclusion: </strong>Pre-TX LMM is common in ITX patients but does not significantly impact long-term survival or body composition post-transplant. Thus, LMM alone may not be a contraindication for ITX, and muscle mass remained relatively stable over the follow-up period.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149601","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":"Protein and total sugars intake modulate the rs9939609 single nucleotide polymorphism effect at the fat mass and obesity-associated gene on body composition","authors":"Luciana Olmedo ,&nbsp;Fernando Javier Luna ,&nbsp;Hernán Dopazo ,&nbsp;Magalí Pellon-Maison","doi":"10.1016/j.clnesp.2025.05.032","DOIUrl":"10.1016/j.clnesp.2025.05.032","url":null,"abstract":"<div><h3>Background and aims</h3><div>The A allele of the rs9939609 single nucleotide polymorphism (SNP) at the fat mass and obesity-associated gene (FTO) has been linked to a higher body mass index (BMI). Still, some environmental factors could modulate this effect. This study aimed to find gene-nutrient interactions on BMI, visceral fat (VF), skeletal muscle (SM), and body fat (BF).</div></div><div><h3>Methods</h3><div>The data were obtained from a cross-sectional investigation performed on Argentinian adults of both sexes. Body composition measurements were collected by bioelectrical impedance analysis, dietary variables by a food frequency questionnaire, and genetic data by real-time polymerase chain reaction (qPCR). Multiple linear regression was used to assess the per-allele effect on body composition, and covariance (ANCOVA) analysis was used to find gene–diet interactions.</div></div><div><h3>Results</h3><div>The minor A variant increased BMI (1.4 kg/m² [0.50–2.2], p = 0.002), BF (2.5 % [0.8–4.2], p = 0.004), and VF (0.7 arbitrary units [0.09–1.4], p = 0.026) and decreased SM (1.5 % [-2.5, 0.6], p = 0.009). Gene∗nutrient interaction terms were statistically significant for protein intake on BMI (η_p² = 0.051, p = 0.027) and VF (η_p² = 0.069, p = 0.005), for total sugars intake on BMI (η_p^{2 =}0.051, p = 0.026), BF (η_p^{2 =}0.062, p = 0.01) and VF (η_p^{2 =}0.053, p = 0.018), and saturated fatty acids (SFA) intake on SM (η_p²⁼0.056, p = 0.018). Consistently, interactions were found for “milk and yogurt” (η_p² = 0.052, p = 0.041) and “meat and eggs” (η_p² = 0.039, p = 0.049) on BMI and for “meat and eggs” (η_p² = 0.069, p = 0.006) and “fruits” (η_p² = 0.054, p = 0.013) on VF.</div></div><div><h3>Conclusion</h3><div>The A allele contributes to body composition variability, and diet modulates its effect.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 359-367"},"PeriodicalIF":2.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141523","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}