Clinical nutrition ESPEN最新文献

{"title":"Effects of antioxidants on oxidative stress in adult patients with coronary artery disease: A systematic review","authors":"Islam M. Alhusban ,&nbsp;Misook L. Chung ,&nbsp;Martha Biddle","doi":"10.1016/j.clnesp.2025.08.037","DOIUrl":"10.1016/j.clnesp.2025.08.037","url":null,"abstract":"<div><h3>Background</h3><div>Oxidative stress (OS) accelerates the pathogenesis of coronary artery disease (CAD) by contributing to atherosclerotic plaque formation. Current research indicates that antioxidants can mitigate OS by reducing the production of free radicals. Despite many studies that have tested the effects of antioxidants on oxidative stress in patients with CAD, the literature still lacks an updated and comprehensive systematic review. The aim of this study was to identify the effects of administering exogenous antioxidants on OS levels among adult patients with CAD.</div></div><div><h3>Methods</h3><div>A systematic review searched PubMed, Medline, and CINAHL for randomized controlled trials (RCTs) published between January 2013 and May 2025, which examined antioxidants to lower OS in adult participants with CAD. Studies were excluded if participants had chronic or acute inflammatory conditions, renal failure, liver failure, or had undergone major operations before being enrolled.</div></div><div><h3>Results</h3><div>Among 2338 studies reviewed, 15 RCTs met the inclusion criteria. Out of the 15 RCTs, nine reported on supplemental antioxidants (i.e., L-carnitine and melatonin), and two reported on dietary antioxidants (Khorasan wheat diet and wine) that were effective at lowering OS (P &lt; 0.05). One study found Brazil nuts (dietary antioxidants) ineffective at lowering OS. The three remaining RTCs reported that intravenously administered antioxidants, including alpha-lipoic acid, vitamin C, or N-acetylcysteine, significantly lowered OS.</div></div><div><h3>Conclusions</h3><div>The reviewed RTCs provide evidence that antioxidants may lower OS in patients with CAD. The utility of this conclusion is limited by the studies’ methodologies that examine various antioxidants and measure OS through a variety of biomarkers. This heterogeneity in methodologies between studies indicates that further research is needed with standardized interventions and outcomes.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 794-801"},"PeriodicalIF":2.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008202","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":"Demystifying intricate factors of nutritional anemia beyond iron deficiency–A narrative review","authors":"Richa Soni ,&nbsp;Deepak Verma ,&nbsp;Rajni Chopra ,&nbsp;Vishakha Singh ,&nbsp;Dweipayan Goswami","doi":"10.1016/j.clnesp.2025.08.034","DOIUrl":"10.1016/j.clnesp.2025.08.034","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Nutritional anemia is a widespread public health issue, impacting about one-quarter of the global population (24.3 % in 2021; ∼1.92 billion people). Iron-deficiency anemia (IDA) is the most prevalent form, primarily caused by inadequate dietary intake, poor iron absorption, or increased physiological needs. However, the complexity of nutritional anemia extends beyond iron deficiency, involving other micronutrients such as vitamin B12, folate, zinc, copper, and vitamin A. Additionally, anti-absorptive dietary inhibitors (e.g., phytates, polyphenols, oxalates), chronic infections, and inflammation exacerbate the condition. This review aims to provide a comprehensive understanding of the multifactorial etiology of nutritional anemia and discuss emerging insights and innovative approaches for its prevention and management.</div></div><div><h3>Objective</h3><div>To critically examine the contributions of various micronutrient deficiencies, the impact of anti-absorptive dietary inhibitors, and the influence of socioeconomic and environmental determinants. The review also evaluates the challenges of modern dietary trends, such as the rise of plant-based diets, and explores promising strategies for mitigating anemia prevalence.</div></div><div><h3>Approach</h3><div>Narrative review synthesizing evidence from recent literature, including epidemiological studies, clinical trials, and public health interventions. This integrative approach provides a holistic understanding of nutritional anemia and identifies gaps in current knowledge and intervention strategies.</div></div><div><h3>Insights</h3><div>The review highlights the intricate interplay of micronutrient deficiencies, dietary inhibitors, and socio-environmental factors that contribute to the high prevalence of anemia. Emerging solutions such as hepcidin modulation, biofortification, and novel iron formulations have shown promise in clinical and public health settings. However, the success of anemia reduction efforts varies across different regions, emphasizing the need for culturally tailored, multi-pronged approaches.</div></div><div><h3>Conclusions</h3><div>Addressing nutritional anemia requires an integrated strategy that includes improving micronutrient bioavailability, implementing effective public health policies, and addressing underlying social and environmental determinants. Continued interdisciplinary research and policy development are crucial to creating sustainable, impactful solutions, particularly for the most vulnerable populations, including young children, women of reproductive age, and the elderly.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 745-764"},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005943","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":"Association between the gut microbiota composition and alpha-diversity on the hormonal response and appetitive measures of individuals with obesity after a meal either rich in ultra-processed foods or without ultra-processed foods: Secondary analysis of a randomized clinical trial","authors":"Nayara Gomes Graciliano,&nbsp;Ana Debora Santos de Oliveira,&nbsp;Guilherme César Oliveira de Carvalho,&nbsp;Maria Bárbara Galdino-Silva,&nbsp;Karine Maria Moreira Almeida,&nbsp;Samyra Araújo Monteiro Carvalho,&nbsp;Nassib Bezerra Bueno","doi":"10.1016/j.clnesp.2025.08.028","DOIUrl":"10.1016/j.clnesp.2025.08.028","url":null,"abstract":"<div><h3>Background</h3><div>Obesity and the consumption of ultra-processed foods (UPF) are associated with gut microbiota composition and diversity, which may contribute to alterations in the regulation of hormones involved in satiety, given the gut microbiota's role in regulating host appetite. Therefore, this study aimed to investigate the association of gut microbiota composition and alpha-diversity at the genus-level on postprandial changes in satiety hormones, and appetitive measures in individuals with obesity, given either a meal rich in UPF or a meal without UPF.</div></div><div><h3>Methods</h3><div>Individuals were randomized to two groups: a) a non-UPF meal and b) a UPF meal. Both meals were matched for energy, energy density, macronutrients, fiber, and sodium content. The gut microbiota composition was analyzed using DNA <em>metabarcoding</em> and 16S rRNA sequencing. Alpha-diversity was assessed using the Shannon, Simpson's, and Inverse-Simpson indices at the genus level. Blood samples for hormonal (ghrelin, leptin, and GIP) and appetitive measures (hunger, satiety, fullness, and capacity to eat) were taken using visual analog scales after a 12-h fast and 90 min post-meal.</div></div><div><h3>Results</h3><div>Twenty individuals were included in the UPF group, and 19 were in the control group, with no significant differences in gut microbiota composition or alpha-diversity indices between the groups. All hormone concentrations and appetitive measures varied significantly over time, regardless of the type of meal. A greater alpha-diversity of gut microbiota at the genus-level was associated with increased postprandial fullness (p &lt; 0.05 for all indices), with clues that this association varied significantly between groups according to meal type (p = 0.02 for the inverse-Simpson index and p = 0.07 for the other indices), indicating a positive correlation only in the control group.</div></div><div><h3>Conclusion</h3><div>Gut microbiota alpha diversity at the genus level appears to be associated with the subjective sensation of fullness after a meal, and this association may vary depending on the ultra-processed food content of the meal. This finding warrants further investigation due to the exploratory nature of this study.</div></div><div><h3>Trial registration number</h3><div>RBR-56nsh92 (<span><span>https://ensaiosclinicos.gov.br/rg/RBR-56nsh92</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 722-732"},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005996","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":"Association between serum vitamin D metabolite levels and cognitive function in community-dwelling older adults: A cross-sectional study","authors":"Cai Yu ,&nbsp;Minae Ide ,&nbsp;Taiki Sugimoto ,&nbsp;Rei Otsuka ,&nbsp;Koji Takahashi ,&nbsp;Masaki Takiwaki ,&nbsp;Kiyoshi Tanaka ,&nbsp;Hiroaki Kanouchi ,&nbsp;Shigeo Takenaka ,&nbsp;Takashi Sakurai ,&nbsp;Shumpei Niida ,&nbsp;Akiko Kuwabara","doi":"10.1016/j.clnesp.2025.08.032","DOIUrl":"10.1016/j.clnesp.2025.08.032","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Vitamin D deficiency has been associated with cognitive decline and Alzheimer's disease (AD); however, findings remain inconsistent. Assessing vitamin D status based solely on total 25-hydroxyvitamin D [25(OH)D] may be insufficient, and other metabolites, such as 24,25-dihydroxyvitamin D₃ [24,25(OH)₂D₃] and 3-epimer-25-hydroxyvitamin D₃ [3-epi-25(OH)D₃], may provide additional insights. This study aimed to examine the association between serum vitamin D metabolite concentrations and cognitive function in older adults.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted involving 289 community-dwelling participants aged 65–85 years clinically diagnosed with AD, mild cognitive impairment (MCI), or were cognitively normal (CN). Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Serum concentrations of 25-hydroxyvitamin D₃ [25(OH)D₃], 25-hydroxyvitamin D₂ [25(OH)D₂], 24,25(OH)₂D₃, 3-epi-25(OH)D₃, and 1,25-dihydroxyvitamin D₃ [1,25(OH)₂D₃] were measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The Vitamin D metabolite ratio (VMR) was calculated as 24,25(OH)₂D₃/25(OH)D₃ × 100 (%). Associations among metabolite concentrations, MMSE scores, and AD prevalence were analyzed.</div></div><div><h3>Results</h3><div>Participants had relatively high serum total 25(OH)D levels (median: 23.5 ng/mL), with males showing higher vitamin D metabolite concentrations. Total 25(OH)D correlated with 24,25(OH)₂D₃, 3-epi-25(OH)D₃, and VMR. In males, 3-epi-25(OH)D₃ and 24,25(OH)₂D₃ were associated with lower MMSE scores (p &lt; 0.01) and higher AD risk (OR = 2.78, p = 0.03). In females, VMR was associated with higher MMSE scores (p = 0.01) and lower AD risk (OR = 0.64, p &lt; 0.01), while 1,25(OH)₂D₃ was linked to higher AD risk (OR = 1.04, p = 0.01) and quartile 2 with lower MCI risk (p &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Sex-based differences in vitamin D–cognition associations may reflect disparities in vitamin D levels and hormonal effects, such as estrogen-enhancing and testosterone-suppressing metabolism. 1,25(OH)₂D₃, VMR, and 3-epi-25(OH)D₃ may be more sensitive than total 25(OH)D.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 785-793"},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006003","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":"Omega-3 fatty acid supplementation in solid organ transplant recipients: A systematic review and meta-analysis of randomized controlled trials","authors":"Sama Samankan ,&nbsp;Afshin Gharekhani ,&nbsp;Sajad Khiali ,&nbsp;Afraa Rezagholizadeh ,&nbsp;Amin Agabalazadeha ,&nbsp;Parvin Sarbakhsh ,&nbsp;Leila Alizadeh ,&nbsp;Ali Sharifi ,&nbsp;Amin Sadrazar","doi":"10.1016/j.clnesp.2025.08.035","DOIUrl":"10.1016/j.clnesp.2025.08.035","url":null,"abstract":"<div><h3>Background</h3><div>Omega-3 polyunsaturated fatty acids are known for anti-inflammatory and cardiovascular benefits, but their impact on solid organ transplant outcomes is unclear.</div></div><div><h3>Objectives</h3><div>To assess the effects of omega-3 supplementation on clinical outcomes in solid organ transplant recipients.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis of randomized controlled trials was conducted according to PRISMA guidelines. Databases including PubMed, Scopus, and Web of Science were searched through May 2025. Eligible studies were evaluated for transplant-related outcomes, with the primary outcome being graft rejection at 30-day, 3-month, and 1-year post-transplant. Secondary outcomes included changes in lipid profile, blood pressure, renal function, and infection rates.</div></div><div><h3>Results</h3><div>Sixteen trials involving 1,020 patients were included. Omega-3 supplementation did not result in a statistically significant reduction in rejection rates at 30 days, 3 months, or 1 year post-transplant. Diastolic blood pressure decreased significantly (Hedges' g = −0.72; 95 % CI: −1.31 to −0.13), and total cholesterol levels also declined (Hedges' g = −0.64; 95 % CI: −1.04 to −0.24), particularly in kidney transplant recipients. In heart transplant recipients, systolic blood pressure decreased significantly (Hedges’ g = −1.03; 95 % confidence interval: −1.53 to −0.54). Effects on high- and low-density lipoproteins, triglycerides, glomerular filtration rate, and creatinine clearance were inconsistent and largely non-significant. A single study reported reduced sepsis rates in kidney recipients (log odds ratio = −1.16; 95 % confidence interval: −2.25 to −0.07). No significant impact was seen on calcineurin inhibitor toxicity.</div></div><div><h3>Conclusion</h3><div>Omega-3 supplementation may have benefits for solid organ transplant recipients in terms of improving lipid profiles and reducing blood pressure. However, study heterogeneity and limited outcome data highlight the need for larger, standardized trials.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 809-820"},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005918","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":"Association between sodium-glucose Co-transporter-2 inhibitor use and prognosis in underweight patients with diabetes mellitus and heart failure","authors":"Yudai Fujimoto ,&nbsp;Keisuke Kida ,&nbsp;Norio Suzuki ,&nbsp;Tomomi Ide ,&nbsp;Shouji Matsushima ,&nbsp;Hidetaka Kaku ,&nbsp;Nobuyuki Enzan ,&nbsp;Masataka Ikeda ,&nbsp;Takeshi Kitai ,&nbsp;Tatsunori Taniguchi ,&nbsp;Takahiro Okumura ,&nbsp;Takeshi Tohyama ,&nbsp;Hiroyuki Tsutsui ,&nbsp;Yuya Matsue","doi":"10.1016/j.clnesp.2025.08.031","DOIUrl":"10.1016/j.clnesp.2025.08.031","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>It remains unclear whether sodium-glucose co-transporter-2 (SGLT2) inhibitors are effective for patients with underweight. This study aimed to elucidate the association between SGLT2 inhibitors use and prognosis in underweight patients with diabetes mellitus (DM) and HF.</div></div><div><h3>Methods</h3><div>This study was a post-hoc analysis of data from the Japanese Registry of Acute Decompensated Heart Failure, a prospective, multicenter, observational, nationwide registry. All hospitalized patients with HF decompensation requiring treatment were assessed for eligibility between April 2019 and April 2021. Patients with DM and body mass index (BMI) &lt; 18.5 kg/m² at discharge without a history of dialysis were included in this study. The patients were categorized into two groups based on SGLT2 inhibitor use at discharge. The main analysis relied on inverse probability of treatment weighting (IPTW) to balance the differences between the two groups, and the primary endpoint was 2-year all-cause mortality.</div></div><div><h3>Results</h3><div>Of the 4016 patients registered from 87 hospitals, 178 underweight patients with HF and DM (mean age: 77 years, 57 % men, and mean BMI: 16.9 kg/m²) were analyzed. Of them, 59 patients were on SGLT2 inhibitors at discharge while 119 patients were not. Compared with the patients in non-SGLT2 inhibitor group, those in SGLT2 inhibitor group were younger, more often men, and had a lower left ventricular ejection fraction and higher albumin levels. After IPTW, the patient characteristics were well balanced with all the standardized mean difference &lt;0.2. Kaplan–Meier curves showed that the SGLT2 inhibitor group had a significantly lower incidence of mortality than the non-SGLT2 inhibitor group (14.7 % versus 33.3 %), which was mainly driven by the difference in cardiovascular death (6.4 % versus 18.8 %). The association between SGLT2 inhibitor use and lower mortality was maintained even after IPTW with additional regression adjustment (hazard ratio, 0.40; 95 % confidence interval 0.17–0.93; P = 0.033).</div></div><div><h3>Conclusions</h3><div>SGLT2 inhibitor use is associated with lower mortality in underweight patients with DM and HF.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 767-774"},"PeriodicalIF":2.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999860","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":"Sucralose consumption modifies glucose homeostasis, gut microbiota, Curli protein, and related metabolites in healthy individuals: A randomized placebo-controlled, triple-blind trial","authors":"Alonso Romo-Romo ,&nbsp;Mónica Sánchez-Tapia ,&nbsp;M. Guadalupe López-Carrasco ,&nbsp;Luz E. Guillén-Pineda ,&nbsp;Griselda X. Brito-Córdova ,&nbsp;Alexandro J. Martagón ,&nbsp;Omar Granados-Portillo ,&nbsp;Guillaume Walther ,&nbsp;Francisco J. Gómez-Pérez ,&nbsp;Carlos A. Aguilar-Salinas ,&nbsp;Armando R. Tovar ,&nbsp;Nimbe Torres ,&nbsp;Paloma Almeda-Valdes","doi":"10.1016/j.clnesp.2025.08.029","DOIUrl":"10.1016/j.clnesp.2025.08.029","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Sucralose consumption has been associated with a reduction in insulin sensitivity, potentially through changes in gut microbiota, induction of low-grade inflammation and other pathophysiologic mechanisms, thus the aim of this study was to evaluate the effect of sucralose consumption on glucose tolerance, insulin sensitivity, postprandial glucagon-like peptide 1 (GLP-1), gut microbiota composition, Curli protein, and related metabolites.</div></div><div><h3>Methods</h3><div>Randomized placebo-controlled triple blind trial including healthy lean individuals assigned to consume 30 % of the sucralose acceptable daily intake or placebo for 30 days. A mixed meal tolerance test (MMTT) was performed before and after intervention to evaluate the postprandial changes in the main outcomes. Insulin sensitivity was estimated with the Matsuda index. Gut microbiota was assessed by sequencing the 16 S rRNA gene. Serum biochemical parameters, branched chain amino acids (BCAA), fatty acid profile, and inflammatory markers were measured.</div></div><div><h3>Results</h3><div>Glucose, insulin and GLP-1 areas under the curve increased after the MMTT, along with a significant decrease in insulin sensitivity after sucralose consumption. A reduction in α-diversity of the gut microbiota was observed. Additionally, proinflammatory markers, BCAA, acetate, and fecal Curli protein increased, whereas serum glutamic acid and fecal butyrate, decreased after sucralose consumption.</div></div><div><h3>Conclusion</h3><div>The consumption of sucralose in healthy lean individuals for 30 days caused a 20.3 % significant decrease in insulin sensitivity. This might be mediated by changes in gut microbiota composition associated with related metabolites potentially leading to a pro-inflammatory environment that can affect insulin signaling pathways.</div></div><div><h3>Clinical trial registry number and website where it was obtained</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> Identifier: NCT06094894.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 733-744"},"PeriodicalIF":2.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999804","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":"Time-restricted eating and its metabolic benefits in obesity and insulin resistance","authors":"Najd Al Sarayreh,&nbsp;Hayder Al-Domi,&nbsp;Aseel Jawamis","doi":"10.1016/j.clnesp.2025.08.033","DOIUrl":"10.1016/j.clnesp.2025.08.033","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>This study aimed to critically review the potential effects of time-restricted eating (TRE) on lipemic and glycemic control, as well as certain inflammatory biomarkers, including interleukin-1 beta (IL-1β), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) levels, in individuals with obesity and insulin resistance.</div></div><div><h3>Methods</h3><div>A critical review of the relevant published articles (56 original articles) from 2007 to 2025 was carried out using several search engines, including PubMed, Scopus, Cochrane, and Google Scholar. The following keywords were used: TRE, insulin resistance, inflammatory biomarkers, and blood glucose.</div></div><div><h3>Results</h3><div>TRE shows potential in improving glycemic and lipemic control in obese individuals with insulin resistance, although its effect on inflammatory markers such as IL-1β, TNF-α, and IL-6 remains inconsistent. Mechanistic studies suggest that activation of adenosine monophosphate-activated protein kinase (AMPK), suppression of mammalian target of rapamycin (mTOR), and ketosis help enhance glucose metabolism, promote autophagy, boost mitochondrial function, and lower triglyceride and low-density lipoprotein (LDL) levels. Despite these benefits, human trial results are mixed, with inconsistencies mainly caused by small sample sizes, varying TRE protocols, and differences in study design and populations characteristics.</div></div><div><h3>Conclusion</h3><div>The effect of TRE is contradictory regarding body weight, insulin sensitivity, lipid profile, and pro-inflammatory status. Furthermore, a well-designed, randomized controlled trial with a long study duration is warranted to investigate the effectiveness of TRE, as it would provide critical insights into the sustainability and broader health impact of this dietary approach.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 703-710"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991574","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":"Exploring the application of Dietary Approaches to Stop Hypertension (DASH) in the management of patients with Chronic Kidney Disease: A systematic review and meta-analysis","authors":"Yaa Boahemaa Gyasi Aderoju ,&nbsp;Frank Ekow Atta Hayford ,&nbsp;Gloria Achempim-Ansong ,&nbsp;Evans Duah ,&nbsp;Tinyiko Violet Baloyi ,&nbsp;Smangaliso Morerwa ,&nbsp;Percival Agordoh ,&nbsp;Gladys Dzansi","doi":"10.1016/j.clnesp.2025.08.030","DOIUrl":"10.1016/j.clnesp.2025.08.030","url":null,"abstract":"<div><h3>Background &amp; aim</h3><div>Chronic Kidney Disease (CKD) remains a significant global non-communicable disease (NCD) that affects more than 10 % of the world's population. Attention is gradually shifting to tertiary prevention of CKD to avoid End-Stage Renal Disease (ESRD) progression. This study reviewed evidence of the use of a Dietary Approach to Stop Hypertension (DASH) and its effect on disease progression among patients living with CKD.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted using the Scopus, PubMed, Web of Science, ProQuest, and EBSCOHost databases for studies published from 1997 to 2025. The PICO framework guided the search, focusing on patients with CKD, DASH as the intervention, other dietary and non-dietary approaches as comparisons, and CKD progression measured by changes in estimated Glomerular Filtration Rate (eGFR) and/or Urine Albumin-to-Creatinine Ratio (UACR) as outcomes. Effect sizes with 95 % confidence intervals and pooled effects were calculated using random effects REML models and Z-tests. Percentage changes in renal function post-intervention, based on eGFR, were also computed. Cochran's Q test and the I-squared (I²) statistic assessed study heterogeneity. This review protocol is registered with PROSPERO (CRD42024588682).</div></div><div><h3>Results</h3><div>Of the 174 studies screened, four met the eligibility criteria and were included in the review. All were prospective cohort studies with an average follow-up of 5.5 years and a combined patient sample size of 7033. Across studies, low DASH adherence was defined as scores in the lower half of the possible range used, and high adherence as scores in the upper half (e.g., 0–40 vs. 41–80; 0–4 vs. 5–9; 8–24 vs. 25–40). Low DASH adherence was associated with a mean eGFR improvement of 0.54 ml/min/1.73 m² (1.2 %) (Z = 0.57, p = 0.57), while high adherence showed a greater improvement of 3.34 ml/min/1.73 m² (6.8 %) (Z = 1.77, p = 0.08). Only one study assessed UACR, reporting a lower median UACR with high DASH adherence (33.6 mg/g) compared to low adherence (55.6 mg/g).</div></div><div><h3>Conclusions</h3><div>The DASH diet has the potential to slow CKD progression; however, consistent adherence is crucial to maximize its clinical benefits and improve renal outcomes. Although improvements in eGFR with DASH diet adherence are clinically meaningful, they lack statistical significance. These findings support global efforts towards achieving Sustainable Development Goal 3 for NCDs.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 711-721"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991496","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":"MALNUTRITION, SARCOPENIA AND NUTRITION THERAPY FOR PATIENTS WITH DIABETES - A GENERAL FRAMEWORK AND FOCUS ON HOSPITAL CARE.","authors":"Jarvis C Noronha, Jeffrey I Mechanick, Rocco Barazzoni, Francisco J Tarazona-Santabalbina, Charilaos Dimosthenopoulos, Anne Raben, Cyril W C Kendall, Laura Chiavaroli, John L Sievenpiper","doi":"10.1016/j.clnesp.2025.08.027","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.08.027","url":null,"abstract":"<p><strong>Background & aims: </strong>The prevalence of diabetes is increasing globally and is particularly high among hospitalized patients, presenting challenges for inpatient care. While traditional inpatient management emphasizes glycemic control, medication adjustments, and comorbidity management, malnutrition and muscle loss remain underrecognized factors that significantly influence clinical outcomes. This review aims to highlight the role of malnutrition and muscle dysfunction in hospitalized patients with diabetes and to evaluate the potential of medical nutrition therapy (MNT), particularly diabetes-specific nutrition formulas (DSNFs), to improve patient outcomes.</p><p><strong>Methods: </strong>This narrative review is based on the proceedings of a joint session between the Diabetes Nutrition Study Group (DNSG) and the European Society for Clinical Nutrition and Metabolism (ESPEN). Relevant literature was synthesized to explore the prevalence, pathophysiology, and clinical impact of malnutrition and muscle loss in diabetes, as well as the clinical applications of MNT and DSNFs in hospital and intensive care settings.</p><p><strong>Results: </strong>Malnutrition is prevalent among hospitalized patients with diabetes yet frequently goes undiagnosed, contributing to delayed recovery, increased complications, and functional decline. Muscle mass and function are now recognized as key determinants of metabolic regulation and recovery. Recent advances in diagnostic frameworks, including those developed by the Global Leadership Initiative on Malnutrition (GLIM), offer practical tools for the early identification of malnutrition and sarcopenia. Evidence supports the use of MNT, particularly DSNFs, as a strategy to support glycemic control, preserve muscle mass, and reduce complications in both general hospital and ICU settings.</p><p><strong>Conclusions: </strong>Malnutrition and muscle dysfunction are important but often overlooked components of inpatient diabetes care. Early identification using validated screening tools, coupled with timely implementation of MNT, including DSNFs, offers a promising strategy to improve metabolic management and clinical outcomes in hospitalized and critically ill patients with diabetes.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945267","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}