Clinical nutrition ESPEN最新文献

{"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}

{"title":"REDuced CARBohydrate enteral nutrition compared to standard care in hyperglycaemic critically ill patients: A randomised phase II clinical trial (REDCARB)","authors":"Ra'eesa Doola ,&nbsp;Lee-anne Chapple ,&nbsp;Adam Deane ,&nbsp;Alison Griffin ,&nbsp;Meg Harward ,&nbsp;Anne Leditschke ,&nbsp;Emma Ridley ,&nbsp;David Sturgess ,&nbsp;James Walsham ,&nbsp;Peter Kruger","doi":"10.1016/j.clnesp.2025.05.029","DOIUrl":"10.1016/j.clnesp.2025.05.029","url":null,"abstract":"<div><h3>Background</h3><div>Critically ill patients often experience dysglycaemia which is strongly associated with increased morbidity and mortality. While exogenous insulin therapy is used to manage hyperglycaemia, it has been demonstrated to increase the frequency of hypoglycaemic episodes and variability in blood glucose, both of which have been shown to increase mortality.</div><div>Enteral feeding may worsen glycaemic control due to its carbohydrate content.</div><div>This study aims to determine if the use of a reduced carbohydrate formula improves overall glycaemic control when compared to standard care in critically ill patients with hyperglycaemia.</div></div><div><h3>Methods</h3><div>This is the protocol for a multicentre, prospective randomised controlled trial conducted at 7 intensive care units (ICU). One hundred and sixty patients admitted to ICU, receiving or about to receive enteral nutrition expected to continue until the day after tomorrow, who have had two consecutive blood glucose levels &gt;10 mmol/L or have received insulin based on local protocols within the previous 24-h period, and who meet none of the exclusion criteria, will be eligible. Patients in the standard care arm will receive enteral nutrition as per usual site practice and patients in the intervention arm will receive Glucerna Select® to achieve a caloric equivalent to that prescribed or delivered prior to study recruitment. All other aspects of nutrition management remain as per routine clinical practice. The primary outcome measure is units of insulin administered per day in the ICU to a maximum of seven days post randomisation. Key secondary outcome measures include measures of glycaemic control, nutrition provision, nutrition tolerance and clinical outcomes such as infectious complications, duration of ventilation, ICU and hospital stay as well as in hospital mortality.</div></div><div><h3>Discussion</h3><div>This study will provide data on whether the use of a reduced carbohydrate enteral nutrition formula reduces insulin administration thereby improving dysglycaemia in critically ill patients. It will also be used to refine the design of a larger multi-centre trial to definitively ascertain the impact of using reduced carbohydrate enteral formula on clinical outcomes.</div></div><div><h3>Ethics and trial registration</h3><div>Ethical approval was obtained from the local Research Ethics Committee (HREC Approval HREC/2021/QMS/74667). The trial was registered on the Clinical Trials Registry with registration number ACTRN12621000859886.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 368-374"},"PeriodicalIF":2.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141524","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":"A proposal for a fat mass index criterion for the assessment of sarcopenic obesity in the community-dwelling older women.","authors":"Pilar Pérez-Ros, Cristina Flor-Rufino, Rosa Fonfría-Vivas, Ana Pablos-Monzó, Joaquin Barrahina-Igual, Francisco Miguel Martínez-Arnau","doi":"10.1016/j.clnesp.2025.05.033","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.05.033","url":null,"abstract":"<p><strong>Introduction: </strong>Among older populations, sarcopenic obesity (SO) is a prevalent condition, characterized by the coexistence of both low muscle mass and excess fat. Accurate early diagnosis is crucial for managing this disorder and preventing its associated health risks. The aim of this study is to provide a fat mass index (FMI) cutoff value for diagnosing SO in community-dwelling older women according to (Blinded) consensus.</p><p><strong>Material and methods: </strong>This cross-sectional study included a sample of older women aged 70 years and older, residing in community settings in (blinded).</p><p><strong>Results: </strong>Among the 145 included women (mean age 77.4 years), prevalence of SO was 16.6%. A complete assessment revealed independence and adequate nutritional status, despite high levels of comorbidity. Significant between-group differences were observed in body mass index (BMI), fat mass, and brachial and waist circumferences, but not in calf circumference. Compared to women without SO, those with the condition had lower handgrip strength but performed similarly in the sit-to-stand test. Mean FMI was higher in the SO group. A ROC curve identified an FMI cutoff of >12 kg/m², with 77% sensitivity and 75% specificity, and a post-test probability of SO of 39.2%.</p><p><strong>Conclusions: </strong>Our results indicate that FMI is a promising diagnostic tool for SO, with acceptable sensitivity and specificity values for clinical implementation. However, further research is needed to validate these findings across different populations and healthcare settings to ensure its broader applicability.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141492","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":"Oxylipin serum profile changes in response to an open-label anti-inflammatory dietary intervention","authors":"Marta Sala-Climent ,&nbsp;Esha Lal ,&nbsp;Francesca Cedola ,&nbsp;Maram Alharthi ,&nbsp;Marta Fernandez-Bustamante ,&nbsp;Meritxell Agustin-Perez ,&nbsp;Abha Singh ,&nbsp;Soo-In Choi ,&nbsp;Tania Rivera ,&nbsp;Katherine Nguyen ,&nbsp;Susan Lee ,&nbsp;Shahrokh Golshan ,&nbsp;Tiffany Holt ,&nbsp;Oswald Quehenberger ,&nbsp;Roxana Coras ,&nbsp;Monica Guma","doi":"10.1016/j.clnesp.2025.05.027","DOIUrl":"10.1016/j.clnesp.2025.05.027","url":null,"abstract":"<div><h3>Introduction</h3><div>Oxylipins are bioactive lipids involved in inflammation. This study evaluated how a 2-week anti-inflammatory diet (ITIS, omega-3/omega-6 ratio of 1:1.5) affects plasma oxylipin profiles in patients with active Rheumatoid Arthritis (RA).</div></div><div><h3>Methods</h3><div>In an open-label pilot trial, 20 RA patients (≥3 tender and ≥3 swollen joints) followed the ITIS diet. Targeted lipidomics by mass spectrometry was used to quantify oxylipins. Patients were classified as responders or non-responders based on ≥50 % pain reduction (Pain-50). Dietary intake was assessed through diet scores, and statistical analyses were performed using RStudio.</div></div><div><h3>Results</h3><div>Participants were predominantly female (90 %) with an average age of 57.1. At baseline, responders consumed more walnuts (p = 0.08), almond milk (p = 0.06), avocado (p = 0.04), and quinoa (p = 0.05), and fewer burgers (p = 0.02). No differences in diet adherence were observed between groups. Baseline oxylipin levels did not differ significantly. However, after the intervention, six oxylipins—5-HETE, 11,12-diHETrE, 14,15-diHETrE, 19,20-DiHDPA, 9-oxo-ODE, and 14,15-EET—differed significantly between responders and non-responders. Notably, oxylipins derived from both arachidonic acid (omega-6) and eicosapentaenoic acid (omega-3) decreased significantly after the diet (p = 0.0006 and p = 0.01, respectively).</div></div><div><h3>Conclusion</h3><div>The anti-inflammatory diet modified circulating levels of both pro- and anti-inflammatory oxylipins. These changes varied by pain response, suggesting that diet can influence inflammatory pathways in RA. Further studies are warranted to clarify the mechanisms linking dietary changes, oxylipin modulation, and clinical outcomes.</div></div><div><h3>Clinical Trials Identifier</h3><div>NCT04999683.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 389-402"},"PeriodicalIF":2.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141495","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":"Neuroprotective nutrients in pregnancy and infant brain function","authors":"D.N. Christifano ,&nbsp;K. Liao ,&nbsp;N.B. Mathis ,&nbsp;S.E. Carlson ,&nbsp;J. Colombo ,&nbsp;L. Chollet-Hinton ,&nbsp;K.M. Gustafson","doi":"10.1016/j.clnesp.2025.05.030","DOIUrl":"10.1016/j.clnesp.2025.05.030","url":null,"abstract":"<div><div>Neuroprotective nutrients including omega 3 fatty acid docosahexaenoic acid (DHA), choline, and carotenoids play an important role in infant brain structure and function; however, the effects of maternal nutrition on the infant brain are understudied. We leveraged data from our large randomized clinical trial among pregnant women to determine whether maternal nutrients including DHA, choline, lutein/zeaxanthin (L/Z) and egg intake (a food source of these nutrients) were related to infant brain function. Data from n = 241 maternal and infant dyads were included in this secondary analysis. Food frequency questionnaires (Diet History Questionnaire II) at 32 weeks' gestation were used to assess choline and carotenoid intake and a brief survey on egg consumption (# eggs consumed per week) was used to assess egg intake. Maternal red blood cell DHA status was measured at 32 weeks' gestation. Infant brain function was measured using high density electroencephalogram (EEG) to auditory (1 month of age) and visual (6 months of age) event-related potentials (ERP). At 1 month of age, maternal DHA status was associated with greater delta-band spectral power to the novel tone during the ERP. Choline, choline∗L/Z, L/Z∗DHA, and choline∗L/Z∗DHA were each related to power to the frequent tone during the ERP. At 6 months, choline, DHA status, and choline∗DHA were related to shorter latency to the novel visual stimulus. Choline∗L/Z and choline∗L/Z∗DHA were related to greater amplitude to the novel stimulus. Overall, maternal neuroprotective nutrients were related to several markers of infant brain function.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 417-422"},"PeriodicalIF":2.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141493","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":"Optimal delivery of enteral protein in the critically ill: A protocol for a systematic review and meta-analysis of randomised controlled trials","authors":"Matthew J. Summers ,&nbsp;Julia L.M. Bels ,&nbsp;Amalia Karahalios ,&nbsp;Jeffrey J. Presneill ,&nbsp;Mark P. Plummer ,&nbsp;Zheng-Yii Lee ,&nbsp;Daren K. Heyland ,&nbsp;Dieter Mesotten ,&nbsp;Christian Stoppe ,&nbsp;Marcel C.G. van de Poll ,&nbsp;Adam M. Deane ,&nbsp;Lee-anne S. Chapple","doi":"10.1016/j.clnesp.2025.05.034","DOIUrl":"10.1016/j.clnesp.2025.05.034","url":null,"abstract":"<div><h3>Background</h3><div>The optimal dose of enteral protein to deliver during critical illness remains uncertain. International clinical practice guidelines recommend protein targets ranging from 1.2 to 2.0 g/kg body weight/day, which is greater than the amount recommended in health. This protocol details the conduct of a systematic review and meta-analysis to evaluate the effect of enteral protein delivered within the international recommended guidelines (1.2–2.0 g/kg/day) compared to less than international recommended guidelines (&lt;1.2 g/kg/day) on mortality and morbidity outcomes.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis will be undertaken in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 statement. A comprehensive literature search of studies indexed in MEDLINE, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials will be conducted. Studies will be included if they are randomised controlled trials (RCTs) enrolling adult critically ill patients comparing predominately enteral protein delivery with one arm receiving 1.2–2.0 g/kg/day protein/kg/day (‘greater protein’) and another arm receiving <em>&lt;</em>1.2 g protein/kg/day (‘lesser protein’). Two independent reviewers will perform title and full text screening for study inclusion, extract data from included studies, and assess study quality using the Cochrane Risk of Bias 2 tool. The primary outcome will be mortality at 90 days. Secondary outcomes will be clinical (infectious complications, and durations of ICU and hospital stays and mechanical ventilation), patient-centred (discharge destination, physical function and quality of life) and muscle (muscle mass, strength) outcomes.</div></div><div><h3>Results</h3><div>Random-effects meta-analysis will be fitted for all outcomes, and, for the primary outcome, risk ratios will be pooled using a random-effects meta-analysis model and pooled treatment effect presented as risk ratio (95% Confidence Interval).</div></div><div><h3>Conclusions</h3><div>This systematic review and meta-analysis will compile data to determine whether outcomes are optimised with greater or lesser amounts of enteral protein delivered during critical illness.</div></div><div><h3>Systematic review registration</h3><div>CRD42025547923.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 375-381"},"PeriodicalIF":2.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141494","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 in nursing home residents: A nutritionDay analysis of staff judgment of residents’ nutritional status and a validated tool","authors":"Isabel Galicia Ernst ,&nbsp;Hanna Siebentritt ,&nbsp;Silvia Tarantino ,&nbsp;Michael Hiesmayr ,&nbsp;Dorothee Volkert","doi":"10.1016/j.clnesp.2025.05.023","DOIUrl":"10.1016/j.clnesp.2025.05.023","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Malnutrition among nursing home (NH) residents increases the mortality risk, with prevalence differing based on the screening tool utilized. This study aims to analyze the differences between NH staff's judgment of residents' nutritional status (NH staff) and Mini Nutritional Assessment Short-Form® (MNA) and examine the relationship between these methods and various health factors with six-month mortality in NH residents.</div></div><div><h3>Methods</h3><div>The nutritionDay is a one-day cross-sectional audit with outcome evaluation. The analysis included NH residents ≥65 years old from units participating with ≥5 residents. Differences between NH staff and MNA were analyzed using a cross table, and concordance, minor, and major discrepancies were calculated. Mortality rates for residents with malnutrition, according to both methods, are reported. Two unadjusted and five adjusted binomial logistic regression models analyzed differences regarding mortality, MNA, and NH staff.</div></div><div><h3>Results</h3><div>The analysis included 7767 residents (mean age of 87 ± 8 years, 74 % female). MNA identified 18.4 % as malnourished and 48.7 % at risk, while NH staff classified 10.2 % as malnourished and 26.2 % at risk. MNA and NH staff categorizations concurred in 52 % of the cases, 44 % were minor, and 4 % major discrepancies. Overall mortality was 13.8 %, with higher rates observed among malnourished residents (27.1 % MNA and 27.0 % NH staff) and at risk (19.1 % MNA, 13.8 % NH staff). The odds ratio (OR) for mortality was higher for malnourished residents and those at risk (MNA OR 4.4 [95 % confidence interval (CI) 3.6–5.5]; at risk MNA 2.2 [1.8–2.6]) and malnutrition NH staff 2.8 [2.3–3.4]; at risk NH staff 1.988 [1.7–2.3]). These associations were consistent across models, with differences in OR and 95 % CI. Factors such as the inability to express oneself, requiring ≥5 drugs/day, &gt;120 min of care/day, and almost all MNA items were linked to increased mortality risk.</div></div><div><h3>Conclusions</h3><div>The prevalence of malnutrition varied depending on the screening method, with the MNA identifying more residents as malnourished or at risk than the NH staff. Both MNA and NH staff were associated with six-month mortality, confirming previous literature. Consistency across models indicates robust predictors for identifying high-risk residents.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 326-334"},"PeriodicalIF":2.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126897","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 an oral nutritional supplement on the recovery of the nutritional status of older patients with fragility hip fracture: Controlled and randomized clinical trial","authors":"R. Fernández Jiménez ,&nbsp;S. García-Rey ,&nbsp;I.M. Vegas Aguilar ,&nbsp;A. Jiménez-Sánchez ,&nbsp;N. Montero Madrid ,&nbsp;M.C. Roque Cuellar ,&nbsp;A. Galán ,&nbsp;P. Garrancho Domínguez ,&nbsp;R. González León ,&nbsp;P. Zamora ,&nbsp;R. Moreno-Domínguez ,&nbsp;R. de Castellar Sansó ,&nbsp;P.P. García-Luna ,&nbsp;J.M. García Almeida","doi":"10.1016/j.clnesp.2025.05.025","DOIUrl":"10.1016/j.clnesp.2025.05.025","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Hip fracture due to fragility (HFF) has a high mortality rate and leads to a decline in quality of life due to advanced age and compromised nutritional status, among others. The aim of this study was to evaluate the impact of early nutritional intervention (hyperproteic and hypercaloric oral nutritional supplement; HP/HC-ONS) on the nutritional and functional recovery of older patients with HFF.</div></div><div><h3>Methods</h3><div>Double-blind, placebo-controlled clinical trial in patients &gt;65 years old with scheduled HFF surgery (≤72 h). Patients were randomly assigned to HP/HC-ONS or placebo group (two doses/day) for 4 months. Nutritional diagnosis was based on Mini Nutritional Assessment (MNA), and \"morphofunctional assessment\": a combination of body composition techniques, such as bioelectrical impedance analysis (BIA) with phase angle (PhA), and nutritional ultrasound (US) with rectus femoris cross-sectional area (RF-CSA) and circumference; and muscle function measured using handgrip strength (HGS). Primary statistical analysis endpoints were changes between baseline and 4-month PhA and HGS. Laboratory parameters (C reactive protein and prealbumin, amongst others), dependency (Barthel index), and disease burden (Charlson Comorbidity Index, CCI) were registered. All measurements took place at baseline, 2-month (except for BIA), and 4-month on-site visits. Hospital length of stay (LoS) was extracted from health records. Adverse events (AEs) were reported, and product tolerability was assessed by stool frequency and the Bristol Stool Form Scale (BSFS).</div></div><div><h3>Results</h3><div>85 patients were included (HP/HC-ONS, <em>n</em> = 45; placebo, <em>n</em> = 40); 75.9% women. Final PhA displayed a significant interaction between treatment group and baseline PhA (ANCOVA, <em>p</em> = 0.002): the HP/HC-ONS group developed a significantly higher 4-month PhA if basal PhA was &gt;4°. Significantly higher increases of RF-CSA and circumference were observed in the HP/HC-ONS group. HGS and MNA improved, yet without significant differences between groups. No statistically significant differences between groups were noted in LoS, BSFS, Barthel Index, CCI, and laboratory parameters at 4-month. AEs reported at 4-month: placebo, 14 (70%) and HP/HC-ONS, 6 (30%); with 3 serious AEs related with the product (HP/HC ONS, 2 [diarrhea], and placebo, 1 [vomits]).</div></div><div><h3>Conclusions</h3><div>In older adults recovering from HFF, an early 4-month HP/HC-ONS intervention was well tolerated, safe, and demonstrated a beneficial impact on body composition outcomes.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 348-358"},"PeriodicalIF":2.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119005","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 real-life food consumption in hospital with an automatic image recognition device: A pilot study","authors":"Laura Albaladejo ,&nbsp;Joris Giai ,&nbsp;Cyril Deronne ,&nbsp;Romain Baude ,&nbsp;Jean-Luc Bosson ,&nbsp;Cécile Bétry","doi":"10.1016/j.clnesp.2025.05.017","DOIUrl":"10.1016/j.clnesp.2025.05.017","url":null,"abstract":"<div><h3>Background and aims</h3><div>Accurate dietary intake assessment is essential for nutritional care in hospitals, yet it is time-consuming for caregivers and therefore not routinely performed. Recent advancements in artificial intelligence (AI) offer promising opportunities to streamline this process. This study aimed to evaluate the feasibility of using an AI-based image recognition prototype, developed through machine learning algorithms, to automate dietary intake assessment within the hospital catering context.</div></div><div><h3>Methods</h3><div>Data were collected from inpatient meals in a hospital ward. The study was divided in two phases: the first one focused on data annotation and algorithm's development, while the second one was dedicated to algorithm's evaluation. Six different dishes were analyzed with their components grouped into three categories: cereals and starchy food, meat and fish, and vegetables. Manual weighing (MAN) was used as the reference method, while the AI-based prototype (PRO) automatically estimated component weights. Lin's concordance correlation coefficients (CCC) were calculated to assess agreement between PRO and MAN. Linear regression models were applied to estimate measurement differences between PRO and MAN for each category and their associated 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>A total of 246 components were used for data annotation and 368 for testing. CCC values between PRO and MAN were: Cereals and starchy food (n = 219; CCC = 0.957, 95 % CI: 0.945–0.965), meat and fish (n = 114; CCC = 0.845, 95 % CI: 0.787–0.888), and vegetables (n = 35; CCC = 0.767, 95 % CI: 0.604–0.868). Mean differences between PRO and MAN measurements were estimated at −12.01g (CI 95 % −15.3, −8,7) for cereals and starchy food (reference category), 1.19 g (CI 95 % −3.2, 5.6) for meat and fish, and −14.85 (CI 95 % −22.1, −7.58) for vegetables.</div></div><div><h3>Conclusion</h3><div>This pilot study demonstrates an AI-based system to assess food types and portions in a hospital setting. Further improvements are necessary before the system can be reliably used in direct patient care.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 319-325"},"PeriodicalIF":2.9,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101393","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":"Continuous versus intermittent tube feeding after feeding jejunostomy, a pilot randomized controlled trial","authors":"Peticha Tanprasert ,&nbsp;Phanuwat Tharathipphayakun ,&nbsp;Wasana Ko-iam ,&nbsp;Sirikan Limpakan ,&nbsp;Bandhuphat Chakrabandhu","doi":"10.1016/j.clnesp.2025.05.018","DOIUrl":"10.1016/j.clnesp.2025.05.018","url":null,"abstract":"<div><h3>Background</h3><div>Feeding jejunostomy is employed in cases of upper gastrointestinal tract disorders; nonetheless, there are limited guidelines about post-procedural feeding approaches. This study aims to examine the effects of continuous and intermittent feeding strategies on time to achieve full feeding, gastrointestinal adverse events, and metabolic alterations following jejunostomy surgery.</div></div><div><h3>Method</h3><div>This randomized controlled pilot non-inferiority trial included 40 people with diseases of the upper GI tract who had a feeding jejunostomy at Chiang Mai University Hospital. The patients were not blinded and were randomly split into two groups using the block-of-four method. After completion of recruitment, 18 patients in the continuous feeding group and 20 patients in the intermittent feeding group (5 separated meals in 15 min each) were included in the final analysis. The primary outcome was determined based on the time to achieve complete feeding (30 ml/kg/day). The secondary outcome includes the presence of adverse gastrointestinal symptoms and any metabolic alterations.</div></div><div><h3>Results</h3><div>There were no statistically significant differences in the time taken to achieve a full feed in continuous and intermittent (48 ± 0 h. vs. 50.4 ± 5.6 h, p = 0.080) or as regards gastrointestinal adverse events, abdominal discomfort (27.8 vs. 30.0 %) and diarrhea (5.6 vs. 10 %) (p = 1.000). The metabolic outcome also showed no difference between the two groups.</div></div><div><h3>Conclusion</h3><div>There was no significant difference between continuous and intermittent feeding in terms of the time required to achieve a full feed, gastrointestinal adverse events such as abdominal discomfort and diarrhea, or metabolic changes.</div></div><div><h3>Trial registration</h3><div>TCTR20241008004; Thai Clinical Trials Registry.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 292-299"},"PeriodicalIF":2.9,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101397","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}