Clinical nutrition ESPEN最新文献

{"title":"A nomogram model combining sarcopenic obesity and biomarkers to predict the risk of vascular stiffness","authors":"Wenwen Liu ,&nbsp;Mingyu Zhu ,&nbsp;Ziyi Wei ,&nbsp;Ningxin Chen ,&nbsp;Tingting Han ,&nbsp;Ting Zhang ,&nbsp;Yurong Weng ,&nbsp;Yiling Fan ,&nbsp;Yaomin Hu","doi":"10.1016/j.clnesp.2025.07.021","DOIUrl":"10.1016/j.clnesp.2025.07.021","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Accumulating evidence reveals that sarcopenia and obesity display a close association with vascular aging. However, comprehensive analysis of the clinical model for estimating the risk of arterial stiffness based on the co-existence of sarcopenia and obesity has not yet been performed.</div></div><div><h3>Methods</h3><div>Here, we curated anthropometric, serological, clinical and computerized tomography (CT) variables from 1136 patients and applied univariate analysis (to eliminate irrelevant predictors) and logistic regression analysis (p &lt; 0.05) in the development cohort to establish the clinical model. The precision of the model was evaluated through area under the curve (AUC) of receiver operator characteristic (ROC), calibration plot and decision curve analysis (DCA), for its discriminative power, calibration consistency and clinical usefulness.</div></div><div><h3>Results</h3><div>Logistic regression analysis identified that body mass index (BMI), total triglyceride (TG), interleukin-6 (IL-6), previous diabetes and hypertension, skeletal muscle fat index (SMFI) and skeletal muscle index (SMI) served as independent predictors for arterial stiffness and three clinical models based on these variables were constructed. The Model incorporating SMI and SMFI simultaneously (model ^{SMI + SMFI}), exhibited superior performance as compared to the models with only SMI (model ^SMI) or only SMFI (model ^SMFI), with reference to the discriminative power (ROC ^{SMI + SMFI} 0.795), calibrative ability (Eavg ^{SMI + SMFI} 0.022, Emax ^{SMI + SMFI} 0.041) and clinical utility in the validation cohort.</div></div><div><h3>Conclusions</h3><div>This research presents a model for the estimation of pulse wave velocity (PWV), which incorporates BMI, TG, IL-6, previous diabetes and hypertension, SMI and SMFI. The model incorporating sarcopenia and obesity simultaneously instead individually, predicts arterial stiffness more accurately. This advancement could enhance our understanding of the role of sarcopenic obesity in vascular dysfunction.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 323-332"},"PeriodicalIF":2.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667324","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":"Early alterations in nutritional indices in metabolic dysfunction-associated steatotic liver disease-related cirrhosis","authors":"Teruki Miyake ,&nbsp;Shinya Furukawa ,&nbsp;Osamu Yoshida ,&nbsp;Ayumi Kanamoto ,&nbsp;Yoshimasa Murakami ,&nbsp;Masumi Miyazaki ,&nbsp;Makoto Morita ,&nbsp;Sho Ishikawa ,&nbsp;Yuki Numata ,&nbsp;Hironobu Nakaguchi ,&nbsp;Yoshiko Nakamura ,&nbsp;Mitsuhito Koizumi ,&nbsp;Takao Watanabe ,&nbsp;Yasunori Yamamoto ,&nbsp;Yoshio Tokumoto ,&nbsp;Masashi Hirooka ,&nbsp;Hirohito Mori ,&nbsp;Eiji Takeshita ,&nbsp;Teru Kumagi ,&nbsp;Yoshio Ikeda ,&nbsp;Yoichi Hiasa","doi":"10.1016/j.clnesp.2025.07.029","DOIUrl":"10.1016/j.clnesp.2025.07.029","url":null,"abstract":"<div><h3>Background and aim</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) is primarily driven by relative overnutrition. Dietary restrictions and weight loss through exercise are known to improve this condition. However, as MASLD progresses, adequate nutritional intake is required to prevent decompensated cirrhosis. Therefore, appropriate nutritional assessment tools are needed to guide the transition from dietary restriction to adequate nutritional intake. However, early risk indicators of malnutrition in MASLD, particularly before decompensated cirrhosis develops, remain unclear. This study aimed to explore nutritional markers indicative of deterioration in MASLD with cirrhosis.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 154 patients (aged 18–79 years) diagnosed with MASLD by liver biopsy between October 2007 and June 2024 at Ehime University Hospital and received nutritional assessments during hospitalization.</div></div><div><h3>Results</h3><div>The Royal Free Hospital Nutritional Prioritizing Tool classified all patients as low risk. Multivariate analysis, adjusted for age, sex, body mass index, creatinine levels, and nonalcoholic fatty liver disease activity score, identified lower albumin, lower cholinesterase, higher hemoglobin A1c, lower total cholesterol, and lower low-density (LDL) cholesterol as independently associated with advanced fibrosis. However, no significant differences were observed in body composition, nutritional intake, and non-protein respiratory quotients.</div></div><div><h3>Conclusions</h3><div>Blood indices reflecting protein syntheses, including albumin and cholinesterase, were useful makers for comprehending the change in nutritional status in MASLD-related cirrhosis. Clinicians should consider these markers when initiating timely changes in nutritional interventions for MASLD-related cirrhosis.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 286-291"},"PeriodicalIF":2.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658503","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":"Letter to the Editor: Different regimens of preoperative carbohydrate loading on insulin resistance: A network meta-analysis","authors":"Hery Sumasto,&nbsp;Suwitho Suwitho,&nbsp;Suhermin Suhermin,&nbsp;Sari Luthfiyah,&nbsp;Nurwening Tyas Wisnu","doi":"10.1016/j.clnesp.2025.07.025","DOIUrl":"10.1016/j.clnesp.2025.07.025","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 292-293"},"PeriodicalIF":2.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The nutritional adequacy of the ketogenic diet in paediatric epilepsy: Detailed nutrient analysis and dietary recommendations","authors":"Erica Tsang ,&nbsp;Richard Webster ,&nbsp;Shekeeb Mohammad ,&nbsp;Manoj Menezes ,&nbsp;Kavitha Kothur ,&nbsp;Esther Tantsis ,&nbsp;Christopher Troedson ,&nbsp;Sachin Gupta ,&nbsp;Deepak Gill ,&nbsp;Shrujna Patel ,&nbsp;Russell C. Dale","doi":"10.1016/j.clnesp.2025.07.023","DOIUrl":"10.1016/j.clnesp.2025.07.023","url":null,"abstract":"<div><h3>Background and aims</h3><div>Much of the focus of ketogenic diet (KD) literature has been on the macronutrient profile, as the appropriate distribution of carbohydrate, fat and protein is essential to inducing ketosis. Few studies have evaluated the micronutrient adequacy of the KD in paediatric epilepsy, despite the importance of adequate vitamin and mineral intake in growth and development. Our study evaluated the nutritional adequacy of the Modified Atkins Diet (MAD) and Classical Ketogenic Diet (CKD) in children with epilepsy, relative to baseline diets and Nutrient Reference Values (NRVs).</div></div><div><h3>Methods</h3><div>Twenty children with epilepsy on the MAD and CKD underwent dietary analysis of 28 key nutrients at baseline and 3 months on diet ( ± multivitamin). Nutrient intake was expressed as % relative to recommended daily intake (RDI), adequate intake (AI), and upper limit as per the Australian NRVs. Nonparametric statistical comparisons were performed with a significance of p &lt; 0.05.</div></div><div><h3>Results</h3><div>Sixty percent of children were KD ‘responders,’ exhibiting &gt;50 % seizure reduction with median beta-hydroxybutyrate (blood ketone) level of 2.75 mmol/L on MAD and 4.25 mmol/L on CKD. Despite restriction of fruits, vegetables, dairy and wholegrains, children on MAD (without multivitamin) met 100 % of RDI for all nutrients except potassium. Intake of fibre and polyunsaturated fat increased significantly on the MAD compared to baseline. With multivitamin supplementation, some children on MAD were close to meeting upper limits for vitamin A, zinc, and selenium. Dietary recommendations to optimise nutritional adequacy using a ‘food-first’ ketogenic approach are provided.</div></div><div><h3>Conclusions</h3><div>Although it is commonly reported that the restrictive nature of the KD induces nutritional deficiencies, our findings indicate that a well-designed MAD can induce positive dietary changes including increased fibre intake, increased mono- and polyunsaturated fat intake, and increased omega-3 essential fatty acid intake in children with epilepsy, whilst producing adequate ketosis.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 274-285"},"PeriodicalIF":2.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648747","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 protein content of plant-derived nutrition limits the protein transition in hospitalized patients: Results from an observational study","authors":"M.A. van Bree ,&nbsp;B.C. Schouten ,&nbsp;E.S. Wolters ,&nbsp;M.R. Soeters ,&nbsp;H.M. Kruizenga","doi":"10.1016/j.clnesp.2025.07.024","DOIUrl":"10.1016/j.clnesp.2025.07.024","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>To improve global- and environmental health, the Dutch Green Deal Sustainable Healthcare (DGD) guidelines recommend to replace at least 50 % of animal protein with plant-derived protein. This may be a challenge for hospitalized patients due to the low protein content and the lack of Essential Amino Acids (EAA) in individual plant-derived sources in combination with anabolic resistance during disease. Yet, there is little knowledge about the effect on protein- and amino acid intake among hospitalized patients as we shift to more plant-derived diets. Therefore, this observational study examines (plant- and animal) protein intake and Amino Acid Scores (AAS) of predominantly plant- and animal derived meals in a large university hospital.</div></div><div><h3>Methods</h3><div>Food intake data were collected through direct observation in non-critically ill adult patients between October and November 2023. Protein requirements were set on 1.2 g/kg body weight, adjusted for BMI. For data analysis, patients were divided into three groups based on their total protein intake: low (&lt;0.8 g/kg), moderate (0.8–1.1 g/kg) and adequate (≥1.2 g/kg). Meals were considered predominantly plant-derived if plant protein (in grams) accounted for over 50 % of its total protein content. AAS were determined per meal by assessing the amount of EAA per gram of protein relative to EAA requirements.</div></div><div><h3>Results</h3><div>In total, 234 patients were included. Protein intake was insufficient in 80 % of all patients. The overall animal-to plant protein ratio was 69:31. Among patients who consumed more than 50 % plant-derived protein per meal, lysine was the most common limiting amino acid (AAS &lt;1). In contrast, no limiting AAS per gram of protein were found for patients consuming more than 50 % animal-derived protein per meal.</div></div><div><h3>Conclusion</h3><div>Achieving sufficient protein intake (1.2 g/kg) is a key challenge especially in the shift towards more plant-derived nutrition. Although the predominantly plant-derived meals require careful attention to amino acid profiles, especially for lysine, the low total protein content of predominantly plant-derived meals poses the greatest challenge, thereby limiting the feasibility of the protein transition for hospitalized patients.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 311-317"},"PeriodicalIF":2.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Navigating complexity: The challenge of reaching consensus on the diagnosis of malnutrition in patients with obesity via a modified delphi study\" [Clin Nutr ESPEN 68 (2025) 591-601].","authors":"Natasha Nalucha Mwala, Jeanne J F A In 't Hulst, Barbara S van der Meij, Emmelyne Vasse, Jos W Borkent, Carliene van Dronkelaar, Patty L M Lakenman, Esmee M Reijnierse, Josje D Schoufour, Peter J M Weijs, Renate M Winkels, Maarten R Soeters, Marian A E de van der Schueren","doi":"10.1016/j.clnesp.2025.07.001","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.07.001","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Provision of additional oral nutritional supplements to postgastrectomy patients based on regular diet intake to meet their energy requirements reduces body weight loss.","authors":"Hitoshi Harada, Shingo Kanaji, Moe Tsuboi, Saki Nakatani, Satoko Tabuchi, Ikuko Yamamoto, Yutaka Sugita, Taro Ikeda, Yasufumi Koterazawa, Tomoaki Aoki, Yasunori Otowa, Naoki Urakawa, Hironobu Goto, Hiroshi Hasegawa, Kimihiro Yamashita, Takeru Matsuda, Michiko Takahashi, Yoshihiro Kakeji","doi":"10.1016/j.clnesp.2025.07.015","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.07.015","url":null,"abstract":"<p><strong>Background & aims: </strong>Oral nutritional supplements (ONS) administered after gastrectomies can prevent postoperative weight loss. However, the amount of additional energy to be added to energy requirements after gastrectomy is unclear. This study aimed to clarify dietary energy intake and its association with weight loss in postgastrectomy patients.</p><p><strong>Methods: </strong>We performed a single-center, single-arm, open-label, non-randomized clinical trial. Fifty patients with gastric cancer who underwent distal or total gastrectomy were included in this study. Until 3 months postoperatively, the patients continuously consumed ONS and their intake was recorded. Additionally, the patients took photos of their regular diets. Hospital visits were made every 2 weeks to investigate calorie intake (from regular diet plus ONS), physical findings, and nutritional status. The primary endpoint was the percentage of body weight loss (%BWL) at 3 months after gastrectomy.</p><p><strong>Results: </strong>Data were available for 45 patients. %BWL was 7.5±5.1% at 3 months postoperatively. The group with ONS intake <200 kcal/day tended to show a lower %BWL; however, this was not significant. No correlation was observed between ONS and regular dietary calorie intake. The required calorie intake was 1588±157 kcal/day. Calorie intake from regular diet alone and from regular diet plus ONS were 1330±280 and 1487±300 kcal/day, respectively. The sufficient group, whose total calorie intake met the requirements, had significantly reduced body weight loss, compared with the insufficient group.</p><p><strong>Conclusions: </strong>After gastrectomy, regular diet alone often fails to meet nutritional requirements, and ONS supplementation may reduce %BWL at 3 months postoperatively by correcting energy deficits. This study was registered with the University Hospital Medical Information Network Clinical Trial Registry (UMIN-CTR; UMIN000047451; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000054111).</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary habits are suboptimal in patients referred to lipid clinics on suspicion of familial hypercholesterolaemia","authors":"Jonas Pedersen ,&nbsp;Christian Bork ,&nbsp;Helle Kanstrup ,&nbsp;Kristian Korsgaard Thomsen ,&nbsp;Merete Heitmann ,&nbsp;Lia Evi Bang ,&nbsp;Finn Lund Henriksen ,&nbsp;Lars Juel Andersen ,&nbsp;Thomas Gohr ,&nbsp;Bo Kobberø Lauridsen ,&nbsp;Anne Merete Boas Soja ,&nbsp;Frank Peter Elpert ,&nbsp;Tomas Joen Jakobsen ,&nbsp;Anette Sjøl ,&nbsp;Albert Marni Joensen ,&nbsp;Ib Christian Klausen ,&nbsp;Børge Grønne Nordestgaard ,&nbsp;Erik Berg Schmidt ,&nbsp;Berit Storgaard Hedegaard","doi":"10.1016/j.clnesp.2025.07.010","DOIUrl":"10.1016/j.clnesp.2025.07.010","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Diet and lifestyle are cornerstones in the prevention of atherosclerotic cardiovascular disease, especially in individuals with familial hypercholesterolaemia (FH). The aim of this cross-sectional study was to investigate dietary habits among adults admitted to lipid clinics on suspicion of FH.</div></div><div><h3>Methods</h3><div>From September 2020 through November 2021, all patients referred on suspicion of FH to all lipid clinics were invited to participate and 97.4 % (n = 1488) accepted. Information on dietary habits was collected using a validated food frequency questionnaire based on a score ranging from 0 to 100.</div></div><div><h3>Results</h3><div>A total of 1095 subjects were included of whom 5.7 % adhered to a heart-healthy diet. Overall, participants’ diets were suboptimal and in particular the intake of fish, fruit, and vegetables was low with a median score of 52 points compared to the recommended heart-healthy 75 points. Women and individuals with a personal history of atherosclerotic cardiovascular disease showed marginally better adherence to a heart-healthy diet. Notably, intake of fish, fruit, vegetables, and whole-grains were insufficient in all groups.</div></div><div><h3>Conclusion</h3><div>Most participants referred to lipid clinics on suspicion of FH did not adhere to a heart-healthy diet regardless of history of atherosclerotic cardiovascular disease. These findings reinforce the importance of providing and supporting dietary counselling among individuals with hypercholesterolaemia.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 257-265"},"PeriodicalIF":2.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616603","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":"Vitamin D Deficiency in COPD: A Call for Multilevel Interventions and Broader Assessment.","authors":"Nana Wang, Wenmei Bai, Yujiao He","doi":"10.1016/j.clnesp.2025.07.017","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.07.017","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616609","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 genotype-guided nutritional intervention to reduce cardiometabolic risk factors in young adults: Study protocol for a randomized controlled trial","authors":"Karina Rodrigues ,&nbsp;Marcela M. Mendes ,&nbsp;Lana Pacheco Franco-Gedda ,&nbsp;Nara R. da Silva ,&nbsp;Mariana Oliveira ,&nbsp;Flávia C.F. Silva ,&nbsp;Flávia Campos Corgosinho ,&nbsp;Kristy Soraya Coelho ,&nbsp;Franco Maria Lajolo ,&nbsp;José M. Aldrighi ,&nbsp;Carla M. Prado ,&nbsp;Lu Qi ,&nbsp;Karani Santhanakrishnan Vimaleswaran ,&nbsp;Maria Aderuza Horst","doi":"10.1016/j.clnesp.2025.07.008","DOIUrl":"10.1016/j.clnesp.2025.07.008","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Cardiometabolic diseases (CMD), including cardiovascular disease, obesity and diabetes, are major public health challenges influenced by lifestyle factors (e.g., diet), vitamin D status, and genetic predisposition. Single nucleotide polymorphisms (SNPs) contribute to genetic risk scores for CMD-related traits (M-GRS) and recent research suggests that genotype-based nutritional interventions have the potential to reduce these risks. This study aims to evaluate the effectiveness of genotype-guided nutritional interventions versus standard dietary recommendations in young adults.</div></div><div><h3>Methods</h3><div>This 12-month study includes a 6-month intervention phase and a 6-month free-living phase. Data will be collected at baseline, 3, 6 and 12 months. We plan to recruit young adults (aged 23–29) previously genotyped from the Obesity, Lifestyle, and Diabetes in Brazil (BOLD) study and randomized by BMI, sex, and M-GRS based on 34 SNPs. The control group will follow a standard Brazilian diet with CMD-related recommendations and 1000 IU of vitamin D3 daily. The personalized intervention group will receive a genotype-guided dietary plan based on gene–diet interactions for SNPs in the M-GRS, along with personalized vitamin D3 supplementation (1000 or 4000 IU) based on their genetic risk for deficiency (D-GRS). Body composition, biochemical markers and metabolomics will be assessed, with the reduction in body fat percentage as the primary outcome.</div></div><div><h3>Discussion</h3><div>This study will contribute to precision nutrition by assessing genotype-guided dietary recommendations for CMD risk management, potentially demonstrating how genetic information can optimize dietary interventions and reduce CMD burdens, improving overall health outcomes.</div></div><div><h3>Trial registration</h3><div>Brazilian Registry of Clinical Trials: RBR-7b43sfr <span><span>http://ensaiosclinicos.gov.br/rg/RBR-7b43sfr</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 196-206"},"PeriodicalIF":2.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616600","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}