Clinical nutrition ESPEN最新文献

{"title":"3D assessment of skeletal muscle and adipose tissue for prognosis of hepatocellular carcinoma: A multicenter cohort study","authors":"Jinxiong Zhang ,&nbsp;Shuoling Zhou ,&nbsp;Yurong Jiang ,&nbsp;Wei Zhao ,&nbsp;Weiguo Xu ,&nbsp;Jiawei Zhang ,&nbsp;Taixue An ,&nbsp;Jianfeng Yan ,&nbsp;Chongyang Duan ,&nbsp;Xiaojun Wang ,&nbsp;Sihui Yang ,&nbsp;Tao Wang ,&nbsp;Dandan Dong ,&nbsp;Yuan Chen ,&nbsp;Feixiang Zou ,&nbsp;Xiangrong Yu ,&nbsp;Meiyan Huang ,&nbsp;Sirui Fu","doi":"10.1016/j.clnesp.2025.03.168","DOIUrl":"10.1016/j.clnesp.2025.03.168","url":null,"abstract":"<div><h3>Background</h3><div>Changes in protein and lipid metabolism could provide additional prognostic information for hepatocellular carcinoma (HCC).This study aimed to explore whether 3D automatic assessment of skeletal muscle and adipose tissue can contribute to the precise prognosis for HCC.</div></div><div><h3>Methods</h3><div>The data of 458 HCC patients from 6 hospitals were divided into training and external validation datasets. Preoperative CT Images were used for this study. First, we tested the stability of the 2D factors. Second, we tested whether standardization for volume assessment was necessary. Third, we compared the clinical (Model^C), skeletal muscle and adipose tissue (Model^NSA), and combined (Model^C−NSA) models by discrimination and calibration to identify the optimal model. Subgroup analysis was performed for the optimal model.</div></div><div><h3>Results</h3><div>For the 16 2D factors, 13 factors were statistically different among the three 2D slices. Standardization of the volume factors was necessary. Among the three models, Model^C−NSA had a higher area under the curve [AUC] than Model^C and Model^NSA, both in the training dataset (0.809 vs. 0.649 vs. 0.797) and the validation dataset (0.770 vs. 0.718 vs. 0.719). For calibration, the performance of Model^C−NSA was similar to those of Model^C and Model^NSA. The performance of Model^C−NSA was not influenced by age (<em>P</em> = 0.753), sex (<em>P</em> = 0.781), treatments (<em>P</em> = 0.504), Barcelona Clinic Liver Cancer stage (<em>P</em> = 0.913), or Child-Pugh class (<em>P</em> = 0.580).</div></div><div><h3>Conclusions</h3><div>Compared to 2D evaluation, 3D assessment is more stable. 3D automatic assessment of skeletal muscle and adipose tissue can accurately predict progression in patients with HCC.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 626-634"},"PeriodicalIF":2.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788008","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":"Maternal sleep and psychological status in the postpartum period are associated with functional protein alterations in breast milk:a mother-infant cohort study","authors":"Celi Yang ,&nbsp;Xiaona Na ,&nbsp;Haibing Yang ,&nbsp;Menglu Xi ,&nbsp;Yucheng Yang ,&nbsp;Yalu Yan ,&nbsp;Sufang Duan ,&nbsp;Ting Li ,&nbsp;Ignatius Man-Yau Szeto ,&nbsp;Ai Zhao","doi":"10.1016/j.clnesp.2025.03.167","DOIUrl":"10.1016/j.clnesp.2025.03.167","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Postpartum sleep disorder and mental disorders are common unpleasant conditions faced by women after delivery, and they have many adverse effects on both mothers and infants. It is unclear whether breast milk composition is affected by maternal sleep, psychological state, diet and gut microbiome. This study aims to explore the effects of these key factors on the functional protein components of breast milk.</div></div><div><h3>Methods</h3><div>With a prospective design, this pilot study included a total of 41 postpartum women. Breast milk and maternal faecal samples collected at 42 days and 3 months postpartum were tested by liquid chromatography-mass spectrometry and 16S RNA sequencing, respectively. Sleep state, psychological state and dietary intake data were also collected from the mothers with validated questionnaires.</div></div><div><h3>Results</h3><div>In the early postpartum period, sleep disorders and depression were associated with a decrease in the functional proteins in breast milk. Disordered sleep was significantly negatively correlated with α-lactalbumin (cor = −0.578, p &lt; 0.001), osteopontin (cor = −0.522, p &lt; 0.01) and κ-casein (cor = −0.451, p &lt; 0.01). Depression was negatively correlated with αs1-casein (cor = −0.422, p &lt; 0.01), β-casein (cor = −0.317, p &lt; 0.05) and casein (cor = −0.318, p &lt; 0.05). In 3 months postpartum, most associations were disappeared. But a positive correlation was observed between β-casein (cor = 0.414, p &lt; 0.01), casein (cor = 0.372, p &lt; 0.05), total protein (cor = 0.376, p &lt; 0.05) and depression, while a positive correlation was found between total protein (cor = 0.357, p &lt; 0.05) and disordered sleep at 3 months postpartum. Faecal microbiome data illustrated that changes in the gut microbiome at early postpartum were associated with sleep disorders/depression, but not with the diet. Furthermore, functional pathway analysis revealed metabolic regulation in the amino acid synthesis and metabolic pathways associated with specific microbes was involved in the reduction of breast milk protein.</div></div><div><h3>Conclusion</h3><div>Sleep disorders/depression could lead to significant changes in breast milk profiles at 42 days postpartum. Maternal gut microbiome might affect breast milk protein composition through regulating amino acid synthesis and metabolic pathways.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 510-522"},"PeriodicalIF":2.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to dietary guidelines and liver cancer risk: Results from two prospective cohort studies","authors":"Jia-Yi Tuo ,&nbsp;Qiu-Ming Shen ,&nbsp;Zhuo-Ying Li ,&nbsp;Dan-Ni Yang ,&nbsp;Yi-Xin Zou ,&nbsp;Yu-Ting Tan ,&nbsp;Hong-Lan Li ,&nbsp;Yong-Bing Xiang","doi":"10.1016/j.clnesp.2025.03.173","DOIUrl":"10.1016/j.clnesp.2025.03.173","url":null,"abstract":"<div><h3>Background and aims</h3><div>Although dietary factors have been extensively investigated as potential risk factors for liver cancer, the evidence is inconclusive. Our study systematically assessed the associations between ten dietary guidelines compliance scores and liver cancer risk among adult people, and found out the dietary patterns for liver cancer prevention.</div></div><div><h3>Methods</h3><div>Participants of 59,844 men and 72,680 women, aged 40–74 years and living in urban Shanghai, were included in two prospective cohort studies conducted between 2002–2006 and 1996–2000, respectively. Dietary intakes were assessed during baseline in-person interviews using validated food-frequency questionnaires, and dietary guideline compliance scores were calculated by adjusting for total energy intake and adapting existing dietary recommendations. Hazards ratios (HRs) with 95 % confidence intervals (CIs) were evaluated by both tertile categories and per standard deviation (SD) increment using Cox proportional hazard regression models to assess the associations between ten dietary guideline compliance scores and liver cancer risk.</div></div><div><h3>Results</h3><div>In the two cohorts, 431 male and 256 female incident liver cancer cases were identified during a mean follow-up of 11.90 and 17.44 years, respectively. There were no statistically significant associations between these ten dietary guidelines and male liver cancer risk (<em>P</em> &gt; 0.05). In contrast, only the modified reversed Empirical Dietary Inflammation Pattern (rEDIP) tended to be associated with the low risk of female liver cancer (HR _{T3 vs. T1} = 0.67, 95 % CI: 0.48–0.92, <em>P</em> _{<em>trend</em>} = 0.016, HR per SD = 0.94, 95 % CI: 0.85–1.03). The inverse associations appeared stronger between rEDIP and liver cancer risk at younger ages (&lt;55 years) in women (HR per SD = 0.91, 95 % CI: 0.84–0.99) compared to the older women (≥55 years). There were suggestive but non-significant inverse associations between the modified Diabetes Risk Reduction Diet (mDRRD) (men: HR per SD = 0.92, 95 % CI: 0.84–1.02; women: HR per SD = 0.97, 95 % CI: 0.84–1.02) and the modified World Cancer Research Fund/American Institute for Cancer Research (mWCRF/AICR) (men: HR per SD = 0.93, 95 % CI: 0.84–1.02; women: HR per SD = 0.91, 95 % CI: 0.80–1.03) and liver cancer incidence. The associations of mDRRD (HR per SD = 0.82, 95 % CI: 0.75–0.98) and mWCRF/AICR (HR per SD = 0.83, 95 % CI: 0.74–0.99) on liver cancer risk were significant in men who ever smoked.</div></div><div><h3>Conclusions</h3><div>Our findings confirm that greater adherence to some healthy dietary patterns (i.e. rEDIP, mDRRD and mWCRF/AICR) is inversely associated with liver cancer risk, especially in certain populations. Future studies are required to confirm these findings and elucidate potential mechanisms.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 599-611"},"PeriodicalIF":2.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788011","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":"Postprandial glycemic effects of lactose-hydrolyzed milk supplemented with mulberry leaf and corn silk extracts in adults with type 2 diabetes: A randomized crossover trial","authors":"You Sun ,&nbsp;Yong Zhang ,&nbsp;Xiaokang Niu ,&nbsp;Yan Liu ,&nbsp;Lingling Xu ,&nbsp;Yifan Wang ,&nbsp;Qi Zhang ,&nbsp;Jingjing He ,&nbsp;Yinghua Liu ,&nbsp;Kaishuai Zhang ,&nbsp;Ran Wang ,&nbsp;Jian He ,&nbsp;Jie Guo","doi":"10.1016/j.clnesp.2025.03.174","DOIUrl":"10.1016/j.clnesp.2025.03.174","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Lactose-hydrolyzed milk is widely used to address lactose intolerance. However, its monosaccharide content may rapidly increase postprandial blood glucose levels and heighten glycemic variability. We aimed to explore the effects of mulberry leaf and corn silk extracts (medicinal and edible homologous materials) and their supplementation in lactose-hydrolyzed milk on postprandial glycemic control in adults with type 2 diabetes.</div></div><div><h3>Methods</h3><div>Eligible participants in this crossover trial were randomized to four interventions, separated by a 7 d washout. Intervention foods were whole-grain bread (50 g carbohydrates) together with water, mulberry leaf and corn silk extracts (MCE), lactose-hydrolyzed milk (LHM), or lactose-hydrolyzed milk supplemented with mulberry leaf and corn silk extracts (LHM-MCE). Continuous glucose monitoring systems were used to collect fasting and postprandial interstitial glucose over 2 h after interventions and to calculate the incremental area under the curve (iAUC). Paired Wilcoxon signed-rank test was used to compare the difference in iAUC, 1-h postprandial glycemic (1h PG), 2h PG, maximum glycemic, and maximum glucose excursion from baseline across interventions.</div></div><div><h3>Results</h3><div>Twenty-eight adults with type 2 diabetes (55 ± 10 years old, fasting blood glucose: 6.93 ± 1.22 mmol/L) completed the trial. MCE was associated with lower levels of maximum glycemic (median of difference [interquartile range]: (−0.9 [−1.9, 0.4], <em>P = 0.025</em>) and maximum glucose excursion from baseline (−0.9 [−1.5, −0.03], <em>P = 0.005</em>) compared to water. LHM-MCE was associated with lower levels of 1h PG (−0.7 [−1.9, 0.4], <em>P = 0.04</em>), maximum glycemic (−0.9 [−2.2, 0.4], <em>P = 0.014</em>), and maximum glucose excursion from baseline (−1.0 [−2.3, −0.4], <em>P = 0.003</em>) compared to LHM.</div></div><div><h3>Conclusions</h3><div>Mulberry leaf and corn silk extracts may benefit postprandial glycemic control and their incorporation into lactose-hydrolyzed milk could be a promising dietary intervention for patients with type 2 diabetes.</div></div><div><h3>Registration number of clinical trial</h3><div>ChiCTR2400086442.</div></div><div><h3>Website</h3><div><span><span>https://www.chictr.org.cn/showproj.html?proj=235132</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 549-554"},"PeriodicalIF":2.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788017","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 quality of plant-based diets and liver cancer incidence and liver disease mortality in the UK Biobank","authors":"Xiaocong Dong ,&nbsp;Mingjie Zhang ,&nbsp;Jing Shu ,&nbsp;Yunshan Li ,&nbsp;Peishan Tan ,&nbsp;Tianyou Peng ,&nbsp;Jialin Lu ,&nbsp;Yaojun Zhang ,&nbsp;Xiali Zhong ,&nbsp;Aiping Fang","doi":"10.1016/j.clnesp.2025.03.166","DOIUrl":"10.1016/j.clnesp.2025.03.166","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Plant-based diets have been associated with a lower risk of various chronic diseases. However, their role in preventing liver cancer and liver-related death is currently unclear. We aimed to investigate the association between plant-based diets and the risk of liver cancer incidence and liver disease mortality in the UK Biobank.</div></div><div><h3>Methods</h3><div>We included 85,810 males and 101,971 females from the UK Biobank in our analyses. Three plant-based diet indices, including an overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI), and an unhealthful plant-based diet index (uPDI), were created based on 17 food groups using data from at least one 24-hour dietary assessments. Cox proportional hazards models were used to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>During follow-up, 109 males and 68 females developed liver cancer, and 190 males and 108 females died from liver diseases. Overall PDI scores were not associated with liver cancer incidence or liver disease mortality in either males or females. However, higher hPDI scores were linked to a lower risk of liver cancer incidence (HR_{Q5 vs. Q1}: 0.47; 95%CI: 0.26, 0.85; <em>P</em>-trend=0.005) and liver disease mortality (HR_{Q5 vs. Q1}: 0.46; 95%CI: 0.27, 0.77; <em>P</em>-trend=0.011) in males. Higher uPDI scores were associated with an increased incidence of liver cancer (HR_{Q5 vs. Q1}: 1.90; 95%CI: 1.00, 3,63; <em>P</em>-trend=0.038) and a higher risk of liver disease-related deaths (HR_{Q5 vs. Q1}: 2.21; 95%CI: 1.37, 3.57; <em>P</em>-trend &lt;0.001). However, no such associations between hPDI or uPDI and the risk of liver cancer or liver disease mortality were observed in females.</div></div><div><h3>Conclusions</h3><div>Our results suggest that higher adherence to plant-based diets, emphasizing healthful plant-based foods while restricting less healthful plant foods, may protect against liver cancer and liver disease-related deaths in males, but not in females.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788023","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 characteristics and experiences of survivors of critical illness after hospital discharge: A multi-method narrative review","authors":"Josephine M. Dudzik ,&nbsp;Ethan K. Balk ,&nbsp;Andrea L. Deierlein","doi":"10.1016/j.clnesp.2025.03.171","DOIUrl":"10.1016/j.clnesp.2025.03.171","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Many survivors of critical illness experience long-term functional, cognitive, and psychological impairments known as post-intensive care syndrome (PICS). Yet, the nutritional recovery experiences of intensive care unit (ICU) survivors after hospital discharge remain underrecognized and poorly understood. The objective of this review was to characterize nutritional indices and nutrition-related outcomes in survivors of critical illness, and to understand the nutritional recovery experience after hospital discharge.</div></div><div><h3>Methods</h3><div>Searches were conducted for eligible quantitative and qualitative studies between June and August 2024 using PubMed, CINAHL Complete, and Scopus electronic databases. Abstracts and full texts were screened against predetermined inclusion and exclusion criteria. Primary research analyzing anthropometric, nutritional, and/or experiential data of adult survivors of critical illness after hospital discharge were included in this review.</div></div><div><h3>Results</h3><div>21 quantitative (n = 3054) and 7 qualitative (n = 162) studies were included. After hospital discharge, ICU survivors seldom returned to their baseline weight with many having small to modest weight gains in the first months of recovery. Average calorie (18–33.5 calories/kilogram/day) and protein (0.96–1.6 g/kg/day) intakes largely did not meet requirements needed to facilitate recovery, resulting in high rates of malnutrition, ranging from 16.8 to 63 % 3 months after discharge. A multitude of barriers to nutritional recovery were faced in the post-discharge period resulting from persistent physical and functional limitations due to critical illness. Ongoing individualized nutrition monitoring and follow-up from dietetic professionals knowledgeable in post-ICU care has the potential to improve nutrition-related outcomes for survivors yet remains underutilized. Improving the availability and affordability of such services is a key facilitator to improve the nutritional recovery experience for ICU survivors.</div></div><div><h3>Conclusions</h3><div>After hospital discharge, many survivors of critical illness face numerous barriers to nutritional recovery resulting in long-term nutritional complications. Future research efforts should target nutritional characterization, associations between nutritional variables and PICS, and the identification and development of effective nutrition interventions to improve long-term outcomes for survivors of critical illness after hospital discharge.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 612-625"},"PeriodicalIF":2.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788020","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":"Comment on “Lifestyle aspects are associated with common mental disorders in women over 40 years older in a population-based study” clinical nutrition ESPEN 2024","authors":"Ingrid Thayanne Souza Alves da Silva,&nbsp;Débora Eduarda da Silva Fidelis Nóbrega,&nbsp;Matheus Santos de Sousa Fernandes","doi":"10.1016/j.clnesp.2025.03.036","DOIUrl":"10.1016/j.clnesp.2025.03.036","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 652-653"},"PeriodicalIF":2.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751541","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":"Taste preference of patients shortly after surgery in the Post Anaesthesia Care Unit (PACU)","authors":"E.S. de Klerk ,&nbsp;M. Koetsier ,&nbsp;S.C.M. Rietveld ,&nbsp;S. Boesveldt ,&nbsp;E.M. Postma ,&nbsp;P. Morquecho Campos ,&nbsp;M.W. Hollmann ,&nbsp;B. Preckel ,&nbsp;J. Hermanides ,&nbsp;M.F.M. van Stijn","doi":"10.1016/j.clnesp.2025.03.047","DOIUrl":"10.1016/j.clnesp.2025.03.047","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Early postoperative oral feeding is safe and enhances recovery after surgery. To facilitate oral intake directly after surgery in the Post Anaesthesia Care Unit (PACU) and to enhance its associated benefits, knowledge on what patients would like to eat and/or drink is essential. Data on taste preferences in the immediate postoperative period is scarce, therefore this study investigated the taste preference of patients directly after surgery in the PACU.</div></div><div><h3>Methods</h3><div>A prospective observational study in adult patients scheduled for elective surgery under general anaesthesia. Taste preference was our primary outcome, for which we used the Macronutrient and Taste Preference Ranking Task (MTPRT) questionnaire. As secondary outcomes we asked additional questions to evaluate specific food characteristics separately, including consistency, texture, and temperature of food/drinks. Finally, we evaluated the appetite of our patients, using descriptive statistics, and analysing differences in the MTPRT liking scores.</div></div><div><h3>Results</h3><div>We included 57 surgical patients. The MTPRT liking data showed that our patients liked low-energy products with a sweet taste the most. The MTPRT ranking data showed a dislike for high-protein products. Data from the additional questionnaire revealed that our patients seemed to like food products with soft, juicy, crispy, hot and cold characteristics. The majority of patients (n = 44, 79 %) did have an appetite for food directly after surgery during their PACU admission.</div></div><div><h3>Conclusion</h3><div>This study showed that postoperative patients in the PACU tended to like low-energy food products with a sweet taste the most. In addition, this study showed that patients seemed to favour a broad variety of food products directly after surgery. Due to our small sample size the results should be interpreted with caution, but they do provide initial insights to help improve PACU food services, and thereby can contribute to enhance early postoperative oral intake. Registered at NTR (<span><span>trialregister.nl</span><svg><path></path></svg></span>) with study ID Trial NL9048.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 578-584"},"PeriodicalIF":2.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751542","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 role of micro-ribonucleic acid and small interfering-ribonucleic acid in precision nutrition for obesity management","authors":"Wardina Humayrah ,&nbsp;Nindy Sabrina ,&nbsp;Megah Stefani ,&nbsp;Nurpudji Astuti Taslim ,&nbsp;Reggie Surya ,&nbsp;Matthew Nathaniel Handoko ,&nbsp;Vincent Lau ,&nbsp;Hardinsyah Hardinsyah ,&nbsp;Trina Ekawati Tallei ,&nbsp;Rony Abdi Syahputra ,&nbsp;Fahrul Nurkolis","doi":"10.1016/j.clnesp.2025.03.049","DOIUrl":"10.1016/j.clnesp.2025.03.049","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Precision nutrition aims to tailor dietary interventions based on genetic and molecular profiles. MicroRNAs (miRNAs) and small interfering RNAs (siRNAs) are emerging as critical tools in precision obesity management. miRNAs serve as biomarkers for predicting dietary response and obesity risk, while siRNAs provide a targeted approach to silencing obesity-related genes. This review explores the mechanisms, applications, and potential of integrating miRNA and siRNA in personalized dietary strategies to combat obesity.</div></div><div><h3>Methods</h3><div>A comprehensive literature review was conducted using Boolean operations to identify studies on miRNAs, siRNAs, and their roles in precision nutrition. The review focused on molecular mechanisms, clinical applications, challenges, and future directions in integrating miRNA detection and siRNA therapy for obesity management.</div></div><div><h3>Results</h3><div>miRNAs regulate gene expression related to lipid metabolism, adipogenesis, and insulin sensitivity, with miRNA-33 and miRNA-103/107 being notable examples. siRNAs offer precise gene silencing for targets like SREBP-1c and PPARγ, addressing metabolic pathways resistant to dietary interventions. The synergistic integration of miRNAs as biomarkers and siRNAs as therapeutic tools enhances the personalization and efficacy of obesity management.</div></div><div><h3>Conclusions</h3><div>The dual application of miRNAs and siRNAs in precision nutrition represents a transformative approach to obesity management. While challenges such as molecular stability and delivery systems persist, advancements in RNA technology and clinical research promise to revolutionize personalized dietary strategies. Future research should focus on large-scale trials and ethical considerations to ensure equitable and effective implementation.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 463-475"},"PeriodicalIF":2.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750110","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 association between body mass index, waist circumference and waist-to-hip-ratio with all-cause mortality in older adults: A systematic review","authors":"Gabriela Ueta Ortiz ,&nbsp;Leonardo Santos Lopes da Silva ,&nbsp;Leonardo da Silva Gonçalves ,&nbsp;Gabriela Ferreira Abud ,&nbsp;Ana Claudia Rossini Venturini ,&nbsp;Adelino Sanchez Ramos da Silva ,&nbsp;Ellen Cristini de Freitas","doi":"10.1016/j.clnesp.2025.03.051","DOIUrl":"10.1016/j.clnesp.2025.03.051","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background &amp; aims&lt;/h3&gt;&lt;div&gt;The association between anthropometric obesity parameters and all-cause mortality in older adults is of significant interest due to the implications for public health and clinical practice. This systematic review aims to assess and synthesize the literature on the relationship between anthropometric obesity parameters, such as the body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), with all-cause mortality in older adults.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This systematic review was registered on the International Prospective Register of Systematic Reviews (PROSPERO - CRD42024521886). A systematic search was conducted across five databases: PubMed, EMBASE, Web of Science, SCOPUS, and LILACS. The study included: (1) older adults (≥60 years); (2) an observational-longitudinal study design (prospective and retrospective cohorts); (3) different anthropometric methods for the diagnosis of obesity; and (4) all-cause mortality as an outcome. The National Institutes of Health quality assessment tool for observational cohort and cross-sectional studies was employed to assess the methodological quality of the included studies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 38 studies were included. Most studies have investigated associations between BMI and all-cause mortality. Among them, 9 studies found no significant association, 25 reported a protective effect, 1 identified BMI as a risk factor, and 4 observed a U-shaped relationship. Regarding WC, the results were conflicting: 15 studies found no association with mortality, 8 identified WC as a risk factor, and 6 suggested a protective effect. As for WHR, although it was the least frequently assessed measure, 8 studies identified it as a risk factor for mortality in older adults, 4 found no significant association, and 1 reported an inverse relationship. These findings highlight discrepancies in the associations between obesity measures and mortality.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;BMI appears to be inversely associated with mortality in older adults, while findings for WC remain controversial. WHR demonstrates a positive association with mortality, but further research is needed to confirm these findings. Clinicians should ensure that older patients do not remain at lower BMI thresholds, as higher BMI values appear protective, particularly in the presence of diseases. This recommendation should be made on an individualized basis, considering the individual's health status. Recommendations at the individual level should also consider functional status and body composition measurements. Moreover, WHR may provide additional insights into mortality risk beyond BMI, highlighting its importance for clinical practice. These findings support an integrative approach to monitoring both metrics to better inform preventative strategies and resource allocation for aging populations. Cut-off points for anthropometric measures of obesity sh","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 493-509"},"PeriodicalIF":2.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751543","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}