Clinical nutrition ESPEN最新文献

{"title":"Phase angle as a predictor of complications in acute stroke: A cohort study","authors":"Keisuke Honma ,&nbsp;Tomoyuki Ogino ,&nbsp;Koichiro Sota ,&nbsp;Naoki Sasanuma ,&nbsp;Masataka Igeta ,&nbsp;Yuki Uchiyama ,&nbsp;Kazuhisa Domen","doi":"10.1016/j.clnesp.2025.09.004","DOIUrl":"10.1016/j.clnesp.2025.09.004","url":null,"abstract":"<div><h3>Background and aims</h3><div>Complications following acute stroke can worsen prognosis. Skeletal muscle mass and quality may influence these outcomes. To investigate the association between skeletal muscle quantity and quality with the incidence of complications in patients hospitalized for acute stroke.</div></div><div><h3>Methods and results</h3><div>This single center prospective cohort study evaluated 646 consecutive patients who were hospitalized for acute stroke (women: 45 %, hemorrhagic stroke: 20 %). The main study outcome was the occurrence of complications during acute hospitalization. Skeletal muscle mass and quality were assessed via bioelectrical impedance analysis, with skeletal muscle index (SMI) representing mass and phase angle (PhA) reflecting quality. A binary logistic regression analysis was performed to determine the factors that were associated with the occurrence of complications upon admission. A total of 179 patients (27.7 %) experienced complications. These individuals were significantly older, had lower body mass index, higher NIH Stroke Scale (NIHSS) scores, and poorer nutritional status. Multivariate analysis showed that higher NIHSS (OR 1.10, 95 % CI 1.08–1.13, p = 0.001), older age (OR 1.03, 95 % CI 1.00–1.05, p = 0.030), and lower PhA (OR 0.74, 95 % CI 0.57–0.97, p = 0.028) were independently associated with complications. SMI was not a significant predictor.</div></div><div><h3>Conclusions</h3><div>PhA was independently associated with the occurrence of complications during acute hospitalization. Moreover, its evaluation in acute stroke is noninvasive and easy to perform, potentially enabling early prediction of complications.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 45-49"},"PeriodicalIF":2.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058411","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":"Italian SIGENP (Italian Society of gastroenterology, hepatology and pediatric nutrition) registry of pediatric home artificial nutrition: First report","authors":"Antonella Lezo ,&nbsp;Antonella Diamanti ,&nbsp;Leila Cravero ,&nbsp;Teresa Capriati ,&nbsp;Laura Lacitignola ,&nbsp;Paolo Gandullia ,&nbsp;Lorenzo Norsa ,&nbsp;Elvira Verduci ,&nbsp;Silvia Salvatore ,&nbsp;Giovanna Verlato ,&nbsp;Barbara Parma ,&nbsp;Giuseppe Pasolini ,&nbsp;Claudio Romano ,&nbsp;Maria Immacolata Spagnuolo","doi":"10.1016/j.clnesp.2025.07.1129","DOIUrl":"10.1016/j.clnesp.2025.07.1129","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Home Artificial Nutrition (HAN), including Home Enteral Nutrition (HEN) and Home Parenteral Nutrition (HPN), is essential for managing pediatric patients with complex nutritional needs. This article presents the first report from the Italian Pediatric HAN registry, promoted and endorsed by the Italian Society for Pediatric Gastroenterology, Hepatology, and Nutrition (SIGENP) in order to document HAN practices and clinical outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aims&lt;/h3&gt;&lt;div&gt;The registry aims to analyze data from the Italian network of pediatric HAN to provide insights into its epidemiology, efficacy and safety.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Established in 2020, the registry is an online platform accessible via the SIGENP website (&lt;span&gt;&lt;span&gt;www.nad-sigenp.org/site/home&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;) for recording data on pediatric patients aged 0–19 years who currently or previously required HAN. Registered SIGENP network centers enter data on patient demographics, nutritional support details, clinical outcomes and complications.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;As of December 31, 2022, the registry included 3525 home artificial nutrition programs (2402 HEN, 917 oral nutritional supplements [ONS]and 206 HPN) provided by 13 centers across 9 regions. The prevalence of pediatric HAN in Italy reached 365 programs per million inhabitants aged 0–19 years (249 HEN, 57 ONS, and 21 HPN), showing a clear increase compared to previous national surveys conducted by the Italian Society of Artificial Nutrition and Metabolism (SINPE) [12]. Mean age at initiation was 1.8 years for HEN and 0.9 years for HPN. Median duration of HEN was 1.4 years, predominantly prescribed for neurological patients, showing significant correlation between early HEN initiation and improved nutritional outcomes. Major complication rate for HEN was 2.3 % (n = 55; e.g. gastrocolic fistula, aspiration pneumonia, significant bleeding). Among HPN patients, intestinal failure-associated liver disease (IFALD) was detected in 8.3 % based on gamma-glutamyl transferase (GGT) ≥2 × normal, 3.9 % based on bilirubin &gt;1 mg/dL, and 11.6 % based on alanine aminotransferase (ALT) ≥2 × normal each persisting for more than three months. Hepatic steatosis and biliary sludge occurred in 23.3 % and 16.0 % of patients, respectively. Complications rate and prevalence align with international trends, confirming the importance and safety of home care in children with chronic diseases.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The registry provides a comprehensive overview of pediatric HAN practices in Italy, highlighting a significantly growing need for specialized nutritional care. The predominance of HEN, especially among neurological patients, underscores its critical role in long-term nutritional management. The observed correlation between early initiation of HEN and improved nutritional outcomes reinforces the importance of timely nutritional interventions. HPN re","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 107-118"},"PeriodicalIF":2.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058493","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":"Correlation Study of Nutritional Status, Mental Health, Sleep Quality, and Prognosis in Patients with Acute Myeloid Leukemia: Construction of Early Warning Combined with Mindfulness Awareness Countermeasures.","authors":"Jiani Xiao, Tingting Xia","doi":"10.1016/j.clnesp.2025.06.054","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.06.054","url":null,"abstract":"<p><strong>Objective: </strong>To explore the correlation between nutritional status, mental health, sleep quality and prognosis of Acute Myeloid Leukemia (AML) patients, and implement the combined countermeasures of early - warning and mindfulness - based interventions.</p><p><strong>Methods: </strong>A total of 141 AML patients admitted to our hospital between January 2020 and April 2023 were enrolled as research subjects. Based on the follow-up outcomes, the patients were categorized into a poor - prognosis group (n=32) and a good-prognosis group (n=109). The general demographic data, clinical data, Prognostic nutritional index (PNI), Self-rating Anxiety Scale (SAS) score, Self-rating Depression Scale (SDS) score and Pittsburgh Sleep Quality Index (PSQI) were collected for analysis. Pearson correlation analysis was performed to assess the associations between nutritional status, psychological state, sleep quality, and prognosis, and multivariate Logistic regression analysis was used to analyze the difference indicators. Based on this, a nomogram was constructed, and the calibration curve and decision curves were plotted for internal validation of model discrimination and calibration.</p><p><strong>Results: </strong>A statistically significant difference was observed in the scores of the Self - Rating Anxiety Scale (SAS), Self - Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), and Prognostic Nutritional Index (PNI) between the two patient groups (P<0.05). These indices were positively correlated with the prognosis of AML patients (P<0.05). Upon Logistic regression analysis, the SAS, SDS, PSQI scores, and PNI were all identified as independent risk factors for poor prognosis in patients, with OR > 1, indicating increased risk of poor prognosis. A prognostic prediction model incorporating these four predictors was established using Logistic regression. In the defined threshold range, the net benefit of the prediction model was relatively high, suggesting that the model exhibited good accuracy in predicting the prognosis of AML patients.</p><p><strong>Conclusion: </strong>The SAS, SDS, PSQI scores, and PNI were significantly associated with the prognosis of AML patients and served as independent predictors. The prognostic prediction model constructed based on these factors could effectively identify high-risk groups. This provides a potential framework for the clinical implementation of the combined countermeasures of early-warning and mindfulness - based interventions.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058447","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":"Cachexia risk classification using the Asian Working Group for cachexia criteria in patients with dysphagia: A retrospective cohort study","authors":"Shingo Kakehi ,&nbsp;Hidetaka Wakabayashi ,&nbsp;Takako Nagai ,&nbsp;Eri Isono ,&nbsp;Junki Ninomiya ,&nbsp;Yukiko Otsuka ,&nbsp;Shinta Nishioka ,&nbsp;Ryo Momosaki","doi":"10.1016/j.clnesp.2025.09.007","DOIUrl":"10.1016/j.clnesp.2025.09.007","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Although diagnostic criteria for cachexia exist, few risk classification systems are applicable in clinical practice. This study aimed to evaluate the clinical relevance of a novel cachexia risk classification based on the Asian Working Group for Cachexia (AWGC) criteria in patients with dysphagia.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 431 adult patients with dysphagia from a multicenter Japanese database. Sarcopenia and malnutrition were diagnosed using the AWGS 2019 and GLIM criteria, respectively. Patients were categorized into four original risk groups developed for this study based on AWGC criteria: No Risk (n = 255), Low Risk (n = 4), At Risk (n = 44), and Cachexia (n = 128). Low Risk group was excluded from analysis due to its small sample size. Mortality and functional outcomes were compared across the remaining three groups. Multinomial logistic regression was performed to identify factors independently associated with mortality.</div></div><div><h3>Results</h3><div>Mortality was significantly higher in Cachexia group (15.6 %) compared to At Risk (2.2 %) and No Risk (1.9 %) groups (P &lt; 0.01). BI and FILS did not differ significantly among groups. BMI and calf circumference declined with increasing cachexia risk. Malnutrition and sarcopenia were most prevalent in Cachexia group. Cachexia classification was independently associated with mortality (OR: 7.98, 95 % CI: 3.08–24.7, P &lt; 0.01), and women were also associated with higher mortality risk (OR: 2.57, 95 % CI: 1.04–6.91, P = 0.03).</div></div><div><h3>Conclusions</h3><div>Novel AWGC criteria for cachexia risk classification were significantly associated with mortality, malnutrition, and sarcopenia in patients with dysphagia.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 1-7"},"PeriodicalIF":2.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039266","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 and predictive value of preoperative nutritional risk index with one-year mortality in heart transplant recipients from a understudied population","authors":"Wenchi Guan,&nbsp;Chaoqun Wu,&nbsp;Baihan Luo,&nbsp;Run Yuan,&nbsp;Zhongkai Liao,&nbsp;Chuyun Wang,&nbsp;Jie Huang,&nbsp;Xiaoying Hu ,&nbsp;Xiang Li","doi":"10.1016/j.clnesp.2025.09.005","DOIUrl":"10.1016/j.clnesp.2025.09.005","url":null,"abstract":"<div><h3>Background</h3><div>Preoperative nutritional status plays a critical role in surgical outcomes. While the Nutritional Risk Index (NRI) has prognostic value in diverse surgical cohorts, its use in heart transplantation (HTx) remains unclear in populations with limited organ donation rates and distinct post-transplant care environments.</div></div><div><h3>Methods</h3><div>This retrospective study involved patients who underwent HTx from January 2013 to December 2016. Preoperative health data were collected, NRI scores were calculated, and all-cause mortality was recorded during a one-year follow-up. The relationship between NRI and all-cause mortality at 30, 90, 180, and 360 days were analyzed using restricted cubic spline (RCS) and multivariate logistic regression models. The optimal NRI cut-off for mortality prediction was identified using the Youden index.</div></div><div><h3>Results</h3><div>A total of 186 patients were analyzed, with 15 (8.06 %) deaths recorded within 360 days. The mortality group had significantly lower NRI scores compared to the survival group (103.80 vs. 107.48). Each 1-point increase in NRI was associated with a 10 % reduction in mortality risk at 90 and 180 days (Odds ratio [OR]: 0.90, p = 0.04) and an 8 % reduction at 360 days (OR: 0.92, p = 0.05). The optimal NRI cutoffs for predicting mortality were 108.6, 105.68, 105.68, and 109.01 at 30, 90, 180, and 360 days, respectively, as determined by the Youden index.</div></div><div><h3>Conclusion</h3><div>There was a linear association between preoperative NRI and one-year mortality for patients with heart transplant. Our findings challenge conventional NRI thresholds, suggesting higher cut-offs may better stratify risk in populations with unique nutritional profiles and healthcare resource allocation patterns.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 77-82"},"PeriodicalIF":2.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039285","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":"Investigation into the prevalence of malnutrition, sarcopenia and frailty in very old hospitalised patients and relationship with clinical outcomes","authors":"Adrian Slee ,&nbsp;Manuela Sumar Vignau ,&nbsp;Paul Bassett ,&nbsp;Xinrui Jin ,&nbsp;Junyi Guo ,&nbsp;David Smithard","doi":"10.1016/j.clnesp.2025.08.036","DOIUrl":"10.1016/j.clnesp.2025.08.036","url":null,"abstract":"<div><h3>Background and aims</h3><div>Malnutrition, sarcopenia and frailty represent common conditions in the geriatric population that have a detrimental impact on quality of life and clinical outcomes. These syndromes also display resembling clinical features and may often co-exist, aggravating adverse health outcomes. This study aimed to investigate the prevalence and co-occurrence of the conditions in a very old aged cohort of hospital patients, and the associations with clinical outcomes.</div></div><div><h3>Methods</h3><div>A registered clinical audit was performed in a Hospital setting and data collected from older patients aged &gt;85 years of age, between 2019 and 2024. Malnutrition risk was assessed using the nutritional screening tool (NST), geriatric nutritional risk index (GNRI) and global leadership initiative malnutrition (GLIM) criteria. Sarcopenia screening was evaluated with the SARC-F (Strength, Assistance in walking, Rising from a chair, Climbing stairs, and Falls) questionnaire and frailty using the clinical frailty scale (CFS). The prevalence and concurrence of the conditions was calculated, alongside the analysis of in-hospital mortality risk and routine blood biomarkers (albumin, C-reactive protein, urea, creatinine and haemaglobin).</div></div><div><h3>Results</h3><div>768 audits were included for analysis and the median age was 89 years (87–92). Malnutrition was detected in 28.4 %, 32.8 % and 41.2 % of patients by NST, GNRI and GLIM respectively, while the prevalence of sarcopenia was 68.3 % and 73.2 % for frailty. Between 20.8 % and 29.2 % of patients presented all three conditions concomitantly, while 79.2 %–85.1 % had at least one. Cox regression analysis between geriatric syndromes and the risk of in-hospital death showed that high malnutrition risk by NST (adjusted HR = 1.78, p = 0.03), as well as the presence of sarcopenia by SARC-F (adjusted HR = 2.60, p = 0.001) and severe frailty (adjusted HR = 4.89, p &lt; 0.001), were all significantly associated with an increased risk of mortality. Likewise, biomarker levels differed depending on the presence of conditions, with reduced albumin showing most significant associations with heightened risk/presence of malnutrition, sarcopenia and frailty.</div></div><div><h3>Conclusion</h3><div>The study showed a high prevalence and overlap between the explored conditions in this large, very old aged cohort, with nearly a third of patients presenting all three simultaneously, which may present significant health burden. Further research is needed to optimise the screening and assessment of conditions and establishing most accurate tools and techniques, to enhance clinical practical and potentially better guide interventions potentially affecting clinical outcomes.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 129-137"},"PeriodicalIF":2.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039244","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 quality in mid-pregnancy and pubertal timing in offspring: A population-based cohort study","authors":"Camilla Wibrand ,&nbsp;Anne Gaml-Sørensen ,&nbsp;Anne Ahrendt Bjerregaard ,&nbsp;Sjurdur Frodi Olsen ,&nbsp;Cecilia Ramlau-Hansen","doi":"10.1016/j.clnesp.2025.09.006","DOIUrl":"10.1016/j.clnesp.2025.09.006","url":null,"abstract":"<div><h3>Background and aims</h3><div>Animal studies have suggested that nutrition received <em>in utero</em> may impact pubertal timing. However, the potential association between maternal dietary quality during pregnancy and pubertal timing remains unevaluated in humans. We examined if a measure reflecting dietary quality in mid-pregnancy is related to pubertal timing.</div></div><div><h3>Methods</h3><div>We utilized data from the Danish National Birth Cohort and its sub-cohort, the Puberty Cohort with children born in 2000–2003. Data on diet, the primary exposure, was collected in mid-pregnancy using a Food Frequency Questionnaire and condensed into eight domains based on Danish National Food-based Dietary Guidelines. Based on guideline compliance, a maternal healthy eating index (mHEI) ranging from 0 to 80 was constructed. Self-reported data on pubertal development, the primary outcome, was collected half-yearly from age 11 years and throughout puberty. Main outcome was age difference in months at reaching individual pubertal milestones as well as reaching all pubertal milestones in a combined estimate, which was analyzed according to mHEI in quartiles, continuous and as restricted cubic splines using multi-variable interval-censored regression models. The analyses were stratified by sex.</div></div><div><h3>Results</h3><div>The study population consisted of 12,979 mother-offspring pairs. The mHEI ranged from 4.5 to 54.7 with a median of 22.3. In girls, we found an indication of an association between mHEI and slightly earlier pubertal timing, as both high and low mHEI were associated with an earlier combined pubertal estimate compared to the median mHEI as restricted cubic splines. Not meeting fruit and vegetable recommendations was associated with later pubertal onset in girls. We found no association between mHEI and pubertal timing in boys.</div></div><div><h3>Conclusion</h3><div>There might be an association between mHEI and puberty timing in girls, but results should be interpreted cautiously due to the study's lack of consistent results, possible unmeasured residual confounding, a risk of misclassification and few participants meeting the dietary recommendations.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 18-28"},"PeriodicalIF":2.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039309","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":"Intelligent Diet Recommendation System Powered by Artificial Intelligence for Personalized Nutritional Solutions.","authors":"Tohid Amadeh, Matin Rafie, Shadmehr Radmanesh, Alireza Azizi, Ahmadreza Ahangarian, Pourya Fathollahi, Hadise Ahmadloo","doi":"10.1016/j.clnesp.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.09.002","url":null,"abstract":"<p><strong>Background and aims: </strong>The increasing number of non-communicable diseases, such diabetes and obesity, makes it even more important to have accurate and personalized dietary solutions. Based on a lot of research, standard diet advice may not be accurate enough to meet individual health demands. The Intelligent Diet Recommendation System is an artificial intelligence-powered platform that gives personalized dietary recommendations based on extensive body composition data and cultural eating habits.</p><p><strong>Methods: </strong>The Intelligent Diet Recommendation System gathers key measurements, including body mass index and body fat percentage, using cutting-edge body analysis tools. Customized diets were created using 3D body modeling technologies and machine learning algorithms. The system's performance was evaluated by assessing the inaccuracy rate of its dietary recommendations.</p><p><strong>Results: </strong>The Intelligent Diet Recommendation System made personalized diet plans based on physiological and cultural factors with an error rate of less than 3%.</p><p><strong>Conclusions: </strong>The results show that the Intelligent Diet Recommendation System is a scalable, artificial intelligence-based way to solve global health problems that makes dietary advice much more accurate and easy to find. This system offers a new way of doing nutritional therapy that could improve health outcomes around the world.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022919","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 malnutrition in lung cancer resection patients: Modification of global leadership initiative on malnutrition (GLIM) criteria for implementation in surgical practice","authors":"Laura Gorenshtein ,&nbsp;Sonal Swain ,&nbsp;Jonathan Laredo ,&nbsp;Trevor Sytsma ,&nbsp;Ben Nguyen ,&nbsp;Paul Wischmeyer ,&nbsp;Krista L. Haines","doi":"10.1016/j.clnesp.2025.09.003","DOIUrl":"10.1016/j.clnesp.2025.09.003","url":null,"abstract":"<div><h3>Background</h3><div>Up to 70 % of lung cancer may be malnourished. This study aims to examine the effects of malnutrition on outcomes in lung cancer patients undergoing resection using modified GLIM criteria.</div></div><div><h3>Methods</h3><div>The study utilized the mGLIM criteria to identify malnourished patients. The modified criteria included (1) BMI ≤20 for age ≤70 years and BMI ≤22 for age ≥71 years, (2) weight loss &gt;10 % within the past 6 months, and (3) admission albumin ≤3.5. Patients meeting all three criteria were classified as malnourished. The study focused on lung cancer patients who underwent elective surgery. Multivariate models were employed to evaluate the impact of mGLIM criteria on multiple outcomes.</div></div><div><h3>Results</h3><div>We analyzed 37,386 patients who underwent elective lung resection from. 55.60 % were female (n = 20,787), 73.35 % White (n = 27,421), and 6.30 % Black or African American (n = 2354). Only 0.15 % (n = 57) had data available for all three mGLIM variables. 52 patients who met all three mGLIM criteria had mortality as an outcome. Malnourished patients experienced longer length of stay (p &lt; 0.001, CI [2.40, 5.18]), increased complications (p &lt; 0.001, CI [2.27, 6.87]), and increased discharge to facilities (p &lt; 0.001, CI [1.80, 7.69].</div></div><div><h3>Conclusion</h3><div>Malnourished lung cancer patients, as per mGLIM criteria, experience worse post-operative outcomes. While mGLIM is a practical adaptation, our findings suggest that the full GLIM criteria should be more widely applied in clinical practice. Incorporating GLIM criteria preoperatively could enhance the identification of malnourished patients, allowing for earlier, tailored nutritional interventions.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 36-44"},"PeriodicalIF":2.6,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013983","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 screening methods, prevalence, and risk factors of malnutrition in multiple sclerosis: A scoping review","authors":"Tyler J. Titcomb ,&nbsp;Farnoosh Shemirani ,&nbsp;Tracey A. Cho ,&nbsp;Linda G. Snetselaar","doi":"10.1016/j.clnesp.2025.09.001","DOIUrl":"10.1016/j.clnesp.2025.09.001","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>People with multiple sclerosis (MS) may be predisposed to malnutrition as several malnutrition risk factors are common among this group; however, evidence on malnutrition in MS is sparse. Therefore, the aim of the present study is to explore what is known about malnutrition in MS.</div></div><div><h3>Methods</h3><div>A scoping review was performed in 5 databases (Ovid Medline, Embase, Cochrane Central, Scopus, and the Web of Science Core Collection) in February 2024. Studies were included if they defined how malnutrition was evaluated or used a validated malnutrition screening tool among people with MS.</div></div><div><h3>Results</h3><div>Seven studies reported the prevalence at risk for malnutrition and eight reported the prevalence with malnutrition using several different methods to assess or screen for malnutrition including the Subjective Global Assessment (SGA), Patient-generated SGA, Mini Nutrition Assessment, Nutrition Risk Screening 2002, Global Leadership Initiative on Malnutrition criteria, serum albumin, and International Classification of Diseases taxonomy. One study reported prevalences based on two different methods; therefore, eight prevalences of risk for malnutrition and nine prevalences with malnutrition are reported. The reported prevalences at risk for malnutrition were 87.8 % and 85.5 %, 69.3 %, 57 %, 53.9 %, 24.8 %, 6.5 %, and 5.5 %. The reported prevalences of malnutrition were 15.5 % and 12.2 %, 13.4 %, 11.8 %, 10.4 %, 10.3 %, 1.6 %, 1.6 %, and 0.7 %. Several risk factors for malnutrition were reported including disability burden, age, and progressive subtype; however, bubble plots showed no associations for baseline age, sex distribution, MS duration, body mass index, or disability status. One study observed that malnutrition was associated with lower physical and mental quality of life.</div></div><div><h3>Conclusion</h3><div>The available evidence suggests that malnutrition may be common among people with MS; however, given the wide variation in reported prevalences more studies are needed to better evaluate the scope of malnutrition in MS.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 802-808"},"PeriodicalIF":2.6,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013953","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}