Clinical nutrition ESPEN最新文献

{"title":"Commentary on “Different regimens of preoperative carbohydrate loading on insulin resistance: A network meta-analysis”","authors":"Shubham Kumar, Rachana Mehta, Ranjana Sah","doi":"10.1016/j.clnesp.2025.06.023","DOIUrl":"10.1016/j.clnesp.2025.06.023","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 645-646"},"PeriodicalIF":2.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301237","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":"Preoperative tyrosine is associated with postoperative delayed neurocognitive recovery in elderly: Evidence from two hospitals","authors":"Lei Zhang ,&nbsp;Jianhui Liu ,&nbsp;Ren Zhou ,&nbsp;Jiehui Liu ,&nbsp;Jingya Zhang ,&nbsp;Haoli Mao ,&nbsp;Jia Yan ,&nbsp;Hong Jiang","doi":"10.1016/j.clnesp.2025.06.016","DOIUrl":"10.1016/j.clnesp.2025.06.016","url":null,"abstract":"<div><h3>Background</h3><div>Elderly individuals have metabolite alterations that may contribute to delayed neurocognitive recovery (dNCR) following surgery and exposure to anesthesia. Despite its increasing popularity in geriatrics and aging research, dNCR currently lacks specific biomarkers, impeding diagnosis and potential clinical interventions.</div></div><div><h3>Objectives</h3><div>To determine which metabolites could serve as clinically valuable biomarkers for dNCR.</div></div><div><h3>Methods</h3><div>Preoperative serum metabolomics were measured in two cohorts: cohort 1 (TJ; N = 43) and cohort 2 (JY; N = 67). dNCR was measured with neuropsychological tests. Differential metabolites were selected from orthogonal partial least-squares discrimination analysis and validated by internal standards. We used logistic regression to examine associations and receiver operating characteristic curves to evaluate predictive ability.</div></div><div><h3>Results</h3><div>Preoperative serum tyrosine levels were significantly decreased in dNCR compared to non-dNCR groups. Tyrosine levels were associated with dNCR after adjusting for possible confounders in all participants and in subgroup analyses. Areas under the curve were 0.73 in all participants, 0.82 in the TJ cohort, and 0.67 in the JY cohort.</div></div><div><h3>Conclusions</h3><div>Low preoperative blood tyrosine levels were associated with increased risk of postoperative dNCR in elderly patients.</div><div>This trial was registered with chictr.org.cn (ChiCTR2200057080) and clinicaltrials.gov (NCT05105451).</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 727-736"},"PeriodicalIF":2.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301243","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":"Validation of new anthropometry-based standard for metabolic syndrome and nutritional status screening: A pilot study.","authors":"Brooke Butterick, Lexi Kasofsky, Jason Siegler, Andrea De Cristofaro, Paolo De Cristofaro, Marco Santello","doi":"10.1016/j.clnesp.2025.06.013","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.06.013","url":null,"abstract":"<p><strong>Background and aims: </strong>Metabolic syndrome is one of the greatest health threats in the modern world. Challenges associated with diagnostics and absence of a preventive strategy contribute to the evolution of metabolic syndrome towards central obesity and type 2 diabetes. Indicators such as body mass index (BMI) and body fat percentage (BF%) have limited clinical applications. Although anthropometrical indicators strongly correlate with risk of mortality, they have limited clinical applicability due to their inability to grade risk of cardiovascular and metabolic disease. We evaluated the ability of an anthropometry-based method, the Morphogram, that integrates body segment circumferences with validated cut-offs from the literature, to estimate body composition (BF% and lean mass percentage, LM%) and compute a score for metabolic syndrome risk (MSR). The aims of our study were (1) to assess the extent to which BF% and LM% measured by dual energy X-ray absorptiometry (DXA) can be captured by Morphogram and (2) to propose a novel method to quantify the stage of MSR.</p><p><strong>Methods: </strong>We tested 52 study participants (26 males, 26 females; age: 39.2 ±8.4; BMI: 28.9 ±2.6). We compared BF% and LM% estimated by Morphogram vs. DXA and the MSR score vs. health risks associated with DXA adiposity parameters and anthropometric variables. Although we expected Morphogram to under-estimate BF% and, consequently, over-estimate LM% estimated by DXA, we hypothesized the MSR scores to exhibit stronger correlations with anthropometric variables than DXA parameters.</p><p><strong>Results: </strong>BF% and LM% estimated by Morphogram (mean ±S.E.: 31.37 ±1.09% and 68.50 ±1.08%, respectively) significantly under-estimated and over-estimated BF% and LM%, estimated by DXA (34.68 ±1.30% and 65.41 ±1.35%, respectively; p < 0.001). The largest under-estimation discrepancies (> -5% of BF%) were caused by excessive subcutaneous fat and relative fat-free mass deficits, and/or excessive android fat in a subset of participants (35%). Lastly, we found stronger correlations between MSR scores and risk factors that have been linked by epidemiological studies to anthropometric variables than adiposity parameters measured by DXA.</p><p><strong>Conclusion: </strong>Morphogram has significant potential as a screening and monitoring tool of metabolic status, thus making it a clinically relevant approach for prevention of metabolic diseases.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293456","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":"Ultra-processed food consumption is linked to an increased risk of chronic respiratory diseases: A systematic review and meta-analysis of prospective cohort studies","authors":"Tefera Chane Mekonnen ,&nbsp;Zumin Shi ,&nbsp;Bereket Gebremichael ,&nbsp;Yohannes Adama Melaku ,&nbsp;Tiffany K. Gill","doi":"10.1016/j.clnesp.2025.06.011","DOIUrl":"10.1016/j.clnesp.2025.06.011","url":null,"abstract":"<div><h3>Background</h3><div>Chronic respiratory diseases (CRDs) are a leading cause of global mortality, with dietary factors, including ultra-processed food (UPF) consumption, contributing to their burden. The relationship between UPF intake and CRD risk in adults remains unclear.</div></div><div><h3>Objectives</h3><div>This study evaluates epidemiological evidence linking UPF exposure to overall CRD risk and cause-specific respiratory conditions.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted using PubMed, Embase, PsycINFO, Scopus, ProQuest, Web of Science, and Cochrane Library databases, covering studies from 2009 to January 2024. Cohort studies examining UPF exposure and CRD risk were included. Risk of bias was assessed using the National Institute of Health tool, and NutriGrade scoring evaluated the quality of meta-evidence. Adjusted hazard ratios (HRs) were pooled using random-effects meta-analysis.</div></div><div><h3>Results</h3><div>Six cohort studies (k = 18) involving 948,428 participants and 11,341 CRD events were analyzed. Higher UPF exposure was associated with an increased CRD risk but not lung cancer. Each 10 % increase in UPF intake corresponded to a 19 % higher CRD risk (relative risk [RR] = 1.19; 95 % confidence interval [CI]:1.004–1.40; NutriGrade = moderate) but showed no significant association with lung cancer (RR = 1.09; 95 % CI: 0.88–1.38; NutriGrade = very low). Results were consistent across sensitivity analyses.</div></div><div><h3>Conclusions</h3><div>Greater UPF consumption is linked to higher CRD risk, underscoring the need for public health interventions to reduce UPF exposure and mitigate CRD burden. High study heterogeneity highlights the need for further mechanistic research.</div></div><div><h3>Systematic review registration</h3><div>PROSPERO CRD42022345920.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 647-659"},"PeriodicalIF":2.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293455","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: “Prognostic significance of the Cachexia Index (CXI) in patients with cancer: A systematic review and meta-analysis”","authors":"Renu Sah,&nbsp;Ankita Mathur,&nbsp;Venkata Dileep Kumar Veldi","doi":"10.1016/j.clnesp.2025.06.020","DOIUrl":"10.1016/j.clnesp.2025.06.020","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 626-627"},"PeriodicalIF":2.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293381","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":"Muscle mass evaluation in patients with intestinal failure or insufficiency: Comparison of methods","authors":"Sabina Mikkelsen ,&nbsp;Sara Munk Nielsen ,&nbsp;Karoline Bastholm Weesgaard ,&nbsp;Pernille Thy Christensen ,&nbsp;Sofie Byskov ,&nbsp;Mette Holst ,&nbsp;Marianne Køhler ,&nbsp;Jakob Lykke Poulsen ,&nbsp;Henrik Højgaard Rasmussen","doi":"10.1016/j.clnesp.2025.06.015","DOIUrl":"10.1016/j.clnesp.2025.06.015","url":null,"abstract":"<div><h3>Background and aims</h3><div>Reduced muscle mass (MM) is commonly seen in patients suffering from malnutrition and sarcopenia. Both predispose for increased mortality as well as increased length- and cost of hospital-stays. Calf circumference (CC) has been demonstrated as a simple tool for MM estimates. Measuring CC is more available compared to the methods bioelectrical impedance analysis (BIA) and dual-energy x-ray absorptiometry. Like arm muscle circumference (AMC), the accuracy of CC has been evaluated in a few studies, but its specificity and sensitivity need further investigation. Therefore, the aim of this study is to investigate if CC, CC corrected with body mass index (BMI) (CC-corr), AMC and fat free mass index (FFMI) can be used as a proxy measurement for MM compared to skeletal muscle (SM) in a cohort of 300 patients suffering from intestinal failure (IF) or intestinal insufficiency (INS). Further, we aimed to investigate the prevalence of reduced MM with the different methods and between the groups IF and INS.</div></div><div><h3>Methods</h3><div>Anthropometric measurements were collected from patients affiliated to Center for Nutrition and Intestinal Failure with IF or INS between 2021 and 2024 by a medical laboratory scientist (co-author). Descriptive statistics including Pearson correlation coefficients were performed between SM and CC, CC-corr, AMC and FFMI. Furthermore, agreement analysis using Cohens Kappa as well as sensitivity and specificity were calculated to compare the diagnostic accuracy between SM and CC, CC-corr, AMC and FFMI.</div></div><div><h3>Results</h3><div>Reduced MM in IF and INS is common in both groups. Based on AMC (7.0 %), FFMI (42.7 %), CC-corr (57.3 %), CC (52.7 %) and SM (58.0 %) low MM were seen respectively. The best agreement was between SM index (SMI) and FFMI (κ = 0.700), where the agreement between SM and AMC, SM and CC-corr and SM and CC were below the minimal satisfactory agreement of 0.6 (κ = 0.093, κ = 0.276, κ = 0.570). Pearson correlation coefficient was nearest 1 between SMI and FFMI (r &gt; 0.800, p &lt; 0.001). There were significant linear associations between SMI and FFMI as well as SM and CC-corr, CC and AMC both unadjusted and adjusted for gender, age, BMI and the two patient groups (p &lt; 0.05), however only CC-corr differed between the groups.</div></div><div><h3>Conclusions</h3><div>The findings of this study show limited agreement between CC-corr and AMC on the study population in question, however the agreement was better when using CC without adjusting for BMI. Thus, it is dubious if CC-corr can serve as a proxy measure for MM in IF and INS patients. This study advises for more research on a reference material conducted on a more comparable population (i.e., a Danish standard population adjusted for age, gender, and BMI). Independent of methods, both groups showed a high prevalence of reduced MM.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 660-667"},"PeriodicalIF":2.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293454","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":"An assessment of nutrition and physical activity guidelines for adult patients with chronic constipation: A systematic review","authors":"Sarah Kamareddine,&nbsp;Trishnee Bhurosy","doi":"10.1016/j.clnesp.2025.06.009","DOIUrl":"10.1016/j.clnesp.2025.06.009","url":null,"abstract":"<div><h3>Background and aim</h3><div>To document and assess dietary and physical activity-based guidelines by expert committees for patients with chronic constipation.</div></div><div><h3>Methods</h3><div>A systematic review was performed using PubMed, CINAHL, PsychInfo, and Sage Journals databases. Inclusion criteria consisted of articles that documented guidelines on addressing chronic constipation among adults by expert committees during the last twenty years. This study excluded articles that focused on pediatric chronic constipation, short-term constipation or pharmacological guidelines, abstracts, conference proceedings, and articles not published in peer-reviewed journals.</div></div><div><h3>Results</h3><div>A total of 10 articles from different expert groups in Europe, Latin America, Mexico, the United Kingdom, and the United States were retrieved using the inclusion criteria. Behavioral modification with a gradual increase in dietary fiber was commonly agreed in eight consensuses. Four consensuses were specific in recommending a daily dose of 25–30 g of fiber to treat mild to moderate chronic constipation. Other dietary modifications included drinking water rich in minerals, especially magnesium. There was a lack of and/or discrepancies among the expert panels for recommending regular physical activity to relieve symptoms of chronic constipation.</div></div><div><h3>Conclusions</h3><div>A gradual increase in dietary fiber was the most cited nutritional advice. Guidelines for regular physical activity were low to moderate and at times conflicting. There is a need for future research to develop specific and evidence-based non-pharmacological guidelines to treat chronic constipation among adults.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 630-637"},"PeriodicalIF":2.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293380","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":"Loss of skeletal muscle mass during treatment is associated with reduced overall survival in gastric cancer patients undergoing conversion surgery","authors":"Marta Sandini ,&nbsp;Giulio Bagnacci ,&nbsp;Vincenzo Ricchiuti ,&nbsp;Irene Gambassi ,&nbsp;Stefania Piccioni ,&nbsp;Iacopo Capitoni ,&nbsp;Maria Antonietta Mazzei ,&nbsp;Daniele Marrelli ,&nbsp;Franco Roviello","doi":"10.1016/j.clnesp.2025.06.014","DOIUrl":"10.1016/j.clnesp.2025.06.014","url":null,"abstract":"<div><h3>Background</h3><div>The recent introduction of multimodal approach in the setting of conversion surgery (CS) significantly improved survival of stage IV gastric cancer (GC) patients. The prognosis has been related to several tumor and patient factors. Abnormal body composition, specifically the depletion of the lean mass compound, have been associated with impaired short- and long-term outcomes in GC. Aim was to analyze potential variation of body composition during systemic treatment and to evaluate aftermath on further resection and survival.</div></div><div><h3>Methods</h3><div>In this retrospective monocenter analysis, we assessed pre-treatment and preoperative body composition of stage IV GC patients who underwent surgical exploration following systemic treatment in the setting of CS, over a 12-year period. A radiologist blinded to the patient outcomes assessed the areas of skeletal muscle, and adipose tissue by a dedicated software through standardized protocols. Demographics and clinical data were obtained from prospectively maintained databases and patient records.</div></div><div><h3>Results</h3><div>We included 42 GC patients. Median age was 59 years, 27, 64.3 % were male, and 22/42 were Yoshida category 3 and 4. Surgical interventions included curative resection (23/42 cases), or palliation (19/42). We observed difference in the distribution of body components according to gender, at diagnosis, with more subcutaneous adipose tissue in males (p &lt; 0.001) vs. more visceral adipose tissue in females (p = 0.039). During systemic treatment, a significant increase in total muscle area was observed, but nor in males (median delta TMA -7cm² in males and delta TMA +4.8 cm² in females, p = 0.048). Increased TMA during chemotherapy was associated with improved overall survival, with median OS 63 months, vs. 27 months for patients who lost lean mass (p = 0.042). The protective effect of increased TMA was also confirmed at a multivariate analysis after normalization for age and type of surgical procedure (HR 0.98, 95%CI 0.97–0.99; p = 0.035).</div></div><div><h3>Conclusion</h3><div>As increased skeletal muscular mass during systemic treatment independently improved the overall survival, longitudinal evaluation of body composition must be part of routinary work-up of gastric cancer patients in the setting of conversion surgery. Potential effects of nutritional interventions must be evaluated.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 737-743"},"PeriodicalIF":2.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293453","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":"Evaluation of semi-automated versus fully automated technologies for computed tomography scalable body composition analyses in patients with severe acute respiratory syndrome Coronavirus-2","authors":"Amy Wozniak ,&nbsp;Paula O'Connor ,&nbsp;Jared Seigal ,&nbsp;Vasilios Vasilopoulos ,&nbsp;Mirza Faisal Beg ,&nbsp;Karteek Popuri ,&nbsp;Cara Joyce ,&nbsp;Patricia Sheean","doi":"10.1016/j.clnesp.2025.06.006","DOIUrl":"10.1016/j.clnesp.2025.06.006","url":null,"abstract":"<div><h3>Rationale and objectives</h3><div>Fully automated, artificial intelligence (AI) -based software has recently become available for scalable body composition analysis. Prior to broad application in the clinical arena, validation studies are needed. Our goal was to compare the results of a fully automated, AI-based software with a semi-automatic software in a sample of hospitalized patients.</div></div><div><h3>Materials and methods</h3><div>A diverse group of patients with Coronovirus-2 (COVID-19) and evaluable computed tomography (CT) images were included in this retrospective cohort. Our goal was to compare multiple aspects of body composition procuring results from fully automated and semi-automated body composition software. Bland-Altman analyses and correlation coefficients were used to calculate average bias and trend of bias for skeletal muscle (SM), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), intermuscular adipose tissue (IMAT), and total adipose tissue (TAT-the sum of SAT, VAT, and IMAT).</div></div><div><h3>Results</h3><div>A total of 141 patients (average (standard deviation (SD)) age of 58.2 (18.9), 61 % male, and 31 % White Non-Hispanic, 31 % Black Non-Hispanic, and 33 % Hispanic) contributed to the analysis. Average bias (mean ± SD) was small (in comparison to the SD) and negative for SM (−3.79 cm² ± 7.56 cm²) and SAT (−7.06 cm² ± 19.77 cm²), and small and positive for VAT (2.29 cm² ± 15.54 cm²). A large negative bias was observed for IMAT (−7.77 cm² ± 5.09 cm²), where fully automated software underestimated intramuscular tissue quantity relative to the semi-automated software. The discrepancy in IMAT calculation was not uniform across its range given a correlation coefficient of −0.625; as average IMAT increased, the bias (underestimation by fully automated software) was greater.</div></div><div><h3>Conclusions</h3><div>When compared to a semi-automated software, a fully automated, AI-based software provides consistent findings for key CT body composition measures (SM, SAT, VAT, TAT). While our findings support good overall agreement as evidenced by small biases and limited outliers, additional studies are needed in other clinical populations to further support validity and advanced precision, especially in the context of body composition and malnutrition assessment.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 638-644"},"PeriodicalIF":2.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293382","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":"Growth, neurodevelopmental outcomes and micronutrient intake in 18-month-old children with exposure to maternal human immunodeficiency virus and placental insufficiency: The UmbiGodisa cross-sectional study","authors":"Mothusi Nyofane ,&nbsp;Marinel Hoffman ,&nbsp;Helen Mulol ,&nbsp;Tanita Botha ,&nbsp;Robert Pattinson ,&nbsp;Ute Feucht","doi":"10.1016/j.clnesp.2025.06.010","DOIUrl":"10.1016/j.clnesp.2025.06.010","url":null,"abstract":"<div><h3>Background and aim</h3><div>Maternal human immunodeficiency virus (HIV) and intrauterine growth restriction (IUGR) are both associated with suboptimal childhood growth and neurodevelopment. This study assessed growth and neurodevelopmental outcomes and micronutrient intakes in children who are HIV-exposed-uninfected (CHEU), compared to HIV-unexposed-uninfected children (CHUU), stratified based on evidence of placental insufficiency.</div></div><div><h3>Methods</h3><div>Placental insufficiency, as proxy for IUGR, was identified using abnormal umbilical artery resistance indices (UmA-RI) on pregnancy Doppler ultrasound. At 18-months postpartum, 264 mother–child pairs were evaluated and categorized into four subgroups: CHUU with normal UmA-RI (control group), CHEU with normal UmA-RI (HIV exposure only), CHUU with abnormal UmA-RI (placental insufficiency only) and CHEU with abnormal UmA-RI (double-exposure). Dietary intake was assessed using a single 24-h dietary recall, and dietary intake of iron, zinc, and iodine was quantified by meal analysis on FoodFinder™ 3.0. Anthropometric data were collected and converted into z-scores. The Bayley Scales of Infant and Toddler Development (Bayley-III) assessed cognitive, language, and motor function. Statistical comparisons used t-test or Mann–Whitney U-tests; associations were analyzed with Spearman's correlation.</div></div><div><h3>Results</h3><div>Children with dual exposure (CHEU/AbN-RI) had significantly lower z-scores compared to the control group, including length-for-age z-score (−1.4 ± 1.4 vs 0.0 ± 1.3; p = 0.001), weight-for-age z-score (−0.6 ± 1.0 vs 0.0 ± 1.2; p = 0.024) and head circumference-for-age z-score (0.4 ± 0.7 vs 0.9 ± 1.2; p = 0.035). Mean cognitive scores were also lower in this group (93.9 ± 12.9 vs 100.1 ± 10.8; p = 0.042). Language composite scores were low across all groups. Higher zinc intake was positively associated with language scores (r = 0.10; p = 0.042) and weight-for-age z-scores were associated with motor outcomes (r = 0.10; p = 0.028). Among CHEU, better growth parameters were positively associated with cognitive and motor developmental domains.</div></div><div><h3>Conclusion</h3><div>Children exposed to both maternal HIV and placental insufficiency showed signs of suboptimal growth, particularly stunting, and delayed cognitive development, compared to unexposed controls. These findings highlight the need for early identification and targeted interventions for high-risk children within Child Health/Nutrition programmes.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 608-618"},"PeriodicalIF":2.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293383","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}