Clinical nutrition ESPEN最新文献

{"title":"Response to the Letter to the Editor: Critical appraisal of the IKF-010 trial","authors":"Salah- Eddin Al- Batran, Thorsten Oliver Goetze, Georg Martin Haag","doi":"10.1016/j.clnesp.2025.08.017","DOIUrl":"10.1016/j.clnesp.2025.08.017","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 616-617"},"PeriodicalIF":2.6,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890660","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":"Randomized controlled trial of a natural whole food diet versus habitual diet for Crohn's disease: Is diet quality the key?","authors":"Berkeley N. Limketkai ,&nbsp;Jieping Yang ,&nbsp;Lydia Chau ,&nbsp;Shaya Noorian ,&nbsp;Zhaoping Li","doi":"10.1016/j.clnesp.2025.08.015","DOIUrl":"10.1016/j.clnesp.2025.08.015","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Diets can help induce remission in patients with Crohn's disease (CD). However, given inconsistent recommendations across purportedly beneficial anti-inflammatory diets and prior studies highlighting benefits of plant-based diet patterns, we hypothesized that the benefit of diet therapy stems from the overall “healthfulness” of diet patterns.</div></div><div><h3>Methods</h3><div>In a randomized controlled trial, adults with mild-to-moderate CD were assigned to receive guidance on a natural whole food diet that comprised principles of a healthful diet versus continuation of one's habitual diet. Primary outcomes included clinical remission and change in calprotectin in weeks 4 and 8. Secondary outcomes included nutritional parameters (nutrient and energy intake, body composition, metabolic rate) and adverse events. Healthy Eating Index (HEI) served as a surrogate of diet quality and adherence.</div></div><div><h3>Results</h3><div>Twenty-eight participants with active CD were randomized. In intention-to-treat analysis, whole food diet led to overall greater clinical remission (odds ratio [OR] 1.41; 95 % CI 1.03–1.93; <em>P</em> = 0.03) and similar change in calprotectin. In per protocol analysis, adherence to a healthful diet was associated with clinical remission (OR 1.18; 95 % CI 1.02–1.38; <em>P</em> = 0.03) and change in calprotectin (−234; 95 % CI -465 to −3; <em>P</em> = 0.047). There was no increased risk of nutritional deficiency or reported adverse events.</div></div><div><h3>Conclusion</h3><div>Following a natural whole food diet based on principles of a “healthful” diet was safe and effective for inducing clinical remission and reducing fecal calprotectin concentrations in mild-to-moderate CD. Further investigation is needed to confirm these findings and to identify mechanisms to improve adherence to healthy anti-inflammatory diets.</div></div><div><h3>Clinicaltrials.gov registration</h3><div>NCT04431700.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 580-589"},"PeriodicalIF":2.6,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862178","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":"Associations of Serum Carotenoid Concentrations with All-cause Mortality in Cancer Survivors.","authors":"Jing Han, Ruiyun Wang, Lijuan Bai, Yun Liu, Man Liao, Liting Zhang, Lihua Liu, Benling Qi","doi":"10.1016/j.clnesp.2025.08.014","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.08.014","url":null,"abstract":"<p><strong>Background: </strong>Cancer is the second leading cause of mortality in the United States, surpassed only by cardiovascular disease. As of January 1, 2019, approximately 16.9 million Americans were living with a history of cancer. Current evidence regarding the effect of serum carotenoids on all-cause mortality in cancer populations is limited. This study aims to investigate the association between serum carotenoid concentrations and survival among cancer survivors in the United States.</p><p><strong>Methods: </strong>This prospective study examines the association between serum concentrations of five major carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein/zeaxanthin) and all-cause mortality risk among cancer survivors in a nationally representative cohort. Data were obtained from the National Health and Nutrition Examination Survey (NHANES) III and Continuous NHANES (2001-2006). Multivariable Cox proportional hazards regression models assessed the relationship between carotenoid levels and all-cause mortality outcomes, adjusting for relevant confounders. Restricted cubic spline (RCS) analyses were performed to determine the association between carotenoid concentrations and outcomes.</p><p><strong>Results: </strong>During a mean follow-up of 15.2 years, 1,089 deaths were recorded. In adjusted models, elevated serum concentrations of α-carotene, β-carotene, lycopene, and lutein/zeaxanthin were significantly associated with reduced risk of all-cause mortality (P trends <0.05). In contrast, β-cryptoxanthin showed no significant association. RCS plots revealed L-shaped associations for α-carotene, β-carotene, and lycopene, and U-shaped associations for lutein/zeaxanthin and β-cryptoxanthin.</p><p><strong>Conclusions: </strong>Elevated serum α-carotene, β-carotene, lycopene, and lutein/zeaxanthin levels are associated with lower all-cause mortality in cancer survivors. These findings suggest that serum carotenoids could serve as important biomarkers for assessing long-term mortality risk and may inform dietary recommendations for cancer survivors.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862177","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 diagnostic value of controlled attenuation parameter (CAP) and magnetic resonance imaging derived proton density fat fraction (MRI-PDFF) for the evaluation of intestinal failure-associated liver steatosis among adult chronic intestinal failure patients","authors":"Angelique Huijbers ,&nbsp;Julia W. Korzilius ,&nbsp;Veerle E.L.M. Gillis ,&nbsp;Marinette van der Graaf ,&nbsp;Geert J.A. Wanten","doi":"10.1016/j.clnesp.2025.08.016","DOIUrl":"10.1016/j.clnesp.2025.08.016","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Chronic intestinal failure (CIF) can cause intestinal failure-associated liver disease (IFALD), with hepatic steatosis being a predominant feature in adult CIF patients. Asymptomatic steatosis may progress to steatohepatitis and its downstream complications. While proton magnetic resonance spectroscopy (1H-MRS) is considered one of the most accurate non-invasive techniques for quantifying liver steatosis, its high cost and limited availability hinder widespread clinical use. Therefore, more accessible and reliable alternatives are needed for routine clinical assessment of liver fat in CIF patients in daily practice. Controlled Attenuation Parameter (CAP) is a non-invasive, ultrasound-based method, obtained via transient elastography, to quantify hepatic steatosis. This study aims to evaluate the diagnostic accuracy of controlled attenuation parameter (CAP) and magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF) for assessing liver steatosis in CIF patients, using 1H-MRS as the reference standard.</div></div><div><h3>Methods</h3><div>Sixty adult CIF patients, receiving home parenteral nutrition or intravenous fluids for at least three months, were enrolled. Liver fat content (LFC) was measured using 1H-MRS. The diagnostic performance of CAP and MRI-PDFF in detecting liver steatosis (defined as LFC &gt;5.5 %) was evaluated through receiver operating characteristic (ROC) curve analysis, and optimal cut-off values were determined. Spearman's rho correlation was used to assess associations between LFC as measured by 1H-MRS and the two non-invasive modalities.</div></div><div><h3>Results</h3><div>Valid liver fat measurements were obtained in 60 patients with 1H-MRS, 53 with MRI-PDFF and 34 with CAP. According to 1H-MRS, liver steatosis was present in 17 % of patients.</div><div>The Spearman correlation coefficients between 1H-MRS and CAP and between 1H-MRS and MRI-PDFF were 0.70 and 0.82 respectively. The area under the curve for CAP and MRI-PDFF in detecting steatosis (LFC &gt;5.5 %) were 0.95 (p &lt; 0.001, CI 0.88–1.00) and 1.00 (p &lt; 0.0005, CI 1.00–1.00) respectively.</div></div><div><h3>Conclusion</h3><div>Both MRI-PDFF and CAP demonstrate high diagnostic accuracy in detecting liver steatosis (LFC &gt;5.5 %) in adult CIF patients. Additionally, CAP shows a strong correlation, while MRI-PDFF exhibits an excellent correlation with severity of 1H-MRS-derived LFC. Both non-invasive techniques, may serve a valuable role in routine assessment of steatosis and steatosis severity in this population, potentially improving early diagnosis, monitoring and understanding of IFALD pathogenesis, ultimately improving patient outcomes.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 634-643"},"PeriodicalIF":2.6,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859006","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":"Development and validation of equations to estimate the body fat percentage in older adults using anthropometric measurements and portable a-mode ultrasound","authors":"Lara Vilar Fernandes ,&nbsp;Gabriela Benatti de Oliveira ,&nbsp;Rita S. Guerra ,&nbsp;Xiayu Summer Chen ,&nbsp;Flavia Cristina Drumond Andrade ,&nbsp;Teresa F. Amaral ,&nbsp;Ana Carolina Junqueira Vasques ,&nbsp;Ligiana Pires Corona","doi":"10.1016/j.clnesp.2025.08.012","DOIUrl":"10.1016/j.clnesp.2025.08.012","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Considering the importance of accurate methods for assessing body fat in older adults, this study aimed to develop and validate equations for estimating body fat percentage (%BF) using portable A-mode ultrasound (US) and anthropometric data in older adults.</div></div><div><h3>Methods</h3><div>A total of 149 healthy older adults (≥60 years old) were included in the cross-sectional study. Three-fourths (n = 111) were randomly assigned to the development sample and one-fourth to the validation sample (n = 38). Prediction equations using body mass index (BMI), sex, triceps, subscapular, abdominal, and anterior thigh subcutaneous fat thickness (SFT), and thigh circumference (TC) were generated for the development sample through multiple regression analysis and validated through the validation sample.</div></div><div><h3>Results</h3><div>Three equations were developed, the first with six parameters (R² = 0.78; SEE = 3.05), the second with the same six parameters as the first plus thigh circumference (R² = 0.80; SEE = 2.96), and the third with three parameters (R² = 0.77; SEE = 3.19). There was no statistical difference between the %BF estimated by the equations developed using portable A-mode US and the %BF estimated by Dual-energy x-ray absorptiometry (DXA) in the development and validation samples. The three equations showed mean errors from 0.16 to 0.27 % and agreement limits from −5.89 to 6.28 %.</div></div><div><h3>Conclusion</h3><div>The best model had sex, BMI, triceps, subscapular, abdominal, anterior thigh SFT, and TC as predictor variables. The equation with only one US measurement (triceps SFT) could be an option for estimating %BF in clinical practice due to its practicality and quickness.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 608-615"},"PeriodicalIF":2.6,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859005","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":"Nurse-administered malnutrition screening tool improves access to nutrition care and malnutrition diagnoses","authors":"Jamie Olsen ,&nbsp;Mary Chew ,&nbsp;Janet Fawcett ,&nbsp;Christina Badaracco","doi":"10.1016/j.clnesp.2025.07.1135","DOIUrl":"10.1016/j.clnesp.2025.07.1135","url":null,"abstract":"<div><h3>Background and aims</h3><div>Malnutrition is common in hospitalized patients. Early identification and treatment can improve outcomes. The objective of the study was to determine the impacts of using a nurse-administered Malnutrition Screening Tool (MST).</div></div><div><h3>Methods</h3><div>This was a mixed-methods retrospective cohort study of 6163 patients admitted to a VA hospital for at least 48 h and screened for malnutrition risk from May 1, 2018, to March 1, 2020. Data was abstracted from the VA Corporate Data Warehouse (CDW) and electronic surveys were administered to staff RNs and RDNs to evaluate perceptions. Alchemer and Excel were used to collect and assess clinician survey responses and care coordination. Mann–Whitney tests assessed outcome measures of changes in time from admission to malnutrition screening, assessment, diagnosis; number of nutrition assessments completed by RDNs.</div></div><div><h3>Results</h3><div>The time from admission to screening was reduced post-MST implementation [1.0 IQR (0.5, 2.4) to 14.6 IQR (9.6, 19) hours, p &lt; 0.001]. The time to assessment increased [20.6 IQR (3.8, 29.5) to 34.1 IQR (16.6, 54.7) hours, p &lt; 0.001], but the time to malnutrition diagnosis did not change [34.8 IQR (18.2, 47.8) vs. 28.1 IQR (17.3, 44.6) hours, p = 0.263]. The percentage of patients assessed increased from 4.8 % (164/3383) to 25.8 % (717/2780) (p &lt; 0.001) and the percentage diagnosed with malnutrition increased from 5.3 % to 11 % (p &lt; 0.001). Most registered nurses (RNs) felt that the MST improved quality of care, while RDNs did not. Most RNs reported that the MST was easy to use. The majority of RDNs felt their workflows improved. Both RNs and RDNs agreed that the process change improved collaboration.</div></div><div><h3>Conclusion</h3><div>MST implementation improved overall access to care. Findings from this study can be used to optimize resources to improve clinical workflows.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 571-579"},"PeriodicalIF":2.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854753","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 intakes and physical activity of women with gestational diabetes are not associated with continuous glucose monitoring metrics; Secondary analysis of the DiGest trial.","authors":"Danielle L Jones, Laura C Kusinski, Lewis Griffiths, Kirsten L Rennie, Linda M Oude Griep, Claire L Meek","doi":"10.1016/j.clnesp.2025.08.007","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.08.007","url":null,"abstract":"<p><strong>Background: </strong>Diet and lifestyle modifications are key to managing gestational diabetes mellitus (GDM), yet current dietary recommendations lack detail. It remains unclear what the dietary intakes or physical activity of pregnant women with GDM are or to what extent these alter glycaemic control.</p><p><strong>Aims: </strong>To describe dietary intake, diet quality, and PA patterns in women diagnosed with GDM and assess their associations with continuous glucose monitoring (CGM) metrics.</p><p><strong>Methods: </strong>This secondary, cross-sectional analysis of the Dietary Intervention in Gestational Diabetes (DiGest) trial included 425 pregnant women with GDM (BMI >25 kg/m²) at 28 weeks' gestation, recruited for an 8-12-week dietary intervention. Baseline dietary intake and PA were assessed through self-reported, validated questionnaires. Diet quality was evaluated using adherence to the Dietary Approaches to Stop Hypertension (DASH) diet (score range: 8-40). A masked Dexcom G6 CGM device was worn for up to 10 days to measure mean glucose (mmol/L), coefficient of variation (%), and the percentage of time spent in, above, and below the target glucose range (3.5-7.8 mmol/L). Associations between dietary intake, DASH score, and physical activity were examined using linear regression.</p><p><strong>Results: </strong>Across 223 dietary recalls, mean (SD) intakes included energy (1571 (666) kcal); carbohydrates (157g (86)); fibre; (19g (10)); protein; (77g (34)) and fat (75g (39)). Median physical activity energy expenditure (PAEE) was 18.62 kJ/kg/d. No significant associations were found between dietary intake, diet quality, PA, and CGM metrics.</p><p><strong>Conclusions: </strong>Women with GDM consumed a diet low in calories, carbohydrates, and fibre but high in saturated fat. PAEE was lower than the background, non-pregnant female population. Diet and PA were not associated with CGM metrics, highlighting the need for optimisation to short-term and long-term metabolic function in women with GDM.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854785","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":"Artificial intelligence-driven body composition analysis enhances chemotherapy toxicity prediction in colorectal cancer","authors":"Yu-Zhen Liu ,&nbsp;Pei-Fang Su ,&nbsp;An-Shun Tai ,&nbsp;Meng-Ru Shen ,&nbsp;Yi-Shan Tsai","doi":"10.1016/j.clnesp.2025.08.013","DOIUrl":"10.1016/j.clnesp.2025.08.013","url":null,"abstract":"<div><h3>Background and aims</h3><div>Body surface area (BSA)-based chemotherapy dosing remains standard despite its limitations in predicting toxicity. Variations in body composition, particularly skeletal muscle and adipose tissue, influence drug metabolism and toxicity risk. This study aims to investigate the mediating role of body composition in the relationship between BSA-based dosing and dose-limiting toxicities (DLTs) in colorectal cancer patients receiving oxaliplatin-based chemotherapy.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 483 stage III colorectal cancer patients treated at National Cheng Kung University Hospital (2013–2021). An artificial intelligence (AI)-driven algorithm quantified skeletal muscle and adipose tissue compartments from lumbar 3 (L3) vertebral-level computed tomography (CT) scans. Mediation analysis evaluated body composition's role in chemotherapy-related toxicities.</div></div><div><h3>Results</h3><div>Among the cohort, 18.2 % (n = 88) experienced DLTs. While BSA alone was not significantly associated with DLTs (OR = 0.473, p = 0.376), increased intramuscular adipose tissue (IMAT) significantly predicted higher DLT risk (OR = 1.047, p = 0.038), whereas skeletal muscle area was protective. Mediation analysis confirmed that IMAT partially mediated the relationship between BSA and DLTs (indirect effect: 0.05, p = 0.040), highlighting adipose infiltration's role in chemotherapy toxicity.</div></div><div><h3>Conclusion</h3><div>BSA-based dosing inadequately accounts for interindividual variations in chemotherapy tolerance. AI-assisted body composition analysis provides a precision oncology framework for identifying high-risk patients and optimizing chemotherapy regimens. Prospective validation is warranted to integrate body composition into routine clinical decision-making.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 696-702"},"PeriodicalIF":2.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844793","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":"Beyond the plate: A pilot study exploring the microbial landscape of omnivores and vegans through 16S rRNA gene amplicon sequencing and metagenomics","authors":"Jasmin Wenderlein ,&nbsp;Wiebke Burkhardt ,&nbsp;Stefan Dietrich ,&nbsp;Iris Trefflich ,&nbsp;Katharina Penczynski ,&nbsp;Katharina Thomas ,&nbsp;Carina Salzinger ,&nbsp;Klaus Abraham ,&nbsp;Burkhard Malorny ,&nbsp;Cornelia Weikert ,&nbsp;Rebecca Ansorge ,&nbsp;Josephine Grützke","doi":"10.1016/j.clnesp.2025.08.008","DOIUrl":"10.1016/j.clnesp.2025.08.008","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Previous studies have described benefits and risks on human health associated with a vegan diet. Although it is recognized that diet affects the gut microbiota, there is no consensus on the effects of a vegan diet compared to omnivorous diet on the gut microbiota. We have conducted a pilot study to assess the differences between the gut microbiome of vegans and omnivores in 2017 and 2021.</div></div><div><h3>Methods</h3><div>Fecal samples of 23 vegans and 23 omnivores (<em>n</em> = 46) were collected in 2017 and 2021 together with more than 300 dietary, lifestyle, and health related characteristics. The fecal microbiome was assessed comparing both amplicon sequencing and metagenome sequencing, to determine robust signals agnostic of sequencing approaches.</div></div><div><h3>Results</h3><div>Dietary grouping itself explained a small (∼4 %) but significant proportion of the individual variation between microbiota. Natural clustering of microbiomes explained an even larger proportion. We found <em>Ruminococcus torques</em> to be relatively enriched in omnivores compared to vegans across methods and years. Interestingly, this species has been previously associated with unfavorable health outcomes. Despite a low sample size, we found some consistent differences between microbiota of individuals consuming either a vegan or omnivorous diet.</div></div><div><h3>Conclusions</h3><div>These results were consistent with recently published gut microbiome signatures of vegans and omnivores across three different countries. Therefore, this small dataset allows a first insight into the gut microbiota of another county's omnivores and vegans whereby detailed and relevant dietary, lifestyle and health related characteristics collected in this study aid in understanding of the connection between respective diets and the microbiome.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 551-565"},"PeriodicalIF":2.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844794","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":"Does l-citrulline supplementation and watermelon intake reduce blood pressure in middle-aged and older adults? A systematic review and meta-analysis of randomized controlled trials","authors":"Ping Luo ,&nbsp;Jingfeng Chen ,&nbsp;Kang Liu ,&nbsp;Jia Zhang","doi":"10.1016/j.clnesp.2025.07.1130","DOIUrl":"10.1016/j.clnesp.2025.07.1130","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to investigate the effects of <span>l</span>-citrulline supplementation and watermelon intake on blood pressure (BP) in middle-aged and elderly individuals.</div></div><div><h3>Methods</h3><div>Data analysis was conducted using RevMan 5.4.1 software, employing a random effects model to statistically analyze the pooled effect sizes of the obtained systolic blood pressure (SBP) and diastolic blood pressure (DBP) data. Results are reported as weighted mean differences (WMD) with 95 % confidence intervals (95 % CI).</div></div><div><h3>Results</h3><div>A total of 15 randomized controlled trials (RCTs) investigating the effects of <span>l</span>-citrulline supplementation and watermelon intake on BP in middle-aged and elderly individuals were included, comprising 24 datasets involving 415 participants. The results indicate that <span>l</span>-citrulline supplementation and watermelon intake significantly reduced SBP (−4.02 mmHg [95 % CI: −6.54 to −1.50], <em>P</em> = 0.002) and DBP (−2.54 mmHg [95 % CI: −4.27 to −0.81], <em>P</em> = 0.004) in the elderly. Subgroup analysis showed that the combined supplementation of <span>l</span>-citrulline and <span>l</span>-arginine significantly decreased SBP (−10.44 mmHg [95 % CI: −13.57 to −7.31], <em>P</em> &lt; 0.00001) and DBP (−4.86 mmHg [95 % CI: −7.93 to −1.79], <em>P</em> = 0.002) in this population.</div></div><div><h3>Conclusion</h3><div><span>l</span>-citrulline supplementation and watermelon intake overall lowered BP in middle-aged and elderly individuals. Subgroup analysis indicates that the combined supplementation of <span>l</span>-citrulline and <span>l</span>-arginine is superior to <span>l</span>-citrulline or watermelon supplementation alone. These findings provide new dietary recommendations for BP management in the elderly, suggesting that dietary interventions can effectively improve cardiovascular health and reduce the risk of cardiovascular disease (CVD).</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 653-664"},"PeriodicalIF":2.6,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820698","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}