Clinical nutrition ESPEN最新文献

{"title":"Vitamin D Deficiency in COPD: A Call for Multilevel Interventions and Broader Assessment.","authors":"Nana Wang, Wenmei Bai, Yujiao He","doi":"10.1016/j.clnesp.2025.07.017","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.07.017","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A genotype-guided nutritional intervention to reduce cardiometabolic risk factors in young adults: Study protocol for a randomized controlled trial","authors":"Karina Rodrigues ,&nbsp;Marcela M. Mendes ,&nbsp;Lana Pacheco Franco-Gedda ,&nbsp;Nara R. da Silva ,&nbsp;Mariana Oliveira ,&nbsp;Flávia C.F. Silva ,&nbsp;Flávia Campos Corgosinho ,&nbsp;Kristy Soraya Coelho ,&nbsp;Franco Maria Lajolo ,&nbsp;José M. Aldrighi ,&nbsp;Carla M. Prado ,&nbsp;Lu Qi ,&nbsp;Karani Santhanakrishnan Vimaleswaran ,&nbsp;Maria Aderuza Horst","doi":"10.1016/j.clnesp.2025.07.008","DOIUrl":"10.1016/j.clnesp.2025.07.008","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Cardiometabolic diseases (CMD), including cardiovascular disease, obesity and diabetes, are major public health challenges influenced by lifestyle factors (e.g., diet), vitamin D status, and genetic predisposition. Single nucleotide polymorphisms (SNPs) contribute to genetic risk scores for CMD-related traits (M-GRS) and recent research suggests that genotype-based nutritional interventions have the potential to reduce these risks. This study aims to evaluate the effectiveness of genotype-guided nutritional interventions versus standard dietary recommendations in young adults.</div></div><div><h3>Methods</h3><div>This 12-month study includes a 6-month intervention phase and a 6-month free-living phase. Data will be collected at baseline, 3, 6 and 12 months. We plan to recruit young adults (aged 23–29) previously genotyped from the Obesity, Lifestyle, and Diabetes in Brazil (BOLD) study and randomized by BMI, sex, and M-GRS based on 34 SNPs. The control group will follow a standard Brazilian diet with CMD-related recommendations and 1000 IU of vitamin D3 daily. The personalized intervention group will receive a genotype-guided dietary plan based on gene–diet interactions for SNPs in the M-GRS, along with personalized vitamin D3 supplementation (1000 or 4000 IU) based on their genetic risk for deficiency (D-GRS). Body composition, biochemical markers and metabolomics will be assessed, with the reduction in body fat percentage as the primary outcome.</div></div><div><h3>Discussion</h3><div>This study will contribute to precision nutrition by assessing genotype-guided dietary recommendations for CMD risk management, potentially demonstrating how genetic information can optimize dietary interventions and reduce CMD burdens, improving overall health outcomes.</div></div><div><h3>Trial registration</h3><div>Brazilian Registry of Clinical Trials: RBR-7b43sfr <span><span>http://ensaiosclinicos.gov.br/rg/RBR-7b43sfr</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 196-206"},"PeriodicalIF":2.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation and applicability of appendicular skeletal muscle mass estimation equations in a geriatric hospital setting","authors":"Shuzo Miyahara ,&nbsp;Keisuke Maeda ,&nbsp;Shosuke Satake ,&nbsp;Hiroyasu Akatsu ,&nbsp;Hidenori Arai","doi":"10.1016/j.clnesp.2025.07.013","DOIUrl":"10.1016/j.clnesp.2025.07.013","url":null,"abstract":"<div><h3>Background&amp;aims</h3><div>Sarcopenia and malnutrition are linked to adverse outcomes in older adults, requiring muscle mass assessment for diagnosis. While specialized equipment is recommended, limited accessibility highlights the need for alternative methods. Various skeletal muscle mass estimation equations exist, but their validity across clinical settings is uncertain. This study evaluated the validity and applicability of previously reported appendicular skeletal mass (ASM) estimation equations in older adults across two hospital settings.</div></div><div><h3>Methods</h3><div>This study utilized registry data from the National Center for Geriatrics and Gerontology, including patients aged ≥65 years from a frailty outpatient clinic and geriatric ward. ASM was assessed using dual-energy X-ray absorptiometry (DXA) as the reference standard. A comprehensive review identified multiple ASM estimation equations based on age, sex, height, weight, and creatinine-to-cystatin C ratio (Cre/CysC). As an exception, one skeletal muscle mass index (SMI) estimation equation was included in the analysis. In both groups, intraclass correlation coefficients (ICCs) were calculated to assess the agreement between ASM estimates and DXA measurements. Estimation errors were standardized as T-scores, plotted, and visualized with 95 % confidence ellipses for each group.</div></div><div><h3>Results</h3><div>The analysis included 856 patients from the frailty clinic group (mean age: 78.2 ± 6.1 years, 58.3 % women) and 328 from the geriatric ward group (mean age: 86.2 ± 6.4 years, 60.7 % women). ICCs between the ASM estimation equations and DXA were generally higher in the frailty clinic group. Several equations achieved ICC ≥0.9 in the frailty clinic group and ICC ≥0.8 in the geriatric ward group. Equations based on age, sex, height, and weight performed well in both groups, with minimal benefit from adding Cre/CysC. Estimation errors showed no substantial differences between groups.</div></div><div><h3>Conclusion</h3><div>Several ASM estimation equations showed strong agreement with DXA in older adults across outpatient and inpatient settings. While dedicated equipment is ideal, using common patient data for muscle mass estimation improves accessibility and may support the wider adoption of muscle assessment for sarcopenia and malnutrition diagnosis.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 216-224"},"PeriodicalIF":2.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616608","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":"Pathways for integration of body composition and energy metabolism assessments throughout the nutrition care process: Protocol for implementation planning","authors":"Camila E. Orsso ,&nbsp;Homa Ghomashchi ,&nbsp;Anne Caretero ,&nbsp;Marlis Atkins ,&nbsp;Thiago G. Barbosa-Silva ,&nbsp;Carlota Basualdo-Hammond ,&nbsp;Diana Cardenas ,&nbsp;Stephanie Chevalier ,&nbsp;M. Cristina Gonzalez ,&nbsp;Leah Gramlich ,&nbsp;Harriët Jager-Wittenaar ,&nbsp;Nicole Kiss ,&nbsp;Sarah A. Purcell ,&nbsp;Maira Quintanilha ,&nbsp;Satnam Sidhu ,&nbsp;Puneeta Tandon ,&nbsp;Mei Tom ,&nbsp;Carla M. Prado","doi":"10.1016/j.clnesp.2025.07.014","DOIUrl":"10.1016/j.clnesp.2025.07.014","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Body composition and energy metabolism (BC and EM) assessments inform patients’ nutritional status and allow the identification, diagnosis, and management of core nutritional problems. However, a structured approach or care model for integrating these assessments into the nutrition care process is currently lacking. This manuscript describes the protocol for a planning project aimed at convening a multidisciplinary team of researchers, healthcare providers, provincial managers, and industry partners to identify a practical pathway for implementing BC methods and indirect calorimetry for EM assessment in targeted clinical settings.</div></div><div><h3>Methods</h3><div>Using purposive sampling, dietitians from six specialty areas (oncology, liver or kidney diseases, critical care, weight management/bariatric surgery, and inpatient care) within Alberta Health Services are invited to participate in this two-phase planning project. In phase 1, participants attend a 4-h evidence-based educational session to establish a baseline understanding of BC and EM. In phase 2, seven 4-h focus group discussions are conducted, facilitated by trained moderators using a semi-structured interview guide. Discussions are audio-recorded and will be transcribed verbatim. Data will be analyzed using an inductive, descriptive qualitative content analysis approach. The Consolidated Framework for Implementation Research will inform barriers and facilitators identification, and the Expert Recommendations for Implementing Change will inform implementations strategies. Peer debriefings and reflexivity will ensure trustworthiness of the findings.</div></div><div><h3>Conclusions</h3><div>The proposed pathway will serve as a roadmap to dietitians and other healthcare professionals involved in nutrition assessment and a catalyst for practice improvement. Beyond outlining the proposed pathway, this initiative will inform the development of a larger implementation project focused on evaluating the feasibility and cost-effectiveness of BC and EM assessments in daily practice. Ultimately, a structured approach to integrating these assessments into routine care may enhance patient outcomes and improve nutrition care standards.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 234-240"},"PeriodicalIF":2.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616605","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 of homozygous fat mass and obesity-associated (FTO rs9939609) gene with body mass, body mass index (BMI), and the binge eating scale in women: A cross-sectional study","authors":"Annete Bressan Rente Ferreira Marum ,&nbsp;Aline Boveto Santamarina ,&nbsp;Pedro Andrade ,&nbsp;Ana Flávia Marçal Pessoa ,&nbsp;Bruna Vidal Dias ,&nbsp;Maria Arlete Meil Schimith Escrivão","doi":"10.1016/j.clnesp.2025.07.016","DOIUrl":"10.1016/j.clnesp.2025.07.016","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>This study aimed to investigate the association between the homozygous fat mass and obesity-associated (FTO rs9939609) risk genotype and body weight, body mass index (BMI), and binge eating behavior in a women cross-sectional study. Specifically, it sought to assess whether the FTO polymorphism correlates with increased BMI and scores on the Binge Eating Scale (BES).</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted with 80 women who provided data on body weight, BMI, and BES scores. Genotypic analysis for the FTO rs9939609 gene was performed, grouping participants into three genotypes: TT (wild-type), AT (heterozygous), and AA (homozygous risk). Anthropometric measures were collected either in person or through self-reported methods. Statistical analyses included Kruskal–Wallis tests, Fisher's exact test, and logistic regression to assess associations between genotype and study outcomes.</div></div><div><h3>Results</h3><div>The AA homozygous genotype was significantly associated with higher body weight and BMI compared to the TT and AT groups (p = 0.004 and p = 0.008, respectively). Moreover, AA carriers exhibited higher BES scores, indicating a greater predisposition to binge eating behavior (p = 0.043). Logistic regression revealed that the AA genotype had a higher odds ratio for elevated body weight, BMI, and BES scores compared to the TT genotype.</div></div><div><h3>Conclusions</h3><div>The FTO rs9939609 polymorphism, particularly the homozygous risk genotype (AA), is associated with increased body weight, BMI, and binge eating behavior in women. These findings highlight the genetic contribution to obesity and eating disorders, offering potential implications for personalized interventions targeting those at higher genetic risk.</div></div><div><h3>Ethical approval</h3><div><em>Universidade Federal de São Paulo</em> Ethics Committee (CEP-UNIFESP No.0565/2018).</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 225-232"},"PeriodicalIF":2.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616601","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":"Effect of weight gain rate in the second and third trimesters of pregnancy on maternal and neonatal health: A cross-sectional study","authors":"Wen Hua ,&nbsp;Sha Lu ,&nbsp;Lijun Zhang ,&nbsp;Fangfang Chen ,&nbsp;Jiahui Xu ,&nbsp;Danxiao Wang ,&nbsp;Nisile Kakongoma ,&nbsp;Wensheng Hu","doi":"10.1016/j.clnesp.2025.07.004","DOIUrl":"10.1016/j.clnesp.2025.07.004","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to investigate the association between gestational weight gain rate (GWGR) in the second and third trimesters (ISTT) and both pregnancy complications and perinatal outcomes.</div></div><div><h3>Methods</h3><div>This was a cross-sectional study of data from the 2664 pregnant women between March 2018 and December 2018. Pregnant women were grouped by different GWGRs ISTT according to the latest recommendation for maternal weight gain in 2021 and they were classified as below (insufficient GWGR), within (normal GWGR) and above (excessive GWGR) the standard. According to the level of pre-pregnancy body mass index (BMI), these pregnancies were further divided into low BMI, normal BMI and high BMI subgroups. Pregnancy complications and outcomes in each group were analyzed. One-way ANOVA test, Chi-squared test, Fisher's exact test and Logistic regression were used for statistical analysis.</div></div><div><h3>Results</h3><div>Logistic regression analysis demonstrated that excessive GWGR was associated with an increased risk of hypertensive disorders of pregnancy (HDP) (AOR = 2.197, 95%CI: 1.561–5.274), hyperlipidemia (AOR = 1.567, 95%CI: 1.284–1.871), macrosomia (AOR = 1.788, 95%CI: 1.183–2.702), LGA (AOR = 1.661, 95%CI: 1.327–2.088), preterm neonates (AOR = 2.416, 95%CI: 1.429–3.519) and caesarean section (AOR = 1.434, 95%CI: 1.191–1.727), while a decreased risk of gestational diabetes mellitus (GDM) (AOR = 0.436, 95%CI: 0.332–0.572); and insufficient GWGR was associated with a decreased risk of hyperlipidemia (AOR = 0.578, 95%CI: 0.351–0.951) and gestational hepatic dysfunction (AOR = 0.348, 95%CI: 0.182–0.811), while an increased risk of GDM (AOR = 2.212, 95%CI: 1.652–2.962). In the low BMI subgroup, insufficient GWGR were associated with a decreased risk of GDM respectively (AOR = 0.295, 95%CI: 0.139–0.629; AOR = 0.471, 95%CI: 0.234–0.948). In the high BMI subgroup, insufficient GWGR was associated with an increased risk of GDM (AOR = 3.593, 95%CI: 1.586–8.140), hyperlipidemia (AOR = 4.929, 95%CI: 1.315–18.479) and preterm neonates (AOR = 3.083, 95%CI: 1.050–9.155), and excessive GWGR was associated with an increased risk of GDM (AOR = 2.819, 95%CI: 1.346–3.208), hyperlipidemia (AOR = 2.029, 95%CI: 1.168–5.365), macrosomia (AOR = 3.008, 95%CI: 1.003–9.020), LGA (AOR = 1.459, 95%CI: 1.046–2.036) and caesarean section (AOR = 1.552, 95%CI: 1.142–2.110).</div></div><div><h3>Conclusions</h3><div>In this study, we found that 65.4 % of women did not achieve optimal GWGR. Insufficient GWGR ISTT was associated with decreased risk of pregnancy complications, in particular with hyperlipidemia. Excessive GWGR ISTT was associated with severe adverse birth outcomes, especially among women with high pre-pregnancy BMI. Although associations between GWGR and perinatal outcomes were observed, subsequent longitudinal studies are required to establish causal relationships.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 207-215"},"PeriodicalIF":2.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616604","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":"Reply-Letter to the editor","authors":"Izolde Bouloukaki,&nbsp;Antonios Christodoulakis,&nbsp;Ioanna Tsiligianni","doi":"10.1016/j.clnesp.2025.07.018","DOIUrl":"10.1016/j.clnesp.2025.07.018","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Page 233"},"PeriodicalIF":2.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616607","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 of self-reported physical activity with sarcopenia in patients with kidney failure","authors":"Limy Wong ,&nbsp;Emily Schembri ,&nbsp;Lawrence P. McMahon","doi":"10.1016/j.clnesp.2025.07.007","DOIUrl":"10.1016/j.clnesp.2025.07.007","url":null,"abstract":"<div><h3>Objective</h3><div>Sarcopenia is prevalent in patients with chronic kidney disease, especially those on maintenance dialysis treatment. Physical inactivity might have a role in the development of sarcopenia. However, supportive evidence in maintenance dialysis patients is scarce. The association between physical activity and sarcopenia has not been studied extensively in this population.</div></div><div><h3>Methods</h3><div>A single institution cross-sectional study was performed. Sarcopenia was defined in accordance with the European Working Group on Sarcopenia in Older People 2019 and the Asian Working Group for Sarcopenia 2019 criteria. Clinical assessment methods included bioelectrical impedance analysis, anthropometric measurement, handgrip strength and physical performance appraisal. The level of physical activity was quantified using the Physical Activity Scale for Elderly (PASE) and stratified into 3 categories: sedentary (0–40), light physical activity (41–90) and moderate to intense physical activity (&gt;90). Logistic regression was performed to examine the association between sarcopenia and physical activity.</div></div><div><h3>Results</h3><div>Eighty-one maintenance dialysis patients were included with a median age of 75 years (IQR 67–80) and 63 % were male. An inverse relationship between moderate-to-intense physical activity and sarcopenia was identified (OR = 0.10, 95 % CI 0.01–0.51) following adjustment for confounding factors, while no associations were found with low physical activity when compared to sedentary lifestyle.</div></div><div><h3>Conclusion</h3><div>Moderate-to-intense physical activity is a protective factor for sarcopenia in maintenance dialysis population, where sarcopenia is highly prevalent. Our findings suggest that emphasis should be placed on the intensity of physical activity when recommending physical exercise to patients to help prevent sarcopenia.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 140-144"},"PeriodicalIF":2.9,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604405","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":"Metabolic rate and energy requirements by indirect calorimetry versus predictive formulas in mechanically ventilated patients on full very high protein-to-energy polymeric formula: A retrospective study","authors":"Heidi Louwaege ,&nbsp;Kurt Boeykens ,&nbsp;Elisabeth De Waele ,&nbsp;Dimitri Beeckman ,&nbsp;Tim Torsy","doi":"10.1016/j.clnesp.2025.07.012","DOIUrl":"10.1016/j.clnesp.2025.07.012","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>In ventilated critically ill patients, both overfeeding and underfeeding can be harmful. Determining energy expenditure is challenging due to various factors. Accurate estimation of nutritional requirements is essential for optimal care. This study compared resting energy expenditure in patients on full-dose high protein-to-energy tube feeding, using indirect calorimetry (IC) and the Roza &amp; Shizgal (R&amp;S) formula. It also examined the effects of sex, age, BMI, primary diagnoses, and non-intentional energy intake, and assessed adherence to European Society for Clinical Nutrition and Metabolism guidelines on protein intake.</div></div><div><h3>Methods</h3><div>A retrospective cohort study included 178 ventilated ICU patients who received ≥7 days of full-dose high-protein enteral tube feeding between June 2019 and December 2022. IC was compared to the R&amp;S formula, and 24-h nutritional intake data, including non-intentional sources, were analysed. Multivariate regression identified predictors of energy expenditure differences.</div></div><div><h3>Results</h3><div>A significant difference of −146.64 kcal (SD = 276.38) was found between measured and estimated resting energy expenditure, with severe or morbid obesity and COVID-19 pneumonia as significant predictors. This difference increased when non-intentional energy intake in the preceding 24 h was considered (M = −514.51; SD = 326.37). When excluding non-intentional energy intake, patients achieved the ESPEN daily protein target of ≥1.3 g/kg actual or adjusted body weight/day, with averages of 1.3–1.5 g/kg using both indirect calorimetry and the Roza &amp; Shizgal formula.</div></div><div><h3>Conclusion</h3><div>The Roza &amp; Shizgal formula for estimating resting energy expenditure can overestimate or underestimate, so caution is needed, especially in severely to morbidly obese patients. Monitoring energy intake is important, particularly in tube feeding. Protein targets per international guidelines are generally met, except in patients with high non-intentional energy intake.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 188-195"},"PeriodicalIF":2.9,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607702","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":"Investigating the effects of probiotics during the menopause transition: A systematic review & meta-analysis","authors":"Robin A.F. Andrews ,&nbsp;Arron Lacey ,&nbsp;Helen Roach ,&nbsp;Rebeccah Tomlinson ,&nbsp;Emma J. Kidd ,&nbsp;Kate Bache","doi":"10.1016/j.clnesp.2025.07.009","DOIUrl":"10.1016/j.clnesp.2025.07.009","url":null,"abstract":"<div><div>This review investigated the impact of probiotics during the menopause transition and explored their potential to enhance the effectiveness of estrogenic substances in perimenopausal or recently postmenopausal women.</div><div>A thorough literature search of EMBASE, MEDLINE, Cochrane Library, Scopus, and Web of Science was conducted, identifying 39 studies involving 3187 women. Quality assessments were conducted using the relevant Cochrane Risk of Bias tools.</div><div>The results demonstrated that probiotics had positive effects on menopausal symptoms, urogenital health, bone health, and the efficacy and safety of estriol and isoflavones. Meta analysis of 7 studies comparing probiotics versus placebo demonstrated large effects of probiotics on menopausal symptoms (total score) [standardized mean difference (SMD) = 0.82, 95 % CI -0.52 to −1.09], vasomotor symptoms (SMD = −0.96, 95 % CI -1.25 to −0.68), psychological symptoms (SMD = −0.51, 95 % CI -0.95 to −0.08), vaginal dryness (SMD = 0.95, 95 % CI -1.40 to −0.49), and vaginal microbiome health (Nugent score) (SMD = −0.91, 95 % CI -1.32 to −0.49). Meta-analysis results were nonsignificant for reducing somatic and sexual symptoms.</div><div>Probiotics hold promise in addressing symptoms related to low estrogen levels and may enhance the effects of estriol and isoflavones, offering potential benefits as part of the management of menopausal women. It's important to note that the included studies had a high risk of bias, emphasising the need for further rigorous research in this area. Should findings continue to show promise, clinicians should consider incorporating probiotics into their strategies for managing menopausal symptoms.</div></div><div><h3>Systematic Review Registration Number</h3><div>CRD42019146270.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 241-256"},"PeriodicalIF":2.9,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607701","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}