Clinical nutrition ESPEN最新文献

{"title":"Nutritional intake and diet quality over three years following liver transplantation","authors":"Amal Trigui ,&nbsp;Crystèle Hogue ,&nbsp;Mélanie Tremblay ,&nbsp;Geneviève Huard ,&nbsp;Christopher F. Rose ,&nbsp;Chantal Bémeur","doi":"10.1016/j.clnesp.2025.06.026","DOIUrl":"10.1016/j.clnesp.2025.06.026","url":null,"abstract":"<div><div>Recipients of liver transplantation (LT) are at high risk of malnutrition, sarcopenia and cardiovascular disease, yet no long-term dietary guideline after LT exists. This study aims to describe the nutritional intake and diet quality of LT recipients at 1-, 2-, and 3-years post-transplantation.</div></div><div><h3>Methods</h3><div>This cross-sectional study included adult patients with previous cirrhosis who underwent LT, divided into three cohorts: Cohort A (1-year post-LT), cohort B (2-years post-LT) and cohort C (3-years post-LT). Dietary intakes were assessed using the web-based 24 h dietary recall (R24W) and compared to the Acceptable Macronutrient Distribution Ranges (AMDR) and micronutrient reference values for the general population. Adherence to the Mediterranean diet and to the Canada's Food Guide were assessed using the Mediterranean (MED) score and the Healthy Eating Food Index (HEFI)-2019, respectively.</div></div><div><h3>Results</h3><div>Sixty-two LT recipients (62.9 % male) were included in this study: Cohort A (n = 23), cohort B (n = 14) and cohort C (n = 25). No significant differences were found between cohorts A, B and C in terms of intake of energy (2436.0; 2097.5; 1847.0 kcal), protein (90.3; 75.2; 85.6 g), carbohydrate (267.6; 269.1; 227.4 g) and total fat (95.3; 74.9; 70.7 g), respectively. Total fat intake was at the upper limit of the AMDR across all cohorts. Compared to males, females showed lower adherence to the AMDR of carbohydrate and to the recommended intakes for iron and calcium (p = 0.036; 0.004; and 0.002; respectively). Fiber and vitamins A, D and E intakes were below recommended levels, while sodium exceeded the recommended level for both sexes. Adherence to the Mediterranean diet (score 18.0/44) and Canada's Food Guide (score 39.0/80) was relatively low.</div></div><div><h3>Conclusions</h3><div>Nutritional intakes and diet quality indices in LT recipient remained unchanged across the three years post-LT, with significant deficiencies in certain micronutrients. Macronutrients intake could be optimized to better meet the specific needs of this population. Tailored dietary guidelines are needed for LT recipients, after the early phase post-surgery.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 669-678"},"PeriodicalIF":2.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301241","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":"Distinct associations of type 1 and type 2 diabetes with osteoporosis and limitations of bone mineral density-based fracture risk prediction","authors":"Chi-Yuan Li,&nbsp;Chien-Hsiao Su,&nbsp;Heng-Wei Lin,&nbsp;Wei-Chih Kan,&nbsp;Chih-Chung Shiao","doi":"10.1016/j.clnesp.2025.06.022","DOIUrl":"10.1016/j.clnesp.2025.06.022","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 628-629"},"PeriodicalIF":2.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal and neonatal vitamin D levels and hyperbilirubinemia: A systematic review and meta-analysis","authors":"Arezoo Ghavi ,&nbsp;Kathleen L. Meert ,&nbsp;Mohammad Asghari-Jafarabadi ,&nbsp;Rebecca Hill Renirie ,&nbsp;Zahra Mohammadi-Pirouz","doi":"10.1016/j.clnesp.2025.06.030","DOIUrl":"10.1016/j.clnesp.2025.06.030","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Vitamin D (Vit D) deficiency during pregnancy may have potential adverse effects on the health of mothers and neonates. The relationship between Vit D deficiency and neonatal hyperbilirubinemia is unknown. The aim of this study is to determine the relationship between Vit D levels in mothers and neonates and the occurrence of neonatal hyperbilirubinemia.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis were guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A literature search was conducted in electronic databases: PubMed, Cochrane, CINAHL, Scopus, Web of Science, Ovid MEDLINE, and MEDLINE Ultimate until the end of 2024 to find studies published in English that investigated Vit D levels in mothers or neonates and their associations with hyperbilirubinemia. The Newcastle Ottawa Scale (NOS) tool was used to assess the quality of the articles included. A random effects model was used for (subgroup) meta-analyses, assessing heterogeneity with I-squared, publication bias with funnel plot, Egger and Begg tests, and conducting meta-regression to explore heterogeneity sources.</div></div><div><h3>Results</h3><div>Of the 29 studies included in this systematic review, 25 were eligible for meta-analysis. Despite the overall lack of significant results in some aspects of this meta-analysis, the random-effects model showed that Vit D levels were significantly lower during pregnancy in mothers of neonates with hyperbilirubinemia compared to mothers of neonates without hyperbilirubinemia (MD: −7.98 nmol/L, 95%CI: −11.02 to −4.94, I2: 49.82 %, p &lt; 0.001). Additionally, Vit D levels were significantly lower in neonates with hyperbilirubinemia compared to neonates without hyperbilirubinemia (MD: −19.53 nmol/L, 95%CI: −25.42 to −13.64, I2: 93.76 %, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>This review suggests that higher maternal Vit D levels during pregnancy may lead to higher Vit D levels in neonates and ultimately a lower risk of neonatal hyperbilirubinemia.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 715-726"},"PeriodicalIF":2.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301240","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":"Commentary on “Different regimens of preoperative carbohydrate loading on insulin resistance: A network meta-analysis”","authors":"Shubham Kumar,&nbsp;Rachana Mehta,&nbsp;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}