Clinical nutrition ESPEN最新文献

{"title":"Incidence of chronic intestinal failure due short bowel syndrome in adults: A feasibility study","authors":"Loris Pironi ,&nbsp;Federica Sacilotto ,&nbsp;Anna Simona Sasdelli ,&nbsp;Carlotta Cavoli ,&nbsp;Mariacristina Guidetti ,&nbsp;Gentilini Lorenzo ,&nbsp;Claudio Ricci ,&nbsp;Riccardo Casadei ,&nbsp;Gilberto Poggioli","doi":"10.1016/j.clnesp.2025.08.009","DOIUrl":"10.1016/j.clnesp.2025.08.009","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of short bowel syndrome associated chronic intestinal failure (SBS-CIF) is entirely unknown. A feasibility study was carried out in the tertiary-level hospital of the Bologna University (Italy), to test a protocol devised to investigate the in-hospital and the population incidences of SBS-CIF.</div></div><div><h3>Methods</h3><div>A 3-month (January–March 2024) retrospective survey was carried out in the two digestive disease surgical units of the hospital. Patient inclusion criteria were: age ≥18 years, abdominal surgery with small bowel resection and no-home parenteral nutrition (HPN) before hospital admission. Exclusion criterion: patient already on HPN at hospital admission. Criterion for the diagnosis of “SBS-CIF” was patient discharge on HPN within 3 months from inclusion of the study (end of the follow-up, June 30th 2024).</div><div>The 3-month in-hospital and population incidences were calculated as percentage of patients who underwent abdominal surgery with a small bowel resection procedure and who developed SBS-CIF, and as “SBS-CIF” per million of inhabitants of the Bologna metropolitan area, respectivelyy.</div></div><div><h3>Results</h3><div>Sixty-seven patients met the inclusion criteria. At June 30th, 56 patients were discharged without HPN (83.5 %), 5 died during hospitalization, 6 were discharged on HPN (in-hospital incidence SBS-CIF: 8.9 %). Two SBS-CIF were resident in the Bologna metropolitan area (SBS-CIF incidence: 1.96 cases/10⁶ inhabitants).</div></div><div><h3>Conclusions</h3><div>Our study proposes a model to investigate the incidence of SBS-CIF in adults. The results provide new data on this hitherto unexplored area of SBS-CIF epidemiology and, importantly, offer a model for multicenter studies to further investigate the epidemiology of SBS-CIF on a national and international scale.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 566-570"},"PeriodicalIF":2.6,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815872","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 “Association between atherosclerosis risk and dietary inflammatory index: A systematic review and meta-analysis”","authors":"Keerthi Sanapala,&nbsp;Rachana Mehta,&nbsp;Ranjana Sah","doi":"10.1016/j.clnesp.2025.08.002","DOIUrl":"10.1016/j.clnesp.2025.08.002","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 622-623"},"PeriodicalIF":2.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811889","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 role of microbial-derived p-Cresol in autism spectrum disorder: A systematic review of the gut–brain axis","authors":"Desirée Victoria-Montesinos,&nbsp;Ana María García-Muñoz,&nbsp;María Teresa Mercader-Ros,&nbsp;Carmen Lucas-Abellán,&nbsp;Mónica González-Monjarás,&nbsp;Pablo Barcina-Pérez","doi":"10.1016/j.clnesp.2025.08.010","DOIUrl":"10.1016/j.clnesp.2025.08.010","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition increasingly associated with gut microbiota alterations. Among microbial metabolites, p-Cresol has emerged as a potential contributor to the pathophysiology of ASD. This systematic review aims to examine the evidence linking p-Cresol and its metabolites with ASD and explore their potential role within the gut–brain axis framework, a bidirectional communication system where gut microbiota influence brain function via immune, metabolic, and neural pathways (e.g., vagus nerve, microbial metabolites).</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted in PubMed, Web of Science, Scopus, and Cochrane up to March 2025, following PRISMA 2020 guidelines. Studies were included if they quantified p-Cresol or its derivatives in biological samples from individuals with ASD. Data extraction and risk of bias assessment were performed independently by two reviewers. The protocol was prospectively registered in PROSPERO (CRD420251007080).</div></div><div><h3>Results</h3><div>Seventeen studies met the inclusion criteria. Most reported elevated urinary or fecal p-Cresol levels in individuals with ASD compared to controls, with consistent associations found between p-Cresol concentrations and (1); gastrointestinal symptoms, particularly constipation and diarrhea; (2) specific microbiota alterations including increased <em>Clostridium difficile</em> and <em>Desulfovibrio</em> abundance; and (3) behavioral manifestations and ASD severity. However, heterogeneity in study designs, small sample sizes, and variability in analytical techniques limit the generalizability of the results.</div></div><div><h3>Conclusion</h3><div>p-Cresol and its microbial precursors may contribute to ASD pathophysiology through gut–brain axis interactions. Although current evidence supports this association, further longitudinal and mechanistic studies are needed to confirm causality and evaluate p-Cresol as a biomarker or therapeutic target in ASD.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 535-544"},"PeriodicalIF":2.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811890","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":"Survival predictions of different arm circumference classifications in patients under intensive care.","authors":"Jorge Z Silva-Filho, Jarson P Costa-Pereira, Ivan K S Zapanta, Evi C L Brasil, Rodrigo L S Silva, Flávia M Silva","doi":"10.1016/j.clnesp.2025.07.1131","DOIUrl":"10.1016/j.clnesp.2025.07.1131","url":null,"abstract":"<p><strong>Background & aims: </strong>Mid-upper arm circumference (MUAC) is a simple anthropometric measure widely used as a marker of nutritional reserves, in the context of critical illness and other clinical conditions. Although MUAC can be classified using different approaches, few studies have investigated the prognostic value of these classifications in critically ill patients. In this study, we aimed to evaluate the ability of different MUAC classifications approaches to predict survival among patients admitted to the intensive care unit (ICU).</p><p><strong>Methods: </strong>This was a secondary analysis of a cohort study with prospective data collection. Adults of all ages admitted to a general ICU were included. MUAC was measured upon ICU admission and classified using four different approaches: two continuous and two categorical. Continuous measures included (1) absolute MUAC in centimeters (MUAC_cm) and (2) MUAC adequacy percentage (MUAC%), calculated using the 50th percentiles from Frisancho. Categorical classifications were (3) MUAC% based on Blackburn & Thornton criteria, categorized as low (<90 %), adequate (90-110 %), and excess (>110 %), and (4) using the Malnutrition Universal Screening Tool (MUST) cutoff, with low MUAC defined as <23.5 cm. Outcomes of interest were 28-day ICU mortality and in-hospital mortality.</p><p><strong>Results: </strong>A total of 426 patients were included (53.1 % male, median age: 64 years, interquartile range: 53 to 71). Metabolic disorders were the most common cause of ICU admission (49.5 %). Cox regression analysis using continuous variables showed that for each 1 cm decrease in MUAC, the risk of ICU mortality increased by 11 % (HR _adjusted 1.11, 95 % CI 1.01 to 1.20). Furthermore, for each 1 % decrease in MUAC, the risk of ICU mortality increased by 4 % (HR _adjusted 1.04, 95 % CI 1.01 to 1.06). Low MUAC according to the MUST classification was associated with a 3.73-fold increase in the hazard of 28-day ICU mortality and a 2.70-fold increase in the hazard of in-hospital mortality. No significant associations were observed using the Blackburn & Thornton classification.</p><p><strong>Conclusion: </strong>As a continuous variable, MUAC was an independent predictor of 28-day ICU mortality, but not of in-hospital mortality. In contrast, low MUAC classified according to the MUST criterion independently predicted both 28-day ICU and in-hospital mortality. No significant associations were observed using the Blackburn & Thornton classification. These findings highlight the prognostic utility of a simple anthropometric measure; however, they also suggest that different classification methods may yield distinct prognostic implications.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"428-434"},"PeriodicalIF":2.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774783","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 “Adipokines in critically ill patients: A systematic review and meta-analysis of observational studies”","authors":"Keerthi Sanapala,&nbsp;Rachana Mehta,&nbsp;Ranjana Sah","doi":"10.1016/j.clnesp.2025.08.001","DOIUrl":"10.1016/j.clnesp.2025.08.001","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 620-621"},"PeriodicalIF":2.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811888","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":"Four days of a moderate dose of caffeine does not alter raw bioelectrical impedance analysis parameters in healthy males","authors":"Rúben Francisco ,&nbsp;Gil B. Rosa ,&nbsp;Pedro B. Júdice ,&nbsp;João P. Magalhães ,&nbsp;André D. Cruz ,&nbsp;Luís B. Sardinha ,&nbsp;Henry C. Lukaski ,&nbsp;Analiza M. Silva","doi":"10.1016/j.clnesp.2025.08.005","DOIUrl":"10.1016/j.clnesp.2025.08.005","url":null,"abstract":"<div><h3>Background and aims</h3><div>This study investigated the effects of a moderate caffeine dose on resistance (R), reactance (Xc), impedance (Z), capacitance (Cap), and phase angle (PhA) over four days in males. Thirty men aged 20–39 years, with low caffeine consumption (&lt;100 mg/day), participated in this double-blind, randomized crossover trial (ClinicalTrials.gov: NCT01477294). The study consisted of two conditions - caffeine (5 mg/kg/day) and placebo (maltodextrin) - each lasting four days, separated by a three-day washout period.</div></div><div><h3>Methods</h3><div>Assessments were performed at baseline and on the fourth day of each condition. The R, Xc, Z, and PhA were measured through bioelectrical impedance spectroscopy using a frequency of 50 kHz. These were mathematically transformed in a parallel array.</div><div>Fat mass (FM) and fat-free mass (FFM) were assessed by dual-energy X-ray absorptiometry, while urine specific gravity (USG) was determined using a refractometer. Water intake (WI) was estimated through dietary food records.</div></div><div><h3>Results</h3><div>A linear mixed model analysis, adjusting for FFM and WI and baseline values, found no significant differences in R, Xc, and Z in both series and parallel arrays, Cap, and PhA across conditions. Comparisons between baseline, placebo, and caffeine conditions did not reach statistical significance for any parameter (p &gt; 0.05). USG values remained stable, indicating no changes in hydration status (p &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>This study shows that caffeine intake does not significantly affect raw bioelectrical impedance parameters. These findings simplify research by removing caffeine restrictions, enhancing study feasibility, and improving participant adherence. Clinical and sports settings allow for more flexible assessments.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 599-607"},"PeriodicalIF":2.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798357","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":"Outcomes of glepaglutide on intestinal absorption and parenteral support in patients with short bowel syndrome","authors":"Ismail Pinar ,&nbsp;Thor Schütt Svane Nielsen ,&nbsp;Lise Soldbro ,&nbsp;Mark Krogh Hvistendahl ,&nbsp;Mark Berner-Hansen ,&nbsp;Palle Bekker Jeppesen","doi":"10.1016/j.clnesp.2025.08.006","DOIUrl":"10.1016/j.clnesp.2025.08.006","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Glepaglutide, a long-acting glucagon-like peptide 2 (GLP-2) analog, is under development for the treatment of patients with short bowel syndrome (SBS). GLP-2 enhances intestinal adaptation and absorption. This study assessed glepaglutide in terms of its 24-week efficacy on intestinal wet weight and energy absorption, as well as its impact on reducing parenteral support (PS) and maintaining body composition at week 52 in patients with SBS.</div></div><div><h3>Methods</h3><div>In this single-center, open-label, phase 3b study, 10 patients with SBS - 8 with intestinal failure (SBS-IF) and 2 with intestinal insufficiency - received glepaglutide 10 mg once weekly via subcutaneous injection. Intestinal absorption was assessed by the gold-standard metabolic balance studies. The primary endpoint was absolute change in intestinal wet weight absorption, while secondary endpoints assessed changes in energy, electrolyte, and macronutrient absorption after 24 weeks of treatment. Additional endpoints included changes in PS use, body composition and safety after 52 weeks of treatment.</div></div><div><h3>Results</h3><div>At week 24, mean numerical increase in intestinal wet weight absorption was 398 g/day (P = 0.0585) and mean energy absorption 1038 kJ/day (P = 0.0215). Improvements occurred in electrolyte and macronutrient absorption. At week 52, mean PS volume was reduced by 800 mL/day (P = 0.0106) with a reduction in mean PS energy content of 866 kJ/day (P = 0.0103). Body composition and weight remained stable, and glepaglutide demonstrated a manageable safety profile.</div></div><div><h3>Conclusion</h3><div>Patients with SBS treated with glepaglutide demonstrated increased intestinal wet weight and energy absorption, allowing corresponding reductions in PS requirements in those with SBS-IF. Glepaglutide demonstrated a favorable safety profile, positioning it as a promising treatment for patients with SBS.</div><div>ClinicalTrials.gov no: NCT04991311; ClinicalTrialsRegister.eu EudraCT no: 2020-005194-27.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 590-598"},"PeriodicalIF":2.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798359","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 between plasma polyunsaturated fatty acids and metabolic syndrome risk: A prospective and mediation study in a multiethnic Asian population","authors":"Yu Qi Lee ,&nbsp;Bee Choo Tai ,&nbsp;Xueling Sim ,&nbsp;Rob M. van Dam ,&nbsp;Mary F-F Chong","doi":"10.1016/j.clnesp.2025.08.004","DOIUrl":"10.1016/j.clnesp.2025.08.004","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Metabolic syndrome is prevalent in Asian populations, but it remains to be established if polyunsaturated fatty acids (PUFA) play a preventive role. We aimed to investigate the association between the longitudinal change in plasma n-3 and n-6 PUFA and MetS incidence and potential mediating role of inflammation on the association between baseline plasma PUFA and MetS incidence.</div></div><div><h3>Methods</h3><div>Prospective data were collected from 1303 males and females (aged 21–75 years) in a Multi-Ethnic Cohort at baseline and at a median follow-up of 6 years. Anthropometric measures and blood pressure were measured during physical examinations. Plasma levels of PUFA and the inflammatory marker glycoprotein acetyls (GlycA) were quantified using nuclear magnetic resonance. MetS was defined as meeting ≥3 of the following components: abdominal obesity, elevated triglycerides, reduced high-density lipoprotein (HDL) cholesterol, elevated blood pressure, and elevated fasting glucose. Mixed effects logistic regression was used to investigate the prospective associations, and Generalised Structural Equation Modeling was used to assess mediation.</div></div><div><h3>Results</h3><div>Plasma total n-3 PUFA [odds ratio (OR) 0.55 per 1 % of total fatty acids increment], docosahexaenoic acid (DHA) (OR 0.30), total n-6 PUFA (OR 0.55) and linoleic acid (LA) (OR 0.70) were inversely associated with incidence of MetS (all p &lt; 0.001). Regarding MetS components, higher plasma total n-3, total n-6 PUFA, and LA were associated with lower odds of elevated triglycerides, reduced HDL cholesterol, elevated blood pressure, and elevated fasting glucose (p &lt; 0.05). Using mediation analyses, GlycA significantly mediated the associations between baseline plasma total n-6 PUFA (20 %) and LA (50 %) and MetS.</div></div><div><h3>Conclusion</h3><div>Higher plasma levels of total n-3, DHA, total n-6, and LA are associated with a lower risk of MetS. The inverse association between LA concentration and MetS incidence may be mediated by reduction in systemic inflammation, however, further studies are warranted to verify.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 482-491"},"PeriodicalIF":2.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798356","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":"Localized bioelectric impedance parameters can predict quadriceps muscle strength, but not independently from lean soft tissue in young adults","authors":"Brenda Carla Sene Vaz ,&nbsp;Pâmela Teodoro Oliveira ,&nbsp;Maria Eduarda Fernandes Leite ,&nbsp;Natália Viana Isoldino ,&nbsp;Jeniffer Kelly Christiano ,&nbsp;Nubia Maria Oliveira ,&nbsp;Catarina Nunes Matias ,&nbsp;Gil Guerra-Júnior ,&nbsp;Ezequiel Moreira Gonçalves","doi":"10.1016/j.clnesp.2025.07.022","DOIUrl":"10.1016/j.clnesp.2025.07.022","url":null,"abstract":"<div><h3>Objective</h3><div>To verify the relationship between muscular strength, determined by an isokinetic dynamometer, and the parameters of whole-body and localized bioelectrical impedance analysis (WB-BIA and L-BIA) in young adults of both sexes.</div></div><div><h3>Methods</h3><div>This is a cross-sectional study involving 66 university students (ages 18 to 30, 41 women). Dual-energy X-ray absorptiometry (DXA) was used to determine lean soft tissue (LST in kg). Resistance (R), reactance (Xc), and phase angle (PhA) were assessed both for whole-body and localized (thigh) measurements using a 50 kHz tetrapolar unifrequency BIA device. Isometric and isokinetic peak torque (PT) and mean peak torque (PTM) during knee extension were measured using an isokinetic dynamometer.</div></div><div><h3>Results</h3><div>LST was the variable that best explained muscular strength in both sexes (adjusted R²: ≥0.60; p &lt; 0.001). In males, the variables WB-R, WB-Xc, and thigh Xc showed the strongest relationships with muscular strength indicators (adjusted R²: 0.25 to 0.45; p &lt; 0.05). In females, WB-R and thigh R were the BIA parameters that showed the strongest relationships with muscular strength indicators (adjusted R²: 0.25 to 0.46; p &lt; 0.05). Thigh R was the only parameter that independently and significantly explained the isometric PTM (β: −0.292; p = 0.029), whereas all other BIA parameters, whether whole-body or thigh-related, demonstrated dependent relationships with LST. When comparing the tertiles of LST, it was observed in both sexes that the amount of LST influenced muscular strength and the whole-body and thigh BIA parameters (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>In our sample, although both whole-body and localized BIA parameters showed significant relationships with muscular strength in both sexes, only thigh R in the female group was an independent predictor of LST in isometric PTM.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 527-534"},"PeriodicalIF":2.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803747","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":"Nutritional impact of leucine-enriched supplements: Evaluating protein type through artificial intelligence (AI)-augmented muscle ultrasonography in hypercaloric, hyperproteic support","authors":"Juan José López-Gómez ,&nbsp;Jaime González-Gutiérrez ,&nbsp;Olatz Izaola-Jauregui ,&nbsp;Ángela Cebriá ,&nbsp;Lucía Estévez-Asensio ,&nbsp;David Primo-Martín ,&nbsp;Pablo Fernández-Velasco ,&nbsp;Paloma Pérez-López ,&nbsp;Rebeca Jimenez-Sahagún ,&nbsp;Daniel Rico-Bargues ,&nbsp;Eduardo Jorge Godoy ,&nbsp;Daniel A. De Luis-Román","doi":"10.1016/j.clnesp.2025.07.1134","DOIUrl":"10.1016/j.clnesp.2025.07.1134","url":null,"abstract":"<div><h3>Introduction</h3><div>Malnutrition adversely affects physical function and body composition in patients with chronic diseases. Leucine supplementation has shown benefits in improving body composition and clinical outcomes. This study aimed to evaluate the effects of a leucine-enriched oral nutritional supplement (ONS) on the nutritional status of patients at risk of malnutrition.</div></div><div><h3>Methods</h3><div>This prospective observational study followed two cohorts of malnourished patients receiving personalized nutritional interventions over 3 months. One group received a leucine-enriched oral supplement (20 % protein, 100 % whey, 3 g leucine), while other received a standard supplement (hypercaloric and normo-hyperproteic) with mixed protein sources. Nutritional status was assessed at baseline and after 3 months using anthropometry, bioelectrical impedance analysis, AI assisted muscle ultrasound, and handgrip strength.</div></div><div><h3>Results</h3><div>A total of 142 patients were included (76 Leucine-ONS, 66 Standard-ONS), mostly women (65.5 %), mean age 62.00 (18.66) years. Malnutrition was present in 90.1 % and 34.5 % had sarcopenia. Cancer was the most common condition (30.3 %). The Leucine-ONS group showed greater improvements in phase angle (+2.08 % vs. −1.57 %; p = 0.02) and rectus femoris thickness (+1.72 % vs. −5.89 %; p = 0.03). Multivariate analysis confirmed associations between Leucine-ONS and improved phase angle (OR = 2.41; 95%CI: 1.18–4.92; p = 0.02) and reduced intramuscular fat (OR = 2.24; 95%CI: 1.13–4.46; p = 0.02).</div></div><div><h3>Conclusions</h3><div>Leucine-enriched-ONS significantly improved phase angle and muscle thickness compared to standard ONS, supporting its role in enhancing body composition in malnourished patients. These results must be interpreted in the context of the observational design of the study, the heterogeneity of comparison groups and the short duration of intervention. Further randomized controlled trials are needed to confirm these results and assess long-term clinical and functional outcomes.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 516-526"},"PeriodicalIF":2.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798358","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}