Clinical nutrition ESPEN最新文献

{"title":"Exploring the role of human papillomavirus (HPV) status in body composition and nutritional features in patients with oropharyngeal cancer","authors":"M. Choulli ,&nbsp;F. Morey ,&nbsp;S. Tous ,&nbsp;J. Brenes ,&nbsp;X. Wang ,&nbsp;B. Quirós ,&nbsp;A.R. González-Tampán ,&nbsp;M.A. Pavón ,&nbsp;M. Gomà ,&nbsp;M. Taberna ,&nbsp;M.E. Alemany ,&nbsp;M. Oliva ,&nbsp;M. Mena ,&nbsp;L. Arribas ,&nbsp;R. Mesia","doi":"10.1016/j.clnesp.2025.03.013","DOIUrl":"10.1016/j.clnesp.2025.03.013","url":null,"abstract":"<div><h3>Background and aims</h3><div>Patients with oropharyngeal squamous cell carcinoma (OPSCC) are highly prone to malnutrition and sarcopenia due to the tumor's location and treatment-related toxicity. Human papillomavirus (HPV)-related and HPV-unrelated OPSCC represent two distinct biological entities. This study aimed to assess nutritional characteristics and body composition differences at diagnosis, as well as 3- and 6-months post- (chemo) radiation treatment, stratified by HPV status in OPSCC patients.</div></div><div><h3>Methods</h3><div>Retrospective data analysis of a prospective cohort of OPSCC patients diagnosed and treated with curative intent from 2016 to 2022 at our center. Sociodemographic, clinical, and nutritional data were retrieved from medical records from diagnosis to 6 months post-treatment. Body composition parameters were assessed by analyzing the cross-sectional area of the third lumbar vertebra (L3) using available positron emission tomography (PET) and computed tomography (CT) scans at baseline, 3- and 6-months post-treatment.</div></div><div><h3>Results</h3><div>Seventy patients were included, 33 (47.1 %) of whom had HPV-related OPSCC. HPV-related patients had higher body mass index (27.3 vs 21.9 kg/m²; p &lt; 0.001) and better baseline nutritional status (p = 0.023), but no differences in skeletal muscle index (SMI, p = 0.103) compared to HPV-unrelated patients. At 3- and 6-months post-treatment the two groups showed similar SMI and total adipose tissue index loss (p &gt; 0.05 for both). HPV status was not independently associated with body composition changes over time (p = 0.624).</div></div><div><h3>Conclusions</h3><div>Although HPV-related patients were better nourished than HPV-unrelated patients at diagnosis, by the end of treatment, both groups exhibited similar nutritional deterioration.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 417-426"},"PeriodicalIF":2.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673253","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":"Heparin in peripherally inserted central catheters did not alter elective removal and complication rates in preterm infants","authors":"Dirk Wackernagel ,&nbsp;Vanessa Gavelli ,&nbsp;Per Nydert","doi":"10.1016/j.clnesp.2025.03.024","DOIUrl":"10.1016/j.clnesp.2025.03.024","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>In preterm and sick newborn infants, peripherally inserted central catheters (PICC) are used for the delivery of concentrated parenteral nutrition and other high risk drugs. Despite the precaution issued by the ESPGHAN 2018, heparin is used in many neonatal intensive care units (NICU) and is thought to extend PICC usability. This study aimed to examine the association of prophylactic heparin with elective PICC removal rates, with complication rates and dwell-times.</div></div><div><h3>Methods</h3><div>All PICCs placed at two different Level III NICUs during 2017, were analyzed retrospectively. Out of 168 PICCs, 36 had to be excluded, leaving 132 PICCs for analysis. Prophylactic heparin was used in 90 PICCs (heparin-group) and 42 PICCs without (control group)</div></div><div><h3>Results</h3><div>Sixty-six PICCs (73 %) vs 30 (71 %) could be removed electively in the heparin-group (adjusted Odds Ratio 95 % confidence interval (CI) 0.95 [0.31, 2.89], p &gt; 0.9). Complications occurred in 17 (19 %) and 8 (19 %) PICCs in the heparin-group and control-group, respectively. Dwell-times did not differ significantly with median 10 days (Interquartile range (IQR) 6,17) in the heparin-group and 8 days (IQR 7,12) in the control-group with an adjusted hazard ratio 0.70 (95 % CI [0.45, 1.09], p = 0.11).</div></div><div><h3>Conclusion</h3><div>In our retrospective analysis, adding heparin to admixtures infused via PICCs did not alter the odds of elective removals or complication rates. Furthermore, Dwell-times did not differ significantly between the two groups. In line with the ESPGHAN recommendations, our data can not support the use of heparin to improve PICC usability.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 200-205"},"PeriodicalIF":2.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of bariatric surgeries on Binge eating disorders, Food addiction, and eating behaviors: A comprehensive systematic review of RCTs","authors":"Reyhaneh Morad-Abbasi ,&nbsp;Fatemeh zare-shahne ,&nbsp;Fatemeh Naeini ,&nbsp;Atoosa saidpour ,&nbsp;Farnaz Etesam ,&nbsp;Mohammad Javad Hosseinzadeh-Attar","doi":"10.1016/j.clnesp.2025.03.016","DOIUrl":"10.1016/j.clnesp.2025.03.016","url":null,"abstract":"<div><div>Different types of bariatric surgery have emerged as a major and most effective treatment for obesity. With the rapid growth of bariatric surgery in this decade, it is crucial to understand the postoperative outcomes, especially eating-related outcomes, such as non-preexisting eating disorders, food addiction, emotional eating, and eating behaviors. This systematic review of RCTs seeks to evaluate the impact of various bariatric surgery procedures on eating behaviors, eating disorders, and food addiction to better understand their post-operative effects and guide future clinical practice. Following the 2015 PRISMA guidelines, a systematic review was conducted using PubMed/Medline, Scopus, and WOS databases through May 2024. After assessing 1158 full-text articles, 14 studies were selected based on the established criteria.</div><div>Based on the obtained results, bariatric surgery significantly improved eating behaviors and weight concerns among patients. Eating behavior was assessed by various questionnaires, such as TFEQ and PFS, across different types of bariatric surgeries, including RYGB, SG, LSG, DJBL, and LAGB. While some studies found varying degrees of improvements across different surgical procedures, the general trend suggests that bariatric surgery can lead to significant improvements in eating behaviors.</div><div>In conclusion, bariatric surgery appears to influence eating behaviors, food addiction, and binge eating disorders by altering the gut microbiota, gut hormones, and brain regions associated with appetite. However, there is no significant difference in these outcomes among different types of surgery.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 222-232"},"PeriodicalIF":2.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668764","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":"Influence of high-fiber diet on ipilimumab-induced gastrointestinal toxicity in metastatic melanoma.","authors":"Pawel Majenka, Matthias Hoffmann, Sophia Strobel, Ingeborg Rötzer, Alexander Enk, Jessica C Hassel","doi":"10.1016/j.clnesp.2025.03.026","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.03.026","url":null,"abstract":"<p><strong>Background: </strong>The anti-cytotoxic T-lymphocyte-associated protein (CTLA)-4 antibody ipilimumab (ipi) and the anti-programmed death (PD)-1 antibody nivolumab (nivo) are routinely used to treat metastatic melanoma. One of the most frequent severe immune-related adverse events (irAEs) induced by ipi is diarrhea as a symptom of ir-colitis. Here, the composition of the gut microbiome was shown to correlate with the risk of developing colitis. Stimulated by a patient case and the knowledge that nutrition influences the gut microbiome, we performed a retrospective analysis to evaluate dietary habits and the frequency of colitis in patients with ipi +/- nivo therapy.</p><p><strong>Methods: </strong>Patients with metastasized stage III or IV melanoma who were treated with ipi +/- nivo and who were willing to take part in a nutritional survey and interview at least three months after the first ipi dose were included into the study. Dietary habits were investigated using the food frequency questionnaire (FFQ) and personal interviews. The calculated daily intake of calories, carbohydrates, fats, proteins, sugars, and dietary fiber was correlated with the development of ir-colitis.</p><p><strong>Results: </strong>20 patients were included into this study, and all but one received ipi-nivo combination therapy. The median age was 59.5 years, and 60% were male. 4 of 20 patients (20%) developed ir-colitis grade 3 after two cycles in the median and were managed with at least high-dose corticosteroids. The FFQ and interview were conducted in a median of six months after treatment initiation. In general, the interviewed patients followed a typical western-pattern diet based on carbohydrates as the main, followed by fat as the second most important energy substrate. Comparing patients with and without colitis our investigation revealed that the achieved amount of recommended dietary fiber intake per total energy intake (TEI) was negatively associated with diarrhea and colitis (p = 0.061). No significant differences concerning daily intake of calories, carbohydrates, fats, proteins, and sugar were found. In addition, no significant differences were found among patients in terms of their age, gender, tobacco use, supplement intake, therapy regime, or body mass index (BMI).</p><p><strong>Conclusions: </strong>This pilot study gives first hints that nutritional habits might influence treatment tolerability to ipi +/- nivo therapy. A high-fiber diet might protect against ir-colitis and diarrhea in ipi-treated patients. This observation should be validated by a prospective randomized interventional trial. However, if it is possible to prevent ir-colitis by a high-fiber diet that would be of great impact on routine patient treatment.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668938","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 sarcopenia index, a surrogate marker of muscle mass, and incident chronic kidney disease","authors":"Fan Zhang ,&nbsp;Aojiao Chu ,&nbsp;Yan Bai,&nbsp;Liuyan Huang,&nbsp;Yifei Zhong,&nbsp;Yi Li","doi":"10.1016/j.clnesp.2025.03.019","DOIUrl":"10.1016/j.clnesp.2025.03.019","url":null,"abstract":"<div><h3>Background</h3><div>Sarcopenia, characterized by loss of muscle mass and strength, has been linked to various health outcomes, including chronic kidney disease (CKD). This study aims to investigate the association of sarcopenia index, based on serum creatinine and cystatin C levels, with incident CKD in middle-aged and older adults.</div></div><div><h3>Methods</h3><div>This study extracted data from a nation cohort, including age ≥45 years adults without CKD at baseline. Sarcopenia index was calculated based on serum creatinine and cystatin C levels, and incident CKD was assessed through follow-up surveys. Cox proportional hazards regression models were used to analyze the association between sarcopenia index and incident CKD, adjusting for potential confounders, with hazard ratio (HR) with 95 % confidence interval (95 % CI) reported.</div></div><div><h3>Results</h3><div>A total of 8618 participants were included in the analysis. The median age was 61.0 years, and 44.7 % were male. During a mean follow-up period of 5.0 years, 514 cases of incident CKD were identified. After adjusting for covariates, compared with participants in the lowest tertile, the corresponding CKD HRs (95 % CIs) for participants in the medium and highest tertile were 0.701 (95 % CI: 0.558–0.880, <em>P</em> = 0.002), 0.784 (95 % CI: 0.618–0.994; <em>P</em> = 0.045). Restricted cubic spline curves revealed that incident rate decreased with increase in sarcopenia index.</div></div><div><h3>Conclusion</h3><div>This study provides national longitudinal evidence on the association of higher sarcopenia index with lower incident CKD. Our findings suggest that sarcopenia index may be a useful biomarker for predicting the risk of CKD in this population.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 184-191"},"PeriodicalIF":2.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669423","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":"Determination of the international dysphagia diet standardization initiative level of commercially available oral nutritional supplements","authors":"Paraskevi Detopoulou ,&nbsp;Maria G. Grammatikopoulou ,&nbsp;Eleni Lytra ,&nbsp;Ioanna Pylarinou ,&nbsp;George Panoutsopoulos","doi":"10.1016/j.clnesp.2025.03.022","DOIUrl":"10.1016/j.clnesp.2025.03.022","url":null,"abstract":"<div><h3>Background/objective</h3><div>The International Dysphagia Diet Standardization Initiative (IDDSI), a global multi-disciplinary non-profit framework, has created a standardized communication code to describe foods and liquids for individuals with dysphagia. For liquids, four levels have been determined (Level 0: Thin 1; Level 1: Slightly thick; Level 2: Mildly thick; Level 3: Moderately thick; Level 4: Extremely thick). The implementation of the IDDSI terminology is still in progress. Thus, most commercially available oral nutritional supplements lack an IDDSI identification label. The objective of the present work was to characterize oral nutritional supplements in terms of IDDSI, to facilitate its implementation.</div></div><div><h3>Methods</h3><div>Several supplements commercially available were tested and categorized according to the IDDSI system for liquids. Supplements in powder form were prepared according to manufacturers’ instructions. The IDDSI Flow Test was performed with specified syringes according to standard methodology.</div></div><div><h3>Results</h3><div>In total, 40 products from seven companies (Abbott, Medella, Nestle Health Science, Nutricia, Nutrisens, and Nutrimedica) were assessed, including different flavors from the same product line. Most products were classified at IDDSI 0 and 1 levels. Compact product forms were classified at the IDDSI 2 level, while soups and creams were classified at the IDDSI 3 or 4 level.</div></div><div><h3>Conclusions</h3><div>Patients with dysphagia and malnutrition can choose from various products classified according to the IDDSI classification to meet their nutritional needs.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 404-409"},"PeriodicalIF":2.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-density enteral formula in critically ill pediatric patients: A systematic review and meta-analysis","authors":"Natsuhiro Yamamoto ,&nbsp;Yoshiyuki Shimizu ,&nbsp;Keichiro Shimoyama ,&nbsp;Aya Tampo ,&nbsp;Norihiko Tsuboi ,&nbsp;Ryo Yamamoto ,&nbsp;Yujiro Matsuishi ,&nbsp;Kensuke Nakamura ,&nbsp;Joji Kotani","doi":"10.1016/j.clnesp.2025.03.025","DOIUrl":"10.1016/j.clnesp.2025.03.025","url":null,"abstract":"<div><h3>Background and aims</h3><div>Critically ill pediatric patients, particularly infants, require sufficient nutrition even in the acute phase because they are at a high risk of malnutrition. Water restrictions are frequently required to avoid the adverse effects of fluid overload. Administration of energy or protein-dense enteral formulas is considered a potential therapeutic strategy to achieve these requirements simultaneously. This study aimed to assess efficacy and safety of energy or protein-dense enteral formula through a systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>We searched MEDLINE via PubMed, Cochrane Central Register of Controlled Trials, and Igaku-Chuo-Zasshi in April 2023 for randomized controlled trials comparing high-density formulas (more than 0.9 kcal/mL) to standard-density formulas (0.67 to less than 0.9 kcal/mL) in critically ill pediatric patients undergoing enteral nutrition by artificial formula. The primary outcome was mortality, and secondary outcomes included length of stay in the intensive care unit (ICU), duration of mechanical ventilation, adverse events (emesis, diarrhea, and gastrointestinal bleeding), and weight-for-age Z score (WAZ). Data extraction and risk of bias assessment were performed by two independent reviewers using the Cochrane risk-of-bias tool. A meta-analysis was conducted using a random-effects model, and the certainty of the findings was assessed using the Grading of Recommendations Assessment, Development, and Evaluation methodology.</div></div><div><h3>Results</h3><div>Seven studies involving 542 patients were included in the meta-analysis. Six of these seven studies included patients with congenital heart disease, and the remaining study included infants with acute respiratory failure due to viral infection. The effects on mortality were not significant (risk ratio: 2.05, 95 % confidence interval: [CI] 0.76–5.50, P = 0.16, low certainty). No significant effects were observed on length of ICU stay, length of hospital stay, duration of mechanical ventilation, or adverse events. High-density formulas had a significant effect on increasing WAZ (mean difference: 0.61, 95 % CI: 0.28–0.94, P &lt; 0.001, low certainty).</div></div><div><h3>Conclusion</h3><div>Our results showed that the administration of high-density formulas was effective in increasing WAZ. Further investigation will contribute to improving the certainty of this evidence.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 192-199"},"PeriodicalIF":2.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668868","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":"Exploring beyond numeric weight loss: The metabolic effects of semaglutide","authors":"Sara Sokary,&nbsp;Hiba Bawadi","doi":"10.1016/j.clnesp.2025.03.010","DOIUrl":"10.1016/j.clnesp.2025.03.010","url":null,"abstract":"<div><div>The global burden of overweight and obesity has increased by threefold since the 1970s, which led to increased incidences of cardiovascular disease and type 2 diabetes. This review aimed to explore the metabolic impacts of semaglutide, including its effects on hunger and satiety, weight loss maintenance and regain, body composition, lipid profile, and glycemic control. Studies have shown that semaglutide reduced fat mass, particularly visceral fat, while preserving lean muscle mass, as the proportion relative to total body mass decreased by 3.5 % and 2.0 % for total and visceral fat mass, respectively, while it increased by 3.0 % for lean body mass. Also, it enhanced glycemic control, as evidenced by significant reductions in hemoglobin A1C (HbA1c) with the 0.5 mg and 1.0 mg doses. From a baseline range of 8.1–8.7 %, 0.5 mg dose lowered HbA1c by 1.2–1.5 %, while the 1.0 mg dose reduced it by 1.4–1.8 %. Furthermore, semaglutide was the only effective Glucagon Like Peptide-1 Receptor Agonist in reducing Low-Density Lipoprotein and total cholesterol levels, with mean differences of −0.16 mmol/L and −0.48 mmol/L, respectively. Evidence shows that withdrawing semaglutide led to weight regain, while continued treatment resulted in further weight loss. Semaglutide also slowed weight regain and promoted weight loss after failed bariatric surgery. It also significantly reduced ad libitum energy intake, decreased hunger, and increased satiety in multiple trials. Overall, these findings underscore the potential of semaglutide as a comprehensive treatment for obesity and type 2 diabetes.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 435-440"},"PeriodicalIF":2.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protein supplementation optimizes muscle strength and hypertrophic responses induced by low-load training with blood flow restriction in resistance-trained individuals","authors":"Levi da Silva Vendruscolo ,&nbsp;Helderson Brendon ,&nbsp;Victoria Hévia Larrain ,&nbsp;André Yui Aihara ,&nbsp;Vitor de Salles Painelli","doi":"10.1016/j.clnesp.2025.03.018","DOIUrl":"10.1016/j.clnesp.2025.03.018","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Low-load blood flow restriction (LL-BFR) training induces favorable changes in muscle hypertrophy and strength. However, the potential additive effect of LL-BFR and protein supplementation on these outcomes remains unclear.</div></div><div><h3>Methods</h3><div>Twenty-four recreationally resistance-trained men were randomly assigned to either a protein (PRO) or placebo (PLA) supplementation group in a 2:1 ratio. After being submitted to maximum dynamic strength (1-RM) and elbow flexors muscles cross-sectional area (EFCSA) assessments at baseline, participants were enrolled in a 3-week unilateral LL-BFR training (4 days per week, 4 sets of 15 repetitions, 30 % 1-RM) for the elbow flexors muscles in the incline dumbbell curl exercise. Psychological outcomes (rate of perceived exertion, pain and muscle soreness) were obtained at the first and last training session. EFCSA and 1-RM were reassessed after LL-BFR, with EFCSA being assessed at 45 %, 65 % and 85 % of humerus length.</div></div><div><h3>Results</h3><div>Psychological responses to LL-BFR improved in PRO and PLA (both <em>p</em> &lt; 0.05), with no significant between-group differences (all comparisons, <em>p</em> &gt; 0.05). A significant improvement in 1-RM was detected for PRO (+7.2 %, <em>p</em> = 0.0002), but not PLA (+3.5 %, <em>p</em> = 0.156). PRO experienced significant increases in EFCSA at 45 % (+7.5 %, <em>p</em> = 0.021), 65 % (+5.2 %, <em>p</em> = 0.033) and 85 % lengths (+8.4 %, <em>p</em> = 0.002), while PLA experienced increases only at the 85 % length (+5.9 %, <em>p</em> = 0.045). Absolute increases in 1-RM were greater for PRO vs. PLA (<em>p</em> = 0.039), whereas increases in EFCSA tended to be greater for PRO vs. PLA at 45 % (<em>p</em> = 0.086) and 65 % lengths (<em>p</em> = 0.072).</div></div><div><h3>Conclusion</h3><div>Our results showed that protein supplementation optimized the LL-BFR-induced muscle strength and hypertrophy improvements in trained individuals under comparable psychological responses.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 206-216"},"PeriodicalIF":2.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of nutrition therapy in critically ill patients with Clostridioides difficile infection","authors":"Anna M. Kroninger,&nbsp;BreAnna L. Davids,&nbsp;Andrew J. Franck","doi":"10.1016/j.clnesp.2025.03.017","DOIUrl":"10.1016/j.clnesp.2025.03.017","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Nutrition therapy in the intensive care unit (ICU) is a fundamental aspect of care, but there is minimal guidance for patients with <em>Clostridioides difficile</em> infection (CDI) despite the potentially severe consequences of this infection on the gastrointestinal tract. The aim of this study was to assess nutrition therapy in critically ill patients with CDI compared to those without CDI for differences in nutrition delivery, need for nutrition support, and safety of nutrition therapy.</div></div><div><h3>Methods</h3><div>This was a single-center, retrospective cohort study of patients admitted to the ICU from January 1, 2013, through December 31, 2022. This study compared nutrition therapy in critically ill patients who had CDI compared to a cohort who had diagnoses of other infections. Outcomes included doses of nutrition prescribed, need for nutrition support, and measures of enteral feeding tolerance.</div></div><div><h3>Results</h3><div>A total of 66 patients were included in this study, 33 in each group. The CDI group received higher median maximum calories (24.3 kcal/kg/day) compared to the control group (21.7 kcal/kg/day) [MD 3.5, 95 % CI 0.05–7.49, p = 0.04] and higher median maximum protein doses (1.1 g/kg/day) to (0.9 g/kg/day) [MD 0.2, 95 % CI 0.04–0.38, p = 0.02]. In the CDI group, significantly more patients required nutrition support (75.8 % and 48.5 %, respectively) [OR 3.32, 95 % CI 1.16–9.84, p = 0.02], but there was no difference in the number of patients who received parenteral nutrition. Measures of enteral feeding safety and tolerance were similar between both groups.</div></div><div><h3>Conclusion</h3><div>Nutrition therapy for critically ill patients did not appear to be negatively impacted by CDI, and provision of diet or enteral nutrition therapy appeared similarly safe and tolerated compared to those without CDI.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 217-221"},"PeriodicalIF":2.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662650","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}