Clinical nutrition ESPEN最新文献

{"title":"Investigation into the prevalence of malnutrition, sarcopenia and frailty in very old hospitalised patients and relationship with clinical outcomes","authors":"Adrian Slee ,&nbsp;Manuela Sumar Vignau ,&nbsp;Paul Bassett ,&nbsp;Xinrui Jin ,&nbsp;Junyi Guo ,&nbsp;David Smithard","doi":"10.1016/j.clnesp.2025.08.036","DOIUrl":"10.1016/j.clnesp.2025.08.036","url":null,"abstract":"<div><h3>Background and aims</h3><div>Malnutrition, sarcopenia and frailty represent common conditions in the geriatric population that have a detrimental impact on quality of life and clinical outcomes. These syndromes also display resembling clinical features and may often co-exist, aggravating adverse health outcomes. This study aimed to investigate the prevalence and co-occurrence of the conditions in a very old aged cohort of hospital patients, and the associations with clinical outcomes.</div></div><div><h3>Methods</h3><div>A registered clinical audit was performed in a Hospital setting and data collected from older patients aged &gt;85 years of age, between 2019 and 2024. Malnutrition risk was assessed using the nutritional screening tool (NST), geriatric nutritional risk index (GNRI) and global leadership initiative malnutrition (GLIM) criteria. Sarcopenia screening was evaluated with the SARC-F (Strength, Assistance in walking, Rising from a chair, Climbing stairs, and Falls) questionnaire and frailty using the clinical frailty scale (CFS). The prevalence and concurrence of the conditions was calculated, alongside the analysis of in-hospital mortality risk and routine blood biomarkers (albumin, C-reactive protein, urea, creatinine and haemaglobin).</div></div><div><h3>Results</h3><div>768 audits were included for analysis and the median age was 89 years (87–92). Malnutrition was detected in 28.4 %, 32.8 % and 41.2 % of patients by NST, GNRI and GLIM respectively, while the prevalence of sarcopenia was 68.3 % and 73.2 % for frailty. Between 20.8 % and 29.2 % of patients presented all three conditions concomitantly, while 79.2 %–85.1 % had at least one. Cox regression analysis between geriatric syndromes and the risk of in-hospital death showed that high malnutrition risk by NST (adjusted HR = 1.78, p = 0.03), as well as the presence of sarcopenia by SARC-F (adjusted HR = 2.60, p = 0.001) and severe frailty (adjusted HR = 4.89, p &lt; 0.001), were all significantly associated with an increased risk of mortality. Likewise, biomarker levels differed depending on the presence of conditions, with reduced albumin showing most significant associations with heightened risk/presence of malnutrition, sarcopenia and frailty.</div></div><div><h3>Conclusion</h3><div>The study showed a high prevalence and overlap between the explored conditions in this large, very old aged cohort, with nearly a third of patients presenting all three simultaneously, which may present significant health burden. Further research is needed to optimise the screening and assessment of conditions and establishing most accurate tools and techniques, to enhance clinical practical and potentially better guide interventions potentially affecting clinical outcomes.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 129-137"},"PeriodicalIF":2.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary quality in mid-pregnancy and pubertal timing in offspring: A population-based cohort study","authors":"Camilla Wibrand ,&nbsp;Anne Gaml-Sørensen ,&nbsp;Anne Ahrendt Bjerregaard ,&nbsp;Sjurdur Frodi Olsen ,&nbsp;Cecilia Ramlau-Hansen","doi":"10.1016/j.clnesp.2025.09.006","DOIUrl":"10.1016/j.clnesp.2025.09.006","url":null,"abstract":"<div><h3>Background and aims</h3><div>Animal studies have suggested that nutrition received <em>in utero</em> may impact pubertal timing. However, the potential association between maternal dietary quality during pregnancy and pubertal timing remains unevaluated in humans. We examined if a measure reflecting dietary quality in mid-pregnancy is related to pubertal timing.</div></div><div><h3>Methods</h3><div>We utilized data from the Danish National Birth Cohort and its sub-cohort, the Puberty Cohort with children born in 2000–2003. Data on diet, the primary exposure, was collected in mid-pregnancy using a Food Frequency Questionnaire and condensed into eight domains based on Danish National Food-based Dietary Guidelines. Based on guideline compliance, a maternal healthy eating index (mHEI) ranging from 0 to 80 was constructed. Self-reported data on pubertal development, the primary outcome, was collected half-yearly from age 11 years and throughout puberty. Main outcome was age difference in months at reaching individual pubertal milestones as well as reaching all pubertal milestones in a combined estimate, which was analyzed according to mHEI in quartiles, continuous and as restricted cubic splines using multi-variable interval-censored regression models. The analyses were stratified by sex.</div></div><div><h3>Results</h3><div>The study population consisted of 12,979 mother-offspring pairs. The mHEI ranged from 4.5 to 54.7 with a median of 22.3. In girls, we found an indication of an association between mHEI and slightly earlier pubertal timing, as both high and low mHEI were associated with an earlier combined pubertal estimate compared to the median mHEI as restricted cubic splines. Not meeting fruit and vegetable recommendations was associated with later pubertal onset in girls. We found no association between mHEI and pubertal timing in boys.</div></div><div><h3>Conclusion</h3><div>There might be an association between mHEI and puberty timing in girls, but results should be interpreted cautiously due to the study's lack of consistent results, possible unmeasured residual confounding, a risk of misclassification and few participants meeting the dietary recommendations.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 18-28"},"PeriodicalIF":2.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039309","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":"Intelligent diet recommendation system powered by artificial intelligence for personalized nutritional solutions","authors":"Tohid Amadeh ,&nbsp;Matin Rafie ,&nbsp;Shadmehr Radmanesh ,&nbsp;Alireza Azizi ,&nbsp;Ahmadreza Ahangarian ,&nbsp;Pourya Fathollahi ,&nbsp;Hadise Ahmadloo","doi":"10.1016/j.clnesp.2025.09.002","DOIUrl":"10.1016/j.clnesp.2025.09.002","url":null,"abstract":"<div><h3>Background and aims</h3><div>The increasing number of non-communicable diseases, such diabetes and obesity, makes it even more important to have accurate and personalized dietary solutions. Based on a lot of research, standard diet advice may not be accurate enough to meet individual health demands. The Intelligent Diet Recommendation System is an artificial intelligence-powered platform that gives personalized dietary recommendations based on extensive body composition data and cultural eating habits.</div></div><div><h3>Methods</h3><div>The Intelligent Diet Recommendation System gathers key measurements, including body mass index and body fat percentage, using cutting-edge body analysis tools. Customized diets were created using 3D body modeling technologies and machine learning algorithms. The system's performance was evaluated by assessing the inaccuracy rate of its dietary recommendations.</div></div><div><h3>Results</h3><div>The Intelligent Diet Recommendation System made personalized diet plans based on physiological and cultural factors with an error rate of less than 3 %.</div></div><div><h3>Conclusions</h3><div>The results show that the Intelligent Diet Recommendation System is a scalable, artificial intelligence-based way to solve global health problems that makes dietary advice much more accurate and easy to find. This system offers a new way of doing nutritional therapy that could improve health outcomes around the world.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 194-203"},"PeriodicalIF":2.6,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022919","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":"Assessing malnutrition in lung cancer resection patients: Modification of global leadership initiative on malnutrition (GLIM) criteria for implementation in surgical practice","authors":"Laura Gorenshtein ,&nbsp;Sonal Swain ,&nbsp;Jonathan Laredo ,&nbsp;Trevor Sytsma ,&nbsp;Ben Nguyen ,&nbsp;Paul Wischmeyer ,&nbsp;Krista L. Haines","doi":"10.1016/j.clnesp.2025.09.003","DOIUrl":"10.1016/j.clnesp.2025.09.003","url":null,"abstract":"<div><h3>Background</h3><div>Up to 70 % of lung cancer may be malnourished. This study aims to examine the effects of malnutrition on outcomes in lung cancer patients undergoing resection using modified GLIM criteria.</div></div><div><h3>Methods</h3><div>The study utilized the mGLIM criteria to identify malnourished patients. The modified criteria included (1) BMI ≤20 for age ≤70 years and BMI ≤22 for age ≥71 years, (2) weight loss &gt;10 % within the past 6 months, and (3) admission albumin ≤3.5. Patients meeting all three criteria were classified as malnourished. The study focused on lung cancer patients who underwent elective surgery. Multivariate models were employed to evaluate the impact of mGLIM criteria on multiple outcomes.</div></div><div><h3>Results</h3><div>We analyzed 37,386 patients who underwent elective lung resection from. 55.60 % were female (n = 20,787), 73.35 % White (n = 27,421), and 6.30 % Black or African American (n = 2354). Only 0.15 % (n = 57) had data available for all three mGLIM variables. 52 patients who met all three mGLIM criteria had mortality as an outcome. Malnourished patients experienced longer length of stay (p &lt; 0.001, CI [2.40, 5.18]), increased complications (p &lt; 0.001, CI [2.27, 6.87]), and increased discharge to facilities (p &lt; 0.001, CI [1.80, 7.69].</div></div><div><h3>Conclusion</h3><div>Malnourished lung cancer patients, as per mGLIM criteria, experience worse post-operative outcomes. While mGLIM is a practical adaptation, our findings suggest that the full GLIM criteria should be more widely applied in clinical practice. Incorporating GLIM criteria preoperatively could enhance the identification of malnourished patients, allowing for earlier, tailored nutritional interventions.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 36-44"},"PeriodicalIF":2.6,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013983","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 the screening methods, prevalence, and risk factors of malnutrition in multiple sclerosis: A scoping review","authors":"Tyler J. Titcomb ,&nbsp;Farnoosh Shemirani ,&nbsp;Tracey A. Cho ,&nbsp;Linda G. Snetselaar","doi":"10.1016/j.clnesp.2025.09.001","DOIUrl":"10.1016/j.clnesp.2025.09.001","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>People with multiple sclerosis (MS) may be predisposed to malnutrition as several malnutrition risk factors are common among this group; however, evidence on malnutrition in MS is sparse. Therefore, the aim of the present study is to explore what is known about malnutrition in MS.</div></div><div><h3>Methods</h3><div>A scoping review was performed in 5 databases (Ovid Medline, Embase, Cochrane Central, Scopus, and the Web of Science Core Collection) in February 2024. Studies were included if they defined how malnutrition was evaluated or used a validated malnutrition screening tool among people with MS.</div></div><div><h3>Results</h3><div>Seven studies reported the prevalence at risk for malnutrition and eight reported the prevalence with malnutrition using several different methods to assess or screen for malnutrition including the Subjective Global Assessment (SGA), Patient-generated SGA, Mini Nutrition Assessment, Nutrition Risk Screening 2002, Global Leadership Initiative on Malnutrition criteria, serum albumin, and International Classification of Diseases taxonomy. One study reported prevalences based on two different methods; therefore, eight prevalences of risk for malnutrition and nine prevalences with malnutrition are reported. The reported prevalences at risk for malnutrition were 87.8 % and 85.5 %, 69.3 %, 57 %, 53.9 %, 24.8 %, 6.5 %, and 5.5 %. The reported prevalences of malnutrition were 15.5 % and 12.2 %, 13.4 %, 11.8 %, 10.4 %, 10.3 %, 1.6 %, 1.6 %, and 0.7 %. Several risk factors for malnutrition were reported including disability burden, age, and progressive subtype; however, bubble plots showed no associations for baseline age, sex distribution, MS duration, body mass index, or disability status. One study observed that malnutrition was associated with lower physical and mental quality of life.</div></div><div><h3>Conclusion</h3><div>The available evidence suggests that malnutrition may be common among people with MS; however, given the wide variation in reported prevalences more studies are needed to better evaluate the scope of malnutrition in MS.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 802-808"},"PeriodicalIF":2.6,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013953","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":"Effects of antioxidants on oxidative stress in adult patients with coronary artery disease: A systematic review","authors":"Islam M. Alhusban ,&nbsp;Misook L. Chung ,&nbsp;Martha Biddle","doi":"10.1016/j.clnesp.2025.08.037","DOIUrl":"10.1016/j.clnesp.2025.08.037","url":null,"abstract":"<div><h3>Background</h3><div>Oxidative stress (OS) accelerates the pathogenesis of coronary artery disease (CAD) by contributing to atherosclerotic plaque formation. Current research indicates that antioxidants can mitigate OS by reducing the production of free radicals. Despite many studies that have tested the effects of antioxidants on oxidative stress in patients with CAD, the literature still lacks an updated and comprehensive systematic review. The aim of this study was to identify the effects of administering exogenous antioxidants on OS levels among adult patients with CAD.</div></div><div><h3>Methods</h3><div>A systematic review searched PubMed, Medline, and CINAHL for randomized controlled trials (RCTs) published between January 2013 and May 2025, which examined antioxidants to lower OS in adult participants with CAD. Studies were excluded if participants had chronic or acute inflammatory conditions, renal failure, liver failure, or had undergone major operations before being enrolled.</div></div><div><h3>Results</h3><div>Among 2338 studies reviewed, 15 RCTs met the inclusion criteria. Out of the 15 RCTs, nine reported on supplemental antioxidants (i.e., L-carnitine and melatonin), and two reported on dietary antioxidants (Khorasan wheat diet and wine) that were effective at lowering OS (P &lt; 0.05). One study found Brazil nuts (dietary antioxidants) ineffective at lowering OS. The three remaining RTCs reported that intravenously administered antioxidants, including alpha-lipoic acid, vitamin C, or N-acetylcysteine, significantly lowered OS.</div></div><div><h3>Conclusions</h3><div>The reviewed RTCs provide evidence that antioxidants may lower OS in patients with CAD. The utility of this conclusion is limited by the studies’ methodologies that examine various antioxidants and measure OS through a variety of biomarkers. This heterogeneity in methodologies between studies indicates that further research is needed with standardized interventions and outcomes.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 794-801"},"PeriodicalIF":2.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008202","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":"Demystifying intricate factors of nutritional anemia beyond iron deficiency–A narrative review","authors":"Richa Soni ,&nbsp;Deepak Verma ,&nbsp;Rajni Chopra ,&nbsp;Vishakha Singh ,&nbsp;Dweipayan Goswami","doi":"10.1016/j.clnesp.2025.08.034","DOIUrl":"10.1016/j.clnesp.2025.08.034","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Nutritional anemia is a widespread public health issue, impacting about one-quarter of the global population (24.3 % in 2021; ∼1.92 billion people). Iron-deficiency anemia (IDA) is the most prevalent form, primarily caused by inadequate dietary intake, poor iron absorption, or increased physiological needs. However, the complexity of nutritional anemia extends beyond iron deficiency, involving other micronutrients such as vitamin B12, folate, zinc, copper, and vitamin A. Additionally, anti-absorptive dietary inhibitors (e.g., phytates, polyphenols, oxalates), chronic infections, and inflammation exacerbate the condition. This review aims to provide a comprehensive understanding of the multifactorial etiology of nutritional anemia and discuss emerging insights and innovative approaches for its prevention and management.</div></div><div><h3>Objective</h3><div>To critically examine the contributions of various micronutrient deficiencies, the impact of anti-absorptive dietary inhibitors, and the influence of socioeconomic and environmental determinants. The review also evaluates the challenges of modern dietary trends, such as the rise of plant-based diets, and explores promising strategies for mitigating anemia prevalence.</div></div><div><h3>Approach</h3><div>Narrative review synthesizing evidence from recent literature, including epidemiological studies, clinical trials, and public health interventions. This integrative approach provides a holistic understanding of nutritional anemia and identifies gaps in current knowledge and intervention strategies.</div></div><div><h3>Insights</h3><div>The review highlights the intricate interplay of micronutrient deficiencies, dietary inhibitors, and socio-environmental factors that contribute to the high prevalence of anemia. Emerging solutions such as hepcidin modulation, biofortification, and novel iron formulations have shown promise in clinical and public health settings. However, the success of anemia reduction efforts varies across different regions, emphasizing the need for culturally tailored, multi-pronged approaches.</div></div><div><h3>Conclusions</h3><div>Addressing nutritional anemia requires an integrated strategy that includes improving micronutrient bioavailability, implementing effective public health policies, and addressing underlying social and environmental determinants. Continued interdisciplinary research and policy development are crucial to creating sustainable, impactful solutions, particularly for the most vulnerable populations, including young children, women of reproductive age, and the elderly.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 745-764"},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005943","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 the gut microbiota composition and alpha-diversity on the hormonal response and appetitive measures of individuals with obesity after a meal either rich in ultra-processed foods or without ultra-processed foods: Secondary analysis of a randomized clinical trial","authors":"Nayara Gomes Graciliano,&nbsp;Ana Debora Santos de Oliveira,&nbsp;Guilherme César Oliveira de Carvalho,&nbsp;Maria Bárbara Galdino-Silva,&nbsp;Karine Maria Moreira Almeida,&nbsp;Samyra Araújo Monteiro Carvalho,&nbsp;Nassib Bezerra Bueno","doi":"10.1016/j.clnesp.2025.08.028","DOIUrl":"10.1016/j.clnesp.2025.08.028","url":null,"abstract":"<div><h3>Background</h3><div>Obesity and the consumption of ultra-processed foods (UPF) are associated with gut microbiota composition and diversity, which may contribute to alterations in the regulation of hormones involved in satiety, given the gut microbiota's role in regulating host appetite. Therefore, this study aimed to investigate the association of gut microbiota composition and alpha-diversity at the genus-level on postprandial changes in satiety hormones, and appetitive measures in individuals with obesity, given either a meal rich in UPF or a meal without UPF.</div></div><div><h3>Methods</h3><div>Individuals were randomized to two groups: a) a non-UPF meal and b) a UPF meal. Both meals were matched for energy, energy density, macronutrients, fiber, and sodium content. The gut microbiota composition was analyzed using DNA <em>metabarcoding</em> and 16S rRNA sequencing. Alpha-diversity was assessed using the Shannon, Simpson's, and Inverse-Simpson indices at the genus level. Blood samples for hormonal (ghrelin, leptin, and GIP) and appetitive measures (hunger, satiety, fullness, and capacity to eat) were taken using visual analog scales after a 12-h fast and 90 min post-meal.</div></div><div><h3>Results</h3><div>Twenty individuals were included in the UPF group, and 19 were in the control group, with no significant differences in gut microbiota composition or alpha-diversity indices between the groups. All hormone concentrations and appetitive measures varied significantly over time, regardless of the type of meal. A greater alpha-diversity of gut microbiota at the genus-level was associated with increased postprandial fullness (p &lt; 0.05 for all indices), with clues that this association varied significantly between groups according to meal type (p = 0.02 for the inverse-Simpson index and p = 0.07 for the other indices), indicating a positive correlation only in the control group.</div></div><div><h3>Conclusion</h3><div>Gut microbiota alpha diversity at the genus level appears to be associated with the subjective sensation of fullness after a meal, and this association may vary depending on the ultra-processed food content of the meal. This finding warrants further investigation due to the exploratory nature of this study.</div></div><div><h3>Trial registration number</h3><div>RBR-56nsh92 (<span><span>https://ensaiosclinicos.gov.br/rg/RBR-56nsh92</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 722-732"},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005996","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 serum vitamin D metabolite levels and cognitive function in community-dwelling older adults: A cross-sectional study","authors":"Cai Yu ,&nbsp;Minae Ide ,&nbsp;Taiki Sugimoto ,&nbsp;Rei Otsuka ,&nbsp;Koji Takahashi ,&nbsp;Masaki Takiwaki ,&nbsp;Kiyoshi Tanaka ,&nbsp;Hiroaki Kanouchi ,&nbsp;Shigeo Takenaka ,&nbsp;Takashi Sakurai ,&nbsp;Shumpei Niida ,&nbsp;Akiko Kuwabara","doi":"10.1016/j.clnesp.2025.08.032","DOIUrl":"10.1016/j.clnesp.2025.08.032","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Vitamin D deficiency has been associated with cognitive decline and Alzheimer's disease (AD); however, findings remain inconsistent. Assessing vitamin D status based solely on total 25-hydroxyvitamin D [25(OH)D] may be insufficient, and other metabolites, such as 24,25-dihydroxyvitamin D₃ [24,25(OH)₂D₃] and 3-epimer-25-hydroxyvitamin D₃ [3-epi-25(OH)D₃], may provide additional insights. This study aimed to examine the association between serum vitamin D metabolite concentrations and cognitive function in older adults.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted involving 289 community-dwelling participants aged 65–85 years clinically diagnosed with AD, mild cognitive impairment (MCI), or were cognitively normal (CN). Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Serum concentrations of 25-hydroxyvitamin D₃ [25(OH)D₃], 25-hydroxyvitamin D₂ [25(OH)D₂], 24,25(OH)₂D₃, 3-epi-25(OH)D₃, and 1,25-dihydroxyvitamin D₃ [1,25(OH)₂D₃] were measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The Vitamin D metabolite ratio (VMR) was calculated as 24,25(OH)₂D₃/25(OH)D₃ × 100 (%). Associations among metabolite concentrations, MMSE scores, and AD prevalence were analyzed.</div></div><div><h3>Results</h3><div>Participants had relatively high serum total 25(OH)D levels (median: 23.5 ng/mL), with males showing higher vitamin D metabolite concentrations. Total 25(OH)D correlated with 24,25(OH)₂D₃, 3-epi-25(OH)D₃, and VMR. In males, 3-epi-25(OH)D₃ and 24,25(OH)₂D₃ were associated with lower MMSE scores (p &lt; 0.01) and higher AD risk (OR = 2.78, p = 0.03). In females, VMR was associated with higher MMSE scores (p = 0.01) and lower AD risk (OR = 0.64, p &lt; 0.01), while 1,25(OH)₂D₃ was linked to higher AD risk (OR = 1.04, p = 0.01) and quartile 2 with lower MCI risk (p &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Sex-based differences in vitamin D–cognition associations may reflect disparities in vitamin D levels and hormonal effects, such as estrogen-enhancing and testosterone-suppressing metabolism. 1,25(OH)₂D₃, VMR, and 3-epi-25(OH)D₃ may be more sensitive than total 25(OH)D.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 785-793"},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006003","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":"Omega-3 fatty acid supplementation in solid organ transplant recipients: A systematic review and meta-analysis of randomized controlled trials","authors":"Sama Samankan ,&nbsp;Afshin Gharekhani ,&nbsp;Sajad Khiali ,&nbsp;Afraa Rezagholizadeh ,&nbsp;Amin Agabalazadeha ,&nbsp;Parvin Sarbakhsh ,&nbsp;Leila Alizadeh ,&nbsp;Ali Sharifi ,&nbsp;Amin Sadrazar","doi":"10.1016/j.clnesp.2025.08.035","DOIUrl":"10.1016/j.clnesp.2025.08.035","url":null,"abstract":"<div><h3>Background</h3><div>Omega-3 polyunsaturated fatty acids are known for anti-inflammatory and cardiovascular benefits, but their impact on solid organ transplant outcomes is unclear.</div></div><div><h3>Objectives</h3><div>To assess the effects of omega-3 supplementation on clinical outcomes in solid organ transplant recipients.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis of randomized controlled trials was conducted according to PRISMA guidelines. Databases including PubMed, Scopus, and Web of Science were searched through May 2025. Eligible studies were evaluated for transplant-related outcomes, with the primary outcome being graft rejection at 30-day, 3-month, and 1-year post-transplant. Secondary outcomes included changes in lipid profile, blood pressure, renal function, and infection rates.</div></div><div><h3>Results</h3><div>Sixteen trials involving 1,020 patients were included. Omega-3 supplementation did not result in a statistically significant reduction in rejection rates at 30 days, 3 months, or 1 year post-transplant. Diastolic blood pressure decreased significantly (Hedges' g = −0.72; 95 % CI: −1.31 to −0.13), and total cholesterol levels also declined (Hedges' g = −0.64; 95 % CI: −1.04 to −0.24), particularly in kidney transplant recipients. In heart transplant recipients, systolic blood pressure decreased significantly (Hedges’ g = −1.03; 95 % confidence interval: −1.53 to −0.54). Effects on high- and low-density lipoproteins, triglycerides, glomerular filtration rate, and creatinine clearance were inconsistent and largely non-significant. A single study reported reduced sepsis rates in kidney recipients (log odds ratio = −1.16; 95 % confidence interval: −2.25 to −0.07). No significant impact was seen on calcineurin inhibitor toxicity.</div></div><div><h3>Conclusion</h3><div>Omega-3 supplementation may have benefits for solid organ transplant recipients in terms of improving lipid profiles and reducing blood pressure. However, study heterogeneity and limited outcome data highlight the need for larger, standardized trials.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 809-820"},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005918","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}