Clinical nutrition ESPEN最新文献

{"title":"Navigating complexity: The challenge of reaching consensus on the diagnosis of malnutrition in patients with obesity via a modified delphi study","authors":"Natasha Nalucha Mwala ,&nbsp;Jeanne J.F.A. in ’t Hulst ,&nbsp;Barbara S. van der Meij ,&nbsp;Emmelyne Vasse ,&nbsp;Jos W. Borkent ,&nbsp;Carliene van Dronkelaar ,&nbsp;Patty L.M. Lakenman ,&nbsp;Esmee M. Reijnierse ,&nbsp;Josje D. Schoufour ,&nbsp;Peter J.M. Weijs ,&nbsp;Renate Winkels ,&nbsp;Maarten R. Soeters ,&nbsp;Marian A.E. de van der Schueren","doi":"10.1016/j.clnesp.2025.05.043","DOIUrl":"10.1016/j.clnesp.2025.05.043","url":null,"abstract":"<div><h3>Background &amp; aim</h3><div>Diagnosing (disease-related) malnutrition in patients with obesity is challenging due to the complex interplay between excess body weight and physiological changes associated with illness and inadequate dietary intake, factors often overlooked in clinical assessments. Current global definitions of malnutrition do not adequately account for the distinctive characteristics of patients with obesity. This study aimed to develop a working definition of malnutrition in this population.</div></div><div><h3>Methods</h3><div>A modified three-round Delphi method was conducted between March and July 2024, involving 25 experts to achieve consensus on diagnosing malnutrition in obesity. In Round 1, participants evaluated 45 statements using a 5-point Likert scale. Feedback from this round guided revisions for Round 2, which focused on the Global Leadership Initiative on Malnutrition (GLIM) criteria and introduced nine revised statements. Round 3 further refined these statements, with the final consensus assessed using a binary agree/disagree scale. A threshold of ≥70 % agreement was set to define consensus in all rounds, with statements not meeting this threshold left undecided.</div></div><div><h3>Results</h3><div>Participation rates were 88 % (n = 22) in Round 1, 77 % (n = 17) in Round 2, and 50 % (n = 11) in Round 3. Of the 45 statements assessed in Round 1, 11 were accepted, 32 were undecided, and two were rejected. Round 2 introduced nine revised statements, of which seven were accepted and two remained undecided. In Round 3, nine statements were assessed, of which six were accepted, and three remained undecided. Consensus supported adopting the GLIM criteria as the foundation for the working definition. However, thresholds for weight loss and muscle mass and the relevance of functional parameters remained unresolved. C-reactive protein thresholds were agreed upon, but their relevance was debated due to the challenges in interpreting chronic low-grade inflammation in obesity. Participants emphasised the importance of assessing dietary quality and quantity, recommending dietitian involvement for improved accuracy.</div></div><div><h3>Conclusion</h3><div>Although a working definition for diagnosing malnutrition in patients with obesity was not achieved, this study lays a crucial foundation for further research. Key areas for future investigation include refining and validating parameters related to involuntary weight loss, muscle mass, inflammatory markers and dietary intake.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 591-601"},"PeriodicalIF":2.9,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257497","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":"Fruit type ingestion and risk of hepatic steatosis: Analysis from two national database 2017–2020","authors":"Thanathip Suenghataiphorn ,&nbsp;Narisara Tribuddharat ,&nbsp;Pojsakorn Danpanichkul ,&nbsp;Narathorn Kulthamrongsri","doi":"10.1016/j.clnesp.2025.06.005","DOIUrl":"10.1016/j.clnesp.2025.06.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Hepatic Steatosis is an intrahepatic fat accumulation and can lead to liver dysfunction, inflammation, and advanced forms of nonalcoholic fatty liver disease (NAFLD). Fruits have been explored as a possible beneficial factor for some individuals with metabolic-associated liver diseases, but the evidence regarding the specific relationship between fruit types and hepatic steatosis remains limited.</div></div><div><h3>Methods</h3><div>We examined the data from a nationwide cross-sectional study using the 2017–March 2020 National Health and Nutrition Examination Survey (NHANES) database and the Food Patterns Equivalents Database (FPED) database. Using controlled attenuation parameter scores to differentiate between S0 to S3, for participants aged 18 years and older, we employed multivariable logistic regression to determine the association between specific types of fruit intake (citrus fruits, non-citrus fruits, and fruit juice) and the presence of hepatic steatosis.</div></div><div><h3>Results</h3><div>A total of 7568 participants were included in our study. Hepatic steatosis was present in 63 % of our participants. The average age was 48.8 years, with 50 % being females. Patients who consumed at least 0.86 cup-equivalents of citrus fruits daily (adjusted odds ratio [aOR] 0.82, 95 % confidence interval [CI] (0.71, 0.94), p = 0.004) had lower odds of having hepatic steatosis, whereas intake of fruit juice and non-citrus fruits was not statistically significantly associated with hepatic steatosis.</div></div><div><h3>Conclusion</h3><div>Citrus fruit consumption was associated with reduced odds of having hepatic steatosis in this U.S. adult population. Additional investigations into the pathophysiology, as well as longitudinal studies, are required to understand this relationship further and establish causality.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 583-590"},"PeriodicalIF":2.9,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257496","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 estimated glucose disposal rate and cardiovascular disease risk across different Sarcopenia statuses: A retrospective cohort study","authors":"Xiongmu Tan ,&nbsp;Xiaoqin Chen ,&nbsp;Yanrui shen,&nbsp;Yinqiu Wang,&nbsp;Linyan Huang,&nbsp;Liqing Peng","doi":"10.1016/j.clnesp.2025.06.001","DOIUrl":"10.1016/j.clnesp.2025.06.001","url":null,"abstract":"<div><h3>Background</h3><div>Recent research indicates that the estimated glucose disposal rate (eGDR) is regarded as a reliable surrogate marker for insulin resistance (IR) and is associated with the incidence of cardiovascular diseases (CVD). Sarcopenia, characterized by a decline in skeletal muscle mass, strength, or physical function, exhibits complex interactions with chronic diseases. This study aims to investigate the association between eGDR, sarcopenia, and CVD among middle-aged and elderly individuals, and to explore the potential impact of eGDR on CVD risk in the overall population as well as stratified by sarcopenia status.</div></div><div><h3>Materials and methods</h3><div>This study comprised 5938 participants who were free of cardiovascular disease at baseline and possessed complete data on sarcopenia-related indicators and eGDR. The primary endpoint was the occurrence of cardiovascular events. The relationship between baseline eGDR levels and the incidence of CVD among individuals with sarcopenia was analyzed using Kaplan–Meier curves, multivariable Cox proportional hazards models, restricted cubic spline analysis, subgroup analysis, and sensitivity analysis.</div></div><div><h3>Results</h3><div>During an average follow-up of 8.14 years, cardiovascular events occurred in 1164 participants (19.6 %). The risk of cardiovascular events decreased with each quartile (Q) increase in baseline eGDR levels. Kaplan–Meier curve analysis revealed significant differences in cardiovascular incidence among all participants across eGDR groups (P &lt; 0.05). After adjusting for potential confounding factors, the cardiovascular risk for participants in Q2, Q3, and Q4 was significantly lower than that in Q1. The hazard ratios (95 % confidence intervals) for CVD in groups Q2, Q3, and Q4 were 0.71 (0.61–0.82), 0.57 (0.47–0.68), and 0.55 (0.45–0.67), respectively. Furthermore, in all three Cox models, high levels of eGDR were associated with a reduced risk of cardiovascular events in non-sarcopenic, possibly sarcopenic, and sarcopenic individuals.</div></div><div><h3>Conclusion</h3><div>Elevated baseline eGDR levels are significantly associated with a reduced risk of CVD in middle-aged and elderly individuals, exhibiting notable characteristics in both non-sarcopenic and sarcopenic populations.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 749-760"},"PeriodicalIF":2.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246764","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 sarcopenic obesity and the risk of knee osteoarthritis in the middle-aged and elderly Chinese population: A 7-year cohort study","authors":"Xinyang Wang,&nbsp;Yubao Liu,&nbsp;Yucheng Lin,&nbsp;Yuanhao Liu,&nbsp;Linshu Guan,&nbsp;Jun Lu","doi":"10.1016/j.clnesp.2025.06.002","DOIUrl":"10.1016/j.clnesp.2025.06.002","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the relationship between sarcopenic obesity and the risk of knee osteoarthritis (KOA) in middle-aged and elderly individuals.</div></div><div><h3>Methods</h3><div>This study utilized cohort data from the China Health and Retirement Longitudinal Study (CHARLS) database, focusing on middle-aged and elderly individuals without knee osteoarthritis in 2011. A total of 4299 participants aged over 45 who met the inclusion and exclusion criteria were included. Using overweight as the criterion for obesity, participants were divided into four groups: normal control, only overweight, only sarcopenia, and sarcopenic overweight. Cox proportional hazards models were employed for survival analysis, comparing the normal control group with the other three groups to assess their impact on the risk of developing knee osteoarthritis. Sensitivity analyses were conducted using sarcopenia obese and sarcopenia abdominal obesity to ensure the robustness of the results. Additionally, subgroup analyses were performed to explore the influence of different populations on the outcomes. Lastly, we investigated the association between probable sarcopenic obesity and KOA.</div></div><div><h3>Results</h3><div>Compared to the normal control group, the sarcopenic obesity group showed a significantly increased risk of KOA Hazard Ratio (HR) = 1.53, 95 % Confidence interval (CI) = 1.19–1.98). Sensitivity analyses demonstrated consistent patterns, with the sarcopenic obese group showing a 57 % elevated risk of KOA (HR = 1.57, 95%CI = 1.04–2.35) and the sarcopenic abdominal obesity group a 40 % increased risk (HR = 1.40, 95%CI = 1.08–1.80), both relative to the normal control cohort. Subgroup analyses revealed a significant interaction effect of gender on the results (P for interaction &lt;0.05), with females in the sarcopenic overweight group showing a statistically significant difference compared to the normal group (HR = 1.45, 95 % CI = 1.06–1.99). Moreover, in the context of probable sarcopenic overweight and KOA, the probable sarcopenic overweight group (HR = 1.44, 95 % CI = 1.11–1.87) was associated with an increased risk of developing KOA.</div></div><div><h3>Conclusion</h3><div>This study is the first longitudinal investigation to examine the association between sarcopenic obesity (and probable sarcopenic obesity) and the risk of KOA in a large sample of middle-aged and elderly individuals. The findings suggest that through weight management and adequate muscle strength, it may be probable to reduce the risk of KOA in middle-aged and elderly populations, especially among women, thereby improving quality of life in later years.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 575-582"},"PeriodicalIF":2.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative study of malnutrition screening tools in advanced liver disease: Sensitivity, specificity, and patient acceptability","authors":"Shaye Ludlow ,&nbsp;Emmah McKeown ,&nbsp;Kelly Squires ,&nbsp;Sarah Pullen ,&nbsp;Paulett Barnes ,&nbsp;Alison Gibberd ,&nbsp;Lucy Leigh ,&nbsp;John Attia ,&nbsp;Katie Wynne","doi":"10.1016/j.clnesp.2025.06.003","DOIUrl":"10.1016/j.clnesp.2025.06.003","url":null,"abstract":"<div><h3>Background</h3><div>Patients with advanced liver disease (ALD) are at increased risk of malnutrition, significantly impacting patient outcomes and quality of life. Screening for malnutrition in ALD can be challenging with changes in weight potentially concealed by fluid from ascites and oedema, or muscle wasting. Current validated malnutrition screening tools used in ALD account for physiological symptoms, but there are no known validated tools that also screen for non-physiological symptoms or fluid overload.</div></div><div><h3>Aim</h3><div>To examine the sensitivity and specificity of a novel malnutrition screening tool for adults with ALD, (Child-Pugh score B or C) with or without ascites attending a regional and metropolitan health site, against three established malnutrition screening tools compared with a Subjective Global Assessment (SGA) as the reference standard.</div></div><div><h3>Methods</h3><div>A cross-sectional study was undertaken within the outpatient and inpatient hepatology services of a metropolitan and a regional hospital. Each participant completed four malnutrition screening tools, the Patient Generated Subjective Global Assessment Short Form (PG-SGA SF), Royal Free Hospital Nutrition Prioritizing Tool (RFH-NPT), Malnutrition Screening Tool (MST), and a newly developed novel screening tool (Nutrition-ALD) as well as a diagnostic SGA with the dietitian. Performance of each tool was compared by calculating sensitivity, specificity, and area under the curve (AUC). Wellbeing scores measured by Integrated Palliative care Outcome scale (IPOS) were correlated with the malnutrition screening tool scores.</div></div><div><h3>Results</h3><div>50 participants with Child-Pugh B and C liver disease [n = 33 (66 %) outpatient setting; n = 17 (34 %) inpatient setting] were recruited for this study. 82 % of participants were diagnosed with mild to moderate or severe malnutrition using SGA. Relative to the SGA, the PG-SGA SF had the highest AUROC, followed by the novel screening tool. PG-SGA SF demonstrated the highest sensitivity (0.88) and specificity (0.89). Participant-reported experience was most favourable for the novel screening tool, followed by PG-SGA SF.</div></div><div><h3>Conclusion</h3><div>A nutrition screening tool should be quick, sensitive, and specific to detect malnutrition risk to allow for early nutrition intervention. In this study population, the PG-SGA SF had the highest sensitivity and specificity, and the novel tool was most acceptable to the participants. Consideration of wellbeing with a holistic and supportive approach to malnutrition screening may improve accuracy and timeliness of referrals for patients requiring nutrition support and improve efficiency in low-resource settings.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 557-566"},"PeriodicalIF":2.9,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246763","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":"Hepatoprotective properties of Cordia africana leaf extract inhibiting isoniazid and rifampicin-related toxicity in mice","authors":"Endalkachew Gugsa Andargie ,&nbsp;Wubet Tizazu Ferede ,&nbsp;Tadesse Asmamaw Dejenie ,&nbsp;Markeshaw Tiruneh Gebremedhin ,&nbsp;Gashaw Dessie ,&nbsp;Bewketu Abebe Alemu ,&nbsp;Banchamlak Teferi ,&nbsp;Tewodros Shibabaw Molla","doi":"10.1016/j.clnesp.2025.05.028","DOIUrl":"10.1016/j.clnesp.2025.05.028","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite baseline investigation before the start of therapeutic management, patients being treated for pulmonary tuberculosis often suffer from liver injury due to the effects of anti-tuberculosis drugs, particularly isoniazid (INH) and rifampin (RIF). However, there is no treatment against the hepatotoxic effect of INH and RIF. Therefore, it is better to focus on medicinal plants for the prevention of liver injury caused by these drugs. <em>Cordia africana</em> has been used traditionally as a treatment for liver related diseases. This study aimed to evaluate the hepatoprotective effect of aqueous extract of <em>Cordia africana</em> leaves against isoniazid and rifampicin-induced liver toxicity in mice.</div></div><div><h3>Methods</h3><div><em>Cordia africana</em> leaf powder was decocted in water and 30 Swiss albino mice 28.0–35.0 g were grouped into five groups: Group I mice were given 20 ml/kg distilled water and Group II mice were given 75mg/kg INH and 150 mg/kg RIF body weight. Group III, group IV, and group V mice were given, 75 mg/kg INH plus 150 mg/kg RIF in addition to 200 mg/kg extract, 400 mg/kg extract, and 50 mg/kg silymarin respectively. The treatments lasted for 14 days. Blood samples were taken from each study subject for liver biochemical tests. In addition, livers were also taken for histopathological examination.</div></div><div><h3>Results</h3><div>Compared to Group I, Group II showed a significant increase (P &lt; 0.05) in serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and total bilirubin. This elevation likely dictates the possibility of liver dysfunction or damage. Also, in the groups of mice that were treated with <em>Cordia africana</em> at a dose of 400 mg/kg and silymarin demonstrated that a marked decrease in ALT, AST, ALP and total bilirubin levels. This reduction indicates that both <em>Cordia africana</em> and silymarin might have a protective effect on liver function, especially when compared to Group II which they didn't receive such treatment. The liver index of Group IV mice showed a decrease significantly (P &lt; 0.05) compared to Group II. Besides histopathologic analysis showed that the plant extract at a higher dose did not show inflammation and showed negligible degeneration of hepatocytes and congestion in sinusoids, whereas in the negative control severe degeneration of hepatocytes and moderate inflammation were seen.</div></div><div><h3>Conclusion</h3><div>From this experiment we found that the aqueous extract of <em>Cordia africana</em> has hepatoprotective effect against isoniazid and rifampicin-induced hepatotoxicity in mice. This protective effect of <em>Cordia africana</em> extract might be due to its anti-inflammatory and antioxidant activity and could be considered a potential therapeutic option against INH and RIF induced liver injury.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 567-574"},"PeriodicalIF":2.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246766","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 intake of pulses and vegetables is associated with an increase in the Lachnospira abundance and a decrease in stress: Analysis of the ‘Sukoyaka Health Survey’","authors":"Hiroyuki Sasaki,&nbsp;Hirofumi Masutomi,&nbsp;Katsuyuki Ishihara","doi":"10.1016/j.clnesp.2025.05.048","DOIUrl":"10.1016/j.clnesp.2025.05.048","url":null,"abstract":"<div><div>Stress negatively affects physical and mental health, leading to conditions like depression and anxiety. Diet and gut microbiota are crucial factors influencing stress and mental health. We hypothesized that not a single nutrient but a combination of nutrients affects stress response via gut microbiota. This study investigated the relationships among diet quality, gut microbiota, and stress in healthy adults, specifically examining the associations between Nutrient Rich Food index 9.3 (NRF9.3) scores, gut microbiota, and stress responses. Data were collected from the “Sukoyaka Health Survey,” which included the Food Frequency Questionnaire (FFQ), Brief Job Stress Questionnaire (BJSQ), and gut microbiota analysis of 1058 participants. Stress scores were calculated using the BJSQ, and diet quality was assessed using the NRF9.3. Cluster analysis was used to create clusters based on stress scores, and diet and gut microbiota were compared between clusters. A probabilistic network modeling was used to evaluate the relationships among diet, gut microbiota, and stress. Participants with higher stress scores had lower NRF9.3 scores and altered gut microbiota, particularly a lower abundance of <em>Lachnospira</em>. Foods like natto, tomatoes, and green peppers were consumed less by the high-stress group. Using exploratory probabilistic network modeling, our analysis predicted that higher consumption of these foods was associated with an increase in the NRF9.3 score and may reduce stress by enhancing <em>Lachnospira</em> abundance. These findings suggest that the consumption of natto, tomatoes, and green peppers may contribute to increasing NRF9.3 scores and the abundance of Lachnospira, and potentially decreasing the physical and mental stress response scores.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 530-547"},"PeriodicalIF":2.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233380","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":"Is adherence to the alternate healthy eating index an effective approach for prediabetes reversion? A longitudinal follow-up","authors":"Zahra Bahadoran ,&nbsp;Parvin Mirmiran ,&nbsp;Fereidoun Azizi","doi":"10.1016/j.clnesp.2025.05.046","DOIUrl":"10.1016/j.clnesp.2025.05.046","url":null,"abstract":"<div><h3>Aim</h3><div>We investigated the potential effect of adherence to a healthy diet on the probability of reversion to normal glucose regulation (NGR) among different phenotypes of prediabetes (Pre-DM), a heterogeneous metabolic disorder affecting glucose metabolism, i.e., isolated impaired fasting glucose (i-IFG; fasting glucose 100–125 mg/dL with normal glucose tolerance), isolated impaired glucose tolerance (i-IGT; 2-h post-load glucose 140–199 mg/dL with normal fasting glucose) and combined IFG-IGT (meeting both criteria).</div></div><div><h3>Methods</h3><div>Adherence of 1456 individuals with Pre-DM to a healthy diet was assessed using the Alternate Healthy Eating Index (AHEI) at baseline, and the participants were followed for a median of 5.8 years. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95 % confidence intervals (CIs) for Pre-DM reversion to NGR across the categories of adhering to AHEI (i.e., low and high-adherence of AHEI) and per each 10-increment of AHEI. The estimated time to Pre-DM reversion was compared among low- and high-adherence to AHEI using a log-rank test.</div></div><div><h3>Results</h3><div>The mean age of the participants was 47.2 ± 12.8, and 52.5 % were men. Overall rate of Pre-DM reversion was 46.8 %, with rates of 53.6, 55.1, and 15.7 % in i-IGT, i-IFG, and IFG-IGT, respectively. After adjustment of diabetes risk score, high-adherence to AHEI increased the probability of a reversion to NGR, HR = 1.31, 95 % CI = 1.13–1.51. Considering Pre-DM phenotypes, subjects with combined IFG-IGT showed a greater benefit from high adherence to AHEI compared to those with isolated phenotypes, HR = 2.33 and 95 % CI = 1.27–4.30. Furthermore, the mean of estimated time to reversion to NGR from IFG-IGT showed a marginally significant trend toward being shorter, 6.2 y (5.1–6.2) <em>vs.</em> 8.4 y (8.0–8.8) and <em>P</em>_log-rank = 0.051.</div></div><div><h3>Conclusion</h3><div>Adherence of individuals with Pre-DM to healthy diet effectively increased the probability of reversion to NGR, and the observed effect was stronger in subjects with combined IFG-IGT than the isolated phenotypes.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 548-556"},"PeriodicalIF":2.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246767","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":"Post-pyloric feeding improves the nutritional status of severe tetanus patients and reduces the incidence of feeding intolerance","authors":"Yanwei Rao ,&nbsp;Yang Chen ,&nbsp;Di Wang ,&nbsp;Lijing Chen ,&nbsp;Xinzao Xu ,&nbsp;Cen Shen ,&nbsp;Wenchao Duan ,&nbsp;Yongjie Wang","doi":"10.1016/j.clnesp.2025.05.047","DOIUrl":"10.1016/j.clnesp.2025.05.047","url":null,"abstract":"<div><h3>Background</h3><div>Patients with severe tetanus exhibit clinical features such as trismus, tetanic spasms, and rigidity, primarily affecting muscle groups including masseter muscles, erector spinae muscles, abdominal muscles, and limb muscles. The main objective of this study is to investigate whether post-pyloric feeding can improve the nutritional level of patients and reduce the incidence of feeding intolerance during the treatment of severe tetanus.</div></div><div><h3>Methods</h3><div>A convenience sampling method was used to select 122 patients with tetanus who met the inclusion criteria from January 2020 to November 2023, and divided into groups that received Nasogastric feeding (NGF, n = 36) and Nasointestinal feeding (NIF, n = 36). Basic information was collected, nutritional biochemical indicators and frequency of intolerance were analyzed.</div></div><div><h3>Results</h3><div>By day 7 and 14, the NIF group exhibited significantly higher levels of Albumin (ALB), Total Protein (TP), Prealbumin (PA) and Retinol Binding Protein (RBP) compared to the NGF group. At the same time, the incidence of nutritional intolerance in the NIF group was significantly lower compared to the NGF group.</div></div><div><h3>Conclusion</h3><div>Post-pyloric feeding can improve the nutritional level of patients with severe tetanus and reduce the frequency of feeding intolerance (diarrhea, abdominal distension and vomiting).</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 509-514"},"PeriodicalIF":2.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242701","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 association between dietary patterns and severity of COVID-19: A cross-sectional study","authors":"Hanieh Ansaralhosieni ,&nbsp;Noushin Mohammadifard ,&nbsp;Marzieh Taheri ,&nbsp;Jamshid najafian ,&nbsp;Marzieh Kafeshani ,&nbsp;Nizal Sarrafzadegan","doi":"10.1016/j.clnesp.2025.05.039","DOIUrl":"10.1016/j.clnesp.2025.05.039","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>COVID-19 is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Studies show that nutrition plays a role in disease prevention and control. So, in this study, we investigate the association between dietary patterns and the severity of COVID-19 in adults.</div></div><div><h3>Methods</h3><div>This cross-sectional study was performed on 3018 moderate/severe and 717 mild coronavirus patients with an average age of 47.29 ± 13.73 years. The COVID-19 infection severity was defined following the World Health Organization criteria. The dietary patterns were extracted using the food frequency questionnaire (FFQ) and factor analysis with the PCA (Principal Components Analysis) approach. Multivariable logistic regression was used to assess the association between dietary patterns and COVID-19 severity.</div></div><div><h3>Results</h3><div>Four patterns of Western, Semi-Mediterranean, Semi-Western, and high meat were extracted There wasn't a positive association between the Western pattern and the severity of COVID-19 in the crude model, but after adjusting for all covariates, the positive association was significant (OR: 1.50; 95%CI: 1.14–1.97). The highest tertile of the Semi-Mediterranean dietary pattern was associated with lower odds of severe disease (OR: 0.31; 95 % CI: 0.24–0.41). A direct association between the Semi-Western dietary pattern and COVID-19 severity was seen in all models and remained strongly after adjustment for all covariates in final models (OR: 2.14; 95 % CI: 1.66–2.77). Finally, after adjusting for confounders, participants in the highest quartile of a high-meat dietary pattern adherence had a lower chance of severe COVID-19(OR: 0.16; 95 % CI: 0.11–0.21).</div></div><div><h3>Conclusion</h3><div>The findings showed that adherence the Western and Semi-Western dietary patterns increases the odds of severity of COVID-19, while semi-Mediterranean and high-meat dietary patterns adherence may reduce the severity of COVID-19.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 470-476"},"PeriodicalIF":2.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223209","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}