Clinical nutrition ESPEN最新文献

{"title":"The effect of percentage of time spent above different glucose levels on 90 days mortality of critically ill patients - A retrospective cohort study","authors":"Liran Statlender ,&nbsp;Eyal Robinson ,&nbsp;Allon Grossman ,&nbsp;Hadar Duskin-Bitan ,&nbsp;Tzippy Shochat ,&nbsp;Moran Hellerman Itzhaki ,&nbsp;Guy Fishman ,&nbsp;Pierre Singer ,&nbsp;Ilya Kagan ,&nbsp;Itai Bendavid","doi":"10.1016/j.clnesp.2024.11.024","DOIUrl":"10.1016/j.clnesp.2024.11.024","url":null,"abstract":"<div><h3>Introduction</h3><div>Glycemic control is a major concern during critical illness. Several prospective studies have yielded conflicting results regarding its mortality effect. Current recommendations are to initiate insulin therapy for all patients when glucose levels are higher than 180 mg/dL. Some suggest decreasing this threshold for non-diabetic patients to 140 mg/dL. These thresholds haven't been compared to each other or to other glucose thresholds. This study aimed to find out whether different glucose levels are associated with 90-d mortality.</div></div><div><h3>Methods</h3><div>A retrospective cohort study. Critically ill patients who were admitted from 2019 to 2022 to a mixed medical-surgical intensive care unit for more than 48 h were included. Collected data included baseline characteristics, and all glucose levels recorded (time-indexed to the admission time). Glucose levels were considered constant until the following glucose level. The percentage of time above several chosen glucose cutoff levels was calculated and analyzed for mortality adjusted to other baseline covariates.</div></div><div><h3>Results</h3><div>45,512 glucose measurements of 1429 patients were included in the study; 21.76 % of the patients had diabetes. Mean glucose level and glucose variability were higher in diabetic patients (165.86 mg/dL vs 135.47 mg/dL, p &lt; 0.0001, and 30.81 % vs 20.86 %, p &lt; 0.0001, respectively), along with a higher incidence of hypoglycemia (40.84 % vs 24.89 %, p &lt; 0.001). 90-d mortality was higher in diabetic patietns (42.12 % vs 32.41 %, p = 0.0014) and was found associated with age, acute physiology and chronic health evaluation 2 score, medical or surgical admission reasons. Percentage of time above cutoffs ≥150 mg/dL was associated with 90-d mortality only in non-diabetic patients.</div></div><div><h3>Conclusions</h3><div>In non-diabetic patients, hyperglycemia greater than 150 mg/dL, was associated with increased 90-day mortality.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 118-125"},"PeriodicalIF":2.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738663","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":"Impact of breakfast skipping on esophageal health: A mendelian randomization study","authors":"Jiaming Lei ,&nbsp;Ling Wu","doi":"10.1016/j.clnesp.2024.11.028","DOIUrl":"10.1016/j.clnesp.2024.11.028","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Previous studies have indicated that, in addition to the types of food consumed, eating habits are also associated with the risk of esophageal diseases. Some studies have suggested a possible link between breakfast skipping and esophageal tumors as well as gastroesophageal reflux disease. However, it remains unclear whether breakfast skipping has a causal relationship with esophageal diseases. To address this issue, this study aimed to investigate the potential causal relationship between breakfast skipping and esophageal diseases using a two-sample mendelian randomization (MR) approach.</div></div><div><h3>Methods</h3><div>We obtained data from genome-wide association studies (GWAS) involving 193,860 individuals from the UK Biobank on breakfast skipping. The summary statistics for the esophageal diseases were derived from the IEU open GWAS project. In this two-sample MR analysis, inverse variance weighted was used, supplemented with weighted median, simple mode and weighted mode methods.</div></div><div><h3>Results</h3><div>The results revealed significant causal relationships between breakfast skipping and esophageal cancer (odds ratio (OR): 5.992, 95 % confidence interval (CI): 1.606–22.350, p = 0.008), Barrett's esophagus (OR: 4.041, 95 % CI: 1.837–8.889, p &lt; 0.001), gastroesophageal reflux disease (OR: 2.463, 95 % CI: 1.995–3.041, p &lt; 0.001), and esophageal varices (OR: 4.454, 95 % CI: 1.785–11.112, p = 0.001). All of the supplementary methods supported the findings.</div></div><div><h3>Conclusion</h3><div>Our research provides evidence for the association between breakfast skipping and esophageal diseases. Breakfast skipping could be a potential risk factor for esophageal cancer, Barrett's esophagus, gastroesophageal reflux disease and esophageal varices. For high-risk groups prone to these esophageal diseases, emphasizing the importance of regular breakfast and maintaining consistent dietary habits is crucial for esophageal health.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 86-92"},"PeriodicalIF":2.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738661","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":"High penetrance and phenotypic landscape of methylenetetrahydrofolate reductase c.665 C>T polymorphism in the absence of folate fortification","authors":"Srilatha Kadali ,&nbsp;Ananthaneni Radhika ,&nbsp;Yadam Reddy Kanaka Durga Devi ,&nbsp;Jagadeesh Babu Sreemanthula ,&nbsp;Gopi Palakonda ,&nbsp;Tajamul Hussain ,&nbsp;Shaik Mohammad Naushad","doi":"10.1016/j.clnesp.2024.11.027","DOIUrl":"10.1016/j.clnesp.2024.11.027","url":null,"abstract":"<div><h3>Background</h3><div>Studies have linked the methylenetetrahydrofolate reductase (MTHFR) c.665C &gt; T (rs1801133) with hyperhomocysteinemia. Mandatory folate fortification nullified this association. However, its relevance persists in regions with no folate fortification resulting in a relatively low frequency of this variant in healthy population. This study explored the MTHFR variant's association with 50 clinical manifestations in the absence of folate fortification.</div></div><div><h3>Methods</h3><div>We performed mutation analysis via whole exome and Sanger sequencing in 2431 cases and 1265 healthy controls and the food frequency-based dietary folate intake assessment.</div></div><div><h3>Results</h3><div>The cohort's average dietary folate intake was 373 ± 141 μg/day. MTHFR rs1801133 variant demonstrated ≥4.49-fold increased risk for respiratory distress, recurrent pregnancy loss (RPL), ischemic stroke, autism, global developmental delay, dysplasia, myoclonic jerks, intellectual disability, aggressive behavior, motor delay, Alzheimer's, cerebellar atrophy, failure to thrive, cerebral atrophy, increased tendon reflexes, and spasticity (p &lt; 0.0001). MTHFR T-allele showed 1.81–4.04 folds increased risk for mental retardation, behavioral problems, dystonia, anemia, gait abnormality, hypotonia, recurrent pneumonia, liver disease, cerebral palsy, short stature, hyperactivity, and cognitive decline. The association of this variant with seizures was moderate (OR: 1.51, 95 % CI: 1.13–2.02, p = 0.009). MTHFR TT-genotype was associated with a 5.81-fold risk for the abnormal phenotype (95 % CI: 1.39–24.28, p = 0.005). MTHFR T-allele was associated with low 25-hydroxy vitamin D, Ferritin, TIBC, and elevated total cholesterol.</div></div><div><h3>Conclusion</h3><div>The MTHFR rs1801133 increases the risk for RPL, developmental milestones, neuronal development, autism, ischemic stroke, and late-onset neurological functions. The MTHFR TT-genotype is strongly associated with abnormal phenotypes.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 126-133"},"PeriodicalIF":2.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743968","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 matter of taste: The need for dietitian referral in managing smell and taste changes in childhood cancer patients","authors":"Mirjam van den Brink ,&nbsp;Nina C. van der Linden–de Munk ,&nbsp;Wim J.E. Tissing","doi":"10.1016/j.clnesp.2024.11.031","DOIUrl":"10.1016/j.clnesp.2024.11.031","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 115-117"},"PeriodicalIF":2.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743969","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":"Association of serum total folate and serum vitamin D concentrations with W-shape in depressed older adults with cognitive dysfunction: A cross-sectional observational study","authors":"Qinghua Guo ,&nbsp;Yong Wang ,&nbsp;Libo Guo ,&nbsp;Ke Xu ,&nbsp;Shaomei Shang","doi":"10.1016/j.clnesp.2024.11.021","DOIUrl":"10.1016/j.clnesp.2024.11.021","url":null,"abstract":"<div><h3>Background</h3><div>Depression and cognitive dysfunction are prevalent in the elderly population and have a serious impact on patients' quality of life and social functioning. Nutritional factors play a key role in the prevention and management of these disorders, particularly folate and vitamin D. The aim of this study was to elucidate the association between serum total folate and serum vitamin D concentrations and depressive symptoms and cognitive dysfunction in older adults.</div></div><div><h3>Methods</h3><div>Using data from the National Health and Nutrition Examination Survey (NHANES) 2011–2014, 2042 participants aged 60 years and older were analyzed. Depressive symptoms were assessed by the Patient Health Questionnaire (PHQ-9) and cognitive function was assessed by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Animal Fluency test and the Digit Symbol Substitution Test (DSST). Associations between serum total folate and vitamin D concentrations and depression with cognitive dysfunction were analyzed using multivariate logistic regression models, incorporating stratification and sensitivity analyses.</div></div><div><h3>Results</h3><div>For every 1 nmol/L increase in serum vitamin D concentration, there was a 1 % reduction in the risk of depression in older adults (OR = 0.99 95 % CI 0.98–0.99). Serum total folate showed a significant W-shaped association with depression with cognitive dysfunction: when serum total folate concentration was below 33.00 nmol/L, the risk of depression was reduced by 7.6 % for every 1 nmol/L increase in its concentration (OR = 0.924 95 % CI 0.89–0.959); this association was not significant when the concentration was above 33.00 nmol/L (OR = 1.006 95 % CI 0.998–1.013).</div></div><div><h3>Conclusions</h3><div>Adequate levels of vitamin D and folate may help prevent and manage depression and cognitive dysfunction in older adults. The W-shaped association between serum total folate and these conditions suggests that folic acid supplementation could be effective within a specific range, warranting further exploration and validation through clinical studies.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 50-58"},"PeriodicalIF":2.9,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709763","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":"Skeletal muscle is independently associated with grade 3–4 toxicity in advanced stage pancreatic ductal adenocarcinoma patients receiving chemotherapy","authors":"Merel R. Aberle ,&nbsp;Mariëlle M.E. Coolsen ,&nbsp;Gilles Wenmaekers ,&nbsp;Leroy Volmer ,&nbsp;Ralph Brecheisen ,&nbsp;David van Dijk ,&nbsp;Leonard Wee ,&nbsp;Ronald M. Van Dam ,&nbsp;Judith de Vos-Geelen ,&nbsp;Sander S. Rensen ,&nbsp;Steven W.M. Olde Damink","doi":"10.1016/j.clnesp.2024.11.004","DOIUrl":"10.1016/j.clnesp.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Patients with advanced-stage pancreatic ductal adenocarcinoma (PDAC) are regularly treated with FOLFIRINOX, a chemotherapy regimen based on 5-fluorouracil, irinotecan and oxaliplatin, which is associated with high toxicity. Dosing of FOLFIRINOX is based on body surface area, risking under- or overdosing caused by altered pharmacokinetics due to interindividual differences in body composition. This study aimed to investigate the relationship between body composition and treatment toxicity in advanced stage PDAC patients treated with FOLFIRINOX.</div></div><div><h3>Methods</h3><div>Data from patients treated at the Maastricht University Medical Centre + between 2012 and 2020 were collected retrospectively (n = 65). Skeletal muscle-, visceral adipose tissue, subcutaneous adipose tissue-, (SM-Index, VAT-Index, SAT-Index resp.) and Skeletal Muscle Radiation Attenuation (SM-RA) were calculated after segmentation of computed tomography (CT) images at the third lumbar level using a validated deep learning method. Lean body mass (LBM) was estimated using SM-Index. Toxicities were scored and grade 3-4 adverse events were considered dose-limiting toxicities (DLTs).</div></div><div><h3>Results</h3><div>Sixty-seven DLTs were reported during the median follow-up of 51.4 (95%CI 39.2–63.7) weeks. Patients who experienced at least one DLT had significantly higher dose intensity per LBM for all separate cytotoxics of FOLFIRINOX. Independent prognostic factors for the number of DLTs per cycle were: sarcopenia (β = 0.292; 95%CI 0.013 to 0.065; <em>p</em> = 0.013), SM-Index change (% per 30 days, β = −0.045; 95%CI −0.079 to −0.011; <em>p</em> = 0.011), VAT-Index change (% per 30 days, β = −0.006; 95%CI −0.012 to 0.000; <em>p</em> = 0.040) between diagnosis and the first follow-up CT scan, and cumulative relative dose intensity &gt;80 % (β = −0.315; 95 % CI −0.543 to −0.087; <em>p</em> = 0.008).</div></div><div><h3>Conclusion</h3><div>Sarcopenia and early muscle and fat wasting during FOLFIRINOX treatment were associated with treatment-related toxicity, warranting exploration of body composition guided personalized dosing of chemotherapeutics to limit DLTs.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 134-143"},"PeriodicalIF":2.9,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692481","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":"The effects of Omega-3 fatty acids and vitamin D supplementation on the quality of life and blood inflammation markers in newly diagnosed breast cancer women: An open-labelled randomised controlled trial","authors":"Heba F. Almassri ,&nbsp;Azidah Abdul Kadir ,&nbsp;Mohammed Srour ,&nbsp;Leng Huat Foo","doi":"10.1016/j.clnesp.2024.11.014","DOIUrl":"10.1016/j.clnesp.2024.11.014","url":null,"abstract":"<div><h3>Background and aims</h3><div>Nutritional intervention is one of the primary steps to improvement of health status and quality of life (QoL) in patients with cancer treated by chemotherapy. There is limited evidence on the potential nutritional intervention to complement active oncological treatment strategies in breast cancer (BC) patients in developing countries. The aim of the present study was to assess the effects of omega-3 fatty acids (ω3) and vitamin D₃ (VitD) supplementations on the QoL and blood inflammation markers of tumor necrosis factor-alpha (TNF-α) and high-sensitive C-reactive protein (hsCRP) assessed among women newly diagnosed with BC in the Gaza Strip, Palestine.</div></div><div><h3>Methods</h3><div>A total of 88 BC women were randomly assigned into one of four groups: i) omega-3 fatty acid (ω3) group; ii) vitamin D (VitD) group; iii) ω3+VitD group, and iv) the control. Participants were received either two 300 mg ω3 capsules daily, or one 50,000IU VitD tablet weekly, or both supplementation for 9-weeks. The QoL status was assessed by the European Organization for Research and Treatment of Cancer (EORTC) instruments of QLQ-C30 and QLQ-BR23 tools, while blood inflammatory markers of TNF-α hsCRP were used. All measurements were taken from baseline to the end of the intervention period. The detailed procedures of the present study were registered on ClinicalTrial.gov with the identifier NCT05331807.</div></div><div><h3>Results</h3><div>At the end of the trial, participants in the ω3+VitD group showed a significant increase in overall global health status (p &lt; 0.01) compared to other groups. Additionally, this group showed significantly higher functional scores (all p &lt; 0.05) and lower scores for fatigue (p &lt; 0.01), nausea and vomiting, pain, and appetite loss (all p &lt; 0.05) at the end of the trial compared to baseline. Furthermore, comparisons between the intervention groups revealed a significant difference in blood concentrations of TNF-α and hsCRP (p &lt; 0.05). These significant differences were identified in hsCRP between ω3 and control groups (p &lt; 0.01). The ω3+VitD group demonstrated a significant reduction in both hsCRP and TNF-α levels (both p &lt; 0.05) from baseline. No significant changes in blood inflammatory markers were observed within the ω3 or VitD groups alone.</div></div><div><h3>Conclusion</h3><div>Participants receiving daily ω3 and weekly VitD supplementation for 9 weeks showed a significant improved in QoL and blood inflammation markers among the newly diagnosed BC during their chemotherapy treatment.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 64-75"},"PeriodicalIF":2.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692498","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 associations between nutrition and circulating gut microbiota-derived uremic toxins in patients undergoing kidney replacement therapy: An observational, cross-sectional study","authors":"Sylwia Czaja-Stolc ,&nbsp;Marta Potrykus ,&nbsp;Jakub Ruszkowski ,&nbsp;Daniel Styburski ,&nbsp;Alicja Dębska-Ślizień ,&nbsp;Sylwia Małgorzewicz","doi":"10.1016/j.clnesp.2024.11.022","DOIUrl":"10.1016/j.clnesp.2024.11.022","url":null,"abstract":"<div><h3>Background</h3><div>Gut microbiota generates a series of bioactive metabolites that can be converted into uremic toxins such as trimethylamine-N-oxide (TMAO), p-cresyl sulfate (pCS), and indoxyl sulfate (IS). The aim of the study was to examine the association between diet and the concentrations of the mentioned gut microbiota-derived uremic toxins.</div></div><div><h3>Methods</h3><div>An observational cross-sectional study was conducted involving 210 participants: 84 hemodialysis (HD) patients, 44 peritoneal dialysis (PD) patients, 52 kidney transplant recipients (KTR), and 30 healthy controls. Dietary intake was assessed using a 3-day food diary and a food frequency questionnaire with 6 answers (FFQ-6). The alternate Mediterranean diet (aMED) score was calculated based on data obtained from the 3-day food diary and FFQ-6. Blood samples were analyzed for TMAO, pCS, and IS concentrations using liquid chromatography-mass spectrometry (LC-MS/MS).</div></div><div><h3>Results</h3><div>Significant differences in TMAO, pCS, and IS concentrations were observed among the study groups. HD and PD patients exhibited higher levels of these metabolites compared to KTR and healthy controls. The median aMED score was 4 (3−5) points in the HD group, 4.5 (4−6) points in the PD group, 5 (4−6) points in the KTRs, and 6 (5−7) points in the control group. Higher adherence to the Mediterranean diet (aMED score) was associated with lower pCS levels in dialysis patients. Vegetable intake several times a day was found to mitigate the effects of phenylalanine and tyrosine intake on pCS concentration among dialysis patients.</div></div><div><h3>Conclusions</h3><div>The diet of patients undergoing kidney replacement therapy (KRT) significantly affects the concentrations of gut microbiota-derived uremic toxins. These findings highlight the importance of dietary management in mitigating the adverse effects of these toxins in patients with chronic kidney disease (CKD).</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 105-114"},"PeriodicalIF":2.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692497","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":"Gastrointestinal hormones and subjective ratings of appetite after low-carbohydrate vs low-fat low-energy diets in females with lipedema – A randomized controlled trial","authors":"Julianne Lundanes ,&nbsp;Gunnhild Eggen Storliløkken ,&nbsp;Marte Siwsdotter Solem ,&nbsp;Simon N. Dankel ,&nbsp;Randi J. Tangvik ,&nbsp;Rønnaug Ødegård ,&nbsp;Jens Juul Holst ,&nbsp;Jens Frederik Rehfeld ,&nbsp;Catia Martins ,&nbsp;Siren Nymo","doi":"10.1016/j.clnesp.2024.11.018","DOIUrl":"10.1016/j.clnesp.2024.11.018","url":null,"abstract":"<div><h3>Background</h3><div>Ketosis seems to attenuate, or prevent, the rise in both ghrelin concentrations and subjective hunger ratings that follow weight loss. However, most of the previous studies have employed very-low energy diets (VLED) and are therefore limited in terms of generalizability.</div></div><div><h3>Objectives</h3><div>To compare changes in ghrelin plasma concentrations after a low-carbohydrate (LCD) versus an isocaloric low-fat low energy diet (LED) in females with lipedema. Secondary objectives were to determine potential differences between diets in changes in satiety hormones, and subjective ratings of appetite.</div></div><div><h3>Methods</h3><div>Females with obesity and lipedema were randomized to either an LCD (75 g carbohydrates) or low-fat diet (180 g carbohydrates) for 8 weeks. Plasma concentrations of ghrelin, peptide YY, cholecystokinin (CCK), and glucagon-like peptide 1 (GLP-1), and subjective ratings of appetite were measured in the fasting and postprandial states, pre and post intervention.</div></div><div><h3>Results</h3><div>55 females (30 in LCD) were included (age 47.9 ± 11.3 years, BMI 36.8 ± 5.1 kg/m²). Both LCD and low-fat groups lost weight (10.3 %, P &lt; 0.001 and 7.3 %, P &lt; 0.001, respectively), but the LCD lost significantly more. No within or between groups differences were found for ghrelin in the fasting state. A reduction in postprandial (tAUC) ghrelin was seen only in the LCD group (P = 0.002), and this change was significantly different from the low-fat group (P = 0.046). The LCD group also reported an increase in postprandial (both iAUC and tAUC) fullness ratings (P = 0.035 and P = 0.005, respectively), but this was not significantly different from the low-fat group (P = 0.703 and P = 0.365, respectively), despite the latter experiencing no change (P = 0.127 and P = 0.152, respectively). Conversely, only the low-fat group reported increased hunger in fasting (P = 0.046), but changes were not significantly different from the LCD group (P = 0.711). A decrease in postprandial (both tAUC and iAUC) CCK was observed in both LCD and low-fat diet groups (P ≤ 0.005 for all).</div></div><div><h3>Conclusion</h3><div>Despite no changes in fasting ghrelin concentrations in either of the diet groups, a reduction in postprandial ghrelin and increased fullness was seen in the LCD group. These favorable changes in appetite in the LCD group might have contributed to the greater weight loss observed in this group.</div></div><div><h3>Clinical trial registration</h3><div>NCT04632810, Effect of Ketosis on Pain and Quality of Life in Patients With Lipedema (Lipodiet).</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 16-24"},"PeriodicalIF":2.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680983","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":"Six-month trajectory of phase angle after cardiovascular surgery and associated factors of the recovery during cardiac rehabilitation: A retrospective cohort study","authors":"Kenichi Shibata ,&nbsp;Masataka Kameshima ,&nbsp;Takuji Adachi ,&nbsp;Hisako Kito ,&nbsp;Chikako Tanaka ,&nbsp;Taisei Sano ,&nbsp;Mizuki Tanaka ,&nbsp;Masayuki Ida ,&nbsp;Yoriyasu Suzuki ,&nbsp;Hideki Kitamura","doi":"10.1016/j.clnesp.2024.11.017","DOIUrl":"10.1016/j.clnesp.2024.11.017","url":null,"abstract":"<div><h3>Background and aims</h3><div>Although the phase angle (PhA), a measure of frailty and sarcopenia, determined by bioelectrical impedance analysis has been reported as a prognostic factor after cardiovascular surgery, few studies have reported the trajectory of the PhA after discharge. In this study, we examined the trajectory of the PhA along with conventional physical function measures and explored the factors associated with recovery for 6 months after hospital discharge in patients who had undergone cardiovascular surgery.</div></div><div><h3>Methods</h3><div>We included 116 patients who underwent elective cardiovascular surgery and cardiac rehabilitation after discharge. The PhA, physical function measures (grip strength, knee extension isometric muscle strength [KEIS], and usual gait speed), and Geriatric Nutritional Risk Index (GNRI) were assessed preoperatively, at discharge, and 3 and 6 months. Correlations between the PhA recovery rates and physical function and nutritional indices were assessed using Spearman's correlation analysis. Multivariate linear regression analysis was performed to examine the factors associated with recoveries of PhA and physical function indices (grip strength, KEIS, gait speed) after discharge.</div></div><div><h3>Results</h3><div>Mean values of the PhA and physical function measurements and the GNRI score at discharge were lower than the preoperative values (PhA, −8.0 %; grip strength, −8.7 %; KEIS, −6.9 %; usual gait speed, −8.3 %; GNRI, −11 %). The grip strength, KEIS, and gait speed recovered to almost preoperative values 3 months after discharge. Values for the PhA and GNRI were still lower than preoperative values 3 months after discharge but had recovered to preoperative values at 6 months. The PhA was not significantly correlated with the recovery rates of the other indicators. Older age was negatively associated with PhA recovery rate, however, recovery rates decreased significantly with post-discharge physical activity.</div></div><div><h3>Conclusions</h3><div>In patients undergoing cardiovascular surgery, the PhA takes longer to recover than muscle strength or gait speed, requiring up to 6 months to recover to preoperative levels. Post-discharge interventions to increase daily physical activity may be an important method of speeding PhA recovery.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 1-8"},"PeriodicalIF":2.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680989","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}