Clinical nutrition ESPEN最新文献

{"title":"Associations of various medical nutrition therapy strategies with body composition, and physical and clinical outcomes in acute myeloid leukemia patients undergoing intensive remission-induction treatment: A multicenter prospective correlational study","authors":"Rianne van Lieshout , Lidwine W. Tick , Erik A.M. Beckers , Willemijn Biesbroek , Stephanie Custers , Jeanne P. Dieleman , Myrthe Dijkstra , Wanda Groenesteijn , Aniek Heldens , Martine M. Hengeveld , Harry R. Koene , Suzanne Kranenburg , Debbie van der Lee , Liesbeth van der Put , Nicky Rademakers , Josien C. Regelink , Marta Regis , Maaike Somer , Claudia J. van Tilborg , Peter E. Westerweel , Sandra Beijer","doi":"10.1016/j.clnesp.2025.02.028","DOIUrl":"10.1016/j.clnesp.2025.02.028","url":null,"abstract":"<div><h3>Background & aims</h3><div>Medical nutrition therapy (MNT) is commonly used in patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) undergoing intensive remission-induction treatment to prevent malnutrition, particularly the loss of fat-free mass (FFM)/muscle mass, as well as associated adverse outcomes. However, studies examining the associations of proactive versus wait-and-see approaches toward MNT with nutritional, physical, and clinical outcomes in these patients are lacking. Therefore, this study aimed to explore the associations of these different MNT approaches with body composition changes, as well as physical and clinical outcomes in AML/MDS patients undergoing intensive remission-induction treatment. Additionally, the study aimed to explore the relationships between body composition changes and physical and clinical outcomes, and whether these associations varied between the proactive and wait-and-see strategies.</div></div><div><h3>Methods</h3><div>In this multicenter prospective correlational study, newly diagnosed AML/MDS patients undergoing intensive remission-induction treatment were included. Patients were treated in one of five hospitals using a proactive approach toward MNT, initiating MNT when nutritional intake became inadequate, or in the single hospital in the Netherlands that followed a wait-and-see strategy, limiting the use of MNT to exceptional and severe cases only. Body composition was assessed at the start of treatment, weekly during admission and at discharge, and handgrip strength, and patient-reported physical functioning and fatigue at treatment initiation and discharge. Information on number of complications, and duration of fever and hospital length of stay (LOS) was collected from medical records. Within-group changes in body composition and between-group differences were tested using paired or independent <em>t</em>, Wilcoxon signed-rank or two-sample tests, respectively, or chi-square/Fisher's exact tests for proportions. The longitudinal patterns between proactive MNT approach/wait-and-see strategy hospitals were compared by means of linear mixed effects models. Associations between body composition changes and physical and clinical outcomes were explored using multiple linear regression models, and compared between proactive MNT approach/wait-and-see strategy hospitals.</div></div><div><h3>Results</h3><div>In this study, 204 AML/MDS patients (54 % male, mean age: 56.3 ± 13.0 years) were included, of whom 140 underwent treatment in a hospital using a proactive approach toward MNT and 64 in the hospital following a wait-and-see strategy. In the proactive MNT approach hospitals, 57 % of patients received MNT during the first chemotherapy cycle versus 8 % of patients in the wait-and-see hospital (<em>p</em> < 0.0001). Both approaches toward MNT were associated with significant decreases in body weight, FFM/muscle mass, and muscle strength. However, losses in FFM/muscle m","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 276-295"},"PeriodicalIF":2.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585119","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":"Gut microbiome diversity is associated with muscle mass, strength and quality in post-stroke patients","authors":"Yoshihiro Yoshimura ,&nbsp;Hidetaka Wakabayashi ,&nbsp;Fumihiko Nagano ,&nbsp;Ayaka Matsumoto ,&nbsp;Sayuri Shimazu ,&nbsp;Ai Shiraishi ,&nbsp;Yoshifumi Kido ,&nbsp;Takahiro Bise ,&nbsp;Takenori Hamada ,&nbsp;Kouki Yoneda ,&nbsp;Keisuke Maeda","doi":"10.1016/j.clnesp.2025.02.027","DOIUrl":"10.1016/j.clnesp.2025.02.027","url":null,"abstract":"<div><h3>Background</h3><div>The gut microbiome has emerged as a potential influencer of muscle health; however, its role in hospitalized patients remains unclear. This study aimed to investigate the association between gut microbiome diversity and skeletal muscle mass, strength, and quality in hospitalized post-stroke patients.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study of post-stroke patients admitted to a rehabilitation facility. Gut microbiome diversity was assessed using 16S ribosomal ribonucleic acid (rRNA) gene sequencing, calculating Operational Taxonomic Unit (OTU) Richness, Faith's Phylogenetic Diversity (PD), and Shannon index. Muscle health was evaluated using skeletal muscle index (SMI) for muscle mass, handgrip strength (HGS) for muscle strength, and bioimpedance analysis-derived phase angle (PhA) for muscle quality. Multiple linear regression analyses were performed, adjusting for potential confounders.</div></div><div><h3>Results</h3><div>A total of 156 patients (mean age 78.4 years; 55.7 % male) were analyzed. OTU Richness showed significant positive associations with SMI (β = 0.197, p = 0.025), HGS (β = 0.180, p = 0.005), and PhA (β = 0.178, p = 0.022). The Shannon index was also positively associated with SMI (β = 0.120, p = 0.041), HGS (β = 0.140, p = 0.028), and PhA (β = 0.164, p = 0.032). Faith's PD did not demonstrate significant associations with muscle health parameters.</div></div><div><h3>Conclusions</h3><div>Higher gut microbiome diversity, assessed by OTU Richness and Shannon index, is associated with better muscle mass, strength, and quality in post-stroke patients. These findings suggest a potential role for gut microbiota in muscle health during stroke rehabilitation.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 25-33"},"PeriodicalIF":2.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572428","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":"Bidirectional association between sarcopenia and diabetes: A prospective cohort study in middle-aged and elderly adults","authors":"Yu Zhang,&nbsp;Miao Gong,&nbsp;Xu-Man Feng,&nbsp;Yu-Xiang Yan","doi":"10.1016/j.clnesp.2025.02.026","DOIUrl":"10.1016/j.clnesp.2025.02.026","url":null,"abstract":"<div><h3>Background and aims</h3><div>Sarcopenia and diabetes are prevalent diseases among middle-aged and elderly population. This study aimed to investigate the bidirectional association between sarcopenia and diabetes.</div></div><div><h3>Methods</h3><div>This study comprised two longitudinal analyses. In cohort 1, the association between baseline diabetes and the risk of new-onset sarcopenia was assessed. In cohort 2, the association between baseline sarcopenia and the risk of new-onset diabetes was examined. Multivariate logistic regression models were used to calculate odds ratios (OR) and 95 % confidence intervals (95 % CI). Cross-lagged panel analysis was used to further validate their bidirectional associations.</div></div><div><h3>Results</h3><div>Significant bidirectional associations were observed between sarcopenia and diabetes in both cross-sectional and longitudinal analyses (<em>P</em> &lt; 0.05). After four years of follow-up, low handgrip strength (OR: 2.31, 95 % CI: 1.74–3.08) and appendicular skeletal muscle mass index (ASM/Ht²) (OR: 1.25, 95 % CI: 1.20–1.30) were associated with an increased risk of diabetes. Conversely, elevated fasting plasma glucose (FPG) (OR: 1.52, 95 % CI: 1.17–1.96) and glycated hemoglobin A_1c (HbA_1c) (OR: 1.35, 95 % CI: 1.05–1.73) were associated with a higher risk of sarcopenia. Cross-lagged analysis further confirmed their bidirectional longitudinal association.</div></div><div><h3>Conclusions</h3><div>This study identified significant longitudinal bidirectional association between sarcopenia and diabetes, highlighting that each condition serves as a risk factor for the other. Clinically, early assessments of handgrip strength and ASM/Ht² may aid in diabetes prevention, while monitoring FPG and HbA_1c could help reduce the risk of sarcopenia.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 556-563"},"PeriodicalIF":2.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566222","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":"Maternal and infant diet play a role in acute leukemia development: An expanded systematic review and meta-analysis","authors":"M. Karen Flores-García ,&nbsp;Gisela Flores-Collado ,&nbsp;Ángel Mérida-Ortega ,&nbsp;Rodrigo Ugalde-Resano ,&nbsp;Alejandra González-Rocha ,&nbsp;Edgar Denova-Gutiérrez ,&nbsp;Paloma Muñoz-Aguirre ,&nbsp;Marta Zapata-Tarrés ,&nbsp;Lizbeth López-Carrillo","doi":"10.1016/j.clnesp.2025.02.024","DOIUrl":"10.1016/j.clnesp.2025.02.024","url":null,"abstract":"<div><h3>Background</h3><div>The most common subtypes of acute leukemia (AL) are acute lymphoid leukemia (ALL), and acute myeloid leukemia (AML). Among those less than 15 years old, ALL is the most common subtype. It has recently been proposed that diet may play an important role in the development of AL. This review expands on the existing systematic reviews and meta-analyses published on infant and maternal diet in relation to AL.</div></div><div><h3>Methods</h3><div>An electronic search was carried out in four databases (Pubmed/Medline Lilacs, Scopus and Web of Science), through April 2022. Observational epidemiological studies that reported the association between AL (ALL and/or AML) and the food consumed by children (&lt;18 years), their mother or both were included. Fixed effects models were used for meta-analysis and heterogeneity between studies was assessed using the Q statistic test and I2 estimation. The risk of bias was assessed using the Newcastle–Ottawa scale.</div></div><div><h3>Results</h3><div>A total of 15 studies were included (1 cohort and 14 case–control), of which 9 exclusively evaluated the maternal diet, 4 child diet, and 2 that evaluated both. Our results showed that children's consumption of processed meat was positively associated with AL (OR = 1.72; 95 % CI 1.08, 2.72), whereas the consumption of vegetables was found to be inversely associated with AL (OR = 0.61; 95 % CI % 0.39, 0.92). Furthermore, maternal fruit consumption was inversely associated with ALL (OR = 0.71; 95 % CI 0.59–0.83), while coffee consumption was positively associated with AL (OR = 1.20; 95 % CI 1.00, 1.44) and ALL (OR = 1.31; 95 % CI: 1.10, 1.56).</div></div><div><h3>Conclusions</h3><div>Our results support that maternal and early infant diet play a role in the development of AL.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 515-522"},"PeriodicalIF":2.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536706","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 sedentary lifestyle and the prevalence of sarcopenia with the mediation role of systematic inflammation index, 25-hydroxyvitamin D, and testosterone: A nationwide cross-sectional study","authors":"Jiayi Huang ,&nbsp;Qian Li ,&nbsp;Yifan Dou,&nbsp;Jiaping Li,&nbsp;Luyao Liu,&nbsp;Yiqing Xu,&nbsp;Na Yang,&nbsp;Zhaoqiang Jiang","doi":"10.1016/j.clnesp.2025.02.022","DOIUrl":"10.1016/j.clnesp.2025.02.022","url":null,"abstract":"<div><h3>Background</h3><div>While there is some evidence of the association between sedentary behavior and sarcopenia risk, it remains unclear whether systematic inflammation index (SII), 25(OH)D, and testosterone can mediate this association. This study aims to investigate whether sedentary behavior is associated with the prevalence of sarcopenia in the US population and further examine its potential mediators which have not been thoroughly explored, thereby presenting a novel approach to understanding the mechanism between sedentary behavior and sarcopenia.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study involving a representative sample of the US national population of 9902 adults aged 18 years or older from the National Health and Nutrition Examination Survey (NHANES) 2011–2018. The participants with sarcopenia were identified by Dual-energy X-ray (DXA) absorptiometry. Weighted multivariable logistic regressions based on the complex survey designs were used to explore the associations between a sedentary lifestyle and the risk of sarcopenia and restricted cubic spline (RCS) regression was used to examine the non-linear association. Causal mediation analysis using the quasi-Bayesian Monte Carlo method was applied to identify the mediating role of SII, 25(OH)D, and testosterone as potential mediators.</div></div><div><h3>Results</h3><div>A total of 358 participants (3.6 %) had sarcopenia. Compared to those in the lowest quartile of sedentary time, participants in the highest quartile had a hazard ratio of 1.631 (95 % CI: 1.162 to 2.289) for the prevalence of sarcopenia. A non-linear relationship (P for non-linearity &lt;0.001) between sedentary time and the risk of sarcopenia was observed using the RCS method. The odds ratio for sarcopenia was highest (OR = 3.427) when the sedentary time was 1080 min daily. Furthermore, SII, 25(OH)D, and testosterone showed a significant mediation in the association between sedentary time and sarcopenia risk, with a mediation effect of 3.39 %, 10.3 %, and 8.56 %, respectively.</div></div><div><h3>Conclusions</h3><div>This study demonstrated novel findings of the association between sedentary behavior and sarcopenia in the US population. Our study found that sedentary time was associated with the prevalence of sarcopenia. Vitamin D, SII, and testosterone served as mediating factors in the association of sedentary time with the risk of sarcopenia.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 530-538"},"PeriodicalIF":2.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536644","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":"Preoperative glycemic control and postoperative clinical outcomes in patients with type 2 diabetes mellitus undergoing bariatric surgery","authors":"Bárbara Brambilla ,&nbsp;Carina Andriatta Blume ,&nbsp;Taíse Rosa de Carvalho ,&nbsp;Janine Alessi ,&nbsp;Beatriz D. Schaan","doi":"10.1016/j.clnesp.2025.02.016","DOIUrl":"10.1016/j.clnesp.2025.02.016","url":null,"abstract":"<div><h3>Background</h3><div>The preoperative glycated hemoglobin (HbA1c) cutoff point for elective surgery in patients with type 2 diabetes mellitus (T2DM) remains unclear, as does its association with postoperative outcomes, especially in patients undergoing bariatric surgery.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study including patients with T2DM and an electronic record of HbA1c within the four months prior to surgery who underwent Roux-en-Y gastric bypass (RYGB) from August 2010 to May 2019. The primary outcome was postoperative hospital length of stay (LOS), and secondary outcomes included need for intensive care, clinical outcomes (pulmonary, cardiovascular, septic), and surgical wound complications. These outcomes were assessed using an HbA1c cutoff value of 7 %. Comparisons were made using the Mann–Whitney U test and a general linear model adjusting the primary outcome for confounders and for differences in baseline characteristics between groups.</div></div><div><h3>Results</h3><div>A total of 114 individuals were divided into two groups according to HbA1c: ≤7 % (N = 63) or &gt; 7 % (N = 51). No differences were observed between the groups in terms of LOS (4 vs 5 days, p = 0.28) and clinical or operative wound complication rates. Alternative HbA1c cutoff points (7.5 %, 8 %, and 8.5 %) were also evaluated for LOS, with no change in results.</div></div><div><h3>Conclusion</h3><div>Bariatric surgery should not be postponed in patients with T2DM based on an HbA1c greater than 7 %, as LOS, clinical outcomes and operative wound complication rates are not worse in patients with poorer glucose control based on this criterion.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 1-7"},"PeriodicalIF":2.9,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530966","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":"Glycoprotein acetyls response to a mixed meal is associated with increased insulin resistance and risk of type 2 diabetes in a middle-aged population","authors":"Rory C. Monahan ,&nbsp;Ruifang Li-Gao ,&nbsp;Raymond Noordam ,&nbsp;Jeroen H.P.M. van der Velde ,&nbsp;Ko Willems van Dijk ,&nbsp;Eelco de Koning ,&nbsp;Dennis O. Mook-Kanamori ,&nbsp;Saskia le Cessie ,&nbsp;Frits R. Rosendaal ,&nbsp;Renée de Mutsert","doi":"10.1016/j.clnesp.2025.02.013","DOIUrl":"10.1016/j.clnesp.2025.02.013","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Systemic inflammation increases the risk of type 2 diabetes (T2D). It remains unclear whether the inflammatory meal response identifies other people at risk of T2D than fasting levels alone. We aimed to examine associations between the meal response of glycoprotein acetyls (GlycA) with insulin resistance and incident type 2 diabetes.</div></div><div><h3>Methods</h3><div>In 5755 middle-aged participants (47 % men) without pre-existing diabetes GlycA was measured after an overnight fast and 150 min after a liquid mixed meal (400 mL, 600 kCal, 16 percent of energy (En%) derived from protein, 50 En% carbohydrates, and 34 En% fat). With linear regression, we examined associations between the GlycA meal response and measures of insulin resistance. With Cox regression analyses, we examined associations between the GlycA meal response and incident type 2 diabetes, adjusted for demography and lifestyle factors.</div></div><div><h3>Results</h3><div>In our population, mean (SD) fasting GlycA was 1.28 (0.21) mmol/L and mean GlycA meal response was 0.16 (0.13) mmol/L, and these were weakly correlated (ρ = 0.19). After adjustment for confounding, insulin resistance (HOMA-IR) was 1.11-fold higher (95 % CI: 1.09; 1.13) per SD GlycA meal response. During a median follow-up of 6.7 years, 287 participants developed T2D. Per SD GlycA meal response, the adjusted hazard ratio of incident type 2 diabetes was 1.12 (95 % CI: 1.00; 1.26).</div></div><div><h3>Conclusion</h3><div>In this middle-aged population with overweight, those with a high GlycA meal response, including those with low fasting GlycA, had an increased risk of diabetes. A high inflammatory meal response shows promise to identify other people at risk of T2D than fasting levels alone. This risk group may benefit from prevention by precision nutrition to reduce the inflammatory meal response.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 523-529"},"PeriodicalIF":2.9,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531319","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 prognostic impact of body composition assessed by computed tomography in adult patients with newly diagnosed acute lymphoblastic leukemia","authors":"Fausto Alfredo Rios-Olais ,&nbsp;Fernando Gil-Lopez ,&nbsp;Analy Mora-Cañas ,&nbsp;Jessica Zalapa-Soto ,&nbsp;Guillermo Rosales-Sotomayor ,&nbsp;Alejandro Gabutti-Thomas ,&nbsp;Roberta Demichelis-Gomez","doi":"10.1016/j.clnesp.2025.02.010","DOIUrl":"10.1016/j.clnesp.2025.02.010","url":null,"abstract":"<div><h3>Background</h3><div>Body composition has emerged as a significant determinant of cancer patient outcomes, with computed tomography (CT) assessment at the L3 level offering a reliable evaluation method. While muscle mass and adiposity have been linked to poorer outcomes in hematological malignancies, their impact remains unstudied in adults with acute lymphoblastic leukemia (ALL).</div></div><div><h3>Methods</h3><div>This retrospective single-center study enrolled adults newly diagnosed with ALL. Skeletal muscle, visceral, and subcutaneous fat areas were quantified. Low muscle mass was defined as a skeletal muscle index (SMI) less than 55 cm²/m² in men, and less than 39 cm²/m² in women, and receiver operating characteristic curves determined cutoff points for SMI, subcutaneous adipose tissue index (SATI) and visceral adipose tissue index (VATI) correlated with mortality.</div></div><div><h3>Results</h3><div>Ninety patients were included. Low muscle mass was associated with mortality in patients treated with a pediatric inspired regimen (PIR) (HR 4.92, 95 % CI [1.38–17.57], p = 0.014) and lower median SMI was observed in patients who died during induction (p = 0.016). High visceral adiposity (HR 1.89, 95 % CI [1–3.57], p = 0.049) and high subcutaneous adiposity (HR 1.99, 95 % CI [1–3.96], p = 0.05) were also associated with mortality in the whole population. Furthermore, a higher VATI was observed in patients who developed an infectious episode during induction (p = 0.03), and a higher VATI was observed in patients who were treated with a PIR who had measurable residual disease positivity after induction chemotherapy (p = 0.044).</div></div><div><h3>Conclusion</h3><div>CT-assessed muscle mass, and adiposity bear prognostic significance in newly diagnosed ALL patients.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 539-546"},"PeriodicalIF":2.9,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530974","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":"Zinc Supplementation for Mitigating Oral Mucositis in Head and Neck Cancer Patients Undergoing Radiotherapy and Chemoradiotherapy - A Systematic Review","authors":"Goodnews Ikuesiri Agare ,&nbsp;Timothy Prince Chidike Ezeorba ,&nbsp;David C. Michael ,&nbsp;Emmanuel Agbamu ,&nbsp;Ogheneovo Clement Aghoja ,&nbsp;Christian A. Alalor","doi":"10.1016/j.clnesp.2025.02.011","DOIUrl":"10.1016/j.clnesp.2025.02.011","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Head and Neck Cancers (HNCs) pose a significant global health burden, with increasing incidence projected by 2030. Treatment typically involves radiotherapy (RT) and chemoradiotherapy (CMRT), often leading to debilitating oral mucositis (OM), which impairs quality of life and may treatment discontinuation. Currently, there are no established preventive and therapeutic measures for OM in HNC patients. This systematic review aims to consolidate available evidence on the efficacy of zinc supplementation in mitigating the onset, duration, and severity of OM during RT and CMRT in HNC patients.</div></div><div><h3>Methods</h3><div>We searched the Medline, Embase, and Web of Science databases for studies on HNC patients receiving RT or CMRT with zinc supplementation from January 2013 to July 2023. Search terms included various HNC, RT, chemoradiotherapy, and zinc supplementation permutations. Only interventional studies were included, with quality assessment conducted using the JBI risk of bias tools. Findings were synthesized narratively.</div></div><div><h3>Results</h3><div>Eight studies involving 651 HNC patients, comprising six randomized controlled trials (RCTs) and two non-randomized controlled trials, were included. Various radiotherapy techniques and concurrent chemotherapy were utilized across studies, with zinc administered in multiple forms including syrup, tablets, suspension, topical application, and mouthwashes. Overall, six studies reported a beneficial effect of zinc supplementation in reducing the incidence, onset, duration, and severity of OM, while two studies reported no significant impact.</div></div><div><h3>Conclusion</h3><div>Zinc supplementation shows promise in ameliorating OM in HNC patients undergoing RT and chemoradiotherapy, likely due to its antioxidative, anti-inflammatory, and wound healing properties. Further research is warranted to elucidate optimal dosage and regimen for zinc supplementation in this context.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 8-24"},"PeriodicalIF":2.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522672","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 accuracy of estimating equations for total resting energy expenditure in hospitalized patients","authors":"Mie Kristine Bøgedal Pape ,&nbsp;Louise Hyldgaard ,&nbsp;Gustav Wedding Stentoft ,&nbsp;William Kasper Valbirk ,&nbsp;Toke Tinø Toftgård ,&nbsp;Ella Ottilia Magdalena Andås ,&nbsp;Marianne Køhler ,&nbsp;Henrik Højgaard Rasmussen ,&nbsp;Sabina Mikkelsen ,&nbsp;Mette Holst","doi":"10.1016/j.clnesp.2025.02.009","DOIUrl":"10.1016/j.clnesp.2025.02.009","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Methods for estimation of nutritional expenditures for hospitalized patients may not be sufficiently specific. This study aimed to investigate the accuracy of predictive equations compared to indirect calorimetry (IC) and the effect of certain patient characteristics which might correlate with total daily energy expenditure on a heterogeneous population of hospitalized medical patients.</div></div><div><h3>Methods</h3><div>A cross sectional study including demographic information, measures of bioelectric impedance analysis (BIA) including height and bodyweight (BW), IC, heart rate and from patient records, information was collected regarding nutritional risk by Nutrition Risk Screening 2002, biomarkers of C-reactive protein (CRP), albumin and leukocytes. The Harris-Benedict (HB), Mifflin St. Jeor (MSJ), and Schofield equations were calculated. Data were analyzed using T-test, linear and logistic regression analysis.</div></div><div><h3>Results</h3><div>Overall, 197 patients, mean age 63.6 ± 16.0 years were measured with IC and had equations performed. BIA was performed in 187 and 46 withdrew, as they were too ill to measure, has oxygen or forgot fasting. All estimation methods underestimate energy expenditures for patients at nutritional risk (p &lt; 0.001), and HB and MSJ underestimate for those with body mass index (BMI) &lt; 18.5 (p = 0.029 and p &lt; 0.001), while for BMI≥30 all overestimate but only HB significantly (p = 0.025). Elevated CRP and leukocytes, lower heart rate, lower and higher BMI, older patients and patients at nutritional risk can affect estimated total daily energy expenditure by equations compared measured by IC (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>HB, MSJ, and Schofield equations all underestimate energy expenditures with higher variations in patients at nutritional risk. In patients with BMI≥30, energy expenditures are overestimated. Considerations are to measure energy expenditures for patients at nutritional risk with continued weight loss and need for artificial nutrition, and for those with BMI≥30.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 505-514"},"PeriodicalIF":2.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514913","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}