Clinical nutrition ESPEN最新文献

{"title":"Dissecting the global leadership initiative on malnutrition criteria in advanced cancer: Reduced intake vs. inflammation","authors":"Michael S. Yule , Andressa M. Machado , Leo R. Brown , Bruna M.M. Rocha , Rebekah Patton , Judith Sayers , Iona Munro , Jennifer Baxter , Amy McLuskie , Paula P. Lajolo , Jann Arends , Carlos E. Paiva , Mark Stares , Duncan Brown , Iain Phillips , Donald C. McMillan , Yara C.P. Maia , Richard J.E. Skipworth , Barry J.A. Laird","doi":"10.1016/j.clnesp.2025.03.007","DOIUrl":"10.1016/j.clnesp.2025.03.007","url":null,"abstract":"<div><h3>Background & aims</h3><div>The Global Leadership Initiative on Malnutrition (GLIM) criteria have been recommended for the diagnosis of malnutrition. It requires that the patient meets at least one phenotypic criterion and at least one aetiological criterion. For the latter, the patient must either demonstrate reduced food intake or have evidence of systemic inflammation. As both are common in advanced cancer, the aim of the present study was to determine, in patients who met the GLIM phenotypical criteria, which GLIM aetiological criteria (reduced food intake or systemic inflammation) is most useful in predicting overall survival (OS).</div></div><div><h3>Methods</h3><div>Data from two cancer biobanks were combined. Inclusion criteria were: ≥18 years, advanced cancer (stage III or IV) and ability to provide written consent. Weight loss (WL) was selected as the phenotypic criterion of choice, as preliminary analysis demonstrated it to be a superior predictor of OS compared to body mass index. Malnutrition type 1 was defined as >5 % WL over 6 months and a C reactive protein (CRP) ≥3 mg/l. Further analysis was performed with a CRP >10 mg/l cut-off. Malnutrition type 2 was defined as >5 % WL over 6 months and reduced food intake, as reported in the Patient Generated Subjective Global Assessment. Survival was assessed using Kaplan-Meier methodology, log-rank tests and Cox proportional hazards models, with hazard ratios (HR) and confidence intervals (CI) reported.</div></div><div><h3>Results</h3><div>In total, 176 patients were studied, with 147 events observed. The 3-month mortality rate was 32.4 % (CI: 25.1 to 39.0) and the 1-year mortality rate was 71.8 % (CI: 63.8 to 78.0). Malnutrition type 1 and malnutrition type 2 were observed in 37.8 % (HR: 2.27 [CI: 1.54 to 3.33], p < 0.001) and 26.3 % (HR: 1.74 [CI: 1.19 to 2.54], p = 0.005) of patients respectively, with both significantly increasing the risk of death. Following adjustment for relevant confounders both malnutrition type 1 (HR: 1.92 [CI: 1.25 to 2.94], p = 0.003) and malnutrition type 2 (HR: 1.61 [CI: 1.09 to 2.38], p = 0.019) remained significant predictors of OS. Median survival for patients with malnutrition type 1 was 2.14 (CI: 1.74 to 4.90) months compared to 9.5 (6.94–13.64) months for those without (<em>p</em> < 0.001). For malnutrition type 2, this was 2.37 (CI: 1.64 to 5.46) vs. 7.40 months (CI: 6.08 to 10.16), p = 0.004. When the CRP threshold was increased to >10 mg/l, malnutrition type 1 was observed in fewer patients (30.4%), median survival was shorter (1.91 [CI: 1.25 to 2.99] vs. 9.86 months [CI: 7.27 to 14.7], <em>p</em> < 0.001) and in both univariable (HR: 2.91 [CI: 1.94 to 4.63], <em>p</em> < 0.001) and multivariable (HR: 2.32 [CI: 1.50 to 3.60], <em>p</em> < 0.001) analyses, the risk of death increased.</div></div><div><h3>Conclusion</h3><div>The results suggest that the inflammatory component of GLIM appears superior compared to re","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 114-121"},"PeriodicalIF":2.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630177","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":"Specific clinical conditions for colloids use","authors":"Michał P. Pluta,&nbsp;Łukasz J. Krzych","doi":"10.1016/j.clnesp.2025.03.014","DOIUrl":"10.1016/j.clnesp.2025.03.014","url":null,"abstract":"<div><div>Intravenous fluids are among the most commonly prescribed drugs. Many preparations classified by composition as crystalloids or colloids, of natural or synthetic origin, are available in clinical practice. Guidelines favor crystalloids as first-choice fluids in most clinical situations, mainly because of the lack of advantage of using colloids in reducing mortality and organ complications and generating higher treatment costs. This review focuses on the evidence for the use of colloids in selected clinical conditions.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 122-126"},"PeriodicalIF":2.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630178","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":"Cardiometabolic and obesity risk outcomes of dawn-to-dusk, dry intermittent fasting: Insights from an umbrella review","authors":"MoezAlIslam Faris ,&nbsp;Dana N. Abdelrahim ,&nbsp;Salah Eddine El Herrag ,&nbsp;Meghit Boumediene Khaled ,&nbsp;Katia Abu Shihab ,&nbsp;Refat AlKurd ,&nbsp;Mohammed Madkour","doi":"10.1016/j.clnesp.2025.03.006","DOIUrl":"10.1016/j.clnesp.2025.03.006","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>This umbrella review comprehensively and systematically summarizes meta-analyses on the impact of dawn-to-dusk, dry intermittent fasting of Ramadan (RIF) on cardiometabolic and glucose homeostasis indicators.</div></div><div><h3>Methods</h3><div>Twenty meta-analyses were examined on the effects of RIF on body fat percentage (BFP), fat mass, fat-free mass, body mass index (BMI), body weight (BW), waist circumference (WC), systolic and diastolic blood pressure (SBP, DBP), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TG), and very low-density lipoprotein cholesterol (VLDL-C), fasting blood glucose (FBG), glycated hemoglobin (HbA1c), insulin resistance (HOMA-IR), serum insulin, leptin, and adiponectin. Results of continuous outcomes were pooled from included meta-analyses. We employed random-effects meta-analysis using the restricted maximum likelihood method to estimate heterogeneity. P-values were derived from standard meta-analytic tests, including Egger's test for small-study effects and the excess significance test for potential publication bias. Additionally, we applied criteria from Ioannidis' evidence classification to assess the credibility of the findings.</div></div><div><h3>Results</h3><div>In healthy subjects, RIF was associated with significant reductions in BW (Hedges' G = −0.33; 95 % confidence interval (CI) = −0.37, −0.29; p-value = 2.63 × 10–52), WC (Hedges' G = −0.30; 95 % CI = −0.38, −0.23; p-value = 5.73 × 10–15), BFP (Hedges' G = −0.26; 95 % CI = −0.37, −0.14; p-value = 6.81 × 10-06), DBP (n = 3,456; Hedges' G = −0.26; 95 % CI = −0.38, −0.15; p-value = 9.18 × 10-06), TC (n = 9,314; Hedges' G = −0.16; 95 % CI = −0.25, −0.07; p-value = 6.27 × 10-04), and TG levels (n = 9,020; Hedges' G = −0.16; 95 % CI = −0.24, −0.08; p-value = 6.87 × 10-05). Moreover, in general population, TG (n = 16,688; Hedges' G = −0.15; 95 % CI = −0.22, −0.08; p-value &lt;0.01) and FBG (n = 16,106; Hedges’ G = −0.23; 95 % CI = −0.33, −0.13; p-value &lt;0.01) were significantly reduced.</div></div><div><h3>Conclusions</h3><div>Dawn-to-dusk, dry RIF shows promise as a complementary therapy and preventive measure for reducing cardiometabolic and obesity-related risks. However, controlled studies are necessary to validate its effectiveness and fully understand its health implications.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 127-145"},"PeriodicalIF":2.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623811","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":"Metabolic responses to surgical stress","authors":"Mattias Soop ,&nbsp;Olle Ljungqvist","doi":"10.1016/j.clnesp.2025.02.021","DOIUrl":"10.1016/j.clnesp.2025.02.021","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 178-183"},"PeriodicalIF":2.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623813","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":"Effect of perioperative immunonutrition on outcomes in gastric cancer surgery patients: A systematic review and evidence map","authors":"Chen Xin ,&nbsp;Yanqiu Wang ,&nbsp;Yuhong Luo ,&nbsp;Yubiao Gai ,&nbsp;Binru Han","doi":"10.1016/j.clnesp.2025.02.029","DOIUrl":"10.1016/j.clnesp.2025.02.029","url":null,"abstract":"<div><h3>Background</h3><div>Tumors and surgical procedures trigger a series of metabolic responses that put gastric cancer patients at constant risk of malnutrition during the perioperative period. Meanwhile, the effectiveness of enteral immunonutrition (EIN) for these patients remains a subject of ongoing debate.</div></div><div><h3>Objective</h3><div>This systematic review and evidence map aim to retrieve randomized controlled trials (RCTs) on perioperative EIN interventions in gastric cancer patients undergoing surgery and evaluate their effectiveness.</div></div><div><h3>Methods</h3><div>A systematic search strategy was established using the Population, Intervention, Comparison, Outcomes and Study design (PICOS) framework to identify relevant RCTs evaluating EIN for gastric cancer surgery patients. The databases searched were PubMed, Web of Science, Embase, CINAHL, and CENTRAL (Cochrane Library), covering studies published up to September 30, 2024. Two reviewers independently screened titles and abstracts. The quality of the studies was assessed using the Cochrane Risk of Bias Tool version 2 (RoB 2). Data were independently extracted and descriptively synthesized, with the results summarized in an evidence gap map.</div></div><div><h3>Results</h3><div>In this systematic review, 20 studies that met the inclusion criteria were included, focusing on the effects of perioperative EIN on patients with gastric cancer. The interventions involved various immunonutrients such as arginine, omega-3 fatty acids, glutamine, and ribonucleic acid, with different initiation times ranging from preoperative to postoperative, and durations ranging from 5 to 28 days. Most studies used EN as the control, while some used PN. The risk of bias assessment revealed that three studies had a high risk of bias, primarily due to issues with randomization. The majority of studies focused on changes in immune function and inflammatory markers, with some also evaluating postoperative infection complications or other clinical outcomes. The evidence gap map (EGM) analysis showed that although postoperative interventions were more common, only 45.45 % of these studies demonstrated a “positive impact”, while the remaining studies indicated a “possible positive impact” or “no effect”. Overall, EIN interventions showed some positive effects on immune function and inflammatory markers, but results varied across studies.</div></div><div><h3>Conclusions</h3><div>This review summarized the effects of perioperative EIN in gastric cancer surgery patients, highlighted existing gaps and suggested future research to optimize its application.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 90-104"},"PeriodicalIF":2.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613765","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":"Nutrition and dietary therapy in paediatric inflammatory bowel disease","authors":"Konstantinos Gerasimidis","doi":"10.1016/j.clnesp.2025.03.004","DOIUrl":"10.1016/j.clnesp.2025.03.004","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 233-241"},"PeriodicalIF":2.9,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595823","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":"Achieving nutritional goals in prone position: A cohort study in critically ill patients with coronavirus disease","authors":"Rafaela Fernandes Mundstock ,&nbsp;Caroline Marques de Lima Cunha ,&nbsp;Kellen dos Santos de Lima ,&nbsp;Caio Wolff Ramos Baumstein ,&nbsp;Raquel Canuto ,&nbsp;Vera Lúcia Bosa ,&nbsp;Vivian Cristine Luft ,&nbsp;Valesca Dall’Alba ,&nbsp;Zilda de Albuquerque Santos ,&nbsp;Thais Ortiz Hammes","doi":"10.1016/j.clnesp.2025.03.001","DOIUrl":"10.1016/j.clnesp.2025.03.001","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to describe nutritional therapy and clinical outcomes in critically ill patients with coronavirus disease (COVID-19) hospitalized in an intensive care unit, submitted or not to the prone position.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included adult patients with COVID-19 admitted to the intensive care unit (ICU) of a public university hospital from June to December 2020. Sociodemographic, clinical, nutritional, and anthropometric data were collected in electronic medical records with a prestructured collection instrument. Patients who underwent a prone position at least once during hospitalization were considered in the prone group.</div></div><div><h3>Results</h3><div>677 patients were included and 35.4 % were placed in the prone position. Pronated patients had a higher prevalence of obesity (p = 0.005), pressure ulcers (p &lt; 0.001), required more mechanical ventilation (p &lt; 0.001) and renal replacement therapy (p = 0.004), had longer hospital length of stay (p &lt; 0.001) and higher mortality rate (p &lt; 0.001). They required enteral nutrition more frequently and remained on this therapy for a longer duration, despite having similar caloric and protein targets. No significant differences were found in the ability to achieve nutritional goals between pronated and non-pronated patients.</div></div><div><h3>Conclusion</h3><div>Critically ill patients in the prone position had longer hospital stays and higher mortality rates, while being more likely to initiate and remain on enteral nutrition for a longer period. However, no significant differences were observed in the time to achieve protein and caloric goals compared to those in the supine position.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 50-55"},"PeriodicalIF":2.9,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596589","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":"Beyond the gut: Unraveling the multifaceted influence of microbiome on cardiovascular health","authors":"Felix Oladele Okunlola ,&nbsp;Abimbola Rafiat Okunlola ,&nbsp;Babatunde Oluwafemi Adetuyi ,&nbsp;Mahmoud E.S. Soliman ,&nbsp;Athanasios Alexiou ,&nbsp;Marios Papadakis ,&nbsp;Mohamed N. Fawzy ,&nbsp;Gaber El-Saber Batiha","doi":"10.1016/j.clnesp.2025.03.002","DOIUrl":"10.1016/j.clnesp.2025.03.002","url":null,"abstract":"<div><div>Cardiovascular disease is one of the leading causes of death worldwide. Even while receiving adequate pharmacological treatment for their hypertension, people are nonetheless at greater risk for cardiovascular disease. There is growing evidence that the gut microbiota may have major positive and negative effects on blood pressure and illnesses related with it as more study into this topic is conducted. Trimethylamine n-oxide (TMAO) and short-chain fatty acids (SCFA) are two major by-products of the gut microbiota. TMAO is involved in the formation of other coronary artery diseases, including atherosclerosis and hypertension, while SCFAs play an important role in controlling blood pressure. Numerous investigations have confirmed the established link between dietary salt intake and hypertension. Reducing sodium in the diet is linked to lower rates of cardiovascular disease morbidity and mortality as well as lower rates of blood pressure and hypertension. In both human and animal research, high salt diets increase local and systemic tissue inflammation and compromise gut architecture. Given that the gut microbiota constantly interacts with the immune system and is required for the correct maturation of immune cells, it is scientifically conceivable that it mediates the inflammatory response. This review highlights the therapeutic possibilities for focusing on intestinal microbiomes as well as the potential functions of the gut microbiota and its metabolites in the development of hypertension.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 71-89"},"PeriodicalIF":2.9,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595759","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":"Habitual intake of macronutrients and fermentable oligo-, di-, monosaccharides and polyols is not associated with irritable bowel syndrome-like symptoms in inflammatory bowel disease","authors":"Insaf Zerouga ,&nbsp;Jørgen Valeur ,&nbsp;Christine Sommer ,&nbsp;Monica Hauger Carlsen ,&nbsp;Milada Hagen ,&nbsp;Marte Lie Høivik ,&nbsp;Vendel Ailin Kristensen ,&nbsp;Randi Opheim ,&nbsp;Laila Arnesdatter Hopstock ,&nbsp;Vibeke Strande ,&nbsp;Charlotte Lund ,&nbsp;Raziye Boyar ,&nbsp;Øivind Asak ,&nbsp;May-Bente Bengtson ,&nbsp;Tone Bergene Aabrekk ,&nbsp;Øistein Hovde ,&nbsp;Gert Huppertz-Hauss ,&nbsp;Trond Espen Detlie ,&nbsp;Petr Ricanek ,&nbsp;Svein Oskar Frigstad ,&nbsp;Anne-Marie Aas","doi":"10.1016/j.clnesp.2025.03.005","DOIUrl":"10.1016/j.clnesp.2025.03.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Almost a third of patients with inactive inflammatory bowel disease (IBD) suffer from symptoms compatible with irritable bowel syndrome (IBS-like symptoms). The relation between these symptoms and diet in patients with IBD is not fully established. We aimed to assess associations between IBS-like symptoms and intake of macronutrients and fermentable oligo-, di-, monosaccharides, and polyols (FODMAPs) in patients with inactive IBD compared to an IBD-free background population.</div></div><div><h3>Methods</h3><div>Patients with IBD at one-year follow-up from the IBSEN III (Inflammatory bowel disease in South-Eastern Norway) study were compared to an IBD-free Norwegian background population (Tromsø7). A food frequency questionnaire (FFQ) was used to collect dietary data including FODMAP intake, which was compiled as gram/100 g of food and assessed in patients with active versus inactive IBD. Rome IV criteria were applied to define IBS-like symptoms in patients with inactive IBD.</div></div><div><h3>Results</h3><div>A sample of 154 patients ≥40 years with inactive IBD was compared to 11078 adults from the IBD-free background population (Tromsø7). There were no significant associations between IBS-like symptoms and FODMAP and macronutrient intake, neither in patients with inactive IBD nor in the IBD-free background population. Patients with IBD ≥40 years had higher intake of fructans and total FODMAPs compared to the Tromsø7 sample. Intake of nutrients and FODMAPs was similar in patients with active IBD (n = 105), inactive IBD with IBS-like symptoms (n = 55), and without IBS-like symptoms (n = 197).</div></div><div><h3>Conclusion</h3><div>FODMAP and macronutrient intake were not associated with IBS-like symptoms in patients with inactive IBD one-year after diagnosis.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 105-113"},"PeriodicalIF":2.9,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High adherence to a food guide may be associated with lower 24-h urinary sodium excretion and sodium-to-potassium ratio, and higher potassium excretion","authors":"Marina Yamagishi ,&nbsp;Ribeka Takachi ,&nbsp;Junko Ishihara ,&nbsp;Ayane Shiraishi ,&nbsp;Kayo Kurotani ,&nbsp;Sachiko Maruya ,&nbsp;Yuri Ishii ,&nbsp;Kumiko Kito ,&nbsp;Kazutoshi Nakamura ,&nbsp;Junta Tanaka ,&nbsp;Taiki Yamaji ,&nbsp;Hiroyasu Iso ,&nbsp;Motoki Iwasaki ,&nbsp;Shoichiro Tsugane ,&nbsp;Norie Sawada","doi":"10.1016/j.clnesp.2025.03.008","DOIUrl":"10.1016/j.clnesp.2025.03.008","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Salt reduction remains an important issue in population-level studies of diet. One unresolved issue is whether adherence to a food guide which does not assess dietary salt can lead to a reduction in salt intake.</div></div><div><h3>Methods</h3><div>This study aimed to investigate the association between adherence to a food guide calculated by weighed food records (WFRs) or a Food Frequency Questionnaire (FFQ), and urinary sodium and potassium excretion and sodium-to-potassium ratio. Further, salt-added scores were developed and analyzed. We used cross-sectional data, including data from 12-day WFRs, five 24-h urine collections, and an FFQ. A total of 248 participants aged 35–80 years were surveyed between 2012 and 2013. Main outcomes were 24-h urinary sodium and potassium excretion and sodium-to-potassium excretion ratio. Multiple regression analysis was performed with urinary excretion as the dependent variable and the food guide score calculated by WFRs and the FFQ as independent variables. Because scores are not proportional to intake under this food guide scoring method, Spearman's correlation coefficients were calculated between the score and urinary excretion, and between the number of servings and urinary excretion.</div></div><div><h3>Results</h3><div>When scored by WFRs, the higher food guide score group tended to have lower sodium excretion (−129 mg/day per one quartile increase; P for trend, 0.051), higher potassium excretion (137 mg/day per one quartile increase, P &lt; 0.01), and lower sodium-to-potassium ratio (−0.32 per one quartile increase, P &lt; 0.01). When accompanied by salt-added scores, total score was associated with further reductions in sodium excretion (−218 mg/day per one quartile increase; P for trend, &lt;0.001).</div></div><div><h3>Conclusions</h3><div>Even with a study food guide which does not assess dietary salt, high adherence to the guide tended to be associated with lower sodium excretion and sodium-to-potassium ratio and higher potassium excretion. This inverse association with sodium excretion was strengthened by the addition of a salt-added score.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 146-154"},"PeriodicalIF":2.9,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595821","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}