Clinical nutrition ESPEN最新文献

{"title":"Barriers and facilitators to starting and staying on ketogenic diet therapy for children with epilepsy: A scoping review","authors":"Humzah Hameed ,&nbsp;Lenycia de Cassya Lopes Neri ,&nbsp;Natasha Schoeler","doi":"10.1016/j.clnesp.2025.02.020","DOIUrl":"10.1016/j.clnesp.2025.02.020","url":null,"abstract":"<div><h3>Background</h3><div>Ketogenic diet therapy (KDT) is a group of high-fat, low-carbohydrate, moderate protein diets that are an effective treatment option for children and young people with drug-resistant epilepsy. However, 45 % of patients referred to start KDT, who are medically eligible to do so, do not start diet. A further 25 % discontinue KDT before 3 months.</div></div><div><h3>Aim</h3><div>To explore barriers and facilitators for children and young people with epilepsy to start or continue on KDT, and their families. Based on the Participants, Concept and Context (PCC) framework, this review included children and young people with drug-resistant epilepsy (P) referred for KDT (C) or their families, who had expressed their views regarding barriers or facilitators for starting or continuing on dietary treatment (C).</div></div><div><h3>Methods</h3><div>This scoping review followed JBI methodology. Identified barriers/facilitators were matched to relevant sections of the ‘Capability, Opportunity, Motivation – Behaviour’ (COM-B) model and organised according to the phases of the patient journey: pre-diet, diet initiation and maintenance.</div></div><div><h3>Results</h3><div>60 studies were included. 15 barriers and 9 facilitators were identified for the pre-diet and initiation stages; 19 barriers and 14 facilitators were identified for staying on KDT once the diet had been fully established.</div></div><div><h3>Conclusions</h3><div>Barriers and facilitators for children and young people who are considering starting KDT, or who are currently following KDT, and their families, are multifactorial and extend beyond the level of the individual. Our findings will help identify areas to prioritise for interventions to support patients and their families.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 465-473"},"PeriodicalIF":2.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491148","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":"Maternal vitamin D status during pregnancy in relation to childhood cardiometabolic risk factors: The GraviD-Child prospective cohort study","authors":"Anna Amberntsson ,&nbsp;Linnea Bärebring ,&nbsp;Mathilda Forsby ,&nbsp;Anna Winkvist ,&nbsp;Jenny M. Kindblom ,&nbsp;Frida Dangardt ,&nbsp;Hanna Augustin","doi":"10.1016/j.clnesp.2025.02.012","DOIUrl":"10.1016/j.clnesp.2025.02.012","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>In utero exposure to deficiencies of certain nutritional factors such as vitamin D has been related to adverse cardiometabolic outcomes in the offspring, but results are conflicting. The aim of this study was to investigate the association between maternal vitamin D status during pregnancy and markers of cardiometabolic risk in childhood.</div></div><div><h3>Methods</h3><div>Serum 25-hydroxyvitamin D (25OHD) concentrations were measured at 11- and 33-weeks’ gestation. At 7–8 years of age, the children were examined regarding anthropometry, body composition (by bioelectrical impedance), and blood pressure, and a blood sample was drawn. Cardiometabolic risk was assessed using individual cardiometabolic risk factors and a composite score of adiposity, blood pressure, blood lipids, and hemoglobin A1c, using age- and sex-specific z-scores. Associations between maternal vitamin D status in early and late pregnancy and z-scores of markers of cardiometabolic risk were evaluated using adjusted linear and logistic regression analyses.</div></div><div><h3>Results</h3><div>In total, n = 172 mother-child pairs were included. Neither was an association found between maternal 25OHD concentration with a composite score of cardiometabolic risk in childhood (Odds Ratio (OR) 1.02 (confidence interval (CI) 0.99–1.05), and OR 0.99 (CI 0.97–1.01) in early and late pregnancy, respectively), nor with any individual marker of cardiometabolic risk.</div></div><div><h3>Conclusion</h3><div>In conclusion, there were no evidence of an association between maternal vitamin D status during pregnancy and cardiometabolic risk factors in the child at 7–8 years of age.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 460-464"},"PeriodicalIF":2.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491155","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":"Developing a core outcome set for nutrition care in adult outpatients with irritable bowel syndrome (COS-RD-IBS study)","authors":"Sandra Jent ,&nbsp;Joya Jelena Kristin Lüthi ,&nbsp;André Meichtry ,&nbsp;Natalie Sara Bez ,&nbsp;Anita Bucher ,&nbsp;Luzia Valentini ,&nbsp;Gerhard Rogler","doi":"10.1016/j.clnesp.2025.02.017","DOIUrl":"10.1016/j.clnesp.2025.02.017","url":null,"abstract":"<div><h3>Background and aims</h3><div>Irritable bowel syndrome (IBS) is a frequent disorder thought to be caused by a disturbance of the gut–brain axis. Nutrition interventions are an essential pillar of its treatment. However, there is no consensus on which outcomes should be applied to assess the effectiveness of nutrition care in IBS. Standardized outcome sets, or “core outcome sets“ (COS), have been proposed to harmonize outcomes in clinical research and practice. This project aims to develop a COS for dietitian-provided nutrition care in adults with IBS or food intolerances with intestinal symptoms, to be implemented in routine outpatient practice.</div></div><div><h3>Methods</h3><div>A comprehensive outcomes list was developed based on quantitative and qualitative studies, COS and guidelines on IBS, and important outcomes named by participants. Health service users, dietitians, gastroenterologists, and health care decision makers rated the outcomes in two Delphi survey rounds on their importance and ranked them in a third round. Data was analyzed by panel to account for the different views and sample sizes.</div></div><div><h3>Results</h3><div>A total of 192 participants registered for the Delphi process. The following 14 outcomes reached consensus in all panels after two rounds: perception of symptom triggering foods/nutrients, intake of trigger foods/nutrients, practicability of diet, adherence, digestive symptoms overall, abdominal pain, abdominal bloating, stool consistency, stool frequency, physical functioning related QoL, nutrition related QoL, social functioning related QoL, empowerment of self-care.</div></div><div><h3>Conclusions</h3><div>The Delphi process yielded in a 14 outcomes COS, which exceeds what is typically considered feasible in routine nutrition care. Further work is needed to refine the COS and to identify standardized measurement tools for each outcome.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 489-496"},"PeriodicalIF":2.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491151","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":"Measured resting energy expenditure in cardiothoracic surgery patients and changes throughout hospitalization: A descriptive cohort study","authors":"Hilary M. Winthrop ,&nbsp;Megan Beyer ,&nbsp;Paul E. Wischmeyer ,&nbsp;Anthony D. Sung ,&nbsp;Jeroen Molinger ,&nbsp;Krista L. Haines","doi":"10.1016/j.clnesp.2025.02.019","DOIUrl":"10.1016/j.clnesp.2025.02.019","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>There is a general paucity of data on energy needs during critical illness and the subsequent hospital course, particularly in cardiothoracic surgical patients. We measured resting energy expenditure (mREE) via indirect calorimetry on patients post-cardiothoracic surgery and conducted repeat measures throughout hospitalization to evaluate trends and begin to describe metabolic needs in this patient population.</div></div><div><h3>Methods</h3><div>Prospective descriptive cohort study design. Patients status post cardiothoracic surgery and admitted to the intensive care unit were enrolled, and indirect calorimetry measurements were obtained within 72 h post-operative and every 5–7 days thereafter.</div></div><div><h3>Results</h3><div>A total of 11 patients (4 with obesity and 7 without obesity) and 35 indirect calorimetry measurements were included in the analysis. Overall mean resting energy expenditure was 1598 kcals/day [859–2506], and 21 kcal/kg [13.0–37.4]. Overall, the patients with obesity had higher resting energy expenditure than those without obesity in kcals/day (1930 vs. 1425, respectively). This trend continued regardless of the patient being in the intensive care unit (obese 1845 kcals/day vs. non-obese 1244 kcals/day) or the step-down unit (obese 2099 kcals/day vs. 1624 kcals/day). Additionally, measurements on the ventilator were lower than those off the ventilator (1310 kcals vs. 1769 kcals, respectively). Inter-patient variability in mREE was diverse, with some energy needs remaining stable throughout hospitalization while others varied greatly.</div></div><div><h3>Conclusions</h3><div>Measured resting energy expenditure in post-cardiothoracic surgical patients is highly variable. Ventilator and unit status also significantly influenced energy needs, with distinct differences between patients with obesity and those without.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 482-488"},"PeriodicalIF":2.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482281","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":"Low muscle mass as a poor prognostic factor in patients with advanced melanoma","authors":"Kohei Yamakawa ,&nbsp;Yusuke Kurita ,&nbsp;Hideyuki Ishikawa ,&nbsp;Masahiro Aichi ,&nbsp;Shintaro Fujita ,&nbsp;Sho Hasegawa ,&nbsp;Shingo Kato ,&nbsp;Yukie Yamaguchi","doi":"10.1016/j.clnesp.2025.02.004","DOIUrl":"10.1016/j.clnesp.2025.02.004","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Low muscle mass is associated with poor immune checkpoint inhibitor (ICI) efficacy in patients with melanoma; however, whether this is true in all populations remains to be explored. The current study aimed to investigate the effect of low muscle mass on overall survival (OS) and progression-free survival (PFS) of patients with advanced melanoma treated with ICI.</div></div><div><h3>Methods</h3><div>muscle index (SMI) at the third lumbar spine was calculated from computed tomography (CT) images, and SMI values &lt; 42 cm2/m2 for men and &lt;38 cm2/m2 for women diagnosed low muscle mass. The association of low muscle mass, OS, and PFS with ICI treatment in patients was investigated.</div></div><div><h3>Results</h3><div>Seventy-six patients with advanced melanoma were assessed retrospectively at our institution; 32 were in the low muscle mass group, while 44 were in the normal muscle mass group. The median OS in patients with and without low muscle mass was 7.1 and 26.6 months (hazard ratio [HR] 3.12, 95 % confidence interval [Cl], 1.65–5.89; p &lt; 0.001) and median PFS was 2.1 and 14.8 months, respectively (HR, 3.10; 95 % Cl 1.74–5.54, p &lt; 0.001). Multivariate analysis showed significantly poor differences in OS (HR, 2.46; 95 % CI, 1.20–5.03; p = 0.01) and significant differences in PFS independently in the low muscle mass group (HR, 3.10; 95 % CI, 1.74–5.54; p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Low muscle mass may be a poor prognostic factor for patients with advanced melanoma treated with ICI.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 474-481"},"PeriodicalIF":2.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467223","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":"Bioelectrical impedance vector (BIVA) reference values for healthy term newborns 1–2 days old","authors":"Nallely Bueno-Hernández ,&nbsp;Jesús Carlos Briones-Garduño ,&nbsp;Miguel Ángel Fonseca-Sánchez ,&nbsp;Guillermo Meléndez ,&nbsp;Galileo Escobedo ,&nbsp;Marcela Esquivel-Velázquez","doi":"10.1016/j.clnesp.2025.02.005","DOIUrl":"10.1016/j.clnesp.2025.02.005","url":null,"abstract":"<div><h3>Background</h3><div>Bioelectrical impedance vector analysis (BIVA) is a valuable tool for assessing individuals' body fluids and nutritional status by examining the impedance vector's position on the mean reference impedance vector tolerance ellipses from healthy populations. Nevertheless, differences in BIVA tolerance ellipses have been reported between populations with different ethnicities, body mass index (BMI), sex, and age.</div></div><div><h3>Aim</h3><div>To construct BIVA reference values for healthy newborns aged 1–2 days born to term and compare them to those previously reported for newborns from different populations.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted using bioelectrical impedance data collected within the first 48 h after birth from healthy, term newborns with healthy mothers. The mean impedance vector 50 %, 75 %, and 95 % tolerance ellipses were constructed and compared with those previously reported for other newborn populations.</div></div><div><h3>Results</h3><div>The healthy newborns’ mean impedance vector showed significant differences between populations, with similarities observed only between our newborn population and one of the four previously reported populations. No vector displacement was found related to the mode of delivery or sex of the newborns.</div></div><div><h3>Conclusions</h3><div>The mean impedance vector tolerance ellipses for healthy term newborn population aged 1–2 days were constructed. Our results show that there are differences in the mean impedance vector compared to other BIVA newborn studies, which could result from the influence of ethnic background on BIVA tolerance ellipses or be due to differences in the technique for BIA assessment.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 421-428"},"PeriodicalIF":2.9,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432246","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":"Nutritional risk assessment in hemodialysis patients: A comparative analysis of modified creatinine index, geriatric nutritional risk index and simple protein-energy wasting score with malnutrition-inflammation score","authors":"L. Aguiar ,&nbsp;V. Sá Martins ,&nbsp;I. Pinto ,&nbsp;Al Papoila ,&nbsp;C. Dias ,&nbsp;R. Figueiredo ,&nbsp;J. Pereira ,&nbsp;I. Ramião ,&nbsp;B. Velez ,&nbsp;T. Adragão ,&nbsp;N. Borges ,&nbsp;E. Almeida ,&nbsp;J. Garrido ,&nbsp;F. Macário","doi":"10.1016/j.clnesp.2025.02.003","DOIUrl":"10.1016/j.clnesp.2025.02.003","url":null,"abstract":"<div><h3>Background and aims</h3><div>Nutritional status has a great impact on the prognosis of maintenance hemodialysis patients. Therefore, its management should be a priority, and risk screening frequent and easily implemented, based on the biochemical and clinical routine parameters already available, when the use of more comprehensive tools is not possible. Many tools fit these simple criteria, namely the modified creatinine index, geriatric nutritional risk index, and simple protein energy wasting score. These scores are associated with mortality and morbidity risk in hemodialysis patients. This study aims to confirm that these scores are significantly associated with all-cause mortality and to compare them with malnutrition inflammation score.</div></div><div><h3>Methods</h3><div>Historical cohort study of hemodialysis patients from 25 outpatient clinics. The nutritional and inflammation status was assessed at baseline with malnutrition-inflammation score, geriatric nutritional risk index, modified creatinine index, and simple protein-energy wasting score. Univariable and multivariable Cox additive regression models were used to analyse data. Partial likelihood ratio tests to compare the performance of non-nested Cox models were used.</div></div><div><h3>Results</h3><div>We analysed 2322 patients, 59 % males, 31.7 % diabetic, with a median age of 70 years (P₂₅ = 60, P₇₅ = 79), during a median follow-up period of 45 months (P₂₅ = 31; P₇₅ = 45). All-cause mortality was observed in 778 patients (33.5 %).</div><div>The median of the modified creatinine index was 19.9 mg/kg/day (P₂₅ = 18.6, P₇₅ = 23.2), and a higher index value was observed for the surviving patients (<em>p</em> &lt; 0.001).</div><div>Regarding geriatric nutritional risk score, a median of 106.6 (P₂₅ = 99.4, P₇₅ = 114.2) was observed, being significantly higher in the survival group (p &lt; 0.001).</div><div>Simple protein-energy wasting score lower values were more frequent in the group of deceased patients (<em>p</em> &lt; 0.001).</div><div>For the malnutrition-inflammation score the median was 6 (P₂₅ = 4, P₇₅ = 8), and 50.6 % of the patients had a score ≥6, with higher scores being more frequent in the deceased group (<em>p</em> &lt; 0.001).</div><div>Partial likelihood ratio tests showed that the malnutrition-inflammation score only fitted better than the model including simple protein-energy wasting score. All scores had a good discriminative performance with Harrell's C-statistic ranging from 0.71 to 0.73. Malnutrition-inflammation score and modified creatinine index models attained the highest values.</div></div><div><h3>Conclusion</h3><div>All the tools were significantly associated with mortality. The geriatric nutritional risk index was the score that performed most similarly to the malnutrition-inflammation score.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 429-436"},"PeriodicalIF":2.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425024","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":"Does nutritional support prevent severe mucositis in patients with head and neck cancer treated with chemoradiotherapy? A systematic review and meta-analysis","authors":"Aleksandra Krzywon ,&nbsp;Anna Kotylak ,&nbsp;Tomasz Rutkowski","doi":"10.1016/j.clnesp.2025.02.007","DOIUrl":"10.1016/j.clnesp.2025.02.007","url":null,"abstract":"<div><h3>Background</h3><div>For patients with advanced head and neck cancer (HNC) chemoradiotherapy (CHRT) is the main treatment option. CHRT is a severe treatment with a high ratio of side effects which may be even more pronounced due to mucosities related malnutrition. Nutritional intervention like nutritional counseling (NC) and oral nutritional supplements (ONS) may prevent malnutrition. A systematic review and meta-analysis was performed to assess the effect of NC with or without ONS (NC±ONS) on CHRT-related grade ≥3 mucositis in patients with HNC undergoing CHRT.</div></div><div><h3>Methods</h3><div>PubMed/MEDLINE, Web of Science, and Scopus were searched to identify randomized and non-randomized clinical studies of HNC patients undergoing CHRT, where mucositis grade ≥3 data were provided. Comparative and proportional meta-analyses were performed to calculate the odds ratio (OR) and incidence of a mucositis grade ≥3 in the included studies (%) with 95% confidence intervals (95% CI).</div></div><div><h3>Results</h3><div>There were seven studies fulfilling inclusion criteria with 655 participants included. NC±ONS revealed no risk reduction of grade ≥3 mucositis (OR: 1.2, 95%CI: 0.7–1.9). The overall mucositis rate was 38.3% (95% CI: 24.8%–52.6%) and 32.8% (95% CI: 14.9%–53.5%) (P = 0.67) in NC+ONS and NC-ONS respectively.</div></div><div><h3>Conclusion</h3><div>Despite the undeniable role of NC±ONS for patients with HNC undergoing CHRT, we found it insufficient to avoid grade ≥3 CHRT-related mucositis. Further research should be conducted to determine recomendations how to decrease the risk of oral mucosities and, in consequence, how to prevent malnutrition in patients with CHRT.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 547-555"},"PeriodicalIF":2.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425023","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":"Answer to “Comment on “Lifestyle aspects are associated 1 with common mental disorders in women over 40 years older in a population-based study” Clinical Nutrition ESPEN 2024”","authors":"João Valentini Neto,&nbsp;Amália Almeida Bastos,&nbsp;Marcelo Macedo Rogero,&nbsp;Regina Mara Fisberg,&nbsp;Sandra Maria Lima Ribeiro","doi":"10.1016/j.clnesp.2025.02.006","DOIUrl":"10.1016/j.clnesp.2025.02.006","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 409-410"},"PeriodicalIF":2.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425109","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":"Bromelain and liver health: A comprehensive systematic review of preclinical studies","authors":"Irislene Costa Pereira ,&nbsp;Álina Mara Carvalho Pedrosa-Santos ,&nbsp;Jorddam Almondes Martins ,&nbsp;Athanara Alves de Sousa ,&nbsp;Taline Alves Nobre ,&nbsp;Lucillia Rabelo de Oliveira Torres ,&nbsp;Felipe Cavalcanti Carneiro da Silva ,&nbsp;Juliana Soares Severo ,&nbsp;João Marcelo de Castro e Sousa ,&nbsp;Francisco Leonardo Torres-Leal","doi":"10.1016/j.clnesp.2025.02.001","DOIUrl":"10.1016/j.clnesp.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Liver diseases pose a significant challenge to the well-being of the public, given their high prevalence and the potential to escalate to liver failure and hepatocellular carcinoma. The efficacy of current therapies is rather limited, resulting in the manifestation of severe side effects. Bromelain, derived from the pineapple plant, exhibits promising prospects for the treatment of inflammatory disorders, cancer, and wound healing, although its impact on liver functionality remains largely unexplored.</div></div><div><h3>Objective</h3><div>To evaluate the efficiency of bromelain in liver injuries, we performed a systematic review of preclinical studies.</div></div><div><h3>Method</h3><div>Our search was conducted in August 2020 on PubMed and Scopus, employing the search terms “Liver disease,” “Liver injury,” and “Bromelain,” with subsequent updates in December 2023.</div></div><div><h3>Results</h3><div>Out of the 329 articles that were examined, only 7 fulfilled the criteria for inclusion.</div></div><div><h3>Conclusion</h3><div>Our research suggests that bromelain possesses both prophylactic and curative qualities in terms of liver damage, as supported by its ability to decrease enzyme levels, enhance liver structure, reduce oxidative stress markers, and regulate lipid metabolism. In summary, bromelain demonstrates a capacity to enhance liver function across a range of injury types.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"66 ","pages":"Pages 437-445"},"PeriodicalIF":2.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412821","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}