Clinical nutrition最新文献

{"title":"Precision nutrition in breast cancer: Towards patient- and tumour-informed dietary strategies.","authors":"Cristina Crespo-García, Dennis R Taaffe, Carolyn J Peddle-McIntyre, Emily Jeffery, John P Campbell, Robert Thomas, Daniel A Galvao, Robert U Newton","doi":"10.1016/j.clnu.2026.106670","DOIUrl":"https://doi.org/10.1016/j.clnu.2026.106670","url":null,"abstract":"<p><p>Dietary strategies are increasingly recognized as important modulators of breast cancer outcomes, acting through effects on metabolic regulation, weight management, hormone signalling, immune function, and the gut microbiome. However, breast cancer heterogeneity and inter-individual variability mean that generic dietary guidelines may not fully capture patient needs. Precision nutrition offers the opportunity to align dietary interventions with tumour subtype, treatment context, and host biology, potentially enhancing therapeutic response and survivorship in patients diagnosed with breast cancer. In this narrative review, we summarize evidence on dietary patterns and prognosis, and explore how targeted interventions, including fasting regimens, ketogenic diets, and caloric restriction, may be informed by and targeted to host factors such as obesity, metabolic dysfunction, genetics and epigenetics, and microbiome composition, as well as tumour and treatment characteristics. We also discuss the emerging role of digital tools and multi-omics approaches to support personalization. While clinical translation is at an early stage, refining dietary recommendations through precision approaches may open new opportunities to improve prognosis and long-term care in breast cancer.</p>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"61 ","pages":"106670"},"PeriodicalIF":7.4,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of solute carrier family 23 member 1 (SLC23A1) rs6596473 genetic variant with serum vitamin C status and gut microbial profiles in healthy adults: A cross-sectional study.","authors":"Minju Sim, Geum-Sook Hwang, Dong-Mi Shin, Yunju Jeong","doi":"10.1016/j.clnu.2026.106669","DOIUrl":"https://doi.org/10.1016/j.clnu.2026.106669","url":null,"abstract":"<p><strong>Background & aims: </strong>Solute carrier family 23 member 1 (SLC23A1) encodes sodium-dependent vitamin C transporter 1, which mediates intestinal vitamin C absorption. Although SLC23A1 variants are associated with vitamin C bioavailability, their relationship with gut microbiome remains unexplored. We aimed to investigate the associations of SLC23A1 polymorphism with serum vitamin C status and gut microbial profiles in healthy Korean adults.</p><p><strong>Methods: </strong>We genotyped the SLC23A1 rs6596473 polymorphism in 257 healthy individuals (20-39 years) and measured their serum vitamin C concentrations, which were categorized as optimal (≥50 μM) or suboptimal (<50 μM). Logistic regression analysis was used to evaluate the association between genotypes and suboptimal serum vitamin C status after adjusting for covariates. A subset of 43 participants with suboptimal serum vitamin C status underwent gut microbiota analysis and serum short-chain fatty acid (SCFA) measurements. Microbial profiles and SCFA concentrations were compared across the genotypes.</p><p><strong>Results: </strong>The genotype distributions were 92 CC, 131 CG, and 34 GG, with G as the minor allele. After covariate adjustment, GG carriers had higher odds of suboptimal serum vitamin C status than CC carriers (odds ratio = 2.65; p = 0.03). Among individuals with suboptimal serum vitamin C status, GG carriers (n = 7) exhibited distinct microbial community structures compared with CC (n = 13) and CG (n = 23) carriers, with elevated richness and evenness. GG carriers had higher abundances of Bifidobacterium (vs. CC, p < 0.01; vs. CG, p = 0.054) and Ruminococcaceae incertae sedis (all p < 0.05) compared with CC and CG carriers. In line with these microbial findings, GG carriers had higher propionate and butyrate concentrations than CC and CG carriers (all p < 0.05).</p><p><strong>Conclusions: </strong>The SLC23A1 rs6596473 variant was associated with reduced vitamin C absorption into systemic circulation in the overall population; however, among individuals with suboptimal serum vitamin C status, it was associated with beneficial gut microbial profiles. Our findings suggest that this genetic variant in the vitamin C transporter has complex health effects that extend beyond circulating vitamin C levels to gut microbial ecology, supporting the use of genotype-informed nutritional approaches.</p><p><strong>Clinical trial registry: </strong>Clinical Research Information Services KCT0005074 (https://cris.nih.go.kr/cris/search/detailSearch.do?seq=16832&status=5&seq_group=16832&search_page=M) and KCT0004276 (https://cris.nih.go.kr/cris/search/detailSearch.do?seq=14590&status=5&seq_group=14590&search_page=M).</p>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"61 ","pages":"106669"},"PeriodicalIF":7.4,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurocognition and food cue-related brain reactivity after fiber supplementation within a high-protein, plant-based diet in individuals with overweight and prediabetes: A randomized-controlled trial (the DISTAL-study).","authors":"Colin A J van Kalkeren, Thirza van Deuren, Wenhao Huang, Soyoung Q Park, Ellen E Blaak, Tanja C Adam","doi":"10.1016/j.clnu.2026.106668","DOIUrl":"https://doi.org/10.1016/j.clnu.2026.106668","url":null,"abstract":"<p><strong>Background: </strong>The increasing prevalence of obesity and related diseases, such as type 2 diabetes mellitus (T2DM) and neurocognitive dysfunction, warrants sustainable and effective strategies for treatment and prevention. A healthy diet, containing dietary fibers that are fermented by the gut microbiome, produces short-chain fatty acids, among other metabolites, known to alleviate insulin resistance. SCFA also may protect against neurocognitive decline and increase satiety through food-reward-related pathways of the gut-brain axis, thereby contributing to sustainable dietary habits and counteracting obesity and -related diseases. We therefore studied the effects of dietary fibers in the context of a high-protein, partially plant-based diet on neurocognitive functioning and food-reward related brain activity.</p><p><strong>Methods: </strong>This 12-week RCT compared a potato fiber and sugar beet pectin supplement to an isocaloric placebo (maltodextrin), both within a high-protein (±45% plant-based) diet. We investigated the effects on food-reward-related brain activity using functional magnetic resonance imaging (fMRI) with visual food stimuli, comprising high-calorie, low-calorie, and non-food items. Neurocognitive performance was tested with the Cambridge Neurocognitive Test Automated Battery (CANTAB). Furthermore, satiety hormones, stress, and general well-being were assessed, and associations with cardiometabolic markers were explored.</p><p><strong>Results: </strong>Overall, there was a trend towards an increased amygdala BOLD response over time in the fiber group compared to placebo, independent of visual stimuli conditions. The change in amygdala activity was positively associated with increased colonic permeability in both groups. After the intervention, both groups showed improvements in psychomotor speed, visual memory, and learning abilities, and reported less subjective hunger after 12 weeks on a high-protein, partially plant-based diet. General well-being, stress, and satiety hormone concentrations remained unchanged.</p><p><strong>Conclusion: </strong>Twelve weeks of fiber supplementation did not change brain activity induced by visual food cues in reward-related brain regions. However, the high-protein, partially plant-based diet seemed to provide neurocognitive benefits, improving psychomotor speed and memory, and decrease perceived hunger.</p>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"61 ","pages":"106668"},"PeriodicalIF":7.4,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multidisciplinary Delphi consensus on the formulation of an optimized oral diet for dysphagia and malnutrition (FOOD-DM).","authors":"Lisa Brux, Sriramya Lapa, Jule Hofacker, Cinja Huber, Gero Lueg, Anne Jung, Paul Muhle, Sonja Suntrup-Krueger, Rainer Wirth, Sven G Meuth, Tobias Warnecke, Rainer Dziewas, Bendix Labeit","doi":"10.1016/j.clnu.2026.106667","DOIUrl":"https://doi.org/10.1016/j.clnu.2026.106667","url":null,"abstract":"<p><strong>Background & aims: </strong>Dysphagia and malnutrition frequently co-occur and are associated with aspiration pneumonia, sarcopenia, increased mortality, reduced quality of life and restricted social participation. Yet foods and drinks for individuals with dysphagia and malnutrition are inconsistently specified and lack objective standards. This study aimed to develop a consensus-based, expert-derived framework for evaluating foods and drinks perceived suitable for individuals with dysphagia and malnutrition (FOOD-DM).</p><p><strong>Methods: </strong>A two-round online modified Delphi study was conducted (October 2024-May 2025). International experts in medicine, speech-language pathology and nutrition were eligible with ≥5 years of clinical experience and a Hirsch-index ≥5. In round 1, participants rated nine prespecified items relating to texture, nutritional composition and labeling on a 9-point Likert scale. Consensus required ≥70% ratings at 7-9 (critically important) and <15% at 1-3 (not important). Round 2 provided aggregated results, item refinements and a comparison of the International Dysphagia Diet Standardisation Initiative (IDDSI) with quantitative texture measures expressed in the International System of Units (SI).</p><p><strong>Results: </strong>Forty-eight experts participated in round 1. All nine items achieved consensus and were reaffirmed in round 2 (44/48; 92% retention). The final FOOD-DM framework comprises nine criteria across three domains: (1) Texture: availability of consistent textures, accuracy of texture descriptions (IDDSI and/or SI-based rheology), ability to customize texture, and ability to measure texture modifications (IDDSI and/or SI-based rheology); (2) Nutrition: availability of high-calorie options (e.g., 1.5-2.0 kcal/mL), flexibility to adjust calorie content, availability of high-protein options (≥20% energy from protein), and adaptable macronutrient composition; (3) Labeling: clear indications of suitability for dysphagia and malnutrition including detailed explanations of their specifics and composition. Overall, 91% of experts perceived the proposed measures as potentially helpful in improving access to appropriate nutrition; 61% favored a combined IDDSI-plus-SI model for texture description.</p><p><strong>Conclusions: </strong>Distinct from existing approaches focusing on texture or nutrition alone, FOOD-DM integrates standardized texture specification with nutritional optimization and labeling within a single framework. Implementation of the FOOD-DM framework may support standardized, customizable, and transparent nutrition and foster collaboration between clinical nutrition, dysphagia therapy, and the food industry.</p>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"61 ","pages":"106667"},"PeriodicalIF":7.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal delivery of enteral protein in the critically ill: A systematic review and meta-analysis of randomised controlled trials.","authors":"Matthew J Summers, Julia L M Bels, Amalia Karahalios, Rukshala K Gunaratne, Jeffrey J Presneill, Mark P Plummer, Zheng-Yii Lee, Daren K Heyland, Dieter Mesotten, Christian Stoppe, Marcel C G van de Poll, Sandra Peake, Adam M Deane, Lee-Anne S Chapple","doi":"10.1016/j.clnu.2026.106665","DOIUrl":"https://doi.org/10.1016/j.clnu.2026.106665","url":null,"abstract":"<p><strong>Background and aim: </strong>Critically ill patients experience acute muscle wasting, associated with impaired clinical outcomes. It has been suggested that greater dietary protein delivery may attenuate muscle wasting and improve outcomes, but the optimal dose is unknown. The aim of this systematic review and meta-analysis was to evaluate the effect of enteral protein delivered to achieve doses recommended within international guidelines (1.2-2.0 g/kg bodyweight/day) compared to enteral protein delivered below international guidelines (<1.2 g/kg/day) on mortality and clinical, patient-centred, and muscle outcomes.</p><p><strong>Methods: </strong>A systematic review of databases MEDLINE, EMBASE, CINAHL, and CENTRAL was performed from database inception through to 2 July 2025. Randomised controlled trials (RCTs) of adult critically ill patients comparing 'greater protein' delivery (1.2-2.0 g/kg/day) versus 'lesser protein' delivery (<1.2 g/kg/day) predominantly via enteral nutrition (EN), with similar energy delivery, were identified. Risk ratios were pooled for binary outcomes and mean differences or standardised mean differences for continuous outcomes using random-effects models. Subgroup analyses investigated the effect of exclusive EN; acute kidney injury (AKI) as defined within individual trials; and higher severity of illness (Sequential Organ Failure Assessment score ≥9) for the primary outcome (mortality).</p><p><strong>Results: </strong>From a total of 10,414 citations, 14 RCTs were included, comprising n = 6553 patients (n = 3248 greater protein; n = 3305 lesser protein) from 13 individual patient RCTs and one cluster randomised cross-over trial. Greater protein delivery did not affect mortality (pooled RR 1.01, 95% CI 0.92, 1.12, p = 0.795; I²= 0%; τ²= 0.00; 12 RCTs: greater protein n = 3197; lesser protein n = 3243). Other clinical outcomes were not different; however, the point estimate suggested decreased quality of life for greater protein compared to lesser protein (pooled standardised mean difference -0.11, 95% CI -0.24, 0.01, p = 0.081; I²= 0%; τ²= 0.00; 2 RCTs, n = 921: greater protein n = 456; lesser protein n = 465). In patients with an AKI (as defined within individual trials), greater protein delivery was associated with increased mortality (pooled effect estimate 1.29, 95% CI 1.05, 1.58, p = 0.015; I²= 0%; τ²= 0.00; 3 RCTs, n = 755: greater protein n = 390; lesser protein n = 365), with ICEMAN evaluation suggesting that the evidence for effect modification was of moderate credibility.</p><p><strong>Conclusions: </strong>Greater protein delivery does not reduce mortality or improve any clinical outcomes compared with lesser protein, and may be associated with increased mortality in patients with AKI, though subgroup definitions varied across trials.</p><p><strong>Systematic review registration: </strong>CRD42025547923.</p>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"61 ","pages":"106665"},"PeriodicalIF":7.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use and implementation of prehabilitation in major abdominal surgery: Results of an international survey.","authors":"Mihailo Bezmarević, Marcin Folwarski, Maria Wobith, Arved Weimann, Dileep N Lobo, Luca Gianotti, Mireille van Stijn, Stanislaw Klek, Mattias Soop, Olle Ljungqvist","doi":"10.1016/j.clnu.2026.106666","DOIUrl":"https://doi.org/10.1016/j.clnu.2026.106666","url":null,"abstract":"<p><strong>Background: </strong>Prehabilitation is increasingly recognized as an important component of multimodal preoperative optimization, yet its structure, delivery, and degree of integration into routine practice vary widely across healthcare systems. This survey aimed to examine current implementation strategies, multidisciplinary team configurations, and prevailing barriers to inform standardized adoption.</p><p><strong>Methods: </strong>We conducted a multinational, cross-sectional survey of surgical departments performing major abdominal surgery. The survey, disseminated via the European Society for Clinical Nutrition and Metabolism (ESPEN) and national surgical societies, captured institutional characteristics, prehabilitation implementation practices, delivery settings, multidisciplinary team composition, and 21 predefined barriers. The primary outcome was a 5-point prehabilitation integration score, a novel measure of prehabilitation components integration (1-5 Likert scale; 1 = not integrated, 5 = fully integrated into routine care). Associations were assessed using nonparametric tests and multivariable ordinary least squares regression.</p><p><strong>Results: </strong>A total of 200 departments from 45 countries participated. 31.5% reported a routine formal prehabilitation program; the mean (SD) integration score was 2.6 ± 1.1. Integration differed significantly by delivery setting, highest in departments with dedicated prehabilitation/ERAS units and rehabilitation services. Larger multidisciplinary teams were strongly associated with higher integration. In the final multivariable model, the presence of psychologists (β = +0.49, P = 0.002) and nurses (β = +0.35, P = 0.020) independently predicted greater integration, whereas lack of structured units (β = -0.51, P = 0.009), limited facility access (β = -0.39, P = 0.014), and absence of standardized protocols (β = -0.35, P = 0.031) were significant negative predictors. Hospital type and surgical volume showed no independent association.</p><p><strong>Conclusion: </strong>Prehabilitation is not widely implemented as clinical practice among responding units. Integration of prehabilitation into a multidisciplinary care package is driven primarily by modifiable organizational factors rather than institutional size or academic status. Dedicated perioperative units, standardized protocols, adequate facilities, and inclusion of nurses and psychologists appear critical for successful implementation. These findings support a pragmatic, ERAS-aligned pathway for expanding prehabilitation within existing perioperative care frameworks.</p>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"61 ","pages":"106666"},"PeriodicalIF":7.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipidomic profiling of plasma triglyceride species reveals distinct signatures and dietary associations in drug-refractory hypertriglyceridemia.","authors":"Chih-Ning Cheng, Wei-Chieh Wang, Pei-Lung Chen, Siao-Jyuan Jhan, Wen-Chi Chang, Caitlin Elizabeth Randolph, Ta-Chen Su, Ching-Hua Kuo","doi":"10.1016/j.clnu.2026.106664","DOIUrl":"https://doi.org/10.1016/j.clnu.2026.106664","url":null,"abstract":"<p><strong>Background & aims: </strong>Hypertriglyceridemia (HTG) is a common metabolic disorder associated with acute pancreatitis and cardiovascular events. Although lifestyle modification and medications usually reduce triglycerides (TG), some patients develop drug-refractory HTG (r-HTG), where TG levels remain high despite treatment. Lipidomics has emerged as a powerful tool for elucidating disease mechanisms and nutritional effects. This study aimed to characterize plasma TG species composition in r-HTG using lipidomics and to explore potential genetic and dietary influences.</p><p><strong>Methods: </strong>We recruited 140 participants: 40 normal TG (NTG) controls and 100 HTG patients. HTG patients were subdivided into non-refractory (nr-HTG, n = 26) and refractory (r-HTG, n = 74) groups based on post-treatment TG levels. Plasma TG composition was profiled by LC-MS and analyzed using analysis of covariance and logistic regression. Dietary questionnaires and genotyping of HTG-related genes were also conducted.</p><p><strong>Results: </strong>Proportional TG species patterns were similar in NTG and nr-HTG but distinct in r-HTG, a difference not reflected by total TG concentration. Of 251 TG species, 117 (46.6%) differed significantly between nr-HTG and r-HTG groups, with r-HTG enriched in TG species containing fewer double bonds and lower carbon numbers. A four-species TG panel plus drug use for identifying r-HTG achieved an AUROC of 0.953, increasing to 0.963 with genetic data, outperforming the drug-only model (0.717). Dietary analysis revealed r-HTG patients consumed fried breakfasts more often (64.9% vs. 42.3%, P = 0.044) and less vegetarian food (1.4% vs. 15.4%, P = 0.016), which may suggest a tendency toward higher intake of animal-derived saturated fatty acids.</p><p><strong>Conclusions: </strong>This study demonstrates that the proportional composition of TG species is an important independent factor for r-HTG. The enrichment of saturated and monounsaturated fatty acids within TG compositions of r-HTG patients may be influenced by dietary patterns, highlighting the potential relevance of dietary management. Future studies should assess tailored dietary strategies or targeted modulation of fatty acid composition for treating r-HTG.</p>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"61 ","pages":"106664"},"PeriodicalIF":7.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breath volatilome analysis reveals new gut microbiome-related metabolites that discriminate high versus low dietary fibre intake.","authors":"Manon Autuori, Audrey M Neyrinck, Laetitia Lengelé, Eloïse Viera Olivera, Marie Rombaux, Julie Rodriguez, Patrice D Cani, Jens Walter, Laure B Bindels, Nathalie M Delzenne","doi":"10.1016/j.clnu.2026.106662","DOIUrl":"https://doi.org/10.1016/j.clnu.2026.106662","url":null,"abstract":"<p><strong>Background & aims: </strong>Gut bacteria produce a wide variety of metabolites that are playing important roles in human health. Dietary fibres (DF) are beneficial nutrients that have been shown to modulate key intestinal functions when fermented by gut bacteria. Since most bacteria-derived metabolites are volatile, their presence in exhaled breath allows to propose new non-invasive methods to study DF-microbiome interactions in humans. We aimed to identify potential novel biomarkers of gut microbiota activity released in exhaled breath following the consumption of DF at breakfast, upon untargeted analysis in healthy volunteers.</p><p><strong>Methods: </strong>14 volunteers (7 women/7 men, 21 ± 2 years old) participated to two test days at a one-month interval, where they received either a low-(2.6 g) or high-(16.1 g) fibre breakfast. Before each test days, stools were collected to evaluate the microbiota composition using Illumina sequencing (V5-V6 region of 16S rRNA gene). Throughout the test days, breath samples were analysed using selected-ion flow-tube mass spectrometry (SIFT-MS). A sparse partial least squares-discriminant analysis (sPLS-DA) identified 30 signals that best discriminated between test days, corresponding to 173 candidate breath compounds.</p><p><strong>Results: </strong>The gut microbiota of the volunteers remained stable one month apart. The composition of exhaled breath shifted starting from 5 h after the high-fibre breakfast ingestion. Ninety compounds were identified as potential metabolites of gut microbes, with 81 showing increased concentrations after the high-fibre breakfast. These included acrylic acid (positively correlated with Faecalibacterium/Ruminococcaceae/Bacillota and negatively correlated with Bifidobacterium/Bifidobacteriaceae/Actinomycetota). The high-fibre breakfast also led to increases in limonene, ethylbenzene/xylene, p-cymene, and methionol that were positively correlated with the genus Faecalibacterium. Moreover, positive correlations were observed between cyclooctane/ethylcyclohexane, methanol and the phylum Bacillota. Dimethyl disulfide was strongly negatively correlated with the genus Bacteroides and its family Bacteroidaceae.</p><p><strong>Conclusion: </strong>This study shows that DF consumption at breakfast stimulates the production of exhaled bacteria-derived metabolites reflecting profound changes in the metabolic activity of the gut microbiota. We also identified new potential biomarkers of DF intake, that are not directly linked to DF fermentation. Specific bacteria known to play a role in gut barrier, immunity and host metabolism were associated with those new metabolites.</p>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"61 ","pages":"106662"},"PeriodicalIF":7.4,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral ferrous sulphate supplementation has greater efficacy, but lower tolerance than iron (III)-hydroxide polymaltose complexes in exercising women with low iron stores","authors":"Alannah KA. McKay ,&nbsp;Sophie Broome ,&nbsp;Nicolin Tee ,&nbsp;Kin Lui Yim ,&nbsp;Marc Sim ,&nbsp;Peter Peeling ,&nbsp;Louise M. Burke","doi":"10.1016/j.clnu.2026.106594","DOIUrl":"10.1016/j.clnu.2026.106594","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Iron deficiency (ID) is a global health condition that predominately affects women. Although oral iron supplementation is an effective treatment strategy for this issue, gastrointestinal complaints are common, and if persistent, may lead to poor compliance. The efficacy of different iron formulations which claim to improve tolerance is unclear. This study assessed the efficacy and tolerability of ferrous sulphate (FS) and iron (III)-hydroxide polymaltose complex (IPC) supplementation in three different cohorts of women..</div></div><div><h3>Methods</h3><div>This study implemented a 12-week, single-blind, randomized controlled trial. Eligible participants had a serum ferritin concentration of &lt;50 μg/L and met specific inclusion criteria to be enrolled to either the athlete, pre-menopausal or post-menopausal groups. Participants were randomized to receive FS (equivalent to 105 mg elemental iron) plus sodium ascorbate or IPC (equivalent to 100 mg elemental iron) daily. Venous blood samples were collected at baseline, 4-, 8- and 12-weeks of supplementation. A daily questionnaire was completed throughout the study period, documenting supplement tolerance (number and severity of symptoms), exercise load, menstrual characteristics, and supplement compliance.</div></div><div><h3>Results</h3><div>Fifty-seven participants completed the intervention with a compliance rate of 94.9 % [range: 74.8–100 %]. A significant interaction between supplement and time was evident for ferritin (p &lt; 0.001), where FS increased after 12 weeks (+109 %; p &lt; 0.001) but no change was evident in IPC (+7 %; p = 0.727). No differences were detected between cohorts (p &gt; 0.05). The IPC group had a lower symptom rate compared to FS (28 % vs. 33 %; p &lt; 0.001)..</div></div><div><h3>Conclusions</h3><div>FS was superior in repleting ferritin concentrations after 12 weeks compared with IPC; however, FS also resulted in a greater number and severity of GI symptoms than IPC. Our data shows FS is the superior iron formulation for ID treatment, however future research should continue to address how to improve FS tolerance.. This trial was registered at <span><span>https://www.anzctr.org.au/Trial/Registration/TrialReview</span><svg><path></path></svg></span> as ACTRN12623000529640.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106594"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design and validation of kineanthropometric measurement protocols in adult population with cerebral palsy","authors":"David Expósito ,&nbsp;José Miguel Soriano ,&nbsp;Carla Soler","doi":"10.1016/j.clnu.2025.106572","DOIUrl":"10.1016/j.clnu.2025.106572","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Adults with cerebral palsy (CP) face a high risk of malnutrition, yet most nutritional assessment methods have been developed for children. Despite the known anatomical and functional heterogeneity in adults with CP, there is a lack of validated, adapted tools for this population. This study aims to design and validate a specific anthropometric method for assessing the nutritional status of adults with CP, addressing this critical gap in clinical and research practice.</div></div><div><h3>Methods</h3><div>This cross-sectional study consisted of two phases. First, anthropometric measurements were performed on 47 adults with CP to identify practical challenges and design an adapted protocol. In the second phase, this protocol was applied to 74 healthy adults trained to simulate the postural limitations commonly observed in individuals with CP (e.g., asymmetries, spasticity-related contractures), based on direct observation in the CP group. Measurements obtained with the adapted method were statistically compared to those obtained using the International Society for the Advancement of Kinanthropometry (ISAK) reference protocol.</div></div><div><h3>Results</h3><div>The adapted protocol accounts for the anatomical and functional challenges of individuals with CP by allowing measurements to be performed in a supine position or with limbs flexed or extended, as necessary. Statistical analysis revealed no significant differences between the adapted protocol and the ISAK reference method for any of the anthropometric measurements. These results confirm that the modified approach yields accurate and reliable assessments of nutritional status in adults with CP.</div></div><div><h3>Conclusion</h3><div>The anatomical and functional limitations of adults with CP present significant challenges to traditional ISAK methodology. However, the adapted protocol, performed in a supine position by trained anthropometrists, produces comparable results. Key indicators such as Arm Muscle Area, Arm Adipose Area, and the Adipose-Muscular Index can reliably assess the nutritional status of this population, offering a viable alternative for clinical and research applications..</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106572"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146178130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}