Clinical nutrition最新文献

{"title":"Varied effects of sweeteners on pediatric hypertension: A multicenter study","authors":"Yuan-Jen Tsai ,&nbsp;Hsien-Yu Fan ,&nbsp;Shih-Yuan Hsu ,&nbsp;Yung-Feng Lin ,&nbsp;Chien-Tien Su ,&nbsp;Huang-Ren Lin ,&nbsp;Yang-Ching Chen","doi":"10.1016/j.clnu.2025.08.034","DOIUrl":"10.1016/j.clnu.2025.08.034","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>The link between sugar-sweetened beverage consumption and metabolic syndrome has prompted the use of non-nutritive sweeteners(NNS). However, emerging evidence links NNS to elevated cardiovascular risk in children. This study examines the association between sweetener consumption and pediatric hypertension to guide cardiovascular health recommendations for children.</div></div><div><h3>Methods</h3><div>The Taiwan Pubertal Longitudinal Study, initiated in July 2018, is a multicenter, prospective cohort study involving 1696 patients aged 7–17 years. Baseline dietary exposures were collected using the validated NNS Food Frequency Questionnaire covering acesulfame potassium(AceK), aspartame, sucralose, glycyrrhizin, steviol glycosides, sorbitol, and added sugars. Spot urine samples were collected concurrently. Anthropometric and blood pressure measurements were recorded every 3 months. Pediatric hypertension was defined as systolic or diastolic blood pressure at or above 95th percentile for age, sex, and height, using the measurement closest to dietary assessment. Multivariate generalized linear mixed models were used to examine associations between sweetener exposure and pediatric hypertension, adjusting for age, sex, z-BMI, family history of hypertension, total calorie intake, sodium intake, physical activity, parental education, and household income. Participants were recruited on an ongoing basis, and data collected from July 2018 to September 2022 were analyzed.</div></div><div><h3>Results</h3><div>Aspartame and added sugars were dose-dependently associated with increased pediatric hypertension risk (aspartame: OR = 1.69, 95%CI:1.03–2.75; p = 0.04; added sugar: OR = 2.63, 95%CI:1.50–4.60; p &lt; 0.001), while steviol glycosides showed borderline protective effects (p for trend = 0.05). AceK was negatively associated with hypertension in girls (OR = 0.30, 95%CI:0.09–0.98; p = 0.05), whereas aspartame was positively associated with hypertension risk in boys (OR = 3.13, 95%CI:1.30–7.54; p = 0.01). The association between added sugar intake and hypertension was stronger in overweight children. Substituting added sugars with NNS was associated with lower hypertension risk. Urinary biomarker analysis further supported the inverse association between AceK and hypertension, particularly in girls.</div></div><div><h3>Conclusion</h3><div>This study demonstrated that aspartame and added sugars were associated with a higher pediatric hypertension risk, while steviol glycosides were linked to lower hypertension risk. Replacing added sugar with NNS was associated with lower pediatric hypertension risk. These findings emphasize the need for tailored dietary guidelines and further investigation on sweetener use in children.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"53 ","pages":"Pages 199-210"},"PeriodicalIF":7.4,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145045101","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":"Alternate-day fasting elicits larger changes in fat mass than time-restricted eating in adults without obesity – A randomized clinical trial","authors":"Nina Derron ,&nbsp;Andreas T. Güntner ,&nbsp;Ines C. Weber ,&nbsp;Julia Braun ,&nbsp;İlker Ö. Koska ,&nbsp;Alaa Othman ,&nbsp;Leonie Mönch ,&nbsp;Arnold von Eckardstein ,&nbsp;Milo A. Puhan ,&nbsp;Felix Beuschlein ,&nbsp;Michel Hochuli ,&nbsp;Nicola Zamboni ,&nbsp;Roman Guggenberger ,&nbsp;Philipp A. Gerber","doi":"10.1016/j.clnu.2025.08.033","DOIUrl":"10.1016/j.clnu.2025.08.033","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Intermittent fasting (IF) is a popular nutritional strategy for weight control and improved metabolic health, however it is unclear which type of intermittent fasting is most effective. This randomized trial directly compared short-term alternate-day fasting (ADF) and time-restricted eating (TRE) with controls in adults with overweight or a high normal weight. The aim was to compare the effects of ADF and TRE versus controls regarding whole-body fat mass loss, weight control and cardiometabolic health.</div></div><div><h3>Methods</h3><div>In this 4-week, parallel-arm, randomized clinical trial (February 2021–May 2022), participants aged 18–40 years with a body mass index between 23 and 30 kg/m² were assigned to ADF (alternating fasting and ad libitum eating days), to TRE (eating only between 12:00–20:00), or control (no change in eating times). The primary outcome was change in total fat volume (assessed by whole-body magnetic resonance imaging). Secondary outcomes were subcutaneous and visceral fat mass, body weight, resting metabolic rate, biochemical markers, energy intake, activity energy expenditure and health-related quality of life.</div></div><div><h3>Results</h3><div>Seventy-six participants (mean [standard deviation (SD)] age, 29.6 [5.6] years; body mass index, 25.8 [2.2] kg/m²; 34 [44 %] female) were randomized to ADF (n = 26), TRE (n = 26), or control (n = 24). Seventy-five participants completed the trial (25 in ADF, 26 in TRE, 24 in control). ADF led to a greater reduction in total fat volume than control (mean difference −1059.8 cm³, 95 % CI: −1380.0 cm³ to −739.6 cm³, p &lt; 0.001) and TRE (−695.7 cm³, 95 % CI: −1013.9 to −377.6 cm³, p &lt; 0.001). TRE also reduced total fat volume compared to control (−364.0 cm³, 95 % CI: −621.3 cm³ to −106.7 cm³, p = 0.007). Energy intake was reduced by 34 % [18 %] in ADF, 15 % [21 %] in TRE and 3 % [22 %] in control. ADF, but not TRE, reduced visceral fat mass, resting metabolic rate, triiodothyronine and non-HDL cholesterol compared to controls. Only ADF increased activity energy expenditure and health-related quality of life. No serious adverse events occurred.</div></div><div><h3>Conclusions</h3><div>In this randomized clinical trial, ADF was more effective in reducing energy intake than TRE which has subsequent effects on fat mass and body weight. Only ADF improved several cardiometabolic risk factors.</div></div><div><h3>Registration</h3><div><span><span>https://clinicaltrials.gov/study/NCT04732130</span><svg><path></path></svg></span>; Unique identifier: NCT04732130.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"53 ","pages":"Pages 212-221"},"PeriodicalIF":7.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145045193","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":"The acute changes in intracellular amino acid production during sepsis do not relate to plasma concentrations.","authors":"Nicolaas E P Deutz, Gabriella A M Ten Have, Peter P Nghiem, Macie L Mackey, Sarah A Rice, John J Thaden, Marina B W Horner, Marielle P K J Engelen","doi":"10.1016/j.clnu.2025.07.026","DOIUrl":"10.1016/j.clnu.2025.07.026","url":null,"abstract":"<p><p>It remains unclear how amino acid metabolism is altered during the early phase of sepsis. We therefore investigated the acute changes in amino acid metabolism during sepsis in a pig model. We studied 51 pigs using a pulse stable isotope tracer method to measure kinetic changes in almost all amino acids before and 6.5 h after sepsis induction by continuous infusion of Pseudomonas aeruginosa. Statistics were done by Generalized Linear Mixed Model. Sepsis induced only small (<10 %) changes in plasma concentration of amino acids, while amino acid clearance was substantially increased for amino acids like taurine (+33 %), histidine (+42 %), glycine (+35 %), glutamine (+27 %), arginine (+13 %) and citrulline (+20 %), while reduced for tyrosine (-11 %), threonine (-11 %), lysine (-14 %). Compartmental analysis revealed that changes in extra- and intracellular amino acid pools and fluxes were much larger than the changes in plasma concentrations. Intracellular pool sizes were substantially lower for glutamate (-47 %), lysine (-46 %), phenylalanine (-39 %), threonine (-33 %), and tyrosine (-28 %) and higher for taurine (+21 %), hydroxyproline (+31 %) and glutamine (+35 %). Notably, intracellular productions of essential amino acids like lysine (-49 %), phenylalanine (-25 %), threonine (-26 %), tryptophan (-22 %), and tyrosine (-22 %) were significantly reduced during sepsis, while those of taurine (+24 %) and glutamine (+34 %) were increased, suggesting attenuated protein breakdown in the early phase of sepsis. Plasma cytokine levels, including IL1-beta (+50 %), IL1-ra (+120 %), IL6 (+26 %), and TNF-alpha (+9 %), were also statistically significantly elevated. Large changes in intracellular amino acid metabolism occur relatively quickly during the development of sepsis, while changes in plasma concentration are small. Therefore, compartmental analysis of amino acid metabolism shows that changes in the extra- and intracellular pools and fluxes into these pools seems to precede the changes in plasma concentrations, indicating that amino acid metabolism is affected much more and sooner than could be concluded from measuring plasma concentrations only.</p>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"52 ","pages":"203-214"},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816002","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":"Evaluating health related quality of life in paediatric and adult patients who utilise home enteral tube feeding.","authors":"Mercedez Hinchcliff, Annabel Clancy, Courtney Crawford, Sarah Gray","doi":"10.1016/j.clnu.2025.07.030","DOIUrl":"10.1016/j.clnu.2025.07.030","url":null,"abstract":"<p><strong>Background: </strong>Home enteral tube feeding (HETF) delivers vital nutritional support for individuals unable to consume food orally. While it sustains life, its impact on users' quality of life (QoL) is significant. Limited research has examined the differential effects of HETF across paediatric and adult patients.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 155 HETF users, including paediatric (n = 85) and adult (n = 70) participants. QoL measures were evaluated across four dimensions: social life, working/school life, psychological well-being, and physical functioning. Group comparisons based on age and sex were analysed using non-parametric tests.</p><p><strong>Results: </strong>Adult users were more likely to limit social activities due to tube feeding compared to paediatric users, while carers of paediatric users reported higher social exclusion. Working/school life support was greater for paediatric participants, with males reporting more workplace support than females. Adult HETF users experienced higher levels of physical discomfort and sleep disruption. Psychological concerns, such as body image and missing food, were more pronounced in females. The results revealed significant gaps in financial support, with 47 % receiving no assistance and many spending over $200 monthly on supplies. Half of the users of HETF were entirely dependent on tube feeding for nutrition. Commonly reported needs included financial support, better supply access, and social acceptance.</p><p><strong>Conclusion: </strong>HETF significantly affects QoL, with adult HETF users and females reporting greater challenges in social participation, psychological health, and physical functioning. Age- and sex-specific interventions are needed to enhance support for HETF users.</p>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"52 ","pages":"189-194"},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803806","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":"Crossing barriers? Longitudinal evaluation of intestinal permeability in adolescent anorexia nervosa.","authors":"Hannah Lillig, Larissa Käver, Stefanie Trinh, Clara Voelz, Harin Kim, Astrid Dempfle, Lara Keller, Brigitte Dahmen, Beate Herpertz-Dahlmann, Susanne Gilsbach, Jochen Seitz","doi":"10.1016/j.clnu.2025.07.034","DOIUrl":"10.1016/j.clnu.2025.07.034","url":null,"abstract":"<p><strong>Background & aims: </strong>Anorexia nervosa (AN) is a severe eating disorder with significant somatic complications, potentially involving an altered intestinal barrier. Prior studies yielded heterogeneous results, ranging from decreased to increased intestinal permeability in AN. This study aimed to assess intestinal permeability in adolescent patients with AN by comparing serum markers Zonulin, Lipopolysaccharide-binding protein (LBP), and intestinal Fatty acid-binding protein (iFABP) with healthy controls (HC) over time.</p><p><strong>Methods: </strong>We conducted a longitudinal study on 60 female adolescent patients with AN and 36 age-matched HC. Blood samples were collected at admission to inpatient treatment, at discharge, and at a one-year follow-up. Zonulin, LBP, iFABP and inflammation marker Interleukin 6 levels were measured alongside clinical parameters. Linear mixed models were applied to assess group differences and longitudinal changes. Pearson correlations were used to explore clinical associations.</p><p><strong>Results: </strong>Zonulin levels were significantly decreased in the AN group at admission and again at the follow-up compared to HC. LBP levels were consistently reduced in AN across all three time points. These alterations thus persisted despite weight recovery. No significant differences were observed in iFABP levels between the groups or over time. Zonulin and LBP positively correlated with Interleukin 6, linking gut permeability to inflammatory processes.</p><p><strong>Conclusion: </strong>Decreased Zonulin and LBP levels suggest reduced paracellular intestinal permeability in adolescent AN while transcellular permeability (iFABP) appears to be rather unaffected. The persistence of these alterations despite weight recovery suggests that reduced intestinal permeability may be a trait rather than a state marker in AN. Our findings challenge the concept of a \"leaky gut\" in adolescent AN.This highlights the need for further research on the intestinal barrier in AN, while also integrating the role of nutritional intake, gut microbiome interaction and immune reactions, to support the development of gut-targeted therapies.</p>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"52 ","pages":"215-224"},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820717","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":"Cytokine response to critical illness and its relation to amino acid metabolism.","authors":"Mette M Berger, Pierre Singer, Raven A Wierzchowska-McNew, Marina V Viana, Itai A Ben-David, Olivier Pantet, Caroline Perez, John J Thaden, Mariëlle P K J Engelen, Nicolaas E P Deutz","doi":"10.1016/j.clnu.2025.07.018","DOIUrl":"10.1016/j.clnu.2025.07.018","url":null,"abstract":"<p><strong>Background and aims: </strong>Critical illness is characterized by an intense inflammatory response that triggers major metabolic changes with protein catabolism resulting in major losses of muscle mass. The intensity of the inflammatory response appears as the principal driver of the changes involved in outcome, and especially those affecting protein metabolism and muscle catabolism, and resistance to nutrition. The present exploratory study aims to clarify the role of the different cytokines in amino acid metabolism.</p><p><strong>Methods: </strong>In this post-hoc analysis of the previously published observational study, including 51 critically ill patients and 49 healthy controls aiming at identifying patient changes in amino acid metabolism, we assessed the association between a panel of cytokines and blood levels of amino acids (AA) and their turnover. The subjects were matched for age, sex, and BMI. The study was conducted in postabsorptive state. Blood analysis included cytokines (determined by Luminex), C-reactive protein (CRP or hsCRP), and AA.</p><p><strong>Protocol: </strong>8 mL solution containing 18 stable AA tracers administered as a pulse to calculate amino acid whole body production (WBP). WBP was calculated from fitted decay curves. We measured amino acid enrichments and concentrations by LC-MS/MS and derived statistics using Generalized Linear Model (GLM) t and stepwise regression. Data as means [95%CI].</p><p><strong>Results: </strong>The study included 51 critically ill patients (age 63 yrs [58, 68], APACHEII 21.6 [20, 24]) and 49 matched healthy controls (age 57 yrs [52, 61]). While anthropometric characteristics were similar between critically ill patients and healthy adults, phase angle was lower (3.9 [3.5, 4.2] vs 6.0 [5.6, 6.3], p < 0.001), most AA blood levels were lower, while most cytokine levels were significantly higher. IL-6 and CRP were strongly associated (p < 0.001). IL-6 was the cytokine with the strongest association with the AA blood levels and WBP alterations in patients. Three patterns of changes in the plasma cytokine concentrations were observed. Of the 37 cytokines measured, 12 were higher in ICU patients, 5 were lower, and the rest were similar.</p><p><strong>Conclusions: </strong>The present study shows a comprehensive picture of inflammation and simultaneous alterations of AA metabolism. The levels of IL-6 and CRP may become a good indicator of the metabolic capacity to respond positively to nutrition therapy.</p><p><strong>Clinical trial registry: </strong>Data are from the baseline measurements of study NCT02770092 (URL: https://clinicaltrials.gov/ct2/show/NCT02770092) and NCT03628365 (URL: https://clinicaltrials.gov/ct2/show/NCT03628365).</p>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"52 ","pages":"195-202"},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816001","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":"Handling ethical issues in Clinical Nutrition","authors":"Diana Cárdenas ,&nbsp;Dileep N. Lobo","doi":"10.1016/j.clnu.2025.08.028","DOIUrl":"10.1016/j.clnu.2025.08.028","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"53 ","pages":"Pages 155-157"},"PeriodicalIF":7.4,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996753","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":"The impact of hemodiafiltration with endogenous reinfusion (HFR) on micronutrient status in patients undergoing maintenance hemodialysis: A randomized crossover trial","authors":"Bo Yang ,&nbsp;Zewei Chen ,&nbsp;Cheng Xue ,&nbsp;Changhao Zhu ,&nbsp;Dan Ye ,&nbsp;Qing Shao ,&nbsp;Fanzhou Zeng ,&nbsp;Nanmei Liu","doi":"10.1016/j.clnu.2025.08.031","DOIUrl":"10.1016/j.clnu.2025.08.031","url":null,"abstract":"<div><h3>Background</h3><div>Micronutrient deficiencies are common in patients undergoing maintenance hemodialysis (MHD), potentially contributing to adverse clinical outcomes. Hemodiafiltration with endogenous reinfusion (HFR) integrates convection, diffusion, and adsorption, potentially preserving essential nutrients better than traditional online hemodiafiltration (HDF). This study aimed to compare the acute effects of HFR and HDF on serum micronutrient concentrations in MHD patients.</div></div><div><h3>Methods</h3><div>The research has been registered in chictr.org.cn (ChiCTR2500096698). In this randomized crossover trial, 30 adult MHD patients received one session each of HFR and HDF, separated by a 2-week washout period consisting of their standard maintenance hemodialysis. Blood samples were collected pre- and post-treatment for trace elements and vitamin concentrations. The primary outcome was post-treatment serum iodine concentration, chosen to assess the acute dialytic clearance efficiency of iodine. Secondary outcomes included changes in serum concentrations of other trace elements and water- and fat-soluble vitamins. Linear mixed models (LMM) were used for between-treatment comparisons, and paired tests for within-group changes.</div></div><div><h3>Results</h3><div>A total of 30 patients (mean age 55.7 ± 14.8 years; 63.3 % male) completed the study. No significant difference was observed in post-treatment serum iodine between HFR and HDF (adjusted mean difference: −0.019 μmol/L, p = 0.343). However, HFR was associated with significantly greater reductions in serum calcium, vitamin D3, and selenium, compared to HDF (p &lt; 0.05 for all). In contrast, vitamin B3 concentrations were significantly higher after HFR (p = 0.047). No serious adverse events occurred, and both modalities were well-tolerated.</div></div><div><h3>Conclusions</h3><div>While HFR did not significantly differ from HDF in iodine clearance, it resulted in greater losses of calcium, vitamin D3, and selenium, but resulted in significantly higher post-treatment serum concentrations of vitamin B3. These findings suggest that until long-term studies demonstrate a clear net benefit, the routine clinical implementation of HFR outside of dedicated research contexts appears premature and requires significant caution.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"53 ","pages":"Pages 158-167"},"PeriodicalIF":7.4,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004516","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":"The plasma proteome of plant-based diets: Analyses of 2920 proteins in 49,615 people","authors":"Tammy Y.N. Tong,&nbsp;Karl Smith-Byrne,&nbsp;Keren Papier,&nbsp;Joshua R. Atkins,&nbsp;Mahboubeh Parsaeian,&nbsp;Timothy J. Key,&nbsp;Ruth C. Travis","doi":"10.1016/j.clnu.2025.08.032","DOIUrl":"10.1016/j.clnu.2025.08.032","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Circulating proteins are integral to many biological processes and could be influenced by diet. We aimed to assess differences in the plasma proteome between people of different dietary groups, defined by degree of animal food consumption.</div></div><div><h3>Methods</h3><div>The UK Biobank recruited middle-aged adults (mostly 40–69 years) throughout the UK between 2006 and 2010. Relative concentrations of 2920 plasma proteins were quantified using the Olink Proximity Extension Assay on blood samples from 49,615 participants, who were also asked to report their ethnicity and consumption of red and processed meat, poultry, fish, dairy and eggs. We defined six diet groups among the white British participants (23,243 regular meat eaters, 23,472 low meat eaters, 486 poultry eaters, 1081 fish eaters, 721 vegetarians, and 54 vegans), and two diet groups among the British Indians (391 meat eaters and 167 vegetarians). We used multivariable-adjusted linear regressions to assess the cross-sectional differences in protein concentrations between diet groups, with correction for multiple testing.</div></div><div><h3>Results</h3><div>We observed significant differences in many plasma proteins by diet group (920 proteins in white British participants, 2 in British Indians). Of the biggest differences, compared with regular meat eaters, the non-meat eaters had significantly higher FGF21 (e.g. +0.40 SD in vegetarians), CKB (+0.34), GUCA2A (+0.33), FOLR1 (+0.32), IGFBP2 (+0.31) and DSG2 (+0.30); all groups except the vegans had lower HAVCR1 (−0.38 in vegetarians). Vegetarians also had significantly lower SELENOP (−0.46), while the vegans had lower FGFBP2 (−0.68). The observed differences were generally similar in direction in both ethnicities.</div></div><div><h3>Conclusions</h3><div>In this first comprehensive assessment of plasma proteins by diet group, we identified many differences in proteins between vegetarians, vegans and meat eaters; this variation in protein levels suggests differences in various biological activities, including gastrointestinal tract and kidney function, which may relate to differences in future disease risk.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"53 ","pages":"Pages 144-154"},"PeriodicalIF":7.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989315","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":"Do functional gut parameters predict enteral autonomy and chronic cholestasis in pediatric intestinal failure?","authors":"Lotte E. Vlug ,&nbsp;Frank G. Schaap ,&nbsp;Kaatje Lenaerts ,&nbsp;Esther G. Neelis ,&nbsp;Hans M. van Eijk ,&nbsp;Sander M.J. van Kuijk ,&nbsp;Merit M. Tabbers ,&nbsp;Sjoerd C.J. Nagelkerke ,&nbsp;René M.H. Wijnen ,&nbsp;Edmond H.H.M. Rings ,&nbsp;Jessie M. Hulst ,&nbsp;Steven W.M. Olde Damink ,&nbsp;Barbara A.E. de Koning","doi":"10.1016/j.clnu.2025.08.030","DOIUrl":"10.1016/j.clnu.2025.08.030","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Parenteral nutrition (PN) dependency in patients with intestinal failure (IF) can lead to complications including liver disease. Therefore, IF management strives to wean patients off PN. In adult IF, chronic cholestasis is predicted by the functional gut parameters citrulline (CIT) and enteroendocrine fibroblast growth factor 19 (FGF19), which inhibits hepatic bile salt synthesis. We investigated 1) whether CIT, FGF19 and a marker for enterocyte damage (urinary intestinal fatty acid-binding protein (I-FABP)) are associated with enteral autonomy within 60 days after intestinal surgery in neonates, and 2) the longitudinal patterns of CIT, FGF19, total bile salts and C4 (marker for bile salt synthesis) in subgroups of children on long-term PN (short bowel syndrome (SBS) and functional IF).</div></div><div><h3>Methods</h3><div>A prospective two-center cohort study, including 1) neonates with PN-need after intestinal surgery and 2) children (aged &lt;18y) with &gt;6 months PN-dependency. CIT, FGF19, and I-FABP were measured post-surgery in neonates. CIT, FGF19, total bile salts and C4 were assessed on inclusion in children with long-term PN-dependency. Associations were analyzed using Cox regression models. Longitudinal patterns were analyzed using linear mixed-effects models.</div></div><div><h3>Results</h3><div>Of 50 neonates, 52 % reached enteral autonomy. Residual small bowel length &lt;75 cm (hazard ratio 0.23, p = 0.046), but not CIT, FGF19 or I-FABP concentrations, was negatively associated with 60-day enteral autonomy. Children with SBS (n = 20) had dysregulated bile salt synthesis with lower FGF19 (24.4 vs 108.8 pg/mL, p = 0.004) and higher C4 concentrations (110.3 vs 30.9 pg/mL, p = 0.024) than children with functional IF (n = 20). In children with long-term PN, CIT concentration significantly increased with decreasing PN-dependency and total bile salt concentration significantly increased with increasing PN-duration.</div></div><div><h3>Conclusion</h3><div>Functional gut biomarkers provided no additional value in predicting enteral autonomy in neonates post-intestinal surgery over residual small bowel length. In children on long-term PN, enhanced bile salt synthesis was observed in those with SBS.</div></div><div><h3>Clinical trial registration</h3><div>Overview of Medical research in the Netherlands (OMON) NL-OMON27840 (previously NTR6080), <span><span>https://trialsearch.who.int/Trial2.aspx?TrialID=NL-OMON27840</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"53 ","pages":"Pages 168-176"},"PeriodicalIF":7.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018428","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}