Clinical nutrition最新文献

{"title":"Utility of phase angle in children with intestinal failure","authors":"Dianna Yanchis ,&nbsp;Abina Chandrakumar ,&nbsp;Stephanie So ,&nbsp;Catherine Patterson ,&nbsp;Christina Belza ,&nbsp;Carina Silva ,&nbsp;Elizabeth Garofalo ,&nbsp;Sylvia Wong-Sterling ,&nbsp;Yaron Avitzur ,&nbsp;Paul W. Wales ,&nbsp;Yuxuan Li ,&nbsp;Janice Bowers ,&nbsp;Jessie M. Hulst ,&nbsp;Glenda Courtney-Martin","doi":"10.1016/j.clnu.2025.07.017","DOIUrl":"10.1016/j.clnu.2025.07.017","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Bioelectrical impedance analysis-derived phase angle has been gaining attention in clinical research as a potential biomarker of cell membrane integrity, which may reflect aspects of nutritional status, muscle quality, and overall cellular health. Although phase angle has been associated with various conditions, including malnutrition and reduced strength, it is not currently established as a definitive tool for assessing these outcomes. Rather, it is considered an indirect indicator, with lower values suggesting potential alterations in cell membrane function that may occur in the context of disease or malnutrition. The aims of this study were to 1) compare bioelectrical impedance analysis-derived phase angle in children with intestinal failure to that of healthy literature controls; 2) examine the relationship between phase angle and nutritional status variables in this cohort of children with intestinal failure.</div></div><div><h3>Methods</h3><div>Prospective descriptive cross-sectional study in a cohort of children 1–18 years with intestinal failure. Phase angle was calculated from reactance and resistance values derived from bioelectrical impedance analysis measurements as follows: [arctangent (Reactance/Resistance) x 180°/π]. Anthropometric measurements including weight, height, mid-upper arm circumference and triceps skinfold thickness, and mid-upper arm muscle circumference was calculated. Body composition was measured by dual energy X-ray absorptiometry as part of routine monitoring. Strength and physical activity were assessed by handgrip strength and accelerometry, respectively. Data on subject characteristics were collected. Two-sample t-test was used to compare phase angle of children with intestinal failure to healthy age and sex matched literature controls. Regression analysis was used to assess the relationship between phase angle and nutritional status variables.</div></div><div><h3>Results</h3><div>Sixty-eight children with intestinal failure, mean age 8.9 ± 4.2 years, 25 dependent on parenteral nutrition were studied. Children with intestinal failure had lower phase angle compared to literature controls (5.0 vs 6.0, p &lt; 0.001). Phase angle scores were found to be significantly associated with mid-upper arm circumference (r² = 0.27, p = 0.002), handgrip strength (r² = 0.29, p = 0.003), and mid-upper arm muscle circumference (r² = 0.29, p &lt; 0.001). All relationships were positively mediated by age.</div></div><div><h3>Conclusions</h3><div>These findings suggest that phase angle may provide valuable insights into muscle mass and strength aspects of health beyond conventional assessments, but further study is required before incorporating it into clinical practice for assessing children with intestinal failure.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"52 ","pages":"Pages 94-102"},"PeriodicalIF":7.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738517","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":"Association between computed tomography-based adipose tissue parameters and liver transplant outcomes in patients with hepatocellular carcinoma","authors":"Zhihang Hu ,&nbsp;Hao Chen ,&nbsp;Zuyuan Lin ,&nbsp;Chiyu He ,&nbsp;Wei Shen ,&nbsp;Huigang Li ,&nbsp;Zhe Yang ,&nbsp;Jinzhen Cai ,&nbsp;Shusen Zheng ,&nbsp;Di Lu ,&nbsp;Xiao Xu","doi":"10.1016/j.clnu.2025.07.015","DOIUrl":"10.1016/j.clnu.2025.07.015","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>The prognostic value of skeletal muscle in liver transplant recipients with hepatocellular carcinoma (HCC) has been documented; however, the role of adipose tissue remains ambiguous. This study aimed to evaluate the association between adipose tissue and transplant outcomes in patients with HCC.</div></div><div><h3>Methods</h3><div>A total of 765 patients with HCC who underwent liver transplantation (LT) at 3 transplant centers were included in this retrospective study. Computed tomography (CT) scans were utilized to quantify the area and radiodensity of visceral and subcutaneous adipose tissue. Cut-off values for adipose tissue parameters were determined based on tertiles. The Cox proportional hazards models were established to identify the predictors of overall survival (OS) and tumor recurrence.</div></div><div><h3>Results</h3><div>Median age at transplant was 53 years, most were male (89.0 %) and cirrhotic (91.7 %). The median follow-up was 40.3 months. In univariate survival analysis, patients with high subcutaneous adipose tissue radiodensity (SATr) (&gt;−86.5 HU) exhibited significantly lower 5-year OS rates than those with low SATr (49.9 % vs. 65.3 %, <em>P</em> &lt; 0.001). Adjusted analyses revealed that high SATr independently predicted increased mortality (HR, 1.498; 95 % CI, 1.175–1.909; <em>P</em> = 0.001). SATr significantly increased during the first month postoperatively (<em>P</em> &lt; 0.001), with one-third of the patients exhibiting an SATr change rate exceeding 10 %. An increase in SATr &gt;10 % was independently associated with poorer OS (HR, 1.549; 95 % CI, 1.095–2.190; <em>P</em> = 0.013) and higher recurrence risk (HR, 1.776; 95 % CI, 1.242–2.540; <em>P</em> = 0.002).</div></div><div><h3>Conclusion</h3><div>Higher preoperative SATr was an independent predictor of patient mortality after LT for HCC. Postoperatively, a SATr increase &gt;10 % during the first month was independently associated with elevated risk of mortality and tumor recurrence.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"52 ","pages":"Pages 82-93"},"PeriodicalIF":7.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144725016","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":"Prevalence and predictive importance for short-term clinical outcomes of GLIM-defined malnutrition among adult inpatients: A nationwide cross-sectional study","authors":"Yan Liu ,&nbsp;Yu Wang ,&nbsp;Gaiyun Chen ,&nbsp;Pianhong Zhang ,&nbsp;Zhenqian Cheng ,&nbsp;Shiping Liu ,&nbsp;Zengning Li ,&nbsp;Wenjun Ma ,&nbsp;Ying Yao ,&nbsp;Fan Lin ,&nbsp;Ping Sun ,&nbsp;Wanying Shi ,&nbsp;Hua Jiang ,&nbsp;Xianghua Ma ,&nbsp;Weilian Hou ,&nbsp;Ting Han ,&nbsp;Ying Zhang ,&nbsp;Ji Feng ,&nbsp;Yi Liang ,&nbsp;Yongsheng Zhang ,&nbsp;Wei Chen","doi":"10.1016/j.clnu.2025.07.013","DOIUrl":"10.1016/j.clnu.2025.07.013","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Malnutrition is a significant health issue in hospital settings, with persistent diagnostic challenges. Despite the Global Leadership Initiative on Malnutrition (GLIM) criteria providing a standardised approach, nationwide validation and implementation remain limited. We aimed to estimate the national prevalence of GLIM-defined malnutrition among Chinese adult inpatients and assess the predictive value of the GLIM criteria for short-term clinical outcomes.</div></div><div><h3>Methods</h3><div>We conducted the China Nutrition Fundamental Data 2022 project among adult inpatients from 322 sites across 31 provinces in China between February and October 2023. Malnutrition was defined using the GLIM criteria through a standardised two-step process. The clinical outcomes included discharge outcomes, length of stay, hospitalisation costs, and 30-day mortality. We used logistic and multiple linear regression analyses to examine the association between malnutrition severity and clinical outcomes.</div></div><div><h3>Results</h3><div>The final analysis included 61,283 individuals. Malnutrition was prevalent in 24.6 % of the inpatients (moderate malnutrition: 13.8 %; severe malnutrition: 10.8 %). A dose–response relationship was observed between malnutrition severity and adverse clinical outcomes: moderate and severe malnutrition increased the risk of ineffective discharge outcomes by 1.533 (95 % CI: 1.362–1.725) and 2.200 (1.958–2.473) times, respectively, and 30-day mortality by 1.875 times (1.408–2.496) and 3.065 (2.332–4.028) times, respectively. Additionally, moderate and severe malnutrition were linked to a 0.97-day and 1.20-day increases in hospital stays, respectively.</div></div><div><h3>Conclusions</h3><div>Malnutrition is prevalent among adult Chinese inpatients and strongly associated with adverse clinical outcomes. GLIM-based assessments and interventions are essential to reduce the burden of malnutrition.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"52 ","pages":"Pages 72-81"},"PeriodicalIF":6.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711473","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":"Hydroxytyrosol supplementation improves antioxidant and anti-inflammatory status in individuals with overweight and prediabetes: A randomized, double-blind, placebo-controlled parallel trial","authors":"Ignacio Moratilla-Rivera ,&nbsp;Jara Pérez-Jiménez ,&nbsp;Sonia Ramos ,&nbsp;María Puy Portillo ,&nbsp;María Ángeles Martín ,&nbsp;Raquel Mateos","doi":"10.1016/j.clnu.2025.07.006","DOIUrl":"10.1016/j.clnu.2025.07.006","url":null,"abstract":"<div><h3>Background &amp; aim</h3><div>Hydroxytyrosol (HT), an olive-derived phenolic compound, possesses well-known antioxidant and anti-inflammatory properties. While its benefits in healthy individuals and as part of extra virgin olive oil are well studied, its preventive role as a dietary supplement in at-risk populations remains less explored. This study investigates the potential of HT supplementation in preventing aging-related diseases in overweight individuals with prediabetes.</div></div><div><h3>Methods</h3><div>A randomized, double-blind, placebo-controlled trial was conducted in adults with overweight and prediabetes (40–70 years). For 16 weeks, volunteers consumed either 15 mg of HT or a placebo daily. The primary outcome were oxidized LDL (oxLDL) levels, while secondary outcomes included biochemical and metabolic parameters, oxidative stress and inflammation biomarkers, and lifestyle assessments. Compliance was verified through urinary HT-3′-sulphate levels.</div></div><div><h3>Results</h3><div>A total of 52 participants were recruited and randomized, with 49 completing the study. They were then allocated to either the HT-treated group (n = 24) or the placebo group (n = 25). Compliance was confirmed, as the HT-supplemented group showed increased urinary HT-3′-sulphate levels, whereas the placebo group exhibited a significant decrease (<em>p</em> = 0.039). Compared with placebo, HT supplementation significantly reduced oxLDL levels (<em>p</em> = 0.045), protein carbonyls (<em>p</em> = 0.031), and 8-OHdG (<em>p</em> &lt; 0.01). Additionally, it prevented a decline in total antioxidant status (<em>p</em> &lt; 0.01) and GPx activity (<em>p</em> &lt; 0.01). An anti-inflammatory effect was also observed, with reduced IL-6 levels (<em>p</em> = 0.05). No significant changes were found in lipid profile, anthropometric parameters, or lifestyle factors such as sleep, mental well-being, or physical capacity. No adverse events were observed throughout the intervention.</div></div><div><h3>Conclusion</h3><div>Chronic supplementation with 15 mg/day of HT for 16 weeks significantly improved antioxidant and anti-inflammatory status in individuals with overweight and prediabetes, suggesting a potential preventive role against aging-related diseases.</div></div><div><h3>Registration number of Clinical Trial</h3><div>NCT 06295913 (<span><span>https://clinicaltrials.gov/study/NCT06295913?intr=Hydroxytyrosol&amp;amp;page=2&amp;amp;rank=1</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"52 ","pages":"Pages 17-26"},"PeriodicalIF":6.6,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665712","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":"Questioning skeletal muscle index for muscle mass reduction assessment in computed tomography: Why square the height?","authors":"Joris Giai ,&nbsp;Mélanie Veloso ,&nbsp;Antoine Vilotitch ,&nbsp;Katia Charrière ,&nbsp;Cécile Bétry","doi":"10.1016/j.clnu.2025.07.010","DOIUrl":"10.1016/j.clnu.2025.07.010","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Computes Tomography (CT) scans are commonly used to assess muscle mass reduction by measuring skeletal muscle area (SMA) at the third lumbar vertebra (L3) level. The skeletal muscle index (SMI), which normalizes SMA by height squared, is the current reference standard for evaluating muscle mass reduction. However, recent studies suggest that SMI may not be the most reliable indicator due to its height dependency. This study aimed to assess the clinical relevance of different SMA-derived metrics to determine the most accurate measure of muscle mass reduction.</div></div><div><h3>Methods</h3><div>This retrospective study included inpatients from a tertiary hospital who underwent abdominal CT scans. Skeletal muscle area (SMA) was measured using an AI-based software. The study population was divided into four groups based on age (≤40 years and &gt;40 years) and gender. Four SMA-derived metrics were evaluated: SMI, skeletal muscle height (SMH, calculated as SMA divided by height), and Z-scores for both SMI and SMH (z(SMI) and z(SMH)). Pearson correlations between SMA-derived metrics and age, BMI, and height were calculated, alongside regression models to determine the optimal height scaling power.</div></div><div><h3>Results</h3><div>The study included 674 participants (362 males, 312 females), with a median age of 61 years and body mass index (BMI) of 24.7 kg/m². BMI positively correlated with SMA, SMH, and SMI, but not with z(SMH) or z(SMI). SMH showed no significant correlation with height, except in males over 40. Linear regression for participants under 40 revealed height scaling coefficients of 1.547 (95 % CI: [0.736, 2.359]) for females and 0.982 (95 % CI: [0.047, 1.917]) for males.</div></div><div><h3>Conclusion</h3><div>SMH could be a more suitable metric than SMI for assessing muscle mass reduction in CT scans, particularly due to its better independence from height. We emphasize the importance of clear terminology and recommend adopting “SMH” for SMA divided by height, to differentiate it from SMI in future studies.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"52 ","pages":"Pages 1-7"},"PeriodicalIF":6.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653701","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":"Characterising the diversity of plant-based food and beverage consumption in adults, and exploring associations with cardiometabolic health outcomes: A cross-sectional study","authors":"Alice C. Creedon,&nbsp;Leah Foyle,&nbsp;Natalie McCall,&nbsp;Mary Gracia Arulpragasam,&nbsp;Rachel Gibson,&nbsp;Eirini Dimidi","doi":"10.1016/j.clnu.2025.07.011","DOIUrl":"10.1016/j.clnu.2025.07.011","url":null,"abstract":"<div><h3>Background and aims</h3><div>A growing body of evidence indicates plant-based food diversity as a potential target for improvement of diet-related health outcomes. This study aimed to characterize the quantity and diversity of plant-based foods consumed in the UK and explore associations between plant-based food diversity and cardiometabolic health outcomes.</div></div><div><h3>Methods</h3><div>Cross-sectional data from the UK National Diet and Nutrition Survey Rolling Programme Year 9 (2016/2017) was analysed. Plant-based food quantity (g/d) and diversity (number of discrete plant foods consumed; counts/d) from all plant food sub-groups (fruits, vegetables, grains, herbs, spices, nuts, seeds, fats, oils, beverages), and diet quality (Nutrient Rich Foods index) were determined from 4-day food diaries. Demographic and health outcome data (BMI, blood pressure, blood lipids, glycated haemoglobin (HbA1c)) were collected at nurse visits. Daily diversity count was categorised into terciles. Multiple regression models were conducted to identify predictors of plant-based food diversity, and associations between diversity and cardiometabolic health outcomes.</div></div><div><h3>Results</h3><div>Overall, 677 adults were included. Median quantity and diversity of plant-based food intake were 999.3 g/d (IQR 771.6 g/d) and 8.0 counts/d (IQR 3.8 counts/d), and diversity terciles were low (5.5, IQR 1.8 counts/d), moderate (8.1, IQR 1.3 counts/d), and high (11.0, IQR 2.3 counts/d). Plant-based food diversity was positively correlated with diet quality (Spearman's r = 0.265, <em>p</em> &lt; 0.001). Higher educational attainment, annual income and vegetarian dietary pattern were predictive of higher diversity (adjusted <em>R</em>^<em>2</em> = 0.206; <em>p</em> &lt; 0.001). Higher diversity was associated with higher HDL cholesterol (<em>B</em> = 0.029 mmol/L; 95%CI: 0.01, 0.05; <em>p</em> = 0.003), and lower total:HDL ratio (<em>B</em> = −0.07; 95%CI: −0.13, −0.01; <em>p</em> = 0.023) and HbA1c (<em>B</em> = −0.57 mmol/mol; 95%CI: −1.02, −0.13; <em>p</em> = 0.013), however models were no longer significant following adjustment for BMI.</div></div><div><h3>Conclusions</h3><div>Increasing plant-based food diversity is a potential target for diet quality improvement at population level, with benefits for cardiometabolic health outcomes that warrant further investigation in human trials.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"52 ","pages":"Pages 47-61"},"PeriodicalIF":7.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722904","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":"Arvid Wretlind Lecture 2024 optimal nutrition in critically ill children: Could less be more?","authors":"Koen F. Joosten","doi":"10.1016/j.clnu.2025.07.009","DOIUrl":"10.1016/j.clnu.2025.07.009","url":null,"abstract":"<div><div>This article reflects my journey over the past several decades in challenging the long-held dogma that critically ill children should receive aggressive nutritional support—particularly high protein intake—early in the course of illness to counteract catabolism and promote anabolism. For many years, this belief dominated clinical practice, under the assumption that early and maximal nutritional delivery would improve outcomes in this vulnerable population.</div><div>However, as new evidence began to emerge, this approach was called into question. The multicenter PEPaNIC (Early versus Late Parenteral Nutrition in the Pediatric Intensive Care Unit) randomized controlled trial was a pivotal step in addressing this issue. By investigating causality, the trial demonstrated that early supplementation of insufficient or contraindicated enteral nutrition with parenteral nutrition during the first week of admission to the pediatric intensive care unit (PICU) did not lead to improved clinical outcomes. In contrast, tolerating a temporary macronutrient deficit appeared to be both safe and potentially beneficial, challenging the foundational assumptions of early aggressive nutritional intervention.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"51 ","pages":"Pages 373-380"},"PeriodicalIF":6.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144634110","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":"Burden of negative energy balance in anorexia nervosa: Role of circadian rhythm, mitochondrial dynamics, microbiota–gut–brain axis and their interactions","authors":"Léna Rousseau ,&nbsp;Colin Salaün ,&nbsp;Ludovic Langlois ,&nbsp;Najate Achamrah ,&nbsp;Moïse Coëffier","doi":"10.1016/j.clnu.2025.07.002","DOIUrl":"10.1016/j.clnu.2025.07.002","url":null,"abstract":"<div><div>Anorexia nervosa (AN) is a chronic eating disorder that often requires prolonged hospitalisation for effective treatment. As a multifactorial disease, many environmental, psychiatric, and biological factors impede recovery, creating a vicious circle of anorexia, gastrointestinal disorders, and anxiety-depressive disorders. Individuals with AN often exhibit inappropriate physical activity, sleep disturbances, alterations in circadian hormonal profiles, disruption of the gut barrier, dysbiosis of the gut microbiota, oxidative stress, and alterations in brain function. The aim of this review is to provide a non-exhaustive overview of the biological factors involved to gain a deeper understanding of the pathophysiology of AN and to identify potential targets for clinical cure. We have chosen to describe the interconnected factors of gut microbiota, circadian rhythm, mitochondria, and brain alterations. Indeed, clinical and experimental data allow the establishment of relationships between these altered factors. Sleep disorders and brain changes have been linked to cognitive alterations, mood disorders, and disrupted feeding behaviour. Compulsive exercise behaviour has been associated with a negative energy balance, but adapted physical activity may confer protection against certain comorbidities. Circadian rhythm may be associated with mitochondrial dysfunction, sleep disorders, and physical activity. Mitochondrial dysfunction could lead to putative neuroinflammation, causing a reduction in grey matter volume. The gut microbiota, which exhibits circadian variations, interacts with both homeostatic and hedonic food intake regulation, and is associated with mitochondrial function and physical activity. Better understand all this relationship in anorectic conditions is an important issue to open new therapeutic strategies.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"52 ","pages":"Pages 27-45"},"PeriodicalIF":6.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665711","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 effect of oral feeding on gastrointestinal function, motility and appetite-regulating hormones, insulin, glucose and satiety in normal weight individuals and those with obesity","authors":"Elizabeth J. Simpson ,&nbsp;Sarah Althubeati ,&nbsp;Sally Cordon ,&nbsp;Caroline Hoad ,&nbsp;Debbie Bush ,&nbsp;Sally Eldeghaidy ,&nbsp;Penny A. Gowland ,&nbsp;Ian A. Macdonald ,&nbsp;Dileep N. Lobo","doi":"10.1016/j.clnu.2025.07.008","DOIUrl":"10.1016/j.clnu.2025.07.008","url":null,"abstract":"<div><h3>Background and aims</h3><div>The primary aim of this study was to evaluate the effect of ingestion of a standardized meal on gastric content volume and gastric emptying time in healthy normal weight people and those with obesity. Secondary aims were to evaluate the effect of the meal on superior mesenteric artery blood flow, small bowel water content, subjective satiety, and concentrations of appetite and motility-regulating hormones (PYY, ghrelin, GLP-1, and GLP-2), blood glucose and insulin in the participants.</div></div><div><h3>Methods</h3><div>Ten normal weight male participants and ten with obesity were recruited. After fasted measurements participants consumed a test meal [∼500 g portion, 145 kcal (606 kJ)/100 g]. T₅₀ gastric emptying time, gastric content volume, superior mesenteric artery blood flow and small bowel water content were measured using magnetic resonance imaging. Blood PYY, ghrelin, GLP-1, GLP-2, insulin and glucose were measured along with composite satiety scores. Measurements were repeated at regular intervals for up to 300 min<em>.</em></div></div><div><h3>Results</h3><div>At screening, there were no differences between the groups apart from greater body weight and body mass index in those with obesity. Median ± SD T₅₀ gastric emptying time was not different between normal weight participants and those with obesity (148 ± 16 min vs. 170 ± 15 min, respectively, <em>P</em> = 0.87). Gastric content volume, blood glucose, PYY, ghrelin, active GLP-1 and total GLP-2 concentrations, superior mesenteric artery blood flow, and small bowel water content, when fasted and in response to eating did not differ between groups (all <em>P</em> &gt; 0.05). Repeated measures ANOVA showed no difference in postprandial blood glucose concentrations (<em>P</em> = 0.486) over time between the groups, but postprandial serum insulin was significantly higher (<em>P</em> = 0.015) in those with obesity. Composite satiety scores were significantly higher in the normal weight group immediately after eating and in the postprandial period (<em>P</em> = 0.015).</div></div><div><h3>Conclusion</h3><div>Lower meal-stimulated satiety in males with obesity could lead to greater habitual dietary intake and further weight gain and, therefore, be an important driver for the maintenance of obesity in individuals without comorbidities.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"52 ","pages":"Pages 62-71"},"PeriodicalIF":6.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711472","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":"Plasma kynurenine pathway metabolites in association with diabetes: A cross-sectional study","authors":"Yingjun Mu ,&nbsp;Zijian Gu ,&nbsp;Qingyao Wang ,&nbsp;Xudong Wang ,&nbsp;Jiayao Zhu ,&nbsp;Junyao Huang ,&nbsp;Qiaoliang Huang ,&nbsp;Hui Zuo","doi":"10.1016/j.clnu.2025.07.003","DOIUrl":"10.1016/j.clnu.2025.07.003","url":null,"abstract":"<div><h3>Background</h3><div>Abnormalities of the kynurenine pathway of tryptophan catabolism have been linked with an increased risk of cardiovascular disease. However, the association between kynurenine pathway metabolism and diabetes remains unclear.</div></div><div><h3>Methods</h3><div>We conducted a secondary analysis of the baseline data of 796 adults from the Prospective Follow-up Study on Cardiovascular Morbidity and Mortality in China (PFS-CMMC). Plasma kynurenine pathway metabolites, including tryptophan, kynurenine, kynurenic acid (KA), 3-hydroxykynurenine (3-HK), anthranilic acid (AA), 3-hydroxyanthranilic acid (3-HAA), xanthurenic acid (XA), 2-ketoadipic acid (2-KAA), and nicotinamide, were measured by ultrahigh performance liquid chromatography tandem mass spectrometry. Unconditional logistic regression analyses were used to calculate odds ratios (ORs) and their 95 % confidence intervals (CIs).</div></div><div><h3>Results</h3><div>After adjustment for all confounders, three metabolites were positively associated with increased odds of diabetes. The OR (95 % CI) for the highest compared with the lowest quartile was 2.07 (1.16, 3.78) for 3-HAA, 3.56 (1.93, 6.83) for 2-KAA, and 1.82 (1.01, 3.35) for nicotinamide (all <em>P</em> trend &lt;0.05). In contrast, participants in the fourth quartile of tryptophan levels had reduced odds of diabetes when compared to those in the first quartile (OR: 0.39, 95 % CI: 0.21, 0.72; <em>P</em> trend = 0.007). No significant associations were observed for plasma kynurenine, KA, 3-HK, AA, or XA.</div></div><div><h3>Conclusions</h3><div>Increased plasma 3-HAA, 2-KAA, and nicotinamide were associated with higher odds of diabetes, whereas higher levels of tryptophan were associated with lower odds of diabetes in the community-dwelling population. Our findings suggest that the kynurenine pathway metabolites may be involved in the pathophysiology of diabetes.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"51 ","pages":"Pages 342-348"},"PeriodicalIF":6.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611881","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}