Clinical nutrition最新文献

{"title":"Evidence-based dietary recommendations for patients with psoriasis: A systematic review","authors":"Qingyun Wang ,&nbsp;Jiao Wang ,&nbsp;Xiaoying Sun ,&nbsp;Liu Liu ,&nbsp;Miao Zhang ,&nbsp;Yuanting Yu ,&nbsp;Pengbo Gao ,&nbsp;Seokgyeong Hong ,&nbsp;Xin Li","doi":"10.1016/j.clnu.2025.02.005","DOIUrl":"10.1016/j.clnu.2025.02.005","url":null,"abstract":"<div><div>Psoriasis is a chronic recurrent inflammatory skin disease mediated by immune, genetic, and environmental factors. Numerous studies have demonstrated that the excessive consumption of certain pro-inflammatory foods, including alcohol, dairy products, high-sugar foods, and gluten, can exacerbate psoriasis. Thus, modifying one's dietary habits can alleviate psoriasis symptoms. However, high-quality evidence regarding the relationship between diet and psoriasis is currently lacking. This review provides insight into the dietary management of psoriasis by reviewing previous dietary therapies. An extensive search of the PubMed, Embase, and Cochrane databases for clinical studies of psoriasis and diet revealed that diets meeting Mediterranean, gluten-free, or calorie-restricted principles, dietary fiber, probiotic, prebiotic, and n-3 fatty acid contents may be associated with improved psoriasis outcomes. Additionally, patients with psoriasis should avoid consuming alcohol and high amounts of salt. Overall, based on findings from the current literature, this review aimed to guide dietary treatment options for patients with psoriasis.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 68-82"},"PeriodicalIF":6.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464157","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":"Glucosamine supplementation attenuates progression of metabolic dysfunction-associated steatotic liver disease and related comorbidities","authors":"Tom Ryu ,&nbsp;Young Chang ,&nbsp;Jeong-Ju Yoo ,&nbsp;Sae Hwan Lee ,&nbsp;Soung Won Jeong ,&nbsp;Sang Gyune Kim ,&nbsp;Young Seok Kim ,&nbsp;Hong Soo Kim ,&nbsp;Keungmo Yang ,&nbsp;Jae Young Jang","doi":"10.1016/j.clnu.2025.02.012","DOIUrl":"10.1016/j.clnu.2025.02.012","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>This study examines the impact of glucosamine on the progression and outcomes of metabolic dysfunction-associated steatotic liver disease (MASLD), and metabolic dysfunction and alcohol-associated liver disease (MetALD) using a large scale cohort.</div></div><div><h3>Methods</h3><div>Present study utilized inverse probability of treatment weighting (IPTW) to adjust for confounders in this cohort study. Participants were classified based on glucosamine use, and primary and secondary outcomes included all-cause mortality, liver cirrhosis, cardiovascular disease, cerebrovascular disease, and chronic kidney disease (CKD) incidences. Cox proportional hazards models were used to assess hazard ratios and 95 % confidence intervals.</div></div><div><h3>Results</h3><div>We found that glucosamine significantly reduces all-cause mortality in MASLD and MetALD cohorts after IPTW adjustment (<em>P</em> &lt; 0.001). Additionally, glucosamine use was associated with lower liver cirrhosis incidence in MASLD both before (<em>P</em> = 0.003) and after IPTW adjustment (<em>P</em> = 0.046). Glucosamine also decreased cardiovascular disease risk in MASLD (<em>P</em> &lt; 0.001) and MetALD (<em>P</em> = 0.037) cohorts, though it showed no significant impact on cerebrovascular disease incidence. Furthermore, glucosamine use was associated with a significantly lower incidence of CKD in the MASLD cohort (<em>P</em> = 0.034) and the entire cohort (<em>P</em> = 0.030), but not in the No steatotic liver disease cohort or MetALD cohort.</div></div><div><h3>Conclusion</h3><div>The findings suggest that glucosamine could be a beneficial supplementary therapy for managing steatotic liver diseases, particularly for patients at high risk for cardiovascular and renal complications. Further clinical trials are required to validate these potential benefits.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 119-128"},"PeriodicalIF":6.6,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143508321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral nutritional supplementation in cancer patients: A systematic review and dose–response meta-analysis","authors":"Sajedeh Habibi ,&nbsp;Sepide Talebi ,&nbsp;Darya Khosravinia ,&nbsp;Hamed Mohammadi","doi":"10.1016/j.clnu.2025.02.011","DOIUrl":"10.1016/j.clnu.2025.02.011","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>We performed this systematic review and dose–response meta-analysis of randomized clinical trials (RCTs) to determine the effects of oral nutritional supplements (ONS) in cancer patients undergoing chemo (radio) therapy on body weight, body mass index (BMI), serum albumin, fatigue, quality of life (QOL), patient-generated subjective global assessment (PG-SGA) score and C-reactive protein (CRP).</div></div><div><h3>Methods</h3><div>Appropriate search terms were used for systematic search in PubMed, Scopus, and Web of Science, till April 2024. Both pairwise and dose–response meta-analyses were done. Random effects model was applied for analyses.</div></div><div><h3>Results</h3><div>We found that ONS administration significantly improved weight gain [weighted mean difference (WMD): 1.18 kg; 95 % CI, 0.20 to 2.17, <em>P</em> = 0.019; <em>I</em>² = 56.2 %, <em>P</em>_{<em>Q-test</em>} = 0.002], fatigue scores [standard mean difference (SMD): −1.45; 95 % CI, −2.48 to −0.42, <em>P</em> = 0.006; <em>I</em>^<em>2</em> = 90.1 %, <em>P</em>_{<em>Q-test</em>}&lt; 0.001], PG-SGA scores (WMD: −1.11; 95 % CI, −2.93 to 0.70, <em>P</em> = 0.229; <em>I</em>^<em>2</em> = 72.4 %, <em>P</em>_{<em>Q-test</em>} = 0.001), and QOL (SMD: 1.38; 95 % CI, 0.45 to 2.31; <em>P</em> &lt; 0.001; <em>I</em>^<em>2</em> = 94.4 %, <em>P</em>_{<em>Q-test</em>}&lt; 0.001). The dose–response meta-analysis found a significant relationship between each 200 ml/d increase in ONS and improvement in fatigue (SMD: −7.30; 95 % CI, −10.17 to −4.42, P &lt; 0.001; <em>I</em>^<em>2</em> = 97 %, <em>P</em>_{<em>Q-test</em>}&lt; 0.001) and QOL scores (SMD:7.01; 95 % CI, 3.89 to 10.12, P = 0.001; <em>I</em>^<em>2</em> = 98.3 %, <em>P</em>_{<em>Q-test</em>} &lt; 0.001). Based on a non-linear dose–response meta-analysis, the most significant reduction in fatigue was observed at ONS dosages of ≥400 ml/day, while the most significant improvement in QOL score was seen at ≥ 500 ml/day dosages. Our analysis also showed a significant association between higher albumin levels and ONS intake of ≥200 ml daily.</div></div><div><h3>Conclusions</h3><div>In conclusion, ONS can help improve various cancer-related complications; however, further good-quality research is still needed. The study found that ONS significantly improves QoL, reduces fatigue, and promotes body weight gain in cancer patients. However, there were no significant effects on BMI, serum albumin, CRP, or PG-SGA scores.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 28-39"},"PeriodicalIF":6.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454810","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":"Obesity-related osteopontin protein and methylation blood levels are differentially modulated by a very low-calorie ketogenic diet or bariatric surgery","authors":"Paula M. Lorenzo ,&nbsp;Andrea G. Izquierdo ,&nbsp;Ignacio Sajoux ,&nbsp;Maitane Nuñez-Garcia ,&nbsp;Diego Gomez-Arbelaez ,&nbsp;M. Angeles Zulet ,&nbsp;Itziar Abete ,&nbsp;Javier Baltar ,&nbsp;Daniel de Luis ,&nbsp;Francisco J. Tinahones ,&nbsp;J. Alfredo Martinez ,&nbsp;Felipe F. Casanueva ,&nbsp;Ana B. Crujeiras","doi":"10.1016/j.clnu.2025.02.006","DOIUrl":"10.1016/j.clnu.2025.02.006","url":null,"abstract":"<div><h3>Background &amp; aim</h3><div>Osteopontin (OPN) was proposed to play a role in the pathophysiology of obesity and related disease, such as cancer. The aims were to evaluate the expression of OPN after caloric restriction-induced weight loss in adipose tissue (AT) from an animal model of diet-induced obesity (DIO) and to reflect these results on circulating OPN levels in patients with obesity (PWO); and to explore the effect of a very low-calorie ketogenic diet (VLCKD) on the circulating protein and DNA methylation levels of OPN, compared with a balanced hypocaloric diet (LCD) or bariatric surgery (BS) in PWO.</div></div><div><h3>Methods</h3><div>OPN/SPP1 expression was evaluated in subcutaneous (SAT) and visceral (VAT) AT derived from diet-induced obesity (DIO) mice and after a 4-week weight-loss protocol of calorie restriction (CR). Plasmatic OPN was also evaluated in 32 normal-weight volunteers (20 women) and 79 PWO (59 women) and after a 4–6 months follow up of a VLCKD (n = 20), BS (n = 39) or LCD (n = 20). DNA methylation levels of OPN were extracted from our Infinium HumanMethylation450 BeadChips data sets.</div></div><div><h3>Results</h3><div>OPN levels were higher in VAT of DIO mice and plasma of PWO than in normal-weight individuals and changed after weight loss. Particularly, circulating OPN increased 2 months after BS while it decreased at maximum ketosis-induced by VLCKD. A statistically significant decrease was also observed in methylation levels at cg11226901 after VLCKD.</div></div><div><h3>Conclusions</h3><div>OPN levels were reduced after VLCKD and severely increased after BS. Therefore, it could be a biomarker of the obesity-related metabolic stress and could be epigenetically regulated.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 40-49"},"PeriodicalIF":6.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic analysis of relationships between serum lipids with all-cause and cause-specific mortality: Evidence from prospective cohort studies of UK Biobank and Women's Health Initiative","authors":"Dongfang You ,&nbsp;Yingdan Tang ,&nbsp;Theis Lange ,&nbsp;Yaqian Wu ,&nbsp;Mengyi Lu ,&nbsp;Fang Shao ,&nbsp;Sipeng Shen ,&nbsp;Ruyang Zhang ,&nbsp;Hongwen Zhou ,&nbsp;Hongyang Xu ,&nbsp;Yongmei Yin ,&nbsp;Yongyue Wei ,&nbsp;Feng Chen ,&nbsp;Hongbing Shen ,&nbsp;David C. Christiani ,&nbsp;Yang Zhao","doi":"10.1016/j.clnu.2025.02.009","DOIUrl":"10.1016/j.clnu.2025.02.009","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Serum lipids, including lipoproteins, cholesterol, and triglycerides, are important modifiable factors influencing human health. However, the associations among different serum lipid profiles and mortality remain insufficiently understood, particularly regarding potential causality and population heterogeneity. This prospective study aims to systematically investigate the relationships between serum lipid concentrations of different densities and sizes with all-cause and cause-specific mortality.</div></div><div><h3>Methods</h3><div>Cox proportional and Fine–Gray subdistribution hazard models were applied to investigate the associations of 54 lipid concentrations with all-cause and cause-specific mortality (including cardiovascular disease (CVD), cancer, and respiratory disease) in the UK Biobank cohort of 441,448 individuals with 17-year follow-up. Cohorts of 120,967 and 44,168 individuals from the Women's Health Initiative (WHI) with 16-year follow-up and a large-scale meta-analysis were utilized for external replication. We further assessed the underlying causality using Mendelian randomization (MR) and possible modifiers using multiple subgroup analyses.</div></div><div><h3>Results</h3><div>During a median follow-up of 13.8 years, 39,290 deaths occurred, including 7399 from CVD, 18,928 from cancer, and 2707 from respiratory disease. We identified 160 significant associations between lipid concentrations and all-cause and cause-specific mortality. Importantly, most were inverse, with decreased lipid levels linked to increased risk of premature death [hazard ratios (HRs): 0.70–0.98 per standard deviation (SD)]. In contrast, positives were observed for HDL (large/very large) and triglyceride concentrations [HRs: 1.02–1.25 per SD], indicating increased mortality risk with higher levels. Most lipoproteins and cholesterol exhibited nonlinearly correlations with mortality, especially the significant U-shaped in total/HDL. However, MR showed that elevations in several lipids were associated with increased all-cause and CVD-specific mortality risk. Multiple subgroup analyses revealed that age, sex, and lipid-modifying drugs modified the lipid-mortality relationship; specifically, higher lipid concentrations increased mortality risk in younger adults not taking lipid-modifying drugs, but decreased mortality in older adults taking lipid-modifying drugs. The majority of associations were replicated in the WHI and external cohorts.</div></div><div><h3>Conclusion</h3><div>Our study systematically reported a large number of associations between serum lipid concentrations and mortality. Subgroup-based population heterogeneity analysis suggests that age, sex, and lipid-modifying drugs could be modifiers for the lipid-mortality relationship. These findings provide more guidance for lipid management and individualized prevention.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 94-102"},"PeriodicalIF":6.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479600","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":"Taurine levels and long-term adverse cerebrovascular risk in moyamoya disease: A prognostic perspective study","authors":"Zhiyao Zheng ,&nbsp;Chenglong Liu ,&nbsp;Siqi Mou ,&nbsp;Junsheng Li ,&nbsp;Qiheng He ,&nbsp;Wei Liu ,&nbsp;Bojian Zhang ,&nbsp;Zhikang Zhao ,&nbsp;Wei Sun ,&nbsp;Qian Zhang ,&nbsp;Rong Wang ,&nbsp;Yan Zhang ,&nbsp;Dong Zhang ,&nbsp;Peicong Ge","doi":"10.1016/j.clnu.2025.02.008","DOIUrl":"10.1016/j.clnu.2025.02.008","url":null,"abstract":"<div><h3>Background</h3><div>Taurine has been proven to play a significant role in cardiovascular and cerebrovascular diseases, but its relationship with moyamoya disease (MMD) remains unclear. This study aims to investigate the association between serum taurine levels and long-term adverse cerebrovascular events in patients with MMD after revascularization.</div></div><div><h3>Methods</h3><div>This study involved 352 patients with MMD, from whom comprehensive clinical data and blood samples were collected. Serum taurine levels were measured using liquid chromatography-tandem mass spectrometry, and the relationship between serum taurine concentration and various blood indices was evaluated. Cerebrovascular adverse events included transient ischemic attack, ischemic stroke, and hemorrhagic stroke. Taurine, analyzed as a continuous variable, was found to predict a cut-off for postoperative cerebrovascular adverse events in MMD patients at 842.52 μmol/L. The impact of serum taurine levels on the risk of cerebrovascular events was analyzed using Kaplan–Meier (KM) curves, and univariate and multivariate Cox regression analyses were performed to identify predictive factors for postoperative prognosis.</div></div><div><h3>Results</h3><div>Grouping MMD patients by serum taurine levels revealed that higher taurine levels were significantly associated with a lower proportion of hemorrhagic MMD (p = 0.044). Compared with ischemic MMD, patients with hemorrhagic MMD had lower taurine concentrations (p = 0.005). KM curves showed that the incidence of postoperative cerebrovascular adverse events in the high taurine group was significantly lower than in the low taurine group (p = 0.026). Univariate Cox regression analysis indicated that higher taurine concentrations significantly reduced the risk of postoperative cerebrovascular adverse events (Hazard Ratio [HR] = 0.334, 95 % Confidence Interval [CI] = 0.121–0.923, p = 0.035). Furthermore, the multivariate Cox regression model confirmed that taurine level is an independent predictor of long-term adverse cerebrovascular events, with the high concentration group showing a significantly reduced risk.</div></div><div><h3>Conclusions</h3><div>Low serum taurine levels are associated with a higher risk of long-term adverse cerebrovascular events following MMD revascularization. This suggests the significant potential of serum taurine as a prognostic biomarker for postoperative outcomes.</div></div><div><h3>Clinical trial registry number</h3><div>URL: <span><span>https://www.chictr.org.cn/</span><svg><path></path></svg></span>. Unique identifier: ChiCTR2200061889.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 83-93"},"PeriodicalIF":6.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143471452","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":"Comment on “ESPEN guidelines on nutrition and hydration”","authors":"Pinar Soysal,&nbsp;Cihan Heybeli","doi":"10.1016/j.clnu.2025.02.010","DOIUrl":"10.1016/j.clnu.2025.02.010","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 52-53"},"PeriodicalIF":6.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464076","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":"Muscle mass mediates the association between dietary diversity and mortality among the older adults: A prospective cohort study","authors":"Xiaotong Li,&nbsp;Fengdan Wang,&nbsp;Ruirui Guo,&nbsp;Yan Liu,&nbsp;Zibo Wu,&nbsp;Yu Han,&nbsp;Jing Zhao,&nbsp;Sitong Xin,&nbsp;Bo Li","doi":"10.1016/j.clnu.2025.02.004","DOIUrl":"10.1016/j.clnu.2025.02.004","url":null,"abstract":"<div><h3>Aims</h3><div>The association between dietary diversity and increased mortality risk is well-documented. However, it remains unclear whether and to what extent dietary diversity affects mortality through appendicular skeletal muscle mass (ASM). Therefore, we assessed whether ASM mediated the association between dietary diversity and mortality.</div></div><div><h3>Methods</h3><div>We used data from the Chinese longitudinal healthy longevity survey (CLHLS) (2011–2018). The baseline Dietary Diversity Score (DDS) was derived from 9 food items, and the Anti-inflammatory Dietary Diversity Score (AIDDS) was used to assess the diversity of anti-inflammatory foods in the diet. Cox regression models were employed to estimate the association of DDS and AIDDS with mortality. Interaction analysis was performed to analyze the association between DDS, AIDDS, and ASM in different groups. Subsequently, mediation analysis was performed to examine whether ASM partly accounted for the association.</div></div><div><h3>Results</h3><div>A total of 5422 participants (average age 85.99 years) were included in the analysis. Among them, 3241 participants died during the follow-up period. We observed that participants with higher DDS (HR = 0.907, 95 % CI: 0.842–0.977) and AIDDS scores (HR = 0.947, 95 % CI: 0.917–0.977) had lower mortality rates. Subgroup analyses showed no interaction between DDS, AIDDS, and ASM (<em>p</em> for interaction&gt;0.05). ASM mediated the 14.0 % association between DDS and mortality, and the 10.7 % association between AIDDS and mortality.</div></div><div><h3>Conclusions</h3><div>Dietary diversity and anti-inflammatory dietary diversity could reduce mortality risk and promote longevity in older adults. The association between these factors was partially mediated by an increase in muscle mass among older adults.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 21-27"},"PeriodicalIF":6.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444595","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 new concept to establish protein requirements","authors":"Nicolaas E.P. Deutz ,&nbsp;Robert R. Wolfe ,&nbsp;Mariëlle P.K.J. Engelen","doi":"10.1016/j.clnu.2025.02.002","DOIUrl":"10.1016/j.clnu.2025.02.002","url":null,"abstract":"<div><div>There is an increased need to establish the protein requirements for body weight maintenance and optimal health in humans. Different methods were developed in the past to assess protein requirements in which known amounts of protein/amino acids were provided. The purpose of this paper is to propose a new concept of establishing protein requirements in healthy and diseased conditions using a novel stable isotope approach.</div><div>In the past years, we consistently found that when using a novel stable isotope pulse approach the intracellular production of amino acids (i.e., phenylalanine and tyrosine) is more than double the plasma rate of appearance, as measured by the commonly used primed constant infusion approach, leading to a net protein breakdown that is more than twice than estimated in the past. Net protein breakdown in the fasted state may provide a good estimation of the actual net protein loss that would take place during the day and thus can be used to estimate daily protein requirements. Our recent study found that a net protein breakdown ∼1 g protein/kg body weight/day was equal to the habitual protein intake, suggesting that there is a relation between habitual protein intake and protein requirements. As net protein breakdown is lower with advanced aging and in patient populations with comorbidities, a lower protein requirement for body weight maintenance is suggested.</div><div>We propose a new concept to establish actual protein requirements of healthy and disease conditions, using a pulse tracer administration and to consider individual habitual protein intake and health conditions.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"48 ","pages":"Pages 1-5"},"PeriodicalIF":6.6,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628456","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":"Serum tryptophan and kynurenine levels and risk of heart failure among patients with chronic kidney disease","authors":"Sara Mohiti ,&nbsp;Jacob Christensen ,&nbsp;Nino E. Landler ,&nbsp;Ida MH. Sørensen ,&nbsp;Jesper Qvist Thomassen ,&nbsp;Sasha S. Bjergfelt ,&nbsp;Ditte Hansen ,&nbsp;Bo Feldt-Rasmussen ,&nbsp;Susanne Bro ,&nbsp;Mehrangiz Ebrahimi-Mameghani ,&nbsp;Tor Biering-Sørensen ,&nbsp;Line S. Bisgaard ,&nbsp;Christina Christoffersen","doi":"10.1016/j.clnu.2025.01.028","DOIUrl":"10.1016/j.clnu.2025.01.028","url":null,"abstract":"<div><h3>Background and aims</h3><div>Chronic kidney disease (CKD) is often complicated by heart failure (HF), leading to increased mortality. Emerging evidence suggests that Tryptophan metabolites, through the Kynurenine pathway (KP), play a significant role in HF pathophysiology. Therefore, we explored the association of Tryptophan (TRP), Kynurenine (KYN), and the Kynurenine to Tryptophan ratio (KTR) with HF in CKD, hypothesizing a link between KP alterations and HF occurrence in this population.</div></div><div><h3>Methods</h3><div>673 non-dialysis patients aged 30 to 75 with CKD stages 1–5 were included. Incident HF data were collected through medical record reviews, and the median follow-up time was 3.9 years. Serum concentrations of KYN and TRP were measured using High-Performance Liquid Chromatography (HPLC).</div></div><div><h3>Results</h3><div>Patients with more advanced stages of CKD had higher levels of KYN and KTR, and lower levels of TRP (p &lt; 0.001). Following adjustments for age, sex, BMI, hypertension, and hypercholesterolemia, serum KYN and KTR remained significantly associated with prevalent HF in patients with CKD (p = 0.012, p = 0.028 respectively). Furthermore, Cox-regression analysis indicated that KTR concentration was associated with incident HF after adjusting for confounders such as age, sex, BMI, hypertension, hypercholesterolemia and diabetes (p = 0.019).</div></div><div><h3>Conclusion</h3><div>In conclusion, the present analysis suggests that changes in the kynurenine pathway may be a new biomarker for HF in patients with CKD. Thus, KTR concentration might be associated with prevalent and future HF in patients with CKD. Further research is needed to understand the mechanisms and potential of these metabolites in refining HF risk prediction and prevention in CKD patients.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 14-20"},"PeriodicalIF":6.6,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143438122","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}