Clinical nutrition最新文献

{"title":"Effect of red meat consumption on cardiovascular risk factors: A systematic review and Bayesian network meta-analysis of randomized controlled trials","authors":"Miguel López-Moreno ,&nbsp;José Francisco López-Gil ,&nbsp;Alfredo Bravo-Sánchez ,&nbsp;Gabriele Bertotti ,&nbsp;Alberto Roldán-Ruiz","doi":"10.1016/j.clnu.2025.09.001","DOIUrl":"10.1016/j.clnu.2025.09.001","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>The role of red meat in cardiovascular risk remains controversial. The aim of this systematic review and Bayesian network meta-analysis (NMA) of randomized controlled trials (RCTs) was to investigate the effects of red meat consumption on cardiovascular risk factors concerning different comparison foods.</div></div><div><h3>Methods</h3><div>A systematic search of RCTs was conducted from the inception to April 2024. Studies compared diets containing red meat to those replacing red meat with various foods. Comparison diets were classified into high-quality plant protein sources, animal protein, mixed animal and plant protein and carbohydrates. The effects of the dietary interventions on cardiovascular parameters were evaluated using a random-effects NMA, with an analysis of interactions between the intervention and control groups. The outcomes were the mean changes in blood lipids, blood pressure, and C-reactive protein (CRP) in the red meat group compared to the comparator group.</div></div><div><h3>Results</h3><div>Thirty-six RCTs were included in the analysis. Consuming plant proteins resulted in a greater reduction in total cholesterol (TC) levels (mean difference (MD) = −0.14; 95 % credible interval (CrI): −0.28 to −0.001, <em>p</em> &lt; 0.05) and low-density lipoprotein cholesterol (LDL-C) levels (MD = −0.19; 95 % CrI: −0.36 to −0.03, <em>p</em> &lt; 0.05) compared to red meat interventions. In contrast, interventions combining animal and plant proteins increased TG levels more than red meat interventions (MD = 0.21; 95 % CrI: 0.06 to 0.34, <em>p</em> &lt; 0.05). The certainty of the evidence for all outcomes ranged from very low to low.</div></div><div><h3>Conclusion</h3><div>The findings of this NMA indicate that the effect of red meat on cardiovascular risk factors depends on the comparison food. Replacing red meat with plant protein sources was associated with favorable changes in TC levels and LDL-C.</div></div><div><h3>Registry and registry number for systematic reviews or meta-analyses</h3><div>CRD42024537865 <span><span>https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024537865</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"54 ","pages":"Pages 12-26"},"PeriodicalIF":7.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148075","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":"Prospective associations of dynapenic abdominal obesity status with distinct trajectories of depressive symptoms: A national cohort study","authors":"Xue Tian ,&nbsp;Xue Xia ,&nbsp;Yijun Zhang ,&nbsp;Qin Xu ,&nbsp;Anxin Wang","doi":"10.1016/j.clnu.2025.05.007","DOIUrl":"10.1016/j.clnu.2025.05.007","url":null,"abstract":"<div><h3>Background and aims</h3><div>Dynapenic abdominal obesity has been shown as a risk factor for adverse outcomes. There is no evidence on the longitudinal association of this condition with different courses of depressive symptoms. This study aimed to investigate the association of dynapenic abdominal obesity status with the risk of distinct trajectories of depressive symptoms.</div></div><div><h3>Methods</h3><div>We enrolled 11,917 participants aged over 45 years from the China Health and Retirement Longitudinal Study. Participants were divided into four categories by dynapenia and abdominal obesity status. The primary outcome was the trajectories of depressive symptoms measured by the 10-item Center for Epidemiological Studies–Depression scale during 2011–2018, which was identify by group-based trajectory modelling.</div></div><div><h3>Results</h3><div>Four distinct trajectories were identified as: low-stable (n = 8179, 64.2 %), low-increasing (n = 2341, 21.2 %), high-decreasing (n = 680, 8.4 %), and high-stable trajectory (n = 717, 6.2 %). Participants with dynapenic/abdominal obesity had the highest risk of developing high-stable trajectory of depressive symptoms (relative risk [RR], 2.15; 95 % confidence interval [CI], 1.46–3.18), followed by dynapenic/nonabdominal obesity (RR, 2.01; 95 % CI, 1.49–2.70), which also had the highest risk of developing low-increasing trajectory of depressive symptoms (RR, 1.47; 95 % confidence interval, 1.19–1.80), compared with non-dynapenic/non-abdominal obesity. Additionally, dynapenic/nonabdominal obesity was also associated with a 52 % higher risk of incident depression (RR, 1.53; 95 % CI, 1.07–2.18).</div></div><div><h3>Conclusion</h3><div>The status of dynapenic/abdominal obesity was associated with a higher risk of increasing and high-stable trajectory of depressive symptoms. Therefore, prevention strategies and clinical interventions enabling mitigating the harmful effects of these conditions should be adopted.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"53 ","pages":"Pages 270-277"},"PeriodicalIF":7.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008159","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":"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":"ESPEN guideline on clinical nutrition in surgery – Update 2025","authors":"Arved Weimann ,&nbsp;Mihailo Bezmarevic ,&nbsp;Marco Braga ,&nbsp;M. Isabel T.D. Correia ,&nbsp;Pamela Funk-Debleds ,&nbsp;Luca Gianotti ,&nbsp;Chelsia Gillis ,&nbsp;Martin Hübner ,&nbsp;Jesus Fernando B. Inciong ,&nbsp;Mohammad Shukri Jahit ,&nbsp;Stanislaw Klek ,&nbsp;Takayuki Kori ,&nbsp;Alessandro Laviano ,&nbsp;Olle Ljungqvist ,&nbsp;Dileep N. Lobo ,&nbsp;Carmelo Loinaz Segurola ,&nbsp;Isacco Montroni ,&nbsp;B. Ravinder Reddy ,&nbsp;Nicole M. Saur ,&nbsp;Anna Schweinlin ,&nbsp;Stephan C. Bischoff","doi":"10.1016/j.clnu.2025.08.029","DOIUrl":"10.1016/j.clnu.2025.08.029","url":null,"abstract":"<div><div>Early oral feeding is the preferred mode of nutrition for surgical patients. Avoidance of any nutritional therapy bears the risk of underfeeding during the postoperative course after major surgery. Considering that malnutrition and underfeeding are risk factors for postoperative complications, nutritional therapy is mandatory for any surgical patient at nutritional risk, especially for those undergoing upper gastrointestinal surgery. The focus of this guideline is to cover nutritional aspects of the Enhanced Recovery After Surgery (ERAS) concept and the special nutritional needs of patients undergoing major surgery, e.g. for cancer, and of those developing severe complications despite best perioperative care. From a metabolic and nutritional point of view, the key aspects of perioperative care include: a) Integration of nutrition into the overall management of the patient, b) avoidance of long periods of preoperative fasting c) re-establishment of oral feeding as early as possible after surgery d) start of nutritional therapy early, as soon as a nutritional risk becomes apparent e) metabolic control e.g. of blood glucose, f) reduction of factors which exacerbate stress-related catabolism or impair gastrointestinal function, g) minimized time on paralytic agents in the postoperative period, and h) early mobilization to facilitate protein synthesis and muscle function.</div><div>The guideline presents 44 recommendations for clinical practice in patients undergoing elective and non-elective surgery, including new recommendations for frailty assessment, sarcopenia diagnosis, and prehabilitation. As in the former ESPEN practical guideline, the recommendations were additonally presented in decision-making flowcharts.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"53 ","pages":"Pages 222-261"},"PeriodicalIF":7.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074655","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":"Associations of choline intake and metabolite status with fetal growth outcomes and placental macronutrient transport in pregnancies with or without gestational diabetes mellitus.","authors":"Isma'il Kadam, Chauntelle Nebie, Mudar Dalloul, Anjana Saxena, Lawrence Fordjour, Lori Hoepner, Xinyin Jiang","doi":"10.1016/j.clnu.2025.07.027","DOIUrl":"10.1016/j.clnu.2025.07.027","url":null,"abstract":"<p><strong>Background & aims: </strong>Gestational diabetes mellitus (GDM) is associated with increased risks of fetal overgrowth, possibly due to the increased transport of macronutrients from the placenta to the GDM-exposed fetus. Maternal choline supplementation in obese mice normalizes placental fat and glucose transport and prevents fetal overgrowth. In this study, we aimed to determine the correlation of choline intake and metabolite status with fetal growth outcomes and placental macronutrient metabolism and transport in pregnancies with and without GDM.</p><p><strong>Methods: </strong>In this prospective study, we recruited women with (n = 40) and without (n = 36) GDM at 25-33 weeks gestation and assessed their choline intake and blood choline metabolite concentrations. We also collected placenta and cord blood samples from a subset of participants (21 GDM and 26 non-GDM) at delivery to examine placental macronutrient metabolism and transport.</p><p><strong>Results: </strong>Our results demonstrated that a higher maternal choline intake was associated with lower placental mRNA expression of glucose transporter 3 (GLUT3) (β = -0.002, p = 0.012) in non-GDM pregnancies and leptin (LEP) (β = -0.02, p = 0.034) in GDM pregnancies, respectively. Both maternal blood (β = -77.97, p = 0.03) and placental (β = -0.38, p = 0.049) glycerophosphorylcholine (GPC) concentrations were negatively associated with infant birthweight regardless of GDM status. Maternal GPC concentrations were also negatively associated with placental triglyceride concentrations (β = -0.18, p = 0.017) and cord blood triglyceride (β = -11.1, p = 0.014) and free fatty acid (β = -39.6, p = 0.034) contents, while placental GPC concentrations were negatively associated with fatty acid transporter 1 (FATP1) mRNA expression (β = -1.38E-4, p = 0.036) in all participants. Lipidomics profiling demonstrated that maternal choline intake was negatively associated with concentrations of triglyceride species in the placenta regardless of GDM status.</p><p><strong>Conclusions: </strong>In conclusion, maternal choline intakes demonstrated negative associations with placental macronutrient transporters and triglyceride contents. GPC concentrations seem to be a consistent indicator of reduced placental-fetal fat transport and eventually lower birth weight. These observations suggest the potential of using choline to alleviate GDM-related excess in transplacental fat transport and fetal overgrowth.</p>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"52 ","pages":"179-188"},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803804","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}