Clinical nutrition最新文献

{"title":"Comment on “Emerging EAT-Lancet planetary health diet is associated with major cardiovascular diseases and all-cause mortality: A global systematic review and meta-analysis”","authors":"Wan-Ling Tu, Chia-Chen Chen, Jheng-Yan Wu","doi":"10.1016/j.clnu.2025.02.026","DOIUrl":"10.1016/j.clnu.2025.02.026","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 185-186"},"PeriodicalIF":6.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529323","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":"Low plasma pancreatic lipase as a novel predictor of nutritional target achievement and response to nutritional interventions in malnourished inpatients: Secondary analysis of a randomized clinical trial","authors":"Selina Randegger ,&nbsp;Carla Wunderle ,&nbsp;Odd Erik Johansen ,&nbsp;Pascal Tribolet ,&nbsp;Vojtech Pavlicek ,&nbsp;Michael Braendle ,&nbsp;Christoph Henzen ,&nbsp;Robert Thomann ,&nbsp;Peter Neyer ,&nbsp;Zeno Stanga ,&nbsp;Beat Mueller ,&nbsp;Philipp Schuetz","doi":"10.1016/j.clnu.2025.02.029","DOIUrl":"10.1016/j.clnu.2025.02.029","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Pancreatic lipase plays an essential role in digesting dietary fats in the intestine, facilitating nutrient absorption. Plasma lipase serves as a surrogate for pancreatic exocrine function, which decreases with age and potentially leads to inadequate nutrient digestion and gastrointestinal symptoms. We investigated clinical implications of plasma lipase among medical inpatients at nutritional risk.</div></div><div><h3>Methods</h3><div>This secondary analysis investigated admission plasma lipase concentrations among patients at risk for malnutrition regarding clinical outcomes and treatment response in patients included in the <em>Effect of Early Nutritional Support on Frailty Outcomes, and Recovery of Malnourished Medical Inpatients Trial</em> (EFFORT), a randomized controlled trial comparing individualized nutritional support to usual care.</div></div><div><h3>Results</h3><div>Of 810 patients with available admission plasma lipase concentrations, 158 (19.5 %) had concentrations below the reference range. Patients with low concentrations had a 1.6-fold higher risk of not reaching energy or protein targets during hospitalization (adjusted odds ratio 1.62 [95 % confidence interval 1.07 to 2.45], p = 0.022 and 1.61 [95 % confidence interval 1.07 to 2.44], p = 0.023, respectively). They also tended to have a more pronounced benefit from nutritional interventions in terms of reduced mortality (adjusted hazard ratio for patients with low lipase 0.48 [95 % confidence interval 0.18 to 1.26] compared to 0.99 [95 % confidence interval 0.60 to 1.63] in patients with normal lipase concentrations, p for interaction = 0.224).</div></div><div><h3>Conclusion</h3><div>Findings from this multicenter trial indicate that around 20 % of polymorbid older patients had plasma lipase concentrations below the reference range, suggesting exocrine pancreatic insufficiency, which placed them at a greater risk for failing to meet nutritional targets; however, they also demonstrated a pronounced improvement from nutritional support. Further studies should assess the impact of pancreatic enzyme replacement therapy in this population.</div></div><div><h3>Trial registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> Identifier: NCT02517476.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 196-203"},"PeriodicalIF":6.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534320","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":"The usefulness of the updated bioelectrical impedance vector analysis references for assessing malnutrition, sarcopenia and predicting mortality in hospitalized patients","authors":"Alessandro Guerrini ,&nbsp;Lara Dalla Rovere ,&nbsp;Rocío Fernández-Jiménez ,&nbsp;Carmen Hardy-Añón ,&nbsp;Cristina Herola-Cobos ,&nbsp;Maria Garcia-Olivares ,&nbsp;José Abuín Fernández ,&nbsp;Francisco Hevilla Sánchez ,&nbsp;Virginia Morilla Jiménez ,&nbsp;Isabel Vegas Aguilar ,&nbsp;Abelardo Adarve Castro ,&nbsp;Yeganeh Manon Khazrai ,&nbsp;Francesco Campa ,&nbsp;José Manuel García-Almeida","doi":"10.1016/j.clnu.2025.02.025","DOIUrl":"10.1016/j.clnu.2025.02.025","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>The application of validated pre-screening tools is crucial in clinical practice to identify patients at risk for disease. Bioelectrical Impedance Vector Analysis (BIVA) has gained recognition as a qualitative method for monitoring body composition and assessing the health status of hospitalized patients. This study investigates the utility of updated BIVA reference standards in evaluating malnutrition, sarcopenia, and mortality among hospitalized individuals.</div></div><div><h3>Material and method</h3><div>This retrospective observational study included 2.872 patients admitted to Quironsalud Málaga Hospital between January 2019 and January 2024. Malnutrition and sarcopenia were diagnosed using the Global Leadership Initiative on Malnutrition (GLIM) and the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) guidelines. Mortality was defined as death within one year of their initial discharge or later admissions. BIVA was performed using the former and the new 50th, 75th, and 95th reference tolerance ellipses of general population.</div></div><div><h3>Results</h3><div>BIVA revealed significant differences in bioimpedance vectors between malnourished (n = 1187, 544 women) and non-malnourished patients, sarcopenic (n = 136, 51 women) and non-sarcopenic patients, and non-survivors (n = 317, 160 women) compared to survivors. When previous BIVA references (Piccoli 1995) were applied, the bioimpedance vectors for malnourished, sarcopenic, and non-surviving patients fell within the 75th tolerance ellipses. However, with updated references, these vectors shifted rightward, moving outside the 75th and 95th tolerance ellipses. Univariate Cox analysis showed that participants with vectors outside the new 95th tolerance ellipses faced significantly higher mortality risk (HR = 6.22 [95 % CI 4.40–8.80], p &lt; 0.001) and lower survival rates (log-rank test p &lt; 0.001) compared to those within the 75th ellipses. These trends persisted even after adjusting for age, sex, and BMI (HR = 4.79 [95 % CI 3.29–6.97], p &lt; 0.001). The new reference ellipses demonstrated greater prognostic accuracy compared to the older ones, emphasizing their value in identifying high-risk patients.</div></div><div><h3>Conclusion</h3><div>The implementation of BIVA with newly established reference tolerance ellipses significantly enhances the evaluation of body composition and overall health in hospitalized patients. These updated tolerance ellipses are instrumental in accurately identifying malnutrition, sarcopenia, and heightened mortality risks. The delineation of specific mortality risk zones underscores the potential of incorporating these advanced BIVA ellipses into routine pre-screening protocols, thereby optimizing clinical nutritional assessments and interventions.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 187-195"},"PeriodicalIF":6.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534321","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":"Understanding the role of nutritional status on the outcomes of nonvariceal upper gastrointestinal bleeding: Findings from a retrospective cohort analysis","authors":"Ali Jaan ,&nbsp;Umer Farooq ,&nbsp;Ashish Dhawan ,&nbsp;Muhammad Talha Maqsood ,&nbsp;Syeda Shahnoor ,&nbsp;Adeena Maryyum ,&nbsp;Zeeshan Imtiaz ,&nbsp;Jason Gutman ,&nbsp;Karin Dunnigan ,&nbsp;Mark S. Mcfarland ,&nbsp;Asim Mushtaq","doi":"10.1016/j.clnu.2025.02.021","DOIUrl":"10.1016/j.clnu.2025.02.021","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Nonvariceal upper gastrointestinal bleeding (NVUGIB) is a common cause of hospitalization worldwide. Malnutrition, on the other hand, varies in prevalence and closely correlates with age and comorbidities. Though malnutrition is linked to poor outcomes generally, its impact on NVUGIB patients remains unexplored.</div></div><div><h3>Methods</h3><div>Using the National Readmission Database (NRD) from 2016 to 2020, we employed the International Classification of Diseases, 10th revision, Clinical Modifications (ICD-10-CM) codes to identify adult patients (aged ≥18 years) admitted with a principal diagnosis of NVUGIB. We further stratified NVUGIB hospitalizations based on the presence and severity of malnutrition. Utilizing a multivariate regression model, we assessed the impact of malnutrition on NVUGIB outcomes. STATA 14.2 was utilized for statistical analysis.</div></div><div><h3>Results</h3><div>Out of the 742,592 adult patients admitted with NVUGIB, 76,603 (10.32 %) had malnutrition, categorized as mild to moderate (3.01 %), severe (4.00 %), and malnutrition of unspecified severity (3.29 %). After adjusting for confounding variables, all-cause in-hospital mortality due to NVUGIB was significantly higher in malnourished patients, corresponding to the severity of malnutrition (adjusted odds ratio [aOR] 1.83 &amp; 3.52 in mild-moderate malnutrition and severe malnutrition respectively; <em>P</em> &lt; 0.01). Similarly, malnutrition was associated with progressively higher odds of acute kidney injury (aOR 1.39 &amp; 1.54 for mild-moderate and severe malnutrition, respectively), septic shock (aOR 2.41 &amp; 5.12), hemorrhagic shock (aOR 1.71 &amp; 2.16), and intensive care unit (ICU) admission (aOR 2.00 &amp; 2.97), all increasing with malnutrition severity (<em>P</em> &lt; 0.01). Procedural analysis showed lower odds of diagnostic EGD (aOR 0.95 &amp; 0.92), EGD within 24 h (aOR 0.75 &amp; 0.67), and overall EGD (aOR 0.80 &amp; 0.66) in malnourished patients, but higher odds of rebleeding requiring repeat EGD (aOR 1.12 &amp; 1.19) and radioembolization (aOR 2.04 &amp; 2.75), both rising with malnutrition severity (<em>P</em> &lt; 0.01). Finally, resource utilization estimated by total hospitalization charges, length of stay, discharge to rehabilitation facilities (aOR 1.99 &amp; 2.66), and 30-day readmission rates (aOR 1.29 &amp; 1.38) were also significantly higher among patients with malnutrition (<em>P</em> &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Malnutrition exacerbates the outcomes of NVUGIB including higher in-hospital mortality rates, morbidity and resource utilization. Early identification and targeted management of malnutrition in NVUGIB patients are crucial to reducing adverse outcomes and optimizing healthcare resources.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 204-211"},"PeriodicalIF":6.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534322","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 appetite stimulating effect and safety of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) in older patients with poor appetite: A triple-blinded, randomized, placebo-controlled, cross-over trial","authors":"Rikke Lundsgaard Nielsen ,&nbsp;Olivia Bornæs ,&nbsp;Louise Westberg Strejby Christensen ,&nbsp;Helle Gybel Juul-Larsen ,&nbsp;Ida Klitzing Storgaard ,&nbsp;Thomas Kallemose ,&nbsp;Lillian Mørch Jørgensen ,&nbsp;Baker Nawfal Jawad ,&nbsp;Izzet Altintas ,&nbsp;Trine Meldgaard Lund ,&nbsp;Henrik Højgaard Rasmussen ,&nbsp;Tina Munk ,&nbsp;Ove Andersen ,&nbsp;Morten Baltzer Houlind ,&nbsp;Aino Leegaard Andersen","doi":"10.1016/j.clnu.2025.02.024","DOIUrl":"10.1016/j.clnu.2025.02.024","url":null,"abstract":"<div><h3>Background and aims</h3><div>Anorexia of aging is prevalent and constitutes a significant factor in the onset of malnutrition with limited effective interventions. Cannabis-based medicine (CBM) with delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) may have orexigenic properties in older patients with poor appetite. However, current evidence is insufficient regarding the impact of CBM in older patients with poor appetite. This trial aimed to assess the difference in caloric intake between an oromucosal spray containing CBM versus placebo. The secondary outcomes were safety parameters (tiredness, vertigo, nausea, euphoria, blood pressure, and heart rate).</div></div><div><h3>Methods</h3><div>The trial is an investigator-initiated single-center, triple-blinded, randomized, placebo-controlled, superiority, cross-over trial with 17 patients ≥65 years with poor appetite. Patients received two dosages of CBM (8.1 mg THC and 7.5 mg CBD pr dosage) and placebo at two time points on two separate trial days, with a two-week washout period between trial days. The primary outcome, caloric intake, was measured with a controlled feeding study using standardized homogenous test meals. Safety parameters were assessed with 100 mm numerical visual analog scales.</div></div><div><h3>Results</h3><div>No statically significant difference in mean caloric intake between CBM and placebo was observed (10 kilocalories (kcal) (CI: -55-75 kcal), favoring CBM). During the trial, 36 adverse events were classified as unrelated to CBM, while 16 were classified as possibly-related. Of the 16 possibly-related, five were during placebo conditions and one was reported prior to CBM. All possibly-related adverse events were mild and transient. No serious related adverse events were observed.</div></div><div><h3>Conclusions</h3><div>In older patients with poor appetite, CBM administered buccally at two time points at the same day, with each dose containing 8.1 mg THC and 7.5 mg CBD, did not improve caloric intake compared to placebo. The observed safety parameters suggest that CBM is generally tolerated when administered according to this dosing regimen.</div><div>The trial was registered at EudraCT (2021-002318-15) and Clinicaltrials. gov (NCT05503147).</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 248-257"},"PeriodicalIF":6.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578069","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":"Exploring diet categorizations and their influence on flare prediction in inflammatory bowel disease, using the Sparse Grouped Least Absolute Shrinkage and Selection Operator method","authors":"Corien L. Stevens ,&nbsp;Greetje M.C. Adriaans ,&nbsp;Corinne E.G.M. Spooren ,&nbsp;Vera Peters ,&nbsp;Marie J. Pierik ,&nbsp;Rinse K. Weersma ,&nbsp;Hendrik M. van Dullemen ,&nbsp;Eleonora A.M. Festen ,&nbsp;Marijn C. Visschedijk ,&nbsp;Evelien M.B. Hendrix ,&nbsp;Corine W.M. Perenboom ,&nbsp;Edith J.M. Feskens ,&nbsp;Gerard Dijkstra ,&nbsp;Rui J. Almeida ,&nbsp;Daisy M.A.E. Jonkers ,&nbsp;Marjo J.E. Campmans-Kuijpers","doi":"10.1016/j.clnu.2025.02.027","DOIUrl":"10.1016/j.clnu.2025.02.027","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Diet is an important environmental factor in inflammatory bowel disease (IBD) onset and disease course, but analyses are hindered by its complexity. We aim to explore the Sparse Grouped Least Absolute Shrinkage and Selection Operator (Sparse Grouped LASSO or SGL) method to study whether different food categorizations, representing different dietary patterns, can predict flares in IBD.</div></div><div><h3>Methods</h3><div>Baseline data on habitual dietary intake and longitudinal data on disease course were collected over a 24 month-period in two distinct cohorts. Food items were classified into 22 food groups. These were further classified into three diet categorizations: 1. Plant vs animal vs mixed; 2. Potentially healthy vs potentially unhealthy vs neutral; 3. Ultra-processed vs not ultra-processed. The SGL parameter ‘lambda’ identifies important groups using a-priori group information, while allowing for only a subset of variables within a group to be important predictors.</div></div><div><h3>Results</h3><div>Of 724 eligible patients, 427 were in remission at baseline and were included in the SGL analyses. 106 (24.8 %) included patients developed a flare within 11.2 ± 6.6 months (65.1 % female, 34 % ulcerative colitis, mean age 43.3 ± 14.7 years). They had a higher crude food intake of red meat (p = 0.028) and vegetables (p = 0.027) than those who stayed in remission. Prediction models for flare development were moderate with AUC varying between 0.425 and 0.542 for model 1, 0.512 and 0.562 for model 2 and 0.451 and 0.612 for model 3. All models showed red meat, legumes and vegetables as the first selected predicting variables. However, female sex and energy intake had the highest predictive values in all 3 models.</div></div><div><h3>Conclusion</h3><div>Categorization of the same food groups in different ways influences the predictive value of the SGL method. The current exploration of the SGL method shows that food might not be the most important predictor of flares in IBD.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 212-226"},"PeriodicalIF":6.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550481","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":"Dietary protein intake, protein sources & distribution patterns in community-dwelling older adults: A harmonized analysis of eight studies","authors":"Lotte Koopmans ,&nbsp;Sophie van Oppenraaij ,&nbsp;Maartje W.F. Heijmans ,&nbsp;Sjors Verlaan ,&nbsp;Josje D. Schoufour ,&nbsp;Dominique S.M. Ten Haaf ,&nbsp;Cindy M.T. van der Avoort ,&nbsp;Jantine van den Helder ,&nbsp;Robert Memelink ,&nbsp;Amely Verreijen ,&nbsp;Peter J.M. Weijs ,&nbsp;Thijs M.H. Eijsvogels ,&nbsp;Maria T.E. Hopman","doi":"10.1016/j.clnu.2025.02.022","DOIUrl":"10.1016/j.clnu.2025.02.022","url":null,"abstract":"<div><h3>Objectives</h3><div>Sufficient protein intake is important for older adults to prevent sarcopenia. Better insight into dietary characteristics may be helpful to improve daily protein intake.</div><div>Therefore, this study aimed to compare characteristics of community-dwelling older adults with distinct amounts of daily protein intake.</div></div><div><h3>Methods</h3><div>Baseline data of older adults (age &gt;55 years) from eight intervention studies were pooled. Protein intake was measured using 24-h recalls or 3-day food records. Participants were stratified into one of four different groups based on their habitual protein intake (&lt;0.8 g per kilogram bodyweight per day (g/kg/d), 0.8–0.99 g/kg/d, 1.0–1.2 g/kg/d and &gt;1.2 g/kg/d). Protein intake per meal, animal-versus plant-based protein intake, daily protein distribution patterns (e.g. spread or pulse) and the protein intake from distinct protein-rich food categories (meat, fish, dairy, grains and others) were assessed.</div></div><div><h3>Results</h3><div>Among 814 participants (69 ± 9 years, 54 % male), mean protein intake was 0.98 ± 0.30 g/kg/d. 28 % (n = 227) of the population had a protein intake &lt;0.8 g/kg/d, 29 % (n = 240) 0.8–0.99 g/kg/d, 22 % (n = 179) 1.0–1.2 g/kg/d and 21 % (n = 168) &gt;1.2 g/kg/d. Higher protein intake groups had a lower body weight and BMI and a higher energy intake per day. Although protein intake distribution patterns did not differ across groups, meals with &gt;20 g or &gt;0.4 g protein per kilogram bodyweight per meal more often occurred in the higher protein intake groups. Protein intake was the lowest at breakfast followed by lunch and dinner, in all groups. Higher protein intake groups consumed a higher proportion of animal-based protein sources.</div></div><div><h3>Conclusion</h3><div>Distinct protein intake groups showed comparable intake distribution patterns, with lowest protein consumption at breakfast and highest at dinner. Nevertheless, the highest protein intake group more often consumed &gt;20 gr of protein per meal, indicating that a focus on the absolute amount of protein per meal, particularly at breakfast, could further optimize daily protein intake in older adults.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 177-184"},"PeriodicalIF":6.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527433","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":"Assessing sarcopenia: The JOHAS (Judgment of Objective Hyper-steatosis and Atrophy in Sarcopenia) index as a pragmatic surrogate for skeletal muscle index by bioimpedance analysis","authors":"Yuzo Yamamoto,&nbsp;Kyosuke Agawa,&nbsp;Masahide Awazu,&nbsp;Noriko Omura,&nbsp;Shunji Nakayama,&nbsp;Hiromi Maeda","doi":"10.1016/j.clnu.2025.02.023","DOIUrl":"10.1016/j.clnu.2025.02.023","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>The aim of this study was to develop a new, less cumbersome index for determining sarcopenia using axial slice images from computed tomography (CT) as a surrogate for the skeletal muscle index (SMI) measured by bioelectrical impedance analysis (BIA).</div></div><div><h3>Methods</h3><div>We devised the JOHAS index (<strong>J</strong>udgment of <strong>O</strong>bjective <strong>H</strong>yper-steatosis and <strong>A</strong>trophy in <strong>S</strong>arcopenia), calculated from the measurements of the iliopsoas and erector spinae muscles in the axial CT slices at the L4 lumbar vertebral level. The JOHAS index is defined as: JOHAS index = ∑ [(cross-sectional area of each muscle [cm²]/patient height [cm]) × (CT number + 108)], where ∑ is defined as the sum of the values in the bracket for iliopsoas and erector spinae muscles on both sides, and 108 is the adjustment factor. The accuracy of the JOHAS index for identifying sarcopenia, as determined by BIA, was examined using a receiver operating characteristic (ROC) curve analysis on a sample of 639 patients (331 men and 308 women).</div></div><div><h3>Results</h3><div>The JOHAS index was able to discriminate sarcopenia with an area under the curve (AUC) of around 0.88 in men and 0.75 in women. The JOHAS index outperformed commonly used indices such as the psoas muscle index, erector spinae muscle index, intramuscular adipose tissue content, prognostic nutritional index, and neutrophil/lymphocyte ratio.</div></div><div><h3>Conclusions</h3><div>The JOHAS index is a promising, pragmatic surrogate for SMI measured by BIA. The recommendable cut-off values are 43 (sensitivity 0.7722, specificity 0.8362) for men and 32 (sensitivity 0.6377, specificity 0.7423) for women.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 169-176"},"PeriodicalIF":6.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519248","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":"Nutritional intake as a determinant of high-speed resistance and multicomponent training efficacy on strength in older women at risk of sarcopenia. A randomized clinical trial","authors":"Luis Polo-Ferrero ,&nbsp;Jose I. Recio-Rodriguez ,&nbsp;Susana González-Manzano ,&nbsp;Javier Martín-Vallejo ,&nbsp;Fausto J. Barbero-Iglesias ,&nbsp;Beatriz Montero-Errasquín ,&nbsp;Alfonso J. Cruz-Jentoft ,&nbsp;Roberto Méndez-Sánchez","doi":"10.1016/j.clnu.2025.02.015","DOIUrl":"10.1016/j.clnu.2025.02.015","url":null,"abstract":"<div><h3>Background and aim</h3><div>Despite advances in research on training and nutritional supplementation, it is largely unknown how micronutrient intake modulates the response to training in older adults. This study investigates the relationship between nutrient intake and response to training in older women at risk of sarcopenia.</div></div><div><h3>Methods</h3><div>A randomized clinical trial with two parallel groups (high-speed resistance training (H-RT) and multicomponent training (MT)) was conducted over a 32-week intervention involving 80 older women at risk of sarcopenia (mean age: 77.36 ± 6.71 years). A food frequency questionnaire was administered to assess whether nutrient intake influenced strength outcomes measured by the Five Times Sit-to-Stand Test (5STS) and other functional variables.</div></div><div><h3>Results</h3><div>Significant improvements in the five times sit to stand test (5STS) were observed in both groups post-intervention (p &lt; 0.001), with no significant differences between them (p = 0.127), suggesting comparable effectiveness. In both groups, lower levels of vitamin B12 (H-RT: r_p = −0.52; MT: r_p = −0.50) and vitamin D (H-RT: r_p = −0.55; MT: r_p = −0.69) were associated with worse 5STS performance. Additionally, in the H-RT group, lower levels of vitamin E (r_p = −0.36), magnesium (r_p = −0.48), iron (r_p = −0.43), and potassium (r_p = −0.47) were also correlated with poorer performance.</div></div><div><h3>Conclusions</h3><div>The results indicate that improvements in strength are related to micronutrient sufficiency rather than macronutrient sufficiency. Deficiencies in vitamin D and B12 negatively impacted muscle strength gains in both H-RT and MT, while vitamin E, potassium, magnesium, and iron influenced H-RT outcomes. The lesser effect of micronutrient deficiencies on MT suggests it may be more suitable for individuals with mild deficiencies, as it requires fewer specific nutrients for muscle strength.</div></div><div><h3>Registration</h3><div>The study is registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> under the identifier NCT05870046.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 103-111"},"PeriodicalIF":6.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479599","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 dietary inflammatory potential and its role in the risk and progression of inflammatory bowel disease: A systematic review","authors":"Olivia Mariella Anneberg ,&nbsp;Ida Sofie Bjerregård Petersen ,&nbsp;Tine Jess ,&nbsp;Maiara Brusco De Freitas ,&nbsp;Mahsa Jalili","doi":"10.1016/j.clnu.2025.02.019","DOIUrl":"10.1016/j.clnu.2025.02.019","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Inflammation is central in inflammatory bowel disease (IBD) pathogenesis. Because of diet's pro- and anti-inflammatory properties, multiple observational studies have explored the link between the dietary inflammatory potential and IBD-related outcomes. We aimed to systematically review the literature and provide a comprehensive overview of the dietary inflammatory potential and its association with the development and progression of IBD.</div></div><div><h3>Methods</h3><div>Literature was searched systematically on the 2nd of May 2024 in PubMed, Web of Science, Scopus, Cochrane Library, and Embase to identify the observational studies that explored the link between the dietary inflammatory potential and IBD-related outcomes. A higher dietary inflammatory potential was defined as the ability of a dietary pattern to promote inflammation in the body. Studies were included only if they quantified this using a dietary index, such as the dietary inflammatory index (DII) and the empirical dietary inflammatory pattern (EDIP). Two authors independently performed study selection and data extraction and assessed the risk of bias using the Newcastle-Ottawa scale.</div></div><div><h3>Results</h3><div>Fourteen of the 165 identified records met the inclusion criteria. Seven investigated the risk of developing IBD, but with mixed results. Nine investigated the progression of IBD, which indicated that a higher dietary inflammatory potential contributed to higher disease activity and associated symptoms.</div></div><div><h3>Conclusions</h3><div>The evidence suggested that a higher dietary inflammatory potential worsens the condition of IBD patients, while the link with the risk of developing the disease was less clear. To elucidate this, high-quality intervention studies are needed.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 146-156"},"PeriodicalIF":6.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511485","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}