Clinical nutrition最新文献

{"title":"Proof of concept for an age- and inflammation-adjusted model for the establishment of pediatric serum copper reference intervals","authors":"Helena Rodriguez-Gonzalez ,&nbsp;Angela Arias ,&nbsp;Elisabet Poyatos ,&nbsp;Mariela Mercedes de los Santos ,&nbsp;Beatriz Minguez ,&nbsp;Silvia Meavilla ,&nbsp;Camila Garcia-Volpe ,&nbsp;Ines Loverdos ,&nbsp;Cristina Molera ,&nbsp;Mercedes Casado ,&nbsp;Aida Ormazabal ,&nbsp;Alexandre Perera-Lluna ,&nbsp;Rafael Artuch","doi":"10.1016/j.clnu.2026.106586","DOIUrl":"10.1016/j.clnu.2026.106586","url":null,"abstract":"<div><h3>Background &amp; aims:</h3><div>Copper is a trace element essential for enzymatic reactions, but excessive accumulation can cause toxicity. Accurate interpretation of serum copper concentrations is crucial for diagnosing conditions such as Wilson's disease, liver dysfunction, and nutritional deficiencies. Current reference intervals often ignore the effect of inflammation and are typically established using discrete age groups rather than modelling age as a continuous variable. This study aimed to establish continuous, age-adjusted reference intervals for serum copper and to develop a method for correcting inflammation-related variability.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed serum copper concentrations in a pediatric cohort of 4,368 unique samples. Inflammatory status was assessed using erythrocyte sedimentation rate (ESR), fibrinogen, and C-reactive protein (CRP). Samples without inflammation were used to generate age-continuous reference intervals through polynomial regression. To quantify and adjust for inflammation effects, we developed a composite inflammation score using partial least squares regression on standardized values of the three acute-phase markers and applied it to correct copper concentrations in samples exhibiting inflammation.</div></div><div><h3>Results</h3><div>Serum copper showed a nonlinear relationship with age. Inflammation elevated copper concentrations by approximately 24 %. The composite inflammation score independently predicted this variability in copper concentrations, and adjustment using the score restored copper concentrations within reference limits, reducing the risk of data misinterpretation.</div></div><div><h3>Conclusion</h3><div>Our findings underscore the necessity of considering both age and inflammation variables when interpreting pediatric serum copper concentrations. We provide continuous, age-adjusted reference intervals and a method to correct for inflammation-related variability, enhancing data interpretation. We propose a proof-of-concept potentially applicable to other biomarkers related with metabolic and nutritional disturbances in chronic and acute diseases.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106586"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146104134","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":"How low can we go with hypocaloric feeding for critically ill patients? For how long can it be continued?","authors":"Emmanuel Pardo,&nbsp;Ronan Thibault","doi":"10.1016/j.clnu.2026.106588","DOIUrl":"10.1016/j.clnu.2026.106588","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106588"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164551","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":"Proteins in artificial nutrition: toward an individualized and phase-specific prescription","authors":"Philipp Schuetz ,&nbsp;Frank Carrera-Gil ,&nbsp;Carla Wunderle","doi":"10.1016/j.clnu.2026.106577","DOIUrl":"10.1016/j.clnu.2026.106577","url":null,"abstract":"<div><div>Protein is a central component of artificial nutrition, yet its optimal dose and timing remain controversial. Provision of both insufficient and excessive protein is associated with adverse outcomes. Inadequate intake promotes negative nitrogen balance, muscle wasting, impaired tissue healing and repair, and increased risk of infection, whereas excessive protein may exceed metabolic capacity, causing azotemia, hepatic or renal strain, and reduced metabolic flexibility — particularly in patients with renal dysfunction. Emerging evidence indicates that the optimal protein dose is strongly influenced by patient-specific characteristics and evolves throughout the course of illness, supporting an individualized, phase-adapted strategy for protein provision rather than a fixed universal target. During early critical illness, catabolism predominates and high protein doses may not be effectively utilized. In contrast, during recovery and stabilization, higher protein targets appear beneficial for restoring lean body mass and functional capacity. This dynamic trajectory underscores the need to abandon universal recommendations in favor of personalized prescriptions. Although instruments such as nitrogen balance, body composition analysis, and indirect calorimetry can provide information about protein dosage, their routine use in clinical practice is limited and interpretation in acute illnesses remains difficult. Pragmatic, bedside strategies and the phenotyping of patients using biomarkers are, therefore, needed to tailor protein provision according to disease stage, organ function, and anabolic capacity. This opinion paper explores mechanistic insights, evidence from clinical trials, and guidelines on protein supplementation, explores biomarker-driven personalization, and highlights ongoing challenges and future research priorities in nutritional therapy.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106577"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049112","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":"Teachable moment for lifestyle and dietary changes after a myocardial infarction: Identifying the window of opportunity","authors":"Bahram Yosofi ,&nbsp;Manon Reesink ,&nbsp;Susan van Maren ,&nbsp;Manon G. van den Berg ,&nbsp;Jessica C. Kiefte-de Jong ,&nbsp;Robin Nijveldt ,&nbsp;Saloua El Messaoudi","doi":"10.1016/j.clnu.2026.106589","DOIUrl":"10.1016/j.clnu.2026.106589","url":null,"abstract":"<div><div><em>Background and aims</em>: While lifestyle changes, including dietary modifications, are crucial for reducing cardiovascular risk, adherence to these changes remains low. A ‘teachable moment’ (TM) can improve adherence, and a myocardial infarction (MI) can serve as a TM for initiating lifestyle and dietary changes. However, the timing and duration of receptiveness remain unclear. This study aimed to investigate whether an MI serves as a TM for lifestyle and dietary change intentions, to explore when this TM is most pronounced and to identify predictors of this TM.</div></div><div><h3>Methods</h3><div>In this cross-sectional survey study, patients who experienced an MI reported their intentions to change lifestyle and diet, along with the validated CardiacTM scale. Patients were categorised based on the time since MI: within 2 weeks, 6 months, 1 year, and 3 years ago. Intentions to change lifestyle and diet were compared between groups. Logistic regression analyses were performed to examine the association between the CardiacTM factors, time elapsed post–MI and intentions to change lifestyle and diet.</div></div><div><h3>Results</h3><div>241 patients were included in the analyses. Event-related lifestyle change intentions differed significantly between the 6-month and 1-year post–MI groups (30.6 % vs. 55.4 %, p = 0.003), as well as between the 2-weeks and 6-month post–MI groups (54.3 % and 30.6%p = 0.010). The intention to change dietary behaviour and general lifestyle were comparable across groups. Multivariate logistic regression revealed that time post–MI (p = 0.018), changed self-concept (B = 0.748; p &lt; 0.001) and cardiovascular disease (CVD) group identity (B = 0.550; p = 0.021) were significantly associated with event-related lifestyle change intentions. Affective impact (B = −0.496; p &lt; 0.001), changed self-concept (B = 0.506; p &lt; 0.001), perceived risk of non-communicable diseases (NCD) (B = −0.450; p = 0.003) and anticipated regret (B = 0.345; p = 0.008) were significantly associated with general lifestyle change intentions. Significant predictors of dietary change intentions were affective impact (B = 0.298; p = 0.025) and changed self-concept (B = 0.518; p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>A significant association was found between time post–MI and event-related lifestyle change intentions. Changed self-concept was the strongest predictor of TM for dietary, event-related and general lifestyle change intentions. These results suggest lifestyle interventions should be provided shortly after the event and personalised based on patients' perceptions of their MI to maximise effectiveness.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106589"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164504","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":"Nutrition care in adults with spinal cord injuries and disorders with pressure injuries: A systematic review of clinical practice guidelines","authors":"Yiwen Wang ,&nbsp;Man Ching Lo ,&nbsp;Murray Fisher ,&nbsp;Katherine Desneves ,&nbsp;Amy Nevin ,&nbsp;Priya lyer","doi":"10.1016/j.clnu.2026.106580","DOIUrl":"10.1016/j.clnu.2026.106580","url":null,"abstract":"<div><div>Pressure injuries (PIs) are a common and costly complication in adults with spinal cord injuries and disorders (SCI/D), with a global prevalence of 32 % and a lifetime risk exceeding 85 % in Australia. Nutrition is a key factor in the prevention and management of PIs, supporting wound healing, immune function, and overall recovery. This systematic review evaluated the quality, scope, and methodological rigour of 17 international clinical practice guidelines (CPGs) published since 2010 that included nutrition recommendations for PIs in adults with SCI/D. Using the AGREE II and the AGREE-REX tools, this review assessed overall guideline quality and nutrition-specific recommendations mapped to the Nutrition Care Process domains. Seven CPGs were rated high quality with AGREE II, and three with AGREE-REX. While most guidelines focussed on nutrition interventions, limited detail was provided on assessment and monitoring. Considerable variation was found in the rigour and specificity of recommendations. These findings underscore a need for high-quality, SCI/D-specific guidelines that offer consistent, evidence-based, actionable nutrition guidance, particularly in the under-represented areas of assessment and monitoring, to better support PI prevention and treatment in this vulnerable population.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106580"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077060","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":"Effectiveness of probiotic supplementation in managing depressive symptoms and inflammatory status in patients with depression: A systematic review and meta-analysis","authors":"Hajar Nabeel Shakir Shakir ,&nbsp;Antonio Javier Alias-Castillo ,&nbsp;Daniel Bertini-Pérez ,&nbsp;Lola Rueda-Ruzafa ,&nbsp;Pablo Roman ,&nbsp;Diana Cardona","doi":"10.1016/j.clnu.2025.106554","DOIUrl":"10.1016/j.clnu.2025.106554","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Depression is a multifactorial disorder influenced by genetic, biochemical, psychological, and environmental factors, and it significantly impacts quality of life. Probiotics, especially <em>Lactobacillus</em> and <em>Bifidobacterium</em> strains, have been proposed as adjunct therapies due to their capacity to modulate gut microbiota and the gut–brain axis. This systematic review and meta-analysis aimed to evaluate the effectiveness of probiotic supplementation on depressive symptoms and inflammatory status in individuals with depression.</div></div><div><h3>Methods</h3><div>Articles were identified through searches in databases including PubMed, Scopus, CINAHL, and Zenodo, using terms related to depression, microbiome, and probiotics. The search, conducted between January and February 2025, yielded 780 articles. After removing duplicates and applying eligibility criteria, 13 studies were included in the systematic review and 7 in the meta-analysis.</div></div><div><h3>Results</h3><div>Probiotic supplementation was significantly associated with improvement in depressive symptoms (p &lt; 0.00001). However, no significant changes were found in inflammatory biomarkers, including interleukin-6 (p = 0.45) and tumor necrosis factor-alpha (p = 0.21).</div></div><div><h3>Conclusions</h3><div>These results suggest that probiotics may help alleviate depressive symptoms, although their effect on inflammation remains uncertain. Further high-quality studies are necessary to clarify underlying mechanisms and determine the clinical relevance of probiotics as adjunctive therapy in depression..</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106554"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049111","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":"Gut microbiota responses to complementary food sources differ by milk feeding type","authors":"B.M. Perrett ,&nbsp;K. Miliku ,&nbsp;T.J. Moraes ,&nbsp;E. Simons ,&nbsp;P. Mandhane ,&nbsp;M. Kebbe","doi":"10.1016/j.clnu.2026.106587","DOIUrl":"10.1016/j.clnu.2026.106587","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Early-life nutrition shapes host–microbe interactions with lasting consequences for health. While dietary patterns are known to influence the infant gut microbiome, the impact of solid food source (homemade, commercial, or mixed) has not been examined. Our aims were to determine how solid food source at 6 months relates to infant gut microbiome diversity and composition at 1 year, and whether relationships differ by milk feeding type..</div></div><div><h3>Methods</h3><div>We conducted a secondary analysis within the Canadian Healthy Infant Longitudinal Development (CHILD) cohort. Solid food source was assessed at 6 months, and stool samples at 1 year were profiled using 16S rRNA sequencing. Generalized linear models were used to assess alpha-diversity; permutational multivariate analysis of variance (PERMANOVA) was used to evaluate beta-diversity based on OTU-level Bray–Curtis dissimilarities; and Microbiome Multivariate Association with Linear Models 2 (MaAsLin2), using centered log-ratio normalization, was used to examine taxa–level associations, adjusting for relevant perinatal and dietary covariates. Effect modification by milk feeding type (human milk, formula, combination, or weaned) at 6 months and 1 year was examined. Benjamini–Hochberg correction was applied (p &lt; 0.05; q &lt; 0.25).</div></div><div><h3>Results</h3><div>A total of 368 infants were included. At 6 months, most were mixed-fed (n = 154; 41.8 %), followed by homemade-fed (n = 143; 38.9 %) and commercially-fed (n = 71; 19.3 %). Solid food source explained only 0.53 % of gut microbiota variability. Differences were most pronounced in formula-fed infants: at 6 months, those given homemade or mixed foods showed higher abundances of Firmicutes, Turicibacteraceae, and <em>Turicibacter</em> compared with commercially fed infants. Within this group, mixed feeding was further linked to higher Eubacteriaceae and Lachnospiraceae (all q &lt; 0.25). At 1 year, formula-fed infants who received homemade foods had higher microbial diversity (p = 0.028) but lower Shannon diversity (p = 0.041) than those receiving commercial foods, suggesting shifts in both community richness and evenness. No significant differences in gut microbiome diversity and composition were observed in the overall cohort or among infants receiving human milk or fully weaned (q &gt; 0.25).</div></div><div><h3>Conclusions</h3><div>Solid food source is a previously under-investigated driver of infant microbiome variability, with effects contingent on milk feeding. Human milk may buffer against dietary choices, whereas formula-fed infants show heightened sensitivity to complementary food source, informing precision nutrition in early life.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106587"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123600","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 study of anamorelin in pancreatic cancer cachexia: Clinical and translational insights into response heterogeneity","authors":"Ryosuke Matsukane ,&nbsp;Haruna Minami ,&nbsp;Nao Fujimori ,&nbsp;Keijiro Ueda ,&nbsp;Yasuhiro Komori ,&nbsp;Yu Takamatsu ,&nbsp;Takahiro Ueda ,&nbsp;Minako Kimura ,&nbsp;Chitose Matsuzaki ,&nbsp;Takanori Tanaka ,&nbsp;Aimi Morito ,&nbsp;Saki Kuwahara ,&nbsp;Masako Hashimoto ,&nbsp;Satoshi Hirai ,&nbsp;Tomiko Yokoyama ,&nbsp;Shigeru Ishida ,&nbsp;Takeshi Hirota ,&nbsp;Yoshihiro Ogawa ,&nbsp;Mayako Uchida","doi":"10.1016/j.clnu.2026.106581","DOIUrl":"10.1016/j.clnu.2026.106581","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Clinical evidence for anamorelin in pancreatic cancer is extremely limited, despite its approval in Japan. This study provides the first prospective evaluation of anamorelin specifically in pancreatic cancer, aiming to assess real-world efficacy and safety and to identify factors contributing to treatment-response heterogeneity through integrated biomarker analyses.</div></div><div><h3>Methods</h3><div>This prospective, single-center, observational study enrolled 24 patients with unresectable or metastatic pancreatic cancer who developed cachexia. Efficacy was evaluated in patients who received anamorelin for &gt;1 month. The primary endpoint was change in LBM from baseline, and secondary endpoints included the LBM-based response rate. Responders were defined as those who maintained or increased LBM during treatment. Safety assessment focused on treatment-related adverse events, particularly hyperglycemia.</div></div><div><h3>Results</h3><div>Seventeen patients were included in the efficacy analysis (median age, 68 years; median weight loss, 8.3 %). The mean LBM increased by 0.9 and 1.4 kg at 1 and 2 months, respectively. Quality-of-life scores related to appetite, weight gain, and total scores improved significantly at 1 month. Ten patients (58.8 %) were classified as responders, showing significant LBM gains from baseline (+2.4 kg at 1 month, +3.4 kg at 2 months, p &lt; 0.001). Handgrip strength also improved in responders compared with non-responders at 2 months (+1.7 kg vs −2.0 kg, p &lt; 0.01). Serum levels of insulin-like growth factor-1, inflammatory cytokines, ghrelin, and leptin levels did not differ significantly between baseline and 1 month. However, lower baseline body mass index (BMI) was strongly associated with response (sensitivity 85.7 %, specificity 90.0 %, area under the curve [AUC] 0.886, cutoff 20.4 kg/m²; p = 0.008). In the safety analysis (n = 23), 34.8 % experienced hyperglycemia of any grade, and 26.1 % developed grade ≥2 hyperglycemia—higher than in NSCLC trials. Median time to onset was 4.5 days (range, 2–18). Baseline diabetes was significantly associated with grade ≥2 hyperglycemia. This event was highly predictable by low pre-treatment ΔC-peptide levels (6–0 min; sensitivity 100.0 %, specificity 91.7 %, cut-off 1.03 ng/mL, AUC 0.967; p = 0.0032).</div></div><div><h3>Conclusions</h3><div>Anamorelin effectively improved LBM and appetite/QOL domains in pancreatic cancer, particularly in patients with low BMI. However, hyperglycemia—especially in those with impaired insulin secretion—requires careful monitoring. Baseline BMI and insulin secretion capacity should be evaluated before initiating therapy, and these findings provide preliminary insight into treatment response heterogeneity in pancreatic cancer cachexia.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106581"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077063","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 branched-chain amino acids, dietary factors, and sarcopenia risk in older adults with and without diabetes mellitus","authors":"Shu-Yi Li ,&nbsp;Ting Zhang ,&nbsp;Jason Leung ,&nbsp;Timothy Kwok","doi":"10.1016/j.clnu.2026.106590","DOIUrl":"10.1016/j.clnu.2026.106590","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Branched-chain amino acids (BCAAs), primarily obtained from the diet, can promote muscle protein synthesis, but excessive levels may lead to insulin resistance. How circulating BCAA is associated with diet and sarcopenia risk in older adults with diabetes mellitus (DM) remains unclear. This study aimed to examine the association of dietary factors and serum BCAA levels, and their association with sarcopenia risk, stratified by diabetes status.</div></div><div><h3>Methods</h3><div>This cohort study included 2994 community-dwelling older adults between 2001 and 2003. Serum BCAA levels (leucine, isoleucine and valine) were measured at baseline. Dietary data were collected by a food frequency questionnaire. Sarcopenia was defined as low muscle mass accompanied by low muscle strength and/or low physical performance at baseline and 4-year follow-up. Associations of serum BCAA with dietary factors and sarcopenia risk were examined using generalized linear and logistic regression models with restricted cubic splines.</div></div><div><h3>Results</h3><div>There were 433 participants with DM and 2561 without DM. In non-DM, dietary protein, protein sources, and overall diet quality were significantly associated with serum BCAA levels; in DM, only red meat and whole grain intakes were associated. These associations were attenuated after adjusting for sociodemographic, lifestyle and health-related factors. Elevated serum BCAA levels were associated with lower sarcopenia risk in non-DM (odds ratio [OR]: 0.72, 95% confidence interval [CI]: 0.64–0.81, per standard deviation [SD] of log-BCAA). However, a U-shaped association was observed in DM (<em>p</em>-nonlinearity = 0.0006), with the lowest risk at intermediate levels. Over 4 years of follow-up, higher BCAA levels were associated with reduced sarcopenia incidence in non-DM (OR: 0.79, 95% CI: 0.66–0.94), but no association in DM. Similar patterns were found for individual BCAA.</div></div><div><h3>Conclusions</h3><div>Higher BCAA levels may reduce sarcopenia risk in older adults without DM, but excessive BCAA levels may not offer muscle benefits in DM. Metabolic status should be considered when evaluating BCAA in sarcopenia prevention strategies.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106590"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146178202","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":"Is autism a developmental zinc deficiency?","authors":"Ann Katrin Sauer ,&nbsp;Janelle E. Stanton ,&nbsp;Andreas M. Grabrucker","doi":"10.1016/j.clnu.2026.106592","DOIUrl":"10.1016/j.clnu.2026.106592","url":null,"abstract":"<div><div>Autism spectrum disorder (ASD) is a complex condition influenced by genetic and environmental factors, particularly prenatal ones such as maternal infections, medications, toxins, and nutritional deficiencies. These factors interfere with brain development, leading to the core traits of ASD. Despite extensive research using animal and cell models, few fully replicate the complexity of ASD, highlighting the need to reassess our understanding of its biological processes. Prenatal zinc deficiency has emerged as a significant risk factor, inducing various ASD-related pathologies in studies and potentially uncovering fundamental disrupted biological processes. We propose that a core issue in ASD is metal homeostasis, especially abnormal zinc signaling. This review consolidates current evidence linking zinc to ASD and examines its critical roles in biological functions often affected in individuals with ASD. The findings suggest that prenatal zinc deficiency could reveal the fundamental biological processes disrupted in ASD, which other risk factors might mimic to a lesser extent. Consequently, this narrative review, based on a thorough synthesis of secondary data, provides a critical overview of the growing evidence connecting zinc to ASD while exploring its vital roles in biological functions frequently impaired in affected individuals.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106592"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164499","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}