Clinical nutrition最新文献

{"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}

{"title":"Associations of early life dietary diversity and healthy eating with celiac disease: A prospective cohort study.","authors":"Elin M Hård Af Segerstad, Annie Guo, Karl Mårild, Lars C Stene, Anne Lise Brantsæter, Ketil Størdal","doi":"10.1016/j.clnu.2025.07.012","DOIUrl":"10.1016/j.clnu.2025.07.012","url":null,"abstract":"<p><strong>Background & aims: </strong>The role of early-life overall diet in celiac disease risk is not well explored. The aim was to investigate associations of dietary diversity, and healthy eating in the second year of life with subsequent celiac disease risk.</p><p><strong>Methods: </strong>In 64,315 children born 2002-2009 with available data in the Mother, Father and Child Cohort Study, a Dietary Diversity Score (0-4) and Healthy Eating Index (0-36) were calculated using questionnaire data collected at age 18 months. The outcome was celiac disease diagnosis in the nationwide patient registry. Associations of dietary diversity and healthy eating per standard deviation (SD) increase with celiac disease risk were estimated as adjusted odds ratios (aOR) using logistic regression, accounting for maternal pregnancy smoking and gluten intake, parent's celiac disease, early-life infections, and gluten intake. Data on celiac disease-associated human leukocyte antigen (HLA) haplotypes were available in 50,383 children (78.3 %) RESULTS: After a mean of 16.1 (SD 1.8) years of follow-up, 1041 (1.6 %) children were diagnosed with celiac disease. At age 18 months, the mean Dietary Diversity Score was 2.3 (SD 0.4) and mean Healthy Eating Index 24.9 (SD 3.6). Higher dietary diversity was associated with a lower subsequent celiac disease risk (aOR 0.91, 95 %CI = 0.85-0.98). The association remained in children with HLA risk haplotypes, and when additionally adjusting for potential confounders, including breastfeeding. Healthy eating was not associated with celiac disease (aOR 1.03, 95 %CI = 0.96-1.10).</p><p><strong>Conclusions: </strong>In this population-based study, child dietary diversity in the second year of life (but not healthy eating) was associated with a modestly reduced risk of celiac disease.</p>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"52 ","pages":"171-178"},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803805","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":"Handling ethical issues in Clinical Nutrition","authors":"Diana Cárdenas ,&nbsp;Dileep N. Lobo","doi":"10.1016/j.clnu.2025.08.028","DOIUrl":"10.1016/j.clnu.2025.08.028","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"53 ","pages":"Pages 155-157"},"PeriodicalIF":7.4,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996753","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 impact of hemodiafiltration with endogenous reinfusion (HFR) on micronutrient status in patients undergoing maintenance hemodialysis: A randomized crossover trial","authors":"Bo Yang ,&nbsp;Zewei Chen ,&nbsp;Cheng Xue ,&nbsp;Changhao Zhu ,&nbsp;Dan Ye ,&nbsp;Qing Shao ,&nbsp;Fanzhou Zeng ,&nbsp;Nanmei Liu","doi":"10.1016/j.clnu.2025.08.031","DOIUrl":"10.1016/j.clnu.2025.08.031","url":null,"abstract":"<div><h3>Background</h3><div>Micronutrient deficiencies are common in patients undergoing maintenance hemodialysis (MHD), potentially contributing to adverse clinical outcomes. Hemodiafiltration with endogenous reinfusion (HFR) integrates convection, diffusion, and adsorption, potentially preserving essential nutrients better than traditional online hemodiafiltration (HDF). This study aimed to compare the acute effects of HFR and HDF on serum micronutrient concentrations in MHD patients.</div></div><div><h3>Methods</h3><div>The research has been registered in chictr.org.cn (ChiCTR2500096698). In this randomized crossover trial, 30 adult MHD patients received one session each of HFR and HDF, separated by a 2-week washout period consisting of their standard maintenance hemodialysis. Blood samples were collected pre- and post-treatment for trace elements and vitamin concentrations. The primary outcome was post-treatment serum iodine concentration, chosen to assess the acute dialytic clearance efficiency of iodine. Secondary outcomes included changes in serum concentrations of other trace elements and water- and fat-soluble vitamins. Linear mixed models (LMM) were used for between-treatment comparisons, and paired tests for within-group changes.</div></div><div><h3>Results</h3><div>A total of 30 patients (mean age 55.7 ± 14.8 years; 63.3 % male) completed the study. No significant difference was observed in post-treatment serum iodine between HFR and HDF (adjusted mean difference: −0.019 μmol/L, p = 0.343). However, HFR was associated with significantly greater reductions in serum calcium, vitamin D3, and selenium, compared to HDF (p &lt; 0.05 for all). In contrast, vitamin B3 concentrations were significantly higher after HFR (p = 0.047). No serious adverse events occurred, and both modalities were well-tolerated.</div></div><div><h3>Conclusions</h3><div>While HFR did not significantly differ from HDF in iodine clearance, it resulted in greater losses of calcium, vitamin D3, and selenium, but resulted in significantly higher post-treatment serum concentrations of vitamin B3. These findings suggest that until long-term studies demonstrate a clear net benefit, the routine clinical implementation of HFR outside of dedicated research contexts appears premature and requires significant caution.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"53 ","pages":"Pages 158-167"},"PeriodicalIF":7.4,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004516","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":"Clinical utility of measuring temporal muscle volume by head computed tomography for Global Leadership Initiative on Malnutrition phenotypic criteria in critically ill patients","authors":"Shinya Suganuma ,&nbsp;Kensuke Nakamura ,&nbsp;Naoki Kanda ,&nbsp;Nobuto Nakanishi ,&nbsp;Minoru Yoshida ,&nbsp;Tomoka Miyagi ,&nbsp;Shunsuke Takaki","doi":"10.1016/j.clnu.2025.08.027","DOIUrl":"10.1016/j.clnu.2025.08.027","url":null,"abstract":"<div><h3>Background</h3><div>The Global Leadership Initiative on Malnutrition (GLIM) lacks endorsed criteria for a muscle mass assessment. Since a muscle mass assessment using trunk computed tomography (CT) cannot be performed on all patients, a temporal muscle evaluation may serve as an useful alternative. In the present study, we hypothesized that complementing a total skeletal muscle mass assessment with a temporal muscle evaluation may provide a viable strategy for the GLIM assessment in the intensive care unit (ICU).</div></div><div><h3>Methods</h3><div>This single-center retrospective cohort study analyzed adult ICU patients. We selected optimal cut-off values for temporal muscle mass, measured by head CT, to predict sarcopenia as defined by the total skeletal muscle mass index in patients who underwent both abdominal and head CT. A reduced muscle mass, a component of the phenotypic criteria, was then evaluated using abdominal and head CT images. Muscle mass was assessed using abdominal CT if the patient underwent abdominal CT imaging and head CT if the patient only underwent head CT imaging. Patients who met at least one GLIM phenotypic criterion and one etiologic criterion were diagnosed with malnutrition. Clinical outcomes, including in-hospital mortality, were compared between patients with and without malnutrition.</div></div><div><h3>Results</h3><div>A total of 270 patients were included. The optimal cut-off for temporal muscle area was 250.11, adopted as the threshold for a reduced muscle mass. The combination of head and abdominal CT enabled muscle mass assessments in 215 (80 %) patients, whereas abdominal CT alone allowed assessments in 149 (55 %) patients. Malnutrition was identified in 71 patients (33 %) with assessments using abdominal and head CT. In-hospital mortality was significantly higher in the malnutrition group (29.6 % vs. 9.7 %, p &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>A muscle mass evaluation using both head and abdominal CT images enables the GLIM assessment in a larger patient population. This approach may support the GLIM assessment in ICU patients.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"53 ","pages":"Pages 133-143"},"PeriodicalIF":7.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989313","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 plasma proteome of plant-based diets: Analyses of 2920 proteins in 49,615 people","authors":"Tammy Y.N. Tong,&nbsp;Karl Smith-Byrne,&nbsp;Keren Papier,&nbsp;Joshua R. Atkins,&nbsp;Mahboubeh Parsaeian,&nbsp;Timothy J. Key,&nbsp;Ruth C. Travis","doi":"10.1016/j.clnu.2025.08.032","DOIUrl":"10.1016/j.clnu.2025.08.032","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Circulating proteins are integral to many biological processes and could be influenced by diet. We aimed to assess differences in the plasma proteome between people of different dietary groups, defined by degree of animal food consumption.</div></div><div><h3>Methods</h3><div>The UK Biobank recruited middle-aged adults (mostly 40–69 years) throughout the UK between 2006 and 2010. Relative concentrations of 2920 plasma proteins were quantified using the Olink Proximity Extension Assay on blood samples from 49,615 participants, who were also asked to report their ethnicity and consumption of red and processed meat, poultry, fish, dairy and eggs. We defined six diet groups among the white British participants (23,243 regular meat eaters, 23,472 low meat eaters, 486 poultry eaters, 1081 fish eaters, 721 vegetarians, and 54 vegans), and two diet groups among the British Indians (391 meat eaters and 167 vegetarians). We used multivariable-adjusted linear regressions to assess the cross-sectional differences in protein concentrations between diet groups, with correction for multiple testing.</div></div><div><h3>Results</h3><div>We observed significant differences in many plasma proteins by diet group (920 proteins in white British participants, 2 in British Indians). Of the biggest differences, compared with regular meat eaters, the non-meat eaters had significantly higher FGF21 (e.g. +0.40 SD in vegetarians), CKB (+0.34), GUCA2A (+0.33), FOLR1 (+0.32), IGFBP2 (+0.31) and DSG2 (+0.30); all groups except the vegans had lower HAVCR1 (−0.38 in vegetarians). Vegetarians also had significantly lower SELENOP (−0.46), while the vegans had lower FGFBP2 (−0.68). The observed differences were generally similar in direction in both ethnicities.</div></div><div><h3>Conclusions</h3><div>In this first comprehensive assessment of plasma proteins by diet group, we identified many differences in proteins between vegetarians, vegans and meat eaters; this variation in protein levels suggests differences in various biological activities, including gastrointestinal tract and kidney function, which may relate to differences in future disease risk.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"53 ","pages":"Pages 144-154"},"PeriodicalIF":7.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989315","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":"Do functional gut parameters predict enteral autonomy and chronic cholestasis in pediatric intestinal failure?","authors":"Lotte E. Vlug ,&nbsp;Frank G. Schaap ,&nbsp;Kaatje Lenaerts ,&nbsp;Esther G. Neelis ,&nbsp;Hans M. van Eijk ,&nbsp;Sander M.J. van Kuijk ,&nbsp;Merit M. Tabbers ,&nbsp;Sjoerd C.J. Nagelkerke ,&nbsp;René M.H. Wijnen ,&nbsp;Edmond H.H.M. Rings ,&nbsp;Jessie M. Hulst ,&nbsp;Steven W.M. Olde Damink ,&nbsp;Barbara A.E. de Koning","doi":"10.1016/j.clnu.2025.08.030","DOIUrl":"10.1016/j.clnu.2025.08.030","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Parenteral nutrition (PN) dependency in patients with intestinal failure (IF) can lead to complications including liver disease. Therefore, IF management strives to wean patients off PN. In adult IF, chronic cholestasis is predicted by the functional gut parameters citrulline (CIT) and enteroendocrine fibroblast growth factor 19 (FGF19), which inhibits hepatic bile salt synthesis. We investigated 1) whether CIT, FGF19 and a marker for enterocyte damage (urinary intestinal fatty acid-binding protein (I-FABP)) are associated with enteral autonomy within 60 days after intestinal surgery in neonates, and 2) the longitudinal patterns of CIT, FGF19, total bile salts and C4 (marker for bile salt synthesis) in subgroups of children on long-term PN (short bowel syndrome (SBS) and functional IF).</div></div><div><h3>Methods</h3><div>A prospective two-center cohort study, including 1) neonates with PN-need after intestinal surgery and 2) children (aged &lt;18y) with &gt;6 months PN-dependency. CIT, FGF19, and I-FABP were measured post-surgery in neonates. CIT, FGF19, total bile salts and C4 were assessed on inclusion in children with long-term PN-dependency. Associations were analyzed using Cox regression models. Longitudinal patterns were analyzed using linear mixed-effects models.</div></div><div><h3>Results</h3><div>Of 50 neonates, 52 % reached enteral autonomy. Residual small bowel length &lt;75 cm (hazard ratio 0.23, p = 0.046), but not CIT, FGF19 or I-FABP concentrations, was negatively associated with 60-day enteral autonomy. Children with SBS (n = 20) had dysregulated bile salt synthesis with lower FGF19 (24.4 vs 108.8 pg/mL, p = 0.004) and higher C4 concentrations (110.3 vs 30.9 pg/mL, p = 0.024) than children with functional IF (n = 20). In children with long-term PN, CIT concentration significantly increased with decreasing PN-dependency and total bile salt concentration significantly increased with increasing PN-duration.</div></div><div><h3>Conclusion</h3><div>Functional gut biomarkers provided no additional value in predicting enteral autonomy in neonates post-intestinal surgery over residual small bowel length. In children on long-term PN, enhanced bile salt synthesis was observed in those with SBS.</div></div><div><h3>Clinical trial registration</h3><div>Overview of Medical research in the Netherlands (OMON) NL-OMON27840 (previously NTR6080), <span><span>https://trialsearch.who.int/Trial2.aspx?TrialID=NL-OMON27840</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"53 ","pages":"Pages 168-176"},"PeriodicalIF":7.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018428","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":"Retraction notice to “Effects of omega-3 fatty acid supplementation on insulin metabolism and lipid profiles in gestational diabetes: Randomized, double-blind, placebo-controlled trial” [Clin Nutr 34 (2015) 388–393]","authors":"Mansooreh Samimi ,&nbsp;Mehri Jamilian ,&nbsp;Zatollah Asemi ,&nbsp;Ahmad Esmaillzadeh","doi":"10.1016/j.clnu.2025.08.026","DOIUrl":"10.1016/j.clnu.2025.08.026","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"53 ","pages":"Page 285"},"PeriodicalIF":7.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945495","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":"Proteomic signatures of grip strength and healthy aging among older adults: A prospective cohort study in the UK Biobank","authors":"Zhong-Yue Liu ,&nbsp;Jing Yang ,&nbsp;Fei Fang ,&nbsp;Yong-Gang Hao ,&nbsp;Xiu-Ying Cai ,&nbsp;Meng-Yuan Miao ,&nbsp;Jie-Qiong Lyu ,&nbsp;Ji-Mei Gu ,&nbsp;Yu-Wen Qian ,&nbsp;Zhong-Xiao Wan ,&nbsp;Li-Qiang Qin ,&nbsp;Qi Fang ,&nbsp;Guo-Chong Chen","doi":"10.1016/j.clnu.2025.08.024","DOIUrl":"10.1016/j.clnu.2025.08.024","url":null,"abstract":"<div><h3>Background</h3><div>While grip strength (GS) is recognized as a feasible predictor of various health outcomes, its association with healthy aging and the role of plasma proteins remain unclear.</div></div><div><h3>Methods</h3><div>We included 27,828 apparently healthy adults aged 64 years or older who were eligible to survive to age 80 as of the latest follow-up. Healthy aging was defined as survival to age 80 without developing major chronic diseases (MCDs) during the follow-up. Multivariable Logistic regression models assessed the relationship of absolute or relative GS with the likelihood of healthy aging. In a subset of 3366 participants, plasma proteomic signatures of GS were identified and their mediating effects on the GS-healthy aging relationship were further assessed.</div></div><div><h3>Results</h3><div>In total, 16,844 (60.5 %) participants achieved healthy aging. After multivariable adjustment, higher levels of absolute and relative GS were associated with a 67 % (95 % confidence interval [CI]: 50 %–88 %) and a 92 % (95 % CI: 75 %–110 %) higher likelihood of healthy aging, respectively. There were 298 proteins related to both absolute and relative GS in the same direction (20 upwards and 278 downwards), with 50 proteins showing significant associations (13 positive and 37 inverse) with healthy aging. The majority of these 50 proteins showed mediating effects on the relationship of GS with healthy aging, potentially involving cytokine-cytokine receptor interaction, viral protein interactions with cytokine receptor, and the chemokine signaling pathway.</div></div><div><h3>Conclusions</h3><div>Greater GS is associated with a higher likelihood of healthy aging, partially through the modulation of circulating proteins involving the pathways of inflammation and immunity responses.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"53 ","pages":"Pages 60-68"},"PeriodicalIF":7.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916339","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 Galectin-9 and Decorin in relation to brain aging and the green-Mediterranean diet: A secondary analysis of the DIRECT PLUS randomized trial","authors":"Dafna Pachter ,&nbsp;Anat Yaskolka Meir ,&nbsp;Alon Kaplan ,&nbsp;Gal Tsaban ,&nbsp;Hila Zelicha ,&nbsp;Ehud Rinott ,&nbsp;Gidon Levakov ,&nbsp;Ofek Finkelstein ,&nbsp;Ilan Shelef ,&nbsp;Moti Salti ,&nbsp;Frauke Beyer ,&nbsp;Veronica Witte ,&nbsp;Nora Klöting ,&nbsp;Berend Isermann ,&nbsp;Uta Ceglarek ,&nbsp;Tammy Riklin Raviv ,&nbsp;Matthias Blüher ,&nbsp;Michael Stumvoll ,&nbsp;Dong D. Wang ,&nbsp;Frank B. Hu ,&nbsp;Iris Shai","doi":"10.1016/j.clnu.2025.08.021","DOIUrl":"10.1016/j.clnu.2025.08.021","url":null,"abstract":"<div><h3>Background and aims</h3><div>We explored whether changes in serum proteomic profiles differed between participants with distinct brain aging trajectories, and whether these changes were influenced by dietary intervention.</div></div><div><h3>Methods</h3><div>In this secondary analysis of the 18-month DIRECT PLUS trial, 294 participants were randomized to one of three arms: 1) Healthy dietary guidelines (HDG); 2) Mediterranean (MED) diet (+440 mg/day polyphenols from walnuts); or 3) low red/processed meat green-MED diet (+1240 mg/day polyphenols from walnuts, Mankai plant, and green tea). We measured 87 serum proteins (Olink-CVDII). We used Magnetic-Resonance-Imaging (MRI)-assessed 3D-T1-weighted brain scans for brain age calculation (by convolutional neural network) to identify protein markers reflecting the brain age gap (BAG; deviation of MRI-assessed brain age from chronological age).</div></div><div><h3>Results</h3><div>At baseline, lower weight, waist circumference, diastolic blood pressure, and HbA1c parameters were associated with a younger brain age than expected. Specifically, higher levels of two proteins, Galectin-9 (Gal-9) and Decorin (DCN), were associated with accelerated brain aging (larger BAG). A proteomics principal component analysis (PCA) revealed a difference in PC1 between the two time-points for participants with accelerated brain aging. Between baseline and 18 months, Gal-9 significantly decreased among individuals who completed the intervention with attenuated brain aging, while DCN significantly increased among those who completed the trial with accelerated brain aging. A significant interaction was observed between the green-MED diet and proteomics PCA, resulting in a beneficial change compared to the HDG. Participants in the green-MED diet significantly decreased Gal-9 compared to the HDG diet and from baseline.</div></div><div><h3>Conclusions</h3><div>Higher serum levels of Gal-9 and DCN may indicate an acceleration of brain aging and could be reduced by a green-MED/high-polyphenol (green tea and Mankai) and low-red/processed meat diet.</div></div><div><h3>Trial registration number</h3><div>NCT03020186.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"53 ","pages":"Pages 99-108"},"PeriodicalIF":7.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922135","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}