Clinical nutrition最新文献

{"title":"Reply - Letter to the editor - Comment on “Ultra-processed foods and liver cancer risk: A call for further investigation\"","authors":"Longgang Zhao, Xuehong Zhang","doi":"10.1016/j.clnu.2025.01.024","DOIUrl":"10.1016/j.clnu.2025.01.024","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"46 ","pages":"Page 136"},"PeriodicalIF":6.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348080","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":"Prophylactic anticoagulation in children receiving home parenteral nutrition: An international prospective multicenter study","authors":"Aysenur Demirok ,&nbsp;Sjoerd C.J. Nagelkerke ,&nbsp;Samantha C. Gouw ,&nbsp;Barbara A.E. de Koning ,&nbsp;C. Heleen van Ommen ,&nbsp;Rozemarijn Duister ,&nbsp;Marc A. Benninga ,&nbsp;Cécile Lambe ,&nbsp;Merit M. Tabbers","doi":"10.1016/j.clnu.2025.01.023","DOIUrl":"10.1016/j.clnu.2025.01.023","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Catheter-related thrombosis (CRT) is a serious complication associated with home parenteral nutrition (HPN) in children with chronic intestinal failure (CIF). Guidelines on pediatric HPN state that there is insufficient evidence to advocate the prophylactic use of CRT. Aim is to evaluate the efficacy and safety of prophylactic anticoagulation in preventing CRT in children on HPN.</div></div><div><h3>Methods</h3><div>We performed a prospective, international, multicenter study across three expertise centers. Children aged 0–18 years on HPN were included and divided into two groups: 1) primary/secondary prophylaxis- and 2) non-prophylaxis group. Participants were followed for 24 months and screened for CRT using ultrasonography annually. Primary outcomes included total incidence of CRT per 1000 catheter days, and association between prophylactic anticoagulation and CRT. Propensity score stratification and logistic regression were used to evaluate the association between prophylactic anticoagulation and CRT, adjusting for significant covariates differing between groups. Balance was visually assessed before and after stratification, and statistical significance (p &lt; 0.05) was determined. Secondary outcomes included incidence of catheter-related bloodstream infections (CRBSI) and bleeding events per 1000 catheter days.</div></div><div><h3>Results</h3><div>A total of 115 children, mean age of 6,9 years (SD 4,6), were included. Fifty-seven patients were receiving prophylactic anticoagulation (50 %). The overall incidence of CRT was 0.17 per 1000 catheter days in 13 patients (11 %), with no significant difference between the prophylaxis (n = 6) and non-prophylaxis group (n = 7) (odds ratio 0.64, 95 % CI: 0.12–3.4, <em>p</em> = 0.60). Incidence rate of CRBSIs was 0.34/1000 catheter days (n = 25). Patients with CRT during follow up were significantly more likely to have a CRBSI (54 %) compared to those without (14 %) (p = 0.010). Two minor bleeding events were reported in the prophylaxis group, resulting in an incidence of 0,03/1000 catheter days.</div></div><div><h3>Conclusions</h3><div>Our study shows that prophylactic anticoagulation does not significantly reduce the incidence of CRT in children on HPN. Our results do underline the clinical importance of optimal catheter care and infection prevention as CRBSIs were more likely to occur in patients with CRT, and emphasize the need for larger multicenter trials to establish evidence-based recommendations for the use of prophylactic anticoagulation in children on HPN.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"46 ","pages":"Pages 88-95"},"PeriodicalIF":6.6,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074112","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":"Effects of four-weeks porcine-collagen hydrolysate consumption on glucose concentrations, glycemic variability, and fasting/postprandial cardiometabolic risk markers in men and women with overweight or obesity: A randomized, controlled trial","authors":"Marco A. Chavez-Alfaro,&nbsp;Ronald P. Mensink,&nbsp;Jogchum Plat","doi":"10.1016/j.clnu.2025.01.018","DOIUrl":"10.1016/j.clnu.2025.01.018","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Different collagen hydrolysate sources have reduced fasting glucose concentrations. Although porcine-derived collagen hydrolysate predicts in vitro the highest potency for improving glucose metabolism, these effects have not been studied in humans.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aim&lt;/h3&gt;&lt;div&gt;To evaluate the effects of porcine-derived collagen hydrolysate on continuously monitored glucose concentrations in real-life conditions in individuals with overweight/obesity. Additionally, postprandial responses following a mixed meal test were examined.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Fifty-six men and women participated in this randomized placebo-controlled parallel trial. After a two-week run-in period, participants consumed daily for four weeks 10 g porcine-derived collagen hydrolysate or placebo (erythritol). The primary outcome parameter was the interstitial glucose area under the curve (AUC) during daytime (07:00 to 22:00) measured during three consecutive days. In addition, glycemic variability (GV) was quantified. For this, a continuous glucose monitor (Freestyle Libre ProiQ, Wiesbaden, Germany) was used at the end of the run-in and intervention periods. Postprandial glucose, insulin, and triacylglycerol concentrations were also evaluated after a mixed meal tolerance test. Furthermore, fasting glucose, insulin, hemoglobin A1c (HbA1c), homeostatic model assessment for insulin resistance (HOMA-IR), HOMA of β-cell function (HOMA-β), and triacylglycerol changes were analyzed. Physical activity profiles and dietary intakes were monitored to exclude confounding by these lifestyle factors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Collagen hydrolysate consumption did not significantly affect daytime interstitial glucose AUC concentrations (95%CI for the effect size: −5.1, 30.0 mmol/(L∗h); p-value = 0.159), but increased several GV metrics: standard deviation (95%CI: 0.0, 0.2 mmol/L; p-value = 0.011), continuous overall net glycemic action (CONGA-4) (95%CI: 0.1, 0.4 mmol/L; p-value = 0.015), coefficient of variation (95%CI: 0.1, 3.0 %; p-value = 0.036), M-value (95%CI: 0.2, 1.8; p-value = 0.036), and mean amplitude of glycemic excursions (MAGE) (95%CI: 0.2, 1.8 mmol/L; p-value = 0.036). Furthermore, the postprandial glucose AUC after the mixed meal test significantly increased (95%CI: 0, 103 mmol/L∗4-h; p-value = 0.049), as well as fasting insulin concentrations (p-value = 0.005), HOMA-IR (p-value = 0.008), and HOMA-β (p-value = 0.009). Other parameters, anthropometrics, physical activity, and energy/nutrient intakes were not significantly changed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Four-week collagen hydrolysate intake did not change free-living glucose concentrations, but increased GV, postprandial glucose AUC, fasting insulin, HOMA-IR, and HOMA-β. However, these changes were small with limited clinical relevance. Therefore, it can be concluded that this porcine-derived collagen hydrolysate does not improve glucose metabolism or ot","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"46 ","pages":"Pages 60-71"},"PeriodicalIF":6.6,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073774","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":"Breastmilk polyamines modify gut gene expression in children at three months of age","authors":"María Sánchez-Campillo ,&nbsp;Antonio Gázquez ,&nbsp;María T. Pastor-Fajardo ,&nbsp;María J. López-Andreo ,&nbsp;Adrián Pérez-Andrés ,&nbsp;Carmen Martínez-Graciá ,&nbsp;Jesús Vioque ,&nbsp;Virginia Pérez-Fernández ,&nbsp;Luís García-Marcos ,&nbsp;Elvira Larqué","doi":"10.1016/j.clnu.2025.01.025","DOIUrl":"10.1016/j.clnu.2025.01.025","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Breastmilk is one of the main sources of exogenous polyamines for newborns and contains higher polyamine content than infant formulas. Polyamines are involved in gut maturation and immune system regulation in animals, although the underlying mechanisms are not fully understood. We quantified polyamines in human mature breastmilk and evaluate their effects on intestinal gene expression in babies at three months of age.</div></div><div><h3>Methods</h3><div>Polyamines were quantified in mature milk of 195 women from the prospective Mediterranean NELA birth cohort (Murcia, Spain) at 3 months postpartum. Maternal dietary intake was assessed by food frequency questionnaires. Intestinal gene expression was analysed in babies receiving breastmilk, with high (&gt;p50, n = 25) or low (&lt;p50, n = 27) polyamine content, at 3 m of age, by microarray using a non-invasive method on gut exfoliated cells.</div></div><div><h3>Results</h3><div>Spermidine and spermine were the most prevalent polyamines in breastmilk at 3 months postpartum, while levels of putrescine were lower. Maternal dietary intake of polyamines was not associated with polyamine concentration in breastmilk and there were no differences in the polyamine content between allergic and non-allergic mothers. Microarray analyses of exfoliated gut cells revealed that cell localization and immune system were the most significant biological processes affected by high vs low polyamines in breastmilk. There were 15 differentially expressed genes, 3 up-regulated and 12 down-regulated, in high compared to low polyamine groups. Among the up-regulated genes were tumour necrosis factor alpha-induced protein 6 (<em>TNFAIP6</em>) and interleukin 8; while other immune system-related genes, such as integral membrane protein 2C, lymphocyte antigen 6 complex, transmembrane protein 179B were down-regulated.</div></div><div><h3>Conclusions</h3><div>Mature breastmilk presents spermidine and spermine as the most prevalent polyamines. Babies receiving milk with higher polyamine levels showed differences in the expression of genes associated with cell localization and immune system processes.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"46 ","pages":"Pages 80-87"},"PeriodicalIF":6.6,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073518","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":"Feasibility challenges in protein supplementation research: Insights from the convalescence of functional outcomes after intensive care unit stay in a Randomised Controlled Trial","authors":"Michelle Carmen Paulus ,&nbsp;Imre Willemijn Kehinde Kouw ,&nbsp;Yente Florine Niké Boelens ,&nbsp;Anoek Jacqueline Hubertine Hermans ,&nbsp;Bert Strookappe ,&nbsp;Arthur Raymond Hubert van Zanten","doi":"10.1016/j.clnu.2025.01.020","DOIUrl":"10.1016/j.clnu.2025.01.020","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background &amp; aims&lt;/h3&gt;&lt;div&gt;Dietary protein supplementation may benefit physical outcomes in post-intensive care unit (ICU) patients suffering ICU-acquired weakness (ICU-AW). This study examines the impact of a six-week protein supplementation compared to an isocaloric carbohydrate on physical functioning outcomes in post-ICU patients with a follow-up of 12 weeks after ICU discharge. This paper presents descriptive data, feasibility outcomes, and the barriers faced while conducting this nutritional intervention study in post-ICU patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This two-arm, randomised, double-blind controlled intervention trial involved adult patients (≥18 y) who were admitted to the ICU for ≥72 h with moderate ICU-AW (Medical Research Council (MRC) score 24–48). Patients were randomly assigned to receive 22 g of collagen peptides supplementation or an isocaloric carbohydrate twice daily. The primary outcome was a composite score for physical functioning comprising handgrip strength, leg muscle strength, arm muscle strength, and exercise capacity, adjusted for age, sex, and body weight. Secondary endpoints included nutritional intake and biomarkers, scores in other post-intensive care syndrome (PICS) domains, and mortality rates. Descriptive data is presented, no between-intervention group analyses were conducted due to incomplete sample size.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 900 patients were screened for eligibility to participate in the study, of whom 59 met the requisite criteria between April 2022 and December 2023. The most common reasons for exclusion were treatment limitations, diabetes mellitus, or an MRC score &lt;24 or above &gt;48. Of the 59 patients deemed eligible, 15 patients were included to participate in the study. Due to the slow inclusion rate, the study was terminated early (at ∼20 % of anticipated sample size). At baseline (ICU discharge), patients initially had lower physical scores than reference values but showed improved (higher) scores at three months post-ICU discharge. Differences between the groups regarding the primary outcome (composite score of physical functioning) could not be identified due to early termination. Factors affecting the feasibility of nutrition research in post-ICU patients were identified, including slow patient recruitment rates, low adherence to the intervention, and the inability to complete outcome assessments.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Patients exhibited initial physical functioning scores below the reference values yet demonstrated substantial physical recuperation by the 12-week mark following their ICU discharge in both groups. Patients exhibited lower scores in all domains of PICS compared to reference values, emphasising the necessity for further investigation into the potential role of nutrition interventions in preventing and alleviating PICS symptoms. Furthermore, this study describes the factors affecting the feasibility of po","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"46 ","pages":"Pages 119-130"},"PeriodicalIF":6.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160342","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":"Perturbations in plasma amino acid and lipoprotein subfraction profiles in anorexia nervosa before and after refeeding: A metabolomic cross-sectional and longitudinal analysis","authors":"Nikolaos Perakakis ,&nbsp;Alexander M. Funk ,&nbsp;Theresa Kolb ,&nbsp;Sophie Jonas ,&nbsp;Inger Hellerhoff ,&nbsp;Friederike I. Tam ,&nbsp;Stefan R. Bornstein ,&nbsp;Triantafyllos Chavakis ,&nbsp;Peter Mirtschink ,&nbsp;Stefan Ehrlich","doi":"10.1016/j.clnu.2025.01.014","DOIUrl":"10.1016/j.clnu.2025.01.014","url":null,"abstract":"<div><h3>Background</h3><div>Anorexia nervosa (AN) is a life-threatening eating disorder, which is increasingly being considered a metabo-psychiatric condition. We aimed to assess how the lipoprotein subfraction and plasma metabolome are altered in acutely underweight patients with AN (AcAN), if they change with short-term weight-restoration, and whether these changes point towards altered cardiometabolic risk.</div></div><div><h3>Methods</h3><div>Using nuclear magnetic resonance spectroscopy, we measured and compared the plasma concentrations of 132 metabolites, aminoacids and lipoprotein subfractions in young female patients with AcAN before (n = 72) versus after (n = 46) a short-term inpatient refeeding program resulting in weight-restoration (longitudinal analysis), as well as versus female healthy control (HC) participants of similar age (n = 74) (cross-sectional analysis).</div></div><div><h3>Findings</h3><div>Patients with AcAN showed elevated plasma cholesterol levels due to higher concentrations of small and dense Low Density Lipoprotein (LDL-6) and of large and less dense High Density Lipoprotein (HDL-1) subfractions compared to HC. Additionally, they had lower plasma concentrations of branched chain amino acids and glucose and higher concentrations of the gluconeogenic amino acids glutamine, alanine and methionine. Refeeding elevated the plasma cholesterol levels further, but with a different pattern compared to AcAN, by increasing the concentrations of the larger and less dense LDL (LDL-1, LDL-2, LDL-3) particles and of smaller and more dense HDL (HDL-2, HDL-3) subfractions. However, refeeding only partially restored the amino acid concentrations.</div></div><div><h3>Conclusion</h3><div>Lipoprotein profiles in AcAN point towards a potentially elevated risk for atherosclerosis; an altered lipoprotein profile was also detected after refeeding. Metabolite profiles in AcAN indicate an advanced catabolic state with only partial restoration after refeeding.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"46 ","pages":"Pages 107-116"},"PeriodicalIF":6.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074110","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":"Determinants of journal impact factors in ‘Nutrition and Dietetics’","authors":"Dileep N. Lobo ,&nbsp;Keith R. Neal","doi":"10.1016/j.clnu.2025.01.021","DOIUrl":"10.1016/j.clnu.2025.01.021","url":null,"abstract":"<div><h3>Background and aim</h3><div>The aim of this cross-sectional study was to analyse determinants of the 2023 impact factors (IFs) of journals within the field of ‘Nutrition and Dietetics’.</div></div><div><h3>Methods</h3><div>The Clarivate™ Journal Citation Reports™ website (<span><span>https://jcr.clarivate.com/jcr/home</span><svg><path></path></svg></span>) was searched on 9 January 2025 for journals with a 2023 IF (published in June 2024) ≥ 6.0 in the field of ‘Nutrition and Dietetics’. Analysis was performed using GraphPad Prism software.</div></div><div><h3>Results</h3><div>There were there were 84,040 citations in 2023 to 10,719 works published in 2021 and 2022 in the 12 journals with an IF ≥ 6.0. Median numbers of citations per output were lower than mean citations in all journals. This difference ranged from 0.55 to 3.97. Most outputs (47.5%–79.1 %) had 1–10 citations. The 1538 open access outputs were cited less frequently [mean (95 % CI) 6.98 (6.55–7.40)] than the 9181 subscription outputs [7.99 (7.81–8.16), <em>P</em> &lt; 0.0001]. The 2063 reviews were cited more frequently [8.94 (8.45–9.43)] than the 8656 original articles [7.58 (7.42–7.74), <em>P</em> &lt; 0.0001]. When the highest cited outputs from each journal were excluded, the fall in IFs ranged from 0 to 2.4. The was also the case when the two highest cited outputs were excluded (fall ranged from 0 to 2.7).</div></div><div><h3>Conclusion</h3><div>This comprehensive analysis of journal IFs has shown that although review articles increase IFs of journals, open access outputs do not. IFs can be distorted by 1 or 2 highly cited outputs and may not reflect the impact of the majority of outputs.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"46 ","pages":"Pages 72-79"},"PeriodicalIF":6.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073708","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 associations between irregular breakfast and late-night snacking with metabolic dysfunction-associated steatotic liver disease","authors":"Wenzai Shi ,&nbsp;Xiaopeng Suo ,&nbsp;Yiming Wang ,&nbsp;Nan Yao ,&nbsp;Siyu Xing ,&nbsp;Pengcheng Wei ,&nbsp;Delin Ma ,&nbsp;Jiye Zhu ,&nbsp;Qingsong Zhang ,&nbsp;Zhao Li","doi":"10.1016/j.clnu.2025.01.019","DOIUrl":"10.1016/j.clnu.2025.01.019","url":null,"abstract":"<div><h3>Background</h3><div>The newly coined term Metabolic dysfunction-associated steatotic liver disease (MASLD) emphasizes the critical role of metabolic risk factors in the pathogenesis of fatty liver disease. The consumption of irregular breakfasts or late-night snacks has been identified as a factor closely associated with disruptions in the body's energy homeostasis and metabolic balance. However, the relationship between these behaviors and MASLD has not been previously examined.</div></div><div><h3>Methods</h3><div>Participants in this study were recruited from the Kailuan cohort, a prospective cohort. All participants completed questionnaires regarding breakfast and late-night snack frequencies. The primary outcomes were MASLD and MASLD with increased alcohol intake (MetALD). Cox regression analysis was utilized to calculate the hazard ratios (HR) and 95 % confidence intervals (CI) for MASLD and MetALD in different groups. Mediation analysis was used to assess the mediating effect of BMI on this relationship.</div></div><div><h3>Results</h3><div>A total of 32,030 participants were included in the study. Both irregular breakfast consumption and late-night snacking were associated with an increased risk of MASLD. Compared to participants who consumed regular breakfast and no late-night snacks, the risk of MASLD was elevated in participants who consumed regular breakfast but late-night snacks (HR = 1.12, 95 % CI: 1.05–1.20), irregular breakfast but no late-night snacking (HR = 1.16, 95 % CI: 1.05–1.27), irregular breakfast and late-night snacking (HR = 1.26, 95 % CI: 1.13–1.42), never ate breakfast and no late-night snacking (HR = 1.33, 95 % CI: 1.23–1.44), and never ate breakfast and late-night snacking (HR = 1.52, 95 % CI: 1.30–1.77).</div></div><div><h3>Conclusion</h3><div>Irregular or skipped breakfast and late-night snacking were associated with an increased risk of MASLD and MetALD.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"46 ","pages":"Pages 52-59"},"PeriodicalIF":6.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045834","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":"Effects of ketogenic and low-carbohydrate diets on the body composition of adults with overweight or obesity: A systematic review and meta-analysis of randomised controlled trials","authors":"Leona Yuen-Ling Leung ,&nbsp;Hon-Lon Tam ,&nbsp;Jonathan Ka-Ming Ho","doi":"10.1016/j.clnu.2025.01.017","DOIUrl":"10.1016/j.clnu.2025.01.017","url":null,"abstract":"<div><h3>Background and aims</h3><div>More than one-third of individuals are overweight and obese in the world. Their risks of chronic health conditions are increased, which places additional burden on their family, caregivers, and healthcare system. Dietary modification is widely used for overweight and obese individuals. We investigated the effects of ketogenic diet (KD) and low-carbohydrate diet (LCD) in improving body weight (BW), body mass index (BMI), fat mass (FM), and body fat percentage (BFP) in overweight or obese individuals.</div></div><div><h3>Methods</h3><div>A three-step approach was adopted for searching relevant randomised controlled trials (RCTs) across five electronic databases. Two reviewers conducted the screening, review, and quality appraisal independently. A random-effects model was used because of variations in intervention and participant characteristics. Sensitivity and subgroup analyses were conducted to assess heterogeneity and variations in the results, respectively.</div></div><div><h3>Results</h3><div>Thirty-three RCTs involving 2821 individuals were included. Overall meta-analysis results indicated that KD/LCD significantly reduced BW, BMI, and BFP, but not FM, in individuals with a carbohydrate intake of ≤100 g/d. Subgroup analyses revealed significant improvements in BW, BMI, and FM in individuals on KD/LCD for ≥1 month and in all parameters for those with a carbohydrate intake of ≤50 g/d. High statistical heterogeneity was noted because of variations in interventions and participant characteristics.</div></div><div><h3>Conclusion</h3><div>Adults with overweight or obesity should consume KD/LCD for ≥1 month and limit carbohydrate intake to ≤50 g/d. Further multicentre or multicountry RCTs are needed to improve the generalisability of our findings. We recommend integrating text messaging and evidence-based information to support interventions and ensuring stringent medical supervision throughout the intervention.</div></div><div><h3>PROSPERO registration number</h3><div>CRD42022353074.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"46 ","pages":"Pages 10-18"},"PeriodicalIF":6.6,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037395","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 patterns modify the association between body mass index and mortality in older adults","authors":"Shu-Yi Li ,&nbsp;Zhi-Hui Lu ,&nbsp;Jason Leung ,&nbsp;Yi Su ,&nbsp;Blanche Yu ,&nbsp;Timothy Kwok","doi":"10.1016/j.clnu.2025.01.016","DOIUrl":"10.1016/j.clnu.2025.01.016","url":null,"abstract":"<div><h3>Background</h3><div>The potential modifying roles of dietary patterns in the association between body mass index (BMI) and mortality in older adults remain unclear. This study aimed to examine the stratified and combined associations of dietary patterns and BMI with all-cause, cancer and cardiovascular disease (CVD) mortality.</div></div><div><h3>Methods</h3><div>This prospective cohort study included 3982 Chinese community-dwelling older adults between 2001 and 2003. A 280-item validated food frequency questionnaire was used to calculate five dietary indies: Diet Quality Index-International (DQI-I), Dietary Inflammatory Index (DII), Mediterranean Diet Score (MDS), Dietary Approaches to Stop Hypertension (DASH), and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet. Higher DQI-I scores indicate better overall diet quality, while higher DII scores represent a pro-inflammatory diet. Higher MDS, DASH, and MIND scores indicate greater adherence to these healthy dietary patterns. Mortality data were obtained from official records. Hazard ratios (HRs) and 95 % confidence intervals (CIs) were estimated using Cox proportional hazards models.</div></div><div><h3>Results</h3><div>Over a median follow-up of 16.8 years, there were 1879 all-cause deaths, 561 cancer deaths, and 386 CVD deaths. The J-shaped associations between BMI with all-cause and cancer mortality were weaker in healthier dietary patterns (DQI-I, MDS, DASH, MIND ≥median or DII &lt;median) than in unhealthier dietary patterns (DQI-I, MDS, DASH, MIND &lt;median or DII ≥median). Lower DQI-I scores were associated with increased all-cause mortality risk in participants with underweight (HR: 1.78; 95 % CI: 1.40–2.26) or obesity (HR: 1.25; 95 % CI: 1.02–1.53), while higher DQI-I scores did not have significantly higher risk in participants with underweight (HR:1.24, 95 % CI: 0.94–1.65) or obesity (HR:1.03, 95 % CI: 0.82–1.28), with those having higher DQI-I scores and normal weight as the reference. Higher DQI-I scores attenuated the excess risk of cancer mortality in the underweight or the obese. Similar trends were observed for other dietary patterns. For CVD mortality, lower DII and higher MIND scores reduced the elevated risk associated with obesity, but this modifying effect was not observed in other dietary patterns.</div></div><div><h3>Conclusions</h3><div>Higher diet quality attenuated the increased risks of all-cause and cancer mortality associated with underweight or obesity in older adults. Anti-inflammatory and antioxidative diets may protect against CVD mortality associated with obesity.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"46 ","pages":"Pages 20-29"},"PeriodicalIF":6.6,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037392","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}