Clinical nutrition最新文献

{"title":"1-phenyl-3-methyl-5-pyrazolone activates the AMPK pathway to alleviate western-diet induced metabolic dysfunction-associated steatohepatitis in mice","authors":"Xiaoning Chen ,&nbsp;Jiaofeng Huang ,&nbsp;Yanying You ,&nbsp;Hanxin Xue ,&nbsp;Lisha Wu ,&nbsp;Danyi Zeng ,&nbsp;Qingqing Xing ,&nbsp;Minxia Wu ,&nbsp;Mingfang Wang ,&nbsp;Jinshui Pan ,&nbsp;Su Lin ,&nbsp;Yueyong Zhu","doi":"10.1016/j.clnu.2024.12.033","DOIUrl":"10.1016/j.clnu.2024.12.033","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Approved drugs for the treatment of metabolic dysfunction-associated steatohepatitis (MASH) are limited, although it has become the most common chronic liver disease worldwide. 1-phenyl-3-methyl-5-pyrazolone (PMP) possesses various biological effects such as anti-inflammatory and antioxidant. However, the effects and underlying mechanism of PMP in MASH remain unclear.</div></div><div><h3>Methods</h3><div>Steatosis cells were induced by palmitate/oleic acid (PO). Then, the contents of lipids and reactive oxygen species were measured. To further investigate the effects of PMP on MASH models, C57BL/6J mice were fed a western diet (WD) for 24 weeks and PMP was administered daily by intragastric gavage. Serum enzymes and lipids were assayed by a biochemistry analyzer. RNA sequencing, real-time qPCR, and western blotting were used to measure the expression of different genes. Histological analysis of the liver included HE, Oil red O, and Sirius red staining.</div></div><div><h3>Results</h3><div>PMP alleviated lipid accumulation and oxidative stress induced by PO (<em>P</em> &lt; 0.001). In vivo, WD-induced significant elevation of blood glucose and serum lipids were reduced by PMP (<em>P</em> &lt; 0.05). Furthermore, PMP effectively prevented hepatic steatosis, inflammation, and fibrosis in MASH mice. Western blot results suggested PMP promoted the phosphorylation of LKB1 and AMPKα at T172, which is a marker of activation of the AMPK pathway. RNA sequencing also demonstrated that PMP facilitated the activation of the AMPK pathway. Furthermore, the protective effects of PMP on steatosis cells and MASH mice disappeared after treatment with an AMPK inhibitor.</div></div><div><h3>Conclusions</h3><div>PMP protects against metabolic-stress-induced MASH through activating AMPK signaling, indicating that PMP may be a candidate for MASH therapy in the future.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 136-147"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969838","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 interventions in depression: The role of vitamin D and omega-3 fatty acids in neuropsychiatric health","authors":"Muhammad Liaquat Raza ,&nbsp;Syed Tawassul Hassan ,&nbsp;Subia Jamil ,&nbsp;Wajiha Fatima ,&nbsp;Madiha Fatima","doi":"10.1016/j.clnu.2025.01.009","DOIUrl":"10.1016/j.clnu.2025.01.009","url":null,"abstract":"<div><h3>Background</h3><div>Depression is a pervasive mental health disorder with complex etiologies involving neurotransmitter imbalances, inflammation, and hormonal dysregulation. Emerging evidence highlights the significance of nutritional interventions in improving depressive symptoms.</div></div><div><h3>Objective</h3><div>This review explores the mechanisms of action and clinical applications of Vitamin D and Omega-3 fatty acids in managing depression, providing insights into their potential therapeutic roles.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted across databases, including PubMed, Scopus, Web of Science, and PsycINFO. Keywords such as “depression,” “Vitamin D,” “Omega-3 fatty acids,” “nutritional psychiatry,” and “mental health” were employed. Articles were selected based on relevance, methodology, and contribution to the understanding of nutritional interventions in depression. Observational studies, randomized controlled trials, and meta-analyses were prioritized, while non-peer-reviewed sources were excluded.</div></div><div><h3>Results</h3><div>Vitamin D modulates neurotransmitter activity, reduces neuroinflammation, and influences neuroplasticity, enhancing cognitive function and mood regulation. Omega-3 fatty acids, particularly EPA and DHA, exhibit anti-inflammatory properties, optimize serotonergic transmission, and stabilize neuronal membranes. Clinical evidence suggests that supplementation with these nutrients can significantly reduce depressive symptoms, particularly in patients with comorbid nutritional deficiencies. However, variability in study designs and dosages limits the generalizability of findings.</div></div><div><h3>Conclusion</h3><div>Integrating Vitamin D and Omega-3 supplementation into mental health care holds promise as an adjunctive strategy for treating depression. However, limitations in existing studies, including heterogeneity in study design and dosage, warrant further investigation.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 270-280"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058238","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":"Suboptimal dietary patterns are associated with accelerated biological aging in young adulthood: A study with twins","authors":"Suvi Ravi ,&nbsp;Anna Kankaanpää ,&nbsp;Leonie H. Bogl ,&nbsp;Aino Heikkinen ,&nbsp;Kirsi H. Pietiläinen ,&nbsp;Jaakko Kaprio ,&nbsp;Miina Ollikainen ,&nbsp;Elina Sillanpää","doi":"10.1016/j.clnu.2024.12.018","DOIUrl":"10.1016/j.clnu.2024.12.018","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Suboptimal diets increase morbidity and mortality risk. Epigenetic clocks are algorithms that can assess health and lifespan, even at a young age, before clinical manifestations of diseases. We investigated the association between dietary patterns and biological aging in young adult twins.</div></div><div><h3>Methods</h3><div>The data were drawn from the population-based FinnTwin12 study and consisted of twins aged 21–25 years (n = 826). Food and beverage intakes were assessed using a food frequency questionnaire. Biological aging was estimated using the epigenetic clocks GrimAge and DunedinPACE. Latent class analysis was used to identify dietary patterns. The association between dietary patterns and biological aging was assessed using linear regression modeling at the individual level, followed by within–twin pair analyses to account for genetic liabilities and shared familial confounders.</div></div><div><h3>Results</h3><div>Six dietary patterns were identified: 1) High fast food, low fruits and vegetables (F&amp;V), 2) Plant-based, 3) Health-conscious, 4) Western with infrequent fish, 5) Western with regular fish, and 6) Balanced average. At the individual level, GrimAge acceleration was slower in the Plant-based, Health-conscious, and Balanced-average patterns compared to the High fast food, low F&amp;V, and faster in the Western with infrequent fish pattern compared to the Balanced average, regardless of sex, nonalcoholic energy intake, smoking, and alcohol consumption. After further adjustment for BMI and sports participation, the strengths of the associations modestly decreased; however, the difference between the Balanced-average and High fast food, low F&amp;V patterns remained significant. The pace of aging (DunedinPACE) was slower in the Plant-based pattern compared to the High fast food, low F&amp;V and the Western with infrequent fish patterns after adjustment for sex, nonalcoholic energy intake, smoking, and alcohol. The effect sizes were attenuated and reached a non-significant level when BMI and sports participation were added to the model. Most of the associations were replicated in the within-pair analyses among all twin pairs and among dizygotic twin pairs, but the effect sizes tended to be smaller among monozygotic twin pairs. This suggests that genetics, but not a shared environment, may partially explain the observed associations between diet and biological aging.</div></div><div><h3>Conclusion</h3><div>Diets high in fast food, processed red meat, and sugar-sweetened beverages and low in fruits and vegetables are associated with accelerated biological aging in young adulthood. The clustering effect of lifestyle factors and genetic confounders should be considered when interpreting the findings.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 10-21"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892462","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 interaction between the Circadian Locomotor Output Cycles Kaput and Melanocortin-4-receptor gene variants on obesity and parameters related to obesity","authors":"Sara Rahati ,&nbsp;Mostafa Qorbani ,&nbsp;Anoosh Naghavi ,&nbsp;Hamideh Pishva","doi":"10.1016/j.clnu.2024.12.021","DOIUrl":"10.1016/j.clnu.2024.12.021","url":null,"abstract":"<div><h3>Introduction</h3><div>Obesity is a multifactorial disease caused by an interaction between genetic, environmental and behavioral factors. Polymorphisms of the two genes Circadian Locomotor Output Cycles Kaput (CLOCK) rs1801260 and Melanocortin-4-receptor (MC4R) rs17782313, are associated with obesity. Knowledge is limited on the interaction between CLOCK, MC4R and obesity. The aim was to explore the interactions between the CLOCK and MC4R gene variants on markers related to obesity.</div></div><div><h3>Methods</h3><div>There were 423 subjects with information on two genetic variants of two genes (CLOCK and MC4R). Their interaction was evaluated with: chronotype, sleeping duration, emotional eating, food timing, stress, dietary intake, appetite, physical activity (assessed by questionnaires), anthropometric measures of obesity (assessed by physical measurements), and also hormonal factors (assessed by ELISA). Generalized Linear Models were applied.</div></div><div><h3>Results</h3><div>Our results revealed that significant differences were observed between the genotypes of CLOCK rs1801260 for weight, Body Mass Index (BMI), Glucagon-like peptide-1 (GLP-1), cortisol, energy, fat, sleep duration, chronotype, appetite, depression, stress, emotional eating, physical activity, breakfast, lunch, and dinner time (p˂0.05). Also, significant differences were observed between the genotypes of MC4R rs17782313 for weight, BMI, Waist Circumference (WC), Waist to Hip Ratio (WHR), ghrelin, energy, carbohydrate, fat, appetite, depression, stress, breakfast time, and emotional eating (p˂0.05). Our findings also showed significant interactions between the CLOCK (CC)∗MC4R (CT) genotypes for higher appetite, stress and CLOCK (CT)∗ MC4R (CC) genotypes for higher fat and energy intake and CLOCK (CC)∗MC4R (CC) genotypes for higher weight, BMI, energy and fat intake, appetite, emotional eating, stress, ghrelin, cortisol and lower sleep duration and GLP-1 (p˂ 0.05).</div></div><div><h3>Conclusion</h3><div>Due to the non-significance of the interaction in CLOCK (CT)∗ MC4R (CT) genotypes, it seems that the presence of a healthy arm in the CLOCK and MC4R polymorphism is necessary for the proper function of the genes. Thus, these results highlight that gene variants and their interaction should be considered in obesity assessment.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 193-201"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001277","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":"Brown adipose tissue is associated with reduced weight loss and risk of cancer cachexia: A retrospective cohort study","authors":"Grigorios Panagiotou ,&nbsp;Demsina Babazadeh ,&nbsp;Dario F. Mazza ,&nbsp;Soheila Azghadi ,&nbsp;Joseph M. Cawood ,&nbsp;Aaron S. Rosenberg ,&nbsp;Fumiaki Imamura ,&nbsp;Nita G. Forouhi ,&nbsp;Abhijit J. Chaudhari ,&nbsp;Yasser G. Abdelhafez ,&nbsp;Ramsey D. Badawi ,&nbsp;Maria Chondronikola","doi":"10.1016/j.clnu.2024.12.028","DOIUrl":"10.1016/j.clnu.2024.12.028","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Brown adipose tissue (BAT) has been mainly investigated as a potential target against cardiometabolic disease, but it has also been linked to cancer-related outcomes. Although preclinical data support that BAT and the thermogenic adipocytes in white adipose tissue may play an adverse role in the pathogenesis of cancer cachexia, results from studies in patients have reported inconsistent results. The purpose of this study was to examine the interrelationship between presence of detectable BAT, changes in body weight, and cachexia in patients with cancer. We hypothesized that evidence of BAT at cancer diagnosis would be associated with greater weight loss and risk of cancer cachexia up to a year after cancer diagnosis.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study in treatment-naïve patients with detectable BAT (BAT+, n = 57) and without evidence of BAT (BAT-, n = 73) on 2-deoxy-2-[¹⁸F]fluoro-<span>d</span>-glucose positron emission tomography-computed tomography (¹⁸F-FDG-PET-CT) imaging performed for cancer staging (2004–2020). Patients’ clinical, demographic, and anthropometric characteristics were extracted from their electronic medical record for up to a year after diagnosis. The two groups were <em>a priori</em> matched for demographic, anthropometric, and disease-related characteristics at diagnosis, as well as for season and outdoor temperature on the day of the PET-CT scan. Cancer cachexia was defined as weight loss greater than 5 % or 2 % if body mass index was lower than 20 kg/m². Poisson regression models were fitted to estimate the relative risk (RR) for developing cancer cachexia over the 1-year follow-up among BAT+ compared to BAT- patients.</div></div><div><h3>Results</h3><div>The BAT+ group experienced a lower magnitude of weight loss compared with the BAT- group during the 1-year follow-up (p = 0.014 for interaction between BAT status and time). The risk for cancer cachexia was 44 % lower in the BAT+ than the BAT- group, adjusted for age, sex, outdoor temperature on the day of the ¹⁸F-FDG-PET-CT imaging, cancer site and stage (RR: 0.56, 95 % CI: 0.32 to 0.97).</div></div><div><h3>Conclusion</h3><div>Contrary to our original hypothesis, evidence of BAT assessed by ¹⁸F-FDG-PET-CT imaging at cancer diagnosis was associated with greater body weight maintenance and lower risk for developing cancer cachexia up to one year after diagnosis. Larger, prospective studies and mechanistic experiments are needed to expand and identify the causal factors of our observations.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 262-269"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058235","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":"Adiposity and inflammation markers explain mostly part of the plasma zonulin variation in Brazilian adults with overweight/obesity: A cross-sectional analysis from Brazilian nuts study","authors":"Madalena Geralda Cupertino Ribeiro ,&nbsp;Ana Claudia Pelissari Kravchychyn ,&nbsp;Josefina Bressan ,&nbsp;Helen Hermana Miranda Hermsdorff","doi":"10.1016/j.clnu.2024.12.017","DOIUrl":"10.1016/j.clnu.2024.12.017","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluated intestinal permeability according to plasma zonulin and its association with adiposity, inflammation, cardiometabolic risk, liver function, and intestinal health markers in adults with overweight/obesity.</div></div><div><h3>Methodology</h3><div>This study is a cross-sectional analysis using baseline data from the Brazilian Nut Study, which involved 123 participants (93 women, age 33.2 ± 8.58 years, BMI 33.9 ± 4.30kg/m2). Subjects were divided into quartiles according to plasma zonulin, assessed by Elisa. Cytokines were assessed by flow cytometry; anthropometric measurements were collected by standard procedure and body composition was assessed by DXA. SCFA analysis was performed by high-performance liquid chromatography, and fecal pH, by a pH meter. Linear regression models were performed (α&lt;5 %).</div></div><div><h3>Results</h3><div>Participants included in the last quartile of plasma zonulin had higher values of body fat (%), pro-inflammatory cytokines (CRP, IL-1). According to the multivariate regression model, each one-unit increased in body fat, CRP, IL-12p70, IL-6 and IL-8 resulted correspondingly in an increment of 0.42, 0.14, 0.192, 0.250 and 0.312 ng/ml in plasma zonulin, respectively. Conversely, a one-unit decreased in IL-10 led to an increase of 0.40 ng/ml in plasma zonulin.</div></div><div><h3>Conclusion</h3><div>Intestinal permeability assessed by plasma zonulin is associated with adiposity, subclinical inflammation and reduced serum HDL levels adults with overweight/obesity, while adiposity and inflammation markers are independent factors for plasma zonulin variation.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 22-30"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892456","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":"Vitamin D deficiency may accelerate cognitive decline in female apolipoprotein E ε4 non-carriers","authors":"Jiwon Kim ,&nbsp;Eunjeong Ji ,&nbsp;Jong Bin Bae ,&nbsp;Ji Won Han ,&nbsp;Tae Hui Kim ,&nbsp;Kyung Phil Kwak ,&nbsp;Bong Jo Kim ,&nbsp;Shin Gyeom Kim ,&nbsp;Jeong Lan Kim ,&nbsp;Seok Woo Moon ,&nbsp;Joon Hyuk Park ,&nbsp;Seung-Ho Ryu ,&nbsp;Jong Chul Youn ,&nbsp;Dong Young Lee ,&nbsp;Dong Woo Lee ,&nbsp;Seok Bum Lee ,&nbsp;Jung Jae Lee ,&nbsp;Jin Hyeong Jhoo ,&nbsp;Junghan Song ,&nbsp;Kyunghoon Lee ,&nbsp;Ki Woong Kim","doi":"10.1016/j.clnu.2024.12.029","DOIUrl":"10.1016/j.clnu.2024.12.029","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>The impact of vitamin D deficiency (VDD) on cognition remains controversial. Evidences suggest that variability based on apolipoprotein E (APOE) ε4 status and gender, given APOE ε4's influence on vitamin D metabolism and women's heightened vitamin D sensitivity. We investigated the interplay between APOE ε4, gender, and VDD in cognitive decline among older adults.</div></div><div><h3>Methods</h3><div>In a population-based cohort of 1547 cognitively normal Koreans aged ≥60 years, Mini Mental State Examination (MMSE) changes were tracked biennially (2010–2020). VDD was defined as serum 25-hydroxyvitamin D &lt; 10 ng/mL. Linear mixed models analyzed VDD effects, with subgroup analyses for APOE ε4 status and gender.</div></div><div><h3>Results</h3><div>VDD was present in 21.3 % at baseline and was linked to faster MMSE decline (estimate = −0.054, 95 % CI [-0.091, −0.017], p = 0.004), particularly in APOE ε4 non-carriers (estimate = −0.070, 95 % CI [-0.112, −0.029], p = 0.001). A gender-based analysis revealed that this effect was significant only in female non-carriers (estimate = −0.097, 95 % CI [-0.156, −0.038], p = 0.001). Conversely, male non-carriers demonstrated an absence of a statistically significant association (estimate = −0.017, 95 % CI [-0.076, 0.041], p = 0.562).</div></div><div><h3>Conclusions</h3><div>VDD accelerates cognitive decline in cognitively normal APOE ε4 non-carriers, particularly women, underscoring the importance of tailored prevention strategies.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 167-173"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001282","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":"Disease modifies the dependency of percentiles of the phase angle distribution on age, sex, height and weight in hospitalized patients","authors":"Mathias Plauth ,&nbsp;Peter Bauer ,&nbsp;Melanie Viertel ,&nbsp;Michael Reich ,&nbsp;Michael Hiesmayr","doi":"10.1016/j.clnu.2024.12.024","DOIUrl":"10.1016/j.clnu.2024.12.024","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Phase angle (PhA) is viewed as a holistic indicator of quantity and quality of cellularity and hydration status and has emerged as a significant predictor of patient outcome in clinical medicine. We sought to analyze the impact of hospitalization as a surrogate for disease on the distribution of PhA and its dependency on influence variables age, sex, height and weight without any assumption as to the form of PhA-distribution.</div></div><div><h3>Methods</h3><div>First PhA measurements obtained from 2418 women (median age 75 IQR[63; 82]) and 2541 men (median age 70 IQR[60; 79]) hospitalized in a Community General Hospital were analyzed. Multivariable quantile regression was applied for estimating percentiles P1 – P95 using parsimonious models including a dichotomous factor for sex and cubic polynomials for age (model A) and height and weight (model B) using only linear interaction terms between the four variables sex, age, height, and weight.</div></div><div><h3>Results</h3><div>The association of PhA was strongest with age (women <em>r</em> = −0.48; men <em>r</em> = −0.47). In each age class average PhA values of hospitalized patients were below those reported for healthy individuals. In contrast to percentiles above the median showing a monotonous decrease with age as reported from healthy individuals the lower percentiles of patients showed a marked dip-and-plateau deformation. This deformation was associated with a change in the distribution span of PhA between P1 and P95 which was narrower at young age, expanded markedly due to a persisting fraction of patients with low PhA over the age range from 50 to 80 years and became narrower again at higher age due to the decreasing fraction of patients with high PhA. These distribution patterns were the same, irrespective of using either model A or model B. Furthermore, bootstrapping confirmed the estimated form of the percentile curves.</div></div><div><h3>Conclusions</h3><div>Disease modifies the PhA distribution pattern resulting not only in lower PhA in patients than in healthy individuals but also in a dip-and-plateau deformation of lower PhA percentile curves for the association with age. The dip-and-plateau pattern and the narrowing of the span between P1 and P95 with older age suggest that there is a low threshold value for PhA, below which life is impossible.</div></div><div><h3>Clinical trial registry</h3><div>DRKS00025307, <span><span>https://www.drks.de/DRKS00025307</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 43-52"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909309","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 effects of 6 months dietary counseling on diet quality and cardiovascular risk profile in patients with cardiovascular disease: A randomized controlled trial","authors":"Iris van Damme ,&nbsp;Eva R. van Veldhuisen ,&nbsp;Auke J.C.F. Verkaar ,&nbsp;Remy H.H. Bemelmans ,&nbsp;Marcel M.C. Hovens ,&nbsp;Frank L.J. Visseren ,&nbsp;Charlotte Koopal ,&nbsp;Renate M. Winkels ,&nbsp;Johanna M. Geleijnse","doi":"10.1016/j.clnu.2024.12.020","DOIUrl":"10.1016/j.clnu.2024.12.020","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>A healthy diet improves cardiovascular disease (CVD) risk factors. However, dietary counseling is not yet widely implemented in health care for patients with CVD. We assessed how dietary counseling by a dietitian, focused on improving diet quality, influenced the cardiovascular risk profile of patients with CVD.</div></div><div><h3>Methods</h3><div>In this 6-month trial, 124 patients with CVD (68.1 ± 9.5 years, 72 % men) were randomly assigned to counseling by a dietitian (n = 63) or usual care (n = 61). Difference in cardiovascular risk profile between groups was assessed with a 10-year composite cardiovascular risk prediction score including changes in blood pressure and low-density lipoprotein cholesterol (LDL-C). Secondary outcomes included adherence to a healthy diet as assessed with the Dutch Healthy Eating Index-2015 (DHD15-index), individual risk factors (LDL-C, blood pressure, body weight, and high-sensitivity C-reactive protein [hs-CRP]) as well as depressive symptoms and optimism scores.</div></div><div><h3>Results</h3><div>DHD15-index at baseline was 103 ± 18 out of 160 and increased 5.7 points more in the dietary counseling group compared to the usual care group (95 % confidence interval (CI): 1.3; 10.1). Multivariate analysis revealed no statistically significant differences in changes over time in 10-year cardiovascular risk score (0.6 %, 95%CI: −4.1 %; 5.3 %), blood pressure (−2 mmHg, 95%CI: −7; 4), LDL-C (0.0 mmol/l, 95%CI: 0.2; 0.2), body weight (−0.7 kg, 95%CI: −2.9; 1.5), hs-CRP (0.71 mg/dl, 95%CI: −1.20; 2.62) or depressive symptoms and optimism scores between groups.</div></div><div><h3>Conclusions</h3><div>Dietary counseling for patients with CVD for 6 months only slightly improved adherence to a healthy diet in patients with established CVD and did not result in substantial improvement in cardiovascular risk profile or depressive symptoms and optimism scores.</div></div><div><h3>Clinical trial registration</h3><div>This trial was registered at <span><span>www.clinicaltrials.gov/study/NCT05071092</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 101-110"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969341","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":"Digital dietary interventions for healthy adolescents: A systematic review of behavior change techniques, engagement strategies, and adherence","authors":"Geiziane Leite Rodrigues Melo ,&nbsp;Rafaela Espírito Santo ,&nbsp;Eugeni Mas Clavel ,&nbsp;Marina Bosque Prous ,&nbsp;Karsten Koehler ,&nbsp;Josep Vidal-Alaball ,&nbsp;Judith van der Waerden ,&nbsp;Inese Gobiņa ,&nbsp;José Francisco López-Gil ,&nbsp;Rodrigo Lima ,&nbsp;Cesar Agostinis-Sobrinho","doi":"10.1016/j.clnu.2025.01.012","DOIUrl":"10.1016/j.clnu.2025.01.012","url":null,"abstract":"<div><h3>Background</h3><div>Adolescence is a crucial phase for developing healthy eating habits with lifelong health implications. Digital interventions, such as smartphone apps and web platforms, have emerged as promising strategies to promote healthy eating habits among adolescents by using behavior change techniques (BCTs). This study aims to systematically review internet-based dietary interventions targeting adolescents, focusing on the analysis of BCTs employed, their delivery modes, and their impact on adolescents' adherence and engagement.</div></div><div><h3>Methods</h3><div>PubMed, Scopus, and Web of Science databases were used up to July 2024. Eligible studies included randomized clinical trials involving adolescents aged 12 to 18. The interventions analyzed involved smartphone apps and web platforms promoting changes in eating habits, with results focusing on adherence and techniques used.</div></div><div><h3>Results</h3><div>The initial search identified 5399 articles, of which 16 studies were included in the final analysis. The studies involved a total of 31,971 participants (range: 29–7890), with 40.29 % being female (n = 12,881), aged 12–18 years. The duration of interventions ranged from two weeks up to 12 months, with follow-ups of up to 24 months. Interventions that utilized BCTs such as goal setting (n = 14), feedback on behavior (n = 14), social support (n = 14), prompts/cues (n = 13), and self-monitoring (n = 12), were the most effective in promoting adherence and engagement. Digital dietary interventions that incorporated personalized feedback (n = 9) and gamification (n = 1) showed adherence rates between 63 % and 85.5 %, with notable improvements in dietary habits, such as increased fruit and vegetable consumption and reduced intake of sugar-sweetened beverages. However, the intervention using gamification involved only 36 participants, and its effects require further investigation due to the limited sample size.</div></div><div><h3>Conclusion</h3><div>Digital interventions show potential for promoting healthy dietary behaviors among adolescents, yet mixed outcomes underscore the challenges of maintaining adherence and long-term engagement. Techniques such as self-monitoring, goal setting, and social support can enhance engagement and effectiveness, particularly when combined with gamified features. The trial protocol is registered on PROSPERO (CRD42024564261).</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 176-192"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001379","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}