Clinical nutrition最新文献

{"title":"Association of sarcopenic obesity with dementia risk in a cohort of older women","authors":"Zhongyang Guan ,&nbsp;Blossom CM. Stephan ,&nbsp;Lorenzo M. Donini ,&nbsp;Joshua R. Lewis ,&nbsp;Carla M. Prado ,&nbsp;Richard L. Prince ,&nbsp;David Scott ,&nbsp;Kun Zhu ,&nbsp;Marc Sim ,&nbsp;Mario Siervo","doi":"10.1016/j.clnu.2025.11.026","DOIUrl":"10.1016/j.clnu.2025.11.026","url":null,"abstract":"<div><h3>Background and aims</h3><div>Longitudinal studies have explored the association between sarcopenic obesity (SO) and the risk of cognitive impairment, yet findings remain mixed. This study aimed to investigate the associations of SO with risk of incident dementia in older women, using two diagnostic models: the Sarcopenic Obesity Global Leadership Initiative (SOGLI) and the load-capacity model.</div></div><div><h3>Methods</h3><div>We analysed data from 900 community-dwelling women (aged ≥70 years). SO was defined using two models: (1) the SOGLI criteria, based on low handgrip strength (HGS), low appendicular lean soft tissue to body weight (ALST/W) ratio, and high fat mass percentage (%FM); and (2) the load-capacity model, based on a high truncal fat mass to ALST (TrFM/ALST) ratio. Incident dementia events (hospitalisation and/or death) over 9.5 years were identified through linked health records using International Classification of Diseases (ICD) codes. Cox proportional hazards and Fine–Gray sub-distribution models were applied.</div></div><div><h3>Results</h3><div>Using the SOGLI criteria, SO was not significantly associated with the risk of overall dementia events compared with the non-sarcopenic, non-obesity group (hazard ratio [HR] 0.63, 95 % CI 0.39–1.03); however, SO was significantly associated with a reduced risk of dementia-related hospitalisation (HR 0.57, 95 % CI 0.33–0.98), mainly driven by the reduced risk observed with obesity. When defined by the load-capacity model, SO remained significantly associated with a reduced risk of overall dementia events (HR 0.54, 95 % CI 0.34–0.85). Restricted cubic spline (RCS) analyses demonstrated significant associations of lower HGS, lower %FM, higher ALST/W ratio, and lower TrFM/ALST ratio with increased risk of overall dementia events. Results remained consistent in sensitivity analyses excluding participants with BMI &lt;21 kg/m² (n = 67) or %FM below the 15th percentile (n = 135), and after further adjustment for age at highest education level..</div></div><div><h3>Conclusion</h3><div>This is the first longitudinal study to examine the association between SO and dementia using either the SOGLI or load-capacity models. In this cohort of older women, SO was associated with a lower risk of dementia-related hospitalisation. These findings suggest that the relationship between obesity and dementia risk in late life may differ from current evidence regarding midlife, indicating potential age-specific effects. Further research is needed to clarify the underlying mechanisms and generalisability of these observations to broader populations..</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"56 ","pages":"Article 106542"},"PeriodicalIF":7.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789178","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":"Challenges of nutritional support in patients with diabetes: A position paper of the ESPEN special interest group","authors":"Laurence Genton ,&nbsp;Miguel Leon Sanz ,&nbsp;Marianna Arvanitakis ,&nbsp;María D. Ballesteros-Pomar ,&nbsp;Lia Bally ,&nbsp;Rocco Barazzoni ,&nbsp;Cécile Bétry ,&nbsp;Rosa Burgos ,&nbsp;Cristina Cuerda ,&nbsp;Alia Hadefi ,&nbsp;Stanislav Klek ,&nbsp;Meliha Mahmutovic ,&nbsp;Didier Quilliot ,&nbsp;Diana Rubin ,&nbsp;Stéphane M. Schneider ,&nbsp;Mireille J. Serlie ,&nbsp;Tinh-Hai Collet","doi":"10.1016/j.clnu.2025.106550","DOIUrl":"10.1016/j.clnu.2025.106550","url":null,"abstract":"<div><div>Malnutrition affects up to 30 % of the general population, and especially older people with polymorbid conditions. In parallel, the prevalence of diabetes increases with age affecting over 800 million adults worldwide. Healthcare providers are increasingly challenged to care for patients with diabetes that require nutritional support. To address this issue, the ESPEN Special Interest Group \"Nutrition and Diabetes\", aims to provide guidance for health care providers that treat these patients. This paper had three aims: 1) to summarise the guidelines and recommendations regarding nutritional support and diabetes or stress hyperglycaemia provided by scientific societies, 2) to review the associations of nutritional disorders with diabetes and its pharmacological treatments, and 3) to identify the challenges of optimal nutritional care for patients with diabetes and stress hyperglycaemia. To this end, we conducted a systematic search of guidelines and recommendations on nutritional support for patients with diabetes or stress hyperglycaemia, that have been published in English by national and international societies over the last 15 years. Our systematic search showed that published guidelines and recommendations rarely addressed the practical management of blood glucose control according to the modality of nutritional support. The literature on the association of malnutrition with diabetes and its pharmacological treatment is very limited. The identified challenges include the multidisciplinary and multiprofessional continuity of care between the hospital and ambulatory settings, the ideal pattern of hospital food, the choice of oral nutritional supplements, the adjustment of diabetes management to nutritional support, and diabetes technology to support nutritional care in these patients.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"56 ","pages":"Article 106550"},"PeriodicalIF":7.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145881577","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":"An observational study on the effect of l-ornithine-l-aspartate (LOLA) on the gut microbiome in liver cirrhosis. A single center phase 4 study","authors":"Daniel Habich ,&nbsp;Angela Horvath ,&nbsp;Nicole Feldbacher ,&nbsp;Lavra Rebol ,&nbsp;Maximilian Nepel ,&nbsp;Tobias Madl ,&nbsp;Hans-Jörg Habisch ,&nbsp;Franziska Baumann-Durchschein ,&nbsp;Stefan Fürst ,&nbsp;Johannes Plank ,&nbsp;Florian Rainer ,&nbsp;Walter Spindelböck ,&nbsp;Rudolf E. Stauber ,&nbsp;Elisabeth Tatscher ,&nbsp;Martin Wagner ,&nbsp;Gernot Zollner ,&nbsp;Vanessa Stadlbauer","doi":"10.1016/j.clnu.2025.11.007","DOIUrl":"10.1016/j.clnu.2025.11.007","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background &amp; Aims&lt;/h3&gt;&lt;div&gt;Liver cirrhosis is associated with gut microbiome dysbiosis, intestinal inflammation and gut barrier dysfunction, contributing to reduced quality of life and the development of complications. We showed in a retrospective study that &lt;span&gt;l&lt;/span&gt;-ornithine-&lt;span&gt;l&lt;/span&gt;-aspartate (LOLA) was associated with improvement in taxonomic composition of the microbiome. Here we prospectively studied the influence of LOLA on the gut microbiome, quality of life, sarcopenia and the gut barrier.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In this phase 4 study, patients with liver cirrhosis and hepatic encephalopathy grade 0–2 received LOLA 18 g/day orally for 3 months. We studied faecal microbiome composition (primary endpoint abundance of the genus &lt;em&gt;Flavonifractor)&lt;/em&gt;, microbiome function, quality of life, serum ammonia levels, sarcopenia and frailty, biomarkers of the gut liver axis and the stool, serum and urine metabolome.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We screened 258 patients with liver cirrhosis, included 65, of whom 52 patients (40 % female, age 62 (58; 65)) completed the study. LOLA intake decreased the abundance of the genus &lt;em&gt;Romboutsia&lt;/em&gt;, increased the abundance of the genus &lt;em&gt;Enterococcus,&lt;/em&gt; but did not alter other microbiome parameters. LOLA improved one out of 8 dimension of quality of life (vitality) and decreased serum ammonia concentrations. The subgroup of patients with improved ammonia concentrations responded with a halt in further muscle mass declined over the study period. Diamine oxidase, a marker of intestinal mucosal condition, decreased and LPS binding protein increased. Metabolomic analysis indicated an increase in alanine concentration.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;LOLA improved one quality of life dimension (vitality) and biomarker of the gut–liver axis, altered innate immune response, faecal microbiome and metabolome. LOLA prevented muscle loss only in patients with elevated ammonia concentrations at baseline. LOLA may therefore be a useful adjunct treatment to improve quality of life in cirrhosis and a promising intervention for muscle loss prevention in hyperammonemic patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Clinical Trials Registration number&lt;/h3&gt;&lt;div&gt;clinicaltrials.gov NCT05737030.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Impact and implication&lt;/h3&gt;&lt;div&gt;We conducted a 12-week prospective cohort study to test the effect of the ammonia lowering drug &lt;span&gt;l&lt;/span&gt;-ornithine-&lt;span&gt;l&lt;/span&gt;-aspartate (LOLA) on the gut microbiome, biomarkers along the gut-liver-axis, muscle health and quality of life in patients with liver cirrhosis and hepatic encephalopathy. Although our primary endpoint was not reached, LOLA slightly altered microbiome composition and function and improved vitality, a clinically relevant patient reported outcome parameter. LOLA also improved biomarkers for the gut-liver-axis, innate immune response and prevented muscle loss in patients with elevated ammonia levels at baselin","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"56 ","pages":"Article 106522"},"PeriodicalIF":7.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760785","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":"Tolerability and efficacy of an enteral formula containing partially hydrolyzed guar gum in patients following gastrointestinal surgery: A prospective, multicenter, open-label, randomized controlled study","authors":"Ting Han ,&nbsp;Jialu Zhuo ,&nbsp;Xiaoting Wu ,&nbsp;Qiang Chi ,&nbsp;Bo Chen ,&nbsp;Junqiang Chen ,&nbsp;Wei Chen ,&nbsp;Zhenyi Jia ,&nbsp;Rui Zhao ,&nbsp;Xinyu Zhang ,&nbsp;Peng Zhang ,&nbsp;Yuantian Mao ,&nbsp;Xuan Xu ,&nbsp;Qi Gao ,&nbsp;Xiaoding Shen ,&nbsp;Boshi Sun ,&nbsp;Peiang Guo ,&nbsp;Zhen Wang ,&nbsp;Jun Yang ,&nbsp;Huanlong Qin","doi":"10.1016/j.clnu.2025.12.002","DOIUrl":"10.1016/j.clnu.2025.12.002","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Malnourished patients, who undergo gastrointestinal (GI) surgery, have a higher risk of postoperative complications, including higher rates of morbidity and mortality. Generally, a low-fiber diet is recommended after GI surgery. This study investigated the tolerance and clinical outcomes of an enteral formula supplemented with partially hydrolyzed guar gum (PHGG)—a soluble, prebiotic dietary fiber known to benefit gastrointestinal health—in Chinese patients following GI surgery, using a standard fiber-free formula as the control..</div></div><div><h3>Methods</h3><div>This study enrolled 631 patients requiring enteral nutrition following GI surgery. Participants were subsequently randomized to receive either a fiber-enriched formula containing 15 g/L PHGG (experimental group, n = 313) or a standard fiber-free formula (control group, n = 318) for 5 days. Data on feeding effectiveness, tolerability, and clinical outcomes were subsequently collected.</div></div><div><h3>Results</h3><div>The incidence of diarrhea was 9.6 % (95 % confidence interval [CI]: 6.3 to 12.8) in the experimental group and 10.1 % (95 % CI: 6.8 to 13.4) in the control group, with an absolute difference of −0.5 (95 % CI: −5.1 to 4.2) confirming non-inferiority (<em>P</em> &lt; 0.001). In patients who consumed ≥4500 kcal over 5 days (averaging 900 kcal/day), the experimental group showed significantly improved feeding tolerance, with a reduced prevalence of diarrhea and abdominal distension (10.4 % vs 24.7 %, <em>P</em> = 0.045; 19.4 % vs 38.4 %, <em>P</em> = 0.016). Patients with gastric cancer in the experimental group had significantly less abdominal distension (22.7 % vs 48.8 %; <em>P</em> = 0.014). Regarding weight preservation, the experimental group demonstrated benefits in weight preservation at discharge (%weight change: −1.39 vs −2.33, <em>P</em> = 0.049). Thirty days after surgery, the experimental group had better EQ-5D scores, especially in E4 pain/discomfort and E5 anxiety.</div></div><div><h3>Conclusions</h3><div>The PHGG-enriched enteral nutrition formulation is well-tolerated and non-inferior to a fiber-free formula among patients following GI surgery. To maximize its benefits on GI tolerance and body weight preservation, a daily intake of 800–900 kcal is suggested, though this warrants further validation. The trial protocol was registered at <span><span>www.chictr.org.cn</span><svg><path></path></svg></span> (Identifier: ChiCTR2000038429).</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"56 ","pages":"Article 106543"},"PeriodicalIF":7.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145838347","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":"Postoperative exclusive enteral nutrition as a bridging therapy to reduce endoscopic recurrence after intestinal resection in Crohn’s disease: A randomized controlled trial","authors":"Mengting Zhang ,&nbsp;Qianwen Tu ,&nbsp;Kangcheng Luo ,&nbsp;Daojiang Li ,&nbsp;Songlin Wan ,&nbsp;Zhaoyang Cai ,&nbsp;Xianghai Ren ,&nbsp;Yi Li ,&nbsp;Yi Liu ,&nbsp;Mei Ye ,&nbsp;Min Chen ,&nbsp;Zhao Ding","doi":"10.1016/j.clnu.2025.106545","DOIUrl":"10.1016/j.clnu.2025.106545","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Postoperative recurrence remains a significant challenge in Crohn’s disease (CD) despite surgical intervention. While exclusive enteral nutrition (EEN) has demonstrated anti-inflammatory effects, its role in preventing postoperative recurrence remains underexplored. This study aimed to evaluate whether postoperative EEN reduces endoscopic recurrence at 1 year in CD patients after bowel resection.</div></div><div><h3>Methods</h3><div>This was a single center, open-label and randomized controlled trial. Using fixed block randomization, 100 participants were randomly assigned (1:1) to the normal diet group (unrestricted food intake) or the EEN group (receiving exclusive enteral formula for ≥2 months). The primary endpoint was endoscopic recurrence at 1 year after surgery (Rutgeerts score ≥ i2). Secondary endpoints included biochemical markers, postoperative complications, and quality of life.</div></div><div><h3>Results</h3><div>Overall, 100 participants were assessed for eligibility and randomly assigned to receive a normal diet (<em>n</em> = 50) or EEN (<em>n</em> = 50). All randomized participants were included in the intention-to-treat analysis. Compared to the normal diet group, the EEN group demonstrated a significantly lower postoperative endoscopic recurrence rate at 1 year (38 % [19/50] vs 18 % [9/50]; RR, 0.474; 95 % CI, 0.238–0.944; <em>P</em> = 0.026) and lower postoperative C-reactive protein at 2 months (median [IQR]:3.5 [0,7.75] mg/L vs 1 [1,2] mg/L, <em>P</em> = 0.034). No significant differences were observed in quality of life and 30-day/late-term postoperative complication rates (<em>P</em> &gt; 0.05) and no adverse events occurred between groups.</div></div><div><h3>Conclusion</h3><div>Postoperative EEN (≥2 months) significantly reduces the risk of endoscopic recurrence at 1 year in CD patients after resection. Additionally, CD patients showed high adherence to the oral EEN regimen after surgery.</div></div><div><h3>Clinical trial registration</h3><div>ChinaClinicalTrial.gov (Number: ChiCTR2400081066).</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"56 ","pages":"Article 106545"},"PeriodicalIF":7.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145838348","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":"Comparative performance of the nutritional risk index and modified 5-item frailty index in predicting surgical outcomes: A multi-institutional analysis of 9.7 million patients","authors":"Samuel Knoedler ,&nbsp;Sarah Friedrich ,&nbsp;Kevin Hu ,&nbsp;Leonard Knoedler ,&nbsp;Thomas Schaschinger ,&nbsp;Felix Klimitz ,&nbsp;Jasper Iske ,&nbsp;Gabriel Hundeshagen ,&nbsp;Adriana C. Panayi ,&nbsp;Bong-Sung Kim ,&nbsp;Martin Kauke-Navarro ,&nbsp;Fortunay Diatta ,&nbsp;Bohdan Pomahac","doi":"10.1016/j.clnu.2025.11.020","DOIUrl":"10.1016/j.clnu.2025.11.020","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Preoperative risk stratification is crucial for surgical decision-making and patient counseling. While the Modified 5-Item Frailty Index (mFI-5) is widely used, the Nutritional Risk Index (NRI) has emerged as a promising alternative due to its dynamic and continuous nature. However, their comparative effectiveness remains unclear.</div></div><div><h3>Objective</h3><div>To compare the predictive performance of the NRI versus the mFI-5 for predicting postoperative complications, readmissions, and mortality in a large, multi-institutional surgical cohort.</div></div><div><h3>Methods</h3><div>We analyzed 9,782,974 patients from the American College of Surgeons National Surgical Quality Improvement Program database. Three predictive models using NRI (dichotomous, spline, and adjusted) and two using mFI-5 (unadjusted and adjusted) were developed for six outcomes: overall complications, surgical complications, medical complications, readmission, unplanned reoperation, and mortality. Model discrimination was assessed using the area under the receiver operating characteristic curve (AUC), and calibration was evaluated using bootstrap-validated calibration plots.</div></div><div><h3>Results</h3><div>The overall complication rate was 14.7 % (n = 1,442,984). Both adjusted NRI and mFI-5 models showed excellent discrimination for mortality (AUC = 92.6 for both) and medical complications (AUC = 83.7 and 83.5, respectively). The NRI also demonstrated comparable or superior performance for surgical complications (AUC = 75.8 vs 75.4), readmission (AUC = 69.8 vs 71.3), and unplanned reoperation (AUC = 65.2 vs 65.0). Mortality discrimination was 92.6 for both models. Notably, NRI values were significantly lower in patients who experienced complications compared to those who did not (96.0 vs 103, <em>p</em> &lt; 0.0001).</div></div><div><h3>Conclusions</h3><div>The NRI demonstrates comparable, and in some cases, superior, predictive performance to mFI-5 across surgical outcomes. As a dynamic and continuous measure, NRI may offer advantages over mFI-5 for preoperative risk stratification. These findings support the integration of NRI into surgical risk assessment protocols.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"56 ","pages":"Article 106536"},"PeriodicalIF":7.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145838350","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":"Glucagon-like peptide-1 receptor agonists and sarcopenia-related markers in diabetes: A systematic review and meta-analysis","authors":"Wenjie Chen ,&nbsp;Hongzhuo Qin ,&nbsp;Zhaokai Zhou ,&nbsp;Yun Chen ,&nbsp;Xiaowei Xu ,&nbsp;Yajun Chen ,&nbsp;Jieyu He ,&nbsp;Ran Xu ,&nbsp;Hua Gao ,&nbsp;Qiong Lu","doi":"10.1016/j.clnu.2025.10.006","DOIUrl":"10.1016/j.clnu.2025.10.006","url":null,"abstract":"<div><h3>Aims</h3><div>GLP-1 receptor agonists (GLP-1RAs) are first-line therapies for type 2 diabetes (T2DM) due to their additional weight-lowering and cardiovascular benefits. However, their impact on muscle mass is debated, posing a concern for sarcopenia in older adults with T2DM. This systematic review and meta-analysis aimed to evaluate the effects of GLP-1RAs on body composition and sarcopenia-related markers in diabetic patients and relevant preclinical models, and to explore the underlying mechanisms.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Web of Science, MEDLINE, Cochrane Library, and EMBASE to identify relevant randomized controlled trials and animal studies on the impact of GLP-1 RAs on muscle in diabetic participants. Standardized Mean Difference (SMD) or Mean Difference (MD) with 95 % confidence intervals (CI) were calculated using random-effects or fixed-effect models to synthesize the effects on anthropometric, functional, and molecular endpoints.</div></div><div><h3>Results</h3><div>A total of 254 articles were retrieved, yielding 18 eligible studies after screening against the inclusion criteria. These comprised six human studies measuring lean mass, four clinical trials assessing Skeletal Muscle Mass Index (SMI), and eight animal studies. The animal studies investigated parameters including muscle mass, muscle fiber cross-sectional area, grip strength, lean mass percentage, myogenin, MyoD, Atrogin-1, MuRF-1, myostatin, GLUT4, SIRT1, and inflammatory cytokines (IL-1β, IL-6, TNF-α).</div></div><div><h3>Conclusions</h3><div>GLP-1 RAs were found to increase the percentage of lean body mass in animal models, improve body composition, enhance skeletal muscle strength, elevate concentrations of muscle growth factors, and reduce muscle growth inhibitory factors and inflammatory factors. These effects promote muscle cell proliferation and differentiation, accelerate muscle protein synthesis, leading to better overall muscle function. Confirming these promising preclinical findings requires large-scale randomized controlled trials in humans.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"55 ","pages":"Pages 42-56"},"PeriodicalIF":7.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444106","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":"A novel pulse tracer method to estimate the relationship between amino acid meal composition and its intracellular disposal","authors":"Nicolaas E.P. Deutz,&nbsp;Savanah B. Knezek,&nbsp;Mariëlle P.K.J. Engelen","doi":"10.1016/j.clnu.2025.10.002","DOIUrl":"10.1016/j.clnu.2025.10.002","url":null,"abstract":"<div><h3>Background</h3><div>Continuous intravenous stable isotope infusion approaches underestimate the anabolic response to a protein meal. Pulse tracer approaches can estimate the intracellular appearance of many amino acids simultaneously. We now combined the pulse tracer approach with intake of a mixture of essential (EAA) or a combination of EAA and non-essential amino acids (TAA) to better estimate the anabolic response.</div></div><div><h3>Methods</h3><div>In a randomized, single-blind, placebo-controlled crossover study, 11 older adults (60–80 years) consumed, on separate study days at least three days apart, three oral drinks via sip feeding containing: (a) 20 g EAA, (b) 45 g TAA, or (c) water (baseline). The pulse stable isotope method, containing labeled EAA, BCKA, and many non-essential amino acids, was used to assess their whole-body and compartmental kinetics. Blood samples were collected both pre- and post-pulse IV administration and analyzed using LC-MS/MS and GC–MS.</div></div><div><h3>Results</h3><div>Plasma amino acid concentrations increased in relation to the composition of the meals, yet showed no clear correlation with the extracellular pool (Q₁) or the intracellular pool (Q₂) size changes. For phenylalanine and threonine, the intracellular disposal aligned with the intake. For all other essential amino acids, the % increase in the intracellular disposal was more in agreement with % of the recommended daily allowance, independent of whether consumed in the EAA or TAA meal. When insufficient amounts of amino acids were consumed, these amino acids were sourced from other (unidentified) pathways. The intracellular response of non-essential amino acids in relation to the amount consumed is complex.</div></div><div><h3>Conclusions</h3><div>We show that intracellular amino acid metabolism can be measured using the pulse amino acid tracer approach during intake of free amino acid mixtures. We observed that both the EAA and TAA mixtures stimulate intracellular protein synthesis, and that the elevated disposal of essential amino acids appears to align with the body's amino acid composition. Furthermore, the intracellular appearance of phenylalanine and threonine, in relation to the intake, can be used to estimate the bioavailability of dietary proteins. Our approach can also be applied to different mixed meals with different types of proteins to estimate the anabolic response and effect on metabolism.</div></div><div><h3>Clinical trial registry</h3><div>Trial registration ClinicalTrials.gov: NCT05400733.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"55 ","pages":"Pages 196-207"},"PeriodicalIF":7.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145556418","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":"Experiences and concerns of patients on enteral nutrition, based on their testimonies on public internet forums","authors":"G. Sainte-Claire Deville ,&nbsp;B. Seignez-Dartois ,&nbsp;Danel Buhl","doi":"10.1016/j.clnu.2025.10.004","DOIUrl":"10.1016/j.clnu.2025.10.004","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>This qualitative study aims to provide a sociological assessment of the spontaneous and lived experiences of patients on enteral nutrition, as expressed through testimonies on public internet forums (general health forums and specialized health forums).</div></div><div><h3>Methods</h3><div>By analysing 5715 testimonies from 2873 authors, we aimed to capture an unfiltered view of this treatment, free from the biases often introduced by clinical or medical assessments.</div></div><div><h3>Results and conclusions</h3><div>The findings highlight different experiences and perceptions of enteral nutrition depending on whether the patient has a nasogastric/nasojejunal tube (NGT/NJT) or a gastrostomy/jejunostomy tube (GT/JT). If patients trust enteral nutrition and acknowledge its positive outcomes, their experience is more positive with gastrostomy/jejunostomy tube. This approach offers valuable insights into the impact of the enteral nutrition on the patients’ daily life and allows all healthcare stakeholders to better consider the reality of their experiences.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"55 ","pages":"Pages 141-151"},"PeriodicalIF":7.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470716","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":"Reply – letter to the editor: The JOHAS (Judgement of Objective Hypersteatosis and Atrophy in Sarcopenia) index; an index for sarcopenia or low muscle mass?","authors":"Yuzo Yamamoto ,&nbsp;Kyosuke Agawa,&nbsp;Masahide Awazu,&nbsp;Noriko Omura,&nbsp;Shunji Nakayama,&nbsp;Hiromi Maeda","doi":"10.1016/j.clnu.2025.10.008","DOIUrl":"10.1016/j.clnu.2025.10.008","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"55 ","pages":"Pages 1-2"},"PeriodicalIF":7.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415510","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}