Clinical nutrition最新文献

{"title":"Biomarkers of oxidation, inflammation and intestinal permeability in persons with diabetes mellitus with parenteral nutrition: A multicenter randomized trial","authors":"Virginia Soria-Utrilla ,&nbsp;Corina Verónica Sasso ,&nbsp;Silvana Yanina Romero-Zerbo ,&nbsp;Antonio Adarve-Castro ,&nbsp;Rafael López-Urdiales ,&nbsp;Sandra Herranz-Antolín ,&nbsp;José Manuel García-Almeida ,&nbsp;Katherine García-Malpartida ,&nbsp;Mercedes Ferrer-Gómez ,&nbsp;Alicia Moreno-Borreguero ,&nbsp;Luis Miguel Luengo-Pérez ,&nbsp;Julia Álvarez-Hernández ,&nbsp;Carmen Aragón-Valera ,&nbsp;María Julia Ocón-Bretón ,&nbsp;Álvaro García-Manzanares ,&nbsp;Irene Bretón-Lesmes ,&nbsp;Pilar Serrano-Aguayo ,&nbsp;Natalia Pérez-Ferre ,&nbsp;Juan José López-Gómez ,&nbsp;Josefina Olivares-Alcolea ,&nbsp;Gabriel Olveira","doi":"10.1016/j.clnu.2024.11.044","DOIUrl":"10.1016/j.clnu.2024.11.044","url":null,"abstract":"<div><h3>Background and aims</h3><div>Parenteral nutrition (PN) composition could play a role in the management of systemic inflammatory response and intestinal barrier disruption. We aimed to evaluate changes in biomarkers of inflammation, oxidative status and intestinal permeability in patients with type 2 diabetes mellitus (T2DM) who received different PN lipid formulas.</div></div><div><h3>Methods</h3><div>This was a prospective study, including 94 patients with T2DM who received omega (n)-3 polyunsaturated fatty acids (PUFA)-enriched PN, a mixture of medium and long chain triglycerides (MCT/LCT) PN, or an olive oil-based PN. Serum levels of biomarkers of oxidative status, intestinal permeability and inflammation biomarkers were determined at day 1 and day 5 after PN initiation. Registered under <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> Identifier no. NCT02706119.</div></div><div><h3>Results</h3><div>At day 5 after the onset of PN, the MCT/LCT group had a significant reduction of 2 proinflammatory cytokines [interleukin (IL)-15, IL-17A], elevation of the anti-inflammatory cytokine IL-13 and increase of zonulin and indoxylsulfate. The olive oil group showed a statistically significant reduction of 5 proinflammatory cytokines [IL-1β, IL-17A, IL-6, cytokine-leukemia inhibitory factor (LIF) and tumor necrosis factor alpha (TNF-α)] and reduced concentrations of the anti-inflammatory cytokine IL-1RA, while the n-3 PUFA-enriched group presented a statistically significant reduction of 8 proinflammatory cytokines (interferon-gamma, IL-1β, IL-15, IL-17A, IL-6, LIF, monocyte chemoattractant protein 1, and TNF-α). In the between-group comparisons, indoxylsulfate significantly increased in the MCT/LCT group compared to the n-3 PUFA-enriched group, while 8-isoprostane and indoxylsulfate significantly increased in the MCT/LCT group compared to the other groups and superoxide dismutase significantly decreased in the MCT/LCT group compared to the other groups.</div></div><div><h3>Conclusion</h3><div>In patients with T2DM, PN lipid composition exerts a profound impact on proinflammatory, prooxidative and intestinal permeability biomarkers.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"44 ","pages":"Pages 155-164"},"PeriodicalIF":6.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821868","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":"Letter to the editor “Quality of life of caregivers of patients on home enteral nutrition”","authors":"Júlio César de Carvalho Martins,&nbsp;Matheus Santos de Sousa Fernandes,&nbsp;Raphael Fabricio de Souza","doi":"10.1016/j.clnu.2024.12.002","DOIUrl":"10.1016/j.clnu.2024.12.002","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"44 ","pages":"Pages 220-221"},"PeriodicalIF":6.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876627","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":"Letter to the Editor: “ESPEN Guideline on Nutrition and Hydration in Dementia–Update 2024”","authors":"Artur Barbosa Gomes,&nbsp;David de Sousa Cortez Barros,&nbsp;Nayara Rodrigues de Carvalho","doi":"10.1016/j.clnu.2024.11.013","DOIUrl":"10.1016/j.clnu.2024.11.013","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"44 ","pages":"Page 101"},"PeriodicalIF":6.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791178","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":"Effects of synbiotics surpass probiotics alone in improving type 2 diabetes mellitus: A randomized, double-blind, placebo-controlled trial","authors":"Chao Zhang ,&nbsp;Qi Zhang ,&nbsp;Xiaoxu Zhang ,&nbsp;Shuang Du ,&nbsp;Yong Zhang ,&nbsp;Xifan Wang ,&nbsp;Yinghua Liu ,&nbsp;Bing Fang ,&nbsp;Juan Chen ,&nbsp;Rong Liu ,&nbsp;Yanling Hao ,&nbsp;Yixuan Li ,&nbsp;Pengjie Wang ,&nbsp;Liang Zhao ,&nbsp;Haihong Feng ,&nbsp;Longjiao Zhu ,&nbsp;Lishui Chen ,&nbsp;Shuxing Chen ,&nbsp;Fuqing Wang ,&nbsp;Zhengqiang Jiang ,&nbsp;Jingjing He","doi":"10.1016/j.clnu.2024.11.042","DOIUrl":"10.1016/j.clnu.2024.11.042","url":null,"abstract":"<div><h3>Background and aims</h3><div>Combining probiotics and prebiotics in synbiotics may present a synergistic approach to improve type 2 diabetes mellitus (T2DM); however, further evidence is required to establish the comparative efficacy of synbiotics versus probiotics. This study aimed to evaluate the effects of <em>Bifidobacterium animalis</em> subsp. <em>lactis</em> MN-Gup (MN-Gup) and a synbiotic mixture of MN-Gup and galactooligosaccharide (MN-Gup-GOS) on glycemic control in T2DM patients and explore possible mechanisms.</div></div><div><h3>Methods</h3><div>This randomized, double-blind, placebo-controlled clinical trial assigned 120 T2DM patients, to receive MN-Gup, MN-Gup-GOS, or placebo intervention for 12 weeks. The primary outcome was fasting blood glucose (FBG), with secondary outcomes including hemoglobin A1C (HbA1C), insulin, homeostatic model assessment of insulin resistance (HOMA-IR), inflammatory indicators, oxidative stress indicators, gastrointestinal hormones, gut microbiota, and bile acids (BAs).</div></div><div><h3>Results</h3><div>The median age of the 120 participants was 59 years (interquartile range: 55–62 years), with 40 being men. Compared to baseline, all three groups exhibited significant reductions in FBG. Additionally, the MN-Gup-GOS group demonstrated significant decreases in HbA1c, serum insulin, and HOMA-IR after intervention, whereas no such reductions were observed in the placebo and MN-Gup groups. Regarding the between-group comparisons, the MN-Gup-GOS intervention showed a significantly greater reduction in FBG compared to the placebo (least squares mean difference [95 % CI], −0.69 [-1.29, −0.10] mmol/L, <em>P</em> = 0.022) and MN-Gup (−0.59 [-1.17, −0.01], <em>P</em> = 0.047) group, but not for other indicators of glucose metabolism. Additionally, MN-Gup and MN-Gup-GOS intervention, especially the latter, significantly modified inflammation, oxidative stress, gut microbiota, serum BAs, and GLP-1 levels. Correlation analysis showed significant associations between changes in certain gut microbiota (<em>Bifidobacterium</em>) and BAs (deoxycholic acid and lithocholic acid) with glycemic indicators.</div></div><div><h3>Conclusions</h3><div>The auxiliary effect of synbiotics MN-Gup-GOS on reducing FBG levels surpassed that of MN-Gup probiotics alone in T2DM patients, potentially attributed to the enhanced modulation of gut microbiota, BAs, and GLP-1 secretion.</div></div><div><h3>Trial registration</h3><div>This study was registered on the website of <span><span>www.chictr.org.cn</span><svg><path></path></svg></span>, number ChiCTR2100052187.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"44 ","pages":"Pages 248-258"},"PeriodicalIF":6.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885251","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 impact of fibre and prebiotic interventions on outcomes in cancer and haematopoietic stem cell transplantation: A systematic review","authors":"Breeana Gardiner ,&nbsp;Hannah R. Wardill ,&nbsp;Graeme O'Connor ,&nbsp;Darren Hargrave ,&nbsp;Aaron M. Lett","doi":"10.1016/j.clnu.2024.11.022","DOIUrl":"10.1016/j.clnu.2024.11.022","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Cancer therapy is associated with a range of toxicities that severely impact patient well-being and a range of clinical outcomes. Dietary fibre/prebiotics characteristically improve the gastrointestinal microenvironment, which consequently elicits beneficial downstream effects that could be relevant to the prevention and management of treatment-related toxicities. Despite the compelling theoretical scientific rationale there has been limited effort to synthesise the available evidence to conclude such scientific underpinning to the clinical use of fibre/prebiotics in cancer patients. Therefore, this systematic review aimed to evaluate the clinical impact of fibre/prebiotic-based interventions on gastrointestinal-side effects; gastrointestinal-microbiome; clinical outcomes; nutrition status and body composition; and quality-of-life in children and adults being treated for cancer or undergoing a haematopoietic stem cell transplant (HSCT).</div></div><div><h3>Methods</h3><div>This study was conducted in adherence to PRISMA guidelines, and the protocol was published prospectively with PROSPERO (CRD42022299428). Three databases (MEDLINE (Ovid), CINHAL, EMBASE) were searched from inception to December 2023. All articles were assessed for bias using the Cochrane risk-of-bias tool RoB 2.0 (for RCTs) and ROBINS-I (for non-RCTs).</div></div><div><h3>Results</h3><div>A total of 9989 de-duplicated records were identified, of these, 14 (paediatrics [n = 1], adults [n = 13]) met the inclusion criteria (randomised controlled trials (RCT) [n = 11], observational or non-RCTs [n = 3]). The risk-of-bias was graded to be serious/high (n = 6); moderate/some concerns (n = 7); low (n = 1). Interventions included prebiotic supplement (n = 8), nutrition supplement/formula with added fibre/prebiotic (n = 3) and dietary modification (n = 3). The dose of fibre intervention ranged from 2.4g to 30g per day. Substantial heterogeneity of target parameters was identified across a range all outcome categories, precluding definitive conclusions.</div></div><div><h3>Conclusion</h3><div>The scientific rationale for fibre/prebiotics-based interventions for the prevention or management of cancer treatment-related toxicities is compelling. However, it is clear that the scientific and clinical field remains disconnected in how to effectively translate this approach to improve cancer outcomes. High-quality intervention studies translatable to clinical practice are now evidently crucial to determine if and how fibre/prebiotics should be used to support people undergoing cancer or HSCT therapy.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"44 ","pages":"Pages 86-100"},"PeriodicalIF":6.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791180","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":"Medium-chain triglyceride supplementation and the association with growth, nutritional status and clinical outcomes in infants with biliary atresia","authors":"Sara Mancell ,&nbsp;Anil Dhawan ,&nbsp;Gillian Geaney ,&nbsp;Salma Ayis ,&nbsp;Kevin Whelan","doi":"10.1016/j.clnu.2024.11.028","DOIUrl":"10.1016/j.clnu.2024.11.028","url":null,"abstract":"<div><h3>Background and aims</h3><div>Infants with biliary atresia experience gastrointestinal malabsorption of long-chain triglycerides and are commonly supplemented with medium-chain triglyceride (MCTs) that can be passively absorbed. The aim was to investigate the association of MCT supplementation with growth, nutritional status and clinical outcomes in infants with biliary atresia.</div></div><div><h3>Methods</h3><div>Infants who underwent Kasai portoenterostomy and were followed up for at least two years or until death or transplantation were reviewed. Infants with comorbidities affecting growth or outcome were excluded. Data were extracted from medical records from more than a decade in relation to MCT supplementation, growth, nutritional status and clinical outcome at baseline, 6-weeks, 3-, 6-, 12- and 24-months. Mixed-effects modelling was used to test associations of MCT in the first six months with these outcomes.</div></div><div><h3>Results</h3><div>Of 200 infants (108 male), 108 (54 %) were alive with native liver at two years, 84 (42 %) underwent liver transplantation and eight (4 %) died. MCT percentage prescribed was mean 57.3 % (SD 11.2) while MCT intake was median 2.7 (IQR 2.2, 3.8) g/kg/d. For every g/kg/d MCT consumed, the rate of change in z-score for weight was −0.27 (95 % CI -0.37 to −0.17) and length was −0.31 (−0.42 to −0.17) (both p &lt; 0.001). Compared to the low MCT group (&lt;2.7 g/kg/d), the high group (≥2.7 g/kg/d) consumed more energy (118 vs. 108 kcal/kg; p &lt; 0.001), however, at 3-months they had lower weight (−1.7 (1.2) v. −1.0 (1.2) and length (−1.3 (1.1) v. −0.6 (1.4) z-scores (both p &lt; 0.001) but no differences in growth at later time points. There was no overall association between MCT and nutritional status or clinical outcomes.</div></div><div><h3>Conclusions</h3><div>This is the first study to investigate the association of MCT with growth, nutritional status and clinical outcomes in biliary atresia. No association was found between MCT with growth beyond 3-months, overall nutritional status or clinical outcomes. The association between MCT (g/kg/d) and poorer growth in the first 3-months may be explained by infants with poorer growth drinking more or being prescribed more MCT formula milk. A randomised controlled trial could help to better understand this association.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"44 ","pages":"Pages 134-146"},"PeriodicalIF":6.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817437","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":"Altered body composition in obesity: Prevalence, associated factors and comparison of two methods","authors":"Mathilde Fichet ,&nbsp;Estelle Le Pabic ,&nbsp;Laurence Lacaze ,&nbsp;Mickaël Som ,&nbsp;Emeric Rageul ,&nbsp;Mathilde Barrallier ,&nbsp;Mylène Guiho ,&nbsp;Damien Bergeat ,&nbsp;Ronan Thibault","doi":"10.1016/j.clnu.2024.11.040","DOIUrl":"10.1016/j.clnu.2024.11.040","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>There is still some uncertainty towards the best method to diagnose the sarcopenic obesity, and specifically, altered body composition. A recent international consensus proposes the association of increased fat mass (FM) with reduced skeletal muscle mass adjusted by weight (SMM/W) (method 1). The ratio of fat mass index (FMI)/fat free mass index (FFMI) (method 2) has also been proposed. Aims: to determine and compare the prevalence of altered body composition by the two methods, and its associated factors, in obese patients referred to a specialized center.</div></div><div><h3>Methods</h3><div>Anthropometry, single-frequency bioimpedance analysis (BIA), and risk factors for sarcopenia were collected. SMM, according to the Janssen equation, and the FMI/FFMI ratio, were calculated. The agreement between the two methods was determined by the kappa coefficient. Multivariable analysis identified the factors associated with altered body composition according to the two methods.</div></div><div><h3>Results</h3><div>253 consecutive patients were retrospectively included: 81 % women, age 44.4 ± 13 yr, body mass index (BMI) 43.0 ± 6.8 kg/m², severe obesity, 94 %. Altered body composition was reported in 90 % of the obese patients (n = 227/253) with method 1, and 35 % (83/253) with method 2. The agreement between the two methods was very low (kappa = 0.10). The factors associated with altered body composition were: method 1, age (odds ratio = 1.05 [95 % confidence interval, 1.01; 1.10], P = 0.02), arterial hypertension (0.18 [0.06; 0.57], P = 0.04), hip circumference (1.13 [1.07; 1.20], P &lt; 0.0001), previous obesity follow-up (3.78 [1.30; 10.96], P = 0.002); method 2, female gender (3.12 [1.02; 9.5], P = 0.04), age (1.10 [1.06; 1.14], P &lt; 0.0001), BMI (1.37 [1.26; 1.50], P &lt; 0.0001), history of cancer (5.35 [1.20; 23.84], P &lt; 0.028), phase angle (0.42 [0.27; 0.66], P &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Altered body composition is common in severely obese patients. The two methods are not comparable. Further work will aim at refining the methods of body composition measurements in the obese patients, and especially for the sarcopenic obesity diagnosis.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"44 ","pages":"Pages 147-154"},"PeriodicalIF":6.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821867","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":"Stearic acid metabolism in human health and disease","authors":"Xinyi Shen ,&nbsp;Shuo Miao ,&nbsp;Yaping Zhang ,&nbsp;Xingying Guo ,&nbsp;Wenxian Li ,&nbsp;Xin Mao ,&nbsp;Qingsong Zhang","doi":"10.1016/j.clnu.2024.12.012","DOIUrl":"10.1016/j.clnu.2024.12.012","url":null,"abstract":"<div><div>Named after the Greek term for “hard fat”, stearic acid has gradually entered people's field of vision. As an important component of various physiological cellular functions, stearic acid plays a regulatory role in diverse aspects of energy metabolism and signal transduction. Its applications range from serving as a bodily energy source to participating in endogenous biosynthesis. Similar to palmitate, stearic acid serves as a primary substrate for the stearoyl coenzyme A desaturase, which catalyzes the conversion of stearate to oleate and is involved in the synthesis of triglyceride and other complex lipids. Additionally, stearic acid functions as a vital signaling molecule in pathological processes such as cardiovascular diseases, diabetes development, liver injury and even nervous system disorders. Therefore, we conduct a comprehensive review of stearic acid, summarizing its role in various diseases and attempting to provide a systematic overview of its homeostasis, physiological functions, and pathological process. From a medical standpoint, we also explore potential applications and discuss stearic acid as a potential therapeutic target for the treatment of human diseases.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"44 ","pages":"Pages 222-238"},"PeriodicalIF":6.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876628","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":"Letter to the Editor - Untargeted metabolomics and mendelian randomization analysis identify alpha-linolenic acid and linoleic acid as novel biomarkers of perioperative neurocognitive dysfunction","authors":"Zihao Zhang ,&nbsp;Yiyang Luo ,&nbsp;Yiming Li","doi":"10.1016/j.clnu.2024.12.010","DOIUrl":"10.1016/j.clnu.2024.12.010","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"44 ","pages":"Page 124"},"PeriodicalIF":6.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812343","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":"Why do we need guidelines and why do they fail us?","authors":"Mary E. Brindle","doi":"10.1016/j.clnu.2024.11.035","DOIUrl":"10.1016/j.clnu.2024.11.035","url":null,"abstract":"<div><div>Guidelines are powerful tools that support evidence-based care in a patient population that is increasingly complex and in systems that are rapidly evolving. When high quality guidelines are implemented well, they can improve patient outcomes, decrease clinician workload and even reduce disparities in care. Guidelines, however, are only as good as the evidence used to create them and are their effectiveness relies on the quality and completeness of their implementation. Guidelines have a lifespan and require redevelopment and reimplementation to achieve their greatest value.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"44 ","pages":"Pages 43-45"},"PeriodicalIF":6.6,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756785","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}