Current Opinion in Clinical Nutrition and Metabolic Care最新文献

{"title":"Omega-3 fatty acids and human health: why strong claims remain on fragile consensus.","authors":"Priscila Giacomo Fassini, Serge Rezzi","doi":"10.1097/MCO.0000000000001224","DOIUrl":"10.1097/MCO.0000000000001224","url":null,"abstract":"<p><strong>Purpose of review: </strong>Omega-3 (ω-3) polyunsaturated fatty acids (PUFAs) consumption remains widespread despite inconsistent reported health benefits. This review discusses multiple issues related to the efficiency of ω-3 PUFAs on human health including factors driving ω-3 PUFAs bioavailability and growing concerns about product quality.</p><p><strong>Recent findings: </strong>Recent clinical research reports ω-3 PUFAs benefits in various areas including cardiometabolic health, inflammation, cognitive protection, pregnancy outcomes, cancer and certain neuropsychiatric conditions. However, effects on healthy individuals and dietary recommendations need stronger clinical evidence. Heterogeneity in supplementation response involves genetic variability, microbiome, oxidative stress, diet and differences in supplementation protocols. Moreover, some of ω-3 PUFAs products are prone to significant oxidative degradation which can drastically reduce health benefits while possibly being detrimental. Yet ω-3 PUFAs oxidation status of products remains rarely reported and the effects of long-term consumption of oxidized lipids in humans still need to be established.</p><p><strong>Summary: </strong>Future clinical practices and research should shift toward biomarker-guided and personalized ω-3 PUFAs intervention strategies with mandatory prerequisite knowledge about product quality, e.g. dietary supplements and ω-3 PUFAs rich/fortified foods, and baseline blood-based ω-3 PUFAs nutritional status. Standardized reporting of formulation, oxidation status, and participant baseline characteristics is essential to clarify dose-response relationships and optimize therapeutic efficacy of ω-3 PUFAs.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":" ","pages":"538-543"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147462657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iron deficiency during pregnancy and lactation.","authors":"Laura Wasserfallen, Diego Moretti","doi":"10.1097/MCO.0000000000001257","DOIUrl":"10.1097/MCO.0000000000001257","url":null,"abstract":"<p><strong>Purpose of review: </strong>Iron deficiency persists as the most common nutritional deficiency worldwide and is highly prevalent among women of reproductive age. Pregnancy substantially raises iron requirements, increasing the risk of complications for mother and newborn particularly in low-income and middle-income countries. We summarize current evidence on the determinants, physiological adaptations, diagnostic thresholds, and management of iron deficiency during pregnancy and lactation, focusing on recent developments.</p><p><strong>Recent findings: </strong>Maternal iron regulation during pregnancy involves progressive hepcidin suppression to enhance absorption and fetal iron transfer, though regulatory mechanisms remain incompletely understood. Daily supplementation may maintain maternal iron status more effectively than an alternate-day regimen but is associated with more side effects; thus, the choice of regimen should be individualized and based on context. Multiple micronutrient supplements offer superior clinical outcomes compared to iron-folic supplements. For moderate-to-severe iron deficiency or late-pregnancy correction, intravenous iron has proven to be well tolerated and highly effective.</p><p><strong>Summary: </strong>Effective management requires early identification using ferritin-based diagnostic thresholds. Intravenous iron is an essential clinical tool for rapid correction or when oral iron is poorly tolerated. Sustainably improving maternal iron status globally would prevent iron deficiency in pregnancy but further necessitates integrated public health approaches - addressing dietary quality, low-dose supplementation, sanitation, and digital health interventions.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":" ","pages":"503-509"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bioelectrical impedance analysis instruments: clarifying concepts and the importance of standardization: a comment on the article by Dupertuis et al .","authors":"Steven Brantlov, Christian Lodberg Hvas, Lars Jødal, Leigh C Ward","doi":"10.1097/MCO.0000000000001254","DOIUrl":"10.1097/MCO.0000000000001254","url":null,"abstract":"","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":" ","pages":"533-535"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choline and metabolic health, a missing link in a critical chain.","authors":"Evan M Paules","doi":"10.1097/MCO.0000000000001252","DOIUrl":"10.1097/MCO.0000000000001252","url":null,"abstract":"<p><strong>Purpose of review: </strong>Emerging evidence suggests that choline plays a significant role in mediating metabolic disease beyond the regulation of hepatic triglycerides. The aim of this article is to present a current, brief synthesis focused on the impact of choline intake on metabolic health and to identify future directions in this research space.</p><p><strong>Recent findings: </strong>Recent work has linked low choline intake to obesity, metabolic dysfunction-associated steatotic liver disease (MASLD), type 2 diabetes, and obesity-associated cognitive decline. A new methodology now enables more precise discrimination of choline intake in clinical populations. Emerging evidence reframes circulating trimethylamine N-oxide (TMAO) as a marker of metabolic dysfunction driven by obesity and a high-fat diet, rather than a direct consequence of dietary choline intake. Preclinical and clinical studies further suggest that adequate choline intake may be protective against obesity-related disease progression, particularly when established early in life.</p><p><strong>Summary: </strong>Choline is emerging as an important mediator of metabolic health and disease progression. A deeper understanding of the mechanisms regulating choline metabolism is critical to tailor nutritional therapies and mitigate metabolic disease progression. The impact of new antiobesity medications, including GLP-1 receptor agonists, on choline requirements also warrants investigation.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":" ","pages":"519-526"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond deficiency: micronutrients in the era of precision medicine: are we asking the right questions?","authors":"Karin Amrein, Manfred Eggersdorfer","doi":"10.1097/MCO.0000000000001256","DOIUrl":"https://doi.org/10.1097/MCO.0000000000001256","url":null,"abstract":"","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":"29 6","pages":"501-502"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial introduction.","authors":"","doi":"10.1097/MCO.0000000000001258","DOIUrl":"https://doi.org/10.1097/MCO.0000000000001258","url":null,"abstract":"","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":"29 6","pages":"v"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Micronutrients in adult critically ill patients: lessons learned and the path toward precision.","authors":"Christian Stoppe, Kursat Gundogan, Stefano Marelli","doi":"10.1097/MCO.0000000000001253","DOIUrl":"10.1097/MCO.0000000000001253","url":null,"abstract":"<p><strong>Purpose of review: </strong>Despite strong biological plausibility, empiric high-dose micronutrient supplementation has failed to improve outcomes in critically ill patients. This review synthesizes evidence from the past 18 months and outlines the necessary transition toward biomarker-guided precision nutrition.</p><p><strong>Recent findings: </strong>Recent evidence has further challenged routine high-dose micronutrient therapy. High-dose intravenous vitamin C failed to improve outcomes and was associated with potential harm in patients with sepsis, COVID-19, severe burns, and post-cardiac arrest syndrome. In contrast, a 2025 meta-analysis reported reduced short-term mortality and shorter ICU stay with vitamin D supplementation in patients on mechanical ventilation. Thiamine may shorten the duration of shock without affecting mortality. Observational studies suggest that carnitine deficiency is common during critical illness, and both deficiency and excess may be associated with adverse outcomes in critically ill patients. Selenium supplementation continues to show no clinical benefits in multiple sepsis phenotypes and high-risk surgical populations. Novel evidence also links trace element dysregulation to critical illness-acquired weakness, implicating copper-dependent cuproptosis, zinc homeostasis, and iron metabolism in the pathogenesis of muscle dysfunction. Advances in biomarkers (e.g. hepcidin, soluble transferrin receptor, ferritin, and selenoprotein P) are enabling more accurate identification of true deficiency states and targeted replacement strategies.</p><p><strong>Summary: </strong>Current evidence does not support routine high-dose single-micronutrient therapy in critically ill patients and suggests potential harm with pharmacological doses of vitamin C. Clinicians should ensure that daily baseline requirements are met and reserve supplementation only for patients with biomarker-confirmed deficiency or biologically defined high-risk phenotypes. Future research should prioritize precision nutritional approaches based on validated biomarkers and individualized metabolic profiling.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":" ","pages":"510-518"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The complexity of malnutrition in people living with excess body weight.","authors":"Natasha Nalucha Mwala, Marian A E de van der Schueren","doi":"10.1097/MCO.0000000000001227","DOIUrl":"10.1097/MCO.0000000000001227","url":null,"abstract":"<p><strong>Purpose of review: </strong>Malnutrition in people living with excess body weight is increasingly recognized but remains frequently overlooked because nutritional screening and assessment commonly rely on body mass index (BMI). This review highlights emerging evidence on protein-energy malnutrition, skeletal muscle mass loss, and micronutrient deficiencies in individuals with excess adiposity, and examines the influence of contemporary obesity treatments on these nutritional disturbances.</p><p><strong>Recent findings: </strong>Reduced skeletal muscle mass and micronutrient deficiencies are increasingly recognized in individuals with overweight and obesity. Pharmacological therapies, particularly glucagon-like peptide-1 receptor agonists, and bariatric surgery, produce substantial weight loss accompanied by reductions in skeletal muscle mass. However, these changes may partly reflect physiological adaptations to energy restriction and improvements in muscle composition rather than pathological muscle depletion. Micronutrient deficiencies may occur because of both obesity and its treatment.</p><p><strong>Summary: </strong>Malnutrition in individuals with overweight and obesity represents a complex clinical challenge that cannot be identified using BMI alone. Incorporating nutritional and body composition assessment into obesity treatment is essential to distinguish adaptive tissue changes from clinically significant nutritional compromise and to ensure weight-loss therapies optimize metabolic health while preserving nutritional and functional status.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":" ","pages":"544-549"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of zinc biomarkers and impact on clinical nutrition and public health.","authors":"Murielle Bochud, Mette M Berger","doi":"10.1097/MCO.0000000000001260","DOIUrl":"10.1097/MCO.0000000000001260","url":null,"abstract":"<p><strong>Purpose of review: </strong>Zinc deficiency is a major modifiable nutritional and public health burden worldwide. Because zinc participates in a wide range of biochemical functions, the physiological consequences of deficiency are diverse and nonspecific, complicating the identification of reliable biomarkers of zinc status. The present review summarizes recent evidence regarding zinc status biomarkers, while integrating the impact of novel findings on the genetics of zinc homeostasis.</p><p><strong>Recent findings: </strong>Updated assessment of available zinc biomarkers shows that plasma/serum and urinary zinc excretion respond to changes in zinc intake in humans. Despite the impact of inflammation, plasma/serum zinc remains a good indicator of status. Numerous other putative biomarkers do not meet biomarker efficiency criteria. Zinc homeostasis is tightly controlled through the action of more than 20 membrane transporters belonging to two large families (SLC30 and SLC39). SLC30A2 genetic variants play a key role in controlling urinary zinc excretion, with high geographic variation in allele frequency. The observation from genetic studies that urinary and blood zinc levels are regulated through largely distinct biological pathways suggests that urinary zinc levels may provide relevant complementary information to serum/plasma levels pointing towards urinary-to-plasma ratio as a novel biomarker of human zinc status.</p><p><strong>Summary: </strong>The combined assessment of serum (or plasma) zinc concentration and urinary zinc excretion appears to be the most sensitive and specific approach for evaluating zinc status in humans.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":" ","pages":"527-532"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's response to Brantlov, Lodberg Hvas, Jødal and Ward.","authors":"Yves Marc Dupertuis","doi":"10.1097/MCO.0000000000001255","DOIUrl":"https://doi.org/10.1097/MCO.0000000000001255","url":null,"abstract":"","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":"29 6","pages":"536-537"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}