{"title":"Measuring nutrient content in human milk: are we there yet?","authors":"Donna T Geddes, Lisa Stinson","doi":"10.1097/MCO.0000000000001214","DOIUrl":"10.1097/MCO.0000000000001214","url":null,"abstract":"<p><strong>Purpose of review: </strong>Precise nutrient quantification is essential for developing reference values, guiding fortification strategies and preventing growth deficits, particularly in preterm infants. This review examines current methodologies for measuring nutrient content in human milk, evaluating accuracy, practicality, and limitations of existing analytical approaches.</p><p><strong>Recent findings: </strong>Current analytical methods for human milk nutrients demonstrate a trade-off between accuracy and clinical practicality. While some methods provide the high accuracy for macronutrient measurement, they require large sample volumes and extensive laboratory time. Alternative approaches such as spectroscopic and colorimetric methods offer improved efficiency and smaller sample requirements but with varying degrees of accuracy. Significant methodological challenges persist across all approaches, including the lack of standardized sampling protocols that account for temporal variation in milk composition, and difficulties in adapting analytical technologies originally designed for other matrices. These limitations are particularly problematic for micronutrient analysis, where sample degradation and storage conditions could impact results.</p><p><strong>Summary: </strong>While multiple analytical approaches for human milk exist, significant methodological limitations compromise accuracy and clinical utility. The field requires standardized workflows encompassing rigorous sampling protocols, validated storage conditions, and comprehensive method validation. Future developments should bridge the gap between research-grade accuracy and clinical practicality.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":" ","pages":"299-305"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212493","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":"Strategies to reduce malnutrition in children: what works in low-resource settings?","authors":"Narjis Fatima Hussain, Zulfiqar A Bhutta","doi":"10.1097/MCO.0000000000001193","DOIUrl":"10.1097/MCO.0000000000001193","url":null,"abstract":"<p><strong>Purpose of review: </strong>Child malnutrition in low-and-middle-income countries remains persistently high, driven by converging biological, social, economic, environmental, and conflict-related factors. As progress slows and vulnerabilities intensify, this review synthesises emerging evidence from recent years to identify effective strategies and future directions for reducing undernutrition in resource-constrained settings.</p><p><strong>Recent findings: </strong>Recent literature demonstrates that nutrition-sensitive interventions, including women's empowerment, social protection, WASH, immunisation, kitchen gardens, and biofortification, address key underlying drivers of child malnutrition and contribute to improved growth and dietary diversity. Building on these foundations, nutrition-specific strategies such as antenatal micronutrient supplementation, optimal infant and young child feeding practices, fortified complementary foods, and emerging approaches like microbiota-directed foods and fermentation have shown measurable gains in growth and nutritional status. Across the evidence base, integrated and multisectoral delivery models consistently outperform standalone programs, with particularly strong results when nutrition is combined with health services, social protection, community-based platforms, or climate- and conflict-responsive strategies.</p><p><strong>Summary: </strong>Current evidence underscores a shift toward integrated, layered, and context-responsive programming as the most effective path to reducing child malnutrition. Future research should prioritise implementation models that bridge nutrition-specific and nutrition-sensitive domains, strengthen health and community systems, and adapt to climate and humanitarian pressures.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":" ","pages":"334-343"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827107","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":"A viewpoint review of recent policy changes and public health initiatives to combat obesity.","authors":"Yih-Kai Chan, Nerolie Stickland","doi":"10.1097/MCO.0000000000001228","DOIUrl":"https://doi.org/10.1097/MCO.0000000000001228","url":null,"abstract":"<p><strong>Purpose of review: </strong>Obesity is a growing public health issue worldwide affecting one in three adults in Australia and two in five adults in the United States. Globally, the prevalence of obesity has doubled or even tripled in many countries over the past two decades, predominately driven by urbanization, sedentary lifestyles and increased consumption of high-calorie processed foods. The aim of this viewpoint article is to highlight recent policy changes and public health Initiatives to curb this obesity epidemic.</p><p><strong>Recent findings: </strong>Traditional strategies that focus on individual behaviour have proven insufficient and broader public health policy models to address both societal and environmental contributors to obesity have emerged. Recent public health initiatives directed their focus on promoting healthier lifestyles through policies, family-based interventions, dietary education and sustained community support. Effective obesity prevention requires collaborative efforts across policy, healthcare and community sectors to mitigate its far-reaching physical, psychological and economic impacts from individual to population levels.</p><p><strong>Summary: </strong>Policy and public health efforts against obesity are evolving into comprehensive systems-oriented models. They combine regulation, fiscal tools, healthcare integration, education campaigns, measurement systems and equity-focused approaches. Together, they form a layered strategy aimed at preventing obesity, supporting individuals living with it and ensuring accountability across sectors.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765172","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":"Proteomics for precision nutrition: current evidence and future directions.","authors":"Mirko Marino, Cristian Del Bo', Patrizia Riso","doi":"10.1097/MCO.0000000000001226","DOIUrl":"https://doi.org/10.1097/MCO.0000000000001226","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review critically evaluates proteomics research applied to clinical nutrition and metabolism published between mid-2024 and early-2026, examining whether recent advances have moved the field closer to clinically actionable precision nutrition applications.</p><p><strong>Recent findings: </strong>Large prospective cohort studies show that circulating proteomic signatures reflect dietary patterns and are associated with incident cardiometabolic, hepatic, and neurodegenerative outcomes. In most analyses, these signatures capture plausible biological pathways, but their incremental predictive value beyond established risk models appears modest. Interventional studies confirm that circulating proteins respond to dietary modification, but these trials are considerably smaller than epidemiological cohorts and proteomic-guided randomized allocation has rarely been implemented to date. Although multiomics integration and machine-learning approaches have expanded discovery and improved pathway modeling, independent validation, cross-platform consistency, and clinically meaningful risk reclassification remain inconsistently demonstrated across studies.</p><p><strong>Summary: </strong>Diet-proteome associations are biologically coherent and reproducible at the population level. Nevertheless, translation into individualized dietary prescription remains to be demonstrated at scale. Robust evidence of cross-platform consistency, formal clinical utility, and outcome-driven trials incorporating proteomic-guided interventions will be key to enabling circulating proteomics to support routine precision nutrition practice.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765247","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}
Natasha Nalucha Mwala, Marian A E de van der Schueren
{"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":"https://doi.org/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":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-15","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":"Perioperative drug pharmacokinetics in patients with obesity.","authors":"Damien Rousseleau, Luc De Baerdemaeker","doi":"10.1097/MCO.0000000000001225","DOIUrl":"https://doi.org/10.1097/MCO.0000000000001225","url":null,"abstract":"<p><strong>Purpose of review: </strong>Obesity-related changes in body composition and organ function modify drug pharmacokinetics and pharmacodynamics, challenging standard dosing strategies. This review summarizes recent data on perioperative pharmacokinetics in patients with obesity and discusses implications for anesthetic drug dosing.</p><p><strong>Recent findings: </strong>Recent data confirm that excess adiposity induces drug-specific alterations in distribution, hepatic clearance, and renal elimination. Lipophilic agents exhibit increased volumes of distribution with risk of accumulation, whereas hydrophilic drugs are prone to excessive plasma exposure when dosed according to total body weight. Recent clinical and pharmacokinetic studies have generated dosing data for several perioperative agents in patients with obesity, including remimazolam, ciprofol, and intravenous lidocaine. In contrast, pharmacokinetic evidence remains limited for other commonly used drugs, notably ketamine, magnesium sulfate, and dexamethasone. The incidence of sleep apnea is high in obese patients and restrictive use or avoiding of opioids is advised. Studies evaluating multimodal and opioid-free anesthesia in patients with obesity report heterogeneous outcomes, reflecting uncertainty in dosing strategies and comparator regimens.</p><p><strong>Summary: </strong>Perioperative drug dosing in patients with obesity requires an individualized approach based on pharmacokinetic principles and clinical titration. Further obesity-specific pharmacokinetic and pharmacodynamic studies are needed to support safe and effective management in this population.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697846","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":"Nutrition and gut-brain axis: opposing effects of dietary fiber and Western-style diets on Alzheimer's disease.","authors":"Yuhai Zhao, Nicolas G Bazan","doi":"10.1097/MCO.0000000000001223","DOIUrl":"https://doi.org/10.1097/MCO.0000000000001223","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review summarizes how diet shapes the gut-brain axis and contributes to Alzheimer's disease (AD) pathology, emphasizing the contrasting effects of Western-style diets and dietary fiber.</p><p><strong>Recent findings: </strong>Western diets rich in sugar and saturated fat disrupt gut microbial balance, increase intestinal permeability, and promote systemic inflammation, oxidative stress, and lipid metabolic imbalance, all of which accelerate neurodegeneration. In contrast, dietary fiber supports microbial diversity, improves lipid and glucose metabolism, and reduces neuroinflammation through both short-chain fatty acid (SCFA)-dependent and independent pathways involving bile acids, microbial lipids, and immune modulation. Recent animal and clinical data show that mixed-fiber supplementation can restore metabolic stability and cognitive function. In the 5xFAD mouse model (a transgenic AD model overexpressing five familial AD mutations), adding low-dose fiber to a high-sugar diet reshaped gut microbiota and improved AD-like pathology, identifying a reproducible set of fiber-sensitive bacterial taxa.</p><p><strong>Summary: </strong>Dietary patterns exert opposing effects on gut-brain communication. Nutrient excess drives dysbiosis and neuroinflammation, while dietary fiber promotes metabolic balance and neuronal resilience. Understanding these context-dependent microbial and metabolic interactions may guide precision dietary strategies for AD prevention and therapy.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147484996","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":"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":"https://doi.org/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":""},"PeriodicalIF":3.5,"publicationDate":"2026-03-16","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}
Dongshen Peng, Thanaphong Phongpreecha, Nima Aghaeepour
{"title":"Artificial intelligence-guided nutritional therapy in the ICU.","authors":"Dongshen Peng, Thanaphong Phongpreecha, Nima Aghaeepour","doi":"10.1097/MCO.0000000000001189","DOIUrl":"10.1097/MCO.0000000000001189","url":null,"abstract":"<p><strong>Purpose of review: </strong>Critical care nutrition remains a high-stakes and error-prone domain, particularly given the complex metabolic demands and heterogeneity of ICU populations. This review explores recent progress in integrating artificial intelligence with nutritional therapy in ICUs, highlighting its evolution and potential benefits in precision-guided support, along with current implementation challenges.</p><p><strong>Recent findings: </strong>Widely used in adult and neonatal ICUs, parenteral nutrition faces persistent challenges including ordering errors, practice variability, and insufficient robust long-term outcome evidence. Recent advances in machine learning have demonstrated considerable potential in predicting nutrition-related complications (e.g. neonatal morbidities, cholestasis, feeding intolerances, and malnutrition), optimizing nutrient delivery through dynamic, real-time recommendations, and enhancing clinical decision-making with large language models (LLMs) that synthesize clinical guidelines and patient data into actionable insights. However, future studies must establish causal relationships between optimal parenteral nutrition and long-term outcomes while addressing confounding factors and ingredient heterogeneity.</p><p><strong>Summary: </strong>Artificial intelligence-driven nutrition therapies have the potential to significantly improve the precision, safety, and personalization of ICU nutrition practices. Continued development and validation using standardized, comprehensive, longitudinal datasets, and validation in comparative clinical trials will be critical to realizing this transformative potential.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":" ","pages":"193-201"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12893183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Skeletal muscle protein turnover and mitochondrial responses to omega-3 fatty acid supplementation: an update.","authors":"Jack E Hayden, Colleen S Deane","doi":"10.1097/MCO.0000000000001196","DOIUrl":"10.1097/MCO.0000000000001196","url":null,"abstract":"<p><strong>Purpose of review: </strong>To critically review recent findings related to the effects of omega-3 fatty acid supplementation on skeletal muscle, with a particular focus on skeletal muscle protein turnover and mitochondrial function.</p><p><strong>Recent findings: </strong>Evidence indicates that omega-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), may support skeletal muscle health by influencing muscle protein synthesis (MPS), mitochondrial function, and redox balance. However, recent meta-analyses reveal inconsistent effects of omega-3 fatty acid supplementation on basal and stimulus-induced MPS, likely due to methodological variability. Omega-3 fatty acid supplementation is seemingly more beneficial in clinical cohorts and preclinical data suggests omega-3s may reduce oxidative stress.</p><p><strong>Summary: </strong>Omega-3 fatty acid supplementation is a promising nutritional strategy for supporting skeletal muscle health, via the modulation of MPS and mitochondrial function. However, large-scale trials in a variety of healthy and clinical populations using sustainable sources of omega-3 fatty acids are required before a consensus on efficacy can be made.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":" ","pages":"136-140"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12893146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}