European Journal of Clinical Nutrition最新文献

{"title":"Prevalence, risk factors, and clinical consequence of enteral feeding intolerance in elderly patients with traumatic brain injury: a two-center study.","authors":"Yuanrun Zhu, Wei Ji, Chen Jiang, Kangli Xu, Haibo Li, Xiaofeng Yang, Yadong Wang","doi":"10.1038/s41430-026-01812-4","DOIUrl":"https://doi.org/10.1038/s41430-026-01812-4","url":null,"abstract":"<p><strong>Background: </strong>Enteral nutrition (EN) support is important for patients with traumatic brain injury (TBI). Enteral feeding intolerance (EFI) is common among critically ill patients and may lead to inadequate EN support. Currently, TBI in elderly individuals poses a growing health concern. The aim of this study was to investigate the prevalence, risk factors, and clinical consequences of EFI in elderly patients with TBI.</p><p><strong>Methods: </strong>We performed a two-center retrospective analysis. Elderly patients (>59 years old) with TBI admitted from January 2022 to December 2024 were included. A total of 934 patients were screened, and 159 were finally analyzed.</p><p><strong>Results: </strong>The overall prevalence of EFI was 44.0%. High gastric residual volume (42.9%) and diarrhea (41.4%) were the two most common direct causes of EFI. Age, blood transfusion and ventilation duration were independent risk factors for EFI. Patients with EFI were more likely to receive inadequate EN support (adjusted odds ratio 3.84, 95% CI: 1.39-10.63) and had higher in-hospital mortality (adjusted hazard ratio 2.76, 95% CI: 1.16-6.56), as well as lower Glasgow Outcome Scale (GOS) scores at discharge (adjusted odds ratio 0.49, 95% CI: 0.25-0.96).</p><p><strong>Conclusions: </strong>EFI is common in elderly patients with TBI, and the risk increases with age. Blood transfusion and prolonged ventilation duration are independent risk factors for EFI, in addition to age. EFI episodes are associated with inadequate nutrition support and worse clinical outcomes. Interventions to manage EFI may benefit elderly patients with TBI.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789749","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":"Nutritional intake and growth in very low birth weight infants: a comparison of standardized versus parent-led complementary feeding","authors":"Melanie Gsoellpointner,&nbsp;Margarita Thanhaeuser,&nbsp;Margit Kornsteiner-Krenn,&nbsp;Fabian Eibensteiner,&nbsp;Robin Ristl,&nbsp;Bernd Jilma,&nbsp;Sophia Brandstetter,&nbsp;Angelika Berger,&nbsp;Nadja Haiden","doi":"10.1038/s41430-026-01809-z","DOIUrl":"10.1038/s41430-026-01809-z","url":null,"abstract":"The complementary feeding (CF) period is critical for ensuring adequate nutrient intake to support optimal growth in very low birth weight (VLBW) infants. This analysis compares nutritional intake and growth across two CF strategies: a standardized, protocol-driven approach and a non-standardized, parent-led approach. Both cohorts included infants with a birth weight &lt;1500 g. The standardized group followed an age-dependent CF protocol utilizing commercial baby jars, whereas the non-standardized cohort practiced parent-led feeding without dietary restrictions. Nutritional intake was assessed using 3-day dietary records. Infants in the non-standardized study had significantly higher intakes of protein, fat, arachidonic and docosahexaenoic acid, while the standardized cohort showed higher iron and zinc intakes from 6 months corrected age onwards. Despite nutritional differences, growth was similar between cohorts. This comparison demonstrates notable differences in nutrient intake between CF approaches and may guide individualized strategies to support the nutritional needs of VLBW infants. Clinical trial registration: Randomized, standardized study: ClinicalTrials.gov: NCT01809548. Non-standardized, prospective study: ClinicalTrials.gov: NCT02936219.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"80 10","pages":"1105-1108"},"PeriodicalIF":3.2,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-026-01809-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697074","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":"Vitamin D supplementation and bone health in post-menopausal women: a 24-month randomized controlled intervention with enhanced bioavailability formulations.","authors":"Nauman Rasool, Yusra Munir","doi":"10.1038/s41430-026-01789-0","DOIUrl":"https://doi.org/10.1038/s41430-026-01789-0","url":null,"abstract":"<p><strong>Background: </strong>Postmenopausal osteoporosis is a major public health issue affecting over one billion people worldwide. However, limited evidence exists on how different formulations with enhanced bioavailability compare in clinical outcomes with one another, even if there is extensive research on vitamin D tablets.</p><p><strong>Objective: </strong>Post-menopausal women's bone mineral density (BMD), bone turnover markers, and fracture risk over a 24-month period were evaluated using regular cholecalciferol, micronized cholecalciferol, and liposomal vitamin D3 combined with calcium supplements.</p><p><strong>Methods: </strong>Using age and baseline 25-hydroxyvitamin D [25(OH)D] levels, 612 post-menopausal women (ages 50-75 years) with T-scores ranging from -1.5 to -2.5 on dual-energy X-ray absorptiometry (DXA) were randomly assigned to one of four groups: regular cholecalciferol (1200 IU/day + 1000 mg calcium, n = 153), micronized cholecalciferol (1200 IU/day + 1000 mg calcium, n = 153), liposomal vitamin D3 (800 IU/day + 1000 mg calcium, n = 153), or placebo (n = 153). Other results were changes in femoral neck, lumbar spine, total hip bone mineral density (BMD), bone-specific alkaline phosphatase (BSAP), C-terminal telopeptide of type I collagen (CTX), serum 25(OH)D levels, and incidence of new fragility fractures.</p><p><strong>Results: </strong>Mean serum 25(OH)D levels were substantially higher (p = 0.003) in the liposomal group (38.2 ± 7.5 ng/mL) than those in the control cholecalciferol group (28.5 ± 6.8 ng/mL). The liposomal vitamin D3 group exhibited somewhat higher femoral neck BMD (2.8% ± 1.2%; p = 0.012) and lumbar spine BMD (2.8% ± 1.2%; p = 0.008) enhancement than did the placebo group (1.1% ± 0.9%). The liposomal form showed the highest ratio (2.4 ± 0.6 versus 1.8 ± 0.5 placebo; p = 0.001); hence, BSAP/CTX ratios were significantly better in all the active treatment groups. Eight patients (5.2%) in the placebo group had fresh fragility fractures; two (1.3%), three (2.0%), and one (0.7%) in the conventional, micronized, and liposomal groups, respectively; χ² = 7.42; p = 0.059.</p><p><strong>Conclusions: </strong>Greater success in raising bone mineral density and lowering indicators of bone turnover with recent bioavailability-enhanced vitamin D3 formulas was observed in post-menopausal women, especially those on liposomal delivery systems. These results suggest that public health guidelines and clinical practice have to take into account a rather important element impacting the efficacy of vitamin D supplements: formulation technology.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT04987654.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148688656","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":"Global leadership initiative on malnutrition criteria using different muscle mass assessment methods in hemodialysis patients: Links to physical performance, quality of life, and clinical outcomes","authors":"Ilia Beberashvili,&nbsp;Lawi Suissa,&nbsp;Ada Azar,&nbsp;Racheli Gamliel,&nbsp;Kobi Stav,&nbsp;Shai Efrati","doi":"10.1038/s41430-026-01803-5","DOIUrl":"10.1038/s41430-026-01803-5","url":null,"abstract":"Malnutrition is frequent in maintenance hemodialysis (MHD). We aimed to validate the Global Leadership Initiative on Malnutrition (GLIM) criteria using different muscle mass assessment methods and evaluate their associations with nutritional biomarkers, functional status, quality of life, and mortality. This prospective study included 218 MHD outpatients (63% male; mean age 70.6 ± 12.2 years). Muscle mass was assessed using bioimpedance analysis (BIA), mid-arm muscle circumference (MAMC), and calf circumference (CC). Serum biomarkers, handgrip strength, gait speed, and nutritional scores (Malnutrition Inflammation Score [MIS], Geriatric Nutritional Risk Index [GNRI]) were obtained. Malnutrition was defined as MIS &gt; 10. Associations with SF-36 scales and survival were analysed. Malnutrition prevalence was 26.1% with BIA-based GLIM, 25.2% with MAMC-based GLIM, and 27.1% with CC. BIA-based GLIM correlated with albumin, MIS, GNRI, phase angle, handgrip strength, and gait speed. MAMC-based GLIM showed similar associations except for gait speed. CC-based GLIM correlated with albumin and GNRI. Agreement with MIS was fair (κ = 0.31–0.35). All GLIM variants showed high specificity but low sensitivity. Only BIA- and MAMC-based GLIM were associated with reduced quality of life. BIA-based GLIM predicted higher mortality (HR 1.70, 95% CI 1.01–2.85), and CC-based GLIM showed a stronger association (HR 2.94, 95% CI 1.41–6.14). MAMC-based GLIM showed a nonsignificant trend. GLIM demonstrated fair agreement with MIS, high specificity, and meaningful concurrent validity. MAMC- and CC-based GLIM provided practical alternatives to BIA. These findings support further validation of anthropometric GLIM variants in diverse MHD populations.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"80 10","pages":"1079-1087"},"PeriodicalIF":3.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-026-01803-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683619","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":"Pre-therapeutic prediction of cachexia in lymphoma patients using [18F]FDG PET radiomics of muscle and fat","authors":"Yang Jiang,&nbsp;Mouqing Huang,&nbsp;Yufei Zhao,&nbsp;Jingyue Dai,&nbsp;Xingzhe Tang,&nbsp;Ying Cui,&nbsp;Lin Fu,&nbsp;Wenjun Yang,&nbsp;Xinyi Chen,&nbsp;Yuqing Lan,&nbsp;Zihui Zhao,&nbsp;Xin-Gui Peng","doi":"10.1038/s41430-026-01797-0","DOIUrl":"10.1038/s41430-026-01797-0","url":null,"abstract":"Cachexia adversely affects treatment outcomes in patients with lymphoma, highlighting the need for early risk identification. This study aimed to develop a predictive model using [¹⁸F]fluoro-2-deoxy-D-glucose ([¹⁸F]FDG) positron emission tomography (PET) radiomics features to identify lymphoma patients at risk of developing cachexia. A total of 150 lymphoma patients who underwent pre-treatment [¹⁸F]FDG PET/computed tomography (CT) were retrospectively enrolled from two centers and randomly divided into training and testing cohorts. Radiomics features were extracted from metabolic tissues, including the liver, visceral fat, subcutaneous fat, psoas muscle, and sacrospinal muscle. Three models were constructed: radiomics, clinical, and a combined model integrating both. Model performance was evaluated using area under curve (AUC) and AUCs were compared using DeLong’s test. In the training cohort, 61 of 105 patients developed cachexia; in the testing cohort (n = 45), 26 developed cachexia. The radiomics model incorporated five features from subcutaneous fat, visceral fat, and psoas muscle. The combined model, incorporating radiomics and clinical features, achieved an AUC of 0.916 in the training cohort, significantly outperforming the clinical (AUC = 0.844; P = 0.013) and radiomics (AUC = 0.826; P = 0.005) models. In the testing cohort, the radiomics (AUC = 0.816; P = 0.040) and combined (AUC = 0.759; P = 0.003) models significantly outperformed the clinical model (AUC = 0.601). Radiomics features from [¹⁸F]FDG PET images of visceral fat, subcutaneous fat, and the psoas muscle may effectively identify lymphoma patients at high risk of developing cachexia.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"80 10","pages":"1088-1095"},"PeriodicalIF":3.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683565","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":"Prognostic value of acylcarnitine-to-free carnitine ratio in ischemic stroke: associations with systemic inflammation and atherosclerosis","authors":"Tsubasa Atsuchi,&nbsp;Motohiro Okumura,&nbsp;Kenichiro Sakai,&nbsp;Yoshitaka Nakayama,&nbsp;Hiroyuki Kida,&nbsp;Ryoji Nakada,&nbsp;Tomomichi Kitagawa,&nbsp;Yuri Mizuno-Shojima,&nbsp;Hiroki Takatsu,&nbsp;Teppei Komatsu,&nbsp;Kenichi Sakuta,&nbsp;Hidetaka Mitsumura,&nbsp;Yasuyuki Iguchi","doi":"10.1038/s41430-026-01810-6","DOIUrl":"10.1038/s41430-026-01810-6","url":null,"abstract":"Serum acylcarnitine-to-free carnitine (AC/FC) ratio has been proposed as an indicator of mitochondrial function and plays an important role in brain recovery. Although mitochondrial dysfunction promotes systemic inflammation and atherosclerosis, the prognostic value and pathophysiological implications of the AC/FC ratio in acute ischemic stroke (AIS) remain unclear. This study examined the association between the AC/FC ratio and prognosis as well as its relationship with systemic inflammation and atherosclerosis. We enrolled consecutive patients with AIS admitted within 72 h of onset between October 2022 and November 2024. A favorable outcome was defined as a modified Rankin Scale score of 0–1 at 3 months. We determined the optimal AC/FC cutoff using receiver operating characteristic (ROC) analysis. Systemic inflammation and atherosclerosis were assessed using fibrinogen-to-albumin ratio (FAR) and ankle–brachial index (ABI). Of 463 screened patients, 285 were included (210 [74%] males; median age, 69 years), of whom 80 (28%) had unfavorable outcome. Poisson regression analysis with a robust variance estimator showed that an elevated AC/FC ratio was significantly associated with unfavorable outcome (PR 1.235, 95% CI 1.131–1.350, p &lt; 0.001). Furthermore, higher FAR (PR 1.610, 95% CI 1.218–2.129, p = 0.001) and lower ABI (PR 0.268, 95% CI 0.099–0.727, p = 0.010) were associated with the AC/FC group above the optimal cutoff of 0.29 evaluated based on ROC analysis. An elevated serum AC/FC ratio was independently associated with unfavorable functional outcome in AIS and correlated with markers of systemic inflammation and atherosclerosis.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"80 10","pages":"1018-1024"},"PeriodicalIF":3.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683539","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":"Prenatal adipose tissue estimation using early second trimester anthropometry","authors":"Marcela R. Abrego,&nbsp;Sara Dube,&nbsp;Daniel A. Powers,&nbsp;Jeffrey Luci,&nbsp;Isaiah Janumala,&nbsp;Jack Virostko,&nbsp;Adrienne N. Dula,&nbsp;Amy R. Nichols,&nbsp;Rachel R. Rickman,&nbsp;Saralyn F. Foster,&nbsp;Lorie M. Harper,&nbsp;Dana Dabelea,&nbsp;Alison G. Cahill,&nbsp;Elizabeth M. Widen","doi":"10.1038/s41430-026-01801-7","DOIUrl":"10.1038/s41430-026-01801-7","url":null,"abstract":"Prenatal visceral (VAT) and total (TAT) adipose tissue are associated with gestational diabetes and preeclampsia risk, yet cannot be routinely assessed in clinical or epidemiologic settings. Although anthropometric measures reflect adiposity in non-pregnant individuals, their utility in early pregnancy remains unclear. We examined associations between anthropometrics and TAT and VAT in the early second trimester and evaluated differences by prepregnancy BMI. Among pregnant women (n = 61) in the Mother and Infant NuTrition (MINT) cohort, TAT and VAT were assessed via whole-body MRI at 15-weeks gestation. Anthropometrics included waist (WC), hip (HC), mid-upper arm (MUAC), calf (CC), thigh (TC), and skinfolds (SF) for iliac crest, subscapular, thigh, and triceps. Linear regression evaluated predictors of TAT and VAT by BMI category. TAT demonstrated strong positive correlations with BMI, WC, HC, MUAC, and TC (r = 0.76–0.92) while VAT demonstrated moderate positive correlations with BMI, MUAC, HC (r = 0.48–0.58), and strongest with WC (r = 0.60). The healthy BMI (n = 36) TAT prediction model included MUAC, HC, and iliac SF (R2 = 0.86), and VAT model included MUAC and iliac SF (R2 = 0.60). The overweight and obesity (n = 25) TAT prediction model (R2 = 0.93) included WC and HC and the VAT model (R2 = 0.79) included HC and subscapular SF. Anthropometric measures associated with prenatal adiposity differed by prepregnancy BMI. The TAT prediction model showed an acceptable R2 and included HC, MUAC, and iliac SF for healthy BMI, and WC and HC for overweight or obesity. Incorporating comprehensive anthropometrics into prenatal research and clinical care may improve risk identification and understanding of prenatal adiposity.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"80 10","pages":"1055-1061"},"PeriodicalIF":3.2,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-026-01801-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673269","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":"Plant-based dietary patterns and risk of breast cancer: A systematic review and meta-analysis.","authors":"Yiqun Han, Hangcheng Xu, Li Liu, Nimarta Bheesham, Raveena Manem, Abigail K Fickel, Chenyu Sun","doi":"10.1038/s41430-026-01806-2","DOIUrl":"https://doi.org/10.1038/s41430-026-01806-2","url":null,"abstract":"<p><p>Plant-based dietary patterns have garnered increasing attention for their potential in chronic disease prevention, including cancer. However, the association between adherence to plant-based diets and breast cancer risk remains uncertain. This systematic review and meta-analysis evaluated the relationship between breast cancer incidence and three validated plant-based diet indices: the overall plant-based diet index (PDI), the healthy PDI (hPDI), and the unhealthy PDI (uPDI), which distinguish between healthful and less healthful plant-derived foods. A comprehensive search of PubMed, Embase, and Web of Science through August 2025 identified seven observational studies encompassing 44,680 participants. Studies were eligible if they reported associations between PDI, hPDI, or uPDI and breast cancer risk. Random-effects meta-analyses were conducted to estimate pooled hazard ratios (HRs) or odds ratios (ORs), with subgroup analyses stratified by menopausal and estrogen receptor (ER) status. Heterogeneity was assessed using the I² statistic. This review was registered in PROSPERO (ID: CRD420251127355). Meta-analysis showed that higher adherence to the hPDI was associated with a significant reduction in breast cancer risk (HR = 0.88; 95% CI: 0.81-0.95), with a modest benefit also observed for overall PDI (HR = 0.90; 95% CI: 0.84-0.96). No statistically significant association was found for uPDI (HR = 1.05; 95% CI: 0.98-1.14). Protective associations were stronger in premenopausal women and ER-positive subtypes. These findings suggest that adherence to high-quality, nutrient-dense plant-based diets may lower breast cancer risk. Distinguishing between healthful and unhealthful plant-based foods is essential for developing effective dietary strategies for cancer prevention.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677741","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 role of genetic variation in apolipoprotein response to diet among Brazilians with cardiovascular disease","authors":"Angela C. Bersch-Ferreira,&nbsp;Renato Hideo N. Santos,&nbsp;Marcelo M. Rogero,&nbsp;Rachel Helena V. Machado,&nbsp;Josefina Bressan,&nbsp;Annie Seixas B. Moreira,&nbsp;Cristiane K. Amaral,&nbsp;Aline Marcadenti","doi":"10.1038/s41430-026-01804-4","DOIUrl":"10.1038/s41430-026-01804-4","url":null,"abstract":"Data on the interaction between dietary patterns, single nucleotide polymorphisms (SNPs), and cardiometabolic markers remain limited in genetically admixed populations, particularly among individuals with established cardiovascular disease (CVD). This study aimed to evaluate how SNPs modulate the effects of dietary interventions on apolipoprotein concentrations (A-I, A-II, B, C-II, C-III, and E) in Brazilians undergoing secondary cardiovascular prevention. This sub-study used data from the three-year multicenter BALANCE Trial, which enrolled individuals aged ≥40 with established CVD. Participants were assigned to either an intervention group (following the Brazilian Cardioprotective Diet with intensive monitoring) or a control group receiving general dietary advice. Apolipoproteins were measured via multiplex immunoassay, and SNPs were genotyped using the Axiom 2.0 Assay. GWAS and adjusted linear regression models assessed associations and gene-diet interactions related to apolipoproteins. A total of 266 participants (118 in the intervention group and 148 in the control group) were analyzed. After three years, significant SNP-diet interactions affecting log-transformed apolipoprotein concentrations were identified at a genome-wide significance threshold of 10⁻⁵. For each apolipoprotein evaluated, the following polymorphisms were associated: Apo A-I (rs11542163_T, rs11759163_T, rs13396579_C), Apo A-II (rs11197283_T, rs13185245_G, rs7666435_C), Apo B (rs13205819_G, rs926561_C), Apo C-II (rs143862519_TTC, rs674845_A, rs931606_G), Apo C-III (rs2247572_T, rs4506508_C, rs931606_G), and Apo E (rs4862401_G, rs6835179_G). Per-allele differences ranged from –0.65 mg/dL (Apo C-II, rs143862519_TTC) to +0.52 mg/dL (Apo B, rs13205819_G). Our findings show that genetic variants influence apolipoprotein responses to diet in Brazilians under secondary CVD prevention, supporting genotype-guided nutrition. NCT01620398.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"80 10","pages":"1043-1054"},"PeriodicalIF":3.2,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677783","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":"Digestive enzyme replacement in very preterm infants: a prospective observational study","authors":"Sina Keidel,&nbsp;Sven Wellmann,&nbsp;Holger Michel,&nbsp;Christoph Bührer","doi":"10.1038/s41430-026-01792-5","DOIUrl":"10.1038/s41430-026-01792-5","url":null,"abstract":"Very preterm infants may display poor postnatal growth despite receiving recommended enteral intakes. This has been linked to transient exocrine pancreatic insufficiency, indicated by low fecal pancreatic elastase-1 (FPE-1) concentrations. We aimed to determine whether growth velocity may be improved by exogenous digestive enzyme replacement. In this bicentric prospective observational study, changes in growth velocity were assessed in very preterm infants (&lt;32 weeks gestational age, &lt;1500 g birth weight) with low FPE-1 concentrations (&lt;200 µg/g). Infants received 350 U lipase from Rhizopus oryzae and 5.4 U protease from Aspergillus oryzae with every meal via gavage; the dosage was doubled once infants reached 1000 g. Average daily weight gain relative to body weight was compared during the 14 days preceding initiation of digestive enzyme replacement and during the first 14 days thereafter. In 71 infants (median [interquartile range] birth weight 700 [570–980] g, gestational age 25.4 [24.4–28.4] weeks) born between March 1, 2022, and December 31, 2023, daily weight gain increased from 14.7 [7.3–19.7] to 19.5 [15.7–24.0] g/kg/d (p &lt; 0.001), relative daily weight gain per kg protein fed from 4.0 [2.0–5.9] to 5.4 [4.4–6.5] g/kg (p &lt; 0.001), and relative daily weight gain per kcal fed from 0.11 [0.06–0.16] to 0.15 [0.13–0.19] g/kcal/d (p &lt; 0.001). Effects were non-significant in infants fed raw milk but marked in those who received pasteurized mother’s own milk or donor milk. Administration of exogenous digestive enzymes was associated with increased weight gain in very preterm infants with transient exocrine pancreatic insufficiency.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"80 10","pages":"1012-1017"},"PeriodicalIF":3.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-026-01792-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673128","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}