Frontiers in Nutrition最新文献

{"title":"Intestinal permeability and the zonulin pathway: tight junctions, mucosal immunity, dietary modulators and clinical relevance.","authors":"David Granizo Bermejo, Guillermo García-Pérez-de-Sevilla, Antonio Molina-López","doi":"10.3389/fnut.2026.1938370","DOIUrl":"https://doi.org/10.3389/fnut.2026.1938370","url":null,"abstract":"<p><p>The intestinal barrier separates the luminal content, including the gut microbiota, dietary antigens and toxins, from the mucosal immune system, and its integrity is essential for immune homeostasis. Loss of barrier control, commonly termed increased intestinal permeability or leaky gut, has been implicated in a broad spectrum of gastrointestinal, metabolic, autoimmune, neuropsychiatric, hepatic and cardiovascular conditions. Paracellular transport across the epithelium is governed by apical junctional complexes, of which tight junctions are the principal regulators, while the overlying mucus layer, antimicrobial peptides, secretory immunoglobulin A and the gut-associated lymphoid tissue together constitute a multi-layered defensive interface. Among the physiological modulators of tight junctions, zonulin, identified as pre-haptoglobin-2, is the only endogenous protein currently known to reversibly regulate paracellular permeability, and its release is triggered chiefly by gliadin and by the gut microbiota. This narrative review summarizes the molecular architecture of the intestinal epithelial junctions, the immunological organization of the mucosal barrier, the zonulin signaling pathway, the principal dietary factors that compromise barrier integrity (excess glucose, fructose, fat, omega-6 fatty acids, salt, alcohol and food additives), and the clinical conditions and laboratory tests associated with intestinal permeability. A clearer understanding of the diet-microbiota-barrier-immunity axis may support nutritional strategies aimed at preserving intestinal barrier function and modulating mucosal immune activation.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"13 ","pages":"1938370"},"PeriodicalIF":5.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of <i>Citri Reticulatae Pericarpium</i> powder on the baking quality and volatile flavor compounds of toast bread.","authors":"Yongfeng Jiang, Han Yang, Yuanyuan Hu, Yaoxu Lin, Enrui Hu, Qingjie Shi, Jinxiang Hu, Hao Zhang, Yuwen Yi","doi":"10.3389/fnut.2026.1964585","DOIUrl":"https://doi.org/10.3389/fnut.2026.1964585","url":null,"abstract":"<p><strong>Background: </strong><i>Citri Reticulatae Pericarpium</i> (CRP) is rich in terpene volatiles, particularly D-limonene, and has a distinctive citrus-like aroma. However, its effects as a natural flavoring ingredient on the baking quality and volatile aroma profile of toast bread remain insufficiently characterized. This study evaluated the effects of CRP powder addition on baking quality and aroma characteristics and screened potential odor-active compounds associated with different addition levels.</p><p><strong>Methods: </strong>CRP powder partially replaced high-gluten wheat flour at levels of 0, 1.0, 2.0, and 3.0%. Baking quality attributes were evaluated by measuring specific volume, loaf height, baking loss, color, and texture. Aroma characteristics were assessed by sensory analysis and an electronic nose, while volatile compounds were analyzed by gas chromatography-mass spectrometry (GC-MS). Odor activity values (OAVs) and partial least squares discriminant analysis (PLS-DA) were used to characterize potential odor-active compounds and differences among treatments.</p><p><strong>Results: </strong>Increasing CRP powder reduced specific volume from 2.98 to 2.54 cm³/g and increased hardness from 7.41 to 9.37 N and chewiness from 47.18 to 57.80 mJ. Crumb lightness decreased, whereas yellowness increased. Sensory analysis showed a progressive enhancement of characteristic CRP aroma, with the 2.0% group exhibiting relatively favorable aroma harmony, purity, and fullness. Electronic-nose PCA clearly separated the control from CRP-supplemented samples. GC-MS detected 33 volatile compounds. Terpenes became the dominant volatile class after CRP addition, reaching 3,024.16, 6,745.46, and 8,426.43 μg/kg in the 1.0, 2.0, and 3.0% groups, respectively. D-limonene was the predominant terpene, with OAVs of 82.59, 184.00, and 222.72, suggesting that it was a major potential odor-active contributor to the characteristic CRP aroma. PLS-DA based on OAV data effectively discriminated the four groups.</p><p><strong>Conclusion: </strong>CRP powder substantially reshaped the aroma profile of toast bread but adversely affected loaf expansion and texture at higher addition levels. Overall, 2.0% CRP powder provided a favorable compromise between enhancement of the characteristic CRP aroma and the accompanying changes in baking quality, supporting its potential application as a natural flavoring ingredient in bakery products.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"13 ","pages":"1964585"},"PeriodicalIF":5.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of postoperative dynamic PNI trajectories for biochemical recurrence in patients with high-risk localized prostate cancer: a longitudinal trajectory clustering study.","authors":"Bo Yu, Xuchao Dai, Jianguo Zhu","doi":"10.3389/fnut.2026.1963784","DOIUrl":"10.3389/fnut.2026.1963784","url":null,"abstract":"<p><strong>Background: </strong>The prognostic nutritional index (PNI) reflects nutritional-immune status, but the value of a single baseline PNI for predicting biochemical recurrence (BCR) after radical prostatectomy in high-risk localized prostate cancer remains unclear. We aimed to identify postoperative PNI trajectories and compare their BCR predictive value with baseline PNI.</p><p><strong>Methods: </strong>We retrospectively included 436 patients. PNI was measured preoperatively (T0) and at 3 (T1) and 12 (T2) months post-surgery. Longitudinal trajectory clustering identified three PNI trajectory classes: persistently high (PHigh, <i>n</i> = 169, 46.4%), persistently low (PLow, <i>n</i> = 146, 40.1%), and declining (Declining, <i>n</i> = 49, 13.5%). Cox regression assessed associations with BCR; a Cox-based time-to-event prediction model was evaluated using time-dependent AUC, IPCW Brier score, and calibration at 3-year and 5-year horizons. A 12-month landmark analysis was performed to address potential guarantee-time bias.</p><p><strong>Results: </strong>During median 38.2-month follow-up, 122 (28.0%) developed BCR. Baseline PNI was not independently associated with BCR (continuous HR = 0.97, <i>p</i> = 0.320; dichotomized HR = 1.23, <i>p</i> = 0.347). Three trajectories emerged: persistently high (PHigh, 46.4%), persistently low (PLow, 40.1%), and declining (Declining, 13.5%). Relative to PHigh, PLow (HR = 2.95) and Declining (HR = 5.80) both had significantly higher BCR risk (<i>p</i> < 0.001). A 12-month landmark analysis confirmed these findings (PLow HR = 2.72, <i>p</i> = 0.002; Declining HR = 4.79, <i>p</i> = 1.24 × 10^-6). The multivariable Cox model combining trajectory, log PSA, surgical margin, and nodal metastasis achieved a 3-year time-dependent AUC of 0.823 (optimism-corrected 0.815) and a 5-year AUC of 0.790 (optimism-corrected 0.781). The Brier score was 0.117 at 3 years (25.8% improvement over null) and 0.166 at 5 years; the calibration slope was 1.057 (optimism-corrected 0.989) at 3 years and 1.001 (optimism-corrected 0.940) at 5 years.</p><p><strong>Conclusion: </strong>Postoperative PNI follows three distinct change-pattern subgroups. Dynamic PNI trajectories are strongly associated with BCR risk, whereas a single baseline PNI is not. Patients with persistently low or declining PNI are at high risk, supporting routine PNI monitoring to guide individualized follow-up. These observational findings require prospective multicenter validation.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"13 ","pages":"1963784"},"PeriodicalIF":5.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149230948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustainable sport nutrition behaviors, mental resilience, and perceived athletic performance in competitive athletes.","authors":"Fan Xitong, Miao Cheng","doi":"10.3389/fnut.2026.1935463","DOIUrl":"10.3389/fnut.2026.1935463","url":null,"abstract":"<p><strong>Background: </strong>Sustainable dietary practices may influence athlete health, recovery, psychological stability, and environmental responsibility; however, evidence regarding their relationship with mental resilience and perceived athletic performance remains limited.</p><p><strong>Objective: </strong>This study investigated associations among sustainable sport nutrition practices, sustainability awareness, recovery quality, mental resilience, and perceived athletic performance in competitive athletes.</p><p><strong>Methods: </strong>A cross-sectional mixed-methods study was conducted over 8 weeks. Of 300 invited athletes, 230 agreed to participate and 202 completed the full survey. Participants completed self-report measures assessing sustainable sport nutrition practices, sustainability awareness, recovery quality, mental resilience, and perceived athletic performance. Semi-structured interviews were conducted with 30 survey completers. Quantitative data were analyzed using descriptive statistics, Pearson correlations, and multiple linear regression, while qualitative data were examined using reflexive thematic analysis and integrated through a joint display.</p><p><strong>Results: </strong>Sustainable sport nutrition practices were positively associated with mental resilience (<i>r</i> = 0.47, <i>p</i> < 0.001), recovery quality (<i>r</i> = 0.43, <i>p</i> < 0.001), and perceived athletic performance (<i>r</i> = 0.39, <i>p</i> < 0.001). Sustainability awareness was associated with sustainable nutrition practices (<i>r</i> = 0.51, <i>p</i> < 0.001). Regression analysis showed that sustainable sport nutrition practices (β = 0.32, <i>p</i> < 0.001), recovery quality (β = 0.29, <i>p</i> < 0.001), and sustainability awareness (β = 0.21, <i>p</i> = 0.003) were positively associated with mental resilience, which was associated with perceived athletic performance (β = 0.36, <i>p</i> < 0.001). Qualitative findings indicated that structured nutrition routines supported mental preparation, recovery confidence, emotional regulation, and training discipline.</p><p><strong>Conclusion: </strong>Sustainable sport nutrition behaviors were associated with improved recovery quality, mental resilience, and perceived athletic performance. Findings should be interpreted as associations due to the cross-sectional design and self-report measures. Sustainable sport nutrition should emphasize performance compatibility, adequate energy availability, and sufficient protein intake rather than restrictive approaches.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"13 ","pages":"1935463"},"PeriodicalIF":5.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical evaluation of AI Chatbots' performance and safety for total parenteral nutrition planning in critically ill patients: a simulation-based benchmarking study.","authors":"Sufyan Alomair","doi":"10.3389/fnut.2026.1969789","DOIUrl":"10.3389/fnut.2026.1969789","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Total parenteral nutrition (TPN) is essential for critically ill adults unable to meet their nutritional needs via the gastrointestinal tract. Recent advancements in large language models (LLMs) have sparked interest in their potential to support healthcare providers in complex clinical decisions. Nonetheless, no prior research has systematically compared publicly accessible chatbots to pharmacist-developed reference TPN plans across a diverse patient cohort, using a predefined, guideline-based rubric assessing accuracy, completeness, safety, error types, and numerical precision. This study presents a simulation-based benchmarking to evaluate (i) the accuracy and comprehensiveness of chatbot-generated TPN plans, (ii) their safety, acceptability, and error profiles, and (iii) the numerical agreement and concordance with expert pharmacist references.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This benchmarking study, based on simulations and cross-sectional analysis, evaluated the performance of four publicly accessible AI chatbots-ChatGPT, Gemini, Copilot, and Perplexity-in formulating TPN plans for critically ill adults. Copilot declined to generate patient-specific TPN plans; this refusal was retained as a performance outcome, while Copilot was excluded from analyses requiring an analyzable TPN prescription. Each chatbot produced one plan for each of 10 standardized clinical cases, resulting in a total of 30 TPN plans. Friedman tests, Kendall's &lt;i&gt;W&lt;/i&gt;, and Holm-adjusted Wilcoxon signed-rank tests were used for comparative analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;ChatGPT produced comprehensive plans for all 10 cases, compared to 6 plans from Gemini and 4 from Perplexity. The median accuracy was 57.7% for ChatGPT, 43.9% for Gemini, and 38.5% for Perplexity, with no statistically significant overall difference (&lt;i&gt;p&lt;/i&gt; = 0.124). However, ChatGPT performed better than Perplexity in pairwise comparison (adjusted &lt;i&gt;p&lt;/i&gt; = 0.035). There was a significant difference in completeness among the chatbots (&lt;i&gt;p&lt;/i&gt; = 0.003; Kendall's &lt;i&gt;W&lt;/i&gt; = 0.57), with median scores of 64.6, 41.9, and 32.3%, respectively. All 30 plans had at least one major or critical safety issue, 7 (23.3%) contained a critical concern, and 19 (63.3%) were rejected. The most common errors were related to electrolytes (90.0%), micronutrients (70.0%), and monitoring (66.7%). Recommendations from chatbots often exceeded pharmacist-derived values, with median relative differences of +47% for energy, +120% for lipids, and +100% for potassium. Bland-Altman analysis revealed considerable variability in the agreement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;ChatGPT produced the most comprehensive TPN plans among chatbots. However, none showed enough accuracy, safety, or concordance for independent use. All plans had critical issues, especially with electrolytes, micronutrients, monitoring, and refeeding precautions. AI chatbots can support education or planning but requ","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"13 ","pages":"1969789"},"PeriodicalIF":5.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149230989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of multimodal models combining CT body composition and clinical variables for short-term postoperative complications in colorectal cancer: a systematic review and meta-analysis.","authors":"Yiheng Li, Chi Xue, Xinwei Zhang, Zhi Zhu","doi":"10.3389/fnut.2026.1880518","DOIUrl":"10.3389/fnut.2026.1880518","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition and sarcopenic obesity are prevalent in colorectal cancer (CRC) and linked to adverse surgical outcomes. Conventional screening often overlooks this occult malnutrition. Preoperative computed tomography (CT)-based body composition analysis (BCA) provides objective biomarkers for muscle depletion and fat distribution. This systematic review evaluates multimodal machine learning (ML) models integrating BCA and clinical variables to predict CRC postoperative complications and inform precision nutrition strategies.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, Web of Science, and Cochrane Library (inception to April 13, 2026) for ML models predicting postoperative complications in CRC using BCA. Quality was assessed using PROBAST. Pooled area under the curve (AUC) was estimated via a random-effects model, alongside subgroup analyses.</p><p><strong>Results: </strong>Eight studies (<i>n</i> = 7,835) were included. The pooled AUC was 0.84 (95% CI: 0.76-0.89), indicating good discriminative performance, although substantial heterogeneity was present (<i>I</i> ² = 79.7%). Nomogram-based models showed a pooled AUC of 0.87 (95% CI: 0.78-0.92). For anastomotic leakage, the pooled AUC was 0.83 (95% CI: 0.35-0.98), although this estimate was imprecise because only two studies contributed to this subgroup.</p><p><strong>Conclusion: </strong>Multimodal ML models integrating BCA biomarkers offer a robust, data-driven framework for preoperative risk stratification in CRC. Identifying high-risk body composition phenotypes may facilitate tailored prehabilitation and targeted immunonutrition strategies. Future efforts must prioritize standardized BCA and multi-center external validation.</p><p><strong>Systematic review registration: </strong>CRD420261364363.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"13 ","pages":"1880518"},"PeriodicalIF":5.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LVEF-defined septic cardiomyopathy modifies the association between the prognostic nutritional index and mortality in adults with sepsis: a 72-h landmark analysis.","authors":"Xianju Wang, Min Cheng, Fengqi Ruan, Chong Chen, Shuai Wang","doi":"10.3389/fnut.2026.1903225","DOIUrl":"10.3389/fnut.2026.1903225","url":null,"abstract":"<p><strong>Background: </strong>The prognostic nutritional index (PNI) combines albumin and lymphocyte count and may capture nutrition-related immune-inflammatory status in sepsis. Whether its association with mortality differs by left ventricular ejection fraction (LVEF)-defined septic cardiomyopathy (SCM) is unclear.</p><p><strong>Methods: </strong>We conducted a retrospective 72-h landmark study of MIMIC-IV adults with Sepsis-3 who survived to the landmark, had clinically indicated pre-landmark echocardiographic LVEF assessment, and had calculable early PNI. The prespecified primary analysis tested the lower-PNI-by-LVEF-defined-SCM interaction for 28-day mortality in an adjusted Cox model. Ninety-day and sensitivity analyses were supportive or exploratory. A single-center cohort was examined separately, not as formal validation.</p><p><strong>Results: </strong>Among 1,976 patients, 240 had LVEF-defined SCM; 506 and 633 died by 28 and 90 days, respectively. Each 5-point lower PNI was associated with higher 28-day mortality without SCM (adjusted hazard ratio [HR], 1.18; 95% CI, 1.11-1.24) but not with LVEF-defined SCM (HR, 0.96; 95% CI, 0.87-1.05); the ratio of HRs was 0.82 (95% CI, 0.73-0.91; <i>p</i> < 0.001). The secondary 90-day ratio was 0.84 (95% CI, 0.76-0.94; nominal <i>p</i> = 0.001). Absolute-risk and restricted-mean-survival-time analyses supported attenuation, whereas same-calendar-day PNI pairing and some alternative LVEF definitions attenuated the interaction estimates toward the null. The external estimate was imprecise and statistically inconclusive (ratio of odds ratios, 0.89; 95% CI, 0.51-1.55).</p><p><strong>Conclusion: </strong>Among selected 72-h survivors with clinically indicated pre-landmark echocardiography, the association between lower PNI and 28-day mortality was attenuated with LVEF-defined SCM. PNI should not be used alone for nutritional or clinical decision-making.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"13 ","pages":"1903225"},"PeriodicalIF":5.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Macro-micro dynamics of child undernutrition in Pakistan: a structural learning-based Bayesian network analysis of household and policy drivers.","authors":"Muhammad Shahid, Jiayi Song, Zaiba Ali, Hafiz Muhammad Naveed, Serhat Yuksel, Hasan Dincer","doi":"10.3389/fnut.2026.1882524","DOIUrl":"https://doi.org/10.3389/fnut.2026.1882524","url":null,"abstract":"<p><strong>Background: </strong>Child undernutrition remains a major public health concern and creates health-related inequalities in developing countries, with long-term consequences for human development deficits. Most of these early studies were conducted using conventional econometric techniques; however, understanding the complex, multi-level determinants of undernutrition may require more advanced analytical methods.</p><p><strong>Methods: </strong>This study, PC algorithm is used for Structural Learning-Based Bayesian Networks [SL-BN] (a graphical model based on directed acyclic graph with joint and conditional associations)-which is conceptually different than the weight-based networks, to examine the macro- and micro-level determinants of child undernutrition in Pakistan. Macro-level analysis combines historical nutrition policy evaluation (critical discourse) with WDI and UNDP data (2000-2022), spanning the MDG and SDG eras. Micro-level analysis draws on the Pakistan Demographic and Health Survey (PDHS 2017-18) to identify socioeconomic drivers of child malnutrition and nutritional inequalities.</p><p><strong>Results: </strong>In micro analysis, the SL-BN network structure identifies household-level determinants-such as poor wealth status, rural residence, poor environmental conditions, low maternal education, and diarrhea-as key drivers of child undernutrition. Inequality is stark, with malnutrition disproportionately concentrated among the poorest. However, the SL-BN findings and critical assessment of nutritional policies and programs found that low investment in human development, foreign dependency on health, poverty, inflation, and a history of inconsistent nutritional policies to combat hunger and undernutrition are the fundamental issues at the macro level in Pakistan.</p><p><strong>Conclusion: </strong>The study concluded that the underlying micro level determinants of child undernutrition in Pakistan cannot overcome without long-term targeted policies at macro level.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"13 ","pages":"1882524"},"PeriodicalIF":5.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13681454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between meat consumption and frailty among community-residing older adults in Nanjing municipality, China.","authors":"Zhao Dong, Qing Ye, Caihong Hu, Yunting Xu, Guofeng Ao, Luyan Yang, Fengli Li, Shifen Jia, Yaqing Xiong, Yu Dou","doi":"10.3389/fnut.2026.1955451","DOIUrl":"10.3389/fnut.2026.1955451","url":null,"abstract":"<p><strong>Background: </strong>Frailty is a common complaint in older adults. Although the world is experiencing a rapid process of aging, the relationship between meat consumption and frailty was not well-documented. This study aimed to examine the association of meat consumption with frailty among older adults in China.</p><p><strong>Methods: </strong>In this cross-sectional study, participants were randomly chosen from community-dwelling residents aged 60 years or above in Nanjing municipality, China, in 2023. Frailty, assessed using Groningen Frailty Indicator, was the outcome variable. Meat consumption frequency, measured using a validated food frequency questionnaire, was dichotomized as independent variable based on official recommendations by China Nutrition Society. Mixed-effects logistic regression models were introduced to compute odds ratios (ORs) and 95% confidence intervals (CIs) for examining associations between meat consumption and frailty.</p><p><strong>Results: </strong>Among 5,484 participants, frailty prevalence was 16.9% (95% CI = 15.9, 17.9). Significant difference in frailty prevalence was observed among participants by age (the younger-old <i>vs</i>. the middle-old <i>vs</i>. the oldest-old: 13.2% vs.17.9% vs. 32.8%), sex (men vs. women: 15.8% vs. 17.9%) or area (urban vs. sub-urban: 15.1% vs. 18.1%). After adjustment for potential confounders, participants who reached recommendation of meat consumption were less likely to have frailty (OR = 0.70, 95% CI = 0.60, 0.81) relative to those who consumed meat below the recommended level. Moreover, when data were analyzed by age, sex or residential area, the relationship between meat intake and frailty remained significant among all the subgroups with an exception of that it became non-significant for the oldest-old adults.</p><p><strong>Conclusions: </strong>A inverse relationship may exist between meat intake and frailty among community-dwelling older individuals in regional China. This study has particular significance of public health for building the healthy-aging society, suggesting that inadequate intake of meat may be a risk factor of frailty for community-dwelling older adults.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"13 ","pages":"1955451"},"PeriodicalIF":5.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149230971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feeding practices during high-flow nasal cannula: current evidence and clinical implications for respiratory care.","authors":"Jaber S Alqahtani, Jood Alkhelb, Alaa Alamri, Leen Alqahtani, Razan Alshehri, Abdullah A Ghazwani, Hussam M Almarkhan, Ahmed S Alqahtani, Meshal H Alenezi, Abdulelah M Aldhahir, Rayan A Siraj, Abdullah A Alqarni, Hassan Alwafi, Sulaiman M Almarkhan, Fahad A Salem, Saad Alrabeeah, Faisal R Alanazi, Asma O Alamoudi, Saeed M Alghamdi","doi":"10.3389/fnut.2026.1948830","DOIUrl":"https://doi.org/10.3389/fnut.2026.1948830","url":null,"abstract":"<p><p>High-flow nasal cannula (HFNC) therapy is increasingly used as a noninvasive respiratory support modality across acute and critical care settings. Although nutritional management is integral to the care of patients with respiratory failure, established guidelines for feeding patients receiving HFNC are lacking, and clinical decisions vary widely, reflecting persistent uncertainty about HFNC's effects on swallowing function, airway protection, and aspiration risk. This narrative review found that HFNC may alter swallowing biomechanics, particularly at flow rates >40 L/min, potentially increasing the risk of choking and aspiration. Evidence on aspiration risk is heterogeneous, deriving largely from healthy volunteers and pediatric bronchiolitis cohorts. Adult evidence is limited to retrospective studies; the largest found no increase in respiratory deterioration with enteral feeding. Most institutions lack formal feeding protocols, and practice is driven by individual clinician judgment. Areas of consensus include the safety of early enteral feeding in hemodynamically stable patients and the avoidance of routine prolonged withholding of nutrition based solely on HFNC use. Disagreement persists regarding routine swallowing assessment, optimal flow thresholds during feeding, and the prioritization of oral versus tube feeding. Safe feeding in patients receiving HFNC requires a multidisciplinary, individualized approach that balances respiratory support against nutritional adequacy. Prospective multicenter studies are needed to define safe flow thresholds, validate bedside assessment tools, and establish standardized feeding guidelines, particularly in adult and critically ill populations.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"13 ","pages":"1948830"},"PeriodicalIF":5.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13681048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}