Frontiers in Nutrition最新文献

{"title":"Impact of a dietary intervention with French maritime pine bark extract (Pycnogenol^®) on bone turnover markers in women with osteoporotic bone loss: a randomized, placebo-controlled double-blind study-Part I.","authors":"Christian Scherg, Franca Genest, Jonas Maghary, Lothar Seefried, Denitsa Docheva, Markus Krischke, Petra Högger","doi":"10.3389/fnut.2026.1923949","DOIUrl":"10.3389/fnut.2026.1923949","url":null,"abstract":"<p><strong>Introduction: </strong>Osteoporosis is a highly prevalent health concern both in terms of disability to an individual and costs to society. While antiresorptive drugs are the standard treatment, nutritional supplementation may offer additional advantages, particularly in the pre-therapeutic stage of osteopenia or clinically stable osteoporosis. The French maritime pine bark extract Pycnogenol^® exhibits antioxidant and anti-inflammatory properties, but its influence on bone turnover has not been investigated in humans yet.</p><p><strong>Methods: </strong>In this randomized, placebo-controlled, double-blind clinical trial, 67 women received either Pycnogenol^® (100 mg twice daily; <i>n</i> = 33) or placebo (<i>n</i> = 34) during a 3-month placebo-controlled phase, followed by a 3-month active-treatment extension, in which all participants took Pycnogenol^®. The primary endpoint included changes in the bone resorption marker C-terminal telopeptide of type I collagen (CTX-1) and bone formation marker procollagen type I N propeptide (P1NP) in serum. Secondary endpoints comprised other bone turnover markers (N-terminal telopeptide of type I collagen, NTX-1; tartrate-resistant acid phosphatase 5b, TRAP5b; bone sialoprotein, BSP), an inflammatory marker (interleukin-6, IL-6), the microbial metabolite 5-(3',4'-dihydroxyphenyl)-γ-valerolactone (M1), and <i>in vitro</i> differentiation experiments with human mesenchymal stromal cells (hMSCs).</p><p><strong>Results: </strong>Within the Pycnogenol^® group, serum CTX-1 levels were significantly reduced after both three (<i>p</i> = 0.0327) and 6 months (<i>p</i> = 0.0227) compared to baseline, while no between-group differences were observed at any visit. No significant changes were observed in P1NP concentrations. Additionally, a significant reduction from baseline was observed for NTX-1 serum levels in the Pycnogenol^® group at the end of the active-treatment extension (<i>p</i> = 0.0100). Salivary M1 concentrations were significantly higher following 3 months of Pycnogenol^® supplementation compared to placebo (<i>p</i> = 0.0289) and showed an inverse association with CTX-1 concentrations (<i>r</i> = -0.216, <i>p</i> = 0.013, <i>n</i> = 131).</p><p><strong>Conclusion: </strong>Dietary supplementation with Pycnogenol^® was associated with reductions in key bone resorption markers within the treatment group, while metabolite concentrations in saliva increased. Furthermore, Pycnogenol^® components enhanced the osteogenic differentiation of hMSCs <i>in vitro</i>. These findings suggest a potential protective effect of Pycnogenol^® on bone turnover in osteopenia and clinically stable osteoporosis.</p><p><strong>Clinical trial registration: </strong>https://drks.de/search/de/trial/DRKS00026630, DRKS00026630.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"13 ","pages":"1923949"},"PeriodicalIF":5.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265184","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":"Correction: Clinical and prognostic value of dynapenia in patients with head and neck cancer: a multicenter cohort study. VALOR group.","authors":"María García Olivares, María Teresa Zarco-Martín, Rocío Fernández Jiménez, Montserrat Gonzalo Marín, Jose M Romero-Márquez, Francisco Javier Vilchez López, Inmaculada Prior Sánchez, Alba Carmona Llanos, María Del Carmen Roque Cuéllar, María Josefa Molina Puertas, Felisa Pilar Zarco Rodríguez, Pablo Rodríguez de Vera Gómez, Luis Miguel Luego Pérez, Gabriel Olveira, Jose Manuel García Almeida","doi":"10.3389/fnut.2026.2013721","DOIUrl":"https://doi.org/10.3389/fnut.2026.2013721","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fnut.2026.1894028.].</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"13 ","pages":"2013721"},"PeriodicalIF":5.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13711502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149286121","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":"Laboratory-derived inflammatory-nutritional exploratory phenogroups and their associations with functional limitation and 30-day same-center all-cause unplanned readmission in patients with heart failure.","authors":"Yilian Zhang, Xu Zhang, Hongbin Song, Qiyu Hu, Jingzhu Nan","doi":"10.3389/fnut.2026.1985953","DOIUrl":"10.3389/fnut.2026.1985953","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is characterized by marked clinical heterogeneity, while conventional left ventricular ejection fraction (LVEF)-based classification may not fully capture systemic inflammatory, nutritional, hematologic, and cardiorenal abnormalities. We aimed to identify laboratory-derived inflammatory-nutritional exploratory phenogroups in hospitalized patients with HF and evaluate their associations with functional limitation and 30-day same-center all-cause unplanned readmission.</p><p><strong>Methods: </strong>This single-center retrospective cohort included 1,588 hospitalized patients with HF, of whom 1,455 with complete data for 15 prespecified clustering variables were included in the primary analysis. K-means, Gaussian mixture models, and DBSCAN were compared, and K-means with K = 3 was selected based on internal separation, stability, cluster size, and clinical interpretability, with K = 2 used as a sensitivity analysis. Severe functional limitation was defined as NYHA class III-IV, and 30-day same-center all-cause unplanned readmission was evaluated as the short-term clinical outcome. Multivariable logistic regression with HC3 robust standard errors was used to assess these associations, with multiple-imputation and median-imputation sensitivity analyses conducted in the full cohort.</p><p><strong>Results: </strong>Three phenogroups were identified: an inflammatory-cardiorenal-nutritional vulnerability phenotype, an anemia-immune dysregulation phenotype, and a relatively preserved laboratory phenotype. LVEF was similar across groups, whereas severe functional limitation and 30-day same-center all-cause unplanned readmission differed significantly. After enhanced adjustment, compared with Cluster 3, the odds ratios for severe functional limitation were 3.814 and 5.594 for Clusters 1 and 2, respectively, and the corresponding odds ratios for 30-day same-center all-cause unplanned readmission were 1.966 and 2.616. Higher quartiles of both ALI and PNI were associated with lower odds of severe functional limitation; higher ALI quartiles and the highest PNI quartile were associated with lower odds of 30-day same-center all-cause unplanned readmission.</p><p><strong>Conclusion: </strong>Routine admission laboratory measurements identified three exploratory HF phenogroups with distinct inflammatory, nutritional, hematologic, and cardiorenal profiles. After adjustment for continuous LVEF and NT-proBNP, the two vulnerable phenogroups remained associated with severe functional limitation and 30-day same-center all-cause unplanned readmission, with directionally consistent findings in the full-cohort and K = 2 sensitivity analyses. ALI and PNI reflect laboratory-derived inflammatory-nutritional vulnerability but cannot replace formal nutritional assessment or establish incremental predictive value. These findings remain exploratory and require validation in prospective multicenter cohorts.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"13 ","pages":"1985953"},"PeriodicalIF":5.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13690677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149243674","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":"Development and external validation of an explainable machine learning model for identifying depressive symptoms in middle-aged and older adults with low haemoglobin: a prediction-model study.","authors":"Qilong Wang, Juan He, Siheng Ma, Jianpeng Zhao, Jingjing Zong, Dongmei Ma, Sha Liu, Lei Zhang, Xin Qi, Dongrong Zhao","doi":"10.3389/fnut.2026.1846276","DOIUrl":"10.3389/fnut.2026.1846276","url":null,"abstract":"<p><strong>Background: </strong>Early screening for depressive symptoms in middle-aged and older adults is important for timely risk identification. Low haemoglobin may identify a clinically accessible vulnerable subgroup in which chronic disease burden, fatigue, functional impairment, and reduced physiological reserve often coexist. However, it should be understood as a high-risk phenotype rather than a direct measure of nutritional deficiency or frailty. Evidence in this population remains limited.</p><p><strong>Methods: </strong>This study developed a model using data from the 2015 China Health and Retirement Longitudinal Study (CHARLS), with CHARLS 2011 and a cross-sectional cohort from Gansu Provincial People's Hospital used for temporal and external validation, respectively. Depressive symptoms were defined as a 10-item Centre for Epidemiologic Studies Depression Scale score ≥10. Candidate variables included sociodemographic, behavioural, health status, functional, cognitive, and comorbidity-related information. After least absolute shrinkage and selection operator feature selection, 16 variables were retained. Seven machine learning models were compared, and Random Forest was retained for interpretation and online tool development based on its balanced performance and interpretability.</p><p><strong>Results: </strong>A total of 2,022 participants were included in the development cohort, 1,095 in the temporal validation cohort, and 400 in the external validation cohort. The AUROC values of the Random Forest model were 0.791, 0.776, and 0.809, respectively, with Brier scores of 0.182, 0.193, and 0.182, indicating stable discrimination and acceptable calibration. Shapley additive explanations analysis showed that sleep time, instrumental activities of daily living score, and activities of daily living score were the most important contributors. Threshold sensitivity analysis showed that lower probability thresholds increased sensitivity/recall but reduced specificity. A prototype online assessment tool was developed for individualised estimation of depressive symptom probability.</p><p><strong>Conclusion: </strong>This study developed and validated an interpretable machine learning model for identifying depressive symptoms in middle-aged and older adults with low haemoglobin. The model may support early screening and risk stratification in this clinically vulnerable population. However, the classification threshold and risk-stratification cut-offs are exploratory rather than clinically validated. Further multicentre validation is warranted before broader clinical implementation.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"13 ","pages":"1846276"},"PeriodicalIF":5.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13690525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149243737","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":"Dietary cadmium exposure from <i>Panax notoginseng</i>: cadmium accumulation and bioactive composition changes under cadmium stress.","authors":"Mingyao Sun, Yunfei Li, Wanghai Cai, Tian Zheng, Meiling Chen, Luyan Zheng, Guiping Xu, Xia Zhou, Fei Miao","doi":"10.3389/fnut.2026.1938789","DOIUrl":"https://doi.org/10.3389/fnut.2026.1938789","url":null,"abstract":"<p><strong>Background: </strong><i>Panax notoginseng</i> is widely used as a dietary supplement for cardiovascular health, but cadmium (Cd) contamination may affect its safety and bioactive composition. A systematic assessment is lacking.</p><p><strong>Methods: </strong>We systematically searched Chinese and English databases for experimental studies on Cd residues and bioactive constituents in <i>P. notoginseng</i> under Cd exposure. Random-effects meta-analysis, subgroup analysis, random forest modeling, and consumer intake scenario estimation were performed.</p><p><strong>Results: </strong>Cd exposure increased Cd content by 184.17%, with larger increases under high-concentration (250.33%) and long-term (311.44%) exposure. Cd selectively reduced ginsenoside Re (-24.50%), total flavonoids (-24.19%), notoginsenoside R1 (-21.81%), ginsenoside Rd (-19.54%), and ginsenoside Rg1 (-16.05%). Calcium intervention was associated with a lower Cd accumulation response, decreasing the increase in Cd content from 356.67% to 44.22%, although this subgroup finding should be interpreted cautiously due to the limited number of available effect sizes. Under the predefined dietary exposure scenario with an intake of 6 g/day, contaminated <i>P. notoginseng</i> accounted for 6.8% of the provisional tolerable monthly intake (PTMI) for a 60 kg adult, increasing to 8.4% and 9.9% under the high-concentration and long-term exposure scenarios, respectively.</p><p><strong>Conclusion: </strong>Cd contamination may affect the quality and chemical safety evaluation of <i>P. notoginseng</i> by increasing Cd residues and altering bioactive constituent profiles. The dietary exposure analysis provides screening-level estimates of the potential contribution of <i>P. notoginseng</i>-derived Cd to dietary Cd intake under defined scenarios rather than a direct assessment of consumer health risk. Quality control should integrate monitoring of Cd residues, key bioactive constituents, processing-related Cd transfer, and actual intake patterns.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"13 ","pages":"1938789"},"PeriodicalIF":5.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13691592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265356","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":"Editorial: Health effects of natural compounds from plants.","authors":"Jing Gao, Hui Chen, Mengjie Li, Wenlong Wang","doi":"10.3389/fnut.2026.2002556","DOIUrl":"https://doi.org/10.3389/fnut.2026.2002556","url":null,"abstract":"","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"13 ","pages":"2002556"},"PeriodicalIF":5.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13690964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265369","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":"Riboflavin-photosensitized lipid oxidation in oil-in-water nanoemulsions: effects of oxygen scavengers and metal chelator.","authors":"Fatma Bozanoglu, Sibel Uluata, Gokhan Durmaz","doi":"10.3389/fnut.2026.1924218","DOIUrl":"10.3389/fnut.2026.1924218","url":null,"abstract":"<p><p>This study examined how droplet size affects riboflavin-photosensitized lipid oxidation in oil-in-water emulsions and evaluated the roles of sodium azide (SA), superoxide dismutase (SOD), and ethylenediaminetetraacetic acid (EDTA) under light exposure. A model oil phase containing octadecane as the carrier oil and methyl linoleate as the oxidizable lipid substrate was used, while sodium dodecyl sulfate (SDS) served as a model anionic surfactant. Small- and large-droplet O/W (O/W) emulsions were produced by high-pressure homogenization at 20,000 psi and 1,500 psi, respectively and the emulsion was incubated 32 °C. The particle size of small and large droplets was determined 62.1 nm and 190 nm, respectively. The ζ-potential for small and large droplets was determined -73.3 and -90.8 mV. In the presence of riboflavin, light exposure markedly promoted lipid oxidation in both emulsion systems, as indicated by increased lipid hydroperoxide and headspace hexanal formation. The rate of lipid oxidation was higher in small-droplet emulsions than in large-droplet emulsions during photooxidation, suggesting that reduced droplet size increased oxidative susceptibility. However, SA did not significantly inhibit lipid hydroperoxide or hexanal formation, whereas SOD reduced lipid hydroperoxide accumulation but did not inhibit headspace hexanal formation. In contrast, EDTA strongly inhibited hexanal formation in both small- and large-droplet emulsions, indicating that transition metal-catalyzed hydroperoxide decomposition played an important role in secondary volatile oxidation. Overall, droplet size emerged as a key structural factor affecting riboflavin-photosensitized lipid oxidation in O/W emulsions, whereas metal chelation was particularly effective in limiting secondary volatile oxidation.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"13 ","pages":"1924218"},"PeriodicalIF":5.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13690560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149243721","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":"Dietary diversity among women of reproductive age (15-49 yrs) across rural and urban settings: a scoping review.","authors":"Sujata Murarkar, Jayashree Gothankar","doi":"10.3389/fnut.2026.1893369","DOIUrl":"https://doi.org/10.3389/fnut.2026.1893369","url":null,"abstract":"<p><p>Dietary diversity (DD) reflects micronutrient adequacy and diet quality. Inadequate dietary diversity has adverse effects on health of the women and increases the risk of complications during pregnancy and childbirth due to deficiencies of micronutrients. This scoping review aims to synthesize the current understanding of dietary diversity among WRA in urban and rural settings, highlighting key findings from recent studies. A thorough literature search using electronic databases such as Scopus, PubMed and Google Scholar was conducted. Published articles between 2014 and 2025 were included. The search strategy employed combinations of terms including \"women\", \"reproductive age group\", \"dietary diversity\", \"diet quality\", \"24-h dietary recall\", \"urban informal settlement\", and \"rural area\". Both observational studies and intervention trials that used a 24-h recall method for taking dietary history and studies reporting Minimum dietary diversity for women (MDDW) or dietary diversity score of women (WDDS) were considered for the review. Almost all the studies had reported inadequate dietary diversity in urban informal settlement and rural area except studies conducted at Nouakchott Mauritania (71.7%). The diets in urban informal settlement and rural area are often dominated by grains and tubers, pulses, milk and milk products, other vegetables with lower consumption of green leafy vegetables, eggs and vitamin A rich fruits and vegetables. Present scoping review highlights the persistent inadequacy of dietary diversity among WRA in both urban and rural areas.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"13 ","pages":"1893369"},"PeriodicalIF":5.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13688113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265285","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":"Association of nutritional-immune indicators and their dynamic changes with disease severity and wound healing in diabetic foot ulcers treated by tibial transverse transport: a retrospective study.","authors":"Yueyue Zhu, Sijie Yang, Zhenhong Zhu, Ruiqing Mo, Ruibin Feng, Xingyu Chen, Dapeng Yu, Hongjie Su, Qikai Hua","doi":"10.3389/fnut.2026.1863436","DOIUrl":"https://doi.org/10.3389/fnut.2026.1863436","url":null,"abstract":"<p><strong>Background: </strong>Although tibial transverse transport (TTT) may promote wound repair in complex diabetic foot ulcer (DFU), reliable indicators reflecting postoperative recovery remain limited. This study aimed to investigate the association of nutritional-immune indicators and their dynamic changes with DFU severity and wound healing time after TTT treatment.</p><p><strong>Methods: </strong>This retrospective cohort study included 227 DFU patients who underwent TTT between January 2023 and May 2024. Patients were classified according to Wagner grades. LASSO regression and multivariable logistic regression were used to identify nutritional-immune factors associated with DFU severity, with ROC curve analysis, calibration analysis, and decision curve analysis performed to evaluate model performance. In addition, 147 patients with complete 1-month postoperative laboratory data were analyzed using Cox proportional hazards regression, Kaplan-Meier analysis and time-dependent ROC analysis to evaluate the association between dynamic nutritional-immune changes and subsequent wound healing time.</p><p><strong>Results: </strong>Compared with non-severe DFU patients, severe DFU patients showed greater inflammatory activation and nutritional-immune disturbances. Multivariable logistic regression identified ANLR (OR = 0.993, 95% CI: 0.987-0.999, <i>p</i> = 0.020) and PNI (OR = 0.909, 95% CI: 0.853-0.969, <i>p</i> = 0.004) as independently associated with DFU severity. The model incorporating ANLR and PNI showed good discrimination for severe DFU (AUC = 0.825, 95% CI: 0.756-0.893). Baseline PNI and ANLR were not associated with postoperative wound healing time, whereas greater ΔPNI was independently associated with a higher hazard of subsequent wound healing in the severity-stratified Cox model (HR = 1.030, 95% CI: 1.008-1.053, <i>p</i> = 0.008). Kaplan-Meier analysis showed faster wound healing in patients with greater ΔPNI (log-rank <i>p</i> = 0.018).</p><p><strong>Conclusion: </strong>PNI and ANLR are associated with DFU severity and may provide complementary information for preoperative risk stratification. An increase in PNI at 1 month after TTT is associated with subsequent wound healing time and may represent an integrated response of nutritional-immune status during the treatment course.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"13 ","pages":"1863436"},"PeriodicalIF":5.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13687399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265348","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":"Knowledge, attitudes, and practices of emergency nurses regarding sepsis nutritional management: a multicenter cross-sectional study.","authors":"Lin Xiao, Weijia Pei, Huijun Zhu","doi":"10.3389/fnut.2026.1933045","DOIUrl":"https://doi.org/10.3389/fnut.2026.1933045","url":null,"abstract":"<p><strong>Background: </strong>Nutritional management is an important component of supportive care for patients with sepsis, but its implementation in emergency settings may be challenging alongside other time-critical priorities. This study assessed emergency department (ED) nurses' knowledge, attitudes, and practices (KAP) regarding nutritional management in patients with sepsis.</p><p><strong>Methods: </strong>This multicenter cross-sectional study was conducted among ED nurses from hospitals in Jiangsu Province, China, between January and May 2026. A structured Chinese questionnaire with satisfactory internal consistency was used to assess KAP, with KAP levels descriptively classified using modified Bloom's cut-off criteria. Multivariable linear regression was performed to identify factors associated with KAP scores, and structural equation modeling (SEM) was used to further evaluate the direct and indirect relationships among KAP domains.</p><p><strong>Results: </strong>A total of 630 valid questionnaires were analyzed, including 558 female nurses (88.6%). The median knowledge, attitude, and practice scores were 9.00 (9.00, 15.00), 40.50 (36.00, 45.00), and 29.00 (22.25, 36.00), respectively, out of possible ranges of 0-18, 9-45, and 9-45. In multivariable analyses, nurses without recent training had significantly lower knowledge scores (β = -4.676, 95% CI: -5.386 to -3.965, <i>p</i> < 0.001) and practice scores (β = -3.014, 95% CI: -4.296 to -1.732, <i>p</i> < 0.001). Higher knowledge scores were independently associated with more positive attitudes (β = 0.419, 95% CI: 0.337 to 0.501, <i>p</i> < 0.001) and better practices (β = 0.860, 95% CI: 0.723 to 0.997, <i>p</i> < 0.001), while higher attitude scores were also independently associated with better practices (β = 0.415, 95% CI: 0.294 to 0.537, <i>p</i> < 0.001). SEM demonstrated that knowledge had significant direct effects on attitude (β = 0.470, 95% CI: 0.404-0.536, <i>p</i> < 0.001) and practice (β = 0.512, 95% CI: 0.432-0.589, <i>p</i> < 0.001), and also had an indirect effect on practice through attitude (β = 0.100, 95% CI: 0.061-0.140, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>ED nurses showed insufficient knowledge, positive attitudes and moderate practice toward nutritional management in patients with sepsis. The observed associations of knowledge with both attitude and practice support the potential value of targeted, practice-oriented training, together with standardized documentation and workflow-based support.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"13 ","pages":"1933045"},"PeriodicalIF":5.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13687387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265200","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}