Journal of Parenteral and Enteral Nutrition最新文献

{"title":"Nutritional screening within the GLIM procedure—Part 2: Operationalization of the concept risk of malnutrition using a modified Delphi procedure","authors":"Marian A. E. de van der Schueren RD, PhD,&nbsp;Elke Naumann RD, PhD,&nbsp;Rianne ter Bekke RD, MSc,&nbsp;Rocco Barazzoni MD, PhD,&nbsp;Renée Blaauw RD, PhD,&nbsp;Tommy Cederholm MD, PhD,&nbsp;Lee-anne Chapple RD, PhD,&nbsp;Charlene Compher RD, PhD,&nbsp;M. Isabel T.D. Correia MD, PhD,&nbsp;Ryoji Fukushima MD, PhD,&nbsp;M. Cristina Gonzalez MD, PhD,&nbsp;Gordon L. Jensen MD, PhD,&nbsp;Charles Chin Han Lew RD, PhD,&nbsp;Su Lin Lim RD, PhD,&nbsp;Ainsley Malone RD, MSc,&nbsp;Veeradej Pisprasert MD, PhD,&nbsp;Elisabet Rothenberg RD, PhD,&nbsp;Alison Steiber RD, PhD,&nbsp;Martine Sealy RD, PhD,&nbsp;Harriët Jager-Wittenaar RD, PhD","doi":"10.1002/jpen.70101","DOIUrl":"10.1002/jpen.70101","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Within the original GLIM procedure (2019), the step on nutritional screening was not further elaborated. A new GLIM Risk of Malnutrition Working Group has recently developed a consensus-based conceptual definition of “risk of malnutrition.” The present study aimed to operationalize this definition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study consisted of: (1) a literature search to identify risk factors for malnutrition, and (2) a two-round online modified Delphi study. International professional experts (<i>n</i> = 113) in the field of malnutrition were invited to rate the importance of identified risk factors using a 9-point Likert scale. In questionnaire round 1, risk factors were rated “critically important” if ≥70% of the participants rated them 7–9, or “not important” if &gt;30% rated them 1–3. The remaining risk factors were categorized as “undecided.” In questionnaire round 2, undecided risk factors were classified as “critically important” or “important, but not critical,” based on the same threshold.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The literature search revealed 64 risk factors that were included in the Delphi questionnaires. Of 113 invited experts, 57 responded to Delphi Round 1, and 46 responded to Delphi Round 2. Twenty-nine risk factors (from the overarching risk categories unintentional weight loss, nutrition impact symptoms, disease-related factors, physical factors, psychological factors, decreased food intake, food assimilation, and poor diet) were deemed “critically important,” 10 “important, but not critical,” and 19 “substantially important.”</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this study, we identified which risk factors are considered critical to operationalize “risk of malnutrition.” Screening for risk of malnutrition should take these relevant risk factors into account.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"50 5","pages":"651-664"},"PeriodicalIF":3.3,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.70101","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148311218","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":"Exclusive enteral nutrition and the risk of nonsurgical readmission in patients with Crohn's disease-related intra-abdominal abscess: A retrospective cohort study","authors":"Zhihong Zhang MD,&nbsp;Tanxing Cai MD,&nbsp;Hao Xie MD,&nbsp;Renhan Luo MD,&nbsp;Huashan Liu MD, PhD,&nbsp;Wenxin Li MD, PhD,&nbsp;Ziwei Zeng MD, PhD,&nbsp;Zhenxing Liang MD, PhD,&nbsp;Li Xiong MD, PhD,&nbsp;Xiaosheng He MD, PhD,&nbsp;Liang Huang MD, PhD,&nbsp;Liang Kang MD, PhD,&nbsp;Xiaobin Zheng MD, PhD","doi":"10.1002/jpen.70090","DOIUrl":"10.1002/jpen.70090","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Intra-abdominal abscess management in Crohn's disease patients represents a significant clinical challenge. This study sought to assess the impact of exclusive enteral nutrition on nonsurgical readmission in patients with Crohn's disease-related intra-abdominal abscess.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study was conducted between January 2016 and June 2022 included Crohn's disease patients hospitalized for intra-abdominal abscess. Patients were categorized based on exclusive enteral nutrition administration during hospital stay or not. The primary outcome was nonsurgical readmission within 1-year post-discharge. Secondary outcomes included surgical intervention and abscess recurrence. Multivariable logistic regression analysis and Cox regression analysis were performed to adjust for potential confounding factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 128 patients were enrolled, with 45 allocated to the exclusive enteral nutrition group and 83 to the nonexclusive enteral nutrition group. Compared to the nonexclusive enteral nutrition group, patients treated with exclusive enteral nutrition were less likely to require nonsurgical readmissions (42.2% vs 79.5%, <i>P</i> &lt; 0.001). The multivariate analysis confirmed exclusive enteral nutrition as an independent protective factor against nonsurgical readmissions (hazard ratio: 0.11; 95% confidence interval: 0.04–0.30; <i>P</i> &lt; 0.001). In addition, exclusive enteral nutrition group showed a significantly lower rate of surgical intervention (46.7% vs 75.9%, <i>P</i> = 0.01). Notably, abscess recurrence rates remained comparable between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study provides novel evidence that exclusive enteral nutrition is associated with reduced risks of nonsurgical readmission and surgical burden without affecting abscess recurrence rates in patients with Crohn's disease-related intra-abdominal abscess.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"50 5","pages":"736-746"},"PeriodicalIF":3.3,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694823","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":"Adverse events associated with drug-related thiamine deficiency: A pharmacovigilance study","authors":"Xiaolang Du MPharm,&nbsp;Wenhua Wang MPharm,&nbsp;Zengguang Ma PhD,&nbsp;Xin Zhou MPharm","doi":"10.1002/jpen.70085","DOIUrl":"10.1002/jpen.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Thiamine deficiency can cause severe complications, including beriberi, Wernicke's encephalopathy, and Korsakoff syndrome, potentially leading to irreversible neurological damage or death. While causes such as chronic alcohol use disorder are established, drug-induced thiamine deficiency represents a potential risk that is often overlooked. However, systematic data on this association remain limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We utilized relevant preferred terms from the Medical Dictionary for Regulatory Activities to identify adverse events in the United States Food and Drug Administration Adverse Event Reporting System from 2004 through 2024. Signal detection was performed using four algorithms: the reporting odds ratio, the proportional reporting ratio, the information component, and the empirical Bayes geometric mean.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 1,046 cases of thiamine deficiency, showing an increasing trend. Hospitalization was reported in 46.0% of cases. The median patient age was 55.0 years (interquartile range: 41.0–68.0), and 42.5% were female. Healthcare professionals submitted 81.5% of reports, and the United States contributed the largest share (27.8%). The five agents most frequently reported were furosemide, metformin, fedratinib, metronidazole, and fluorouracil. Overall, 38 drugs demonstrated consistently positive safety signals across all four methods. Additional drugs exhibiting notable signals included arsenic trioxide, torasemide, rabeprazole, and hydrochlorothiazide.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This pharmacovigilance analysis identifies safety signals linking specific medications with thiamine deficiency, potentially mediated by mechanisms such as transport inhibition and metabolic interference. These findings highlight the importance of clinical vigilance and the consideration of thiamine monitoring in high-risk patients to mitigate the risk of neurological complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"50 5","pages":"727-735"},"PeriodicalIF":3.3,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494986","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":"Parenteral nutrition practice in the United States: A cross-sectional survey with gap analysis","authors":"Phil Ayers PharmD,&nbsp;Joseph I. Boullata PharmD, RPh,&nbsp;Todd W. Canada PharmD,&nbsp;Sarah V. Cogle PharmD,&nbsp;Andrew Mays MBA, PharmD,&nbsp;Jessica Monczka BS, RD,&nbsp;Michael Owen-Michaane MD,&nbsp;Titilola M. Afolabi PharmD,&nbsp;Elisabeth Biggs MS, PA-C, RD,&nbsp;M. Petrea Cober PharmD, MEd,&nbsp;Emily Coscia MS, RD,&nbsp;Sharon M. Durfee RPh,&nbsp;Silvia Figueiroa MS, RD,&nbsp;Rosa K. Hand PhD, RDN,&nbsp;Kelly Roehl MS, RDN-AP,&nbsp;Heather Stanner MS, RD,&nbsp;Kathleen Price PhD, RDN","doi":"10.1002/jpen.70087","DOIUrl":"10.1002/jpen.70087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Parenteral nutrition is a high-alert medication with the potential for errors that result in patient harm. The American Society for Parenteral and Enteral Nutrition has published guidance to support safe parenteral nutrition practices; however, the current implementation of this guidance or improvement in clinical practice over time remains unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional survey on current parenteral nutrition practice was distributed to US-based clinicians. Survey items addressed multiple steps in the parenteral nutrition use process. Descriptive statistics were performed and presented as number and percentage of respondents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1160 participants were included. Critical safety gaps included: prescribing practices that lack standardization and do not align with guidance; inadequate storage practices between compounding and administration; lack of adherence to specific filter type guidance; lack of adherence to the maximum hang time of separate lipid injectable emulsion infusions; limited oversight; minimal quality improvement activities; inadequate evaluation of errors; and pervasive unawareness of key institutional parenteral nutrition practices. Practice improvements included greater adoption of safety technologies and an increased use of filters during administration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This survey of current parenteral nutrition practice reveals some improvements in clinical practice; however, it highlights several critical gaps in the adoption of guidance with ongoing unsafe practices, which can result in patient harm.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"50 5","pages":"701-716"},"PeriodicalIF":3.3,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147535466","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":"Timing-specific neutrality in a rigorous ICU anabolic trial","authors":"Carsten Külls MD,&nbsp;Niloufar Dadashpour MD,&nbsp;Majid Golestanieraghi MD","doi":"10.1002/jpen.70083","DOIUrl":"10.1002/jpen.70083","url":null,"abstract":"","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"50 5","pages":"635-636"},"PeriodicalIF":3.3,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489334","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 screening within the GLIM procedure—Part 1: Development of a conceptual definition of risk of malnutrition using a modified Delphi procedure","authors":"Harriët Jager-Wittenaar RD, PhD,&nbsp;Martine Sealy RD, PhD,&nbsp;Rocco Barazzoni MD, PhD,&nbsp;Renee Blaauw RD, PhD,&nbsp;Tommy Cederholm MD, PhD,&nbsp;Lee-anne Chapple RD, PhD,&nbsp;Charlene Compher RD, PhD,&nbsp;M. Isabel T.D. Correia MD, PhD,&nbsp;Ryoji Fukushima MD, PhD,&nbsp;M. Cristina Gonzalez MD, PhD,&nbsp;Gordon L. Jensen MD, PhD,&nbsp;Charles Chin Han Lew RD, PhD,&nbsp;Su Lin Lim RD, PhD,&nbsp;Ainsley Malone RD,&nbsp;Veeradej Pisprasert MD, PhD,&nbsp;Elisabet Rothenberg RD, PhD,&nbsp;Alison Steiber RD, PhD,&nbsp;Elke Naumann RD, PhD,&nbsp;Marian de van der Schueren RD, PhD","doi":"10.1002/jpen.70100","DOIUrl":"10.1002/jpen.70100","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This article presents the results of the modified Delphi study conducted by the GLIM Risk of Malnutrition Working Group to develop a consensus-based conceptual definition of “risk of malnutrition”, as first step in revising the GLIM screening procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Focus groups with nutritional care experts and patient/older adult representatives, and a literature exploration informed 46 statements on risk of malnutrition. Malnutrition experts (<i>n</i> = 112) evaluated these statements, using a five-point Likert scale. Statements with ≥75% agreement were accepted; those with ≥75% disagreement and/or neutrality were rejected. Remaining statements were marked “undecided” and re-evaluated in later rounds.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In three questionnaire rounds (response rates 63%, 59%, and 54%), 26 statements were ultimately accepted to shape the conceptual definition of “risk of malnutrition”. The GLIM Working Group and patient/older adult representatives reviewed the pre-final professional and layperson versions. Risk of malnutrition was defined as: A dynamic state, with or without unintentional weight loss, in which an individual has one or more risk factors, that is, nutrition impact symptoms, and/or disease-related, physical, psychological, social, demographic, and economic risk factors, that may result in malnutrition and may negatively impact clinical outcomes. In the layperson version, sentences were simplified to aid comprehension.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>GLIM has developed the first global (professional and layperson) conceptual definition of risk of malnutrition. This definition will guide future nutritional screening recommendations and a more preventive malnutrition approach. It also implies that screening tools covering “risk of malnutrition” should no longer be validated against signs or the diagnosis of malnutrition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"50 5","pages":"642-650"},"PeriodicalIF":3.3,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.70100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148311213","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":"Impact of fortifiers on donor milk nutrient composition: An experimental study","authors":"Kimberly Mansen MSPH,&nbsp;Hannah Sanders MPH,&nbsp;Sarah N. Taylor MD,&nbsp;Raven Dunstan MPH,&nbsp;Kiersten Israel-Ballard DrPH,&nbsp;Maryanne T. Perrin PhD","doi":"10.1002/jpen.70089","DOIUrl":"10.1002/jpen.70089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Preterm infants frequently require human milk fortification to meet their unique nutrients requirements. How commercial fortifiers change essential macronutrients and micronutrients in donor human milk has not been well-studied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our sampling frame included milk from approved United States milk bank donors (<i>n</i> = 400), measured for macronutrients, vitamins, and minerals, and used to produce 1000 pools of donor milk. Fortification ratios were computed to describe the extent that fortifiers changed donor milk composition (&lt;100% indicates decreased; &gt;100% indicates increased). Intake ratios were computed to evaluate how unfortified and fortified donor milk at 160 mL/kg/day compared to upper and lower preterm nutrient recommendations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fortifiers varied greatly in their impact on individual donor milk nutrients, with final macronutrient concentrations between 75% and 399% of unfortified values, while vitamin and mineral concentrations were between 50% and 800+% of unfortified values. Unfortified donor milk was able to meet the lower intake recommendations for three nutrients—lactose, fat, and pantothenic acid—highlighting the importance of utilizing multi-nutrient fortifiers. Bovine-derived fortifiers frequently did not meet lower targets for protein, choline, and several minerals, while human-derived fortifiers did not meet lower targets for most B-vitamins and choline, and exceeded some targets including protein, fat, calcium, phosphorus, and magnesium.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Fortification products available in the United States, when used with donor milk, frequently lead to both deficient and excessive nutrient intake compared to preterm enteral nutrition recommendations. Development of fortifier products based on robust nutritional reference values for donor milk is warranted to improve the nutritional care of preterm infants.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"50 5","pages":"684-692"},"PeriodicalIF":3.3,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.70089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629782","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":"Different approaches of SARC-tools for Sarcopenia Screening in chronic obstructive pulmonary disease: A cross-sectional validation study","authors":"Alicia S. Hartmann RD,&nbsp;João G. Brum RD,&nbsp;Thiago G. Barbosa-Silva PhD, MD,&nbsp;M Cristina Gonzalez PhD, MD,&nbsp;Juliessa Florian PhD,&nbsp;Flávia M. Silva PhD, RD","doi":"10.1002/jpen.70099","DOIUrl":"10.1002/jpen.70099","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We aimed to assess the concurrent and predictive validity of different screening tools for sarcopenia in outpatients with chronic obstructive pulmonary disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cross-sectional study with 124 community-dwelling adults with chronic obstructive pulmonary disease (67.8 ± 8.4 years, 57.6% female). SARC-F, SARC-CalF, and SARC-CalF_BMI-CC were applied; sarcopenia was diagnosed and considered as reference to test the concurrent validity. The outcomes evaluated to test the predictive validity included dyspnea severity, stage of disease, quality of life, the 6-min walk test, and the prognosis index.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>SARC-CalF_BMI-CC presented the highest sensitivity (79.5% vs 43.2% vs 20.5%), and negative predictive value (78.6% vs 68.8% vs 66.3%) compared to SARC-CalF and SARC-F, respectively. Patients with sarcopenia risk by SARC-CalF_BMI-CC were 3.37 times (95% CI 1.18; 9.63) more likely to walk less than 350 m, 5.31 times (95% CI 2.01; 14.04) more likely to have poorer prognosis, 4.05 times (95% CI 1.55; 10.61) more likely to experience greater shortness of breath, and 6.4 times (95% CI 1.94; 21.13) more likely to have diminished quality of life. Risk of sarcopenia identified by SARC-F (advanced stage of disease, poor prognosis and quality of life) and SARC-Calf (advanced stage of disease, poor prognosis, and reduced functional capacity) was associated with a lower number of outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SARC-CalF_BMI-CC demonstrated the highest accuracy to identify sarcopenia. Patients with sarcopenia risk by SARC-CalF_BMI-CC were more likely to present worse outcomes compared to those identified by SARC-F or SARC-Calf, suggesting the use of SARC-CalF_BMI-CC for these patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"50 5","pages":"717-726"},"PeriodicalIF":3.3,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849254","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":"Reply to “Mechanical tension and autophagy suppression: Unmasking the confounders in ICU muscle preservation strategies”","authors":"Lizl Veldsman PhD, RD,&nbsp;Guy A. Richards MD, PhD,&nbsp;Daniel Nel PhD,&nbsp;Tertius A. Kohn PhD,&nbsp;Renée Blaauw PhD, RD","doi":"10.1002/jpen.70106","DOIUrl":"10.1002/jpen.70106","url":null,"abstract":"","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"50 5","pages":"640-641"},"PeriodicalIF":3.3,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148020543","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":"Reply to: Timing-specific neutrality in a Rigorous ICU anabolic trial","authors":"Lizl Veldsman PhD, RD,&nbsp;Guy A. Richards MD, PhD,&nbsp;Daniel Nel PhD,&nbsp;Tertius A. Kohn PhD,&nbsp;Renée Blaauw PhD, RD","doi":"10.1002/jpen.70091","DOIUrl":"10.1002/jpen.70091","url":null,"abstract":"&lt;p&gt;We thank the authors for their balanced appraisal of our randomized controlled trial evaluating combined intravenous amino acid boluses and cycle ergometry initiated on ICU days 3–4 for a median of six days. We appreciate their careful summary of the methodological rigor of the study and their accurate interpretation of the primary findings.&lt;/p&gt;&lt;p&gt;We agree with their central observation that, under the specific conditions tested, the intervention did not attenuate first-week loss of muscle (ultrasound) or myofiber (biopsy) cross-sectional area, and that the increase in the myofiber protein-to-DNA ratio in the intervention group, despite no structural preservation, may point towards a temporal lag between anabolic signaling and measurable changes in muscle architecture.&lt;/p&gt;&lt;p&gt;We further concur that both phenotype and phase play a role in determining responsiveness to anabolic interventions.&lt;span&gt;&lt;sup&gt;1-4&lt;/sup&gt;&lt;/span&gt; The intervention was delivered in a predominantly young trauma cohort with presumed low nutritional risk and without significant acute kidney injury, over a relatively short duration during what may be considered the late acute phase of critical illness. However, it is important to acknowledge that patients do not progress through metabolic phases uniformly, and validated metabolic markers to define these transitions are currently lacking.&lt;span&gt;&lt;sup&gt;1-5&lt;/sup&gt;&lt;/span&gt; Reliance on chronological ICU day thresholds may therefore not accurately reflect an individual patient's metabolic readiness for anabolic interventions.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; These considerations suggest that initiating anabolic strategies later in the course of illness, potentially after Day 5, and maintaining exposure for longer may be necessary to achieve structural effects, particularly in light of the observed lag between molecular signaling and measurable changes in muscle mass, although the identification of metabolic markers to guide timing would be preferable to fixed day-based cutoffs.&lt;span&gt;&lt;sup&gt;1-5&lt;/sup&gt;&lt;/span&gt; Research is ongoing to identify such markers, with recent studies proposing trajectories in insulin resistance as a possible physiological indicator of metabolic transition.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;As acknowledged in the manuscript, the biphasic ultrasound trajectory and exploratory secondary outcomes should be interpreted as hypothesis-generating. We agree that fluid shifts and edema remain important considerations when assessing ultrasound-derived muscle measures in early critical illness. Although these factors were addressed through sensitivity analyses adjusting for fluid status, the methods used to monitor edema were not entirely objective; therefore, a residual influence of fluid shifts cannot be fully excluded. However, the inclusion of biopsy-derived myofiber cross-sectional area, which is less susceptible to interstitial fluid shifts, and the concordant loss observed across the two primary time points between ultrasound and biopsy ","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"50 5","pages":"637-638"},"PeriodicalIF":3.3,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.70091","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719352","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}