Nutrition最新文献

{"title":"From evidence to action: advancing multi-level policy and leadership for adult undernutrition.","authors":"Katherine L Ford, Carlota Basualdo-Hammond, Roseann Nasser, Heather Keller, Judy D Bauer, M Isabel T D Correia, Diana Cardenas, Andrea Grantham, Leah Gramlich","doi":"10.1016/j.nut.2026.113375","DOIUrl":"https://doi.org/10.1016/j.nut.2026.113375","url":null,"abstract":"<p><strong>Background: </strong>The Canadian Nutrition Society endorsed commitments aligned with the United Nations Decade of Action on Nutrition to advance policy action for adult undernutrition. Currently, undernutrition is not recognized as a condition impacting the Canadian health care system. The aim was to identify key insights and ongoing policy challenges and outline actionable steps for health leaders and governments to prioritize nutrition care amid shifting priorities.</p><p><strong>Methods and procedures: </strong>Evidence was integrated from a targeted undernutrition initiative, and findings were synthesized to develop a conceptual roadmap across health system levels.</p><p><strong>Results: </strong>Challenges include limited awareness, inadequate financing for medical nutrition therapy, and insufficient dietetic workforce capacity. Actionable steps include national recognition of undernutrition through standardized metrics and language, provincial funding and workforce planning, and organizational data systems targeting standardized nutrition care processes, such as admission screening. At point-of-care, access to nutrition care, improved food service standards, and continuity across care transitions are essential. The conceptual roadmap delineates responsibilities across national/federal, provincial/territorial, organizational, and point-of-care levels.</p><p><strong>Conclusions: </strong>Addressing adult undernutrition requires coordinated, multi-level policy action and buy-in from health leaders and government. The conceptual roadmap provides a structured avenue to support integration of nutrition into health policy, improve accountability, and reduce the burden of undernutrition in Canada.</p>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"152 ","pages":"113375"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875608","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":"Author's response re. \"Patterns of parenteral nutrition use in patients with respiratory disease: indications, timing, and metabolic complications\".","authors":"Paola Renata Lamoyi-Domínguez, Iván Armando Osuna-Padilla","doi":"10.1016/j.nut.2026.113334","DOIUrl":"https://doi.org/10.1016/j.nut.2026.113334","url":null,"abstract":"","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":" ","pages":"113334"},"PeriodicalIF":3.6,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471790","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":"Yearlong fluctuations of vitamin D status, intake, and health outcomes in university students: A prospective longitudinal study","authors":"Emilia Zawieja Ph.D.,&nbsp;Aleksandra Bykowska-Derda Ph.D.,&nbsp;Agata Chmurzynska Ph.D.","doi":"10.1016/j.nut.2026.113111","DOIUrl":"10.1016/j.nut.2026.113111","url":null,"abstract":"<div><h3>Objectives</h3><div>This longitudinal observational study examined changes in serum 25(OH)D concentration, C-reactive protein (CRP) concentration, vitamin D intake, cognitive function, depressive symptoms, and body composition in university students across an academic year.</div></div><div><h3>Methods</h3><div>Participants (<em>n</em> = 49) completed four assessments (in October, January, March, and July) that included blood sampling for 25(OH)D, CRP, leptin, and cortisol measurements, body composition via plethysmography, questionnaires, and cognitive testing.</div></div><div><h3>Results</h3><div>Most students had insufficient 25(OH)D concentrations. Supplementation increased 25(OH)D only after 3 mo, with levels declining when supplementation decreased. Vitamin D intake correlated with 25(OH)D concentration. CRP peaked in March despite the greatest frequency of infections occurring in January. Percent fat mass decreased from January to March, and fat-free mass (kg) was higher in March and July than in October and January. Cortisol concentration was the highest in October. Cognitive performance improved after October, while depressive symptoms were greatest in October. No significant associations were observed between 25(OH)D and CRP, body composition, cognition, and depression. Despite a significantly higher vitamin D intake in <em>CYP2R1</em> rs10741657 GG homozygotes (58.0 ± 43.0 µg/d versus 25.3 ± 34.6 µg/da, <em>P</em> = 0.0081) than in AG + AA genotypes, no significant differences in 25(OH)D concentrations were observed between these genotypes.</div></div><div><h3>Conclusions</h3><div>University students were at risk of low vitamin D status throughout the year; only sustained supplementation led to an effective increase in 25(OH)D concentrations. <em>CYP2R1</em> GG homozygotes may require higher intake levels of vitamin D in order to achieve comparable 25(OH)D concentrations to those with AG + AA genotypes.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"146 ","pages":"Article 113111"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173008","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":"Assessing nutritional and hydration status in patients with a diabetic foot ulcer: Agreement between hand-to-hand and hand-to-foot bioimpedance methods","authors":"Kristof Van Dessel M.Sc. ,&nbsp;Patrick Lauwers M.D., Ph.D. ,&nbsp;An Verrijken Ph.D. ,&nbsp;Christophe De Block M.D., Ph.D. ,&nbsp;Eveline Dirinck M.D., Ph.D.","doi":"10.1016/j.nut.2026.113136","DOIUrl":"10.1016/j.nut.2026.113136","url":null,"abstract":"<div><h3>Objectives</h3><div>Malnutrition is prevalent among people with a diabetic foot ulcer (DFU) and is associated with impaired wound healing and increased amputation risk. Assessing fat-free mass (FFM) is crucial for diagnosing malnutrition. However, hand-to-foot (HF) bioelectrical impedance analysis (BIA) measurements are often not feasible due to amputations or ulcerated feet. This study evaluates the agreement between hand-to-hand (HH) and HF BIA measurements in assessing body composition, hydration, and nutritional status in patients with DFU.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, 164 patients with DFU underwent HF and HH BIA measurements to assess body composition. Malnutrition was diagnosed using the GLIM criteria. Agreement between methods was analyzed using one-sample t-tests, Bland–Altman plots, intra-class correlation, and Cohen’s d. Over- or underestimation was defined as deviation &gt;10% from HF values.</div></div><div><h3>Results</h3><div>Statistically significant but small differences were observed between HF and HH measurements for resistance (<em>P</em> &lt; 0.001), reactance (<em>P</em> = 0.036), and phase angle (<em>P</em> &lt; 0.001). Strong agreement was found for body composition and hydration metrics. Malnutrition was diagnosed in 32.3% of patients, with HH showing 88.7% accuracy in identifying malnourished individuals, similar to HF (89%).</div></div><div><h3>Conclusions</h3><div>HH BIA is a reliable alternative for assessing body composition and nutritional status in patients with DFUs. Although statistically significant differences were found in resistance, reactance, and phase angle, the derived body composition and hydration indices showed strong consistency between methods (ICC &gt; 0.75). The small systematic biases observed were clinically negligible, supporting the use of HH BIA when HF measurements are unfeasible.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"146 ","pages":"Article 113136"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147290136","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":"Effect of alternate-day fasting combined with and without voluntary running exercise on body composition and energy metabolism in young adult, normal-weight mice","authors":"Ryona Suzuki M.Sc. ,&nbsp;Kazuhiko Higashida Ph.D. ,&nbsp;Sho Hatayama Ph.D. ,&nbsp;Tsutomu Fukuwatari Ph.D. ,&nbsp;Naoya Nakai Ph.D.","doi":"10.1016/j.nut.2026.113116","DOIUrl":"10.1016/j.nut.2026.113116","url":null,"abstract":"<div><h3>Objectives</h3><div>The effects of alternate-day fasting (ADF) on body composition and metabolic function in young, healthy and nonobese, individuals remain insufficiently understood. We investigated the effects of ADF with and without voluntary running exercise on body composition, energy metabolism, and biochemical parameters in mice.</div></div><div><h3>Methods</h3><div>Eight-week-old male mice were divided into ad libitum (AL) and ADF groups, which were further divided into sedentary (SED) and voluntary wheel running exercise (EX) sub-groups. An oral glucose tolerance test (OGTT) was conducted in week 6 of the experimental period. Mice were euthanized in week 7 of the experimental period, and blood and tissue samples were collected for biochemical analysis.</div></div><div><h3>Results</h3><div>The total food intake was significantly increased in the AL-EX group and decreased in the ADF-SED group. Voluntary running distance was reduced by ADF, particularly on feeding days. Skeletal muscle mass per body weight (BW) was reduced in ADF compared with AL. The epididymal fat weight per BW was reduced in EX and increased in ADF. OGTT results revealed that ADF and EX independently improved glucose tolerance, but their combination showed no additive effect. EX increased the synthesis of mitochondrial enzymes in skeletal muscle and hepatic triglyceride content, whereas ADF led to increased hepatic fatty acid synthase levels.</div></div><div><h3>Conclusions</h3><div>These findings suggest that ADF does not enhance exercise-induced improvements in body composition and may attenuate some beneficial effects of voluntary exercise in healthy young adult mice, potentially because of reduced physical activity associated with ADF.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"146 ","pages":"Article 113116"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213470","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":"Dietary advice alone or with oral nutritional supplements after hospital discharge in colorectal cancer surgery patients: Five year follow-up of a randomized controlled trial","authors":"Shanjun Tan ,&nbsp;Qiulei Xi ,&nbsp;Zhige Zhang ,&nbsp;Mingyue Yan,&nbsp;Qingyang Meng,&nbsp;Qiulin Zhuang ,&nbsp;Guohao Wu","doi":"10.1016/j.nut.2026.113113","DOIUrl":"10.1016/j.nut.2026.113113","url":null,"abstract":"<div><h3>Objectives</h3><div>The efficacy of dietary advice alone compared to dietary advice supplemented with oral nutritional supplements following hospital discharge in post-cancer surgery patients remains a contentious issue. This study was to assess whether combining dietary advice with oral nutritional supplements improves long-term overall survival and other outcomes, compared with dietary advice alone, in patients following discharge after colorectal cancer surgery.</div></div><div><h3>Methods</h3><div>We conducted a 5-year follow-up of a two-arm randomized controlled trial involving colorectal cancer surgery patients at nutritional risk. The control group was offered dietary advice alone, in contrast to the intervention group, which was provided with both oral nutritional supplements and dietary advice. Overall survival was the primary outcome, while secondary outcomes encompassed nonelective hospital readmissions, quality of life, and functional outcomes such as 6-minute walk distance and handgrip strength.</div></div><div><h3>Results</h3><div>This analysis included 193 patients who completed the 5-year follow-up (97 in the intervention group and 96 in the control group). The intervention group demonstrated a significantly higher overall survival rate compared to the control group for the primary outcome (<em>P</em> = 0.042). The nutritional intervention emerged as a favorable prognostic factor for overall survival, even after adjustment for confounding variables (hazard ratio 0.61, 95% confidence interval 0.38–0.98, <em>P</em> = 0.042). However, the secondary outcomes did not differ significantly between the 2 groups (all <em>P</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>Patients with nutritional risk after colorectal cancer surgery who received dietary advice combined with oral nutritional supplements posthospital discharge exhibited improved overall survival compared to those who received dietary advice alone. The results indicate that providing dietary advice combined with oral nutritional supplements may be beneficial for patients after hospital discharge following cancer surgery.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"146 ","pages":"Article 113113"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146258856","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":"Optimising SARC-F cut-off for sarcopenia screening: A comparative analysis with muscle strength and physical performance tests","authors":"Deniz Cengiz M.D. ,&nbsp;Arzu Okyar Baş M.D. ,&nbsp;Yelda Öztürk M.D. ,&nbsp;Ceyda Kayabaşı M.D. ,&nbsp;Murat Pehlivan M.D. ,&nbsp;Özge Özgün M.D. ,&nbsp;Okan Turhan M.D. ,&nbsp;İskender Arda Nacar M.D. ,&nbsp;Mert Eşme M.D. ,&nbsp;Cafer Balcı M.D. ,&nbsp;Burcu Balam Doğu M.D. ,&nbsp;Mustafa Cankurtaran M.D. ,&nbsp;Meltem Gülhan Halil M.D.","doi":"10.1016/j.nut.2026.113132","DOIUrl":"10.1016/j.nut.2026.113132","url":null,"abstract":"<div><h3>Objectives</h3><div>Sarcopenia, a prevalent geriatric syndrome with multifactorial origins, is strongly influenced by malnutrition alongside immobility and chronic illness and contributes substantially to falls, disability, and mortality. The (Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls (SARC-F) questionnaire is widely used to screen for probable sarcopenia; however, the conventional cut-off of ≥4 has yielded insufficient sensitivity across studies. The aim of the study was to evaluate how SARC-F scores correspond to muscle strength and physical performance tests endorsed by the EWGSOP2 algorithm and to determine the most suitable cut-off for screening probable sarcopenia in older adults.</div></div><div><h3>Methods</h3><div>This retrospective cross-sectional study included community-dwelling adults aged ≥65 years who attended a tertiary geriatric outpatient clinic (January 2022–May 2024). Patients with active malignancy, non-ambulatory status, or missing performance data were excluded. Diagnostic accuracy of SARC-F thresholds was assessed against handgrip strength (HGS), the sit-to-stand test (STST), 4-meter gait speed, and the Timed Up and Go (TUG) test using receiver operating characteristic analysis.</div></div><div><h3>Results</h3><div>A total of 1,355 participants (mean age 74.0 ± 6.0 years; 64.9% female) were analyzed. Prevalence of SARC-F ≥4 was 22.2%. For HGS and STST, a cut-off of ≥2 yielded the most favorable discrimination (AUC = 0.705 and 0.735, respectively). Gait speed showed the best accuracy at ≥3 (AUC = 0.788), while TUG demonstrated the highest performance at ≥4 (AUC = 0.881).</div></div><div><h3>Conclusions</h3><div>SARC-F performance varies across muscle strength and functional domains. A threshold of ≥2 may enhance early detection of sarcopenia in community-dwelling older adults, while higher cut-offs better reflect advanced functional impairment.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"146 ","pages":"Article 113132"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326853","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":"Frequency of fluid versus nutrition discussion on rounds in neonatal intensive care units: Is fluid intake a heuristic for nutrition intake?","authors":"Gustave H. Falciglia M.D., M.S.C.I., M.S.H.Q.S. ,&nbsp;Karna Murthy M.D., M.Sc. ,&nbsp;Daniel T. Robinson M.D., M.Sc.","doi":"10.1016/j.nut.2026.113107","DOIUrl":"10.1016/j.nut.2026.113107","url":null,"abstract":"<div><div>Clinicians in the neonatal intensive care unit discuss fluid more frequently than energy and macronutrient (protein, fat and carbohydrate) intake. These findings suggest clinicians use fluid intake as a heuristic for nutrition intake which may lead to nutritional deficits because nutrition concentration varies by source.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"146 ","pages":"Article 113107"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146161846","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":"Serine modulates insulin resistance during short-term bed rest","authors":"Alja Ivetac ,&nbsp;Teresa Cannito ,&nbsp;Alessio Nunnari M.D.,&nbsp;Mariella Sturma ,&nbsp;Filippo Giorgio Di Girolamo Phar. Ph.D.,&nbsp;Gianni Biolo M.D., Ph.D.","doi":"10.1016/j.nut.2026.113121","DOIUrl":"10.1016/j.nut.2026.113121","url":null,"abstract":"<div><h3>Background</h3><div>Insulin resistance (IR) manifesting as a result of muscle unloading is often accompanied by an altered amino acid (AA) profile. The aim of this study was to assess the potential impact of AAs on IR during inactivity.</div></div><div><h3>Methods</h3><div>Plasmatic AA, glucose, and insulin were retrospectively analyzed from three different bed rest studies (BR1, BR2, BR3) involving 26 young healthy males. Since AAs were analyzed on different days, we imputed all missing values with multivariate imputation by chained equations, which allowed us to evaluate trends of plasmatic AAs in relation to IR (HOMA IR) during 9 d of inactivity. A generalized linear mixed model (GLMM) was fitted to examine the effect of selected plasmatic AAs (predictors) on HOMA IR (outcome). Results of GLMM were further validated with data from BR1 and BR2 (19 subjects), in which AAs were analyzed on days 1, 5, and 9.</div></div><div><h3>Results</h3><div>Serine exhibited a sig. negative fixed effect on HOMA IR [−0,015] (<em>P</em> = 0.006), while HOMA-IR had no sig. effect on serine (<em>P</em> = 0.507), suggesting a unidirectional relationship. Furthermore, data from BR1 and BR2 confirmed the inverse effect: serine levels sig. increased during the initial days (+13%), followed by a sig. drop from fifth to the ninth d (−6.5%). When serine was available, HOMA IR was not sig. affected. When serine availability dropped, HOMA IR continued to rise, reaching a sig. difference from baseline values to ninth d of BR (+27%).</div></div><div><h3>Conclusion</h3><div>Our findings indicate that serine can have an inverse impact on IR and not vice versa. Upholding serine levels during short-term BR could have a protective role against IR.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"146 ","pages":"Article 113121"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284623","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":"Effects of the ketogenic-caloric restricted diet on metabolic endotoxemia and metabolic health in adults with prediabetes: A randomized controlled trial","authors":"Aseel Jawamis MSc,&nbsp;Hayder AL-Domi PhD,&nbsp;Najd Al Sarayreh MSc","doi":"10.1016/j.nut.2026.113119","DOIUrl":"10.1016/j.nut.2026.113119","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the effects of a ketogenic-caloric-restricted (KD+CR) diet on metabolic endotoxemia and related metabolic markers in adults with obesity and prediabetes.</div></div><div><h3>Methods</h3><div>A randomized controlled trial was conducted among 90 adults with obesity and prediabetes. Participants were randomized to three groups: 1) KD+CR, 2) normal diet with caloric restriction (ND+CR), or 3) normal diet without caloric restriction (ND). Lipopolysaccharides (LPS), inflammatory biomarkers, fasting glucose, insulin, HOMA-IR, and anthropometric measures were assessed at baseline and week 12.</div></div><div><h3>Results</h3><div>After 12 wk, serum LPS levels were significantly higher in KD+CR group compared with ND+CR and ND (158.6 ± 6.9 versus 129.6 ± 6.6, 126.7 ± 7.0; <em>P</em> = 0.004). Interleukin-6 (IL-6) significantly decreased in KD+CR versus ND (2.4 ± 0.2, 3.9 ± 0.2; <em>P</em> = 0.004). Insulin and HOMA-IR were significantly lower in KD+CR and ND+CR than in ND (insulin: 12.0 ± 1.1, 13.9 ± 1.0, 19.3 ± 1.1; <em>P</em> &lt; 0.001) (HOMA-IR: 2.9 ± 0.28, 3.2 ± 0.27, and 4.7 ± 0.29; <em>P</em> &lt; 0.001). Body weight and fat mass reductions were greater in the KD+CR group than in the ND+CR and ND groups (body weight: –10.5%, –3.9%, –4.5%; <em>P</em> &lt; 0.001), (body-fat mass: –21.7%, –7.7%, –9.8%; <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>A 12-wk KD+CR diet in adults with obesity and prediabetes improved inflammatory markers, insulin sensitivity, and body composition, alongside a significant increase in serum LPS levels and altered LPS–cytokine dynamics. The long-term metabolic consequences of LPS changes during prolonged ketogenic exposure warrant investigation in future studies.</div></div><div><h3>Trial registration</h3><div>This trial was registered with ClinicalTrials.gov (NCT06911879).</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"146 ","pages":"Article 113119"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147308518","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}