Nutrients最新文献

{"title":"An Exploratory Pilot Study of Inflammatory Cytokine Gene Polymorphisms and Residual Postoperative Outcomes in Older Women One Year After Bariatric Surgery.","authors":"Dante Mafra Tourino Teixeira, Antonio Avelino Ferreira Soares, Renata de Souza Freitas, Larissa Sousa Silva Bonasser, Caroline Ferreira Fratelli, Calliandra Maria de Souza Silva, Evelyn Mikaela Kogawa, Linconl Agudo Oliveira Benito, Izabel Cristina Rodrigues da Silva","doi":"10.3390/nu18081294","DOIUrl":"10.3390/nu18081294","url":null,"abstract":"<p><strong>Background/objectives: </strong>Obesity is characterized by chronic low-grade inflammation, and bariatric surgery promotes substantial metabolic and inflammatory improvement. However, residual obesity and microvascular complications may persist in some individuals, suggesting potential genetic influences on postoperative outcomes. This exploratory pilot study investigated the association between inflammatory cytokine gene polymorphisms and clinical, metabolic, and inflammatory outcomes in older women one year after bariatric surgery.</p><p><strong>Methods: </strong>This cross-sectional, hypothesis-generating pilot study included 21 women aged ≥50 years (mean 61.6 ± 5.0) who underwent Roux-en-Y gastric bypass at a public bariatric center in Brazil. Anthropometry, body composition, biochemical markers, and serum levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were assessed 12 months postoperatively. Genotyping for <i>IL6</i>-174G/C (rs1800795) and <i>TNFA</i>-308G/A (rs1800629) was performed using PCR-RFLP. Associations were analyzed using non-parametric statistical tests.</p><p><strong>Results: </strong>Notably, the <i>IL6</i>-174CC genotype was associated with persistent obesity, whereas carriers of the <i>TNFA</i>-308A allele showed a higher prevalence of diabetic retinopathy. These results highlight genotype-specific postoperative outcomes. No significant genotype-related differences were observed for most anthropometric, biochemical, or inflammatory parameters, indicating substantial overall metabolic improvement after surgery regardless of genetic background. However, the observed associations were based on a small sample and should be interpreted cautiously.</p><p><strong>Conclusions: </strong>This exploratory pilot study revealed associations between inflammatory cytokine gene polymorphisms and selected postoperative outcomes, particularly persistent obesity and diabetic retinopathy, in older women one year after bariatric surgery. These hypothesis-generating findings emphasize the need for larger, longitudinal studies to clarify the role of genetic factors in postoperative heterogeneity after bariatric surgery.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 8","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Dual Malnutrition Challenge in Tanzania Explored Through Logistic Regression Analysis.","authors":"Maryam Siddiqa, Gulzar H Shah, Mahnoor Shahid Butt, Tehreem Asif, Bushra Shah","doi":"10.3390/nu18081301","DOIUrl":"10.3390/nu18081301","url":null,"abstract":"<p><strong>Background and objectives: </strong>The double burden of malnutrition (DBM), characterized by the coexistence of malnutrition and overweight within the same household, has become a significant public health concern in low- and middle-income countries. Tanzania is undergoing a nutritional transition marked by persistent child malnutrition alongside increasing maternal overweight. This study examined socio-demographic, maternal, and child-level factors associated with DBM among children under five years in Tanzania.</p><p><strong>Methods: </strong>This cross-sectional study used data from the 2022 Tanzania Demographic and Health Survey, including a weighted sample of 5744 children under five and their mothers aged 15-49 years. DBM was defined as the presence of child malnutrition, measured using the Composite Index of Anthropometric Failure (CIAF), in households where the mother was overweight or obese. Bivariate chi-square tests and binary logistic regression analyses were conducted in STATA 17. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were estimated to identify predictors of DBM.</p><p><strong>Results: </strong>DBM was more prevalent in rural areas. Significant predictors included birth order (AOR = 0.611, <i>p</i> = 0.030), child sex (AOR = 0.708, <i>p</i> = 0.011), perceived birth size (AOR = 0.270, <i>p</i> = 0.004), child age (AOR = 0.474, <i>p</i> < 0.001), maternal age (AOR = 0.599, <i>p</i> = 0.045), and maternal education (AOR = 0.604, <i>p</i> = 0.035). Higher maternal education reduced the likelihood of DBM, while firstborn male and small-sized children were at greater risk.</p><p><strong>Conclusions: </strong>DBM in Tanzania is influenced by both biological and socio-demographic factors. Integrated, multi-sectoral interventions targeting maternal education, prenatal care, and optimal maternal nutrition are essential to reduce DBM and achieve global malnutrition reduction targets.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 8","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Physical Activity, Body Dissatisfaction, and Mindful Eating in Turkish Adults.","authors":"Dilay Ermiş, Rana Turgut Yaman, Ece Akgül, Asu Şevval İçelli, Ceren İşeri, Elif Öztürk, Merve Kızıl, Sude Melis Şahin, Beyzanur Çamlıbel, Gamze Akbulut","doi":"10.3390/nu18081292","DOIUrl":"10.3390/nu18081292","url":null,"abstract":"<p><strong>Objective: </strong>This cross-sectional study examined the associations among physical activity, body dissatisfaction, and mindful eating in adults, while accounting for the influence of demographic and socioeconomic factors.</p><p><strong>Methods: </strong>A total of 9838 adults (60.6% women, 39.4% men; mean age 36.3 ± 16.0 years) were included in the study using a convenience sampling method (women: 34.4 ± 15.1 years; men: 39.2 ± 16.9 years). Physical activity was measured with the International Physical Activity Questionnaire-Short Form (IPAQ-SF), body dissatisfaction was measured with the Stunkard Figure Rating Scale (FRS), and mindful eating was assessed with the Four Facet Mindful Eating Scale (FFaMES). Spearman correlation, Kruskal-Wallis, and hierarchical regression analyses were conducted.</p><p><strong>Results: </strong>Physical activity showed weak but statistically significant positive correlations with body dissatisfaction and mindful eating, while no association was observed between body dissatisfaction and mindful eating. After adjustment for demographic and socioeconomic variables, body dissatisfaction and mindful eating remained associated with physical activity, although the explained variance was small. Participants with moderate physical activity levels had higher mindful eating scores than those with low activity.</p><p><strong>Conclusions: </strong>The findings indicate weak associations among physical activity, body dissatisfaction, and mindful eating among adults. Although statistically significant, these associations were small, suggesting that these psychosocial factors represent only a limited component of the broader determinants of physical activity behaviour.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 8","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional Risk in Patients Admitted to Medical Oncology Departments: Prevalence, Associated Factors and Clinical Outcomes in a Multicentre Prospective Study.","authors":"Francisco Javier Teigell Muñoz, Laia Llobera Rius, Laura Medina Ortega, Pablo Villacé Gallego, Javier Marco-Hernández, Esther Paula Fernández Fernández, Anna Esquerrà Molas, Leyre Liesa Delgado, Luis Manuel Sáez Urán, Jesús González Olmedo, Carlos Heredia-Mena, Javier Romero Hernández, Mariona Llaberia-Torrelles, María Jesús Delgado Heredia, Nagore Bazaga Rodas, Lidia Fernández-Cordón, Cristina Macía-Rodríguez, Jade Soldado, Adrián García-Villa","doi":"10.3390/nu18081296","DOIUrl":"10.3390/nu18081296","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Malnutrition and nutritional vulnerability are common in patients with cancer and are associated with adverse clinical outcomes, particularly among hospitalised patients. However, data specifically describing nutritional risk in patients admitted to medical oncology departments remain limited. This study aimed to estimate the prevalence of nutritional risk at hospital admission and to evaluate factors associated with nutritional risk and its clinical consequences. <b>Methods</b>: The REGIO registry is a national multicentre prospective cohort including adult patients with solid tumours admitted to medical oncology departments in 17 Spanish hospitals between February 2024 and January 2025. Nutritional risk was assessed within the first working day of hospitalisation using the Malnutrition Screening Tool (MST), with a score ≥ 2 indicating nutritional risk. Multivariable logistic regression models were used to identify factors associated with nutritional risk and its association with prolonged hospital stay and mortality. <b>Results</b>: A total of 1229 patients were included (median age 67.8 years; 59% male; 64% metastatic disease). Nutritional risk was identified in 53% of patients. In multivariable analysis, poorer functional status, tumour progression, recent exposure to cytotoxic chemotherapy, and tumour types with higher nutritional impact were independently associated with nutritional risk. Patients at nutritional risk had longer hospital stays (median 10 vs. 7 days; <i>p</i> < 0.001), a higher likelihood of prolonged hospitalisation (adjusted OR 1.38), and increased mortality at 30 days (adjusted OR 1.63) and 60 days after discharge (adjusted OR 1.53). <b>Conclusions</b>: In this large multicentre cohort, nutritional risk was highly prevalent and independently associated with worse clinical outcomes, supporting the clinical relevance of systematic nutritional screening at hospital admission in patients with cancer.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 8","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The NeuroImmunoEndocrine Circuit of Umami Peptides: A Systems Biology Approach.","authors":"Shiva Hemmati, Abdolali Mohagheghzadeh","doi":"10.3390/nu18081299","DOIUrl":"10.3390/nu18081299","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Umami peptides enhance flavor and contribute to appetite regulation (satiety) and metabolic health. By signaling to the orbitofrontal cortex, umami has been shown to improve cognitive function in Alzheimer's disease dementia. This taste boosts the immune system and induces saliva secretion. However, the molecular mechanisms linking umami peptides to systemic physiology remain poorly understood. This study provides the first integrated analysis of neurological, immunological, and endocrinological pathways activated by umami peptides. <b>Methods</b>: Novel umami peptides were identified using machine-learning and deep-learning analyses from a library of marine-derived bioactive peptides. T1R1-T1R3 heterodimer is the dominant receptor for umami taste transmission in humans, expressed on taste cells, intestinal cells, and hypothalamic tanycytes. Molecular docking confirmed the binding of novel ligands to the T1R1-T1R3 receptor complex. New candidates and experimentally validated umami peptides, identified by sensomics approaches from tauco, chicken soup, pufferfish, and dry-cured ham, were analyzed using gene ontology. <b>Results</b>: The functional enrichment analysis revealed crosstalk among key signaling processes, including glutamatergic and opioidergic pathways. In addition to the role of µ1 opioid receptor (OPRM1), hub gene intersections highlight cholecystokinin (CCK), glucagon-like peptide 1 (GLP-1), and the anorexigenic pro-opiomelanocortin (POMC) neurons as potential regulators of the gut-brain axis in satiety signaling. Chemokine-encoding genes, melanin-concentrating hormone (MCH), oxytocin (OXT), and neurotensin (NTS) were other key target genes. <b>Conclusions</b>: The identified targets reveal the coordinated crosstalk between peripheral and central umami signaling that may contribute to the regulation of feeding behavior, satiety, cognition, memory, learning, and immune function. These network-based insights generate hypotheses and guide the design of nutritional and drug-like effectors for metabolic and cognitive health.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 8","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Effectiveness of Pharmacological and Non-Pharmacological Interventions for Nausea and Vomiting in Pregnancy: A Systematic Review and Network Meta-Analysis.","authors":"Lőrinc Frivaldszky, Mahmoud Obeidat, Péter Hegyi, Csongor Kárpáti, Zoltán Kobza, Nándor Ács, Ferenc Bánhidy, Gergely Agócs, Boglárka Lilla Szentes, Márton Keszthelyi","doi":"10.3390/nu18081293","DOIUrl":"10.3390/nu18081293","url":null,"abstract":"<p><p><b>Background:</b> Nausea and vomiting in pregnancy affects up to 80% of pregnant women and may progress to hyperemesis gravidarum, leading to maternal morbidity and adverse pregnancy outcomes. Despite numerous pharmacological and non-pharmacological options, the comparative efficacy and safety of these interventions remain unclear. <b>Methods:</b> We conducted a systematic review and network meta-analysis of randomized controlled trials assessing pharmacological and non-pharmacological interventions for nausea and vomiting in pregnancy. The databases searched included CENTRAL, PubMed, and EMBASE (up to 28 May 2024). Eligible trials compared interventions with a placebo in pregnant women with nausea and vomiting in pregnancy. The primary outcomes were symptom severity, assessed using validated tools. Safety outcomes included adverse effects. Data were pooled using frequentist pairwise and network meta-analyses. The risk of bias was assessed using the RoB2 tool, and the certainty of evidence was evaluated using the CINeMA framework. <b>Results:</b> Of 9844 records screened, 24 randomized controlled trials (3017 participants) met the inclusion criteria, encompassing 16 intervention categories. Network analysis ranked quince, vitamin B6 with pomegranate and mint, acupressure P6, dimenhydrinate, and acupuncture combined with doxylamine-pyridoxine as the most effective interventions for reducing symptoms of nausea and vomiting in pregnancy, with considerable uncertainty and low-to-moderate quality of evidence. Reporting of adverse events was limited. Risk of bias was low to moderate. <b>Discussion:</b> Most interventions demonstrated significant benefit over a placebo. However, high heterogeneity and sparse reporting of adverse effects warrant caution when translating these results into clinical practice. <b>Conclusions:</b> This study indicates that both pharmacological (vitamin B6, metoclopramide, dimenhydrinate) and non-pharmacological (ginger, quince, acupressure, acupuncture) interventions might be effective in reducing symptoms of nausea and vomiting in pregnancy.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 8","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Konjac Glucomannan-Montmorillonite Hybrids as a Gut-Targeted Therapy for Addressing Diet-Induced Obesity in Mice.","authors":"Amin Ariaee, Hannah R Wardill, Alex Hunter, Anthony Wignall, Aurelia S Elz, Amanda J Page, Clive Prestidge, Paul Joyce","doi":"10.3390/nu18081298","DOIUrl":"10.3390/nu18081298","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The growing prevalence of obesity necessitates innovative gut-targeted material strategies to modulate diet-associated metabolic dysfunction. This study investigates a spray-dried konjac glucomannan-montmorillonite (KGM-MMT) hybrid designed to integrate fermentable polysaccharide properties with luminal lipid-adsorptive clay functions within a single micro-engineered formulation. <b>Methods:</b> In HFD-fed mice treated for 42 days with 2% <i>w</i>/<i>w</i> KGM-MMT, cumulative body weight gain was attenuated by 7.6%, with an AUC of 5094 ± 52.95, compared to 5513 ± 81.35 in HFD controls (<i>p</i> < 0.0001). <b>Results:</b> Serum IL-6 concentrations were reduced by 97% (<i>p</i> = 0.0002), while blood glucose decreased by 46% (<i>p</i> < 0.0001); these effects were greater than those observed with MMT (24%, <i>p</i> = 0.0271) and KGM (16%, ns). Gut microbiota profiling demonstrated a significant 6.2-log₂-fold increase in <i>Lactobacillaceae</i> (<i>p</i> = 0.023) and a 2.4-log₂-fold increase in <i>Enterococcaceae</i> (<i>p</i> = 0.015) following KGM-MMT treatment. Functional shifts inferred from 16S rRNA gene-based prediction indicated a 1.9-fold increase in short-chain fatty acid-related pathways and a 5.4-fold increase in bile acid deconjugation pathways. <b>Conclusions:</b> Although the KGM-MMT hybrid did not consistently outperform its individual components across all endpoints, it consolidated complementary KGM- and MMT-associated effects within a single dosage form. These findings support spray-dried KGM-MMT as a gut-targeted biomaterial strategy that integrates multiple luminal and microbiota-associated functions within a single formulation. Future studies should define dose-response relationships, validate microbiota-derived functional predictions using higher-resolution approaches, and assess durability and safety under longer-term exposure.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 8","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Glycaemic Thresholds: Towards a Comprehensive Metabolic Understanding of Gestational Diabetes.","authors":"Sarah Stromberger, Andrea Tura, Christian Göbl","doi":"10.3390/nu18081295","DOIUrl":"10.3390/nu18081295","url":null,"abstract":"<p><p>Gestational diabetes mellitus (GDM) is increasingly recognised as a condition not defined by glucose thresholds alone, but as a manifestation of broader metabolic dysregulation [...].</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 8","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feeding Recovery in Post-PICU Patients: A Case Series in an Intensive Feeding Program.","authors":"Tariq Almanaseer, Ellen Hayhurst, Jessica B Doorn, Ashley Bonebrake, Brooke Dudick, Elizabeth A Rosner, Nancy F Bandstra, Mara L Leimanis-Laurens","doi":"10.3390/nu18081291","DOIUrl":"10.3390/nu18081291","url":null,"abstract":"<p><strong>Background/objectives: </strong>Survival after pediatric intensive care unit (PICU) admission has improved, yet many children experience post-intensive care syndrome in pediatrics (PICS-p), including persistent feeding difficulties that impair growth and quality of life. An intensive feeding program (IFP), also known as intensive interdisciplinary behavioral treatment (IIBT), reduces tube dependence and improves oral intake; however, outcomes in PICU survivors remain understudied. This study aimed to evaluate feeding outcomes in children with prior PICU admission who completed IIBT.</p><p><strong>Methods: </strong>This study was a retrospective case series of children (0-18 years) admitted to the HDVCH, Corewell Health, Grand Rapids, Michigan, who subsequently completed IIBT (from 2007 to 2024). Variables included demographics, PICU course (admission indication, complications, length of stay, ventilation, and nutrition status) and IIBT outcomes (feeding modality, oral skills, and malnutrition status). Feeding outcomes were compared pre- and post-IIBT.</p><p><strong>Results: </strong>Sixteen patients were included (62.5% female; mean age 1.44 ± 1.21 years). Primary PICU admission causes were post-operative recovery (68.8%) and acute respiratory failure (25%). PICU complications included acute respiratory failure (43.8%) and the need for respiratory support beyond baseline (62.5%). At PICU discharge, 75% remained tube-fed and 18.8% were malnourished. The mean time from PICU discharge to IIBT initiation was 641 ± 385 days. At IIBT baseline, 75% were tube-fed and all were non-self-feeders. Following IIBT completion (mean length of stay 4.8 ± 0.9 weeks), 58% of tube-fed patients achieved tube removal eligibility; 44% transitioned to partial or full self-feeding; problematic mealtime behaviors decreased (45.7% → 9.9%); oral acceptance improved (62% → 95%); and mouth clearance improved (59% → 96%). Malnutrition prevalence decreased (20% → 12%).</p><p><strong>Conclusions: </strong>Children with prior PICU admission demonstrated substantial feeding and behavioral improvement during IIBT participation, with over half achieving tube-weaning eligibility. The time from referral to program start reflects barriers that delay intervention.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 8","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcomes of Mediterranean-Adapted Crohn's Disease Exclusion Diet in Mild Pediatric Crohn's Disease: A Real-Life Study from a Referral IBD Center.","authors":"Patrizia Alvisi, Maria Chiara Valerii, Enrico Perre, Gilda Barbieri, Fernando Rizzello, Marco Congiu, Arianna Pranzetti, Nikolas Kostantine Dussias, Francesca Sbravati, Veronica Imbesi, Enzo Spisni, Flavio Labriola","doi":"10.3390/nu18081290","DOIUrl":"10.3390/nu18081290","url":null,"abstract":"<p><p><b>Background</b>: Exclusive enteral nutrition (EEN) is the recommended first-line therapy for induction of remission in pediatric mild-to-moderate Crohn's disease (CD), but its restrictive nature often limits adherence and long-term sustainability. A modified version of the Crohn's Disease Exclusion Diet (CDED), integrating Mediterranean dietary principles, was developed to offer a more acceptable alternative while preserving therapeutic efficacy. <b>Methods</b>: We conducted a retrospective, single-center study comparing short- and long-term outcomes of a Mediterranean-adapted CDED (M-CDED) with partial enteral nutrition (PEN) versus standard EEN in children with mild-to-moderate CD. Clinical remission was assessed after 8 and 16 weeks, while long-term outcomes were assessed after 1 and 2 years. <b>Results</b>: Data collected from thirty-two patients were analyzed (EEN, 14; M-CDED, 18). Clinical remission rates were comparable after 8 weeks (92.8% EEN vs. 94.4% M-CDED) and 16 weeks (100% in both groups). However, at 12 and 24 months, M-CDED was associated with significantly higher rates of clinical and biochemical remission and a markedly lower need for biologic drugs (12-month biologic initiation: 50% EEN vs. 11.1% M-CDED; <i>p</i> = 0.01). Adherence to M-CDED was excellent throughout follow-up. <b>Conclusions</b>: M-CDED with PEN appears to be as effective as EEN for remission induction, with improved long-term disease control and reduced therapeutic escalation. These findings support the feasibility of M-CDED as a sustainable option for long-term management of pediatric CD. Prospective studies are needed to confirm these results.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 8","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13119448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}