Clinical Nutrition Open Science最新文献

{"title":"Time-restricted periodic fasting: A revolutionary approach to combat obesity by enhancing Bcl-2 pro-survival proteins","authors":"Nurma Yuliyanasari ,&nbsp;Hayuris Kinandita Setiawan ,&nbsp;Adi Pranoto ,&nbsp;Nabilah Izzatunnisa ,&nbsp;Eva Nabiha Zamri ,&nbsp;Muhammad Miftahussurur ,&nbsp;Purwo Sri Rejeki","doi":"10.1016/j.nutos.2025.08.006","DOIUrl":"10.1016/j.nutos.2025.08.006","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Obesity is a global health issue related to many physiological functions such as apoptosis and requires specific treatment approaches, especially in nutrition or diet modification. Our study aims to investigate the effects of time-restricted periodic fasting (TRPF) on the obesity phenotype and Bcl-2 pro-survival proteins in overweight or obese adults.</div></div><div><h3>Methods</h3><div>A quasi-experimental study was conducted in 38 young adult men with obesity and overweight. Participants were separated into a control group (CG) and a time-restricted periodic fasting group (PFG). Anthropometric and body composition measurements measured obesity phenotype, whereas B cell lymphoma 2 (Bcl-2) levels were measured by enzyme-linked immunosorbent assay (ELISA) test.</div></div><div><h3>Results</h3><div>A 10-day TRPF intervention could significantly reduce obesity phenotypes such as body weight (BW) (<em>P</em> = 0.00), body mass index (BMI) (<em>P</em> = 0.00), waist circumference (WC) (<em>P</em> = 0.00), waist-to-height ratio (WtHR) (<em>P</em> = 0.01), visceral fat level (VFL) (<em>P</em> = 0.01) and significantly reduced Bcl-2 levels (4.73 ± 4.96 ng/mL) compared to the pretest (5.49 ± 5.94 ng/m; <em>P</em> &lt; 0.05). There was a significant negative correlation between Δ in Bcl-2 levels with certain obesity phenotypes such as waist hip ratio (WHR) (β = -0.35; <em>P</em> &lt; 0.05), BMI (β = -0.35; <em>P</em> &lt; 0.05), body fat (BF) (β = -0.33; <em>P</em> &lt; 0.05), and visceral fat level (VFL) (β = -0.34; <em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>TRPF could reduce some parameters of obesity phenotype. These effects might be related to increased levels of Bcl-2, an anti-apoptotic parameter in young and overweight/obese adult men.</div></div>","PeriodicalId":36134,"journal":{"name":"Clinical Nutrition Open Science","volume":"63 ","pages":"Pages 304-314"},"PeriodicalIF":0.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of bone mineral density in Vietnamese adults: A multifactorial analysis","authors":"Bui Thi Thuy ,&nbsp;Nguyen Trong Hung ,&nbsp;Nguyen The Anh ,&nbsp;Nguyen Thanh Trung ,&nbsp;Nguyen Ngoc Oanh ,&nbsp;Pham Thi Thanh Huyen ,&nbsp;Ngo Thi Ha Phuong ,&nbsp;Vu The Loc ,&nbsp;Phan Hoang Hiep ,&nbsp;Tran Thanh Duong","doi":"10.1016/j.nutos.2025.08.004","DOIUrl":"10.1016/j.nutos.2025.08.004","url":null,"abstract":"<div><h3>Background</h3><div>Bone mineral density (BMD) is demonstrated to be affected by many factors. This study aims to elucidate the relationships between BMI, socioeconomic, biochemical factors and BMD at the spine, hip, and femoral neck sites in Vietnamese adults.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted on 258 women and 90 men. BMD was measured at three skeletal sites by DXA. Generalized linear regression models were used to assess the independent associations of the aforementioned factors with BMD, adjusting for relevant confounders.</div></div><div><h3>Results</h3><div>Higher BMI positively correlated with BMD at all three skeletal sites in women while only shown at the hip (beta=0.016, p&lt;0.001) and femoral neck (beta=0.013, p&lt;0.001) in men. The relation between higher BMI and women spine BMD becomes non-linear after adjusting by relevant confounders (p&lt;0.05). Older age was positively associated with women spine BMD (beta=0.003, p&lt;0.001), and spine (beta=0.004, p&lt;0.05) and femoral neck BMD (beta=0.003, p&lt;0.05) in men. Higher calcium/vitamin D3 were positively associated with women spine BMD and men hip BMD (p&lt;0.05). Higher serum zinc showed a negative association with spine BMD in both genders, women hip BMD (beta=−0.011, p=0.022) and men femoral neck BMD (beta=−0.007, p=0.05).</div></div><div><h3>Conclusion</h3><div>Higher BMI consistently correlated with greater BMD, especially at the hip and femoral neck, in both sexes. Age and calcium/vitamin D3 showed positive associations with BMD at specific sites while higher serum zinc was negatively associated with BMD in both genders. These findings underscore the multifaceted influences on bone health in Vietnamese adults, necessitating longitudinal studies.</div></div>","PeriodicalId":36134,"journal":{"name":"Clinical Nutrition Open Science","volume":"63 ","pages":"Pages 213-225"},"PeriodicalIF":0.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resting energy expenditure in patients with COPD: Agreement between predicted equations and indirect calorimetry","authors":"Santi Silairatana ,&nbsp;Sirakarn Tejavanija","doi":"10.1016/j.nutos.2025.08.001","DOIUrl":"10.1016/j.nutos.2025.08.001","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Accurate, individualized energy and protein, as well as other nutrient components, are highly important to improve the nutritional status and increase muscle mass in COPD patients, particularly those having nutritional depletion and experiencing a loss of lean body mass. Despite having a high degree of accuracy, the determination of energy requirement using indirect calorimetry (IC) is often limited by its availability and therefore predictive equations are used as alternatives. This study aims to determine agreements between measured REE using IC and estimated REE obtained from predictive equations that are commonly used in clinical practice among COPD patients, both with and without malnutrition or sarcopenia.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A cross-sectional study was conducted among clinically- and spirometry-confirmed COPD patients from August 2022 to January 2023. IC, bioelectrical impedance analysis, anthropometry, handgrip strength measurement as well as biochemical tests (serum albumin, ESR and CRP) were performed in all participants to collect data for analysis of correlation and agreement between two methods. The predictive equations tested included the Harris-Benedict, Schofield, Institute of Medicine, Mifflin St Jeor, Westerterp, Morikawa, and Moore &amp; Angelilo equations. The differences of energy expenditure between groups with and without malnutrition or sarcopenia were tested statistically using an independent-sample t-test and Mann-Whitney U test, while correlations, as well as degree of agreement between methods were analyzed and reported using Bland-Altman plots. The significant two-tailed &lt;em&gt;P&lt;/em&gt; value was set at &lt;0.05.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 84 patients with COPD (25% women) were included in the study. the average age was 71±14 years. The average spirometric values were as follows: FEV1/FVC 61.5±9%, FEV1 64±15% of predicted, and FVC 85.52±13.9% of predicted. Among the COPD patients with sarcopenia, the average REE was significantly lower than patients without sarcopenia (1154±238 kcal/day vs 1230±234 kcal/day, &lt;em&gt;P&lt;/em&gt;=0.01). No statistically significant differences of the average measured REE between COPD patients with and without malnutrition or high inflammatory markers was observed. Bland-Altman plots demonstrated that, among the equations tested, estimated REE using Westerterp equation provided the highest accuracy rate (58.3%) followed by the Scofield equation (57.1%) with the bias and limit of agreement of 26 kcal/day and -288 to +340 kcal/day for Westerterp and +32 kcal/day and -353 to +289 kcal/day for Schofield equation, respectively.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Estimation of REE using Schofield and Westerterp equation provides better accuracy rate and lower level of bias in COPD patients across various clinical conditions and may be used for estimation when IC is not available. When FFM measurement is available, Nordenson equation pro","PeriodicalId":36134,"journal":{"name":"Clinical Nutrition Open Science","volume":"63 ","pages":"Pages 226-237"},"PeriodicalIF":0.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food consumption pattern and management of type 2 diabetic patients treated in Dschang District Hospital","authors":"Gisèle Mélanie Dongmo Agokeng ,&nbsp;Donald Sévérin Dangang Bossi ,&nbsp;Marc Bertrand Dandji Saah ,&nbsp;François Ngoufack Zambou","doi":"10.1016/j.nutos.2025.08.003","DOIUrl":"10.1016/j.nutos.2025.08.003","url":null,"abstract":"<div><div>Type 2 diabetes is a global health problem with high morbidity and mortality among patients, most of whom are still economically active. The prevalence of diabetes is increasing worldwide due to changes in eating habits and a reduction of physical activities. In order to determine the level of knowledge, attitude, and practices (KAP) in nutrition in type 2 diabetic (T2D) patients treated in Dschang District Hospital (DDH), West Cameroon, a cross-sectional study was conducted in 103 type 2 diabetic patients aged between 20 and 70 years and over. A structured questionnaire was administered by an interview to collect data. The sociodemographic characteristics showed that participants of ages ranging from 40–70 years were the most affected. Among them, 59.2 % were women and 35.9 % were housewives, whereas 43.7 % were found to have a primary education level. The participants' nutritional status revealed that the prevalence of overweight and obesity was high among married patients (84.2 % and 60.0 %, respectively). It was noted from the anthropometric assessment that the prevalence of obesity among the diabetic women surveyed (77.5 %) was significantly (<em>P</em> &lt; 0.05) higher than among men (22.5 %), while overweight was more prevalent in men (60.5 %). The KAP study showed that the level of education has a significant influence (<em>P</em> = 0.034) on diabetic nutrition practices, especially in primary and secondary level patients. The eating habits of patients confirmed these poor KAP with irregular consumption of fresh fruits and vegetables and daily restriction of basic foods. This investigation highlights the need to promote education in all social strata, with particular emphasis on nutritional education among housewives, where the prevalence of diabetes was highest.</div></div>","PeriodicalId":36134,"journal":{"name":"Clinical Nutrition Open Science","volume":"63 ","pages":"Pages 201-212"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrical muscle stimulation improves vastus medialis quality: A single-case experimental design","authors":"Yoshitsugu Tanino,&nbsp;Yuki Fukumoto,&nbsp;Wataru Yamazaki,&nbsp;Takaki Yoshida","doi":"10.1016/j.nutos.2025.07.013","DOIUrl":"10.1016/j.nutos.2025.07.013","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Studies have shown that qualitative changes, such as ectopic fat accumulation, are associated with muscle weakness and degeneration of the articular cartilage. This study aimed to investigate the effects and timing of electrical muscle stimulation on the vastus medialis using a single-case experimental design to evaluate improvement in muscle quality.</div></div><div><h3>Methods</h3><div>Three healthy males participated in this study. An “ABAB design” was employed over a 14-week period, alternating between baseline phases without electrical muscle stimulation (3 weeks each) and intervention phases with electrical stimulation (4 weeks each). Electrical muscle stimulation was applied to the vastus medialis for 30 min three times per week during the intervention phases. The intensity was adjusted to a tolerable level of discomfort. Sonographic echo intensity of the vastus medialis, reflecting intramuscular fat content, and body fat percentage were measured.</div></div><div><h3>Results</h3><div>During the first electrical muscle stimulation phase, the effect size based on the percentage of non-overlapping data in echo intensity was 0% for all three subjects compared to the baseline. However, during the second baseline phase, subjects A and C achieved 100% (indicating very effective changes). In the second electrical muscle stimulation phase, all subjects exhibited 100%. No significant changes in body fat percentage were observed during the study.</div></div><div><h3>Conclusions</h3><div>These findings suggest that electrical muscle stimulation must be sustained for at least 4 weeks to effectively reduce intramuscular fat and improve vastus medialis muscle quality.</div></div>","PeriodicalId":36134,"journal":{"name":"Clinical Nutrition Open Science","volume":"63 ","pages":"Pages 174-191"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent and predictive validity of nutritional screening tools in hospitalized pediatric patients: Protocol for a single-center, prospective, observational study","authors":"Maria Camila Arbeláez Grajales ,&nbsp;Dianna Ramírez-Prada ,&nbsp;Frank Carrera-Gil","doi":"10.1016/j.nutos.2025.07.012","DOIUrl":"10.1016/j.nutos.2025.07.012","url":null,"abstract":"<div><h3>Background and aim</h3><div>Early identification of nutritional risk is essential in the care of hospitalized children. Although several screening tools exist, evidence on their performance in identifying at-risk patients and predicting nutrition-related outcomes remains limited, especially in non-Caucasian populations. This protocol outlines the rationale and methods to assess the concurrent and predictive validity of nutritional screening tools in hospitalized pediatric patients.</div></div><div><h3>Methods</h3><div>This prospective diagnostic accuracy study will enroll at least 204 patients aged 2–17 years, consecutively admitted to the emergency department of a tertiary pediatric hospital in Colombia and expected to remain hospitalized for ≥3 days. Within 48 hours of admission, nutritional risk will be assessed using STRONGkids, PYMS, and WHO criteria, alongside the Subjective Global Nutritional Assessment (SGNA) as the reference standard. The primary outcome is the concurrent validity of each screening tool to detect disease-related malnutrition, assessed via sensitivity, specificity, predictive values, likelihood ratios, and Kappa coefficient. Secondary outcomes include time to complete each tool and associations between baseline nutritional status, clinical outcomes, and sociodemographic variables. Predictive validity will be analyzed through ROC curves and area under the curve (AUC) values for each tool using a composite adverse outcome: ICU admission, hospital stay ≥7 days, in-hospital mortality within 30 days, and infectious complications.</div></div><div><h3>Discussion</h3><div>This study will generate prospective evidence on the diagnostic accuracy of widely used pediatric screening tools, using an appropriate reference method. Findings may help identify the most effective tool for early nutritional risk detection in underrepresented pediatric populations.</div></div>","PeriodicalId":36134,"journal":{"name":"Clinical Nutrition Open Science","volume":"63 ","pages":"Pages 192-200"},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of nutrition knowledge questionnaire for cancer-related anorexia and cachexia syndrome in Taiwanese patients with cancer","authors":"Tzu-Fang Chen ,&nbsp;Tsae-Jyy Wang ,&nbsp;Shu-Yuan Liang ,&nbsp;Chieh-Yu Liu ,&nbsp;Shiow-Chwen Tsai ,&nbsp;Gwo-Chi Hu","doi":"10.1016/j.nutos.2025.07.011","DOIUrl":"10.1016/j.nutos.2025.07.011","url":null,"abstract":"<div><h3>Background</h3><div>Cancer remains a leading cause of mortality worldwide, with over half of patients dying from cancer-related anorexia–cachexia syndrome (CACS). CACS is characterized by progressive weight loss and reductions in muscle and/or fat mass and considerably affects quality of life, prognosis, treatment tolerance, and length of hospitalization. Nutritional consultation or education is a key strategy for managing cancer-related cachexia. However, its effectiveness is determined by several factors, such as patients' nutritional knowledge. To date, no standardized tool has been developed for assessing the nutrition knowledge of patients with cancer specific to CACS. This study developed and validated the Cancer-Related Anorexia and Cachexia Syndrome Nutrition Knowledge Questionnaire (CACSNKQ) to assess patients' understanding of nutrition in the context of cachexia.</div></div><div><h3>Method</h3><div>The initial version of the CACSNKQ comprised 35 items. The validation process involved content validity assessment, item analysis, reliability testing by using the Kuder–Richardson Formula 20 (KR-20), and the criterion-groups technique. Exploratory factor analysis was conducted to identify underlying factors and refine the questionnaire by eliminating items with low factor loadings or cross loadings.</div></div><div><h3>Result</h3><div>The CACSNKQ was validated in a sample of 203 participants. The content validity analysis revealed that item-level content validity indices exceeded 0.80, and internal consistency was strong, with the KR-20 coefficient being &gt;0.80. The exploratory factor analysis yielded a Kaiser–Meyer–Olkin coefficient of 0.869. Following the analysis, the questionnaire was refined to include 21 items, with higher scores indicating greater knowledge of cachexia-related nutrition.</div></div><div><h3>Conclusion</h3><div>The CACSNKQ is a valid and reliable instrument for assessing cachexia-related nutrition knowledge. In clinical practice, this tool can enhance awareness among patients and health-care providers regarding the importance of nutritional knowledge in managing CACS. In academic and research contexts, it can serve as a valuable tool for evaluating the effectiveness of nutrition education programs.</div></div>","PeriodicalId":36134,"journal":{"name":"Clinical Nutrition Open Science","volume":"63 ","pages":"Pages 143-160"},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144766894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower RXRA and TFRC expression despite higher mineral and vitamin intake in diabetic pregnant women with pregnancy-specific urinary incontinence","authors":"Sarah Maria Barneze Costa ,&nbsp;Raghavendra Lakshmana Shetty Hallur ,&nbsp;Matheus Naia Fioretto ,&nbsp;João Paulo de Castro Marcondes ,&nbsp;Igor de Carvalho Deprá ,&nbsp;Camila Renata Corrêa ,&nbsp;Danielle Cristina Honorio França ,&nbsp;David Rafael Abreu Reyes ,&nbsp;Sérgio Luis Felisbino ,&nbsp;Angélica Mércia Pascon Barbosa ,&nbsp;Marilza Cunha Vieira Rudge","doi":"10.1016/j.nutos.2025.07.010","DOIUrl":"10.1016/j.nutos.2025.07.010","url":null,"abstract":"<div><h3>Background</h3><div>Gestational diabetes mellitus (GDM) and pregnancy-specific urinary incontinence (PSUI) pose significant health challenges for pregnant women, but their metabolic and molecular underpinnings remain poorly understood.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, 1,105 participants from the DIAMATER cohort were categorized based on GDM and PSUI status. Dietary intake of iron, magnesium, zinc, and vitamins A and D was assessed through dietary recalls, while serum levels, gene expression (MTF1, RXRA, TFRC, TRPM6), and protein expression were analyzed using standard techniques. Oxidative stress markers were also measured.</div></div><div><h3>Results</h3><div>GDM-PSUI participants exhibited lower RXRA and TFRC gene expression and decreased TFRC protein levels despite higher intake of magnesium, zinc, and vitamin D compared to GDM controls without PSUI. Serum mineral levels and oxidative stress markers did not differ significantly between groups.</div></div><div><h3>Conclusions</h3><div>Lower RXRA and TFRC expression in GDM-PSUI women, despite increased mineral and vitamin intake, suggests potential molecular targets for interventions aimed at improving management strategies in this population.</div></div>","PeriodicalId":36134,"journal":{"name":"Clinical Nutrition Open Science","volume":"63 ","pages":"Pages 113-130"},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of malnutrition and risk of malnutrition in complex chronic outpatients","authors":"M. Lecha ,&nbsp;C. Vaqué-Crusellas ,&nbsp;A. Peñalva-Arigita ,&nbsp;R. Prats ,&nbsp;A. Sansano ,&nbsp;D. Rubira ,&nbsp;M. Albareda ,&nbsp;L. Vila","doi":"10.1016/j.nutos.2025.07.006","DOIUrl":"10.1016/j.nutos.2025.07.006","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence of disease-related malnutrition (DRM) among Chronic Patients with Complex Needs (CPCN), (a population characterised by multimorbidity, functional decline, and frequent health and social needs), remains poorly established in hospital outpatients settings. These individuals, often older and frail, are presumed to be at higher risk of suffering malnutrition. The Mini Nutritional Assessment (MNA), validated for use in older and frail adults, identifies individuals who are malnourished as well as those at risk of malnutrition (RM).</div></div><div><h3>Objectives</h3><div>1. To determine the prevalence of DRM and RM in CPCN outpatients. 2. To analyse the association between DRM and RM and a set of clinical, dietary, and social factors relevant to this population.</div></div><div><h3>Methods</h3><div>Single-centre observational study conducted over a cross-sectional period (June 2022–January 2023). Consecutive sampling was used from the CPCN outpatient registry, a clinical listing used to monitor patients receiving specialised chronic care follow-up. Inclusion criteria: outpatients, ≥18 years, CPCN, life expectancy ≥1 year, living at home. Exclusion criteria: enteral nutrition, dementia GDS ≥5. Variables: gender, age, nutritional status (MNA), education, living alone/accompanied, risk of dysphagia (EAT-10), dental status, adherence to Mediterranean diet (MEDAS), exercise time (walking ≥30 minutes or other similar exercise) and quality of life (EuroQoL).</div></div><div><h3>Results</h3><div>N=340 patients. Mean age=80.8 years (SD 6.6), 51% female. Ninety percent had only primary education or non, and 23.5% lived alone. Quality of life had a mean score of 61/100 (SD: 17.3). Risk of dysphagia found in 20.6% and 38.2% had missing teeth or teeth in poor condition. While 66.8% adhered correctly to the Mediterranean diet, 55% did not exercise regularly. The prevalence of RM was 31.7% (95% CI: 31.2 to 32.3) with 10.9% being malnourished (95% CI: 10.3 to 11.46). In the multivariate analysis, RM was independently associated with being female (OR: 1.894; 95% CI: 1.102–3.255; <em>P</em>=0.021), the presence of risk of dysphagia (OR: 2.375; 95% CI: 1.241–4.545; <em>P</em>=0.009), teeth in poor condition (OR: 2.897; 95% CI: 1.609–5.217; <em>P</em>&lt;0.001) and non-adherence to the Mediterranean diet (OR: 3.595; 95% CI: 2.034–6.354; <em>P</em>&lt;0.001). The DRM was independently associated with being the presence of risk of dysphagia (OR: 2.722; 95% CI: 1.127–6.573; <em>P</em>=0.026) and non-adherence to the Mediterranean diet (OR: 4.428; 95% CI: 2.005–9.781; <em>P</em>&lt;0.001).</div></div><div><h3>Conclusions</h3><div>There is a high prevalence of CPCN with DRM and RM in the outpatient setting. The results reinforce the need to establish nutritional strategies aimed at improving eating habits and nutritional status in this vulnerable group of people.</div></div>","PeriodicalId":36134,"journal":{"name":"Clinical Nutrition Open Science","volume":"63 ","pages":"Pages 131-142"},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity of NRS-2002, MUST, MST, and MNA-SF as first-step screening tools for malnutrition based on GLIM criteria in older adults","authors":"Xuan Le Thi Thanh ,&nbsp;Phuong Duong Thi ,&nbsp;Huong Le Thi ,&nbsp;Toi Phung Lam ,&nbsp;Dung Nguyen Quang ,&nbsp;Lan Nguyen Thi Huong ,&nbsp;Thuc Luu Thi My ,&nbsp;Hong Nguyen Thi Thuy","doi":"10.1016/j.nutos.2025.07.008","DOIUrl":"10.1016/j.nutos.2025.07.008","url":null,"abstract":"<div><h3>Background</h3><div>According to the Global Leadership Initiative on Malnutrition (GLIM), screening for malnutrition risk using a validated tool is the first essential step in the diagnostic process. This study aimed to compare the diagnostic performance of four commonly used tools - Mini Nutritional Assessment Short Form (MNA-SF), Nutritional Risk Screening 2002 (NRS-2002), Malnutrition Screening Tool (MST), and Malnutrition Universal Screening Tool (MUST) as a first-step screening instrument for hospitalized older adults according to the GLIM criteria.</div></div><div><h3>Methods</h3><div>A prospective cross-sectional study was conducted among 200 hospitalized elderly patients at Hanoi Medical University Hospital, Vietnam, between September and December 2023. Nutritional risk was screened at admission using MNA-SF, NRS-2002, MST, and MUST. Malnutrition was diagnosed using GLIM criteria and full MNA.</div></div><div><h3>Results</h3><div>Of the 200 patients, malnutrition risk or malnutrition was identified in 65.0% by MNA-SF, 45.0% by MST, 45.5% by MUST, and 45.0% by NRS-2002. According to full MNA, 58.5% of patients were at risk of malnutrition, and the prevalence of malnutrition based on GLIM criteria (without prior screening) was 54.0%. Using different screening tools as the first step for GLIM, MNA-SF showed the best performance (sensitivity: 100%, specificity: 82.9%, AUC: 0.91), followed by MUST (AUC: 0.88), NRS-2002 (AUC: 0.87), and MST (AUC: 0.83). Agreement with GLIM-defined malnutrition was high for all tools (Cohen's kappa: 0.81–0.95), with the highest for NRS-2002 (kappa = 0.93).</div></div><div><h3>Conclusions</h3><div>All four screening tools showed good diagnostic performance for detecting malnutrition based on GLIM criteria. Among them, MNA-SF showed the highest accuracy, making it the most effective first-step tool for screening and detecting malnutrition in elderly hospitalized patients based on the GLIM criteria.</div></div>","PeriodicalId":36134,"journal":{"name":"Clinical Nutrition Open Science","volume":"63 ","pages":"Pages 99-112"},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}