American Journal of Clinical Nutrition最新文献

{"title":"A scoping review on the possible immunometabolic properties of the furan fatty acid metabolite 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid.","authors":"Ole Bæk, Björn Klabunde, Tingting Wang, Klaus Bønnelykke, Jakob Stokholm, Nicklas Brustad, Duc Ninh Nguyen, Bo Chawes","doi":"10.1016/j.ajcnut.2025.08.020","DOIUrl":"10.1016/j.ajcnut.2025.08.020","url":null,"abstract":"<p><p>Circulating levels of 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid (CMPF), a metabolite derived from dietary furan fatty acids primarily found in marine food sources, have long been recognized as biomarkers for fish intake. However, elevated CMPF levels are also observed in patients with type 2 diabetes or chronic kidney disease and in healthy people, associated with a reduced infection risk, suggesting potential bioactive roles in metabolism and immune function. Yet, the possible causal mechanisms behind these associations are unknown. The aim of this scoping review, derived from human observations as well as in vivo and in vitro experimental studies, is to present the hypothesis that CMPF has immunometabolic properties by providing an overview of the determinants of circulating CMPF levels and presenting the studies suggesting its influence on cellular energy metabolism, particularly through enhancing lipid β-oxidation, potentially via activation of peroxisome proliferator-activated receptors (PPARs). CMPF notably affects hepatic metabolism by increasing mitochondrial fatty acid utilization and promoting the expression of hepatokines such as fibroblast growth factor 21, which may exert systemic metabolic and anti-inflammatory effects. Additionally, elevated CMPF levels have complex impacts on pancreatic function, potentially impairing insulin secretion and modifying glucose homeostasis. These metabolic alterations in the liver and pancreas can indirectly influence immune responses, shaping energy metabolism within immune cells and enhancing anti-inflammatory phenotypes. Moreover, CMPF may also directly influence immune cell metabolism and function through PPAR activation. Epidemiological evidence further supports that elevated CMPF levels are associated with reduced susceptibility to infections. Collectively, there is compelling evidence supporting the hypothesis that CMPF is a bioactive metabolite with systemic metabolic and immunomodulatory effects, warranting further in-depth investigation.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The interplay of nutritional status and physical function on health outcomes in older adults: a longitudinal study in Singapore","authors":"Lixia Ge,&nbsp;Ruijie Li,&nbsp;Chun Wei Yap","doi":"10.1016/j.ajcnut.2025.07.014","DOIUrl":"10.1016/j.ajcnut.2025.07.014","url":null,"abstract":"<div><h3>Background</h3><div>Nutritional status and physical function are critical determinants of health and health-related quality of life (HRQoL) among older adults. However, their interplay and combined impact on multidimensional health outcomes remain underexplored.</div></div><div><h3>Objectives</h3><div>This study investigated the longitudinal associations of nutritional status and physical function with physical, mental, and social health, HRQoL, and self-reported health (SRH) in older adults.</div></div><div><h3>Methods</h3><div>A total of 699 community-dwelling older adults (≥60 y) identified from the Population Health Index Survey were followed annually over 3 y. Nutritional status was assessed using the Mini Nutritional Assessment, and physical function was measured via the Late-Life Function and Disability Instrument. Mixed-effect models were employed to assess independent and interaction effects of nutritional status and physical function on health outcomes, including frailty, depression, loneliness, HRQoL, and SRH, adjusting for sociodemographic and lifestyle covariates.</div></div><div><h3>Results</h3><div>Undernutrition was associated with higher odds of frailty {odds ratio [95% confidence ratio (CI)]: 8.94 (4.48, 17.87)}, depression [14.94 (7.63, 29.23)], and loneliness [5.13 (2.77, 9.53)], lower HRQoL [<em>β</em> (95% CI): –0.10 (–0.13, –0.07)] and SRH [–8.27 (–10.81, –5.73)] compared with well-nourished individuals. Lower physical function was similarly associated with poorer health outcomes. Including both nutritional status and physical function in the model attenuated the associations for nutritional status. Although their interaction term was not associated with most health outcomes, a significant interaction was found for HRQoL, where the negative impact of undernutrition on EQ-5D scores was greater among those with impaired physical function [interaction term <em>β</em> (95% CI): –0.12 (–0.17,–0.07)].</div></div><div><h3>Conclusions</h3><div>Both nutritional status and physical function are independently and interactively associated with health outcomes in older adults. These findings underscore the need for integrated interventions targeting both nutritional status and physical function to promote healthy aging and reduce frailty. Future research should explore the mediating role of physical function and evaluate strategies to optimize health outcomes in older adults.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 3","pages":"Pages 811-819"},"PeriodicalIF":6.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to F. Hamilton and G. Davey Smith","authors":"Elina Hyppönen ,&nbsp;Anwar Mulugeta ,&nbsp;Ang Zhou","doi":"10.1016/j.ajcnut.2025.04.037","DOIUrl":"10.1016/j.ajcnut.2025.04.037","url":null,"abstract":"","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 3","pages":"Pages 892-893"},"PeriodicalIF":6.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clarification and standardization of dual-energy X-ray absorptiometry terminology for accurate scientific communication and clinical diagnostic accuracy","authors":"Jonathan P Bennett ,&nbsp;Carla M Prado ,&nbsp;Maria Cristina Gonzalez ,&nbsp;Steven B Heymsfield","doi":"10.1016/j.ajcnut.2025.06.023","DOIUrl":"10.1016/j.ajcnut.2025.06.023","url":null,"abstract":"<div><div>The evaluation of skeletal muscle (SM) mass has significant clinical and research relevance in the diagnosis and management of conditions, such as malnutrition, sarcopenia, sarcopenic obesity, and cancer cachexia. Dual-energy X-ray absorptiometry (DXA) is now the most widely used method for estimating SM mass; however, it does not directly measure SM but instead provides proxies that require careful interpretation. A major issue in the field is the inconsistent and sometimes incorrect use of DXA-derived terminology in both scientific literature and clinical practice, leading to potential misdiagnoses and inaccurate research conclusions. This review highlights the importance of using proper terminology and the errors that arise when DXA-based estimates of SM mass are misrepresented. Focusing on the appendicular regions, where most SM is located, we first describe the principles of DXA measurement, including its ability to quantify appendicular lean soft tissue (ALST) and appendicular lean mass (ALM) and their relationship to appendicular skeletal muscle (ASM). We then examined inconsistencies in manufacturer-reported DXA outputs and common reporting errors in the literature, particularly the interchangeable use of ALST and ASM. Additionally, we present data demonstrating how these inconsistencies impact the clinical assessment of sarcopenia and influence population-level prevalence estimates. ALM refers to all nonfat components of the arms and legs, whereas ALST also removes bone mass. Both measures include non-SM components and are, therefore, larger than SM. To address the use of these terms, we propose standardizing DXA terminology and reporting practices in both research and clinical settings. We also highlight the importance of consistent terminology in other clinical and field-based methods of body composition assessment, including bioelectrical impedance analysis and 3-dimensional optical imaging. These recommendations will enhance the clarity of SM-related measures (e.g., ALST, ALM), improve diagnostic accuracy, and facilitate meaningful comparisons across studies.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 3","pages":"Pages 661-670"},"PeriodicalIF":6.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of an ecological approach to address micronutrient malnutrition","authors":"Daniel J Raiten ,&nbsp;Jose M Saavedra ,&nbsp;Gerald F Combs Jr. ,&nbsp;Omar Dary ,&nbsp;Emily Levin ,&nbsp;Andrew A Bremer","doi":"10.1016/j.ajcnut.2025.07.006","DOIUrl":"10.1016/j.ajcnut.2025.07.006","url":null,"abstract":"<div><div>The global public health context has become increasingly complex with the confluence of widespread infectious and noncommunicable diseases, and widespread food insecurity, which has led to alarming rates of hunger and multiple consequences of malnutrition. A key component of this complexity is prevalent deficiencies of micronutrients (MNs, i.e., essential vitamins and minerals), many of which have been overlooked in public health programs addressing malnutrition. Here, we lay out an approach to more comprehensively address this complexity by considering the interactions of internal (biology, health, and developmental context) and external (diet/food environment, social, economic, climate, and physical) environments on humans and their nutritional health, i.e., an ecology. We present a conceptual framework for applying this ecological perspective with foci on the following: <em>1</em>) how to apply this approach to assessments that capture the complexity of the nutritional ecology; and <em>2</em>) how to expand the understanding of the biology of MNs in biological systems and the environmental factors that influence them. Suggestions are included for a targeted clinical, public health, and research agenda to inform the development of context-specific nutritional assessment and interventions.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 3","pages":"Pages 695-702"},"PeriodicalIF":6.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma chylomicron-rich lipidomic and fatty acid profile following a meat or analog meal in healthy males: A randomized controlled trial","authors":"Toan Pham ,&nbsp;Lillian Morton ,&nbsp;Nicola Gillies ,&nbsp;Emma Bermingham ,&nbsp;Scott Knowles ,&nbsp;David Cameron-Smith ,&nbsp;Andrea J Braakhuis","doi":"10.1016/j.ajcnut.2025.07.010","DOIUrl":"10.1016/j.ajcnut.2025.07.010","url":null,"abstract":"<div><h3>Background</h3><div>The composition of a meal impacts the digestion and absorption of dietary fats, potentially affecting their role in cardiovascular and chronic disease risk.</div></div><div><h3>Objectives</h3><div>To compare the fatty acid concentrations, including long-chain ω-3 fatty acids, the lipidome, and lipids in response to a meal containing grain-fed beef, pasture-fed beef, lamb, or Beyond Burger [plant-based meat alternatives (PBMA)].</div></div><div><h3>Methods</h3><div>We conducted a randomized crossover trial where healthy males (<em>n</em> = 27) consumed a standardized burrito-style meal containing meat or an alternative matched for protein and carbohydrate content on 4 separate occasions, with a minimum washout period of 1-wk. Blood samples were collected before the meal and hourly for 4 h after the meal. The changes in the fatty acid distribution, the lipidome of the chylomicron-rich fraction, and plasma lipids were analyzed.</div></div><div><h3>Results</h3><div>Linear mixed modeling and mixed effect analysis of variance showed significant changes in the fatty acid postprandial response following all meals (<em>P</em> &lt; 0.05) and subtle differences between meal types. Significant lipidomic features were predominantly triglyceride for time (89 of 223) and meal (63 of 66). Meat meals had higher lysophosphatidylcholines in the chylomicrons [χ²(3) = 6.00, <em>P</em> = 0.042; W = 0.074, 95% confidence interval (CI): 0.024, 1.030]. The grain beef and lamb showed a significantly lower triglyceride response in plasma compared to PBMA (grain: –0.346; 95% CI: –0.692, –0.0004; lamb: –0.458; 95% CI: –0.880, –0.034).</div></div><div><h3>Conclusions</h3><div>There are subtle differences in the lipid response to beef, lamb, and PMBA-containing meals.</div><div>This trial was registered at <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> as NCT04545398.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 3","pages":"Pages 770-779"},"PeriodicalIF":6.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to J Drouin-Chartier and J Lessard-Lord","authors":"Shunming Zhang ,&nbsp;J Gustav Smith ,&nbsp;Yan Borné ,&nbsp;Emily Sonestedt","doi":"10.1016/j.ajcnut.2025.07.001","DOIUrl":"10.1016/j.ajcnut.2025.07.001","url":null,"abstract":"","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 3","pages":"Pages 888-889"},"PeriodicalIF":6.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel strategies for medical management of obesity: mechanisms, clinical implications, and societal impacts—a report from the 25th Annual Harvard Nutrition Obesity Symposium","authors":"Gitanjali Srivastava ,&nbsp;Sophia L Campbell ,&nbsp;Conner R Hill ,&nbsp;Takara L Stanley ,&nbsp;Elizabeth A Lawson ,&nbsp;Caroline M Apovian ,&nbsp;Jaime P Almandoz ,&nbsp;Lorenzo Leggio ,&nbsp;Darius N Lakdawalla ,&nbsp;Mohammad Dar ,&nbsp;Carmela Socolovsky ,&nbsp;Fatima Cody Stanford ,&nbsp;Sarah Armstrong ,&nbsp;Steven K Grinspoon","doi":"10.1016/j.ajcnut.2025.06.015","DOIUrl":"10.1016/j.ajcnut.2025.06.015","url":null,"abstract":"<div><div>Obesity is a chronic, relapsing disease with a multifactorial etiology. Over the past 5 y, obesity medicine has entered a new era with the advent of novel, game-changing pharmacotherapies that achieve weight loss exceeding 15%–20%. Beyond weight loss, these powerful therapies offer additional benefits, such as cardiovascular improvements. These novel agents, such as glucagon-like peptide-1 receptor agonists, work by reducing appetite, slowing gastric emptying, and increasing feelings of fullness. Recent work also points out the potential role of these medications for other medical conditions, including addictive and neurodegenerative disorders. In June 2024, the National Institutes of Health-funded Nutrition Obesity Research Center at Harvard and the Harvard Medical School Division of Nutrition hosted their 25th annual Harvard Nutrition Obesity Symposium, titled “Novel Strategies for Medical Management of Obesity: Mechanisms, Clinical Implications, and Societal Impacts.” This paper synthesizes the symposium’s discussions, emphasizing the importance of innovative pharmacotherapeutic strategies in addressing the burden of obesity and the associated economic and social inequities, including disparities in access to care in adults and children.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 3","pages":"Pages 866-885"},"PeriodicalIF":6.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of regular oat β-glucan–enriched bread compared with whole-grain wheat bread on long-term glycemic control in adults at risk of type 2 diabetes: a randomized controlled trial","authors":"Therese Hjorth ,&nbsp;Alena Schadow ,&nbsp;Ingrid Revheim ,&nbsp;Ulrike Spielau ,&nbsp;Klara Meyer ,&nbsp;Anne Rieder ,&nbsp;Paula Varela ,&nbsp;Simon Ballance ,&nbsp;Antje Koerner ,&nbsp;Rikard Landberg ,&nbsp;Anette E Buyken ,&nbsp;Jutta Dierkes ,&nbsp;Hanne Rosendahl-Riise","doi":"10.1016/j.ajcnut.2025.06.018","DOIUrl":"10.1016/j.ajcnut.2025.06.018","url":null,"abstract":"<div><h3>Background</h3><div>A high intake of whole grains is associated with reduced risk of type 2 diabetes and cardiovascular disease, and soluble fiber from oats and barley, that is, β-glucans, has been shown to lower blood cholesterol and postprandial glycaemia. Despite such data and the European Food Safety Authority health claims supporting β-glucan–induced reductions in glucose and cholesterol, effectiveness in real-life settings among individuals at elevated risk of developing type 2 diabetes remains unclear.</div></div><div><h3>Objectives</h3><div>This study aims to assess the long-term effectiveness of daily consumption of β-glucan–enriched bread, compared with whole-grain wheat bread, on glycated hemoglobin (HbA1c) and glycemic control in adults at risk of type 2 diabetes.</div></div><div><h3>Methods</h3><div>A 16-wk randomized, double-blind dietary intervention was conducted in 194 adults [58 ± 8 y; BMI: 32 ± 5 kg/m²; HbA1c 5.6% ± 0.3% (38 ± 3 mmol/mol); LDL cholesterol 3.6 ± 1.0 mmol/L] across sites in Germany, Norway, and Sweden. Participants consumed ≥3 slices/d of either β-glucan–enriched bread (6 g β-glucan/d) or control bread, 6 d/wk.</div></div><div><h3>Results</h3><div>After 16 wk, there was no significant between-group difference in HbA1c [Δ = −0.01%, 95% confidence interval (CI): −0.03, 0.06; <em>P</em> = 0.49]. Similarly, no differences were observed in fasting glucose (Δ = −0.02 mmol/L; 95% CI: −0.11, 0.14), insulin (Δ = −0.76 pmol/L; 95% CI: −0.99, 2.5), or LDL cholesterol (Δ = −0.11 mmol/L; 95% CI: −0.27, 0.05) (all <em>P</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>Contrary to expectations from efficacy studies, this effectiveness trial does not support the metabolic benefits of oat-derived β-glucan–enriched bread under real-life conditions. A simple bread replacement may not be sufficient to improve glucose homeostasis in individuals at risk of type 2 diabetes.</div><div>This trial was registered with <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> as NCT04994327.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 3","pages":"Pages 724-732"},"PeriodicalIF":6.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting total body water in infants aged 0.5–24 months and the implications for measuring breast milk intake: a secondary analysis of isotope dilution data","authors":"Marieke AJ de Sévaux ,&nbsp;Pernille Kæstel ,&nbsp;Hinke Haisma ,&nbsp;Teresa HM da Costa ,&nbsp;Adriana Vázquez-Vázquez ,&nbsp;Tinku Thomas ,&nbsp;Regien Biesma ,&nbsp;Rebecca Kuriyan ,&nbsp;Grace Munthali ,&nbsp;Aly Diana ,&nbsp;Ina S Santos ,&nbsp;Andrew P Hills ,&nbsp;V Pujitha Wickramasinghe ,&nbsp;Shabina Ariff ,&nbsp;M Nishani Lucas ,&nbsp;Caroline S Costa ,&nbsp;Shane A Norris ,&nbsp;Vandana Jain ,&nbsp;Helen Mulol ,&nbsp;Ute Feucht ,&nbsp;Jonathan CK Wells","doi":"10.1016/j.ajcnut.2025.06.004","DOIUrl":"10.1016/j.ajcnut.2025.06.004","url":null,"abstract":"<div><h3>Background</h3><div>Total body water (TBW) is commonly used to derive estimates of body composition. The deuterium oxide dose-to-mother (DTM) technique for measuring breast milk intake requires an estimate of infant TBW. The DTM calculation employs a prediction equation for estimating infant TBW from body weight (TBW_pred), but the general validity of this equation is unknown.</div></div><div><h3>Objectives</h3><div>The objectives of this study were to assess the bias of TBW predicted by the equation used in DTM calculations (TBW_pred); derive a new equation based on a multicountry dataset of TBW measured by isotope dilution (TBW_id) in breastfed infants, 0.5 (2 wk) to 24 mo old; and quantify the impact of the new equation on measurements of breast milk and nonmilk water intake using the DTM technique.</div></div><div><h3>Methods</h3><div>We conducted a secondary analysis of 3756 TBW_id measurements from 1457 infants, which were compared to TBW_pred using the Bland-Altman method and used to generate a new prediction equation. Values of breast milk intake and nonmilk water intake from 130 DTM calculation spreadsheets were compared with recalculated values using the Bland-Altman method.</div></div><div><h3>Results</h3><div>TBW_pred underestimates TBW, with absolute and relative bias increasing with age (3 mo: –1.4% ± 9.2%; 24 mo: –11.3% ± 8.3%) and differential by sex (males: –6.4% ± 9.6%; females: –2.4% ± 9.9%). The best prediction equation incorporates log weight, age, and sex, explaining 93.7% of the variability in log TBW_id. Applying this new equation in DTM calculations results in higher estimates of breast milk and nonmilk water intake; for example, in infants aged 6–12 mo, differences averaged 26 g/d (limits of agreement: –17, 69) and 13 g/d (limits of agreement: –10, 36), respectively.</div></div><div><h3>Conclusions</h3><div>The equation used in DTM calculations provides biased TBW estimates. This has implications for measuring breast milk intake and nonmilk water intake and our understanding of nutritional needs during the first 2 y of life.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 3","pages":"Pages 820-829"},"PeriodicalIF":6.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}