JPEN. Journal of parenteral and enteral nutrition最新文献

{"title":"Nutritional and environmental determinants of maturation and disruption of the early life gut microbiome: A narrative review.","authors":"Carly Burow, Romy Shenderey, Fariha Chowdhury, Nyah Shah, Nikhil Pai","doi":"10.1002/jpen.70127","DOIUrl":"https://doi.org/10.1002/jpen.70127","url":null,"abstract":"<p><p>The first 1000 days of life represent a critical window for gut microbiome assembly, with lifelong implications for child growth, immune development, and disease risk. This review synthesizes evidence on maternal, perinatal, and especially nutritional factors that influence early-life intestinal colonization and highlights the consequences of microbial disruptions during this period. In utero exposures and birth-associated factors can profoundly shape microbial development, reducing diversity and beneficial taxa. Nutrition exerts a particularly dominant and modifiable influence: breastfeeding supports Bifidobacterium-rich communities, while formula use and early complementary feeding shape microbiota diversity and metabolic function. Dietary quality, fiber intake, and food diversity are key determinants of microbial maturation and resilience. Undernutrition and inadequate diets contribute to microbial dysbiosis, creating a self-reinforcing cycle of malabsorption, growth failure, and long-term metabolic consequences. Early microbial perturbations are associated with a range of acute and chronic diseases, including necrotizing enterocolitis, obesity, type 1 diabetes, inflammatory bowel disease, and atopic disorders. Strategies to restore microbial balance require further validation, particularly in nutritionally vulnerable populations. The absence of a universal definition for a \"healthy\" pediatric microbiome limits the development of targeted interventions. Emerging metrics, such as microbiota-for-age z-scores and functional microbiome profiling, may help define microbiota maturity and therapeutic efficacy.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671778","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":"Application of current enteral nutrition support recommendations to infants born less than 750 grams or less than 25 weeks' gestation: A critical review.","authors":"Mar Romero-Lopez, Mamta Naik, Teresa Hartman, Ann Anderson-Berry, Melissa Thoene","doi":"10.1002/jpen.70133","DOIUrl":"https://doi.org/10.1002/jpen.70133","url":null,"abstract":"<p><p>Clinicians face a paucity of evidence-based recommendations for provision of enteral nutrition in infants born <750 g or <25 weeks' gestation, termed \"nano-preterm.\" Current enteral nutrition recommendations for extremely low birth weight infants may not be broadly applicable to nano-preterm infants due to physiological and developmental differences, while others may be appropriate. Key enteral nutrition-related considerations include: the unique anatomy and physiology of the gastrointestinal tract, altered metabolic capacity, availability of maternal milk and use of alternative substrates, detailed methods of initiation and advancement of enteral feeding, methods of human milk fortification, targeted requirements for macronutrient and micronutrients, and the safety and efficacy of enteral nutrition support management to optimize the growth and development of the nano-preterm infant. This comprehensive review focused on enteral nutrition provision in nano-preterm infants, thoroughly evaluating available literature and identifying knowledge gaps about the unique physiology and metabolism of the nano-preterm infant as it pertains to enteral nutrition. Ultimately, prospective multicenter research is needed to establish evidence-based guidelines to promote optimal growth and development while minimizing complications of extreme prematurity.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148665546","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":"Glucagon-like peptide-1 analogues in the management of high output stoma in adult patients: A narrative review.","authors":"Zachary Tuttle, Ola Niewiadomski","doi":"10.1002/jpen.70131","DOIUrl":"https://doi.org/10.1002/jpen.70131","url":null,"abstract":"<p><strong>Background: </strong>High output stoma is an adverse complication of intestinal resection in patients with an enterostomy or enterocutaneous fistula. In the absence of a defined stepwise approach and limited options for high output stoma refractory to conventional treatment, glucagon-like peptide-1 (GLP-1) analogues have emerged as a potential therapeutic agent based on their effect on gastrointestinal motility.</p><p><strong>Aim: </strong>This review aims to evaluate the current management strategies for high output stoma and explore the emerging evidence to support the use of GLP-1 analogues, with emphasis on mechanism, clinical efficacy, and adverse effects.</p><p><strong>Methods: </strong>A comprehensive search of MEDLINE, Embase, Cochrane Library, and Scopus was performed to identify case studies, observational studies, and trials involving GLP-1 analogues in patients with enterostomy or enterocutaneous fistula.</p><p><strong>Results: </strong>GLP-1 is an influential neurohormone in modulating gastrointestinal transit via its action on the ileal brake. We identified two case reports of GLP-1 analogue use in the management of high output stoma and three observational pilot studies. GLP-1 analogues demonstrated improvement in clinical parameters, including reduction in stoma output and parenteral support requirements. Nausea was the most reported adverse effect. Comparison across studies is limited by small sizes, variable dosing regimens, and differing primary endpoints.</p><p><strong>Conclusion: </strong>Preliminary evidence based on reports and small observational studies is low quality but suggests GLP-1 analogues may be an efficacious therapy for high output stoma with no major reported safety concerns. Further studies, including randomized control trials are required to determine their role in the future management of high output stoma.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633522","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, risk factors, and outcomes of refeeding-like syndrome in very low birth weight infants: A descriptive study.","authors":"Allison Fialkowski, Hunter Pepin, Deirdre Ellard, Manasa Kuncham, Henry A Feldman, Mandy B Belfort","doi":"10.1002/jpen.70129","DOIUrl":"https://doi.org/10.1002/jpen.70129","url":null,"abstract":"<p><strong>Background: </strong>Refeeding-like syndrome (RLS) occurs in very low birth weight (VLBW) (<1500 g) infants receiving parenteral nutrition. Little is known about prevalence, risk factors, or outcomes.</p><p><strong>Methods: </strong>We performed a single-center descriptive cohort study in 739 VLBW infants born between October 2016 and December 2023. The co-primary outcomes were RLS during the first week of life (any serum phosphate <4 mg/dL [<1.29 mmol/L]) and severe RLS (<2.5 mg/dL [<0.81 mmol/L]). We also examined clinical outcomes associated with RLS, as well as associations of infant gestation length, fetal growth, and maternal hypertensive disorders with RLS outcomes, as well as associations of RLS with infant outcomes, adjusting for covariates in logistic regression.</p><p><strong>Results: </strong>Mean (standard deviation, SD) gestational age was 29.1 (2.8) weeks, 174 (23.5%) infants were small for gestational age (SGA), 36.6% had RLS, and 6.6% had severe refeeding-like syndrome (sRLS). Maternal hypertension was associated with higher odds of RLS (unadjusted odds ratio [OR] 1.8; 95% CI: 1.3, 2.4). Having gestational age <27 + 0 weeks (adjusted OR [aOR] 1.8; 95% CI: 1.2, 2.6) and being small for gestational age (aOR: 4.62; 95% CI: 3.2, 6.6) both increased the odds of RLS. Refeeding-like Syndrome was associated with higher odds of severe intraventricular hemorrhage and severe retinopathy of prematurity.</p><p><strong>Conclusions: </strong>Refeeding-like syndrome is common among VLBW infants, particularly those born with lower gestational age and impaired fetal growth, and may contribute to morbidities associated with VLBW infants. These findings support the importance of screening and preventive strategies.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148595405","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":"JPEN Journal Club 102. The Hochberg Procedure.","authors":"Ronald L Koretz","doi":"10.1002/jpen.70122","DOIUrl":"https://doi.org/10.1002/jpen.70122","url":null,"abstract":"","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364860","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":"JPEN Journal Club 101. Papers from Pharma.","authors":"Ronald L Koretz","doi":"10.1002/jpen.70107","DOIUrl":"https://doi.org/10.1002/jpen.70107","url":null,"abstract":"","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147985097","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":"Response to \"Association between the dietary index for gut microbiota and advanced cardiovascular-kidney-metabolic syndrome among United States adults: A cross-sectional study\".","authors":"Xin Zhang, Hui Qin","doi":"10.1002/jpen.70071","DOIUrl":"10.1002/jpen.70071","url":null,"abstract":"","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"501-502"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147274281","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":"Malnutrition and diabetes outcomes 12 months after total pancreatectomy: A descriptive cohort study.","authors":"Ibrahima Maiga, Antoine Vilotitch, Béatrice Genoux, Mircea Chirica, Edouard Girard, Cécile Bétry","doi":"10.1002/jpen.70076","DOIUrl":"10.1002/jpen.70076","url":null,"abstract":"<p><strong>Background: </strong>Total pancreatectomy is a rare but increasingly performed surgical procedure that systematically induces endocrine and exocrine pancreatic insufficiency. Data on long-term nutritional outcomes after this surgery are limited. The objective of this study was to assess the prevalence of malnutrition at 3 months and 12 months after surgery and to evaluate diabetes control at 12 months.</p><p><strong>Methods: </strong>We performed a descriptive cohort study in 41 adults who underwent total pancreatectomy at the Grenoble Alpes University Hospital (Grenoble, France) between January 2021 and July 2024. Nutritional status was defined according to national criteria based on weight loss, body mass index, and muscle mass with CT scan, or function. Data were collected before surgery, at 3 months, and at 12 months.</p><p><strong>Results: </strong>A total of 41 patients were included. The prevalence of malnutrition increased from 25.0% (95% CI: 12.7-41.2) at the preoperative visit versus 59.5% (95% CI: 42.1-75.2) and 59.0% (95% CI: 42.1-74.4) at both 3 and 12 months. Weight loss exceeded 10% of usual body weight in more than half of patients at 12 months. At 12 months, all patients had type 3c diabetes with a median glycated hemoglobin at 8.0% (7.2-8.8, n = 32) and a time in hypoglycemia defined as the time below range of 0.2 (0.0-1.5).</p><p><strong>Conclusion: </strong>Malnutrition is highly prevalent after total pancreatectomy and persists at 12 months related to important weight loss, while diabetes appears manageable. These findings highlight the need for systematic nutritional monitoring and optimization of perioperative nutritional strategies in this population.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"573-581"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147464642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between specialized nutrition support and 90-day mortality relative to standard of care in malnourished adults with decompensated cirrhosis: A retrospective cohort study.","authors":"Katharina L Hupa-Breier, Laura Buttler, Claudia Seipt, Andrea Markowski, Marie Griemsmann, Tammo L Tergast, Birgit Kaufmann, Hannah Rieland, Heiner Wedemeyer, Benjamin Maasoumy, Andrea Schneider","doi":"10.1002/jpen.70066","DOIUrl":"10.1002/jpen.70066","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition is common among patients with decompensated liver cirrhosis and linked to poor prognosis. Guidelines recommend intensified nutrition support e.g. parenteral nutrition, but evidence regarding safety and effectiveness is scarce. We aimed to investigate the impact of nutrition support, specifically parenteral nutrition, on mortality (primary end point) and on cirrhosis-specific complications (secondary end points) in patients with advanced liver cirrhosis.</p><p><strong>Methods: </strong>Consecutive malnourished patients with decompensated cirrhosis treated at our center between 2013 and 2018 were investigated. Fifty-three patients received specialized nutrition support; 33 received parenteral nutrition. The specialized nutrition support group (cohort 1) and the home parenteral nutrition group (cohort 2) were compared with patients without specific dietary support (standard-of-care group) after 1:1 and 1:2 propensity score matching, respectively. Mortality, hepatic encephalopathy, infections, and rehospitalization were investigated within 90 days.</p><p><strong>Results: </strong>Median baseline Model for End-Stage Liver Disease score (possible range 6-40 points) was 18 in cohort 1 and 16 in cohort 2. No impact of specialized nutrition support on the clinical outcome was detected. Between cohort 2 and standard of care, no differences in mortality and rehospitalization were observed. Whereas parenteral nutrition was associated with increased risk for bloodstream infections (hazard ratio [HR] = 21.3; P = 0.004), overall incidence of bacterial infections was comparable between groups (HR = 0.82; P = 0.45). Of note, the likelihood for hepatic encephalopathy was significantly reduced in cohort 2 in the multivariable competing risk model (HR = 0.28; P = 0.03).</p><p><strong>Conclusion: </strong>Home parenteral nutrition seems safe overall and may ameliorate the risk for hepatic encephalopathy in candidates for liver transplant.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"544-556"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of tools for the diagnosis of malnutrition and overall survival in adults diagnosed with oral squamous cell carcinoma: A comparison study.","authors":"Hao Wang, Chang Liu, Xite Zheng, Yu Huang, Kaixiong Wei, Jianghua Liu, Hanchen Zhou, Yiming Zhang, Chong Wang, Zhien Feng","doi":"10.1002/jpen.70061","DOIUrl":"10.1002/jpen.70061","url":null,"abstract":"<p><strong>Background: </strong>The Global Leadership Initiative on Malnutrition (GLIM) criteria have been suggested for use in clinical practice for multiple tumor types, but there are currently no data on the effectiveness of tools for the diagnosis of malnutrition in patients with oral squamous cell carcinoma.</p><p><strong>Methods: </strong>A retrospective study was conducted including 317 patients who underwent radical surgery for oral squamous cell carcinoma between October 2021 and May 2024. Six preoperative nutrition assessment tools were included: the GLIM criteria, Patient-Generated Subjective Global Assessment, European Society for Clinical Nutrition and Metabolism criteria, Prognostic Nutritional Index, Nutritional Risk Index, and body mass index.</p><p><strong>Results: </strong>Multivariate Cox proportional hazards models indicated that severe malnutrition identified by GLIM (hazard ratio [HR], 2.10; 95% CI, 1.01-4.36; P = 0.04) and the GLIM subcriteria combination of weight loss and cancer (HR, 7.30; 95% CI, 2.98-17.89; P < 0.001) were independent predictors of overall survival. The GLIM subcriteria combination of weight loss and cancer (Brier score, 0.096; C statistics [0.80; 95% CI, 0.74-0.85]) had the best predictive performance for overall survival.</p><p><strong>Conclusion: </strong>The GLIM criteria have predictive value for diagnosing preoperative malnutrition in patients with oral squamous cell carcinoma. However, the GLIM subcriteria combination of weight loss and cancer offers greater advantages in prognostic prediction and may be useful for risk stratification and guidance for nutrition interventions in patients with oral squamous cell carcinoma.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"533-543"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097724","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}