Journal of Human Nutrition and Dietetics最新文献

{"title":"Impact of Achieved Weight Loss by Intermittent Fasting Plus Early Time-Restricted Eating and Calorie Restriction on Systemic and Adipose Tissue Markers of Inflammation in Adults at Risk of Type 2 Diabetes: An Exploratory Sub-Study","authors":"Laurent Turner,&nbsp;Lijun Zhao,&nbsp;Kai Liu,&nbsp;Xiao Tong Teong,&nbsp;Gary Wittert,&nbsp;Amy T. Hutchison,&nbsp;Leonie K. Heilbronn","doi":"10.1111/jhn.70137","DOIUrl":"10.1111/jhn.70137","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Intermittent fasting (IF) and calorie restriction (CR) may reduce inflammation, though it is unclear which is more effective in adults at risk of type 2 diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This exploratory sub-study compared the effects of achieved weight loss by IF plus early time-restricted eating (iTRE) or CR versus standard care (SC) on systemic and adipose tissue markers of inflammation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adults (<i>N</i> = 209, 34.8 ± 4.7 kg/m²) were randomised into three groups (2:2:1): iTRE (30% energy requirements between 0800 and 1200 on 3 days/week); CR (30% energy restriction); or SC for 6 months. Body weight and plasma C-reactive protein (CRP), tumour necrosis factor α (TNF-α), interleukin-6 (IL-6) and interferon-ɣ (IFNɣ) were measured at baseline and month 6 in a subset with weight loss above (CR: <i>N</i> = 32, iTRE: <i>N</i> = 35) or below median (SC: <i>N</i> = 18). The expression of inflammatory genes in adipose tissue was measured using qPCR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Weight loss was greater in iTRE and CR versus SC. While TNF-α and CRP levels decreased at month 6 (CRP: −1.36 ± 0.47 mg/dL, <i>p</i> &lt; 0.001; TNF-α: −0.082 ± 0.03 pg/mL, <i>p</i> = 0.025), there were no between group effects. In adipose tissue, no differences in inflammatory genes were detected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The mode of weight loss intervention did not differentially impact inflammatory markers in participants with weight loss above median.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 5","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing IDDSI in an Acute Care Setting: Experiences From the University Hospital Graz","authors":"Feiner Marlies,&nbsp;Haring Florian,&nbsp;Traub Julia,&nbsp;Domnanich Sandra,&nbsp;Potzinger Martina,&nbsp;Hofer Sarah,&nbsp;Schuster Sophie,&nbsp;Walcher Barbara,&nbsp;Sommer Thomas,&nbsp;Bauer Stefan,&nbsp;Eberhard Katharina,&nbsp;Tervonen Hannaleena","doi":"10.1111/jhn.70139","DOIUrl":"10.1111/jhn.70139","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The International Dysphagia Diet Standardisation Initiative (IDDSI) framework establishes a global standard, with standardized terms, descriptors and measurement criteria, to enhance dysphagia care. This paper presents one of the first documented successful implementations of IDDSI in a large acute care hospital. The implementation at the University Hospital Graz, a 1554-bed acute care facility, took place between 2021 and 2024. The project aimed to standardize practices in five patient-focused areas to improve knowledge, and facilitate multiprofessional communication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Based on the IDDSI Monitor, Aware, Prepare, Adopt (MAPA) model and IDDSI implementation guide, a project plan was developed. An interdisciplinary working group consisting of dietitians, Speech-Language Pathologists (SLPs) and chefs conducted comprehensive audits of all existing recipes and aligned clinical swallowing assessments and dietetic recommendations with IDDSI standards. Training programs ensured the consistent application of terminology across the therapeutic, nursing, and kitchen teams. Two staff surveys were conducted - one before and one after implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The working group successfully integrated IDDSI into clinical workflows, menu planning, charting and electronic health record systems. Staff surveys showed a significant increase in IDDSI awareness, rising from 42.1% to 76.7%, along with greater use of the IDDSI standardized terminology by the staff during the project's duration.</p>\u0000 \u0000 <p>Key implementation challenges included adapting recipes to meet IDDSI texture levels and integrating the framework into the utilized Cook and Chill food preparation system. Dual project lead with one Speech-Language Pathologist (SLP) and one dietitian, targeted training, and the active engagement of kitchen staff were crucial to the project's success.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrates that implementing IDDSI in acute care settings is both feasible and beneficial, leading to multiprofessional knowledge of the framework and fostering collaboration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 5","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Global Survey of Dietitians' Perspectives and Implementation of the International Clinical Guidelines for Classical Galactosaemia","authors":"Erica Wong,&nbsp;Louise Robertson","doi":"10.1111/jhn.70141","DOIUrl":"10.1111/jhn.70141","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Galactosaemia is an inherited metabolic disorder, characterised by the inability to metabolise galactose. Dietary management previously varied worldwide due to the lack of standardised guidelines. The International Clinical Guidelines (CPG) for management of classical galactosaemia were published in 2017. The aim of the current study was to explore dietitians' perspectives and their use of the guidelines worldwide.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>An international cross-sectional online survey was administered from April to June 2021 to registered dietitians who were working or had worked with galactosaemia patients since the guidelines were published. The study was piloted and received ethical approval. Descriptive statistical analysis and thematic analysis were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 39 dietitians from 17 countries participated. 51% of participants had &gt; 10 years of experience working with patients with galactosaemia. 56.4% reported a change in their dietetic practice since the guidelines were published, namely relaxing the diet, and not restricting fruits and vegetable intake (46%). Most dietitians (76.9%) reported improved confidence because the guidelines support their clinical reasoning and existing dietary management approaches. Most dietitians (82%) suggested improvements for the CPG for classical galactosaemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings are considered the first to describe how dietitians view and use the guidelines. The CPG for galactosaemia appears to have positively influenced practice. Currently, implementation of the CPG could be improved by addressing the gaps in the existing evidence base and minimising other barriers e.g. patient-related barriers, institutional barriers and lack of resources. Patient-friendly resources are also necessary to provide accessible, comprehensive information regarding the management of galactosaemia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 5","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Postsecondary Students' Dietary Behaviours: A Systematic Review of Mobile Health Interventions","authors":"Schaafsma Holly,&nbsp;Caruso Olivia,&nbsp;Diaconita Smaranda,&nbsp;McEachern Louise,&nbsp;Seabrook Jamie,&nbsp;Gilliland Jason","doi":"10.1111/jhn.70130","DOIUrl":"10.1111/jhn.70130","url":null,"abstract":"<p>Inadequate dietary intake among postsecondary students can negatively impact academic achievement, mental health and the development of chronic disease later in life. Mobile health (mHealth) interventions offer a unique opportunity to improve dietary behaviours in this population, who report frequent use of mobile devices. This systematic review evaluated the impact of mHealth diet interventions on postsecondary students' dietary behaviours. A literature search was conducted in January 2025 using six electronic databases (Web of Science, Scopus, CINAHL, EMBASE, Medline and PsycINFO). Eligible intervention studies included randomized controlled trials (RCTs) and pre-post studies, with or without a control group. The interventions had to include at least one dietary behaviour outcome variable and involve only enroled postsecondary students. Sample and intervention characteristics, intervention results, as well as equity and behaviour change theory use and reporting, were extracted. Findings were reported as a narrative synthesis. Eleven studies met the inclusion criteria and were included in this review. Of the studies reviewed, 10 reported a positive and significant impact on at least one dietary behaviour in the postsecondary student population. Notably, 5 of the 6 studies assessing fruit and/or vegetable intake found significant improvements following the mHealth interventions. However, the clinical significance of these should be noted: some reported dietary changes were relatively small. Overall, mHealth interventions show promise in improving postsecondary students' dietary behaviours. However, further research is necessary, and future interventions should ensure the use of validated dietary assessment tools and longer follow-up periods to evaluate long-term effectiveness.</p>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 5","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Clinical Nutrition: A Descriptive Comparison of ChatGPT- and Dietitian-Planned Diets for Chronic Disease Scenarios","authors":"Tuba Onay,&nbsp;Duygu Bekar,&nbsp;Ezgi Çoban,&nbsp;Nergiz Doğan,&nbsp;Uğur Günşen","doi":"10.1111/jhn.70135","DOIUrl":"10.1111/jhn.70135","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Nutrition-related chronic diseases are among the leading causes of morbidity and mortality worldwide. The increasing prevalence of obesity and changes in lifestyle and dietary behaviours have necessitated innovative approaches in nutritional care. In this context, artificial intelligence (AI) tools such as ChatGPT have emerged as potential aids in generating personalized dietary recommendations. However, their reliability and clinical utility remain underexplored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study aimed to assess the reliability and appropriateness of ChatGPT in creating diet plans for individuals with obesity and diet-related non-communicable chronic diseases. Dietary plans were generated by both a registered dietitian and ChatGPT for hypothetical individuals with identical clinical profiles and conditions. These plans were then evaluated comparatively in terms of nutritional adequacy, safety, individualization and practicality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ChatGPT-generated diets demonstrated notable deficiencies in meeting specific energy and nutrient requirements and lacked personalization based on individual health needs. In several cases, contraindicated foods were included. These findings highlight the potential risks of using AI tools in clinical dietetics without professional oversight. Ethical and safety considerations are critical when integrating AI into healthcare services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ChatGPT cannot currently substitute for individualized dietary counselling provided by qualified dietitians, particularly due to its inability to offer tailored motivation, emotional support or clinically safe recommendations. Nevertheless, further research is warranted to optimize the role of AI in diet planning and to enhance its integration into personalized nutrition care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 5","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Frequent Commercial Squeeze Pouch Consumption Among a Sample of Australian Infants, Children, and Adolescents","authors":"Katherine Kent,&nbsp;Bianca Smith,&nbsp;Ami Seivwright,&nbsp;Catharine A. K. Fleming","doi":"10.1111/jhn.70138","DOIUrl":"10.1111/jhn.70138","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Foods in commercial squeeze pouches, primarily designed for infants, are expanding into school-aged children and adolescent markets. Such products are increasingly scrutinized for misleading health claims and poor nutritional content. This study aimed to explore the use of commercial squeeze pouches among Australian children (0–17 years), identify sociodemographic predictors of frequent consumption, and examine the relationship between perceived barriers to achieving a healthy diet and commercial squeeze pouch consumption.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional survey of Australian parents explored their children's frequency of commercial squeeze pouch consumption alongside parents’ sociodemographic data and perceived barriers to achieving a healthy diet (e.g., time, cost). Logistic regression was used to identify factors associated with frequent consumption of commercial squeeze pouches (weekly or more).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among our sample (<i>n</i> = 343), 73.8% of children consumed food from commercial squeeze pouches in the past 12 months, and around half consumed them weekly or more (49%). Frequent usage was highest among children 0–2 years old and 2–5 years old (64% of each group), with fruit and dairy-based pouches the most frequently consumed. Dairy-based pouches were consumed by 74% of school-aged children and 30% of adolescents within the past 12 months. Younger parents (OR = 4.2, <i>p</i> &lt; 0.001) and middle-income families (OR = 2.5, <i>p</i> = 0.019) were more likely to report their children were frequent consumption of commercial squeeze pouches. Perceived time constraints significantly increased the likelihood of using commercial squeeze pouches (OR = 2.6, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Commercial squeeze pouches are frequently consumed by Australian children, driven in part by demographic factors and parenting challenges like time constraints. In addition to supporting parents to make informed choices, public health strategies could extend beyond individual-level education to include regulatory reforms that limit inappropriate marketing and improve the nutritional quality of foods in commercial squeeze pouches.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 5","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Change in Diet Quality and Dietary Intake From Pregnancy to 1-Year Postpartum: A Longitudinal Analysis in Australian Women.","authors":"Sasha Fenton, Rachael M Taylor, Melinda J Hutchesson, Poonam Kaur Pannu, Kee June Ooi, Clare E Collins","doi":"10.1111/jhn.70142","DOIUrl":"https://doi.org/10.1111/jhn.70142","url":null,"abstract":"<p><strong>Objective: </strong>This longitudinal analysis in Australian women evaluated change in diet quality and food and nutrient intakes from the third trimester of pregnancy to 1-year postpartum with comparison to national nutrition recommendations. Associations between diet quality, sociodemographic and health characteristics were also investigated.</p><p><strong>Methods: </strong>This study was an analysis of data from the ORIGINS pregnancy cohort (2017-2023). Participants included were those with complete dietary data at both timepoints, aged ≥ 19 years, and not pregnant 1-year postpartum. Dietary intake was assessed using the Australian Eating Survey food frequency questionnaire, and diet quality using the Australian Recommended Food Score (ARFS). Participants self-reported sociodemographic data, and health data were obtained from hospital medical records. Paired sample t-tests analysed change in diet quality and dietary intake, and linear regression estimated associations between maternal characteristics and diet quality. Food group and nutrient intakes were compared to recommendations in the Australian Guide to Healthy Eating and Nutrient Reference Values.</p><p><strong>Results: </strong>Of 337 women (33.1 (4.5) years, 49.9% Australian-born, 51.3% university educated), mean (95% CI) diet quality was suboptimal during pregnancy and 1-year postpartum (ARFS 34.0 (33.0, 35.0) vs. 34.8 (33.8, 35.8) points out of 73, p = 0.038). Higher serves of vegetables and meat, energy intake from protein, and intake of retinol equivalents, and less fruit, dairy, carbohydrate, saturated fat, iodine and folate were consumed 1-year postpartum (p < 0.05). Alignment with recommendations was low during pregnancy and 1-year postpartum for food groups, macronutrients and key micronutrients. Lower diet quality during and after pregnancy was linked to not having had a university education, and a higher pre-pregnancy BMI. Postpartum, younger age and lower income was also associated with poorer diet quality and having a BMI in the overweight category before pregnancy (p < 0.05).</p><p><strong>Conclusion: </strong>These findings highlight persistent nutritional inadequacies and social disparities, and the urgent need for targeted, evidence-based nutrition interventions to improve diet quality and nutrient intakes in pregnant and postpartum women, particularly younger women with lower education and income, and those with a higher pre-pregnancy BMI.</p>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 5","pages":"e70142"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Dietitians' Perspectives on Nutrition Care Discharge Practices for Older Adults With Malnutrition: Insights From a Qualitative Exploratory Study.","authors":"Kristin Gomes, Ben Desbrow, Jack Bell, Shelley Roberts","doi":"10.1111/jhn.70143","DOIUrl":"https://doi.org/10.1111/jhn.70143","url":null,"abstract":"<p><strong>Background: </strong>Nutrition care continuity after hospital discharge is critical for supporting recovery in older adults with malnutrition, yet evidence suggests significant variability in nutrition care discharge practices. This study explored clinical dietitians' experiences, perspectives, and approaches to nutrition care discharge practices for older adults with malnutrition transitioning home from hospital.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with clinical dietitians from two public hospitals in one health service in Queensland, Australia. Interviews, informed by the Theoretical Domains Framework and a recent chart audit conducted at the health service, explored current practices and factors influencing nutrition care continuity. Data were analysed using inductive thematic analysis following Braun & Clarke's six-step framework.</p><p><strong>Results: </strong>Ten clinical dietitians were interviewed. Participants acknowledged the practice gaps identified in the chart audit were reflective of their current practice environment. Four core elements characterising nutrition care discharge practices were identified: dietitians positioned themselves as advocates for nutrition care continuity; practice evolved through clinical experience rather than formal guidance; comprehensive discharge planning was selectively implemented; and documentation and communication approaches varied. Factors influencing practice operated at individual (patient engagement, dietitian capabilities), process (workflow complexities, service coordination), and system levels (healthcare environment and structure, resource constraints and organisational culture).</p><p><strong>Conclusions: </strong>Variability in nutrition care discharge practices reflects the interplay between system constraints, workflow challenges and dietitian adaptations. Addressing these dynamics presents opportunities for system- and practice-level improvements, including standardising documentation workflows, optimising electronic medical record functionality, and strengthening care pathways between acute and community settings to support continuity of nutrition care.</p>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 5","pages":"e70143"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"British Dietetic Association Guidelines for the Dietary Management of Chronic Constipation in Adults.","authors":"Eirini Dimidi, Alice van der Schoot, Kevin Barrett, Adam D Farmer, Miranda C Lomer, S Mark Scott, Kevin Whelan","doi":"10.1111/jhn.70133","DOIUrl":"10.1111/jhn.70133","url":null,"abstract":"<p><strong>Background: </strong>Current clinical guidelines for chronic constipation offer limited dietary recommendations. The aim of this project was to develop the first comprehensive evidence-based dietary guidelines for the management of chronic constipation in adults.</p><p><strong>Methods: </strong>Four systematic reviews and meta-analyses were performed to identify eligible randomised controlled trials (RCTs). The findings generated from the meta-analyses were then used to develop guideline statements using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach and a Delphi consensus survey among a multi-disciplinary expert Guideline Steering Committee. Recommendation statements were produced for treatment response, stool output, gut symptoms, adverse events, and quality of life, and only based on the findings where ≥ 2 RCTs contributed to the meta-analysis. The strength of recommendation was assessed using the GRADE approach. Consensus voting amongst the Guideline Steering Committee was performed using a modified Delphi survey approach.</p><p><strong>Results: </strong>The four systematic reviews included a total of 75 RCTs. Fifty-nine dietary recommendation statements were generated and accepted through the Delphi survey. For dietary supplements, 15 recommendation statements relate to fibre supplements, 20 relate to probiotics, 2 to synbiotics, 5 to magnesium oxide, 2 to senna, and 3 to kiwifruit supplements. For foods, three recommendation statements related to kiwifruits, two to prunes, and two to rye bread. For drinks, five recommendation statements related to high mineral-containing water. No recommendations were made for whole diet approaches due to a lack of evidence. Twelve statements had a very low level of evidence, 39 had a low level of evidence, and 8 had moderate evidence. Twenty-seven statements were strong recommendations, and 32 were qualified recommendations.</p><p><strong>Conclusions: </strong>These are the first comprehensive evidence-based dietary guidelines for the management of constipation based upon a robust systematic review and GRADE processes. Recommendations were made for dietary supplements, foods and drinks that have never been previously included in clinical guidelines, and can now be rapidly implemented into clinical practice, thereby improving clinical care and patient outcomes.</p>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 5","pages":"e70133"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Classical and Modified Ketogenic Diets for Children and Young People With Drug-Resistant Epilepsy: A Reflection of International Dietetic Practice and Best Practice Recommendations for Dietitians.","authors":"Natasha E Schoeler, Victoria J Whiteley, Monica Guglielmetti, Lenycia de Cassya Lopes Neri, Robyn Blackford, Charlene Tan-Smith, Nicole Aylward, Katie Barwick, Maria Eugenia Caballero, Sylwia Gudej-Rosa, Wan-Ling Huang, Meredith Johnson, Christine Ong Bee Keow, Sarianne Madsen, Kath Megaw, Theresa Nyembezi Njobvu, Heidi Pfeifer, Sian Phillips, Elles van der Louw","doi":"10.1111/jhn.70129","DOIUrl":"10.1111/jhn.70129","url":null,"abstract":"<p><strong>Introduction: </strong>A global need was identified for a practical, comprehensive tool to guide dietitians internationally working in ketogenic diet therapy (KDT), detailing all aspects of dietetic management. The aim of this project was to develop best practice recommendations for the dietetic management of classical and modified ketogenic diets in the management of epilepsy and neurometabolic conditions.</p><p><strong>Methods: </strong>Expert ketogenic dietitians from six continents were invited to participate as members of either a core working group or advisory group. A systematic literature review was conducted, covering all aspects of dietetic management, from patient selection to diet discontinuation. To complement this, an international survey was distributed to ketogenic dietitians currently delivering classical and modified ketogenic diets, structured around the same key themes.</p><p><strong>Results: </strong>A total of 111 dietitians responded to the survey, representing six continents. For each theme, findings from the literature were presented alongside survey responses. Recommendations were generated where ≥ 75% consensus was achieved. In areas where this threshold was not met, the most commonly reported practices were presented, acknowledging the variety of international approaches.</p><p><strong>Conclusion: </strong>These are the first international best practice recommendations specifically for ketogenic dietitians and nutrition healthcare professionals supporting children following medically advised classical and modified ketogenic diets. The recommendations are informed by both published evidence and prevailing international dietetic practice, whilst recognizing the variety in clinical delivery.</p>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 5","pages":"e70129"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}