Clinical nutrition research最新文献

{"title":"Factors associated with achieving adequate caloric delivery immediately after percutaneous endoscopic gastrostomy: a retrospective observational study.","authors":"En Amada, Yoshihiro Watanabe","doi":"10.7762/cnr.2026.0004","DOIUrl":"10.7762/cnr.2026.0004","url":null,"abstract":"<p><strong>Objective: </strong>Failure to achieve adequate caloric intake is common after percutaneous endoscopic gastrostomy (PEG) and may contribute to progressive malnutrition in older adults. This study aimed to identify factors associated with achieving adequate caloric delivery early after PEG placement.</p><p><strong>Methods: </strong>This single-center retrospective observational study included patients aged ≥65 years who underwent PEG between January 2022 and December 2024. Target caloric intake was determined based on basal energy expenditure (BEE). The target nutritional intake achievement rate (TaNIAR) was defined as the ratio of final delivered calories to BEE. Patients were classified into an underfeeding group (TaNIAR <100%) and an appropriate-feeding group (TaNIAR ≥100%). Multivariable logistic regression analysis was performed to identify factors independently associated with achieving TaNIAR ≥100%.</p><p><strong>Results: </strong>Fifty-nine patients were analyzed; 15 were classified as underfeeding and 44 as appropriate-feeding. The median final caloric intake, calculated in increments of 300 kcal corresponding to the packet size of the enteral formula, was 1,200 kcal (range, 600-1,200 kcal) in the underfeeding group and 1,200 kcal (range, 900-1,400 kcal) in the appropriate-feeding group. Multivariable analysis identified the use of a pectin-containing oligomeric formula (POF) (odds ratio [OR], 32.8; 95% confidence interval [CI], 3.7-292.9) and BEE ≤990 kcal/day (OR, 29.5; 95% CI, 3.1-277.7) as factors independently associated with achieving TaNIAR ≥100%. The final caloric intake clustered within a relatively narrow range in both groups.</p><p><strong>Conclusion: </strong>Lower BEE and the use of POF were independently associated with achieving adequate caloric delivery after PEG placement. Optimization of enteral formula selection may represent a practical strategy to improve early nutritional adequacy in older patients. Further prospective studies are required to validate these findings.</p>","PeriodicalId":72617,"journal":{"name":"Clinical nutrition research","volume":"15 3","pages":"203-210"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674589","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 nutrient intake, nutrition knowledge, and dietary habits by sports type among adolescent athletes at a physical education high school: a cross-sectional study.","authors":"Saningun Lee, Paul Kim, In Seok Lee","doi":"10.7762/cnr.2026.0024","DOIUrl":"10.7762/cnr.2026.0024","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the nutrient intake, nutrition knowledge, and dietary habits of track-and-field (TF) and weight-class (WC) adolescent varsity athletes.</p><p><strong>Methods: </strong>This cross-sectional study included 144 adolescent athletes (TF group, 76; WC group, 68) aged 15 to 18 years at a physical education high school in Seoul, South Korea. Their nutrient intake, dietary quality, nutrition knowledge, dietary habits, and weight control behaviors were assessed using food records and questionnaires.</p><p><strong>Results: </strong>Regarding nutrient intake, the consumption of carbohydrates, including energy, was substantially lower than the sports nutrition recommendations in both groups. However, the overall diet quality, including the mean adequacy ratio and nutrient adequacy ratio for key micronutrients, was significantly higher in the WC group than in the TF group, with female WC athletes consuming significantly more energy than female TF athletes (P<0.05). For nutrition knowledge, both groups lacked overall sports nutrition understanding; however, the WC group scored significantly higher in dietary fat knowledge (P<0.05). As for dietary habits, despite having better meal quality, harmful weight control behaviors, including skipping breakfast (P<0.001) and fasting (P<0.05), were significantly more common in the WC group than in the TF group.</p><p><strong>Conclusion: </strong>The WC group, while showing better meal quality, practiced unhealthier dietary behaviors and weight control methods more often than the TF group. Additionally, both groups exhibited insufficient energy intake and lacked overall nutrition knowledge. Therefore, tailored sports nutrition education is urgently needed among South Korean adolescent athletes.</p>","PeriodicalId":72617,"journal":{"name":"Clinical nutrition research","volume":"15 3","pages":"172-183"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674599","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":"Secular trends in dietary patterns among South Korean primary school-aged children based on the 2007-2022 Korea National Health and Nutrition Examination Survey.","authors":"Adiyasuren Dookhuu, Diana Shubekova, Juhae Kim, Minji Kang","doi":"10.7762/cnr.2026.0018","DOIUrl":"10.7762/cnr.2026.0018","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify dietary patterns and examine their associations with sociodemographic and lifestyle characteristics among South Korean primary school-aged children.</p><p><strong>Methods: </strong>Data from 10,173 children aged 6-12 years who participated in the 2007-2022 Korea National Health and Nutrition Examination Survey were analyzed. Their dietary intake was assessed using a 24-hour dietary recall, and dietary patterns were derived from the energy contributions of 26 food groups through cluster analysis.</p><p><strong>Results: </strong>Three patterns were identified: rice-based pattern (47.3%), flour-based pattern (17.7%), and diversified type (35.1%). From 2007 to 2022, the prevalence of the rice-based pattern declined substantially (56.6%-32.6%), whereas that of the diversified type markedly increased (27.3%-47.0%). Survey-weighted analyses revealed that the dietary patterns were significantly associated with age, household income, vigorous physical activity, meal-skipping, eating-out frequency, and dietary supplement use (all, P<0.05). Children following the flour-based pattern tended to be older, skip breakfast more often, and engage in less vigorous physical activities. The rice-based pattern included a higher proportion of children from low-income households, whereas the diversified type showed more favorable socioeconomic characteristics and family breakfast practices. Overall, the rice-based and flour-based patterns were associated with less favorable lifestyle behaviors than the diversified type.</p><p><strong>Conclusion: </strong>Dietary patterns among South Korean primary school-aged children appear to be closely related to socioeconomic status and daily health behaviors. Nutrition education and public health interventions promoting balanced diets, reduced meal skipping, and healthier lifestyles during childhood are needed.</p>","PeriodicalId":72617,"journal":{"name":"Clinical nutrition research","volume":"15 3","pages":"149-160"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674455","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":"Prevalence and factors of concurrent wasting and stunting among children aged 6 to 59 months in Cambodia: a cross-sectional study using the Cambodia Demographic and Health Survey 2021-2022.","authors":"Marina Lim, Seungmin Lee","doi":"10.7762/cnr.2026.0023","DOIUrl":"10.7762/cnr.2026.0023","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the prevalence and factors of concurrent wasting and stunting (WaSt) in Cambodian children aged 6-59 months.</p><p><strong>Methods: </strong>This cross-sectional analysis of the Cambodia Demographic and Health Survey from 2021 to 2022 included 3,420 children aged 6-59 months and a subsample of 1,237 aged 6-23 months for whom dietary indicators were available. WaSt was defined as height-for-age and weight-for-height z-scores below -2 standard deviations according to the World Health Organization (WHO) Growth Standards. Dietary indicators followed 2021 WHO/UNICEF infant and young child feeding definitions. Survey-weighted logistic regression was employed in Stata 18.0, with statistical significance set at P<0.05.</p><p><strong>Results: </strong>The prevalence rates were 22.4% for stunting, 9.3% for wasting, and 2.1% for WaSt. The odds of WaSt were higher among children with low birth weight (adjusted odds ratio [AOR], 4.93; 95% confidence interval [CI], 1.92-12.63), those born to underweight mothers (AOR, 2.42; 95% CI, 1.06-5.56), and those from the poorest wealth tertile (AOR, 2.46; 95% CI, 1.14-5.31). Contrarily, the odds were lower among girls (AOR, 0.52; 95% CI, 0.28-0.97) and children of mothers who were overweight or obese (AOR, 0.25; 95% CI, 0.10-0.65). No dietary indicator was associated with WaSt, although power was limited by few cases (n=21).</p><p><strong>Conclusion: </strong>WaSt was independently associated with low birth weight, maternal underweight, and household poverty, whereas no significant association with dietary indicators was observed. Integrated programs targeting maternal nutrition, birth outcomes, and poverty in vulnerable households are warranted.</p>","PeriodicalId":72617,"journal":{"name":"Clinical nutrition research","volume":"15 3","pages":"191-202"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674711","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":"Discrepancies between preschoolers' self-perceived healthy eating practices and parental assessments: a cross-sectional study in South Korea.","authors":"Jiwon An, Seulgi Lee, Kirang Kim","doi":"10.7762/cnr.2026.0009","DOIUrl":"10.7762/cnr.2026.0009","url":null,"abstract":"<p><strong>Objective: </strong>Although healthy dietary habits established in early childhood are critical for lifelong health, most previous studies have relied predominantly on parental proxy reports rather than children's self-perceptions. This study compared preschoolers' self-perceived healthy dietary practices with their parents' evaluations and examined discrepancies between them.</p><p><strong>Methods: </strong>This study included 243 preschoolers aged 2 to 7 years and their parents, recruited from daycare centers in Cheonan, South Korea. Data were collected using the validated, structured, self-administered Healthy Eating Practice Questionnaire, which assessed nutrition and hygiene. Mean Healthy Eating Practice Scores were compared between preschoolers and their parents using paired t-tests, and stratified analyses were conducted by sex and age.</p><p><strong>Results: </strong>Preschoolers rated their healthy dietary practices significantly higher than their parents did (P<0.001). The discrepancy was greater for nutrition than for hygiene, with hygiene ratings more consistent. This domain-specific pattern was consistent across sexes and age groups. When stratified by sex and age, preschooler-parent Healthy Eating Practice Score differences were significantly higher in boys than in girls (25.0±21.0 vs. 20.0±14.9, respectively; P=0.035).</p><p><strong>Conclusion: </strong>Discrepancies between preschoolers' self-perceptions and their parents' evaluations suggest that incorporating both perspectives is essential for accurately assessing children's dietary practices. These findings support the development of dual-perspective dietary assessment and education strategies in early childhood.</p>","PeriodicalId":72617,"journal":{"name":"Clinical nutrition research","volume":"15 3","pages":"184-190"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674584","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":"Personalized nutrition interventions using digital technologies for older adults: a scoping review.","authors":"Soyoung Jung, Hae Jin Kang, Yoo Kyoung Park","doi":"10.7762/cnr.2026.0027","DOIUrl":"10.7762/cnr.2026.0027","url":null,"abstract":"<p><strong>Objective: </strong>As global populations age, nutrition management is important for healthy aging. Digital technologies, including mobile applications, web-based platforms, messaging tools, and artificial intelligence (AI)-enabled systems, are used in personalized nutrition interventions. However, evidence on their characteristics, effectiveness, and user experiences remains limited. This scoping review examined technology-based personalized nutrition interventions for older adults.</p><p><strong>Methods: </strong>This review followed the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. PubMed, Embase, and Web of Science were searched for studies published from January 1, 2010, to June 30, 2026. Among 2,727 records, 2,044 were screened after duplicate removal, 28 full-text articles were assessed, and 13 articles representing 12 studies were included.</p><p><strong>Results: </strong>Technologies included mobile, messaging, web-based, information and communications technology, tablet-based, and AI-supported systems. Interventions involved dietary recording, personalized feedback, remote counseling, coaching, and self-monitoring. Outcomes included dietary intake and quality, nutritional status, physical function, frailty, cognition, cardiometabolic indicators, engagement, usability, and acceptability. Findings were more consistent for dietary behaviors and individualized nutrition management. Evidence for physical function, frailty, cognition, cardiometabolic health, and quality of life was limited and often based on small or multidomain studies. Familiar interfaces and professional support were accepted, whereas low digital literacy, complex navigation, and limited food databases were barriers.</p><p><strong>Conclusion: </strong>Digital personalized nutrition interventions may support dietary behavior change and individualized nutrition management in older adults. Larger studies and user-centered systems addressing digital literacy, usability, cultural context, and AI-feedback validation are needed.</p>","PeriodicalId":72617,"journal":{"name":"Clinical nutrition research","volume":"15 3","pages":"228-241"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674718","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":"Estimating added sugars intake among South Koreans: results from the 2023 Korea National Health and Nutrition Examination Survey.","authors":"Youngmin Nam, Linxi Huang, Cho-Il Kim, Jihyun Yoon","doi":"10.7762/cnr.2026.0025","DOIUrl":"10.7762/cnr.2026.0025","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to adapt a systematic methodology for estimating the added sugars content of South Korean foods and to assess added sugars intake among South Koreans using data from the 2023 Korea National Health and Nutrition Examination Survey.</p><p><strong>Methods: </strong>The estimation procedure developed for Australian foods was modified and applied to South Korean foods. Added sugars content was estimated for 2,314 food items using the modified 7-step estimation procedure, and these estimates were applied to dietary intake data. Mean contents of total sugars and estimated added sugars were summarized by food group. Mean intakes of total sugars and added sugars, the percentage of energy from added sugars, and the prevalence of excessive added sugars intake were estimated.</p><p><strong>Results: </strong>According to the modified estimation procedure, 53% of food items were assigned to step 1 (total sugars=0) or step 2 (non-added sugars food groups) and therefore assigned added sugars content of zero, while 21% were assigned to step 3, in which all total sugars were classified as added sugars. Mean added sugars intake was 30.7 g/day, accounting for about half of total sugars intake (58.3 g/day). Overall, 21.2% of the population had energy intake from added sugars exceeding 10% of total energy intake, with the highest proportion observed among adolescent girls (37.9%).</p><p><strong>Conclusion: </strong>This study provides the first nationally representative estimates of added sugars intake among South Koreans by adapting a systematic methodology. These findings provide a robust foundation for monitoring population-level added sugars intake and informing the development of targeted policies and interventions to reduce added sugars intake.</p>","PeriodicalId":72617,"journal":{"name":"Clinical nutrition research","volume":"15 3","pages":"139-148"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674594","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":"Gender differences in beverage consumption patterns, dietary behaviors, and beverage-derived nutrient intake among South Korean university students: a cross-sectional study.","authors":"So-Yun Kim, Mi-Hyun Kim, Mi-Kyeong Choi","doi":"10.7762/cnr.2026.0019","DOIUrl":"10.7762/cnr.2026.0019","url":null,"abstract":"<p><strong>Objective: </strong>College students exhibit high beverage consumption and various diet-related problems. Therefore, this study investigated gender-specific beverage consumption patterns and evaluated beverage-related behaviors and beverage-derived nutrient intake among college students.</p><p><strong>Methods: </strong>This study included 366 college students (171 men and 195 women) from Chungnam, South Korea. Beverage categories included carbonated and sugar-sweetened beverages, caffeinated beverages, energy drinks, alcoholic beverages, and milk and liquid yogurt products. Beverage preference, consumption frequency, beverage-related dietary behaviors, and dietary intake were assessed using 3-day 24-hour dietary recalls to evaluate beverage-derived nutrient intake.</p><p><strong>Results: </strong>The mean total beverage intake was 433.9 g/day. Carbonated and sugar-sweetened beverages accounted for the highest intake (144.9 g/day), followed by caffeinated beverages (125.6 g/day), alcoholic beverages (124.3 g/day), and milk and liquid yogurt products (39.2 g/day). Beverages contributed 10.1% of total energy intake and 35.5% of total sugar intake. Carbonated and sugar-sweetened beverages were the largest contributors to carbohydrate and sugar intake, whereas alcoholic beverages contributed the most energy. Milk and liquid yogurt products were the largest contributors to beverage-derived fat and protein intake. Male students had significantly higher intakes of carbonated and sugar-sweetened beverages, alcoholic beverages, total beverages, and beverage-derived energy and sugar than female students.</p><p><strong>Conclusion: </strong>These findings highlight the need for nutrition education to promote healthier beverage choices among college students and support the development of gender-specific beverage-related interventions.</p>","PeriodicalId":72617,"journal":{"name":"Clinical nutrition research","volume":"15 3","pages":"161-171"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674604","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":"Short-chain fatty acid-producing psychobiotics in mood disorders: mechanistic insights into the microbiota-gut-brain axis.","authors":"Juhyun Song","doi":"10.7762/cnr.2026.0016","DOIUrl":"10.7762/cnr.2026.0016","url":null,"abstract":"<p><p>Mood disorders, including major depressive disorder, bipolar disorder, generalized anxiety disorder, and posttraumatic stress disorder, constitute a primary source of global disability, and with conventional monoamine-targeted pharmacotherapy, approximately one-third of patients remain with treatment-resistant disease. Over the past decade, the microbiota-gut-brain axis (MGBA) has emerged as a systems-level pathophysiological framework that explains the chronic neuroinflammation, hypothalamic-pituitary-adrenal axis hyperactivity, and impaired neuroplasticity that characterize treatment-resistant mood disorders. Short-chain fatty acids (SCFAs) are key molecular mediators in MGBA signaling, exerting epigenetic regulation through the inhibition of histone deacetylase, suppression of microglial toll-like receptor 4/nuclear factor-kappa B signaling, reinforcement of intestinal and blood-brain barrier integrity, and rebalancing of tryptophan-kynurenine metabolism. A few small randomized controlled trials and meta-analyses have reported that restoring SCFA output using next-generation psychobiotics (Faecalibacterium prausnitzii, Akkermansia muciniphila, and Clostridium butyricum), prebiotic-rich dietary patterns, defined synbiotics, and direct postbiotic supplementation is associated with symptom improvement, although the evidence base remains preliminary, and have been proposed as candidate prognostic biomarkers. This narrative review synthesizes 2022 to 2026 mechanistic and clinical evidence on SCFA-producing psychobiotics in mood disorders; integrates these findings within a clinical nutrition framework that positions dietary fiber, microbiota-accessible carbohydrates, and targeted psychobiotic supplementation as legitimate adjuncts to conventional psychopharmacology; and discusses the translational challenges of strain specificity, dosing variability, and precision-psychobiotic medicine. Nevertheless, current evidence remains dominated by preclinical models, with human trials constrained by size, duration, and number.</p>","PeriodicalId":72617,"journal":{"name":"Clinical nutrition research","volume":"15 3","pages":"211-227"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674471","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":"Exocrine pancreatic insufficiency as an overlooked cause of chronic diarrhea after Billroth II gastrectomy identified through nutrition-focused assessment: a case report.","authors":"Mijin Kang, Dal Lae Ju, Sookyoung Kim, Jiyoung Song, Youngran Kim","doi":"10.7762/cnr.2026.0012","DOIUrl":"10.7762/cnr.2026.0012","url":null,"abstract":"<p><p>Postgastrectomy diarrhea is often attributed to dumping syndrome or functional changes; however, exocrine pancreatic insufficiency (EPI) from anatomical and physiological alterations may be an underrecognized cause of malabsorption and nutritional decline. Because EPI symptoms are often nonspecific, it may remain undiagnosed and lead to progressive malnutrition if untreated. This case report describes severe EPI identified via nutrition-focused assessment in a patient with persistent diarrhea after Billroth II gastrectomy, and the clinical response to pancreatic enzyme replacement therapy (PERT). A patient with a history of subtotal gastrectomy with Billroth II reconstruction for gastric cancer presented with chronic diarrhea, steatorrhea, weight loss, and hypoalbuminemia. Repeated endoscopic and radiologic evaluations identified no structural cause of diarrhea. Comprehensive nutrition-focused assessment indicated fat malabsorption, and fecal pancreatic elastase was markedly reduced (23.8 µg/g), confirming severe EPI. PERT with pancreatin containing 25,000 units of lipase (Norzyme) was initiated with meals. Posttreatment, steatorrhea resolved and bowel movements normalized without dietary fat restriction. Serum albumin levels subsequently normalized, and body weight returned to the normal range, indicating improved nutritional status. This case emphasizes the clinical value of nutrition-focused assessment in identifying treatable causes of malabsorption, such as EPI, in patients with persistent postgastrectomy diarrhea.</p>","PeriodicalId":72617,"journal":{"name":"Clinical nutrition research","volume":"15 2","pages":"117-121"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13176657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943940","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}