Asia Pacific journal of clinical nutrition最新文献

{"title":"The Ajinomoto group nutrient profiling system for Japanese dishes and meals.","authors":"Chie Furuta","doi":"10.6133/apjcn.202607_35(Suppl1).0007","DOIUrl":"10.6133/apjcn.202607_35(Suppl1).0007","url":null,"abstract":"<p><p>Nutrient profiling systems (NPS) are used to rank foods by nutrient composition to support public health policy and consumer guidance. Most existing NPS are designed for packaged foods and evaluate nutrients per 100 g or 100 mL, which may not reflect dietary patterns in cultures where home-cooked meals predominate. In Japan, excessive sodium intake, primarily from seasonings and condiments, remains a major public health issue. The Ajinomoto Group Nutrient Profiling System (ANPS) was developed to evaluate Japanese dishes and meals \"as consumed,\" using culturally relevant serving sizes and four criteria: protein, vegetables, saturated fatty acids, and sodium. ANPS was validated using nutrient composition data from 1,089 dishes and 1,816 meals, including recommended, randomly generated, restaurant, and bento-box meals. Validation analyses examined correlations with established nutrient profiling and diet-quality indices. The ANPS showed moderate positive correlations with the Nutrient Rich Food Index (NRF6.3 for dishes, NRF9.3 for meals) and with meal-quality indicators, including the metric Healthy Eating Index 2015 (mHEI-2015). The system has been implemented in the multi-industry Tsujitsuma Shiawase project, where ANPS-based marks help guide consumers toward healthier choices through recipes and public campaigns. The ANPS offers a culturally appropriate and scientifically robust framework for evaluating Japanese meals and supporting sodium reduction. Limitations include exclusion of desserts and beverages in dishes and the lack of direct assessment of excess energy or sugar intake. Ongoing refinement and broader validation are needed to strengthen its usefulness for dietary assessment and public health promotion.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"35 Suppl1","pages":"S51-S55"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13357021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Away-from-home meals: an integral part of Malaysia's food environment.","authors":"Siok Hui Voon","doi":"10.6133/apjcn.202607_35(Suppl1).0002","DOIUrl":"10.6133/apjcn.202607_35(Suppl1).0002","url":null,"abstract":"<p><p>Away-from-home meals have become an increasingly common part of the Malaysian diet, with the wide availability of hawker stalls, coffee shops, cafes, restaurants, and food delivery services catering to diverse tastes and budgets. This paper provides a narrative overview of the Malaysian context, based on relevant literature and policy initiatives. The growing eating-out practice is driven by urbanisation, lifestyle changes, limited time for home cooking, growing preference for convenience, and rising incomes. While eating out has become a social norm, its increased frequency raises nutrition and public health concerns. Local evidence shows that many commonly consumed hawker foods are high in sodium, sugar, and fat, while lacking healthful ingredients such as vegetables, potentially worsening Malaysia's already high burden of diet-related non-communicable diseases. Existing national policies and programmes, such as the Healthier Dining Programme, MyMeal, Healthy Cafeteria and Healthy Catering Trainings, provide nutrition and food safety criteria for healthier meal provision. However, their reach among informal food vendors remains limited, and data on consumer awareness and uptake are scarce. Strengthening and expanding these programmes to better include informal vendors is crucial to increasing the availability of healthier meals. Other opportunities include developing healthier reference recipes for commonly consumed hawker foods to guide reformulation, exploring meal-based nutrient profiling to inform meal selection, using digital nudges within food delivery platforms, and enhancing consumer education. There is also an urgent need for representative national data on away-from-home meals, including consumption patterns, perceptions, demand for healthier options, purchasing behaviours, and their contribution to overall diet and nutritional status.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"35 Suppl 1","pages":"S8-S18"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13357023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meal-based nutrient profiling models for the away-from-home food environment in Southeast Asia.","authors":"E-Siong Tee","doi":"10.6133/apjcn.202607_35(Suppl1).0001","DOIUrl":"10.6133/apjcn.202607_35(Suppl1).0001","url":null,"abstract":"<p><p>It is imperative to recognise that the main components of the food environment in SEA are not processed foods and the so-called ultra-processed foods. Instead, large segments of the population have their meals frequently away from home, as demonstrated by data from Malaysia and Indonesia in this supplement. A myriad of eating places have mushroomed in countries in the region, ranging from street foods, coffee shops, hawker centres and restaurants as well as through numerous food delivery services. Many of these meals are imbalanced, lacking in the healthful food groups, whilst containing high amounts of sugar, oil and salt. Frequent and excessive consumption of these meals and beverages could very well be the main contributors to the nutrition related health problems in the region. Recognising this, the supplement summarises research car-ried out on developing nutrient profiles based on meals or dishes as one of the strategies to improve the food environment. One article in this supplement summarises the principles and utilisation of nutrient profiles while another three articles summarise such meal-based profiles developed by researchers in Thailand and Japan. Meal-based nutritional profile systems, based on food cultures of countries in the region, could help both food vendors to reformulate and improve their menus as well as to consumers to select healthier away-from-home meals. It is hoped that information in this supplement may prove useful for researchers, policy makers, and health care professionals in their efforts to improve the food environment in SEA.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"35 Suppl1","pages":"S1-S7"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13357019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutrient profiling methods applied to mixed dishes and meals.","authors":"Adam Drewnowski","doi":"10.6133/apjcn.202607_35(Suppl1).0004","DOIUrl":"10.6133/apjcn.202607_35(Suppl1).0004","url":null,"abstract":"<p><p>The stated purpose of nutrient profiling (NP) models is to help implement dietary guidelines by addressing prevailing health issues. In high-income countries, obesity and non-communicable diseases are the main health issues of concern. As a result, NP models typically penalize packaged processed foods that contain calories, total or added sugar, sodium, and saturated fat. This negative nutrition approach may not be optimal for Southeast Asia, where nutrient shortfalls and nutrient deficiencies are still prevalent. A more positive approach featuring nutrients to encourage might be more appropriate. NP models should incorporate protein, fibre, calcium, iron, zinc, vitamin A, B vitamins, vitamin B12, and vitamin E. The specific choice of index nutrients may depend on population health needs. Further, given the diversity of Asian food cultures, it may be time to go beyond packaged foods and apply the NP methodology to mixed dishes and to complete meals. This article illustrates the application of NP models to composite meals.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"35 Suppl 1","pages":"S30-S36"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13357022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tart cherry intake and serum uric acid: Meta-analysis of randomized controlled trials and evidence from network pharmacology.","authors":"Zhenzhen Zhang, Zhiyuan Feng, Wei Yan, Tianyu Wu, Jiayue Xia, Junhui Yu, Jingyi Yang, Yuanyuan Wang, Guiju Sun","doi":"10.6133/apjcn.202606_35(3).0008","DOIUrl":"10.6133/apjcn.202606_35(3).0008","url":null,"abstract":"<p><strong>Background and objectives: </strong>Tart cherry products have been proposed to lower serum uric acid and reduce gout risk, but clinical findings are inconsistent. This study evaluated the effect of tart cherry intake on serum uric acid concentration and explored possible mechanisms.</p><p><strong>Methods and study design: </strong>Randomized controlled trials comparing tart cherry intake with placebo or usual diet and reporting serum uric acid concentration were identified from electronic databases. A random effects meta analysis was used to pool standardized mean differences between groups. In parallel, bioactive compounds in tart cherry were retrieved from public databases, and their potential targets related to serum uric acid and gout were investigated using network based analyses and molecular docking.</p><p><strong>Results: </strong>Four randomized trials (eight comparisons; 392 participants) were included. Tart cherry intake was associated with a modest reduction in serum uric acid concentration compared with control (standardized mean difference -0.22; 95% confidence interval -0.43 to -0.01), with substantial heterogeneity. Network and docking analyses suggested that anthocyanins and other polyphenols may act on inflammatory, oxidative stress and metabolic pathways.</p><p><strong>Conclusions: </strong>Tart cherry intake may modestly lower serum uric acid concentration, but evidence is limited in quantity and consistency. Larger, rigorously designed randomized trials are needed.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"35 3","pages":"451-462"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13236459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148161407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between ultra-processed food exposure and gestational diabetes mellitus by diet balance index for pregnancy in Chinese women.","authors":"Wen Liu, Ziqi Wang, Tao Wu, Qian Zhang, Jianbo Zhou","doi":"10.6133/apjcn.202606_35(3).0016","DOIUrl":"10.6133/apjcn.202606_35(3).0016","url":null,"abstract":"<p><strong>Background and objectives: </strong>This study aims to investigate the impact of ultra-processed food (UPF) intake and the Chinese Diet Balance Index for Pregnancy (DBI-P) index on cesarean section rates and neonatal weight among women with gestational diabetes mellitus (GDM).</p><p><strong>Methods and study design: </strong>This study was a retrospective cohort study involving 279 GDM patients. We have collected dietary data, pregnancy information, and calculated UPF intake and the Chinese Diet Balance Index for Pregnancy (DBI-P) index. The impact of UPF exposure and dietary factors on low birth weight and macrosomia was analyzed using logistic regression.</p><p><strong>Results: </strong>This study revealed widespread insufficient consumption of several food groups among the GDM population. Specifically, compared with the UPF non-exposed group, the UPF-exposed group had a significantly higher rate of insufficiency in vegetables (Z = -4.94, p <0.001) and dairy products (Z = -2.28, p = 0.007), but a lower intake of plant oils (Z = -2.16, p = 0.03). After adjusting for several factors, the logistic regression results showed that UPF exposure was a risk factor for cesarean section (OR = 1.74, p = 0.046). Moreover, GDM patients who were overweight or obese before pregnancy faced a higher risk of a cesarean section when exposed to UPFs (OR = 4.13, 95%CI(1.35, 12.6)).</p><p><strong>Conclusions: </strong>Patients with GDM showed an unbalanced dietary intake pattern, which was more pronounced in the group with higher exposure to UPFs. However, prenatal UPF exposure did not significantly affect the patients' oral glucose tolerance test (OGTT) results. Nonetheless, excessive UPF consumption during pregnancy may increase the risk of cesarean section.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"35 3","pages":"533-540"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13236451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148161577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of intermittent fasting on blood glucose and weight in type 2 diabetes and prediabetes: A comparison with ad libitum and continuous energy restriction diets.","authors":"Jianmei Chen, Pengjuan Liu, Muhan Wang, Xiaowen Yan, Jiangping Li, Jianhong Guo","doi":"10.6133/apjcn.202606_35(3).0003","DOIUrl":"10.6133/apjcn.202606_35(3).0003","url":null,"abstract":"<p><strong>Background and objectives: </strong>This study aimed to evaluate the effects of intermittent fasting (IF) on glycated hemoglobin (HbA1c), fasting blood glucose (FBG), body weight (BW), and body mass index (BMI) in pa-tients with type 2 diabetes mellitus (T2DM) and prediabetes.</p><p><strong>Methods and study design: </strong>A systematic search of PubMed, Cochrane Library, Embase, Scopus, and Web of Science was conducted for randomized controlled trials on IF in T2DM and prediabetes published before September 30, 2025. Meta-analysis was performed using RevMan 5.3 and Stata 17.0.</p><p><strong>Results: </strong>Fourteen studies (sixteen arms), involving 899 patients, were included. Four studies (five arms) compared IF with ad libitum diet (316 patients), and ten studies (eleven arms) compared IF with continuous energy restriction diets (CERD) (583 patients). Meta-analysis showed that IF was more effective than the ad libitum diet in reducing HbA1c, BW, BMI and FBG (Standard-ized Mean Difference (SMD) (Hedges's g) -0.64, 95% Confidence Interval (CI) -1.04, -0.24; p <0.05), (SMD (Hedges's g) -0.30, 95% CI -0.55, -0.05; p <0.05), (SMD (Hedges's g) -0.26, 95% CI -0.51, 0.00; p = 0.05), (SMD (Hedges's g) -0.39, 95% CI -0.64 to -0.15; p <0.05). IF demonstrated effects similar to CERD (p <0.05) in terms of HbA1c, BW, BMI, and FBG. Among 14 studies, dropout rates were 21.5% (IF), 26.2% (CERD), and 15.9% (ad libitum). CERD showed a significantly higher dropout rate than ad libitum, whereas no significant differences were observed between IF and CERD or between IF and ad libitum.</p><p><strong>Conclusions: </strong>Intermit-tent fasting is a effective dietary approach for patients with T2DM and prediabetes.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"35 3","pages":"398-411"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13236458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148161707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between dietary macronutrients and body composition in college students","authors":"Huini Ding, Yuhui Sun, Wenjing Wang, Yijia Liu, Yuning Jiao, Wangziyan Lu, Yuandi Xi","doi":"10.6133/apjcn.202606_35(3).0014","DOIUrl":"10.6133/apjcn.202606_35(3).0014","url":null,"abstract":"<p><strong>Background and objectives: </strong>Evidence regarding macronutrients and body composition remains limited. This study examined the relationship in Chinese college students.</p><p><strong>Methods and study design: </strong>498 Beijing college students aged 18-31 years were included. Dietary intake was assessed using a food frequency questionnaire, and body composition was measured by bioelectrical impedance. Linear and logistic regression analyses examined correlations between macronutrients intake and body composition.</p><p><strong>Results: </strong>Obesity-related indicators including waist and hip circumference, waist-hip ratio, body mass index, body fat mass, fat mass index and body fat percentage, and muscle-related indicators including soft lean mass, fat free mass, fat-free mass index, skeletal muscle mass, skeletal muscle index were negatively correlated with the propor-tion of protein intake (p <0.05), and were positively correlated with the proportion of fat intake (p <0.05). All body composition parameters, except waist-hip ratio, were negatively correlated with the proportion of car-bohydrate intake (p <0.05). The risk of thinness increased progressively with higher proportion of protein in-take (OR: 4.48, 4.57, 7.43; p <0.05). However, higher proportion of protein intake was associated with a reduced risk of overweight (OR :0.41, 0.39; p <0.05) and obesity (OR = 0.09, p = 0.007). Increased risk of overweight (OR = 2.29, p = 0.044) and obesity (OR = 4.42, p = 0.030) were observed in the fourth quartile group of fat intake proportion compared to the first.</p><p><strong>Conclusions: </strong>Further studies are warranted to clarify the relationship between body muscle and fat distribution and macronutrients intake composition.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"35 3","pages":"509-521"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13236456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148161271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel combination of SARC-F, GLIM criteria, and calcium levels to predict short-term mortality in hospitalized older adults with advanced-stage cancer.","authors":"Feride Sevilmis, Sevda Averi, Hanife Usta Atmaca, Ozlem Yilmaz","doi":"10.6133/apjcn.202606_35(3).0012","DOIUrl":"10.6133/apjcn.202606_35(3).0012","url":null,"abstract":"<p><strong>Background and objectives: </strong>Sarcopenia and malnutrition are highly prevalent among older adults with advanced-stage cancers. Although the SARC-F is a simple and widely used screening tool for sarcopenia, its extended prognostic value remains under investigation. This study aimed to evaluate the relationship between SARC-F scores, nutritional status, inflammatory biomarkers, and short-term mortality in hospitalized older adults with advanced solid organ malignancies.</p><p><strong>Methods and study design: </strong>We conducted a retrospective cross-sectional analysis on 72 patients with advanced-stage solid tumors and 52 age and sex matched controls. Nutritional status was evaluated using the Mini Nutritional Assessment Short Form (MNA-SF), Nutrition Risk Screening (NRS-2002), and the Global Leadership Initiative on Malnutrition (GLIM) criteria. Functional and frailty assessments included Activities of Daily Living (ADL), Instrumental ADL (IADL), and the FRAIL scale. Laboratory markers of inflammation were also collected. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were used to identify predictors of mortality.</p><p><strong>Results: </strong>A total of 124 participants were included (72 patients with advanced-stage cancer and 52 controls). The mean age was 74.3±9.4 years, and 58.1% were male. Mortality rates at 1, 3, and 6 months were 41.9%, 59.7%, and 65.3%, respectively. In multivariate analysis, calcium levels were independently associated with increased mortality risk (OR: 4.59, p <0.001). The SARC-F score demonstrated moderate discriminative ability for mortality prediction (AUC: 0.675), with high specificity (96.2%) but low sensitivity (30.6%) at a cut-off of ≥4.</p><p><strong>Conclusions: </strong>The SARC-F score serves as a multidimensional indicator reflecting sarcopenia risk, nutritional deficits, functional impairment, and short-term mortality. Its prognostic utility improves when combined with clinical and laboratory markers. This study proposes a novel prognostic model incorporating SARC-F, GLIM criteria, and serum calcium to enhance short-term mortality prediction in older adults with advanced cancer.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"35 3","pages":"494-501"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13236449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148161580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concordance evaluation of a nutrition self-assessment app and clinical experts in estimating energy requirements and deficits among ONS consumers.","authors":"Chloe Zhu, Mei He, Jie Chen, Min Chen, Renying Xu, Jian Gao, Yi Feng, Hua Xie, Wei Yuan, Qian Ren, Pengkun Song, Jianqin Sun","doi":"10.6133/apjcn.202606_35(3).0013","DOIUrl":"10.6133/apjcn.202606_35(3).0013","url":null,"abstract":"<p><strong>Background and objectives: </strong>The Nutrition Self-Assessment App (APP), a novel smartphone-based tool, was developed to enable users of oral nutritional supplements (ONSs) to self-assess total energy expenditure (TEE) and identify energy deficits, providing personalized ONS recommendations. By integrating step-count track-ing and dietary intake reporting, the app estimates physical activity levels and energy deficits. However, validation against clinician assessments is essential prior to large-scale implementation.</p><p><strong>Methods and study design: </strong>In this multicenter cross-sectional study (October-November 2023), TEE and deficits were evaluated using both the app and clinician assessments. Statistical analyses included paired t-tests, intraclass correlation coefficients (ICC), and Bland-Altman plots. Clinician satisfaction was measured via a 5-point Likert scale.</p><p><strong>Results: </strong>Among 423 ONS users, no significant differences were found between clinician- and app-derived estimates for TEE (1606.2 ± 287.2 vs. 1541.6 ± 300.5 kcal/day, p >0.05) or energy deficits (610.4 ± 376.9 vs. 600.1 ± 384.6 kcal/day, p >0.05). Agreement was moderate for TEE (ICC = 0.66) and excellent for deficits (ICC = 0.94). Bland-Altman analysis showed 93.9% (397/423) of deficit differences within 95% limits of agreement. Clinicians rated the app as \"very satisfied\" (46.1%) or \"fairly satisfied\" (37.1%) for most participants.</p><p><strong>Conclusions: </strong>The app demonstrated moderate agreement with clinician assessments for TEE estimation, while showing high agreement in energy deficit estimation. These findings validate its potential reliabil-ity as a supportive tool for ONS management. Its integration of activity tracking and dietary monitoring supports scalable implementation to improve ONS adherence.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"35 3","pages":"502-508"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13236455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148161659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}