British Journal of Nutrition最新文献

{"title":"Dietary diversity and type 2 diabetes risk: evidence from a prospective Korean cohort study.","authors":"Min-Ji Kim, Hye Won Woo, Min-Ho Shin, Sang-Baek Koh, Hyeon Chang Kim, Yu-Mi Kim, Mi Kyung Kim","doi":"10.1017/S0007114526108733","DOIUrl":"https://doi.org/10.1017/S0007114526108733","url":null,"abstract":"<p><p>Although consuming a diverse diet is generally considered beneficial for chronic disease prevention, its relationship with type 2 diabetes (T2D) remains unclear. This study investigated the associations of overall and within-group dietary diversity scores (DDS) with T2D incidence in the Korean Genome and Epidemiology Study-CVD Association Study. A total of 16 666 participants aged 40 years and older without T2D at baseline were followed for 96 609 person-years, during which 953 incident T2D cases were identified. Cumulative average overall DDS and within-group DDS were derived from repeated FFQ administered at each visit. Modified Poisson regression with a robust error variance estimator was used to estimate incidence rate ratios (IRR) and 95 % CI. A significant inverse linear trend was observed between overall DDS and T2D risk (IRR = 0·56, 95 % CI = 0·40-0·79 for men; IRR = 0·73, 95 % CI = 0·54-0·98 for women). Among the five within-group DDS, those for 'Milk and Dairy products' in both sexes, 'Fruits' in men and 'Vegetables/Seaweeds/Mushrooms' in women were inversely associated with T2D (Q4 <i>v</i>. Q1). No significant sex-related interactions were observed (all <i>p</i> for interaction > 0·05). Higher overall DDS and greater within-group diversity in 'Milk and Dairy products,' 'Fruits' and 'Vegetables/Seaweeds/Mushrooms' were associated with lower T2D risk. These findings suggest that maintaining overall dietary diversity - particularly emphasising non-energy-dense food groups such as fruits, vegetables, and dairy - may help prevent T2D.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-10"},"PeriodicalIF":3.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191268","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":"Burden and trends of protein-energy malnutrition among children under 5 years in WHO South-East Asia Region Countries: an ecological study using the Global Burden of Disease data, 1990-2023.","authors":"Midhun Sasikumar, Kedar Mehta, Tarun Jose, Sreedevi Kotamreddy, Mark Rohit Francis, Sam Marconi David","doi":"10.1017/S0007114526108538","DOIUrl":"https://doi.org/10.1017/S0007114526108538","url":null,"abstract":"<p><p>Malnutrition in its various forms remains a serious public health concern worldwide. This ecological study, based on a secondary analysis of Global Burden of Disease (GBD) 2023 data, examines prevalence trends of protein-energy malnutrition (PEM) among children under 5 years of age in the WHO South-East Asia Region (SEAR) from 1990 to 2023. We utilised Joinpoint regression analysis to identify temporal shifts and calculated the average annual percentage change (AAPC) to summarise overall trends. Regional results show the number of prevalent cases declined from 32·4 million (95 % uncertainty intervals (UI): 32·2-32·7) in 1990 to 18·9 million (95 % UI: 18·7-19·1) in 2023. The prevalence rate per 100 000 population declined from 22 141 to 13 463 over the same period. India maintained the highest prevalence in 2023 at 14·8 % (95 % UI: 14·6-15·0). Joinpoint analysis indicated a significant overall reduction across all countries (<i>p</i> < 0·05), with the most substantial decline in the Democratic People's Republic of Korea (AAPC: -4·05 % (95 % CI -4·08 to -4·01)) and the most modest in Timor-Leste (AAPC: -0·66 % (95 % CI -0·67 to -0·65)). Sex-stratified analysis revealed higher prevalence rates in males than females across the study period. Age-specific findings identified children aged 6-23 months as the most vulnerable group. Furthermore, prevalence was negatively associated with the Socio-demographic Index (SDI), though country-specific trajectories remained heterogeneous. Despite progress, PEM remains a major public health burden in SEAR. These findings highlight the need for targeted, age-specific nutrition strategies and continued socio-economic investment to accelerate progress.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-9"},"PeriodicalIF":3.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179580","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":"Effects of dietary quality on type 2 diabetes risk and the mediating role of inflammatory markers.","authors":"Fengqiong Liu, Ziqi Lin, Qiaofen Lin, Xiaoying Hu, Jiamin Gong, Qingling Su, Weihong Qiu, Shanshan Du, Weimin Ye","doi":"10.1017/S0007114526108605","DOIUrl":"https://doi.org/10.1017/S0007114526108605","url":null,"abstract":"<p><p>This study aimed to explore the association between multiple dietary quality indices and diabetes risk and investigate the potential role of systemic inflammatory markers in such relationships. Data were obtained from 21 476 participants in the Fuqing Cohort Study who completed a FFQ. Dietary quality was assessed using the Healthy Eating Index (HEI), Diet Quality Index (DQI) and Diet Balance Index (DBI). Logistic regression models were used to examine associations among dietary quality, inflammatory markers and glycemic status. Mediation models were employed to evaluate potential mediating effects of eleven systemic inflammatory markers. All three dietary indices were inversely associated with diabetes risk. Compared with participants in the lowest dietary quality category, the adjusted OR (95 % CI) of the highest dietary quality category were 0·863 (0·768, 0·970) for HEI, 0·719 (0·640, 0·807) for DQI and 0·852 (0·754, 0·961) for DBI. Single-mediator analyses showed potential indirect effects of the HEI on diabetes risk via total white blood cell count, neutrophil, monocyte counts, neutrophil-to-lymphocyte ratio and systemic immune-inflammation index, with mediated proportions of 10·67 %, 11·32 %, 4·05 %, 3·22 % and 3·26 %, respectively. In the parallel multiple mediation model including all mediators, a potential indirect effect (OR = 0·980; 95 % CI: 0·759, 0·963) was observed, with a mediated proportion of 8·83 %. Higher dietary quality, as assessed by the HEI, DQI and DBI, is inversely associated with hyperglycaemia risk and linked to lower levels of systemic inflammatory markers. The adverse association of poor dietary quality with diabetes risk may be partially mediated by systemic inflammatory factors.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-11"},"PeriodicalIF":3.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191260","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":"Combined impact of dynapenic abdominal obesity on stroke risk in middle-aged and older adults: evidence from two nationwide prospective cohorts.","authors":"Menghan Sun, Chao Tian, Haibei Liu, Huiying Guo, Ting Yan","doi":"10.1017/S0007114526108253","DOIUrl":"https://doi.org/10.1017/S0007114526108253","url":null,"abstract":"<p><p>Dynapenic abdominal obesity (DAO), characterised by the combination of low muscle strength and abdominal fat accumulation, is an emerging health risk phenotype. Its association with incident stroke remains inadequately explored. This prospective cohort study investigated the relationship between DAO and new-onset stroke in middle-aged and older adults. We analysed data from the China Health and Retirement Longitudinal Study (CHARLS, <i>n</i> 10 153) and used the English Longitudinal Study of Ageing (ELSA, <i>n</i> 5421) for external validation, over a seven-year follow-up. Participants were categorised into four groups: no dynapenia or abdominal obesity (ND/NAO), isolated abdominal obesity, isolated dynapenia and DAO. After adjusting for socio-demographic, lifestyle and comorbidity factors, multivariable logistic regression revealed that DAO was significantly associated with a higher risk of stroke in both CHARLS (OR = 1·96, 95 % CI: 1·37-2·76, <i>P</i> < 0·001) and ELSA (OR = 2·38, 95 % CI: 1·11-5·10, <i>P</i> = 0·025) compared with the ND/NAO group. The risk conferred by DAO exceeded that of either condition in isolation. Stratified analysis suggested a potentially stronger association in urban Chinese men; however, effect modification was not statistically significant. We conclude that DAO is a significant, independent risk factor for stroke in both populations, with combined effects exceeding isolated conditions. This phenotype represents a practical, cross-population marker for clinicians and nutritionists to identify individuals at elevated stroke risk warranting targeted intervention, with potentially important implications for urban Chinese men.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-10"},"PeriodicalIF":3.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179545","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":"Association of Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet with sleep quality and quantity, inflammation and oxidative stress in Iranian adults: a cross-sectional study.","authors":"Zahra Moradmand, Mahdi Moabedi, Arman Laderiean, Ayla Hoodaji, Farnaz Shahdadian, Parisa Rouhani, Parvane Saneei","doi":"10.1017/S0007114526107983","DOIUrl":"https://doi.org/10.1017/S0007114526107983","url":null,"abstract":"<p><p>Although some studies have examined the relation of Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet with sleep disorders, their results were inconclusive and none of them considered inflammation and oxidative stress biomarkers as potential contributors. We evaluated the relation between MIND diet and sleep parameters in Iranian adults, taking biomarkers into account. A sample of 535 adults (46 % were female), with a mean age of 42·6 years, was selected via a multistage-cluster random sampling for this cross-sectional investigation. Dietary data were collected via a validated FFQ. Sleep quality and sleep duration were assessed by the Pittsburgh Sleep Quality Index questionnaire. Concentration of biomarkers was assessed using participants' blood samples, taken after a period of night-fasting. In fully-adjusted model, participants in the highest (<i>v</i>. lowest) tertile of MIND diet had 54 % lower odds of short sleeping (OR_{T3<i>v</i>.T1} = 0·46, 95 % CI: 0·22-0·93), and subjects in the highest tertile of MIND score had 56 % lower odds of poor sleep quality (OR_{T3<i>v</i>.T1} = 0·44, 95 % CI: 0·21-0·95). These associations were stronger in participants with overweight and obesity. Higher adherence to MIND was associated with a lower probability of sleep disturbance (OR_{T3<i>v</i>.T1} = 0·27, 95 % CI: 0·08-0·89). There was no statistically significant association between the MIND diet and either oxidative stress or inflammatory biomarkers (<i>P</i> > 0·05). These findings highlighted inverse associations between higher MIND adherence and sleep disorders among Iranian adults. No significant associations between MIND adherence and biomarkers of inflammation and oxidative stress were found.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-9"},"PeriodicalIF":3.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179612","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":"Knowledge, attitudes and practices of Australian healthcare professionals related to potassium-enriched salt: a mixed-methods study.","authors":"Katrina R Kissock, Nadine Ghammachi, Aletta E Schutte, Xiaoyue Xu, Juliette Crowther, Maoyi Tian, Yuze Xin, Shuangjie Peng, Hannah Greenwood, Loai Albarqouni, Lauren Ball, Bruce Neal, Kathy Trieu","doi":"10.1017/S000711452610854X","DOIUrl":"https://doi.org/10.1017/S000711452610854X","url":null,"abstract":"<p><p>Switching from regular salt to potassium-enriched salt lowers blood pressure and cardiovascular risk, but this intervention is underutilised by healthcare professionals. We assessed Australian healthcare professionals' knowledge, attitudes and practices (KAP) regarding regular salt and potassium-enriched salt for hypertension management. We used mixed-methods research including surveys to quantify KAP towards regular salt and potassium-enriched salt and semi-structured interviews to gather in-depth information about knowledge, attitudes and the barriers and opportunities for recommending potassium-enriched salt use in clinical practice. Participants were general practitioners, medical specialists and allied health professionals working in Australia and caring for individuals with hypertension. Ninety-nine participants completed the survey, and thirty-six participants completed interviews. Survey participants generally had high knowledge related to regular salt; most were aware of potassium-enriched salt (94 %), but only 49 % reported familiarity with it. Of those aware, 73 % considered it safe to use and 66 % knew of the blood pressure-lowering benefits. Only 14 % had recommended it in the previous 12 months, though most interview participants were willing to recommend it in the future. Key barriers to recommendation were limited knowledge about potassium-enriched salt, insufficient time to discuss use with patients and concerns about taste, availability and affordability. The key opportunity identified was incorporating recommendations and information about potassium-enriched salt into existing resources supporting hypertension management by clinicians. Healthcare professionals are mostly aware and supportive of recommending potassium-enriched salt but lack in-depth knowledge. Advice about using potassium-enriched salt needs incorporation into clinical education programmes and hypertension management systems.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-13"},"PeriodicalIF":3.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179527","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":"Intuitive eating and dietary intake: associations by food insecurity status.","authors":"Ayşegül Özkan, Nazan Aktaş","doi":"10.1017/S0007114526108794","DOIUrl":"https://doi.org/10.1017/S0007114526108794","url":null,"abstract":"<p><p>Intuitive eating is an eating approach guided by internal hunger and satiety cues rather than restrictive eating rules. University years are marked by greater autonomy in food choices, vulnerability to food insecurity and sex-related differences in eating behaviours. This study examined the associations between intuitive eating subdimensions and food group-specific consumption scores according to food insecurity status and sex among university students aged 19-24 years in Türkiye. In this cross-sectional study, 545 university students completed a web-based survey comprising the Intuitive Eating Scale-2, the Food Insecurity Experience Scale and a FFQ. These associations were analysed using structural equation modelling separately by sex and food insecurity status. Intuitive eating subdimensions predicted dietary intake in distinct and sometimes opposing directions, with these patterns varying across sex and food insecurity status (<i>p</i> < 0·05). In males, intuitive eating subdimensions predicted intake of milk and dairy products, meat, eggs and legumes and vegetables and fruits; in females, they predicted similar food groups, as well as sugars and sweets and fast foods. Among individuals experiencing moderate or severe food insecurity, these patterns varied across food groups. The body-food choice congruence subdimension generally positively predicted healthier food groups, whereas eating for physical rather than emotional reasons negatively predicted sugars and sweets and fast foods. Unconditional permission to eat positively predicted the consumption of energy-dense foods, while reliance on hunger and satiety cues showed context-dependent patterns. In conclusion, associations between intuitive eating and dietary intake varied by sex and food insecurity status.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-10"},"PeriodicalIF":3.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191381","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":"Nutritional, trace element and heavy metal stability in human milk during standard milk bank processing.","authors":"Ana Rubio-Granda, Marta Suárez-Rodríguez, Leire Cardo González, Clara González-López, María Teresa Peláez-Nava, Nodelina Arias-García, Belén Prieto-García, Gonzalo Solis-Sanchez","doi":"10.1017/S0007114526108654","DOIUrl":"https://doi.org/10.1017/S0007114526108654","url":null,"abstract":"<p><p>Human milk (HM) is the optimal source of nutrition for neonates; however, mothers of preterm infants may experience insufficient milk production. Donor HM from human milk banks (HMB) undergoes freezing and Holder pasteurisation (HoP) to ensure safety, but these processes can alter nutrient and mineral composition. Heavy metals in HM also require monitoring due to neonatal vulnerability. We analysed eighty-eight HM samples from twenty-two donors at four processing stages: fresh, frozen at -20°C, post-HoP and frozen at -80°C. Macronutrients were measured using a MIRIS® HM analyser. Cu, Zn, Se, iodine, As, Cd, Hg and Pb were quantified via ICP-MS. Statistical analyses included repeated-measures ANOVA and paired <i>t</i> tests. Macronutrient concentrations remained largely stable across processing stages. Cu and iodine exhibited significant stage-specific reductions, particularly following HoP and -20°C freezing (<i>p</i> < 0·05). Se and Zn were minimally affected. Hg and As were detectable in some samples but remained below safety thresholds, while Cd and Pb were undetectable at all stages. Notably, carbohydrate levels increased after -80°C freezing, likely due to sample homogenisation variability. Routine HMB processing effectively preserves the nutritional profile of HM while ensuring microbiological safety. Stage-dependent reductions in Cu and iodine suggest that careful monitoring is warranted, especially for preterm infants. Importantly, heavy metal contamination was negligible, confirming the safety of donor HM for neonatal feeding.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-6"},"PeriodicalIF":3.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191345","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":"Unravelling the planetary health diet index-depression nexus: utilisation of network and machine learning approaches.","authors":"Jiaci Lin, Bo Hu, Liuna Geng","doi":"10.1017/S0007114526108617","DOIUrl":"https://doi.org/10.1017/S0007114526108617","url":null,"abstract":"<p><p>Adherence to the planetary health diet index (PHDI) is associated with health benefits, but its relationship with depression, particularly the roles of dietary components and symptoms, remains poorly understood. We aimed to (1) compare PHDI component interrelationships between individuals with and without depression; (2) identify PHDI components most predictive of depression using machine learning and (3) identify bridge nodes connecting PHDI components with depressive symptoms. This cross-sectional study analysed data from 25 542 adults in the National Health and Nutrition Examination Survey 2005-2018. The PHDI was calculated from two 24-h dietary recalls. Depression was assessed with the Patient Health Questionnaire-9 with scores ≥10 indicating depression. We employed network analysis to compare dietary structures, an extreme gradient boosting (XGBoost) model interpreted using shapley additive explanations (SHAP) values to identify predictors and bridge network analysis to identify bridge nodes connecting the PHDI and depressive symptom communities. The PHDI network in the non-depressed group was more densely connected than in the depressed group. SHAP analysis of the XGBoost model identified non-starchy vegetables (PHDI2) and added sugars (PHDI14) as the most important predictors, with higher component scores associated with a lower predicted probability of depression. In the bridge network analysis, appetite problems (PHQ5) and depressed mood (PHQ2) emerged as the strongest bridge nodes between the PHDI and depressive symptom communities. A structured, plant-forward dietary pattern was associated with lower depression levels, with appetite problems and depressed mood identified as the bridge nodes between the PHDI and depressive symptom communities.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-12"},"PeriodicalIF":3.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191480","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":"Resting energy expenditure-guided nutritional support in acute ischaemic stroke patients: a single-centre quasi-randomised controlled trial.","authors":"Xue Yang, Tingting Zuo, Wan Jiang, Hongyan Li, Xiaotian Chen, Wei Shen, Xin Zhang","doi":"10.1017/S0007114526108423","DOIUrl":"https://doi.org/10.1017/S0007114526108423","url":null,"abstract":"<p><p>Acute stroke induces a hypermetabolic/hypercatabolic state, causing malnutrition and muscle wasting that hinder recovery. Weight-based predictive equations for nutritional support may fail to meet individual energy needs. This study compared resting energy expenditure (REE)-guided nutrition with weight-based calorie calculation in acute stroke patients. This single-centre, quasi-randomised controlled trial assessed seventy-four acute ischaemic stroke patients requiring enteral nutrition. Six patients were excluded before allocation, and sixty-eight were allocated by odd/even hospital admission number to the REE-guided group (<i>n</i> 30; energy target 120 % of indirect calorimetry-measured REE) or the control group (<i>n</i> 38; 25 kcal/kg/d). The complete-case analysis included fifty-four patients (REE-guided <i>n</i> 24; control <i>n</i> 30). Primary analyses compared day 14 fat-free mass surrogate indicators after adjustment for baseline values and prespecified covariates. Secondary outcomes included nutritional and inflammatory biomarkers, feeding efficiency and complications. Baseline energy and protein intake were comparable between groups. In unadjusted comparisons at day 14, no statistically significant differences were observed for left or right temporal muscle thickness, whereas calf circumference was lower in the REE-guided group. After adjustment for age, sex, baseline National Institutes of Health Stroke Scale (NIHSS) score, total energy intake and day 0 C-reactive protein (CRP), left temporal muscle thickness was significantly higher in the REE-guided group (<i>β</i> = 0·56, 95 % CI 0·07-1·05, <i>P</i> = 0·031). Right temporal muscle thickness and calf circumference showed non-significant adjusted differences. At day 14, prealbumin was numerically higher in the REE-guided group, but the difference was not statistically significant. Albumin and transferrin were similar between groups. Inflammatory biomarkers, including leucocyte count, CRP and procalcitonin, showed no statistically significant between-group differences. Clinical secondary outcomes, including complications, NIHSS score, time to reach target calories and enteral nutrition interruption, did not differ significantly between groups. REE-guided nutritional support was feasible and safe in acute ischaemic stroke patients and was associated with higher adjusted left temporal muscle thickness at day 14; biomarker findings were exploratory; only prealbumin showed a non-significant favourable numerical trend, whereas inflammatory biomarkers did not show a consistent favourable pattern. Effects on right temporal muscle thickness and calf circumference were not statistically significant. These findings support further evaluation in larger, randomised trials. Trial registration: Chinese Clinical Trial Registry, ChiCTR-IPR-16010051.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-7"},"PeriodicalIF":3.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179552","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}