Pub Date : 2025-12-02DOI: 10.1016/j.clnesp.2025.11.162
Paulo Roberto Santos Lopes , Gisele Bailich , Vinicius Layter Xavier , Igor Lima , Danubia da Cunha de Sá-Caputo , Redha Taiar , Katarzyna Zaborowska-Sapeta , Mario Bernardo-Filho , André Everton de Freitas , Anelise Sonza
Background and aims
Obesity is one of the most common nutritional and metabolic disorders worldwide, affecting all age groups. Multiple regression models can be used to predict bioelectrical impedance analysis (BIA) variables in various populations. These models incorporate a set of anthropometric and simple measures to improve the accuracy of predicting BIA variables. The goal was to develop and internally validate multiple regression models to predict BIA variables using simple clinical and anthropometric measurements in children aged 6–12 years.
Methods
This study employs an observational cross-sectional design. Body mass, height, body composition through BIA, anthropometric circumferences, and skinfolds were evaluated. Anthropometric indices were calculated. Statistical analyses were performed using R software. Non-parametric statistical tests were applied after a normality test. Pearson's correlation coefficients were calculated to assess linear associations between each pair of variables. The multiple regression models were adjusted using a stepwise method with the Akaike information criterion. The significance level was p ≤ 0.05.
Results
This study evaluated 128 children subdivided into eutrophic (N = 64) matched for sex and age with overweight (N = 30) and obese (N = 34) groups matched by sex and age. Significant correlations were observed between BIA variables and simple clinical and anthropometric measurements. Variables with the highest correlations with simple clinical and anthropometric measurements were body fat percentage, skeletal muscle mass, total body water, and fat-free mass, respectively.
Conclusions
Multiple regression analysis indicated that simple clinical and anthropometric measurements could be used to estimate BIA variables in children.
{"title":"Multiple regression models to predict electrical bioimpedance variables through anthropometric and simple measures in children aged 6–12 years","authors":"Paulo Roberto Santos Lopes , Gisele Bailich , Vinicius Layter Xavier , Igor Lima , Danubia da Cunha de Sá-Caputo , Redha Taiar , Katarzyna Zaborowska-Sapeta , Mario Bernardo-Filho , André Everton de Freitas , Anelise Sonza","doi":"10.1016/j.clnesp.2025.11.162","DOIUrl":"10.1016/j.clnesp.2025.11.162","url":null,"abstract":"<div><h3>Background and aims</h3><div>Obesity is one of the most common nutritional and metabolic disorders worldwide, affecting all age groups. Multiple regression models can be used to predict bioelectrical impedance analysis (BIA) variables in various populations. These models incorporate a set of anthropometric and simple measures to improve the accuracy of predicting BIA variables. The goal was to develop and internally validate multiple regression models to predict BIA variables using simple clinical and anthropometric measurements in children aged 6–12 years.</div></div><div><h3>Methods</h3><div>This study employs an observational cross-sectional design. Body mass, height, body composition through BIA, anthropometric circumferences, and skinfolds were evaluated. Anthropometric indices were calculated. Statistical analyses were performed using R software. Non-parametric statistical tests were applied after a normality test. Pearson's correlation coefficients were calculated to assess linear associations between each pair of variables. The multiple regression models were adjusted using a stepwise method with the Akaike information criterion. The significance level was p ≤ 0.05.</div></div><div><h3>Results</h3><div>This study evaluated 128 children subdivided into eutrophic (N = 64) matched for sex and age with overweight (N = 30) and obese (N = 34) groups matched by sex and age. Significant correlations were observed between BIA variables and simple clinical and anthropometric measurements. Variables with the highest correlations with simple clinical and anthropometric measurements were body fat percentage, skeletal muscle mass, total body water, and fat-free mass, respectively.</div></div><div><h3>Conclusions</h3><div>Multiple regression analysis indicated that simple clinical and anthropometric measurements could be used to estimate BIA variables in children.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"71 ","pages":"Article 102842"},"PeriodicalIF":2.6,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145676668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.clnesp.2025.11.133
C.V. Noejovich, P. Miranda, G.H. Rueda, Y. Yuan, J. Szeto, R. Patel, H. Zafar, M. Tedesco, D. Armstrong
Background
The connection between diet, disease activity, and symptoms in inflammatory bowel disease (IBD) has received increasing attention. Although many studies explore associations between dietary patterns and IBD, there is limited understanding of patients’ perspectives on dietary modifications and the challenges they encounter in implementing dietary changes. This scoping review aims to address this issue gap.
Aim
To examine the existing evidence on adult IBD patients’ perspectives on dietary modifications for symptom management and identify knowledge gaps for future research.
Methods
This scoping review followed the Joanna Briggs Institute (JBI) methodology. We searched MEDLINE (Ovid, from 1946) and Embase (Ovid, from 1974) until June 26, 2024. Qualitative, quantitative, and mixed-methods studies published in English that reported on IBD patients' perspectives, behaviors, and challenges regarding diet modification were included. Reference lists of relevant reviews were manually screened. No statistical comparisons were performed.
Results
The search identified 2909 studies, of which 53 met the inclusion criteria. Thirty-four studies focused primarily on patients' beliefs and behaviors regarding diet. Most IBD patients reported modifying their diet after diagnosis (56 %–91 %), most commonly through food avoidance (41–95 %) or by trialing restrictive diets to prevent relapse. Many patients believed diet played a role in IBD onset (8–49.2 %) and relapse prevention (33–74 %). Eighteen studies explored barriers to diet modification, the most commonly reported being negative impacts on social and family life and the unpredictability of dietary effects on overall health. Many patients sought dietary advice online.
Conclusion
Food avoidance and social restrictions are common among IBD patients. While nutrition is believed to play a key role in IBD management, challenges in accessing professional dietary guidance persist. Further research is needed to explore difficulties in implementing dietary changes.
{"title":"Understanding dietary beliefs, behaviors, and barriers in inflammatory bowel disease: A scoping review","authors":"C.V. Noejovich, P. Miranda, G.H. Rueda, Y. Yuan, J. Szeto, R. Patel, H. Zafar, M. Tedesco, D. Armstrong","doi":"10.1016/j.clnesp.2025.11.133","DOIUrl":"10.1016/j.clnesp.2025.11.133","url":null,"abstract":"<div><h3>Background</h3><div>The connection between diet, disease activity, and symptoms in inflammatory bowel disease (IBD) has received increasing attention. Although many studies explore associations between dietary patterns and IBD, there is limited understanding of patients’ perspectives on dietary modifications and the challenges they encounter in implementing dietary changes. This scoping review aims to address this issue gap.</div></div><div><h3>Aim</h3><div>To examine the existing evidence on adult IBD patients’ perspectives on dietary modifications for symptom management and identify knowledge gaps for future research.</div></div><div><h3>Methods</h3><div>This scoping review followed the Joanna Briggs Institute (JBI) methodology. We searched MEDLINE (Ovid, from 1946) and Embase (Ovid, from 1974) until June 26, 2024. Qualitative, quantitative, and mixed-methods studies published in English that reported on IBD patients' perspectives, behaviors, and challenges regarding diet modification were included. Reference lists of relevant reviews were manually screened. No statistical comparisons were performed.</div></div><div><h3>Results</h3><div>The search identified 2909 studies, of which 53 met the inclusion criteria. Thirty-four studies focused primarily on patients' beliefs and behaviors regarding diet. Most IBD patients reported modifying their diet after diagnosis (56 %–91 %), most commonly through food avoidance (41–95 %) or by trialing restrictive diets to prevent relapse. Many patients believed diet played a role in IBD onset (8–49.2 %) and relapse prevention (33–74 %). Eighteen studies explored barriers to diet modification, the most commonly reported being negative impacts on social and family life and the unpredictability of dietary effects on overall health. Many patients sought dietary advice online.</div></div><div><h3>Conclusion</h3><div>Food avoidance and social restrictions are common among IBD patients. While nutrition is believed to play a key role in IBD management, challenges in accessing professional dietary guidance persist. Further research is needed to explore difficulties in implementing dietary changes.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"71 ","pages":"Article 102818"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145667485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.clnesp.2025.11.020
Takashi Aoyama
Background & aims
We aimed to compare the Harris–Benedict Basal Energy Expenditure (HBEE) and the Cunningham Basal Metabolic Rate (CBMR) in relation to weight loss rate (percentage loss of body weight [%LBW]) among patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT).
Methods
Patients who underwent HSCT (transplant date = day 0) at the Division of Stem Cell Transplantation, Shizuoka Cancer Center, between January 2022 and June 2023 were included. We evaluated the association between weight loss rate from the day before pre-treatment to day 42 and the sufficiency of each calculated basal metabolic value.
Results
A total of 31 patients (median age, 53 years; interquartile range, 37–60; 17 male individuals) were analyzed. The median %LBW was −5.0 % (range: −31.2–7.6). %LBW was significantly correlated with sufficiency of HBEE based on current weight (97 %), HBEE based on standard weight (94 %), and CBMR (96 %) (r = 0.56, r = 0.44, r = 0.52, respectively). Using a cutoff of 7.5 % LBW, sufficiency rates were associated with weight loss (odds ratios: 1.08; 95 % confidence interval [CI]: 1.02–1.17; 1.07; 95 % CI: 1.01–1.14; and 1.05; 95 % CI: 1.01–1.11, respectively).
Conclusion
Post-HSCT weight loss was significantly correlated with HBEE (based on both current and standard weight) and CBMR sufficiency, suggesting that these calculations may provide useful indicators for nutritional management following HSCT.
{"title":"Sufficient rate comparison of Harris-Benedict basal metabolic energy expenditure and Cunningham basal metabolic rate for the weight loss rate in allogeneic hematopoietic stem cell transplantation","authors":"Takashi Aoyama","doi":"10.1016/j.clnesp.2025.11.020","DOIUrl":"10.1016/j.clnesp.2025.11.020","url":null,"abstract":"<div><h3>Background & aims</h3><div>We aimed to compare the Harris–Benedict Basal Energy Expenditure (HBEE) and the Cunningham Basal Metabolic Rate (CBMR) in relation to weight loss rate (percentage loss of body weight [%LBW]) among patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT).</div></div><div><h3>Methods</h3><div>Patients who underwent HSCT (transplant date = day 0) at the Division of Stem Cell Transplantation, Shizuoka Cancer Center, between January 2022 and June 2023 were included. We evaluated the association between weight loss rate from the day before pre-treatment to day 42 and the sufficiency of each calculated basal metabolic value.</div></div><div><h3>Results</h3><div>A total of 31 patients (median age, 53 years; interquartile range, 37–60; 17 male individuals) were analyzed. The median %LBW was −5.0 % (range: −31.2–7.6). %LBW was significantly correlated with sufficiency of HBEE based on current weight (97 %), HBEE based on standard weight (94 %), and CBMR (96 %) (r = 0.56, r = 0.44, r = 0.52, respectively). Using a cutoff of 7.5 % LBW, sufficiency rates were associated with weight loss (odds ratios: 1.08; 95 % confidence interval [CI]: 1.02–1.17; 1.07; 95 % CI: 1.01–1.14; and 1.05; 95 % CI: 1.01–1.11, respectively).</div></div><div><h3>Conclusion</h3><div>Post-HSCT weight loss was significantly correlated with HBEE (based on both current and standard weight) and CBMR sufficiency, suggesting that these calculations may provide useful indicators for nutritional management following HSCT.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 684-691"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145556287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.clnesp.2025.09.013
Shashank Dokania, Parth Aphale, Himanshu Shekhar
{"title":"Letter to the Editor: Comment on “Addressing nutritional risk and dehydration in vulnerable older adults in the emergency department: A single-arm feasibility study on detection, treatment, and follow-up”","authors":"Shashank Dokania, Parth Aphale, Himanshu Shekhar","doi":"10.1016/j.clnesp.2025.09.013","DOIUrl":"10.1016/j.clnesp.2025.09.013","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 719-720"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.clnesp.2025.08.025
Leela Kumaran, Sheifali Gupta
{"title":"Letter to the Editor: Nutritional status in retroperitoneal sarcoma: Implication of prognostic Nutritional Index (PNI) and skeletal muscle index (SMI) on postoperative and oncological outcomes","authors":"Leela Kumaran, Sheifali Gupta","doi":"10.1016/j.clnesp.2025.08.025","DOIUrl":"10.1016/j.clnesp.2025.08.025","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 723-724"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.clnesp.2025.11.160
Hsien-Yu Fan , Yih-Jong Chern , Hsin-Yin Hsu , Po-Jui Lai , Ming-Chieh Tsai , Kuo-Liong Chien , Chih-Jun Lai , Chiu-Li Yeh
Background
Blood omega-3 fatty acids have been linked to inflammatory markers and lung function, but their effects in participants with inflammatory bowel disease (IBD) remain unclear.
Objective
This study aimed to investigate inflammatory markers in the relationship between blood omega-3 fatty acids and lung function in IBD participants and subtypes.
Design, setting and patients
A total of 497,134 UK Biobank participants were screened, and 3340 participants with IBD were included in the analysis.
Exposures and outcomes
Participants were classified into quintiles based on blood omega-3 fatty acid levels (% of total fatty acids), with Q1 as the reference. Linear regression compared inflammatory markers across quintiles. We then examined how inflammatory markers might link omega-3 levels to lung function.
Results
IBD participants, particularly those with Crohn's disease, showed stronger reductions in inflammatory biomarkers—white blood cells, basophils, neutrophils, neutrophil-to-lymphocyte ratios, and C-reactive protein (CRP) (p < 0.001)—at higher omega-3 levels. CRP and neutrophils were potential mediators between omega-3 levels and lung function (FEV1 and FVC). A 1 % increase in omega-3 levels reduced CRP by 0.27 mg/L and neutrophils by 0.07 × 109 cells/L, corresponding to reductions of 10.88 mL in FEV1 and 12.36 mL in FVC for CRP, and 38.20 mL in FEV1 and 39.36 mL in FVC for neutrophils. Mediation analysis showed that CRP and neutrophils accounted for 21 % (p = 0.01) and 18 % (p = 0.02) of the FEV1 effect, and 22 % (p = 0.049) and 16 % (p = 0.049) of the FVC effect, respectively.
Conclusions
Higher omega-3 fatty acid levels were associated with reduced inflammatory biomarkers, which may also be associated with lung health in individuals with IBD, particularly those with Crohn's disease. Future studies should investigate additional immune mediators, including cytokines and chemokine.
背景：血液中omega-3脂肪酸与炎症标志物和肺功能有关，但其对炎症性肠病（IBD）患者的影响尚不清楚。目的：本研究旨在探讨IBD参与者及其亚型血液中omega-3脂肪酸与肺功能之间的炎症标志物。设计、环境和患者：共有497,134名UK Biobank参与者被筛选，3340名IBD患者被纳入分析。暴露和结果：参与者根据血液中omega-3脂肪酸水平（占总脂肪酸的百分比）分为五分之一，以Q1为参考。线性回归比较了不同五分位数的炎症标志物。然后，我们研究了炎症标志物如何将ω -3水平与肺功能联系起来。结果：IBD参与者，特别是那些患有克罗恩病的参与者，在较高的omega-3水平下，炎症生物标志物-白细胞、嗜碱性粒细胞、中性粒细胞、中性粒细胞与淋巴细胞比率和c反应蛋白（CRP） （p < 0.001）的减少更明显。CRP和中性粒细胞是omega-3水平与肺功能（FEV1和FVC）之间的潜在介质。omega-3水平增加1%，CRP降低0.27 mg/L，中性粒细胞降低0.07 × 109个细胞/L，对应于CRP降低10.88 mL FEV1和12.36 mL FVC，中性粒细胞降低38.20 mL FEV1和39.36 mL FVC。中介分析显示，CRP和中性粒细胞分别占FEV1效应的21% （p = 0.01）和18% (p = 0.02)，占FVC效应的22% （p = 0.049）和16% （p = 0.049）。结论：较高的omega-3脂肪酸水平与炎症生物标志物减少有关，这也可能与IBD患者，特别是克罗恩病患者的肺部健康有关。未来的研究应探讨更多的免疫介质，包括细胞因子和趋化因子。
{"title":"Associations of blood Omega-3 fatty acid, inflammatory markers, and lung function in UK biobank participants with inflammatory bowel disease","authors":"Hsien-Yu Fan , Yih-Jong Chern , Hsin-Yin Hsu , Po-Jui Lai , Ming-Chieh Tsai , Kuo-Liong Chien , Chih-Jun Lai , Chiu-Li Yeh","doi":"10.1016/j.clnesp.2025.11.160","DOIUrl":"10.1016/j.clnesp.2025.11.160","url":null,"abstract":"<div><h3>Background</h3><div>Blood omega-3 fatty acids have been linked to inflammatory markers and lung function, but their effects in participants with inflammatory bowel disease (IBD) remain unclear.</div></div><div><h3>Objective</h3><div>This study aimed to investigate inflammatory markers in the relationship between blood omega-3 fatty acids and lung function in IBD participants and subtypes.</div></div><div><h3>Design, setting and patients</h3><div>A total of 497,134 UK Biobank participants were screened, and 3340 participants with IBD were included in the analysis.</div></div><div><h3>Exposures and outcomes</h3><div>Participants were classified into quintiles based on blood omega-3 fatty acid levels (% of total fatty acids), with Q1 as the reference. Linear regression compared inflammatory markers across quintiles. We then examined how inflammatory markers might link omega-3 levels to lung function.</div></div><div><h3>Results</h3><div>IBD participants, particularly those with Crohn's disease, showed stronger reductions in inflammatory biomarkers—white blood cells, basophils, neutrophils, neutrophil-to-lymphocyte ratios, and C-reactive protein (CRP) (<em>p</em> < 0.001)—at higher omega-3 levels. CRP and neutrophils were potential mediators between omega-3 levels and lung function (FEV<sub>1</sub> and FVC). A 1 % increase in omega-3 levels reduced CRP by 0.27 mg/L and neutrophils by 0.07 × 10<sup>9</sup> cells/L, corresponding to reductions of 10.88 mL in FEV<sub>1</sub> and 12.36 mL in FVC for CRP, and 38.20 mL in FEV<sub>1</sub> and 39.36 mL in FVC for neutrophils. Mediation analysis showed that CRP and neutrophils accounted for 21 % (<em>p</em> = 0.01) and 18 % (<em>p</em> = 0.02) of the FEV1 effect, and 22 % (<em>p</em> = 0.049) and 16 % (<em>p</em> = 0.049) of the FVC effect, respectively.</div></div><div><h3>Conclusions</h3><div>Higher omega-3 fatty acid levels were associated with reduced inflammatory biomarkers, which may also be associated with lung health in individuals with IBD, particularly those with Crohn's disease. Future studies should investigate additional immune mediators, including cytokines and chemokine.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"71 ","pages":"Article 102840"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145667416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.clnesp.2025.09.017
M.K. Nielsen, E.D.M. Pedersen, A.W. Knudsen, T. Munk, A.M. Beck
{"title":"Authors’ reply to the letter to the editor: Comment on “Addressing nutritional risk and dehydration in vulnerable older adults in the emergency department: A single-arm feasibility study on detection, treatment, and follow-up”","authors":"M.K. Nielsen, E.D.M. Pedersen, A.W. Knudsen, T. Munk, A.M. Beck","doi":"10.1016/j.clnesp.2025.09.017","DOIUrl":"10.1016/j.clnesp.2025.09.017","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 721-722"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.clnesp.2025.11.019
Dmitry M. Davydov , Ailyn Garcia-Hernandez , Carmen M. Galvez-Sánchez , Juan A. Andrade-Ortega , Gustavo A. Reyes del Paso
Background&aim
Previous meta-analyses have suggested that body mass may not significantly influence pain modulation, with any observed effects potentially arising from methodological inconsistencies. This interdisciplinary study, utilizing four distinct subsamples with varied cross-sectional and prospective designs, aimed to challenge these conclusions by considering the divergent impacts of different body mass compartments on pain mechanisms.
Methods
Total body mass and body composition—including fat, fat-free mass, and body water volume—were assessed using anthropometry (body weight, waist circumference), handgrip strength as a physical performance measure, bioimpedance, and dual-energy X-ray absorptiometry. The study explored the relationship between these factors and various pain-evoked measures, including pressure pain threshold, tolerance, sensitization, and intensity and unpleasantness ratings, both at baseline and six months later.
Results
The results demonstrated that while both high fat mass and elevated hydration status contribute to increased body mass, they have distinct effects on pain regulation. Fat mass was linked to hyperalgesia, while hydration was associated with hypoalgesia across all subsamples. These findings underscore the essential role of proper hydration in managing pain sensitivity, identifying inadequate hydration status as a stronger contributor to both short- and long-term pain modulation risks than fat mass. Excess fat mass or hydration deficits were shown to progressively disrupt primary and additional pain control mechanisms in a stepwise or dose-dependent manner, further influencing overall pain states.
Conclusion
The findings challenge the reliability of meta-analyses for complex indicators like body mass. Pain management should prioritize personalized strategies targeting biobehavioral mechanisms regulating both body hydration and fat mass.
{"title":"Opposing roles of body fat and hydration in pain: Insights from chronic pain, healthy, and general populations","authors":"Dmitry M. Davydov , Ailyn Garcia-Hernandez , Carmen M. Galvez-Sánchez , Juan A. Andrade-Ortega , Gustavo A. Reyes del Paso","doi":"10.1016/j.clnesp.2025.11.019","DOIUrl":"10.1016/j.clnesp.2025.11.019","url":null,"abstract":"<div><h3>Background&aim</h3><div>Previous meta-analyses have suggested that body mass may not significantly influence pain modulation, with any observed effects potentially arising from methodological inconsistencies. This interdisciplinary study, utilizing four distinct subsamples with varied cross-sectional and prospective designs, aimed to challenge these conclusions by considering the divergent impacts of different body mass compartments on pain mechanisms.</div></div><div><h3>Methods</h3><div>Total body mass and body composition—including fat, fat-free mass, and body water volume—were assessed using anthropometry (body weight, waist circumference), handgrip strength as a physical performance measure, bioimpedance, and dual-energy X-ray absorptiometry. The study explored the relationship between these factors and various pain-evoked measures, including pressure pain threshold, tolerance, sensitization, and intensity and unpleasantness ratings, both at baseline and six months later.</div></div><div><h3>Results</h3><div>The results demonstrated that while both high fat mass and elevated hydration status contribute to increased body mass, they have distinct effects on pain regulation. Fat mass was linked to hyperalgesia, while hydration was associated with hypoalgesia across all subsamples. These findings underscore the essential role of proper hydration in managing pain sensitivity, identifying inadequate hydration status as a stronger contributor to both short- and long-term pain modulation risks than fat mass. Excess fat mass or hydration deficits were shown to progressively disrupt primary and additional pain control mechanisms in a stepwise or dose-dependent manner, further influencing overall pain states.</div></div><div><h3>Conclusion</h3><div>The findings challenge the reliability of meta-analyses for complex indicators like body mass. Pain management should prioritize personalized strategies targeting biobehavioral mechanisms regulating both body hydration and fat mass.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 701-718"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145539356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.clnesp.2025.10.023
Thi Nhu Ngoc Ha , Teresa Brown , Rachel Willims , Rhiannon Young , Belinda Camilleri , Sarah Andersen
Background & aim
Patients undergoing haematopoietic stem cell transplantation are at high risk of malnutrition, with limited clinical guidelines available to inform energy provision. This systematic review aimed to synthesize and assess the evidence for energy expenditure of patients undergoing stem cell transplantation with and without Graft-versus-Host-Disease.
Methods
A systematic search of PubMed, CINAHL, Embase, Cochrane and Scopus was conducted to include studies published until 20 May 2025. The review utilised the PRISMA framework and the Academy of Nutrition and Dietetics quality criteria checklist. Included studies were those measuring resting energy expenditure or total energy expenditure of patients aged ≥15 undergoing stem cell transplantation. Exclusion criteria were case studies, conference papers, animal studies or non-English language.
Results
Ten studies were eligible and rated as neutral (n = 5) or negative quality (n = 5). High heterogeneity in timepoints, study designs, participants, methodologies, outcomes and energy expenditure unit measures restricted the ability to pool energy expenditure outcome data. Post autologous transplant, energy expenditure remained either relatively stable or increased from baseline. Post allogeneic transplant, energy expenditure was either stable or increased after transplant, but in one study when tested during aplasia, this had declined from baseline. For Graft-versus-Host-Disease, the limited data available indicated equivalent or higher energy expenditure than the control group.
Conclusion
This review highlights the lack of data to guide energy expenditure provision during stem cell transplantation. Nutritional intake and status should be monitored closely during stem cell transplantation and Graft-versus-Host-Disease. Additional high-quality studies with larger sample sizes using validated measurement tools are required.
{"title":"Energy expenditure of patients undergoing stem cell transplantation: A systematic review","authors":"Thi Nhu Ngoc Ha , Teresa Brown , Rachel Willims , Rhiannon Young , Belinda Camilleri , Sarah Andersen","doi":"10.1016/j.clnesp.2025.10.023","DOIUrl":"10.1016/j.clnesp.2025.10.023","url":null,"abstract":"<div><h3>Background & aim</h3><div>Patients undergoing haematopoietic stem cell transplantation are at high risk of malnutrition, with limited clinical guidelines available to inform energy provision. This systematic review aimed to synthesize and assess the evidence for energy expenditure of patients undergoing stem cell transplantation with and without Graft-versus-Host-Disease.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, CINAHL, Embase, Cochrane and Scopus was conducted to include studies published until 20 May 2025. The review utilised the PRISMA framework and the Academy of Nutrition and Dietetics quality criteria checklist. Included studies were those measuring resting energy expenditure or total energy expenditure of patients aged ≥15 undergoing stem cell transplantation. Exclusion criteria were case studies, conference papers, animal studies or non-English language.</div></div><div><h3>Results</h3><div>Ten studies were eligible and rated as neutral (n = 5) or negative quality (n = 5). High heterogeneity in timepoints, study designs, participants, methodologies, outcomes and energy expenditure unit measures restricted the ability to pool energy expenditure outcome data. Post autologous transplant, energy expenditure remained either relatively stable or increased from baseline. Post allogeneic transplant, energy expenditure was either stable or increased after transplant, but in one study when tested during aplasia, this had declined from baseline. For Graft-versus-Host-Disease, the limited data available indicated equivalent or higher energy expenditure than the control group.</div></div><div><h3>Conclusion</h3><div>This review highlights the lack of data to guide energy expenditure provision during stem cell transplantation. Nutritional intake and status should be monitored closely during stem cell transplantation and Graft-versus-Host-Disease. Additional high-quality studies with larger sample sizes using validated measurement tools are required.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 725-735"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.clnesp.2025.11.008
Carmen Ripa , Olatz Olariaga , Sara Vallinas , Mariola Sirvent , Elena Prado , Rosa Romero , Laia Pérez , Paloma Terroba , Sara Hernández , Amelia Chica , Maria José Gandara , Lucrecia Bourgon , Maria Ochagavia , Rocío Tamayo , Larraitz Leunda
<div><h3>Background & aims</h3><div>Disease-related malnutrition (DRM) is a frequent condition among cancer patients, with prevalence varying widely across studies depending on the phase of the disease (e.g., at diagnosis, during advanced stages, or throughout antineoplastic treatment) and tumour location. The aim of the OncoNutridos study was to assess the prevalence of DRM using the Global Leadership Initiative on Malnutrition (GLIM) criteria in cancer patients receiving active antineoplastic treatment in oncohaematology day hospitals. Additionally, the study evaluated the relationship between DRM and cancer-related hospital admissions, as well as 6-month mortality following study inclusion.</div></div><div><h3>Methods</h3><div>This was a national, cross-sectional, observational, multicentre study conducted in accordance with standard clinical practice. Demographic characteristics, comorbidities, clinical variables, and anthropometric data were collected at the time of patient's admission to the chemotherapy suite. Anthropometric data -weight (kg) and height (m)- were obtained from the patient's medical record. Usual weight was obtained through patient's interview. DRM was diagnosed in accordance with the GLIM criteria. Reduced muscle mass was assessed via calf circumference -adjusted for the patient's BMI-. All patients were interviewed to detect reduced food intake. Patient recruitment took place across eight months, with a follow-up period of six months thereafter.</div></div><div><h3>Results</h3><div>A total of 4440 patients were included between 86 hospitals nationwide. The median age was 61.1 years, 71.8 % of the patients were under 70 years of age, and 72.3 % were in advanced tumour stage (III-IV). The overall prevalence of disease-related malnutrition (DRM) according to GLIM criteria was 50.74 % (45.98 % in patients <70 years, and 62.86 % in those ≥70 years). Malnutrition prevalence was significantly higher among patients with advanced-stage tumours (stage III-IV) compared to those in early-stage disease (stage I-II) (54 % vs. 42 %; <em>p</em> < 0.001). Among patients with DRM, 72.52 % had moderate malnutrition, with no significant differences in malnutrition severity observed between age groups. Additionally, 77.2 % of malnourished patients were in advanced stages of disease (Stage III–IV). Compared to well-nourished individuals, malnourished patients had a significantly higher incidence of oncology-related hospitalizations in the six months following recruitment (36.8 % vs 31.32 %; p < 0.001; RR 1.18 IC95 % [1.08; 1.28]). Additionally, a higher percentage of deaths in the 6 months after the inclusion was detected in the group of patients with malnutrition (15.74 % vs 8.37 %; p < 0.001; RR 1.88 IC95 % [1.58; 2.23]).</div></div><div><h3>Conclusion</h3><div>Given the high prevalence of malnutrition observed across all tumour types, cancer stages and age groups, early identification and timely nutritional intervention shou
背景与目的：疾病相关营养不良（disease -related nutrition， DRM）是癌症患者中常见的一种情况，其患病率在不同的研究中差异很大，这取决于疾病的阶段（如诊断时、晚期或整个抗肿瘤治疗过程）和肿瘤位置。oncontridos研究的目的是利用全球营养不良领导倡议（Global Leadership Initiative on nutrition， GLIM）标准，评估在血肿日间医院接受积极抗肿瘤治疗的癌症患者中DRM的患病率。此外，该研究还评估了DRM与癌症相关住院以及纳入研究后6个月死亡率之间的关系。方法：这是一项全国性、横断面、观察性、多中心的研究，按照标准临床实践进行。统计特征、合并症、临床变量和人体测量数据在患者进入化疗套房时收集。人体测量数据-体重（kg）和身高(m)-从患者的医疗记录中获得。通过与患者面谈获得正常体重。DRM诊断符合GLIM标准。减少的肌肉量通过小腿围来评估-根据患者的BMI进行调整。所有患者都接受了访谈，以检测食物摄入量的减少。患者招募进行了8个月，随后随访了6个月。结果：全国86家医院共纳入4440例患者。中位年龄为61.1岁，71.8%的患者年龄在70岁以下，72.3%的患者处于肿瘤晚期（III-IV期）。根据GLIM标准，疾病相关性营养不良（DRM）的总体患病率为50.74%（患者中为45.98%）。结论：鉴于营养不良在所有肿瘤类型、癌症分期和年龄组中的高患病率，应优先考虑早期发现并及时进行营养干预。与疾病相关的营养不良对临床结果的影响表明，需要将营养护理作为肿瘤患者综合管理的关键组成部分。
{"title":"OncoNutridos study: Prevalence of disease-related malnutrition according to GLIM criteria in cancer patients in oncohaematology day hospitals","authors":"Carmen Ripa , Olatz Olariaga , Sara Vallinas , Mariola Sirvent , Elena Prado , Rosa Romero , Laia Pérez , Paloma Terroba , Sara Hernández , Amelia Chica , Maria José Gandara , Lucrecia Bourgon , Maria Ochagavia , Rocío Tamayo , Larraitz Leunda","doi":"10.1016/j.clnesp.2025.11.008","DOIUrl":"10.1016/j.clnesp.2025.11.008","url":null,"abstract":"<div><h3>Background & aims</h3><div>Disease-related malnutrition (DRM) is a frequent condition among cancer patients, with prevalence varying widely across studies depending on the phase of the disease (e.g., at diagnosis, during advanced stages, or throughout antineoplastic treatment) and tumour location. The aim of the OncoNutridos study was to assess the prevalence of DRM using the Global Leadership Initiative on Malnutrition (GLIM) criteria in cancer patients receiving active antineoplastic treatment in oncohaematology day hospitals. Additionally, the study evaluated the relationship between DRM and cancer-related hospital admissions, as well as 6-month mortality following study inclusion.</div></div><div><h3>Methods</h3><div>This was a national, cross-sectional, observational, multicentre study conducted in accordance with standard clinical practice. Demographic characteristics, comorbidities, clinical variables, and anthropometric data were collected at the time of patient's admission to the chemotherapy suite. Anthropometric data -weight (kg) and height (m)- were obtained from the patient's medical record. Usual weight was obtained through patient's interview. DRM was diagnosed in accordance with the GLIM criteria. Reduced muscle mass was assessed via calf circumference -adjusted for the patient's BMI-. All patients were interviewed to detect reduced food intake. Patient recruitment took place across eight months, with a follow-up period of six months thereafter.</div></div><div><h3>Results</h3><div>A total of 4440 patients were included between 86 hospitals nationwide. The median age was 61.1 years, 71.8 % of the patients were under 70 years of age, and 72.3 % were in advanced tumour stage (III-IV). The overall prevalence of disease-related malnutrition (DRM) according to GLIM criteria was 50.74 % (45.98 % in patients <70 years, and 62.86 % in those ≥70 years). Malnutrition prevalence was significantly higher among patients with advanced-stage tumours (stage III-IV) compared to those in early-stage disease (stage I-II) (54 % vs. 42 %; <em>p</em> < 0.001). Among patients with DRM, 72.52 % had moderate malnutrition, with no significant differences in malnutrition severity observed between age groups. Additionally, 77.2 % of malnourished patients were in advanced stages of disease (Stage III–IV). Compared to well-nourished individuals, malnourished patients had a significantly higher incidence of oncology-related hospitalizations in the six months following recruitment (36.8 % vs 31.32 %; p < 0.001; RR 1.18 IC95 % [1.08; 1.28]). Additionally, a higher percentage of deaths in the 6 months after the inclusion was detected in the group of patients with malnutrition (15.74 % vs 8.37 %; p < 0.001; RR 1.88 IC95 % [1.58; 2.23]).</div></div><div><h3>Conclusion</h3><div>Given the high prevalence of malnutrition observed across all tumour types, cancer stages and age groups, early identification and timely nutritional intervention shou","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 666-675"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145523037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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