Clinical nutrition ESPEN最新文献

{"title":"Malnutrition risk in hospitalized patients with diabetes mellitus: Prevalence and associated factors as assessed by Nutritional Risk Screening 2002 (NRS-2002)","authors":"Yanjun Chang ,&nbsp;Wenxing Wang ,&nbsp;Fengni Jin ,&nbsp;Jianhua Li ,&nbsp;Xi Wang ,&nbsp;Jiazhen Zhang ,&nbsp;Yarong Xie","doi":"10.1016/j.clnesp.2026.102910","DOIUrl":"10.1016/j.clnesp.2026.102910","url":null,"abstract":"<div><h3>Background and aims</h3><div>Malnutrition is a common issue among hospitalized diabetic patients, often leading to poor outcomes. The Nutritional Risk Screening 2002 (NRS-2002) is a widely used tool for assessing nutritional risk, but its relevance to diabetic patients and correlation with clinical parameters are unclear. This study aims to assess the prevalence of nutritional risk in hospitalized diabetic patients using NRS-2002, explore its relationship with key clinical indicators, and identify independent factors influencing nutritional risk for better management strategies.</div></div><div><h3>Methods</h3><div>This single-center retrospective study included 329 diabetic inpatients from the Department of Endocrinology at Yuncheng Central Hospital, affiliated with Shanxi Medical University, between December 2022 and June 2025. Data from the Electronic Medical Record (EMR) and Laboratory Information System (LIS) covered demographics, clinical features, anthropometrics, laboratory parameters (nutritional markers, lipids, pancreatic enzymes, inflammatory and metabolic indicators), and comorbidities. Nutritional risk at admission was assessed using NRS-2002 (score ≥3). Associations with clinical indicators were analyzed using Spearman correlation and logistic regression to identify independent predictors.</div></div><div><h3>Results</h3><div>Of the 329 patients, 91 (27.7 %) were at nutritional risk. This group had longer hospital stays, a higher proportion of patients with diabetes duration &lt;5 years, lower BMI, prealbumin, and albumin levels, and higher CRP and HbA1c levels. They also had increased infection and ketosis rates. NRS-2002 scores were positively correlated with ketosis (ρ = 0.468), HbA1c (ρ = 0.386), and infection (ρ = 0.236), and negatively correlated with prealbumin (ρ = −0.404), bicarbonate (ρ = −0.240), and BMI (ρ = −0.205). Multivariate logistic regression identified ketosis (OR = 3.714), HbA1c (OR = 1.265), prealbumin (OR = 0.990), and bicarbonate (OR = 0.896) as independent predictors of nutritional risk. The predictive model showed good performance with an AUC of 0.832.</div></div><div><h3>Conclusion</h3><div>The NRS-2002 tool effectively assesses nutritional risk in hospitalized diabetic patients, with significant correlations to metabolic issues, inflammation, and complications. Low prealbumin, low bicarbonate, high HbA1c, and ketosis were independent predictors of nutritional risk.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"72 ","pages":"Article 102910"},"PeriodicalIF":2.6,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951695","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}

{"title":"Admission systemic inflammation predicts swallowing decline in older adults with pulmonary tuberculosis","authors":"Masayoshi Kakiuchi ,&nbsp;Tatsuro Inoue ,&nbsp;Hikaru Kobayashi ,&nbsp;Aoi Tsukamoto ,&nbsp;Gen Nakano ,&nbsp;Tetsuya Kakehi ,&nbsp;Toshiaki Tanaka ,&nbsp;Masamitsu Nishihara","doi":"10.1016/j.clnesp.2026.102913","DOIUrl":"10.1016/j.clnesp.2026.102913","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Tuberculosis remains a serious infectious disease worldwide. However, the status of swallowing function in older adults with pulmonary tuberculosis and the impact of systemic inflammation on swallowing decline during hospitalization have not been fully elucidated. We aimed to examine whether systemic inflammation at admission affects swallowing function decline in older patients with pulmonary tuberculosis.</div></div><div><h3>Methods</h3><div>This was a single-center, retrospective observational study. The inclusion criteria were patients aged ≥65 years with pulmonary tuberculosis who were admitted to a tuberculosis medical institution between April 2021, and November 2022. Systemic inflammation on admission was assessed with the modified Glasgow Prognostic Score (mGPS). The primary outcome was a decline in swallowing function during hospitalization, defined by a decrease in the Functional Oral Intake Scale (FOIS) score. All data, including mGPS and FOIS, were obtained from medical records. Patients were categorized into a “maintenance” group and a “decline” group based on changes in FOIS. Differences in FOIS scores across mGPS categories were also examined. Logistic regression analyses were performed to identify whether systemic inflammation at admission was an independent risk factor for swallowing decline. Model 1 was adjusted for age, BMI, miliary tuberculosis, and SARC-F ≥4; Model 2 was adjusted for age, miliary tuberculosis, and malnutrition.</div></div><div><h3>Results</h3><div>A total of 119 patients were included in the analysis. During hospitalization, 31 patients (26.1 %) experienced a decline in swallowing function. Compared with the maintenance group, the decline group was significantly older and showed higher mGPS scores, lower serum albumin, lower Geriatric Nutritional Risk Index values, smaller calf circumference, lower walking ability, and lower FOIS scores at discharge. FOIS scores at both admission and discharge significantly differed across mGPS categories (p &lt; 0.01). The prevalence of dysphagia, defined as FOIS ≤5, was 12.6 % (n = 15) at admission and 19.3 % (n = 23) at discharge. Logistic regression analysis revealed that higher mGPS at admission was independently associated with swallowing decline during hospitalization in both Model 1 (odds ratio 2.81, 95 % confidence interval 1.28–7.83) and Model 2 (odds ratio 2.77, 95 % confidence interval 1.23–7.71).</div></div><div><h3>Conclusion</h3><div>Systemic inflammation at admission was associated with the development of dysphagia during hospitalization among older adults with pulmonary tuberculosis. Moreover, the prevalence of dysphagia increased from 12.6 % at admission to 19.3 % at discharge.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"72 ","pages":"Article 102913"},"PeriodicalIF":2.6,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951637","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}

{"title":"The role of nutrition in prostate cancer risk, progression, and mortality: A comprehensive review","authors":"Ariela A. Souroujon Torun ,&nbsp;Vinaik Sundaresan ,&nbsp;Aleksandra Golos ,&nbsp;Michael S. Leapman ,&nbsp;Olga A. Gomez-Santamaría ,&nbsp;Marianne Casilla-Lennon","doi":"10.1016/j.clnesp.2026.102914","DOIUrl":"10.1016/j.clnesp.2026.102914","url":null,"abstract":"<div><h3>Background</h3><div>Prostate cancer (PCa) is one of the most prevalent malignancies among men worldwide, yet evidence-based nutritional recommendations for its prevention and progression remain limited. Growing research indicates that diet may play a significant role in modulating PCa risk, tumor behavior, and mortality.</div></div><div><h3>Objective</h3><div>This narrative review synthesizes current evidence on major dietary components, including carbohydrates, protein sources, fats, vegetables, vitamins, and minerals. It evaluates their associations with PCa incidence, progression, and disease-specific mortality.</div></div><div><h3>Methods</h3><div>This narrative review synthesized evidence from PubMed/MEDLINE, Embase, and Web of Science (up to 2025), including randomized trials, observational studies, and meta-analyses, to evaluate associations between dietary factors and prostate cancer incidence, progression, and mortality.</div></div><div><h3>Findings</h3><div>High intake of simple sugars and refined carbohydrates is associated with elevated PCa risk, whereas complex carbohydrates are associated with a more favorable metabolic profile. Evidence consistently supports increased fish consumption and suggests potential benefit from soy products. In contrast, high intake of red/processed meats and full-fat dairy may increase the risk of aggressive disease. Total and saturated fat intake is associated with poorer outcomes, although evidence on omega-3 fatty acids is mixed. Cruciferous vegetables show a strong protective factor, supported by epidemiologic data, whereas evidence for allium vegetables is emerging. Findings for micronutrients were highly heterogeneous: lycopene and physiologic vitamin E levels may confer benefit, whereas high-dose vitamin A derivatives, supplemental folic acid, selenium, and excessive dairy-derived calcium may increase PCa risk.</div></div><div><h3>Conclusion</h3><div>Although evidence is often inconsistent, several dietary patterns appear promising for PCa prevention and decreasing mortality. Emphasizing complex carbohydrates, fish, soy, plant-based fats, and cruciferous vegetables—while limiting simple sugars, red/processed meats, whole milk, saturated fats, and unnecessary supplementation—may support improved outcomes. High-quality randomized trials remain urgently needed to clarify causality and refine clinical nutrition guidance for PCa.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"72 ","pages":"Article 102914"},"PeriodicalIF":2.6,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951615","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}

{"title":"The role of the gut microbiome in childhood obesity: Mechanistic insights and community-based interventions","authors":"Truong Ngoc Tham ,&nbsp;Ngo Thi Lan Huong ,&nbsp;Quach Nhat Kim ,&nbsp;Nguyen Thi Diem Kieu ,&nbsp;Nguyen Tien Huy","doi":"10.1016/j.clnesp.2026.102911","DOIUrl":"10.1016/j.clnesp.2026.102911","url":null,"abstract":"<div><div>Childhood obesity remains a critical issue, yet traditional efforts focusing on diet and exercise have failed. This review proposes that gut microbiota dysbiosis is not an association, but rather a potentially causal and actionable mechanism underlying childhood obesity. An altered gut microbiome, defined by diminished diversity and specific changes, such as a higher Firmicutes/Bacteroidetes ratio, is a primary contributor to excess weight because of its ability to enhance energy overconsumption, dysregulate production of short-chain fatty acids, regulate appetite, and induce chronic low-grade inflammation. This overview seeks to provide a synthesis of mechanistic evidence and controversies of the gut microbiome as a targetable leverage point, by assessing the microbial signatures of obesity and reflect on the evidence to date and what it implies about the effort: A quest for a singular “obesity microbe” is unlikely to provide success. The unexplained complexity of the host and environment, the lack of a high-quality standard, and evidence of functional microbial pathways and metabolites provide a more fruitful focus. Among other things, this article suggests using high-fiber, whole food dietary strategies to modify the microbiome, the targeted use of evidence-based multi-strain probiotics, and designing school and public health policies to create protective microbiome public health policies. The childhood obesity demands that future efforts focus on the integration of large, multi-omic, longitudinal studies, and the implementation of high-fidelity long-term randomized controlled trial designs that establish the causative relationships, uniform structure to the protocols and enable the implementation of high-impact, equity-based, scalable precision nutrition methodologies.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"72 ","pages":"Article 102911"},"PeriodicalIF":2.6,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951708","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}

{"title":"Corrigendum to \"Obesity and risk of post-operative pneumonia among older adult patients with hip fracture: An obesity paradox\" [Clin Nutr ESPEN 68 (2025) 342-347].","authors":"Masao Narita, Ryutaro Matsugaki, Keiji Muramatsu, Kiyohide Fushimi, Shinya Matsuda","doi":"10.1016/j.clnesp.2025.102904","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.102904","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"102904"},"PeriodicalIF":2.6,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145942801","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}

{"title":"Ethnic differences in thiamine status persist after adjusting for diet; findings from the UK National Diet and Nutrition Survey","authors":"Albert Koulman ,&nbsp;Kerry S. Jones ,&nbsp;David Collins ,&nbsp;Damon Parkington ,&nbsp;Birdem Amoutzopoulos ,&nbsp;Polly Page ,&nbsp;Nita G. Forouhi","doi":"10.1016/j.clnesp.2025.102893","DOIUrl":"10.1016/j.clnesp.2025.102893","url":null,"abstract":"<div><h3>Background/objectives</h3><div>Thiamine (vitamin B1) status might play a role in cognition and mental health. Recent research suggests that there are ethnic differences in thiamine status. We aimed to test the hypothesis that black individuals have a higher risk of thiamine deficiency than white individuals, based on the erythrocyte transketolase activity coefficient (ETKAC), and assess differences in thiamine intake, using nutritional survey data.</div></div><div><h3>Methods</h3><div>We used the published data of the UK's National Diet and Nutrition Survey Rolling programme (2008–2019) and examined differences in the ETKAC between ethnicities and risk of thiamine deficiency (ETKAC &gt;1.25). We also used dietary data to determine differences in thiamine intake between ethnic groups.</div></div><div><h3>Results</h3><div>Within the NDNS 2008–2019 ETKAC measurements were available for 5657 participants (5170 white, 92 black, 228 Asian, 93 mixed and 74 other ethnic groups). The median ETKAC of black participants was higher (1.15 (0.08) median (IQR)) than white (1.10 (0.07)) or Asian (1.12 (0.08)), indicating poorer thiamine status among black participants. The prevalence of thiamine deficiency was 5 % among black participants, being greater than among white (0.5 %) and Asian participants (1.3 %). This was independent of age, sex, body composition and socio-economic status. Dietary assessment data suggested that thiamine intake was on average lower for black participants compared to white or Asian participants Including dietary intake into the model was not sufficient to correct for the ethnic difference in thiamine status.</div></div><div><h3>Conclusions</h3><div>This study suggests that there are ethnic differences in thiamine status that cannot be readily explained by intake alone.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"72 ","pages":"Article 102893"},"PeriodicalIF":2.6,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948574","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}

{"title":"Corrigendum to 'Modulation of ceramides through nutrition: A new target in obesity and insulin resistance (Narrative Review)' [Clin Nutr ESPEN 71 (2026) 102836].","authors":"Ana T Arias-Marroquín, Ivan Torre-Villalvazo, Omar Granados Portillo, Mariana Villegas-Romero, Alberto Camacho-Morales, Armando R Tovar, Carlos A Aguilar Salinas, Daniel Illescas-Zárate, Natalia Vázquez-Manjarrez","doi":"10.1016/j.clnesp.2025.102890","DOIUrl":"10.1016/j.clnesp.2025.102890","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"102890"},"PeriodicalIF":2.6,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145942789","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}

{"title":"Impact of soybean oil lipid emulsion on clinical outcomes in critically ill pediatric patients","authors":"Yuki Yamano ,&nbsp;Yoshiyuki Shimizu ,&nbsp;Yu Inata ,&nbsp;Takeshi Hatachi ,&nbsp;Yuri Etani","doi":"10.1016/j.clnesp.2026.102907","DOIUrl":"10.1016/j.clnesp.2026.102907","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Lipid emulsions are key components of parenteral nutrition (PN); however, concerns persist that soybean oil–based lipid emulsions may increase the risk of infection and catheter occlusion. In pediatric intensive care settings, evidence on the safety of these emulsions remains limited. This study investigated the impact of soybean oil–based lipid emulsion on central venous catheter–related complications and clinical outcomes in children receiving PN in a pediatric intensive care unit (PICU).</div></div><div><h3>Methods</h3><div>We conducted a single-center retrospective study of children admitted to the PICU between 2018 and 2023 who underwent PN for &gt;7 days. Patients who received PN before PICU admission were excluded. Of the 4589 PICU admissions, 172 patients were included and divided into two groups based on soybean oil–based lipid emulsion administration: 67 patients received the lipid emulsion, and 105 did not. The primary outcomes were catheter occlusion and central line–associated bloodstream infection (CLABSI). Secondary outcomes included duration of mechanical ventilation, length of stay in the PICU, and mortality. Catheter-level analysis was also performed to evaluate the complication rates and catheter survival based on lipid emulsion exposure.</div></div><div><h3>Results</h3><div>At the patient level, catheter occlusion occurred in 4.5 % of the lipid emulsion–treated group and 2.9 % of the non-treated group (p = 0.68), whereas CLABSI occurred in 7.5 % of the lipid emulsion–treated group and 3.8 % of the non-treated group (p = 0.31), with no significant differences. In the catheter–level analysis, the incidence of CLABSI per 1000 catheter–days was 2.69 in the treated group and 1.40 in the non-treated group (p = 0.30). No significant differences were observed in catheter survival or complication rates.</div></div><div><h3>Conclusion</h3><div>Soybean oil–based lipid emulsions administered via a central venous catheter did not increase the risk of catheter occlusion nor of CLABSI in critically ill pediatric patients. These findings support the safe use of soybean oil–based intravenous lipid emulsions in PICUs when enteral nutrition is not feasible.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"72 ","pages":"Article 102907"},"PeriodicalIF":2.6,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145942792","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}

{"title":"Valid food intake measures of adult patients for use within the GLIM framework: A scoping review","authors":"R. Blaauw ,&nbsp;G. Bischoff ,&nbsp;M.A.E. de van der Schueren ,&nbsp;C. Compher ,&nbsp;K. Haines ,&nbsp;N. Kiss ,&nbsp;C.C.H. Lew ,&nbsp;A. Malone ,&nbsp;C. Maza ,&nbsp;N. Stoner ,&nbsp;H.H. Keller","doi":"10.1016/j.clnesp.2025.102899","DOIUrl":"10.1016/j.clnesp.2025.102899","url":null,"abstract":"<div><h3>Background</h3><div>Reduced food intake is one of the etiologic criteria proposed by the Global Leadership Initiative on Malnutrition (GLIM). Various tools for the assessment of food intake exist, however, to diagnose malnutrition, as in GLIM, they should be validated against established reference standards, and quick and easy to complete by various members of the health care team.</div></div><div><h3>Aim</h3><div>This scoping review synthesizes the current evidence related to validated assessment measures of food intake for adult patients in healthcare settings and reports on the application of these measures within the GLIM diagnostic framework.</div></div><div><h3>Methods</h3><div>A comprehensive search strategy was performed using four bibliographic databases. To be included, studies needed to be conducted on adults in a healthcare setting, have a dietary intake assessment component (i.e. index method) that can be completed by various healthcare staff members, with minimal training and in a short time period, and make comparison of this method to an established dietary assessment reference. Studies needed to report energy and protein intake data and provide appropriate validation statistics. Two reviewers independently reviewed all abstracts and relevant full-text articles, and extracted data.</div></div><div><h3>Results</h3><div>After duplicate removal, 7866 abstracts were screened; 51 articles were eligible for full article review, 13 articles fulfilled the inclusion criteria and one further article was obtained from grey literature, for a total of 14 articles included in the scoping review. Food weighing before and after consumption was used as a reference method by most studies. For index methods, four different measurement tools, with variations, were used. This included visual estimation methods (VEM) using a 1–10-point scale without any pictorials (2 studies); VEM based on plate-model pictures (8 studies); VEM based on plate-models with associated defined nutritional values (4 studies) and digital technology (2 studies). Various levels of accuracy were found, with accuracy increasing when more options are provided and when employing digital technology. Index methods could be completed by participants themselves, nurses, food service workers and dietitians. Adequate training on completion of the tools is associated with improved results.</div></div><div><h3>Conclusion</h3><div>Index methods to assess food intake accurately for energy and protein intake can determine inadequate intake as compared to the reference method. Yet, a further step is required to interpret food intake relative to the patient's energy requirement to determine sufficiency of that intake for determination of the GLIM criterion. However, visual estimation methods identified in this review can be used by diverse clinicians with confidence to determine patient food intake.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"72 ","pages":"Article 102899"},"PeriodicalIF":2.6,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917162","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}

{"title":"Dietary sodium and potassium intake and risk of diabetes in the Million Veteran Program","authors":"Xuan-Mai T. Nguyen ,&nbsp;Yanping Li ,&nbsp;April R. Williams ,&nbsp;Neha Panigrahy ,&nbsp;Mark S. Nyaeme ,&nbsp;Kerry L. Ivey ,&nbsp;Daniel D. Wang ,&nbsp;Serena Houghton ,&nbsp;Hasan Mahbub ,&nbsp;Walter C. Willett ,&nbsp;Frank B. Hu ,&nbsp;John Michael Gaziano ,&nbsp;Lawrence Phillips ,&nbsp;Peter WF. Wilson ,&nbsp;Kelly Cho ,&nbsp;Luc Djousse ,&nbsp;the VA Million Veteran Program","doi":"10.1016/j.clnesp.2025.102882","DOIUrl":"10.1016/j.clnesp.2025.102882","url":null,"abstract":"<div><h3>Background/objective</h3><div>Studies show an association between elevated blood pressure, obesity, and insulin resistance with a higher risk of developing diabetes. As sodium is closely linked to elevated blood pressure and hypertension, and potassium is a counterbalancing nutrient to sodium, this study examines the association between intake of sodium, potassium, and sodium: potassium (Na:K) ratio and the incidence of diabetes.</div></div><div><h3>Design setting and participants</h3><div>Retrospective data analysis of dietary intake measured by a validated food frequency questionnaire in a prospective cohort of veterans participating in the Million Veteran Program (MVP) between 2011 and 2020, who were free of diabetes at baseline.</div></div><div><h3>Main outcome measurement</h3><div>The main outcome is clinically diagnosed diabetes defined by phenotyping algorithms applied to electronic health records.</div></div><div><h3>Results</h3><div>In this study of 198,049 veterans (mean age: 63.8 ± 13.1 years, 89 % male), 7260 were diagnosed with diabetes over a mean follow-up of 4.3 years. The mean sodium intake was 1218 mg/day. A higher sodium intake was associated with an 11 % higher rate of developing diabetes (hazard ratio, HR) comparing extreme quintiles: 1.11, 95 % CI: 1.03–1.20). The average daily potassium intake was 2589 mg and the highest quintile of potassium intake was associated with a 13 % lower rate of diabetes (HR: 0.87, 95 % CI: 0.81, 0.94) compared to the lowest quintile of potassium. Highest quintile of Na:K ratio was associated with a 21 % higher rate for diabetes (HR: 1.21, 95% CI: 1.12, 1.30). The pattern of associations between Na:K ratio and diabetes closely followed the pattern of dietary sodium intake and diabetes associations.</div></div><div><h3>Conclusion</h3><div>A higher sodium intake and a higher Na:K ratio were associated with a higher risk of diabetes in this large cohort of veterans. These findings may be applied in future work to identify personalized lifestyle and dietary supports to prevent and treat T2DM.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"71 ","pages":"Article 102882"},"PeriodicalIF":2.6,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899280","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}