Clinical nutrition ESPEN最新文献

{"title":"Association of nutrition impact symptoms with dietary intake among patients with advanced cancer referred to palliative care","authors":"Koji Amano ,&nbsp;Vickie E. Baracos ,&nbsp;Saori Koshimoto ,&nbsp;Tatsuma Sakaguchi ,&nbsp;Sayaka Arakawa ,&nbsp;Naoharu Mori","doi":"10.1016/j.clnesp.2025.102894","DOIUrl":"10.1016/j.clnesp.2025.102894","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Considering that cachexia-related symptoms interfere with dietary intake and compromise nutritional status in advanced cancer patients, these symptoms are classified as nutrition impact symptoms (NISs). However, the extent to which each NIS interferes with dietary intake remains unclear. Therefore, we examined the association between each NIS and dietary intake, considering the impact of an NIS cluster, and investigated the ability of each NIS to predict reduced dietary intake.</div></div><div><h3>Methods</h3><div>This is a secondary analysis using two datasets obtained from two surveys using a self-reported questionnaire conducted among advanced cancer patients referred to palliative care in multiple cancer hospitals. Participants evaluated 19 NISs (e.g., lack of appetite, early satiety, nausea, abnormal taste, and fatigue) and their dietary intake using a numerical rating scale (NRS) and the Ingesta-Verbal/Visual Analog Scale (IVVAS), respectively. To assess associations between each NIS and dietary intake, multivariate logistic regression analysis was performed adjusting for potential confounders, including four or more NISs with an NRS score of 4 or more as an NIS cluster. Values of the area under the curve (AUC) were also calculated for predicting a median IVVAS score or lower.</div></div><div><h3>Results</h3><div>Data were obtained from 328 participants in Survey 1 and 220 participants in Survey 2. Lack of appetite, early satiety, nausea, vomiting, abnormal taste, and fatigue were significantly associated with poor dietary intake (odds ratio [OR] 0.73, 95 % confidence interval [CI] 0.66–0.81; OR 0.84, 95 % CI 0.77–0.92; OR 0.80, 95 % CI 0.72–0.89; OR 0.80, 95 % CI 0.71–0.91; OR 0.91, 95 % CI 0.84–1.00; OR 0.90, 95 % CI 0.81–0.99, respectively). However, no significant association was observed for the other 13 NISs. All AUC values were greater than 0.750 for the 19 NISs. The highest AUC values were observed for lack of appetite, early satiety, and nausea (0.831, 95 % CI 0.797–0.866; 0.810, 95 % CI 0.773–0.848; 0.801, 95 % CI 0.764–0.838, respectively).</div></div><div><h3>Conclusions</h3><div>Lack of appetite, early satiety, nausea, vomiting, abnormal taste, and fatigue were significantly associated with dietary intake independently of the influence of other symptoms and other confounders. Furthermore, lack of appetite, early satiety, and nausea were good predictors for reduced dietary intake.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"71 ","pages":"Article 102894"},"PeriodicalIF":2.6,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145892199","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":"Economic consequences when enteral tube feeding intolerance causes unplanned discontinuation in hospitalized older patients with gastroesophageal reflux disease","authors":"Yukikazu Kamada ,&nbsp;Kanako Kawano ,&nbsp;Akina Iguchi ,&nbsp;Noriko Tominaga ,&nbsp;Chisato Okamoto ,&nbsp;Masatoshi Inoue ,&nbsp;Ataru Igarashi ,&nbsp;Masafumi Kitakaze","doi":"10.1016/j.clnesp.2025.102892","DOIUrl":"10.1016/j.clnesp.2025.102892","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Enteral tube feeding intolerance (ETFI) is a common complication in older patients with gastroesophageal reflux disease (GERD), often leading to unplanned discontinuation of nutritional support. While the clinical consequences of ETFI are well-documented, its economic impact on hospital operations remains unclear. This study aimed to evaluate the financial consequences of ETFI-related discontinuation of enteral nutrition in hospitalized older patients with GERD, focusing on changes in medical resource allocation and hospital revenue under Japan's hybrid reimbursement system.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted using patient-level data from a long-term care ward in Japan between April 2018 and March 2021. Patients who initiated enteral tube feeding were categorized based on whether enteral feeding was discontinued due to intolerance. Medical claims data were analyzed to calculate fee-for-service (FFS) and fixed payment system (FPS) charges, unreimbursed medical charges (i.e., revenue loss under FPS), and inpatient living care expenses. Hospital loss simulations were performed based on discontinuation rates and patient characteristics.</div></div><div><h3>Results</h3><div>Among 149 patients, 23.5 % experienced ETFI-related discontinuation. These patients had significantly lower BMI and shorter feeding durations. Discontinuation was associated with increased unreimbursed medical charges (median JPY +2288/day (USD +15.2/day, USD 1.0 = JPY 150.80) at 1 week post-discontinuation) and decreased living care revenue (median JPY −1179/day (USD −7.82/day)). Multivariate analysis identified ETFI and low BMI (&lt;17.4) as independent predictors of increased hospital revenue losses. Simulations estimated a total loss of JPY 248,000 (USD 1644.56) per 10 hospitalized older patients with GERD over 4 weeks, with greater losses observed in low-BMI patients and those receiving polymeric formulas.</div></div><div><h3>Conclusion</h3><div>Unplanned discontinuation of enteral tube feeding due to intolerance in older patients with GERD imposes a substantial economic burden on hospitals, primarily through unreimbursed medical charges and reduced living care revenue. Preventive strategies—such as early nutritional intervention and formula selection—may mitigate these losses and support sustainable hospital management.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"71 ","pages":"Article 102892"},"PeriodicalIF":2.6,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145888750","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":"Global leadership initiative on malnutrition-based nutritional phenotype and factors associated with the outcomes of hospitalized patients managed by a nutrition support team: A retrospective study","authors":"Mathilde Barrallier ,&nbsp;Emeric Rageul ,&nbsp;Charlotte Nesseler ,&nbsp;Quentin Le Cornu ,&nbsp;Ronan Thibault","doi":"10.1016/j.clnesp.2025.102889","DOIUrl":"10.1016/j.clnesp.2025.102889","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and aims&lt;/h3&gt;&lt;div&gt;What are the Global Leadership Initiative on Malnutrition (GLIM) criteria leading to the diagnosis of malnutrition at hospital, specifically in diabetic patients, is not well known. The factors associated with the clinical outcomes of nutritionally at-risk hospitalized patients have been scarcely investigated.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aims&lt;/h3&gt;&lt;div&gt;To characterize the GLIM-based nutritional phenotype of hospitalized patients managed by a Nutrition Support Teams (NST) (primary), and to compare the GLIM malnutrition diagnostic criteria between diabetic and non-diabetic patients (secondary); to identify the factors associated with hospital readmission one month after discharge and one-month mortality (secondary).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a retrospective observational study including all the consecutive adult patients managed by the NST of a tertiary university hospital. The exclusion criteria were age under 18 yr and absence of assessment of body composition by bioimpedance analysis (BIA). Malnutrition was diagnosed according to the GLIM criteria: the etiologic criterion was the hospitalization for an acute or chronic disease, and three phenotypic criteria were: low body mass index (BMI), weight loss, and/or low fat-free mass index (FFMI) derived from BIA. Food intake was assessed by the Simple Evaluation of Food Intake® (SEFI®). Handgrip strength was measured using a dynamometer. Hospital readmission and death one month after discharge were collected from the electronic medical records (EMR). Multivariable logistic regression analyses using a stepwise top-down selection identified factors associated with one-month hospital readmission and mortality.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;231 patients were included: 43 % of females, age (mean ± SD), 62.2 ± 15.9 yr, BMI, 23.5 ± 6.4, 73.6 % (170/231) were malnourished, of whom 66.5 % (113/170) had severe malnutrition, and 20.3 % (47/231) had diabetes. Malnutrition was diagnosed according to the three phenotypic criteria in 59/170 patients (34.7 %), two in 56/170 patients (33.1 %), and only one in 54/170 patients (31.8 %). The diabetic patients were less likely to have a low FFMI (29.8 % (14/47) vs 60.9 % (109/179), P &lt; 0.001) or be malnourished (61.7 % (29/47) vs 76.6 % (141/184), P = 0.04), but more likely to have a low handgrip strength (64.3 % (27/42) vs 45.6 % (68/149), P = 0.03) than non-diabetic patients. Multivariable analyses showed that cancer (odds ratio (OR) = 2.51 [1.17–5.37], P = 0.02) and SEFI® score (OR = 0.89 [95 % confidence interval, 0.79–0.99], P = 0.04) were associated with higher risk of hospital readmission, whereas weight loss (OR = 3.20 [1.26–8.17], P = 0.01) and diabetes (OR = 2.76 [1.10–6.91], P = 0.03) were associated with mortality.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;One third of patients were diagnosed malnutrition with one phenotypic criterion, suggesting that all the GLIM phenotypic criteria should be used t","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"71 ","pages":"Article 102889"},"PeriodicalIF":2.6,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145888788","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":"Can the 13C-octanoic acid breath test accurately measure gastric emptying after sleeve gastrectomy and Roux-en-Y gastric bypass? A proof-of concept analysis","authors":"Nele Steenackers ,&nbsp;Patrick Augustijns ,&nbsp;Wies Deckers ,&nbsp;Ellen Deleus ,&nbsp;Christophe M. Deroose ,&nbsp;Matthias Lannoo ,&nbsp;Wei Li ,&nbsp;Ann Mertens ,&nbsp;Tim Vanuytsel ,&nbsp;Greet Vandermeulen ,&nbsp;Roman Vangoitsenhoven ,&nbsp;Kristin Verbeke ,&nbsp;Bart Van der Schueren ,&nbsp;Christophe Matthys","doi":"10.1016/j.clnesp.2025.102891","DOIUrl":"10.1016/j.clnesp.2025.102891","url":null,"abstract":"<div><h3>Background</h3><div>Bariatric surgery alters gastrointestinal anatomy and physiology, complicating functional assessments such as gastric emptying. The 13C-octanoic acid breath test is a simple, non-invasive alternative to scintigraphy, though its validity in bariatric populations requires further validation.</div></div><div><h3>Methods</h3><div>For this proof-of-concept analysis, gastric emptying data were derived from a cross-sectional study including individuals with obesity, sleeve gastrectomy, and Roux-en-Y gastric bypass (RYGB). Gastric emptying was measured simultaneously using the ¹³C-octanoic breath test and the reference method, scintigraphy. Gastric emptying half-times (GET_1/2) were compared between the two methods using Wilcoxon signed-rank tests in each group. Concordance between both methods was assessed using Kendall's tau correlation coefficients, and Bland–Altman plots.</div></div><div><h3>Results</h3><div>No significant inter-method differences were observed for GET_1/2 in any group. Mean differences were −26.7 min (95 % CI: −72.3; 18.6) for obesity, −3.92 min (95 % CI: −30.8; 23.0) for sleeve gastrectomy, and −8.55 min (95 % CI: −21.3; 4.18) for RYGB. Kendall's tau coefficients indicated positive rank associations within each group, but were non-significant (Obesity: 0.8, <em>P</em> = 0.16; sleeve gastrectomy: 0.90, <em>P</em> = 0.13; RYGB: 0.57, <em>P</em> = 0.33). Bland–Altman plots demonstrated acceptable agreement between the measurements across all groups.</div></div><div><h3>Conclusion</h3><div>This proof-of-concept analysis suggests that the 13C-octanoic acid breath test has potential as a valid, non-invasive method for assessing gastric emptying in post-bariatric surgery patients. However, larger validation studies are warranted to confirm these preliminary findings.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"71 ","pages":"Article 102891"},"PeriodicalIF":2.6,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877834","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":"Body composition and functional status in the COVID-19 recovery phase: Prevalence of sarcopenia and sarcopenic obesity","authors":"Montserrat Montes-Ibarra ,&nbsp;Flavio T. Vieira ,&nbsp;Maria Cristina Gonzalez ,&nbsp;Alan Garcia-Grimaldo ,&nbsp;Ivan Armando Osuna-Padilla ,&nbsp;Andreia Bauermann-Vieira ,&nbsp;Edith Pituskin ,&nbsp;Richard B. Thompson ,&nbsp;D. Ian Paterson ,&nbsp;Carla M. Prado","doi":"10.1016/j.clnesp.2025.102877","DOIUrl":"10.1016/j.clnesp.2025.102877","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>COVID-19 may be associated with unfavourable body composition changes. This includes increased fat mass and decreased muscle mass, which can lead to sarcopenia and sarcopenic obesity (SO), conditions associated with impaired physical performance and reduced quality of life, among other adverse outcomes. This study investigated the prevalence of sarcopenia and SO in individuals who recovered from the first COVID-19 wave and their association with functional outcomes.</div></div><div><h3>Methods</h3><div>Clinical characteristics, body composition (bioelectrical impedance analysis), functional status (handgrip strength [HGS], 6-min walk test [6MWT]), and lung function (spirometry) were collected.</div></div><div><h3>Results</h3><div>37 individuals (89.2 % Caucasians, 64.9 % females, median age 48 years [IQR: 40; 60], 10.8 % &gt; 65y) were assessed after a median of 189 days (IQR: 169; 201) post-COVID-19 infection. The combined prevalence of sarcopenia/SO was 40.5 %, was identified in 37.8 %, while a single case (2.7 %) of sarcopenia without obesity was found. The sarcopenia/SO group had lower 6MWT and phase angle, and higher prevalence of hypertension. Sarcopenia/SO was negatively associated with 6MWT performance (β: −115.35, 95 % CI: −161.57 to −69.12), COVID-19 symptoms, disease severity, and duration were not associated with sarcopenia/SO diagnosis.</div></div><div><h3>Conclusion</h3><div>A high presence of sarcopenia/SO was identified and was negatively associated with health outcomes in individuals post-COVID-19. Thus, it is important to assess and address conditions associated with abnormal body composition after infectious diseases to better inform strategies for improving long-term outcomes.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"72 ","pages":"Article 102877"},"PeriodicalIF":2.6,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877796","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 effect of transcranial direct current stimulation and nutritional counseling therapy on attentional bias to food cues: A randomized clinical trial","authors":"Jessica Lorenzzi Elkfury ,&nbsp;Luciana C. Antunes ,&nbsp;Gibson Weydmann ,&nbsp;Lizia Nardi Menegassi ,&nbsp;Liciane Fernandes Medeiros ,&nbsp;Tiago Madeira Cardinal ,&nbsp;Betina Franceschini Tocchetto ,&nbsp;Iraci L.S. Torres ,&nbsp;Felipe Fregni ,&nbsp;Lisiane Bizarro ,&nbsp;Wolnei Caumo","doi":"10.1016/j.clnesp.2025.102886","DOIUrl":"10.1016/j.clnesp.2025.102886","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>This study investigated the effects of transcranial direct current stimulation (tDCS) and nutritional counseling therapy (NCT) on attentional bias (AB) in binge eating disorder.</div></div><div><h3>Methods</h3><div>This study was designed as a pilot randomized, factorial, blind, parallel-controlled clinical trial. Forty women were allocated to one of four groups: active tDCS (a-tDCS), a-tDCS + NCT, s-tDCS (sham tDCS) + NCT, NCT. The 28 home-based tDCS sessions were applied to the DLPFC (anode/right and cathode/left). The outcome was the delta values (pre- and post-treatment AB scores). Each AB score was calculated based on the stimulus onset asynchrony (SOA) at which stimuli were presented (100, 500, and 2000 ms).</div></div><div><h3>Results</h3><div>Mixed analyses of variance revealed a significant interaction between treatment and SOA (p = 0.035). The a-tDCS with NCT group showed a decrease in AB at an SOA of 500 ms. This decrease significantly differed from the increase observed in the s-tDCS with NCT group for the same SOA (p = 0.027). The a-tDCS with NCT group showed an increase in AB at an SOA of 2000 ms, which differed significantly from the decrease observed at the same SOA in the a-tDCS group (p = 0.032).</div></div><div><h3>Conclusions</h3><div>The combined therapy (a-tDCS with NCT) decreased AB at the pre-conscious orientation of attention and increased it when conscious orientation was possible.</div></div><div><h3>Trial registration</h3><div>ClinicalTrials.gov: NCT 04226794. Registered on July 2, 2019.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"72 ","pages":"Article 102886"},"PeriodicalIF":2.6,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145849100","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":"Geriatric nutritional risk and exceptional longevity: Findings from a large-scale population-based study","authors":"Xuhui Liu ,&nbsp;Xujie Wang ,&nbsp;Rongfei Xie ,&nbsp;Qianyue Pan ,&nbsp;Biyun Wang ,&nbsp;Qiao Zhu ,&nbsp;Chunjian Ma","doi":"10.1016/j.clnesp.2025.102887","DOIUrl":"10.1016/j.clnesp.2025.102887","url":null,"abstract":"<div><h3>Background</h3><div>The Geriatric Nutritional Risk Index (GNRI) is a widely used prognostic marker in elderly populations, but its relevance to exceptional longevity remains unclear.</div></div><div><h3>Methods</h3><div>This study is a cross-sectional analysis using data from 1497 adults aged ≥60 years who participated in the Chinese Healthy Longevity and Mortality Study (CHLMS), a large-scale, population-based study designed to examine the factors influencing exceptional longevity. GNRI was calculated using serum albumin levels and weight-based indices. Multivariable logistic regression models (Models 1–3) were employed to examine the association between GNRI and the probability of reaching age ≥100. Restricted cubic spline and piecewise logistic regression were used to assess nonlinear and threshold effects. Sensitivity analyses included subgroup stratification and categorical transformations of clinical covariates and dietary behaviors.</div></div><div><h3>Results</h3><div>Among 1497 participants, 736 (49.2 %) were aged ≥100 years, with a higher proportion of females (80.0 % vs 59.1 %; p &lt; 0.001). Centenarians had significantly lower GNRI (92 vs 101), BMI (18.0 vs 20.4 kg/m²), and ADL scores (90 vs 100), all p &lt; 0.001. In fully adjusted models, each unit increase in GNRI was associated with an 11 % decrease in the odds of reaching age ≥100 (Model 3 OR = 0.89; 95 % CI, 0.86–0.91; p &lt; 0.001). Centenarian prevalence declined across GNRI quartiles from 79.8 % (Q1) to 20.2 % (Q4). Restricted cubic spline analysis demonstrated a nonlinear association. Subgroup and sensitivity analyses confirmed the robustness of this association across various demographic and dietary strata.</div></div><div><h3>Conclusions</h3><div>In centenarians, lower GNRI is associated with greater odds of exceptional longevity. However, as this is a cross-sectional study, causality cannot be inferred. Longitudinal studies are needed to explore this relationship further.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"72 ","pages":"Article 102887"},"PeriodicalIF":2.6,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145849048","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":"Konjac mannan oligosaccharides as a sustainer of fasting-associated gut microbiome signature after discontinuation of intermittent fasting in overweight individuals: A protocol for an open-label randomized clinical trial","authors":"Junhong Su ,&nbsp;Guorong Ma ,&nbsp;Xianghua Tang ,&nbsp;Zhongren Ma ,&nbsp;Zhenrong Xie ,&nbsp;Maikel P. Peppelenbosch","doi":"10.1016/j.clnesp.2025.102888","DOIUrl":"10.1016/j.clnesp.2025.102888","url":null,"abstract":"<div><h3>Background</h3><div>Our previous studies show that the improvement in cardiometabolic traits by intermittent fasting is associated with remodeling the gut microbiome, with short-chain fatty acids (SCFA) producing bacteria being evident. These effects, however, are largely lost when intermittent fasting is discontinued. Konjac mannan oligosaccharides (KMOS) are a commercial nature-deprived prebiotic, which has been reported to increase the levels of intestinal SCFA-producing bacteria. However, the capacity of continued KMOS consumption to maintain intermittent fasting-provoked levels of SCFA-producing bacteria, remains unknown.</div></div><div><h3>Methods</h3><div>This study aims to test whether a KMOS supplement positively affects fasting-provoked SCFA-producing bacteria levels during, and in particularly, after discontinuation of intermittent fasting. This prospective, randomized, controlled trial will be conducted in overweight volunteers aged 18–65. All participants will perform one month of intermittent fasting followed by one month of an <em>ad libitum</em> diet. Participants will be randomly assigned to receive KMOS (1.5 g/d) during fasting, both during fasting and the subsequent <em>ad libitum</em> period, or neither. Primary outcomes will be relative abundance of SCFA-producing bacteria in fecal samples, as determined by 16s rRNA sequencing. Secondary outcomes will be changes in body weight, blood pressure, and serum lipid levels.</div></div><div><h3>Conclusions</h3><div>Findings from this trial will answer the question whether KMOS can maintain fasting-associated SCFA producer level and metabolic benefits when fasting is discontinued.</div></div><div><h3>Clinical trial registration</h3><div>ChiCTR2200058139.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"71 ","pages":"Article 102888"},"PeriodicalIF":2.6,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145843151","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 impact of olive oil polyphenol supplementation on metabolic syndrome parameters The OleoMetS study: A randomized, controlled clinical trial","authors":"George Samoutis ,&nbsp;Tassos C. Kyriakides ,&nbsp;Nicholas Demetriou ,&nbsp;Evdoxia Poulianiti ,&nbsp;Gregoria Samouti ,&nbsp;Sophronia Samouti ,&nbsp;Panagiotis Diamantakos ,&nbsp;Eleni Melliou ,&nbsp;Prokopios Magiatis","doi":"10.1016/j.clnesp.2025.102883","DOIUrl":"10.1016/j.clnesp.2025.102883","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background &amp; aims&lt;/h3&gt;&lt;div&gt;Olive oil aldehydic phenols (OOPs), including oleocanthal, oleacein, oleuropein aglycone, and ligstroside aglycone, are highly bioactive secoiridoids with unique health-protective properties. Preclinical investigations have demonstrated that OOPs possess anti-inflammatory and antioxidant attributes. The aim of the study was to assess the direct health properties of OOPs as a food supplement in humans diagnosed with metabolic syndrome. Fasting Blood Glucose (FBG) and Hemoglobin A1c (HbA1c) were chosen as primary endpoints because they are key indicators of glucose control, a core aspect of metabolic syndrome. Their combined assessment offers a comprehensive view of both short-term and long-term glucose regulation, making them highly relevant for evaluating interventions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This double-blind, randomized, controlled clinical trial screened 110 individuals for eligibility between September 16, 2024, and January 27, 2025. Eight did not meet the inclusion criteria for metabolic syndrome, and 102 eligible participants were randomly assigned to the OOPs supplement or placebo group using a computer-generated randomization sequence to receive either the OOPs supplement or placebo. The 12-week intervention provided either a 10 mg/day polyphenol-rich olive oil extract food supplement (80 % oleocanthal/oleacein, 18 % oleuropein aglycon/ligstroside aglycon) or a placebo. No changes to lifestyle were recommended, and diet and physical activity were assessed at week 6. Fasting blood glucose (FBG) and hemoglobin A1C (HbA1c) were the primary outcomes. Secondary outcomes included lipid profile, C-reactive protein (CRP), body mass index (BMI), blood pressure, waist circumference, liver function tests (LFTs), estimated glomerular filtration rate (eGFR), uric acid, and fatigue scores. Repeated measures ANOVA/Linear Mixed Models were used to compare the mean changes (12 weeks-baseline) in fasting blood glucose levels between the intervention group and the placebo arm. Similar analysis (changes since baseline) was conducted for the continuous secondary outcomes. For categorical outcomes, changes since baseline were compared using chi-square methods. Bonferroni adjustments were made for multiple comparisons as appropriate.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;All 102 randomized participants completed the 12-week intervention and were included in the final analysis. The intervention group demonstrated significant improvements across various metabolic and physiological markers compared to the placebo group. Notable reductions were observed in FBG (mean difference: −7.06 mg/dL, p &lt; 0.0001) and HbA1c (−0.29 %, p &lt; 0.0001). Additionally, the intervention led to significant decreases in BMI (−1.15, p &lt; 0.0001), systolic blood pressure (−7.66 mmHg, p = 0.004), triglycerides (−8.57, p = 0.0003), oxidized LDL (−5.01, p &lt; 0.0001), uric acid (−1.04, p &lt; 0.0001), ALT (−4.92, p = 0.0002), and fa","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"71 ","pages":"Article 102883"},"PeriodicalIF":2.6,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809600","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":"GLP-2 analogues in short bowel syndrome: A systematic review and meta-analysis of randomized controlled trials","authors":"Pedro Batista Castro ,&nbsp;Heitor Soares Brandão ,&nbsp;Glauco Martins de Araujo ,&nbsp;Gustavo Procópio Silva ,&nbsp;Luísa Gonçalves Carvalho ,&nbsp;Palle Bekker Jeppesen ,&nbsp;Samuel I. dos Santos Pereira","doi":"10.1016/j.clnesp.2025.102881","DOIUrl":"10.1016/j.clnesp.2025.102881","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>The efficacy of glucagon-like peptide-2 (GLP-2) analogues in patients with short bowel syndrome (SBS) with intestinal failure (IF) is not well established. We aimed to compare the efficacy of GLP-2 analogues relative to placebo in patients with SBS dependent on parenteral support (PS).</div></div><div><h3>Methods</h3><div>PubMed, Embase, and Cochrane Central were searched from inception to April 15, 2025 for randomized controlled trials (RCTs) comparing GLP-2 analogues with placebo in patients with SBS. Endpoints included change in weekly PS volume, clinical response, enteral autonomy, and ≥1-day/week PS reduction. Pooled risk ratios (RRs) and standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using random-effects models. SMD was used due to differences in reporting units (mL/day vs. L/week).</div></div><div><h3>Results</h3><div>We included 283 patients from 4 RCTs, including one crossover trial; 188 (66.4%) received GLP-2 analogues. Weekly absolute PS volume reduction was significantly greater with GLP-2 analogues than with placebo (SMD −0.54; 95% CI −0.71 to −0.36; p = 0.0022; I² = 0%), with consistent results in a sensitivity analysis restricted to week 24. There were no significant differences in clinical response (RR 1.94; 95% CI 0.57 to 6.56; p = 0.1453; I² = 23.7%) and enteral autonomy (RR 4.21; 95% CI 0.00 to 280351.17; p = 0.3479; I² = 0%) between groups. Clinical response was defined as achieving a ≥20% reduction in weekly PS volume from baseline sustained through weeks 20 and 24. Reduction in PS by ≥ 1 day/week was more frequent with GLP-2 analogues (RR 2.27; 95% CI 1.59 to 3.26; p = 0.0219; I² = 0%).</div></div><div><h3>Conclusion</h3><div>This meta-analysis of 4 RCTs including 283 patients showed that GLP-2 analogues significantly reduced weekly PS volume and more often achieved ≥1-day/week reductions in PS compared with placebo, with no significant differences in enteral autonomy or clinical response.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"71 ","pages":"Article 102881"},"PeriodicalIF":2.6,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800515","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}