Pub Date : 2025-04-16DOI: 10.1016/j.clnu.2025.04.017
Sha Sha , Ruijie Xie , Tafirenyika Gwenzi , Youqing Wang , Hermann Brenner , Ben Schöttker
Background
Atherosclerotic cardiovascular disease (ASCVD) remains a substantial healthcare burden. The Australian D-Health trial recently showed potential efficacy of vitamin D supplementation (VDS) in reducing major ASCVD events. Whether the efficacy could be translated into real-world effectiveness is unclear.
Methods
Leveraging data from the UK Biobank, we used Cox regression with competing risk of all-cause mortality to assess the association of self-reported regular VDS (83.3 % from over-the-counter) and serum 25-hydroxyvitamin D (25[OH]D) levels with ASCVD as a composite endpoint and as separate endpoints including ischemic heart disease (IHD), cerebrovascular disease, peripheral arterial disease, and atherosclerotic disease.
Results
Among 409,822 study participants aged 40–69 years, 20.7 % were vitamin D deficient (25[OH]D < 30 nmol/L) and 34.4 % were vitamin D insufficient (25[OH]D 30-<50 nmol/L). Regular VDS was reported by 4.3 % of the study participants. During the follow-up of 15.9 years, 11.6 % of participants developed ASCVD. Compared to vitamin D sufficiency, vitamin D deficiency was associated with a significantly increased risk of the total ASCVD (hazard ratio [95 % confidence interval]: 1.10 [1.07–1.13]) and all separate ASCVD endpoints in the fully adjusted model with 48 covariates. Consistently, compared to non-users, VDS was associated with a reduced total ASCVD risk in the model fully adjusted for the 50 covariates (0.94[0.90–0.98]). Regarding the individual ASCVD disorders, VDS was associated with reduced IHD risk (0.90[0.86–0.96]).
Conclusion
Self-reported regular VDS and being vitamin D sufficient were both associated with reduced ASCVD risk in real-world settings. For people with low 25(OH)D levels, regular VDS may be a beneficial strategy for ASCVD prevention.
{"title":"Real-world evidence for an association of vitamin D supplementation with atherosclerotic cardiovascular disease in the UK Biobank","authors":"Sha Sha , Ruijie Xie , Tafirenyika Gwenzi , Youqing Wang , Hermann Brenner , Ben Schöttker","doi":"10.1016/j.clnu.2025.04.017","DOIUrl":"10.1016/j.clnu.2025.04.017","url":null,"abstract":"<div><h3>Background</h3><div>Atherosclerotic cardiovascular disease (ASCVD) remains a substantial healthcare burden. The Australian D-Health trial recently showed potential efficacy of vitamin D supplementation (VDS) in reducing major ASCVD events. Whether the efficacy could be translated into real-world effectiveness is unclear.</div></div><div><h3>Methods</h3><div>Leveraging data from the UK Biobank, we used Cox regression with competing risk of all-cause mortality to assess the association of self-reported regular VDS (83.3 % from over-the-counter) and serum 25-hydroxyvitamin D (25[OH]D) levels with ASCVD as a composite endpoint and as separate endpoints including ischemic heart disease (IHD), cerebrovascular disease, peripheral arterial disease, and atherosclerotic disease.</div></div><div><h3>Results</h3><div>Among 409,822 study participants aged 40–69 years, 20.7 % were vitamin D deficient (25[OH]D < 30 nmol/L) and 34.4 % were vitamin D insufficient (25[OH]D 30-<50 nmol/L). Regular VDS was reported by 4.3 % of the study participants. During the follow-up of 15.9 years, 11.6 % of participants developed ASCVD. Compared to vitamin D sufficiency, vitamin D deficiency was associated with a significantly increased risk of the total ASCVD (hazard ratio [95 % confidence interval]: 1.10 [1.07–1.13]) and all separate ASCVD endpoints in the fully adjusted model with 48 covariates. Consistently, compared to non-users, VDS was associated with a reduced total ASCVD risk in the model fully adjusted for the 50 covariates (0.94[0.90–0.98]). Regarding the individual ASCVD disorders, VDS was associated with reduced IHD risk (0.90[0.86–0.96]).</div></div><div><h3>Conclusion</h3><div>Self-reported regular VDS and being vitamin D sufficient were both associated with reduced ASCVD risk in real-world settings. For people with low 25(OH)D levels, regular VDS may be a beneficial strategy for ASCVD prevention.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"49 ","pages":"Pages 118-127"},"PeriodicalIF":6.6,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143854544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-15DOI: 10.1016/j.clnu.2025.04.008
Borja Martinez-Tellez , Huiwen Xu , Lourdes Ortiz-Alvarez , Carmen Rodríguez-García , Milena Schönke , Lucas Jurado-Fasoli , Francisco J. Osuna-Prieto , Juan M.A. Alcantara , Francisco M. Acosta , Francisco J. Amaro-Gahete , Gert Folkerts , Ramiro Vilchez-Vargas , Alexander Link , Julio Plaza-Diaz , Angel Gil , Idoia Labayen , Sonia Fernandez-Veledo , Patrick C.N. Rensen , Jonatan R. Ruiz
Background
Numerous physiological responses to exercise are observed in humans, yet the effects of long-term exercise and varying intensities on the diversity and composition of human fecal microbiota remain unclear. We investigated the effect of a 24-week supervised concurrent exercise intervention, at moderate and vigorous intensities, on fecal microbiota diversity and composition in young adults.
Methods
This ancillary study was based on data from the ACTIBATE randomized controlled trial (ClinicalTrials.gov ID: NCT02365129), and included adults (aged 18–25 years, 70 % female) that were randomized to (i) a control group (CON: no exercise, n = 20), (ii) a moderate-intensity exercise group (MOD-EX, n = 21), and (iii) a vigorous-intensity exercise group (VIG-EX, n = 20). Fecal samples were collected before and after the 24-week exercise intervention, and the diversity and composition of the fecal microbiota were analyzed by 16S rRNA sequencing. Inferential functional profiling of the fecal microbiota was performed and correlations between microbial changes and cardiometabolic outcomes were assessed.
Results
Exercise did not modify beta or alpha diversities regardless of the intensity (all P ≥ 0.062). The relative abundance of the Erysipelotrichaceae family (Bacillota phylum) (−0.3 ± 1.2 %; P = 0.031) was however reduced in the VIG-EX group. Coprococcus was the only genus showed a significant difference between MOD-EX and VIG-EX after the intervention, with its relative abundance increasing in MOD-EX (+0.4 ± 0.6 %; P = 0.005). None of these changes were related to the exercise-induced cardiometabolic benefits (all P ≥ 0.05).
Conclusions
In young adults, a 24-week supervised concurrent exercise program, at moderate and vigorous intensities, resulted in minor changes in fecal microbiota composition, while neither alpha nor beta diversities were affected.
{"title":"Effect of a 24-week supervised concurrent exercise intervention on fecal microbiota diversity and composition in young sedentary adults: The ACTIBATE randomized controlled trial","authors":"Borja Martinez-Tellez , Huiwen Xu , Lourdes Ortiz-Alvarez , Carmen Rodríguez-García , Milena Schönke , Lucas Jurado-Fasoli , Francisco J. Osuna-Prieto , Juan M.A. Alcantara , Francisco M. Acosta , Francisco J. Amaro-Gahete , Gert Folkerts , Ramiro Vilchez-Vargas , Alexander Link , Julio Plaza-Diaz , Angel Gil , Idoia Labayen , Sonia Fernandez-Veledo , Patrick C.N. Rensen , Jonatan R. Ruiz","doi":"10.1016/j.clnu.2025.04.008","DOIUrl":"10.1016/j.clnu.2025.04.008","url":null,"abstract":"<div><h3>Background</h3><div>Numerous physiological responses to exercise are observed in humans, yet the effects of long-term exercise and varying intensities on the diversity and composition of human fecal microbiota remain unclear. We investigated the effect of a 24-week supervised concurrent exercise intervention, at moderate and vigorous intensities, on fecal microbiota diversity and composition in young adults.</div></div><div><h3>Methods</h3><div>This ancillary study was based on data from the ACTIBATE randomized controlled trial (ClinicalTrials.gov ID: NCT02365129), and included adults (aged 18–25 years, 70 % female) that were randomized to (i) a control group (CON: no exercise, n = 20), (ii) a moderate-intensity exercise group (MOD-EX, n = 21), and (iii) a vigorous-intensity exercise group (VIG-EX, n = 20). Fecal samples were collected before and after the 24-week exercise intervention, and the diversity and composition of the fecal microbiota were analyzed by 16S rRNA sequencing. Inferential functional profiling of the fecal microbiota was performed and correlations between microbial changes and cardiometabolic outcomes were assessed.</div></div><div><h3>Results</h3><div>Exercise did not modify beta or alpha diversities regardless of the intensity (all P ≥ 0.062). The relative abundance of the <em>Erysipelotrichaceae</em> family (<em>Bacillota</em> phylum) (−0.3 ± 1.2 %; P = 0.031) was however reduced in the VIG-EX group. <em>Coprococcus</em> was the only genus showed a significant difference between MOD-EX and VIG-EX after the intervention, with its relative abundance increasing in MOD-EX (+0.4 ± 0.6 %; P = 0.005). None of these changes were related to the exercise-induced cardiometabolic benefits (all P ≥ 0.05).</div></div><div><h3>Conclusions</h3><div>In young adults, a 24-week supervised concurrent exercise program, at moderate and vigorous intensities, resulted in minor changes in fecal microbiota composition, while neither alpha nor beta diversities were affected.</div></div><div><h3>Clinical trial registration</h3><div>ClinicalTrials.gov ID: NCT02365129.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"49 ","pages":"Pages 128-137"},"PeriodicalIF":6.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-12DOI: 10.1016/j.clnu.2025.04.013
Jieyu Liu, Qingqing Shen, Xinxin Wang
{"title":"Letter to the editor–“Emerging EAT-Lancet planetary health diet is associated with major cardiovascular diseases and all-cause mortality: A global systematic review and meta-analysis”","authors":"Jieyu Liu, Qingqing Shen, Xinxin Wang","doi":"10.1016/j.clnu.2025.04.013","DOIUrl":"10.1016/j.clnu.2025.04.013","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"49 ","pages":"Pages 50-51"},"PeriodicalIF":6.6,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-10DOI: 10.1016/j.clnu.2025.04.009
Jos W. Borkent , Barbara S. van der Meij , Marian A.E. de van der Schueren
Background/aims
Malnutrition screening tools often include questions about unintentional weight loss (UWL). It is unclear whether individuals who intentionally desire to lose weight or perceive themselves as overweight interpret questions regarding UWL accurately. We assessed potential misclassification of UWL-related questions in these groups.
Method
Data from the Lifelines cohort was used (ñ125.000, age >18 years). Prevalence ratios (PRs) were calculated with a simple question regarding UWL as the dependent variable and the desire to lose weight and perception of one's body weight (too heavy vs. just right/too light) as separate independent variables. Associations were stratified by body mass index (BMI) group (normal weight vs. overweight/obesity) and adjusted for various comorbidities, demographics, and quality of life.
Results
Of participants with normal weight, 30.3 % desired to lose weight, 37.9 % perceived their body weight as too heavy and 5.1 % reported UWL; this was 80.1 %, 92.7 % and 2.7 % for those with overweight/obesity. In both BMI groups, the prevalence of UWL was ∼60 % lower in participants who desired to lose weight or perceived themselves as too heavy (prevalence ratios 0.40–0.43, p-value <0.05).
Conclusion
Since there is no logical basis for the desire to lose weight or one's perception of body weight to prevent UWL, lower reported prevalence rates on UWL-related questions are likely the result of misinterpretation. Malnutrition screening tools that include questions regarding UWL might underestimate the prevalence rates of malnutrition in higher BMIs, as individuals in these groups often aspire to lose weight or perceive themselves as too heavy.
{"title":"Decoding unintentional weight loss: How the right questions make a difference","authors":"Jos W. Borkent , Barbara S. van der Meij , Marian A.E. de van der Schueren","doi":"10.1016/j.clnu.2025.04.009","DOIUrl":"10.1016/j.clnu.2025.04.009","url":null,"abstract":"<div><h3>Background/aims</h3><div>Malnutrition screening tools often include questions about unintentional weight loss (UWL). It is unclear whether individuals who intentionally desire to lose weight or perceive themselves as overweight interpret questions regarding UWL accurately. We assessed potential misclassification of UWL-related questions in these groups.</div></div><div><h3>Method</h3><div>Data from the Lifelines cohort was used (ñ125.000, age >18 years). Prevalence ratios (PRs) were calculated with a simple question regarding UWL as the dependent variable and the desire to lose weight and perception of one's body weight (too heavy vs. just right/too light) as separate independent variables. Associations were stratified by body mass index (BMI) group (normal weight vs. overweight/obesity) and adjusted for various comorbidities, demographics, and quality of life.</div></div><div><h3>Results</h3><div>Of participants with normal weight, 30.3 % desired to lose weight, 37.9 % perceived their body weight as too heavy and 5.1 % reported UWL; this was 80.1 %, 92.7 % and 2.7 % for those with overweight/obesity. In both BMI groups, the prevalence of UWL was ∼60 % lower in participants who desired to lose weight or perceived themselves as too heavy (prevalence ratios 0.40–0.43, p-value <0.05).</div></div><div><h3>Conclusion</h3><div>Since there is no logical basis for the desire to lose weight or one's perception of body weight to prevent UWL, lower reported prevalence rates on UWL-related questions are likely the result of misinterpretation. Malnutrition screening tools that include questions regarding UWL might underestimate the prevalence rates of malnutrition in higher BMIs, as individuals in these groups often aspire to lose weight or perceive themselves as too heavy.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"49 ","pages":"Pages 98-101"},"PeriodicalIF":6.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-10DOI: 10.1016/j.clnu.2025.03.025
Christina Stene , Jie Xu , Sérgio Fallone de Andrade , Ingrid Palmquist , Göran Molin , Siv Ahrné , Henrik Thorlacius , Louis B. Johnson , Bengt Jeppsson
Background & aims
Colorectal cancer (CRC), particularly rectal cancer, often requires neoadjuvant radiotherapy (RT) as part of its treatment plan. Although effective, RT can cause significant gastrointestinal side effects. Because the onset of RT-induced tissue injury can be anticipated, there is an opportunity to apply preventive measures before the damage occurs. This study aimed to assess whether prebiotic and synbiotic interventions could mitigate RT-induced gut injury by modulating the mucosa-associated microbiota, reducing inflammation, and enhancing gut barrier function in patients undergoing RT for rectal cancer.
Methods
Thirty patients with rectal adenocarcinoma scheduled for preoperative short-term RT (5 × 5 Gy) were divided into three groups: a control group (Ctrl), a prebiotic group (Fiber) receiving oat bran, and a synbiotic group (Synbiotics) receiving oat bran with L. plantarum HEAL19 and blueberry husks. The study products were administered daily for two weeks, starting one week before RT. Blood, faecal, and biopsy samples were collected before and after RT to evaluate inflammatory markers, intestinal permeability, histopathological changes, and mucosa-associated microbiota.
Results
The Fiber and Synbiotics groups exhibited a significant reduction in white blood cell counts following RT (p = 0.01 for both), whereas the Ctrl group did not demonstrate a significant change. However, there was no significant difference in the magnitude of change in white blood cell counts among the three groups (p = 0.12). Histopathological analysis revealed that the Synbiotics group had reduced inflammation and fibrosis compared to the Fiber and Ctrl groups. Although RT reduced bacterial diversity overall, the Synbiotics group preserved a greater proportion of bacterial species, experiencing only a 25.1 % reduction compared to a 55.4 % reduction in the Fiber group.
Conclusion
Synbiotic interventions may protect rectal mucosa by reducing inflammation and modulating mucosa-associated microbiota. The effects were primarily localized to the tissue, reflecting the short-term duration of treatment. While immediate benefits were observed, longer-term interventions should be explored to reduce systemic inflammation.
{"title":"Synbiotics protected radiation-induced tissue damage in rectal cancer patients: A controlled trial","authors":"Christina Stene , Jie Xu , Sérgio Fallone de Andrade , Ingrid Palmquist , Göran Molin , Siv Ahrné , Henrik Thorlacius , Louis B. Johnson , Bengt Jeppsson","doi":"10.1016/j.clnu.2025.03.025","DOIUrl":"10.1016/j.clnu.2025.03.025","url":null,"abstract":"<div><h3>Background & aims</h3><div>Colorectal cancer (CRC), particularly rectal cancer, often requires neoadjuvant radiotherapy (RT) as part of its treatment plan. Although effective, RT can cause significant gastrointestinal side effects. Because the onset of RT-induced tissue injury can be anticipated, there is an opportunity to apply preventive measures before the damage occurs. This study aimed to assess whether prebiotic and synbiotic interventions could mitigate RT-induced gut injury by modulating the mucosa-associated microbiota, reducing inflammation, and enhancing gut barrier function in patients undergoing RT for rectal cancer.</div></div><div><h3>Methods</h3><div>Thirty patients with rectal adenocarcinoma scheduled for preoperative short-term RT (5 × 5 Gy) were divided into three groups: a control group (Ctrl), a prebiotic group (Fiber) receiving oat bran, and a synbiotic group (Synbiotics) receiving oat bran with <em>L. plantarum</em> HEAL19 and blueberry husks. The study products were administered daily for two weeks, starting one week before RT. Blood, faecal, and biopsy samples were collected before and after RT to evaluate inflammatory markers, intestinal permeability, histopathological changes, and mucosa-associated microbiota.</div></div><div><h3>Results</h3><div>The Fiber and Synbiotics groups exhibited a significant reduction in white blood cell counts following RT (p = 0.01 for both), whereas the Ctrl group did not demonstrate a significant change. However, there was no significant difference in the magnitude of change in white blood cell counts among the three groups (p = 0.12). Histopathological analysis revealed that the Synbiotics group had reduced inflammation and fibrosis compared to the Fiber and Ctrl groups. Although RT reduced bacterial diversity overall, the Synbiotics group preserved a greater proportion of bacterial species, experiencing only a 25.1 % reduction compared to a 55.4 % reduction in the Fiber group.</div></div><div><h3>Conclusion</h3><div>Synbiotic interventions may protect rectal mucosa by reducing inflammation and modulating mucosa-associated microbiota. The effects were primarily localized to the tissue, reflecting the short-term duration of treatment. While immediate benefits were observed, longer-term interventions should be explored to reduce systemic inflammation.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"49 ","pages":"Pages 33-41"},"PeriodicalIF":6.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The association of allergic diseases with the intake of fish-derived proteins and fatty acids remains unclear, with studies showing divergent results. We aimed to examine the association of those nutrients with the occurrence of allergic rhinitis (AR).
Methods
A multicenter case–control study was conducted with 411 AR cases and 477 controls. Adjusted odds ratios (OR) of AR and their 95 % confidence intervals (CI) were estimated using multivariate logistic regression models. Stratified analyses by fish type and macronutrient were undertaken.
Results
Blue fish consumption, except tuna, is associated with an important decrease in the odds of AR (1 serving/week: OR = 0.46; 95%CI: 0.27–0.80; 2 servings/week: OR = 0.30; 95%CI: 0.17–0.54; 3–4 servings/week: OR = 0.38; 95%CI: 0.20–0.68). Conversely, compared to no intake, white fish consumption is associated with higher odds of AR (3 servings/week: OR = 5.49; 95%CI: 3.27–9.24).
A high n-6/n-3 polyunsaturated fatty acids (PUFAs) ratio is associated with higher odds of AR (OR = 1.79; 95%CI: 1.03–3.13 for the highest intake level compared to the lowest). High intake of n-3 PUFAs is associated with substantially lower odds of AR ranging between 46 % and 58 % (stearidonic acid OR = 0.42; 95%CI: 0.24–0.74; eicosapentaenoic acid OR = 0.45; 95%CI: 0.25–0.80; and docosapentaenoic acid OR = 0.54; 95%CI: 0.31–0.96).
Conclusions
A high intake of blue fish, except tuna, is associated with lower odds of AR while that of white fish has an opposite association with the disease occurrence.
{"title":"Fish and sea products consumption and allergic rhinitis: A multicenter case–control study","authors":"Carlos Regueira , Narmeen Mallah , Jurgita Saulyte , Francisco-Javier González-Barcala , Bahi Takkouche","doi":"10.1016/j.clnu.2025.04.005","DOIUrl":"10.1016/j.clnu.2025.04.005","url":null,"abstract":"<div><h3>Background</h3><div>The association of allergic diseases with the intake of fish-derived proteins and fatty acids remains unclear, with studies showing divergent results. We aimed to examine the association of those nutrients with the occurrence of allergic rhinitis (AR).</div></div><div><h3>Methods</h3><div>A multicenter case–control study was conducted with 411 AR cases and 477 controls. Adjusted odds ratios (OR) of AR and their 95 % confidence intervals (CI) were estimated using multivariate logistic regression models. Stratified analyses by fish type and macronutrient were undertaken.</div></div><div><h3>Results</h3><div>Blue fish consumption, except tuna, is associated with an important decrease in the odds of AR (1 serving/week: OR = 0.46; 95%CI: 0.27–0.80; 2 servings/week: OR = 0.30; 95%CI: 0.17–0.54; 3–4 servings/week: OR = 0.38; 95%CI: 0.20–0.68). Conversely, compared to no intake, white fish consumption is associated with higher odds of AR (3 servings/week: OR = 5.49; 95%CI: 3.27–9.24).</div><div>A high n-6/n-3 polyunsaturated fatty acids (PUFAs) ratio is associated with higher odds of AR (OR = 1.79; 95%CI: 1.03–3.13 for the highest intake level compared to the lowest). High intake of n-3 PUFAs is associated with substantially lower odds of AR ranging between 46 % and 58 % (stearidonic acid OR = 0.42; 95%CI: 0.24–0.74; eicosapentaenoic acid OR = 0.45; 95%CI: 0.25–0.80; and docosapentaenoic acid OR = 0.54; 95%CI: 0.31–0.96).</div></div><div><h3>Conclusions</h3><div>A high intake of blue fish, except tuna, is associated with lower odds of AR while that of white fish has an opposite association with the disease occurrence.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"49 ","pages":"Pages 42-49"},"PeriodicalIF":6.6,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-09DOI: 10.1016/j.clnu.2025.04.006
Ming Zhao , Chenyu Liang , Jiayi Huang , Luojia Dai , Haili Wang , Xin Zhang , Shuzhen Zhao , Chengnan Guo , Zhenqiu Liu , Tiejun Zhang
Background and aims
Despite increasing evidence linking triglyceride-glucose (TyG) related indices with metabolic and cardiovascular outcomes, the associations with severe infection in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) remain unclear.
Methods
We analyzed data from a large population-based cohort, which included participants who were diagnosed with MASLD and enrolled in 2016 and 2017, with follow-up until December 2022. Severe infections were defined as those requiring hospital admission or resulting in mortality. Multivariate Cox and restricted cubic spline (RCS) regression models were used to evaluate the associations between TyG-related indices and severe infection among participants with MASLD. Additionally, we examined these associations within subgroups defined by age, sex, hypertension, diabetes, obesity, and hyperlipidemia.
Results
Among the 11,782 eligible participants with MASLD (mean age 57.02 years; 34.36 % male), a total of 898 (7.62 %) severe infections occurred during the median follow-up of 5.71 years. The multivariate Cox regression analyses revealed that high levels of TyG (HR = 1.175, 95%CI = 1.049–1.315), TyG-BMI (HR = 1.004, 95%CI = 1.001–1.006), and TyG-WC (HR = 1.002, 95%CI = 1.001–1.003) indices were significantly associated with the severe infection in patients with MASLD. The RCS curves showed positive linear correlations between three TyG-related indices with severe infection in MASLD. Subgroup analyses showed these associations were more pronounced among MASLD patients without obesity. Additionally, incorporating TyG-related indices into the basic model considerably improved the predictive ability for severe infection.
Conclusions
Our study indicated that a high TyG-related indices are associated with an increased risk of severe infection in MASLD patients. TyG-related indices would be the surrogate biomarkers for the follow-up of the MASLD population.
{"title":"Association between triglyceride-glucose related indices and severe infection requiring hospital admission or resulting in mortality among individuals with metabolic dysfunction-associated steatotic liver disease","authors":"Ming Zhao , Chenyu Liang , Jiayi Huang , Luojia Dai , Haili Wang , Xin Zhang , Shuzhen Zhao , Chengnan Guo , Zhenqiu Liu , Tiejun Zhang","doi":"10.1016/j.clnu.2025.04.006","DOIUrl":"10.1016/j.clnu.2025.04.006","url":null,"abstract":"<div><h3>Background and aims</h3><div>Despite increasing evidence linking triglyceride-glucose (TyG) related indices with metabolic and cardiovascular outcomes, the associations with severe infection in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) remain unclear.</div></div><div><h3>Methods</h3><div>We analyzed data from a large population-based cohort, which included participants who were diagnosed with MASLD and enrolled in 2016 and 2017, with follow-up until December 2022. Severe infections were defined as those requiring hospital admission or resulting in mortality. Multivariate Cox and restricted cubic spline (RCS) regression models were used to evaluate the associations between TyG-related indices and severe infection among participants with MASLD. Additionally, we examined these associations within subgroups defined by age, sex, hypertension, diabetes, obesity, and hyperlipidemia.</div></div><div><h3>Results</h3><div>Among the 11,782 eligible participants with MASLD (mean age 57.02 years; 34.36 % male), a total of 898 (7.62 %) severe infections occurred during the median follow-up of 5.71 years. The multivariate Cox regression analyses revealed that high levels of TyG (HR = 1.175, 95%CI = 1.049–1.315), TyG-BMI (HR = 1.004, 95%CI = 1.001–1.006), and TyG-WC (HR = 1.002, 95%CI = 1.001–1.003) indices were significantly associated with the severe infection in patients with MASLD. The RCS curves showed positive linear correlations between three TyG-related indices with severe infection in MASLD. Subgroup analyses showed these associations were more pronounced among MASLD patients without obesity. Additionally, incorporating TyG-related indices into the basic model considerably improved the predictive ability for severe infection.</div></div><div><h3>Conclusions</h3><div>Our study indicated that a high TyG-related indices are associated with an increased risk of severe infection in MASLD patients. TyG-related indices would be the surrogate biomarkers for the follow-up of the MASLD population.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"49 ","pages":"Pages 1-10"},"PeriodicalIF":6.6,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143823208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-09DOI: 10.1016/j.clnu.2025.04.007
Ana Sofia Salsinha , Helena Araújo-Rodrigues , Cindy Dias , André Cima , Luís Miguel Rodríguez-Alcalá , João B. Relvas , Manuela Pintado
Background & aims
Gut microbiota has been gaining increasing attention and its important role in the maintenance of a general good health condition is already established. The potential of gut microbiota modulation through diet is an important research focus to be considered. Lipids, as omega-3 fatty acids, are well known for their beneficial role on organs and corresponding diseases. However, their impact on gut microbiota is still poorly defined, and studies on the role of other polyunsaturated fatty acids, such as conjugated linoleic and linolenic acids, are even scarcer.
Methods
By using an in vitro human fermentation model, we assessed the effect of omega-3, CLA isomers, and punicic acid on microbiota modulation.
Results
Fish oil, Omega-3, and CLA samples positively impact Akkermansia spp. and Bifidobacterium spp. growth. Moreover, all the samples supported Roseburia spp. growth after 24 h of fermentation and, importantly, they were able to maintain the Firmicutes: Bacteroidetes ratio near 1. All the bioactive fatty acid samples, except Pomegranate oil, were able to significantly increase butyrate levels compared to those found in the positive control (FOS) sample. Moreover, Fish oil and Omega-3 samples were able to increase the concentration of GABA, alanine, tyrosine, phenylalanine, isoleucine, and leucine between 12 and 24 h of fermentation.
Conclusions
The impact of the assessed polyunsaturated fatty acids in gut microbiota has been observed in its impact on key bacteria (Akkermansia, Bifidobacterium, and Roseburia) as well as their metabolic byproducts, including butyrate and amino acids, which could potentially play a role in modulating the gut-brain axis.
{"title":"Omega-3 and conjugated fatty acids impact on human microbiota modulation using an in vitro fecal fermentation model","authors":"Ana Sofia Salsinha , Helena Araújo-Rodrigues , Cindy Dias , André Cima , Luís Miguel Rodríguez-Alcalá , João B. Relvas , Manuela Pintado","doi":"10.1016/j.clnu.2025.04.007","DOIUrl":"10.1016/j.clnu.2025.04.007","url":null,"abstract":"<div><h3>Background & aims</h3><div>Gut microbiota has been gaining increasing attention and its important role in the maintenance of a general good health condition is already established. The potential of gut microbiota modulation through diet is an important research focus to be considered. Lipids, as omega-3 fatty acids, are well known for their beneficial role on organs and corresponding diseases. However, their impact on gut microbiota is still poorly defined, and studies on the role of other polyunsaturated fatty acids, such as conjugated linoleic and linolenic acids, are even scarcer.</div></div><div><h3>Methods</h3><div>By using an <em>in vitro</em> human fermentation model, we assessed the effect of omega-3, CLA isomers, and punicic acid on microbiota modulation.</div></div><div><h3>Results</h3><div>Fish oil, Omega-3, and CLA samples positively impact <em>Akkermansia</em> spp. and <em>Bifidobacterium</em> spp. growth. Moreover, all the samples supported <em>Roseburia</em> spp. growth after 24 h of fermentation and, importantly, they were able to maintain the Firmicutes: Bacteroidetes ratio near 1. All the bioactive fatty acid samples, except Pomegranate oil, were able to significantly increase butyrate levels compared to those found in the positive control (FOS) sample. Moreover, Fish oil and Omega-3 samples were able to increase the concentration of GABA, alanine, tyrosine, phenylalanine, isoleucine, and leucine between 12 and 24 h of fermentation.</div></div><div><h3>Conclusions</h3><div>The impact of the assessed polyunsaturated fatty acids in gut microbiota has been observed in its impact on key bacteria (<em>Akkermansia</em>, <em>Bifidobacterium,</em> and <em>Roseburia</em>) as well as their metabolic byproducts, including butyrate and amino acids, which could potentially play a role in modulating the gut-brain axis.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"49 ","pages":"Pages 102-117"},"PeriodicalIF":6.6,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-08DOI: 10.1016/j.clnu.2025.04.004
Ling Wang , Xiangfeng He , Zhen Zhang , Nan Chen
Background
Previous evidence suggests that gut dysbiosis plays an important role in the development and progression of sarcopenia and sarcopenic obesity (SO), but evidence supporting this association is lacking. Thus, this study aimed to investigate the characteristics of gut microbiota in older people with sarcopenia and SO.
Methods
A total of 1558 older adults (age ≥65 years) from a community-based cohort in Shanghai, China, underwent sarcopenia screening using the SARC-F questionnaire, with 351 participants completing further assessment. On the basis of the Asian Working Group for Sarcopenia 2019 and the World Health Organization obesity criteria, 60 participants were categorized into three groups: SO (n = 20), sarcopenia without obesity (Sar, n = 18), and controls (Con, n = 22). Gut microbiota composition was analyzed using 16S rRNA sequencing (V3–V4 regions).
Results
Significant differences in the diversity and composition of the gut microbiota were observed in the Sar and SO groups. A reduction in alpha diversity (Chao1 and ACE indices) was found in the SO group. Beta diversity based on unweighted Unifrac PCoA was significantly different among the three groups. LEfSe analysis identified 39 taxa with significant differential abundances across groups. The Sar group exhibited enrichment of Christensenellaceae_R-7_group, Alistipes, Ruminococcus, Odoribacter, Prevotellaceae_UCG-001, Hungatella, Family_XIII_AD3011_group, Anaerotruncus, Ruminiclostridium, and Oxalobacter, along with their high taxonomic classifications. Meanwhile, Enterobacteriaceae, Allisonella, and Peptoclostridium were enriched in the SO group. Feature selection via Boruta algorithm identified five and four discriminatory taxa to construct random forest models, effectively distinguishing individuals with Sar and SO from Con. Key predictors for Sar included reduced Enterococcus, Enterobacter, and Hungatella and increased Odoribacter and Christensenellaceae_R-7_group. Conversely, SO was characterized by decreased Enterobacter, Alloprevotella, and Enterococcus and increased Allisonella. Five-fold cross-validation confirmed robust diagnostic efficacy, achieving AUCs of 0.860 (95 % CI: 0.786–0.996) for Sar and 0.826 (95 % CI: 0.735–0.970) for SO.
Conclusion
This study demonstrated that the gut microbiota of SO and Sar have distinct diversity and composition profiles. The results provide new insights into the role of gut microbiota in SO, highlighting its potential as a therapeutic target in this condition.
背景以前的证据表明，肠道菌群失调在肌肉疏松症和肌肉疏松性肥胖症（SO）的发生和发展过程中起着重要作用，但目前还缺乏支持这种关联的证据。因此，本研究旨在调查患有肌肉疏松症和肌肉疏松性肥胖症的老年人肠道微生物群的特征。方法来自中国上海一个社区队列的 1558 名老年人（年龄≥65 岁）使用 SARC-F 问卷进行了肌肉疏松症筛查，其中 351 人完成了进一步评估。根据 2019 年亚洲肌少症工作组和世界卫生组织肥胖标准，60 名参与者被分为三组：SO组（20人）、无肥胖症的肌肉疏松症组（18人）和对照组（22人）。采用 16S rRNA 测序（V3-V4 区域）分析了肠道微生物群的组成。结果在 Sar 组和 SO 组观察到肠道微生物群的多样性和组成存在显著差异。在 SO 组中，α 多样性（Chao1 和 ACE 指数）有所降低。基于非加权 Unifrac PCoA 的 Beta 多样性在三组中存在显著差异。LEfSe 分析发现，有 39 个分类群在各组间存在明显的丰度差异。Sar 组富集了 Christensenellaceae_R-7_group、Alistipes、Ruminococcus、Odoribacter、Prevotellaceae_UCG-001、Hungatella、Family_XIII_AD3011_group、Anaerotruncus、Ruminiclostridium 和 Oxalobacter，这些分类群的分类等级也较高。同时，SO 组中富含肠杆菌科、Allisonella 和肽杆菌。通过 Boruta 算法进行特征选择，确定了 5 个和 4 个具有区分性的类群，从而构建了随机森林模型，有效区分了 Sar 和 SO 与 Con 的个体。Sar的主要预测因子包括肠球菌、肠杆菌属和Hungatella减少，Odoribacter和Christensenellaceae_R-7_group增加。相反，SO 的特征是肠杆菌、Alloprevotella 和肠球菌减少，Allisonella 增加。五倍交叉验证证实了诊断的有效性，Sar 的 AUC 为 0.860（95 % CI：0.786-0.996），SO 的 AUC 为 0.826（95 % CI：0.735-0.970）。这些结果为了解肠道微生物群在 SO 中的作用提供了新的视角，突出了其作为 SO 治疗靶点的潜力。
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Pub Date : 2025-04-08DOI: 10.1016/j.clnu.2025.03.021
Tarun Sontam , Nicolaas E.P. Deutz , Clayton L. Cruthirds , Robert Mbilinyi , Laura E. Ruebush , Gabriella AM. Ten Have , John J. Thaden , Mariёlle P.K.J. Engelen
Background & aims
Disturbances in arginine (ARG) and protein metabolism, as well as in gut function have been observed in response to an endurance exercise session in patients with Chronic Obstructive Pulmonary Disease (COPD). We studied whether resistance exercise also affects the acute response in arginine (role in nitric oxide synthesis), citrulline (CIT, marker of gut health), and (muscle) protein metabolism differently in COPD as compared to healthy older adults.
Methods
Patients with stable moderate to severe COPD (n = 24) and healthy controls (n = 25) completed a high-intensity resistance exercise session in the postabsorptive state. We administered a pulse of multiple stable isotopes of amino acids before, and 1 h and 24 h post-resistance exercise to assess the whole body production (WBP) and intracellular productions by compartmental analysis of ARG and CIT, and of tau-methylhistidine (TauMETHIS), phenylalanine (PHE), tyrosine (TYR), and PHE > TYR conversion as markers of muscle (myofibrillar) protein breakdown and whole body (net) protein breakdown, respectively. Muscle fatigue was determined by assessing the decay in peak leg extension torque post-resistance exercise.
Results
COPD patients overall exhibited lower WBP ARG (p < 0.0001), CIT (p < 0.0001), PHE (p = 0.0001), TYR (p < 0.0001), and tau-METHIS (p = 0.0004) compared to controls. Resistance exercise did not change WBP of PHE, tau-METHIS, or PHE > TYR conversion, despite prolonged muscle fatigue in COPD. WBP CIT was increased at 1- and 24-h post-exercise in both groups (p < 0.003). Plasma CIT concentrations were reduced in both groups (p < 0.006) and remained lower at 24 h post-exercise in COPD only (p < 0.05) despite a third less work performed.
Conclusions
Both COPD and healthy participants exhibited upregulated whole-body citrulline production following resistance exercise. However, in COPD, this increase was insufficient to counteract the sustained reduction in plasma citrulline concentration, despite performing significantly less work during the exercise session. This prolonged disturbance in citrulline metabolism in COPD points to a potential exercise-induced enterocyte dysfunction, highlighting a novel area for understanding the impact of resistance exercise on gut health in this population.
{"title":"Prolonged disturbances in citrulline metabolism following resistance exercise in COPD","authors":"Tarun Sontam , Nicolaas E.P. Deutz , Clayton L. Cruthirds , Robert Mbilinyi , Laura E. Ruebush , Gabriella AM. Ten Have , John J. Thaden , Mariёlle P.K.J. Engelen","doi":"10.1016/j.clnu.2025.03.021","DOIUrl":"10.1016/j.clnu.2025.03.021","url":null,"abstract":"<div><h3>Background & aims</h3><div>Disturbances in arginine (ARG) and protein metabolism, as well as in gut function have been observed in response to an endurance exercise session in patients with Chronic Obstructive Pulmonary Disease (COPD). We studied whether resistance exercise also affects the acute response in arginine (role in nitric oxide synthesis), citrulline (CIT, marker of gut health), and (muscle) protein metabolism differently in COPD as compared to healthy older adults.</div></div><div><h3>Methods</h3><div>Patients with stable moderate to severe COPD (n = 24) and healthy controls (n = 25) completed a high-intensity resistance exercise session in the postabsorptive state. We administered a pulse of multiple stable isotopes of amino acids before, and 1 h and 24 h post-resistance exercise to assess the whole body production (WBP) and intracellular productions by compartmental analysis of ARG and CIT, and of tau-methylhistidine (TauMETHIS), phenylalanine (PHE), tyrosine (TYR), and PHE > TYR conversion as markers of muscle (myofibrillar) protein breakdown and whole body (net) protein breakdown, respectively. Muscle fatigue was determined by assessing the decay in peak leg extension torque post-resistance exercise.</div></div><div><h3>Results</h3><div>COPD patients overall exhibited lower WBP ARG (p < 0.0001), CIT (p < 0.0001), PHE (p = 0.0001), TYR (p < 0.0001), and tau-METHIS (p = 0.0004) compared to controls. Resistance exercise did not change WBP of PHE, tau-METHIS, or PHE > TYR conversion, despite prolonged muscle fatigue in COPD. WBP CIT was increased at 1- and 24-h post-exercise in both groups (p < 0.003). Plasma CIT concentrations were reduced in both groups (p < 0.006) and remained lower at 24 h post-exercise in COPD only (p < 0.05) despite a third less work performed.</div></div><div><h3>Conclusions</h3><div>Both COPD and healthy participants exhibited upregulated whole-body citrulline production following resistance exercise. However, in COPD, this increase was insufficient to counteract the sustained reduction in plasma citrulline concentration, despite performing significantly less work during the exercise session. This prolonged disturbance in citrulline metabolism in COPD points to a potential exercise-induced enterocyte dysfunction, highlighting a novel area for understanding the impact of resistance exercise on gut health in this population.</div></div><div><h3>Clinical trial registry</h3><div>Trial registration ClinicalTrials.gov: <span><span>NCT02780219</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"49 ","pages":"Pages 21-32"},"PeriodicalIF":6.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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