Clinical nutrition最新文献

{"title":"Impacts of an antioxidant-rich diet and lifestyle factors on gut microbiota diversity and brain health: An exploratory analysis from the NutBrain study","authors":"Federica Prinelli ,&nbsp;Alfonso Mastropietro ,&nbsp;Sara Bernini ,&nbsp;Tania Camboni ,&nbsp;Clarissa Consolandi ,&nbsp;Silvia Conti ,&nbsp;Alfredo Costa ,&nbsp;Matteo Cotta Ramusino ,&nbsp;Nithiya Jesuthasan ,&nbsp;Orietta Pansarasa ,&nbsp;Elena Perdixi ,&nbsp;Anna Pichiecchio ,&nbsp;Giovanna Rizzo ,&nbsp;Eveljn Scarian ,&nbsp;Marco Severgnini ,&nbsp;the NutBrain Study Working Group","doi":"10.1016/j.clnu.2026.106585","DOIUrl":"10.1016/j.clnu.2026.106585","url":null,"abstract":"<div><h3>Background and aims</h3><div>Healthy diet and lifestyle have been linked to improved gut microbiota diversity and neurocognitive outcomes. However, few human studies have simultaneously examined an antioxidant-rich diet (ARD) in combination with other lifestyle factors and their effects on gut microbiota diversity, brain morphometry, and cognitive function. Our aim was to investigate how the dietary antioxidant capacity and a healthy lifestyle profile influence gut microbiota diversity and composition, brain morphometry, and global cognitive function in older adults.</div></div><div><h3>Methods</h3><div>In a cross-sectional analysis of the NutBrain study (2019–2023), a cohort of 246 dementia-free individuals aged ≥65 years, completed a 3-day food diary to estimate the total dietary antioxidant capacity (Oxygen Radical Absorbance Capacity - ORAC). Global cognitive function was assessed using the Mini-Mental State Examination (MMSE). Gut microbiota α- and β-diversities and taxa abundances were derived by 16S rRNA amplicon-based sequencing of stool samples. Brain morphometry - including total brain, white matter, grey matter, and ventricular cerebrospinal fluid volumes - was assessed using magnetic resonance imaging. Multiple linear regression models, accounting for many potential confounders (i.e.: socio-demographics, use of drugs, energy intake, inflammatory and anthropometric markers, and APOE genotyping) examined how ORAC, both alone and combined with smoking and physical activity (devising a healthy lifestyle score, Hscore), affected microbiota diversity, MMSE scores, and brain volumes.</div></div><div><h3>Results</h3><div>Higher ORAC adherence was associated with greater gut microbiota diversity (p ≤ 0.05). Several taxa, such as <em>Barnesiella</em>, <em>Coprococcus</em>, <em>Ruminococcus</em>, <em>Parabacteroides</em>, <em>Lachnospiraceae</em> NK4A136 group, and <em>Clostridia</em> UCG-014 group exhibited increased abundances within the highest ORAC and Hscore tertiles, as compared to the lowest ones. The highest tertile of total ORAC was also positively and significantly associated with greater total brain, white matter, and grey matter volumes (p ≤ 0.05). These associations were stronger in participants classified as having a favourable lifestyle profile (regular physical activity, non-smokers), with notable correlations observed for total brain volume, gut α-diversity, white matter volume and MMSE (p ≤ 0.05).</div></div><div><h3>Conclusions</h3><div>ARD is associated with increased gut microbiota diversity and enrichment of specific taxa, better cognitive function and brain morphometry outcomes. These associations were stronger in individuals with a healthy lifestyle profile.</div></div><div><h3>Clinical Trial Registry number and website where it was obtained</h3><div>NCT04461951, <span><span>https://clinicaltrials.gov/</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106585"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146156299","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}

{"title":"Bariatric surgery improves fibrinolysis in individuals with obesity with and without concomitant type 2 diabetes","authors":"Maja Andersson ,&nbsp;Anders Thorell ,&nbsp;Peter Henriksson ,&nbsp;Anders Kallner ,&nbsp;Håkan Wallén ,&nbsp;Tomas L. Lindahl ,&nbsp;Anna Ågren","doi":"10.1016/j.clnu.2026.106584","DOIUrl":"10.1016/j.clnu.2026.106584","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Hypofibrinolysis is prevalent in obesity and type 2 diabetes mellitus (T2D) and may be involved in their pathophysiology. Metabolic bariatric surgery (MBS) markedly improves both obesity and T2D, but whether these improvements are related to fibrinolysis is not known. In this study, biomarkers of fibrinolysis were assessed before and after MBS in patients with and without T2D.</div></div><div><h3>Methods</h3><div>A single center prospective cohort study with 2-year follow-up. The participants were adults with obesity with (n = 28) or without T2D (n = 33) undergoing MBS preceded by 2 weeks of a low-calorie diet (LCD). The plasma concentrations of plasminogen activator inhibitor 1 activity (PAI-1_act), tissue plasminogen activator <em>activity</em> (tPA_act) and <em>antigen</em> (tPA_ag), plasmin-antiplasmin complexes (PAP) and fibrinogen were determined at baseline, after LCD and at 6 weeks, 1 and 2 years after MBS.</div></div><div><h3>Results</h3><div>After LCD and prior to MBS, PAI-1_act decreased and PAP increased significantly. Two years after MBS, PAI-1_act decreased from baseline 29.8 (63) to 3.8 (121) while tPA_act increased (0.08 (390) to 0.23 (150) IU), and PAP increased (544 (54) to 814 (60) ng/mL). tPA_ag and fibrinogen decreased (16.4 (29) to 9.7 (51) ng/mL and 4.15 (23) to 3.82 (20) g/L, respectively); p &lt; 0.001 for all; (geometric means, except tPA_act which is arithmetic mean, coefficient of variation (%CV)). There were no differences in fibrinolysis between groups at baseline or after surgery. Multivariate analysis showed that reduction in body weight and fat mass had the most important influence on fibrinolysis.</div></div><div><h3>Conclusion</h3><div>Fibrinolysis is significantly improved two years after MBS, as also indicated earlier after the two-week LCD. The lack of differences between patients with vs. without T2D suggests that fat mass reduction rather than improvement of glucose control is most important for improved fibrinolysis after MBS. In summary, our results support hypofibrinolysis as a mechanism in the pathophysiology in obesity.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106584"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146104144","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}

{"title":"Dietary flavonoid intake and psychological well-being – A bidirectional relationship","authors":"Alysha S. Thompson ,&nbsp;Nicola P. Bondonno ,&nbsp;Yan Lydia Liu ,&nbsp;Farah Qureshi ,&nbsp;Laura D. Kubzansky ,&nbsp;Claudia Trudel-Fitzgerald ,&nbsp;Julia K. Boehm ,&nbsp;Eric B. Rimm ,&nbsp;Aedín Cassidy","doi":"10.1016/j.clnu.2026.106579","DOIUrl":"10.1016/j.clnu.2026.106579","url":null,"abstract":"<div><h3>Background and aim</h3><div>Higher dietary flavonoid intake has been associated with lower risks of mortality and major chronic disease, yet its relationship with psychological well-being (PWB), a key contributor to health and quality of life, remains unclear. This study aimed to investigate bidirectional associations between dietary flavonoid intake and two PWB facets: happiness (positive emotional state) and optimism (generalized expectation of positive outcomes). Specifically, we examined whether (1) overall flavonoid-rich dietary patterns (flavodiet score), (2) intake of specific flavonoid-rich foods, and (3) total flavonoid and subclass intakes were each associated with happiness and optimism over time.</div></div><div><h3>Methods</h3><div>Data were drawn from the Nurses’ Health Study to form two analytical samples. Flavonoid intake measured in 1990 (n = 44,659) was examined in relation to sustained happiness (1992–2000) while intake in 2002 (n = 36,723) was analysed in relation to sustained optimism (2004–2012). Secondary analyses assessed whether higher baseline levels of each PWB facet were associated with sustained higher flavonoid intake, over up to 18 years. Associations were assessed using generalized estimating equations, adjusting for potential confounders.</div></div><div><h3>Results</h3><div>Higher flavodiet scores were associated with a 3–6 % higher likelihood of sustained happiness [RR_Q4vsQ1 (95 % CI): 1.03 (1.02–1.05)] and optimism [RR_Q4vsQ1 (95 % CI): 1.06 (1.01–1.11)]. Specific flavonoid-rich foods (strawberries, apples, oranges, grapefruit, blueberries) were associated with a 3–16 % greater likelihood of sustained PWB, across the two facets. Similarly, total flavonoid and subclass intakes were associated with a 2–18 % greater likelihood of sustained PWB. Women with higher baseline levels of happiness or optimism were also more likely to sustain a higher flavonoid intake.</div></div><div><h3>Conclusions</h3><div>Consuming ∼3 servings/day of flavonoid-rich foods is associated with sustained PWB, and higher baseline PWB is associated with sustained higher flavonoid intake over up to 18 years. This bidirectional relationship suggests that integrated interventions targeting both diet and well-being may help promote long-term health and reduce chronic disease risk.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106579"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077176","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}

{"title":"Retraction notice to “A randomized trial of iron- and zinc-biofortified pearl millet-based complementary feeding in children aged 12 to 18 months living in urban slums” [Clin Nutr 41 (2022) 937–947]","authors":"Saurabh Mehta ,&nbsp;Samantha L. Huey ,&nbsp;Padmini S. Ghugre ,&nbsp;Ramesh D. Potdar ,&nbsp;Sudha Venkatramanan ,&nbsp;Jesse T. Krisher ,&nbsp;Caleb J. Ruth ,&nbsp;Harsha V. Chopra ,&nbsp;Aparna Thorat ,&nbsp;Varsha Thakker ,&nbsp;Lynn Johnson ,&nbsp;Laura Powis ,&nbsp;Yadurshini Raveendran ,&nbsp;Jere D. Haas ,&nbsp;Julia L. Finkelstein ,&nbsp;Shobha A. Udipi ,&nbsp;Project Sabal","doi":"10.1016/j.clnu.2026.106578","DOIUrl":"10.1016/j.clnu.2026.106578","url":null,"abstract":"<div><div>This article has been retracted: please see Elsevier policy on article withdrawal (<span><span>https://www.elsevier.com/about/policies-and-standards/article-withdrawal</span><svg><path></path></svg></span>). This article is retracted at the request of the authors. During post-publication data re-analyses, the authors found four additional hemoglobin datapoints at the endpoint of the trial reported in the above-named article that move the p-value for the primary outcome - the impact of intervention on the change in hemoglobin concentrations across the duration of the trial - from 0.053 to 0.044. Furthermore, the WHO has recently released a revised set of cutoffs for anemia [WHO 2024], and the anemia cutoff for the age group of interest in this article, 12–23 months, was lowered from a hemoglobin concentration of 11 g/dL to 10.5 g/dL. As such, the authors wish to report these revised estimates of anemia based on the revised WHO cutoffs to keep the findings as updated as possible and useful for guidelines. The Editors considered this request and agreed to the retraction of the article. The authors were invited to submit a revised version of the article, which has been peer-reviewed and accepted for publication in the journal. This retraction notice will be updated with a link to the revised paper when it is published.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106578"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146028378","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}

{"title":"Proof of concept for an age- and inflammation-adjusted model for the establishment of pediatric serum copper reference intervals","authors":"Helena Rodriguez-Gonzalez ,&nbsp;Angela Arias ,&nbsp;Elisabet Poyatos ,&nbsp;Mariela Mercedes de los Santos ,&nbsp;Beatriz Minguez ,&nbsp;Silvia Meavilla ,&nbsp;Camila Garcia-Volpe ,&nbsp;Ines Loverdos ,&nbsp;Cristina Molera ,&nbsp;Mercedes Casado ,&nbsp;Aida Ormazabal ,&nbsp;Alexandre Perera-Lluna ,&nbsp;Rafael Artuch","doi":"10.1016/j.clnu.2026.106586","DOIUrl":"10.1016/j.clnu.2026.106586","url":null,"abstract":"<div><h3>Background &amp; aims:</h3><div>Copper is a trace element essential for enzymatic reactions, but excessive accumulation can cause toxicity. Accurate interpretation of serum copper concentrations is crucial for diagnosing conditions such as Wilson's disease, liver dysfunction, and nutritional deficiencies. Current reference intervals often ignore the effect of inflammation and are typically established using discrete age groups rather than modelling age as a continuous variable. This study aimed to establish continuous, age-adjusted reference intervals for serum copper and to develop a method for correcting inflammation-related variability.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed serum copper concentrations in a pediatric cohort of 4,368 unique samples. Inflammatory status was assessed using erythrocyte sedimentation rate (ESR), fibrinogen, and C-reactive protein (CRP). Samples without inflammation were used to generate age-continuous reference intervals through polynomial regression. To quantify and adjust for inflammation effects, we developed a composite inflammation score using partial least squares regression on standardized values of the three acute-phase markers and applied it to correct copper concentrations in samples exhibiting inflammation.</div></div><div><h3>Results</h3><div>Serum copper showed a nonlinear relationship with age. Inflammation elevated copper concentrations by approximately 24 %. The composite inflammation score independently predicted this variability in copper concentrations, and adjustment using the score restored copper concentrations within reference limits, reducing the risk of data misinterpretation.</div></div><div><h3>Conclusion</h3><div>Our findings underscore the necessity of considering both age and inflammation variables when interpreting pediatric serum copper concentrations. We provide continuous, age-adjusted reference intervals and a method to correct for inflammation-related variability, enhancing data interpretation. We propose a proof-of-concept potentially applicable to other biomarkers related with metabolic and nutritional disturbances in chronic and acute diseases.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106586"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146104134","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}

{"title":"How low can we go with hypocaloric feeding for critically ill patients? For how long can it be continued?","authors":"Emmanuel Pardo,&nbsp;Ronan Thibault","doi":"10.1016/j.clnu.2026.106588","DOIUrl":"10.1016/j.clnu.2026.106588","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106588"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164551","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}

{"title":"Proteins in artificial nutrition: toward an individualized and phase-specific prescription","authors":"Philipp Schuetz ,&nbsp;Frank Carrera-Gil ,&nbsp;Carla Wunderle","doi":"10.1016/j.clnu.2026.106577","DOIUrl":"10.1016/j.clnu.2026.106577","url":null,"abstract":"<div><div>Protein is a central component of artificial nutrition, yet its optimal dose and timing remain controversial. Provision of both insufficient and excessive protein is associated with adverse outcomes. Inadequate intake promotes negative nitrogen balance, muscle wasting, impaired tissue healing and repair, and increased risk of infection, whereas excessive protein may exceed metabolic capacity, causing azotemia, hepatic or renal strain, and reduced metabolic flexibility — particularly in patients with renal dysfunction. Emerging evidence indicates that the optimal protein dose is strongly influenced by patient-specific characteristics and evolves throughout the course of illness, supporting an individualized, phase-adapted strategy for protein provision rather than a fixed universal target. During early critical illness, catabolism predominates and high protein doses may not be effectively utilized. In contrast, during recovery and stabilization, higher protein targets appear beneficial for restoring lean body mass and functional capacity. This dynamic trajectory underscores the need to abandon universal recommendations in favor of personalized prescriptions. Although instruments such as nitrogen balance, body composition analysis, and indirect calorimetry can provide information about protein dosage, their routine use in clinical practice is limited and interpretation in acute illnesses remains difficult. Pragmatic, bedside strategies and the phenotyping of patients using biomarkers are, therefore, needed to tailor protein provision according to disease stage, organ function, and anabolic capacity. This opinion paper explores mechanistic insights, evidence from clinical trials, and guidelines on protein supplementation, explores biomarker-driven personalization, and highlights ongoing challenges and future research priorities in nutritional therapy.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106577"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049112","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}

{"title":"Teachable moment for lifestyle and dietary changes after a myocardial infarction: Identifying the window of opportunity","authors":"Bahram Yosofi ,&nbsp;Manon Reesink ,&nbsp;Susan van Maren ,&nbsp;Manon G. van den Berg ,&nbsp;Jessica C. Kiefte-de Jong ,&nbsp;Robin Nijveldt ,&nbsp;Saloua El Messaoudi","doi":"10.1016/j.clnu.2026.106589","DOIUrl":"10.1016/j.clnu.2026.106589","url":null,"abstract":"<div><div><em>Background and aims</em>: While lifestyle changes, including dietary modifications, are crucial for reducing cardiovascular risk, adherence to these changes remains low. A ‘teachable moment’ (TM) can improve adherence, and a myocardial infarction (MI) can serve as a TM for initiating lifestyle and dietary changes. However, the timing and duration of receptiveness remain unclear. This study aimed to investigate whether an MI serves as a TM for lifestyle and dietary change intentions, to explore when this TM is most pronounced and to identify predictors of this TM.</div></div><div><h3>Methods</h3><div>In this cross-sectional survey study, patients who experienced an MI reported their intentions to change lifestyle and diet, along with the validated CardiacTM scale. Patients were categorised based on the time since MI: within 2 weeks, 6 months, 1 year, and 3 years ago. Intentions to change lifestyle and diet were compared between groups. Logistic regression analyses were performed to examine the association between the CardiacTM factors, time elapsed post–MI and intentions to change lifestyle and diet.</div></div><div><h3>Results</h3><div>241 patients were included in the analyses. Event-related lifestyle change intentions differed significantly between the 6-month and 1-year post–MI groups (30.6 % vs. 55.4 %, p = 0.003), as well as between the 2-weeks and 6-month post–MI groups (54.3 % and 30.6%p = 0.010). The intention to change dietary behaviour and general lifestyle were comparable across groups. Multivariate logistic regression revealed that time post–MI (p = 0.018), changed self-concept (B = 0.748; p &lt; 0.001) and cardiovascular disease (CVD) group identity (B = 0.550; p = 0.021) were significantly associated with event-related lifestyle change intentions. Affective impact (B = −0.496; p &lt; 0.001), changed self-concept (B = 0.506; p &lt; 0.001), perceived risk of non-communicable diseases (NCD) (B = −0.450; p = 0.003) and anticipated regret (B = 0.345; p = 0.008) were significantly associated with general lifestyle change intentions. Significant predictors of dietary change intentions were affective impact (B = 0.298; p = 0.025) and changed self-concept (B = 0.518; p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>A significant association was found between time post–MI and event-related lifestyle change intentions. Changed self-concept was the strongest predictor of TM for dietary, event-related and general lifestyle change intentions. These results suggest lifestyle interventions should be provided shortly after the event and personalised based on patients' perceptions of their MI to maximise effectiveness.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106589"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164504","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}

{"title":"Nutrition care in adults with spinal cord injuries and disorders with pressure injuries: A systematic review of clinical practice guidelines","authors":"Yiwen Wang ,&nbsp;Man Ching Lo ,&nbsp;Murray Fisher ,&nbsp;Katherine Desneves ,&nbsp;Amy Nevin ,&nbsp;Priya lyer","doi":"10.1016/j.clnu.2026.106580","DOIUrl":"10.1016/j.clnu.2026.106580","url":null,"abstract":"<div><div>Pressure injuries (PIs) are a common and costly complication in adults with spinal cord injuries and disorders (SCI/D), with a global prevalence of 32 % and a lifetime risk exceeding 85 % in Australia. Nutrition is a key factor in the prevention and management of PIs, supporting wound healing, immune function, and overall recovery. This systematic review evaluated the quality, scope, and methodological rigour of 17 international clinical practice guidelines (CPGs) published since 2010 that included nutrition recommendations for PIs in adults with SCI/D. Using the AGREE II and the AGREE-REX tools, this review assessed overall guideline quality and nutrition-specific recommendations mapped to the Nutrition Care Process domains. Seven CPGs were rated high quality with AGREE II, and three with AGREE-REX. While most guidelines focussed on nutrition interventions, limited detail was provided on assessment and monitoring. Considerable variation was found in the rigour and specificity of recommendations. These findings underscore a need for high-quality, SCI/D-specific guidelines that offer consistent, evidence-based, actionable nutrition guidance, particularly in the under-represented areas of assessment and monitoring, to better support PI prevention and treatment in this vulnerable population.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106580"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077060","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}

{"title":"Effectiveness of probiotic supplementation in managing depressive symptoms and inflammatory status in patients with depression: A systematic review and meta-analysis","authors":"Hajar Nabeel Shakir Shakir ,&nbsp;Antonio Javier Alias-Castillo ,&nbsp;Daniel Bertini-Pérez ,&nbsp;Lola Rueda-Ruzafa ,&nbsp;Pablo Roman ,&nbsp;Diana Cardona","doi":"10.1016/j.clnu.2025.106554","DOIUrl":"10.1016/j.clnu.2025.106554","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Depression is a multifactorial disorder influenced by genetic, biochemical, psychological, and environmental factors, and it significantly impacts quality of life. Probiotics, especially <em>Lactobacillus</em> and <em>Bifidobacterium</em> strains, have been proposed as adjunct therapies due to their capacity to modulate gut microbiota and the gut–brain axis. This systematic review and meta-analysis aimed to evaluate the effectiveness of probiotic supplementation on depressive symptoms and inflammatory status in individuals with depression.</div></div><div><h3>Methods</h3><div>Articles were identified through searches in databases including PubMed, Scopus, CINAHL, and Zenodo, using terms related to depression, microbiome, and probiotics. The search, conducted between January and February 2025, yielded 780 articles. After removing duplicates and applying eligibility criteria, 13 studies were included in the systematic review and 7 in the meta-analysis.</div></div><div><h3>Results</h3><div>Probiotic supplementation was significantly associated with improvement in depressive symptoms (p &lt; 0.00001). However, no significant changes were found in inflammatory biomarkers, including interleukin-6 (p = 0.45) and tumor necrosis factor-alpha (p = 0.21).</div></div><div><h3>Conclusions</h3><div>These results suggest that probiotics may help alleviate depressive symptoms, although their effect on inflammation remains uncertain. Further high-quality studies are necessary to clarify underlying mechanisms and determine the clinical relevance of probiotics as adjunctive therapy in depression..</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"58 ","pages":"Article 106554"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049111","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}