Pub Date : 2026-01-01DOI: 10.1016/j.clnu.2025.11.005
Nikhitha M. John , Bhargavi Ashok , Obed John , Kanagalakshmi V , Dilip Abraham , Prasanna Samuel , Yesudas Sudhakar , Surjit K.S. Srai , Molly Jacob
Background and aims
There is little universal consensus on the optimal regime for oral iron supplementation to treat iron deficiency (ID) and iron-deficiency anemia (IDA) in women of reproductive age (WRA). A few studies in a high-income country have reported higher fractional absorption from oral iron supplements (OIS) given on alternate days than daily doses; however, there were no significant improvements in hematological indices in the women in these studies who received the alternate-day doses. There are also concerns about adverse gastrointestinal effects resulting from daily OIS. Data on these aspects from low and middle-income countries (LMIC), where the burden of IDA is high, are limited.
Methods
We conducted a double-blinded, parallel-arm, non-inferiority, randomized controlled trial in non-pregnant WRA aged 18–45 years with ID (serum ferritin <20 μg/L) (CTRI/2020/03/024144). They were randomized to receive either 60 mg elemental iron daily (n = 30) or 120 mg elemental iron on alternate days (n = 30) for 14 days. The primary outcome was to determine the comparative effectiveness of daily versus alternate-day OIS in improving hematological and iron-related parameters in blood, at the end of the intervention. Secondary outcomes included extent of adherence to intervention, adverse events experienced, and changes in fecal calprotectin concentrations (a marker of gut inflammation) and the gut microbiome profile.
Results
Adherence to the regimes was excellent (≥90 %) in both arms. Both regimes significantly improved hematological and iron-related parameters in blood at the end of 14 days. Daily OIS resulted in greater increases in mean corpuscular volume (fL) [1.25 (0.25, 2.32) vs. 0.50 (−0.35, 1.42); p = 0.043], mean corpuscular hemoglobin (pg/cell) [0.52 (0.54) vs. 0.17 (0.56); p = 0.019], and reticulocyte counts (%) [0.32 (0.13, 0.75) vs. 0.27 (0.02, 0.45); p = 0.055] than alternate-day doses. There were no significant differences between the groups in extent of improvements in iron-related parameters, incidence of adverse effects, and effects on gut inflammation and microbiome profile.
Conclusion
In iron-deficient WRA in an LMIC setting, daily OIS (60 mg) for 14 days was more effective than equivalent amounts on alternate days in improving hematological parameters.
{"title":"Daily oral iron supplementation produced greater improvements in hematological parameters than alternate day doses – A pilot double-blind randomized control trial in iron-deficient young women","authors":"Nikhitha M. John , Bhargavi Ashok , Obed John , Kanagalakshmi V , Dilip Abraham , Prasanna Samuel , Yesudas Sudhakar , Surjit K.S. Srai , Molly Jacob","doi":"10.1016/j.clnu.2025.11.005","DOIUrl":"10.1016/j.clnu.2025.11.005","url":null,"abstract":"<div><h3>Background and aims</h3><div>There is little universal consensus on the optimal regime for oral iron supplementation to treat iron deficiency (ID) and iron-deficiency anemia (IDA) in women of reproductive age (WRA). A few studies in a high-income country have reported higher fractional absorption from oral iron supplements (OIS) given on alternate days than daily doses; however, there were no significant improvements in hematological indices in the women in these studies who received the alternate-day doses. There are also concerns about adverse gastrointestinal effects resulting from daily OIS. Data on these aspects from low and middle-income countries (LMIC), where the burden of IDA is high, are limited.</div></div><div><h3>Methods</h3><div>We conducted a double-blinded, parallel-arm, non-inferiority, randomized controlled trial in non-pregnant WRA aged 18–45 years with ID (serum ferritin <20 μg/L) (CTRI/2020/03/024144). They were randomized to receive either 60 mg elemental iron daily (n = 30) or 120 mg elemental iron on alternate days (n = 30) for 14 days. The primary outcome was to determine the comparative effectiveness of daily versus alternate-day OIS in improving hematological and iron-related parameters in blood, at the end of the intervention. Secondary outcomes included extent of adherence to intervention, adverse events experienced, and changes in fecal calprotectin concentrations (a marker of gut inflammation) and the gut microbiome profile.</div></div><div><h3>Results</h3><div>Adherence to the regimes was excellent (≥90 %) in both arms. Both regimes significantly improved hematological and iron-related parameters in blood at the end of 14 days. Daily OIS resulted in greater increases in mean corpuscular volume (fL) [1.25 (0.25, 2.32) vs. 0.50 (−0.35, 1.42); <em>p</em> = 0.043], mean corpuscular hemoglobin (pg/cell) [0.52 (0.54) vs. 0.17 (0.56); <em>p</em> = 0.019], and reticulocyte counts (%) [0.32 (0.13, 0.75) vs. 0.27 (0.02, 0.45); <em>p</em> = 0.055] than alternate-day doses. There were no significant differences between the groups in extent of improvements in iron-related parameters, incidence of adverse effects, and effects on gut inflammation and microbiome profile.</div></div><div><h3>Conclusion</h3><div>In iron-deficient WRA in an LMIC setting, daily OIS (60 mg) for 14 days was more effective than equivalent amounts on alternate days in improving hematological parameters.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"56 ","pages":"Article 106520"},"PeriodicalIF":7.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699937","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 : 2026-01-01DOI: 10.1016/j.clnu.2025.106551
Aneurin Young , Tim J. Cole , James Ashton , R Mark Beattie , Mark J. Johnson
Background & Aims
Early growth of very preterm infants is associated with later neurodevelopmental outcome. Current growth charts are based on in utero growth rather than a growth pattern associated with good outcomes. This study aimed to generate growth standards using infants who were developing normally.
Methods
Data were obtained from the National Neonatal Research Database. Logistic regression identified associations of in-hospital and post-discharge weight gain and head circumference growth with the chance of healthy development at two years. The LMS method was used to construct centile curves reflecting the growth of very preterm infants with a positive developmental outcome. Infants with surgical necrotising enterocolitis or a significant brain injury were excluded from the cohort used to generate growth charts.
Results
Growth data were available for 37700 infants, of whom 14120 had a documented developmental assessment. Healthy development was positively associated with three factors: In-hospital weight gain (adjusted OR 1·09 per unit z-score change, 95 % CI: 1·02–1·17), weight gain from discharge to two-year assessment (aOR 1·08, 1·04–1·12) and in-hospital head growth (aOR 1·12, 1.04–1·21). A web app is available (www.bit.ly/preterm-plotter) to generate individualised growth charts for preterm infants, conditioned on their weight and head circumference at birth, to plot their growth and indicate whether their growth was expected to align with that of healthily developing infants.
Conclusion
This study presents a novel method of forming individualised growth charts. It can be implemented using a web app or by integration with clinical information systems to allow an infant's growth to be compared to a cohort of infants with a favourable developmental outcome.
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Pub Date : 2026-01-01DOI: 10.1016/j.clnu.2025.106550
Laurence Genton , Miguel Leon Sanz , Marianna Arvanitakis , María D. Ballesteros-Pomar , Lia Bally , Rocco Barazzoni , Cécile Bétry , Rosa Burgos , Cristina Cuerda , Alia Hadefi , Stanislav Klek , Meliha Mahmutovic , Didier Quilliot , Diana Rubin , Stéphane M. Schneider , Mireille J. Serlie , Tinh-Hai Collet
Malnutrition affects up to 30 % of the general population, and especially older people with polymorbid conditions. In parallel, the prevalence of diabetes increases with age affecting over 800 million adults worldwide. Healthcare providers are increasingly challenged to care for patients with diabetes that require nutritional support. To address this issue, the ESPEN Special Interest Group "Nutrition and Diabetes", aims to provide guidance for health care providers that treat these patients. This paper had three aims: 1) to summarise the guidelines and recommendations regarding nutritional support and diabetes or stress hyperglycaemia provided by scientific societies, 2) to review the associations of nutritional disorders with diabetes and its pharmacological treatments, and 3) to identify the challenges of optimal nutritional care for patients with diabetes and stress hyperglycaemia. To this end, we conducted a systematic search of guidelines and recommendations on nutritional support for patients with diabetes or stress hyperglycaemia, that have been published in English by national and international societies over the last 15 years. Our systematic search showed that published guidelines and recommendations rarely addressed the practical management of blood glucose control according to the modality of nutritional support. The literature on the association of malnutrition with diabetes and its pharmacological treatment is very limited. The identified challenges include the multidisciplinary and multiprofessional continuity of care between the hospital and ambulatory settings, the ideal pattern of hospital food, the choice of oral nutritional supplements, the adjustment of diabetes management to nutritional support, and diabetes technology to support nutritional care in these patients.
{"title":"Challenges of nutritional support in patients with diabetes: A position paper of the ESPEN special interest group","authors":"Laurence Genton , Miguel Leon Sanz , Marianna Arvanitakis , María D. Ballesteros-Pomar , Lia Bally , Rocco Barazzoni , Cécile Bétry , Rosa Burgos , Cristina Cuerda , Alia Hadefi , Stanislav Klek , Meliha Mahmutovic , Didier Quilliot , Diana Rubin , Stéphane M. Schneider , Mireille J. Serlie , Tinh-Hai Collet","doi":"10.1016/j.clnu.2025.106550","DOIUrl":"10.1016/j.clnu.2025.106550","url":null,"abstract":"<div><div>Malnutrition affects up to 30 % of the general population, and especially older people with polymorbid conditions. In parallel, the prevalence of diabetes increases with age affecting over 800 million adults worldwide. Healthcare providers are increasingly challenged to care for patients with diabetes that require nutritional support. To address this issue, the ESPEN Special Interest Group \"Nutrition and Diabetes\", aims to provide guidance for health care providers that treat these patients. This paper had three aims: 1) to summarise the guidelines and recommendations regarding nutritional support and diabetes or stress hyperglycaemia provided by scientific societies, 2) to review the associations of nutritional disorders with diabetes and its pharmacological treatments, and 3) to identify the challenges of optimal nutritional care for patients with diabetes and stress hyperglycaemia. To this end, we conducted a systematic search of guidelines and recommendations on nutritional support for patients with diabetes or stress hyperglycaemia, that have been published in English by national and international societies over the last 15 years. Our systematic search showed that published guidelines and recommendations rarely addressed the practical management of blood glucose control according to the modality of nutritional support. The literature on the association of malnutrition with diabetes and its pharmacological treatment is very limited. The identified challenges include the multidisciplinary and multiprofessional continuity of care between the hospital and ambulatory settings, the ideal pattern of hospital food, the choice of oral nutritional supplements, the adjustment of diabetes management to nutritional support, and diabetes technology to support nutritional care in these patients.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"56 ","pages":"Article 106550"},"PeriodicalIF":7.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145881577","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 : 2025-12-30DOI: 10.1016/j.clnu.2025.106567
Kondwani J. Banda , Hsin Chu , Chien-Mei Sung , Ruey Chen , Pi-Yu Su , Li-Fang Chang , Li-Chung Pien , Chu-Yi Wang , Kuei-Ru Chou
<div><h3>Background</h3><div>Dysphagia compromises swallowing safety and efficiency, leading to malnutrition, dehydration, aspiration pneumonia, and frequent hospitalizations. Cortical neurostimulation therapies including transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and theta burst stimulation (TBS), peripheral neurostimulation therapies including, neuromuscular electrical stimulation (NMES) and pharyngeal electrical stimulation (PES), and paired associative stimulation (PAS) complement swallowing rehabilitative therapy (SRT) in dysphagia management. Despite growing evidence of their therapeutic potential, comparative evaluation of cortical and peripheral neurostimulation therapies in dysphagia management remains unexplored. Therefore, we conducted the first network meta-analysis (NMA) to explore comparative evidence of cortical and peripheral neurostimulation therapies on swallowing function, aspiration, and dysphagia severity for individuals with dysphagia.</div></div><div><h3>Methods</h3><div>Cochrane Library, EBSCOHost, Embase, PubMed, CINAHL, and Web of Science were searched until June, 2025. MetaInsight, an interactive web-based application for conducting NMA, employing Frequentist and Bayesian approaches was used for data analysis presenting standardized mean difference with corresponding 95 % confidence intervals. Surface Under the Cumulative Ranking (SUCRA) was used for ranking of neurostimulation therapies.</div></div><div><h3>Results</h3><div>A total of 72 randomized controlled trials with 3589 individuals with dysphagia were included. PAS + SRT 3.47 [1.43−5.50], TBS + SRT 2.56 [0.31−4.82], NMES + SRT 2.34 [0.60−4.07], tDCS + SRT 2.28 [0.51−4.06], and rTMS + SRT 2.12 [0.38−3.85] significantly improved global swallowing function with very-large effect. NMES + SRT −0.50 [−0.76−(−0.24)], rTMS + SRT −0.45 [−0.74−(−0.17)], and SRT −0.28 [−0.54−(−0.02)] significantly reduced pharyngeal transit time (PTT) with moderate to small effect. TBS + SRT −1.81 [−3.47−(−0.16)] and rTMS −1.58 [−3.04−(−0.12)] significantly reduced aspiration with very-large effect. PAS + SRT −5.43 [−8.81−(−2.04)], NMES + SRT −5.22 [−8.46−(−1.99)], NMES −4.90 [−8.50−(−1.30)], TBS + SRT −4.79 [−8.13−(−1.46)], tDCS + SRT −4.79 [−8.05−(−1.54)], PES + SRT −4.59 [−8.05−(−1.13)], and rTMS + SRT −4.58 [−7.74−(−1.43)], SRT −3.99 [−7.14−(−0.84)], rTMS −3.94 [−7.02−(−0.87)], and PAS −0.80 [−1.37−(−0.22)] significantly reduced dysphagia severity with very-large effect. SUCRA ranking revealed PAS + SRT for global swallowing function (94.6 %) and dysphagia severity (87.3 %), NMES + SRT for PTT (86.9 %), tDCS + SRT for OTT (87.2 %), and TBS + SRT for aspiration (91.0 %) as first ranked neurostimulation therapies.</div></div><div><h3>Conclusion</h3><div>The findings suggest that the integration of PAS, followed by either cortical (tDCS, rTMS, TBS) or peripheral (NMES) neurostimulation therapies in combination with SRT, promote supe
{"title":"Cortical and peripheral neurostimulation to improve swallowing function, aspiration, and dysphagia severity in dysphagia management: A network meta-analysis of randomized controlled trials","authors":"Kondwani J. Banda , Hsin Chu , Chien-Mei Sung , Ruey Chen , Pi-Yu Su , Li-Fang Chang , Li-Chung Pien , Chu-Yi Wang , Kuei-Ru Chou","doi":"10.1016/j.clnu.2025.106567","DOIUrl":"10.1016/j.clnu.2025.106567","url":null,"abstract":"<div><h3>Background</h3><div>Dysphagia compromises swallowing safety and efficiency, leading to malnutrition, dehydration, aspiration pneumonia, and frequent hospitalizations. Cortical neurostimulation therapies including transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and theta burst stimulation (TBS), peripheral neurostimulation therapies including, neuromuscular electrical stimulation (NMES) and pharyngeal electrical stimulation (PES), and paired associative stimulation (PAS) complement swallowing rehabilitative therapy (SRT) in dysphagia management. Despite growing evidence of their therapeutic potential, comparative evaluation of cortical and peripheral neurostimulation therapies in dysphagia management remains unexplored. Therefore, we conducted the first network meta-analysis (NMA) to explore comparative evidence of cortical and peripheral neurostimulation therapies on swallowing function, aspiration, and dysphagia severity for individuals with dysphagia.</div></div><div><h3>Methods</h3><div>Cochrane Library, EBSCOHost, Embase, PubMed, CINAHL, and Web of Science were searched until June, 2025. MetaInsight, an interactive web-based application for conducting NMA, employing Frequentist and Bayesian approaches was used for data analysis presenting standardized mean difference with corresponding 95 % confidence intervals. Surface Under the Cumulative Ranking (SUCRA) was used for ranking of neurostimulation therapies.</div></div><div><h3>Results</h3><div>A total of 72 randomized controlled trials with 3589 individuals with dysphagia were included. PAS + SRT 3.47 [1.43−5.50], TBS + SRT 2.56 [0.31−4.82], NMES + SRT 2.34 [0.60−4.07], tDCS + SRT 2.28 [0.51−4.06], and rTMS + SRT 2.12 [0.38−3.85] significantly improved global swallowing function with very-large effect. NMES + SRT −0.50 [−0.76−(−0.24)], rTMS + SRT −0.45 [−0.74−(−0.17)], and SRT −0.28 [−0.54−(−0.02)] significantly reduced pharyngeal transit time (PTT) with moderate to small effect. TBS + SRT −1.81 [−3.47−(−0.16)] and rTMS −1.58 [−3.04−(−0.12)] significantly reduced aspiration with very-large effect. PAS + SRT −5.43 [−8.81−(−2.04)], NMES + SRT −5.22 [−8.46−(−1.99)], NMES −4.90 [−8.50−(−1.30)], TBS + SRT −4.79 [−8.13−(−1.46)], tDCS + SRT −4.79 [−8.05−(−1.54)], PES + SRT −4.59 [−8.05−(−1.13)], and rTMS + SRT −4.58 [−7.74−(−1.43)], SRT −3.99 [−7.14−(−0.84)], rTMS −3.94 [−7.02−(−0.87)], and PAS −0.80 [−1.37−(−0.22)] significantly reduced dysphagia severity with very-large effect. SUCRA ranking revealed PAS + SRT for global swallowing function (94.6 %) and dysphagia severity (87.3 %), NMES + SRT for PTT (86.9 %), tDCS + SRT for OTT (87.2 %), and TBS + SRT for aspiration (91.0 %) as first ranked neurostimulation therapies.</div></div><div><h3>Conclusion</h3><div>The findings suggest that the integration of PAS, followed by either cortical (tDCS, rTMS, TBS) or peripheral (NMES) neurostimulation therapies in combination with SRT, promote supe","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"57 ","pages":"Article 106567"},"PeriodicalIF":7.4,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965232","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 : 2025-12-30DOI: 10.1016/j.clnu.2025.106570
Noora-Maria Ahl , Sari Hantunen , Tomi-Pekka Tuomainen , Christel Lamberg-Allardt , JoAnn E. Manson , Tarja Nurmi , Matti Uusitupa , Ari Voutilainen , Tommi Tolmunen , Jyrki K. Virtanen
Background and aims
Depression is a significant public health issue, but current prevention methods are limited. Vitamin D has shown some promise in treatment of depression, but evidence for primary prevention is inconclusive. We investigated the effects of long-term vitamin D3 supplementation on the incidence of major depressive disorder (MDD).
Methods
The study was a randomized placebo-controlled clinical trial conducted in 2012–2018. Participants were randomized to receive either 1600 IU/day (n = 814) or 3200 IU/day (n = 817) of vitamin D3 or placebo (n = 803) for 5 years. The primary endpoint of the current study was incident MDD, diagnosed by physician, during the 5-year supplementation period. The secondary endpoint was incident MDD during an extended follow-up until the end of 2021. A sub-cohort of 542 participants had more detailed in-person investigations.
Results
Among 2434 participants (mean age 68.2 years; 42.5 % women), 1786 completed the 5-year intervention. During the mean 4.2-year follow-up, there were 14, 11 and 8 MDD events in the placebo, 1600 IU/day (hazard ratio (HR), 0.78; 95 % CI 0.35–1.71; P = 0.53), and 3200 IU/day (HR, 0.57; 95 % CI 0.24–1.35; P = 0.20) arms. During the extended mean 7.8-year follow-up, there were in total 29, 18 and 16 MDD events in the placebo, 1600 IU/day (HR, 0.61; 95 % CI 0.34–1.10; P = 0.10) and 3200 IU/day (HR 0.54; 95 % CI 0.30–1.00; P = 0.05) arms. In the sub-cohort, the mean ± SD baseline serum 25-hydroxyvitamin D concentration was 75 ± 18 nmol/L. After 12 months, the concentrations were 73 ± 18 nmol/L, 100 ± 21 nmol/L, and 120 ± 22 nmol/L in the placebo, 1600 IU/day, and 3200 IU/day arms, respectively.
Conclusions
Vitamin D3 supplementation did not lower the incidence of MDD during the 5-year supplementation period among largely vitamin D sufficient aging adults. However, there was a borderline indication of benefit during a longer follow-up, possibly suggesting a delayed effect of supplementation.
Clinical Trial Registry number
ClinicalTrials.gov: NCT01463813, https://clinicaltrials.gov/ct2/show/NCT01463813 (date of registration Nov 1, 2011).
背景与目的抑郁症是一个重要的公共卫生问题，但目前的预防方法有限。维生素D在治疗抑郁症方面显示出一定的前景，但在一级预防方面的证据尚无定论。我们研究了长期补充维生素D3对重度抑郁症（MDD）发病率的影响。方法2012-2018年进行随机安慰剂对照临床试验。参与者随机接受1,600 IU/天（n = 814）或3200 IU/天（n = 817）维生素D3或安慰剂（n = 803），为期5年。本研究的主要终点是在5年补充期间由医生诊断的偶发性重度抑郁症。次要终点是延长随访至2021年底期间的MDD事件。一个由542名参与者组成的亚队列进行了更详细的面对面调查。结果在2434名参与者中（平均年龄68.2岁，女性占42.5%），1786名参与者完成了5年的干预。在平均4.2年的随访期间，安慰剂组分别有14、11和8例重度抑郁症事件，发生率为1600 IU/天(风险比（HR）， 0.78；95% ci 0.35-1.71；P = 0.53)和3200 IU/day （HR, 0.57; 95% CI 0.24-1.35; P = 0.20）组。在延长的平均7.8年随访期间，安慰剂组，1600 IU/天（HR 0.61; 95% CI 0.34-1.10; P = 0.10）和3200 IU/天（HR 0.54; 95% CI 0.30-1.00; P = 0.05）共发生29、18和16例MDD事件。在亚队列中，平均±SD基线血清25-羟基维生素D浓度为75±18 nmol/L。12个月后，安慰剂组、1600 IU/天组和3200 IU/天组的浓度分别为73±18 nmol/L、100±21 nmol/L和120±22 nmol/L。结论在维生素D充足的老年人中，补充维生素D3并没有降低5年补充期间MDD的发生率。然而，在更长时间的随访中，有一个边缘性的益处迹象，可能表明补充剂的延迟效应。临床试验注册编号：clinicaltrials.gov: NCT01463813, https://clinicaltrials.gov/ct2/show/NCT01463813（注册日期为2011年11月1日）。
{"title":"Vitamin D supplementation and incidence of major depressive disorder – A randomized clinical trial","authors":"Noora-Maria Ahl , Sari Hantunen , Tomi-Pekka Tuomainen , Christel Lamberg-Allardt , JoAnn E. Manson , Tarja Nurmi , Matti Uusitupa , Ari Voutilainen , Tommi Tolmunen , Jyrki K. Virtanen","doi":"10.1016/j.clnu.2025.106570","DOIUrl":"10.1016/j.clnu.2025.106570","url":null,"abstract":"<div><h3>Background and aims</h3><div>Depression is a significant public health issue, but current prevention methods are limited. Vitamin D has shown some promise in treatment of depression, but evidence for primary prevention is inconclusive. We investigated the effects of long-term vitamin D<sub>3</sub> supplementation on the incidence of major depressive disorder (MDD).</div></div><div><h3>Methods</h3><div>The study was a randomized placebo-controlled clinical trial conducted in 2012–2018. Participants were randomized to receive either 1600 IU/day (n = 814) or 3200 IU/day (n = 817) of vitamin D<sub>3</sub> or placebo (n = 803) for 5 years. The primary endpoint of the current study was incident MDD, diagnosed by physician, during the 5-year supplementation period. The secondary endpoint was incident MDD during an extended follow-up until the end of 2021. A sub-cohort of 542 participants had more detailed in-person investigations.</div></div><div><h3>Results</h3><div>Among 2434 participants (mean age 68.2 years; 42.5 % women), 1786 completed the 5-year intervention. During the mean 4.2-year follow-up, there were 14, 11 and 8 MDD events in the placebo, 1600 IU/day (hazard ratio (HR), 0.78; 95 % CI 0.35–1.71; <em>P</em> = 0.53), and 3200 IU/day (HR, 0.57; 95 % CI 0.24–1.35; <em>P</em> = 0.20) arms. During the extended mean 7.8-year follow-up, there were in total 29, 18 and 16 MDD events in the placebo, 1600 IU/day (HR, 0.61; 95 % CI 0.34–1.10; <em>P</em> = 0.10) and 3200 IU/day (HR 0.54; 95 % CI 0.30–1.00; <em>P</em> = 0.05) arms. In the sub-cohort, the mean ± SD baseline serum 25-hydroxyvitamin D concentration was 75 ± 18 nmol/L. After 12 months, the concentrations were 73 ± 18 nmol/L, 100 ± 21 nmol/L, and 120 ± 22 nmol/L in the placebo, 1600 IU/day, and 3200 IU/day arms, respectively.</div></div><div><h3>Conclusions</h3><div>Vitamin D<sub>3</sub> supplementation did not lower the incidence of MDD during the 5-year supplementation period among largely vitamin D sufficient aging adults. However, there was a borderline indication of benefit during a longer follow-up, possibly suggesting a delayed effect of supplementation.</div></div><div><h3>Clinical Trial Registry number</h3><div>ClinicalTrials.gov: <span><span>NCT01463813</span><svg><path></path></svg></span>, <span><span>https://clinicaltrials.gov/ct2/show/NCT01463813</span><svg><path></path></svg></span> (date of registration Nov 1, 2011).</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"57 ","pages":"Article 106570"},"PeriodicalIF":7.4,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145923138","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 : 2025-12-30DOI: 10.1016/j.clnu.2025.106560
Nengjuan Li , Zhigang Zhu , Shuang Wu , Daochen Gong , Richard Day , Vineetha Vijayakumar , Xiao Yu , Qiuxia Chen , Yuting Feng , Qiong Wang , Zhiming Hu , Jinjun Li , Jun Du , Changyun Xu , Wang Li , Liang Chen , Jiang Hu , Xiaoqiong Li
Background and aims
Emerging evidence highlight the gut microbiome as an important regulator of metabolic health, with probiotics and prebiotics demonstrating exciting potential for their role in health promotion. This study aims to investigate a novel synbiotic formulation comprising four probiotic strains (Bifidobacterium animalis subsp. lactis CECT 8145, and three Lacticaseibacillus rhamnosus strains), prebiotics (inulin, fructooligosaccharides), and Chrysanthemum morifolium extract. We hypothesized that this intervention would improve metabolic health parameters, particularly visceral adiposity.
Methods
In a 12-week, double-blind, randomized, placebo-controlled, parallel-group trial with a 6-week post-intervention follow-up, 112 participants (BMI: 24.0–34.9 kg/m2) received daily synbiotic or a matched placebo. Changes in visceral adipose tissue (VAT) area, serving as the primary endpoint, were quantified by dual-energy X-ray absorptiometry (DXA). Secondary outcomes included analysis of blood biochemical parameters, body composition, and fecal microbiota characterization.
Results
Compared with placebo, synbiotic supplementation significantly reduced VAT area from baseline to week 12 (p = 0.048). In subgroup analyses by gender and BMI, the effect was more pronounced in men than in women (p = 0.051) and was highly significant in individuals with 24 ≤ BMI <28 (p = 0.003). However, subcutaneous adipose tissue (SAT) increased in the 24 ≤ BMI <28 subgroup (p = 0.027). Although no significant changes occurred in blood biochemistry, BMI, or waist circumference, the synbiotic group showed a trend toward greater total body fat reduction between weeks 12–18 (p = 0.077). Microbiota analysis revealed transient enrichment of B. animalis subsp. lactis (ASV110) and L. rhamnosus (ASV473), which dissipated by week 18.
Conclusions
This synbiotic formulation reduced visceral fat, a key driver of metabolic dysfunction, and modulated adipose distribution, particularly in men and overweight (24 ≤ BMI <28) individuals. These results support its use as a functional food for visceral adiposity management.
Trial registration
This study was registered on the website of www.chictr.org.cn, number ChiCTR2400088457.
{"title":"Effects of a novel synbiotic intervention on abdominal visceral fat reductions and gut microbiota in overweight and obese adults: A randomized, double-blind, placebo-controlled trial","authors":"Nengjuan Li , Zhigang Zhu , Shuang Wu , Daochen Gong , Richard Day , Vineetha Vijayakumar , Xiao Yu , Qiuxia Chen , Yuting Feng , Qiong Wang , Zhiming Hu , Jinjun Li , Jun Du , Changyun Xu , Wang Li , Liang Chen , Jiang Hu , Xiaoqiong Li","doi":"10.1016/j.clnu.2025.106560","DOIUrl":"10.1016/j.clnu.2025.106560","url":null,"abstract":"<div><h3>Background and aims</h3><div>Emerging evidence highlight the gut microbiome as an important regulator of metabolic health, with probiotics and prebiotics demonstrating exciting potential for their role in health promotion. This study aims to investigate a novel synbiotic formulation comprising four probiotic strains (<em>Bifidobacterium animalis</em> subsp. <em>lactis</em> CECT 8145, and three <em>Lacticaseibacillus rhamnosus</em> strains), prebiotics (inulin, fructooligosaccharides), and <em>Chrysanthemum morifolium</em> extract. We hypothesized that this intervention would improve metabolic health parameters, particularly visceral adiposity.</div></div><div><h3>Methods</h3><div>In a 12-week, double-blind, randomized, placebo-controlled, parallel-group trial with a 6-week post-intervention follow-up, 112 participants (BMI: 24.0–34.9 kg/m<sup>2</sup>) received daily synbiotic or a matched placebo. Changes in visceral adipose tissue (VAT) area, serving as the primary endpoint, were quantified by dual-energy X-ray absorptiometry (DXA). Secondary outcomes included analysis of blood biochemical parameters, body composition, and fecal microbiota characterization.</div></div><div><h3>Results</h3><div>Compared with placebo, synbiotic supplementation significantly reduced VAT area from baseline to week 12 (p = 0.048). In subgroup analyses by gender and BMI, the effect was more pronounced in men than in women (p = 0.051) and was highly significant in individuals with 24 ≤ BMI <28 (p = 0.003). However, subcutaneous adipose tissue (SAT) increased in the 24 ≤ BMI <28 subgroup (p = 0.027). Although no significant changes occurred in blood biochemistry, BMI, or waist circumference, the synbiotic group showed a trend toward greater total body fat reduction between weeks 12–18 (p = 0.077). Microbiota analysis revealed transient enrichment of <em>B. animalis</em> subsp. <em>lactis</em> (ASV110) and <em>L. rhamnosus</em> (ASV473), which dissipated by week 18.</div></div><div><h3>Conclusions</h3><div>This synbiotic formulation reduced visceral fat, a key driver of metabolic dysfunction, and modulated adipose distribution, particularly in men and overweight (24 ≤ BMI <28) individuals. These results support its use as a functional food for visceral adiposity management.</div></div><div><h3>Trial registration</h3><div>This study was registered on the website of <span><span>www.chictr.org.cn</span><svg><path></path></svg></span>, number ChiCTR2400088457.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"57 ","pages":"Article 106560"},"PeriodicalIF":7.4,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145923144","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}
There is a knowledge gap about the dose–response association between types of protein intake and frailty risk. We designed a systematic review and dose–response meta-analysis of prospective cohort studies to synthesize the current evidence on the relationship between total, animal, and plant protein consumption and the risk of frailty.
Methods
We conducted a systematic literature search across online databases, including PubMed, Scopus, Web of Science, and Google Scholar to identify relevant publications up to August 1, 2025. We calculated the pooled relative risk (RR) and 95 % confidence intervals (95 % CI) for the highest and lowest protein intake categories, using a random-effects model to account for variation across studies. To shed light on the shape of the association between total, animal, and plant protein intake and frailty, both linear and non-linear dose–response analyses were performed.
Results
A total of seven prospective cohort studies were included in the analysis. Among the 125,322 individuals, 18,486 cases were reported during the 3 to 22-year follow-up. Higher total protein consumption was associated with a lower risk of frailty than the lowest intake (RR: 0.79; 95 % CI: 0.62, 1.00; I2 = 82.7 %; n = 7; GRADE = very low). Plant protein intake was found to reduce the risk of frailty significantly (RR: 0.87; 95 % CI: 0.82, 0.93; I2 = 3.2 %; n = 4; GRADE = moderate). We did not observe any linear or non-linear association between total, animal, and plant protein intake and frailty.
Conclusions
Our research suggests that higher consumption of total and plant protein is linked to a reduced risk of frailty. Larger-scale prospective cohort studies are essential for obtaining stronger and more accurate results.
背景和目的关于蛋白质摄入类型与虚弱风险之间的剂量-反应关系，目前还存在知识缺口。我们设计了一项前瞻性队列研究的系统回顾和剂量反应荟萃分析，以综合目前关于总蛋白、动物蛋白和植物蛋白摄入与虚弱风险之间关系的证据。方法系统检索PubMed、Scopus、Web of Science、b谷歌Scholar等在线数据库，确定2025年8月1日之前的相关文献。我们计算了最高和最低蛋白质摄入量类别的总相对风险（RR）和95%置信区间（95% CI），使用随机效应模型来解释研究间的差异。为了阐明总蛋白、动物蛋白和植物蛋白摄入与虚弱之间的关系，进行了线性和非线性剂量反应分析。结果共纳入7项前瞻性队列研究。在125,322人中，在3至22年的随访期间报告了18,486例病例。总蛋白质摄入量较高的人比最低摄入量的人患虚弱的风险低（RR: 0.79; 95% CI: 0.62, 1.00; I2 = 82.7%; n = 7; GRADE =非常低）。植物蛋白摄入可显著降低虚弱的风险（RR: 0.87; 95% CI: 0.82, 0.93; I2 = 3.2%; n = 4; GRADE =中等）。我们没有观察到总蛋白质、动物和植物蛋白质摄入量与虚弱之间的任何线性或非线性关联。我们的研究表明，摄入更多的总蛋白和植物蛋白可以降低身体虚弱的风险。大规模的前瞻性队列研究对于获得更有力、更准确的结果至关重要。
{"title":"Dietary intake of total, animal, and plant proteins and risk of frailty: A GRADE-assessed systematic review and dose–response meta-analysis of prospective cohort studies","authors":"Mohammadreza Moradi Baniasadi , Maryam Khakbaz , Leila Azadbakht","doi":"10.1016/j.clnu.2025.106569","DOIUrl":"10.1016/j.clnu.2025.106569","url":null,"abstract":"<div><h3>Background & Aims</h3><div>There is a knowledge gap about the dose–response association between types of protein intake and frailty risk. We designed a systematic review and dose–response meta-analysis of prospective cohort studies to synthesize the current evidence on the relationship between total, animal, and plant protein consumption and the risk of frailty.</div></div><div><h3>Methods</h3><div>We conducted a systematic literature search across online databases, including PubMed, Scopus, Web of Science, and Google Scholar to identify relevant publications up to August 1, 2025. We calculated the pooled relative risk (RR) and 95 % confidence intervals (95 % CI) for the highest and lowest protein intake categories, using a random-effects model to account for variation across studies. To shed light on the shape of the association between total, animal, and plant protein intake and frailty, both linear and non-linear dose–response analyses were performed.</div></div><div><h3>Results</h3><div>A total of seven prospective cohort studies were included in the analysis. Among the 125,322 individuals, 18,486 cases were reported during the 3 to 22-year follow-up. Higher total protein consumption was associated with a lower risk of frailty than the lowest intake (RR: 0.79; 95 % CI: 0.62, 1.00; <em>I</em><sup><em>2</em></sup> = 82.7 %; n = 7; GRADE = very low). Plant protein intake was found to reduce the risk of frailty significantly (RR: 0.87; 95 % CI: 0.82, 0.93; <em>I</em><sup><em>2</em></sup> = 3.2 %; n = 4; GRADE = moderate). We did not observe any linear or non-linear association between total, animal, and plant protein intake and frailty.</div></div><div><h3>Conclusions</h3><div>Our research suggests that higher consumption of total and plant protein is linked to a reduced risk of frailty. Larger-scale prospective cohort studies are essential for obtaining stronger and more accurate results.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"57 ","pages":"Article 106569"},"PeriodicalIF":7.4,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145923145","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 : 2025-12-29DOI: 10.1016/j.clnu.2025.106561
Sanne Ahles , Jogchum Plat , Kevin MR. Nijssen , Peter J. Joris
Background and Aims
Dietary anthocyanins are recognized for their potential beneficial effects on cognitive performance. It remains unclear which mechanisms underlie these effects. This study aimed to investigate the effects of anthocyanin-rich Aronia Melanocarpa extract (AME) on (brain) vascular function and cognitive performance in adults at increased risk of cognitive impairment.
Methods
Thirty healthy older adults (age: 65 ± 6 years old) with overweight or obesity (BMI: 28.3 ± 2.7 kg/m2) were included in a randomized, double-blind, placebo-controlled cross-over study of 6 weeks (40 mg anthocyanins/day). At the end of each study period, cerebral blood flow (CBF), a marker of brain vascular function, was assessed using arterial spin labeling magnetic resonance imaging (ASL-MRI). Additionally, cognitive performance was assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB), cerebral perfusion with transcranial Doppler ultrasound, and peripheral vascular function through endothelial function and retinal microvascular caliber measurements.
Results
AME supplementation did not affect CBF in predefined brain regions, but regional CBF decreased in one cluster located in the right insular cortex (treatment effect 4.4 ± 3.6 mL/100 g/min; p = 0.004), compared to placebo. Furthermore, cognitive performance was improved on the spatial working memory test, reflecting the executive function domain as the between errors and total errors were reduced by 20 % (−3; 95 % CI: −5 to −1; p = 0.006). Memory and psychomotor speed did not change, while cerebral perfusion and peripheral vascular function measurements were also not affected.
Conclusions
Six weeks of AME supplementation improved executive functioning in older adults with overweight or obesity. Although CBF decreased in the right insular cortex, the relevance remains unclear. CBF in predefined brain regions and other potential underlying mechanisms were not affected..
Clinical Trial Registry
This trial was registered at clinicaltrial.gov as NCT 05268133.
{"title":"Aronia melanocarpa extract supplementation affects brain vascular function and cognitive performance: A randomized, double-blind, placebo-controlled, cross-over study in older adults with overweight or obesity","authors":"Sanne Ahles , Jogchum Plat , Kevin MR. Nijssen , Peter J. Joris","doi":"10.1016/j.clnu.2025.106561","DOIUrl":"10.1016/j.clnu.2025.106561","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Dietary anthocyanins are recognized for their potential beneficial effects on cognitive performance. It remains unclear which mechanisms underlie these effects. This study aimed to investigate the effects of anthocyanin-rich Aronia Melanocarpa extract (AME) on (brain) vascular function and cognitive performance in adults at increased risk of cognitive impairment.</div></div><div><h3>Methods</h3><div>Thirty healthy older adults (age: 65 ± 6 years old) with overweight or obesity (BMI: 28.3 ± 2.7 kg/m<sup>2</sup>) were included in a randomized, double-blind, placebo-controlled cross-over study of 6 weeks (40 mg anthocyanins/day). At the end of each study period, cerebral blood flow (CBF), a marker of brain vascular function, was assessed using arterial spin labeling magnetic resonance imaging (ASL-MRI). Additionally, cognitive performance was assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB), cerebral perfusion with transcranial Doppler ultrasound, and peripheral vascular function through endothelial function and retinal microvascular caliber measurements.</div></div><div><h3>Results</h3><div>AME supplementation did not affect CBF in predefined brain regions, but regional CBF decreased in one cluster located in the right insular cortex (treatment effect 4.4 ± 3.6 mL/100 g/min; p = 0.004), compared to placebo. Furthermore, cognitive performance was improved on the spatial working memory test, reflecting the executive function domain as the between errors and total errors were reduced by 20 % (−3; 95 % CI: −5 to −1; p = 0.006). Memory and psychomotor speed did not change, while cerebral perfusion and peripheral vascular function measurements were also not affected.</div></div><div><h3>Conclusions</h3><div>Six weeks of AME supplementation improved executive functioning in older adults with overweight or obesity. Although CBF decreased in the right insular cortex, the relevance remains unclear. CBF in predefined brain regions and other potential underlying mechanisms were not affected..</div></div><div><h3>Clinical Trial Registry</h3><div>This trial was registered at <span><span>clinicaltrial.gov</span><svg><path></path></svg></span> as NCT 05268133.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"57 ","pages":"Article 106561"},"PeriodicalIF":7.4,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917261","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 : 2025-12-29DOI: 10.1016/j.clnu.2025.106562
Javier Maroto-Rodriguez , Rosario Ortolá , Esther García-Esquinas , Fernando Rodríguez-Artalejo , Mercedes Sotos-Prieto
Background and Aims
The Planetary Health Diet Index (PHDI) was designed to align environmental objectives with human health. This is the first study to assess the relationship between the PHDI and healthy aging, measured by intrinsic capacity (IC) and physical frailty.
Methods
We analyzed data from 19,505 participants in the UK Biobank cohort. Dietary intake was assessed using two to five 24-h assessments, and the PHDI was constructed based on 15 food groups. IC was assessed according to the Integrated Care for Older People guidelines with a score between 0 and 10 points (higher score indicated higher IC); while frailty was assessed using Rockwood's frailty index (FI) and Fried's frailty phenotype (FP). Linear regression was used to examine the relationship between PHDI and IC, and logistic regression for associations with frailty.
Results
After a median follow-up of 6.25 years, higher adherence to the PHDI was associated with greater IC: the mean difference (95 % CI) for the 3rd vs. 1st tertile of PHDI was 0.46 (0.05, 0.86). Higher adherence to the PHDI was associated with lower frailty risk: the odds ratios comparing extreme tertiles of PHDI were 0.80 (0.71, 0.90) for FI and 0.62 (0.43, 0.88) for FP. Fish & seafood was independently associated with higher IC and less frailty, while whole grains, fruits, vegetables, nuts & seeds and limiting added sugars & juices were linked to lower frailty risk..
Conclusions
In this cohort of British adults, greater adherence to the PHDI was associated with improved IC and lower frailty risk.
{"title":"Adherence to the planetary health diet and healthy aging: A prospective analysis","authors":"Javier Maroto-Rodriguez , Rosario Ortolá , Esther García-Esquinas , Fernando Rodríguez-Artalejo , Mercedes Sotos-Prieto","doi":"10.1016/j.clnu.2025.106562","DOIUrl":"10.1016/j.clnu.2025.106562","url":null,"abstract":"<div><h3>Background and Aims</h3><div>The Planetary Health Diet Index (PHDI) was designed to align environmental objectives with human health. This is the first study to assess the relationship between the PHDI and healthy aging, measured by intrinsic capacity (IC) and physical frailty.</div></div><div><h3>Methods</h3><div>We analyzed data from 19,505 participants in the UK Biobank cohort. Dietary intake was assessed using two to five 24-h assessments, and the PHDI was constructed based on 15 food groups. IC was assessed according to the Integrated Care for Older People guidelines with a score between 0 and 10 points (higher score indicated higher IC); while frailty was assessed using Rockwood's frailty index (FI) and Fried's frailty phenotype (FP). Linear regression was used to examine the relationship between PHDI and IC, and logistic regression for associations with frailty.</div></div><div><h3>Results</h3><div>After a median follow-up of 6.25 years, higher adherence to the PHDI was associated with greater IC: the mean difference (95 % CI) for the 3rd vs. 1st tertile of PHDI was 0.46 (0.05, 0.86). Higher adherence to the PHDI was associated with lower frailty risk: the odds ratios comparing extreme tertiles of PHDI were 0.80 (0.71, 0.90) for FI and 0.62 (0.43, 0.88) for FP. Fish & seafood was independently associated with higher IC and less frailty, while whole grains, fruits, vegetables, nuts & seeds and limiting added sugars & juices were linked to lower frailty risk..</div></div><div><h3>Conclusions</h3><div>In this cohort of British adults, greater adherence to the PHDI was associated with improved IC and lower frailty risk.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"57 ","pages":"Article 106562"},"PeriodicalIF":7.4,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145974162","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}
We aimed to prospectively examine the associations of serum mercury, lead, cadmium, and arsenic with type 2 diabetes.
Methods
This is a nested case–control study within a cohort of employees (n = 4754), who underwent comprehensive health checkups and provided blood samples, between 2008 and 2009. Serum cadmium, lead, mercury, and arsenic levels were measured using inductively coupled plasma mass spectrometry. During a 5-year follow-up period, type 2 diabetes was identified by plasma glucose, HbA1c, or self-report. Using the incident density method, two controls were randomly matched to each case by age, sex, and health checkup date, resulting in 325 cases and 611 controls with measurements of serum metal(loid)s. A conditional logistic regression model was used to estimate the odds ratio and 95% CI of type 2 diabetes across the quartiles of these metal(loid)s.
Results
Higher serum mercury concentrations were associated with higher odds of type 2 diabetes after adjusting for job section, shift work, smoking, alcohol consumption, leisure-time physical activity, family history of diabetes, BMI, hypertension, and serum concentrations of long-chain omega-3 fatty acids, vitamin D, magnesium, selenium, lead, cadmium, and arsenic. The odds ratios (95% CIs) for the lowest to the highest quartiles of serum mercury were 1 (reference), 1.15 (0.70, 1.90), 1.41 (0.85, 2.36), and 1.98 (1.13, 3.47), respectively (Ptrend = 0.01). There were no associations between serum cadmium, lead, and arsenic and type 2 diabetes.
Conclusions
Our findings suggest that individuals with higher concentrations of serum mercury were more likely to develop type 2 diabetes.
{"title":"Serum mercury, lead, cadmium, and arsenic and incidence of type 2 diabetes among adults: A nested case–control study","authors":"Aoi Ito , Shohei Yamamoto , Miyuki Iwai-Shimada , Yayoi Kobayashi , Tomohiko Isobe , Kenta Iwai , Shoji F. Nakayama , Maki Konishi , Shuichiro Yamamoto , Tohru Nakagawa , Shin Yamazaki , Tetsuya Mizoue","doi":"10.1016/j.clnu.2025.106563","DOIUrl":"10.1016/j.clnu.2025.106563","url":null,"abstract":"<div><h3>Background & Aims</h3><div>We aimed to prospectively examine the associations of serum mercury, lead, cadmium, and arsenic with type 2 diabetes.</div></div><div><h3>Methods</h3><div>This is a nested case–control study within a cohort of employees (<em>n</em> = 4754), who underwent comprehensive health checkups and provided blood samples, between 2008 and 2009. Serum cadmium, lead, mercury, and arsenic levels were measured using inductively coupled plasma mass spectrometry. During a 5-year follow-up period, type 2 diabetes was identified by plasma glucose, HbA<sub>1c</sub>, or self-report. Using the incident density method, two controls were randomly matched to each case by age, sex, and health checkup date, resulting in 325 cases and 611 controls with measurements of serum metal(loid)s. A conditional logistic regression model was used to estimate the odds ratio and 95% CI of type 2 diabetes across the quartiles of these metal(loid)s.</div></div><div><h3>Results</h3><div>Higher serum mercury concentrations were associated with higher odds of type 2 diabetes after adjusting for job section, shift work, smoking, alcohol consumption, leisure-time physical activity, family history of diabetes, BMI, hypertension, and serum concentrations of long-chain omega-3 fatty acids, vitamin D, magnesium, selenium, lead, cadmium, and arsenic. The odds ratios (95% CIs) for the lowest to the highest quartiles of serum mercury were 1 (reference), 1.15 (0.70, 1.90), 1.41 (0.85, 2.36), and 1.98 (1.13, 3.47), respectively (<em>P</em><sub>trend</sub> = 0.01). There were no associations between serum cadmium, lead, and arsenic and type 2 diabetes.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that individuals with higher concentrations of serum mercury were more likely to develop type 2 diabetes.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"57 ","pages":"Article 106563"},"PeriodicalIF":7.4,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146008650","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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