Clinical nutrition最新文献

{"title":"Effects of 5:2 intermittent fasting meal replacement on body composition and abdominal fat distribution in overweight and obese adults with early type 2 diabetes","authors":"Dongni Yu ,&nbsp;Mingzhu Zou ,&nbsp;Bo cheng ,&nbsp;Peng Yang ,&nbsp;Dongni Huang ,&nbsp;Qi Pan ,&nbsp;Lixin Guo","doi":"10.1016/j.clnu.2025.11.025","DOIUrl":"10.1016/j.clnu.2025.11.025","url":null,"abstract":"<div><h3>Background and Aims</h3><div>The 5:2 intermittent fasting meal replacement (5:2 MR) improved glycemic control and weight loss in adults with type 2 diabetes mellitus (T2DM).</div></div><div><h3>Objective</h3><div>This analysis further investigated the exploratory outcomes related to body composition and abdominal fat distribution.</div></div><div><h3>Methods</h3><div>This was a single-center analysis of a randomized, active-controlled trial (EARLY), which enrolled overweight and obese patients with early T2DM. A total of 85 participants were randomly assigned to receive metformin (n = 28), empagliflozin (n = 28), or 5:2 MR (n = 29) for 16 weeks. Body composition was assessed using InBody device, and the energy spectrum CT was used to measure abdominal fat distribution. Spearman's correlation coefficient was used to evaluate the associations between change in body mass index (BMI) and change in the exploratory outcomes.</div></div><div><h3>Results</h3><div>Compared with the metformin and empagliflozin groups, the 5:2 MR group showed the most significant reductions in BMI (least-squares mean, −3.41 kg/m² [standard error, 0.31], P &lt; 0.001), waist circumference (−8.83 cm [1.07], P &lt; 0.001), waist-to-hip ratio (WHR) (−0.04 [0.01], P &lt; 0.05), waist-to-height ratio (WHtR) (−0.05 [0.01], P &lt; 0.001), body fat percentage (BF%) (−4.84 % [0.66], P &lt; 0.05), abdominal cross-sectional area (ACSA) (−66.05 cm² [9.46], P &lt; 0.01), subcutaneous fat area (−58.27 cm² [5.99], P &lt; 0.001), and an increase in the liver-to-spleen (L/S) ratio) (0.43 [0.04], P &lt; 0.01). In the 5:2 MR group, changes in BMI exhibited linear associations and significant positive correlations with changes in WHR (r = 0.411, P = 0.030), WHtR (r = 0.635, P &lt; 0.001), BF% (r = 0.528, P = 0.020) and ACSA (r = 0.562, P = 0.003).</div></div><div><h3>Conclusion</h3><div>The 5:2 MR regimen may be more effective than metformin and empagliflozin in improving body composition and abdominal fat distribution in early T2DM, and is proposed as a therapeutic option.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"57 ","pages":"Article 106541"},"PeriodicalIF":7.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145891179","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":"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 ,&nbsp;Hsin Chu ,&nbsp;Chien-Mei Sung ,&nbsp;Ruey Chen ,&nbsp;Pi-Yu Su ,&nbsp;Li-Fang Chang ,&nbsp;Li-Chung Pien ,&nbsp;Chu-Yi Wang ,&nbsp;Kuei-Ru Chou","doi":"10.1016/j.clnu.2025.106567","DOIUrl":"10.1016/j.clnu.2025.106567","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;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":"2026-02-01","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}

{"title":"Adherence to the planetary health diet and healthy aging: A prospective analysis","authors":"Javier Maroto-Rodriguez ,&nbsp;Rosario Ortolá ,&nbsp;Esther García-Esquinas ,&nbsp;Fernando Rodríguez-Artalejo ,&nbsp;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 &amp; seafood was independently associated with higher IC and less frailty, while whole grains, fruits, vegetables, nuts &amp; seeds and limiting added sugars &amp; 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":"2026-02-01","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}

{"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 ,&nbsp;Jogchum Plat ,&nbsp;Kevin MR. Nijssen ,&nbsp;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/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.</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":"2026-02-01","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}

{"title":"Serum mercury, lead, cadmium, and arsenic and incidence of type 2 diabetes among adults: A nested case–control study","authors":"Aoi Ito ,&nbsp;Shohei Yamamoto ,&nbsp;Miyuki Iwai-Shimada ,&nbsp;Yayoi Kobayashi ,&nbsp;Tomohiko Isobe ,&nbsp;Kenta Iwai ,&nbsp;Shoji F. Nakayama ,&nbsp;Maki Konishi ,&nbsp;Shuichiro Yamamoto ,&nbsp;Tohru Nakagawa ,&nbsp;Shin Yamazaki ,&nbsp;Tetsuya Mizoue","doi":"10.1016/j.clnu.2025.106563","DOIUrl":"10.1016/j.clnu.2025.106563","url":null,"abstract":"<div><h3>Background &amp; 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_1c, 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>_trend = 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":"2026-02-01","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}

{"title":"Poly- and perfluoroalkyl substances (PFAS) associate with alterations in adipokine levels and eating behavior in the first 2 years of life","authors":"Inge A.L.P. van Beijsterveldt ,&nbsp;Demi J. Dorrepaal ,&nbsp;Bertrand D. van Zelst ,&nbsp;Leonie C. van Vark-van der Zee ,&nbsp;Monique T. Mulder ,&nbsp;Sjoerd A.A. van den Berg ,&nbsp;Anita C.S. Hokken-Koelega","doi":"10.1016/j.clnu.2025.106555","DOIUrl":"10.1016/j.clnu.2025.106555","url":null,"abstract":"<div><h3>Background and aims</h3><div>The non-degradable poly- and perfluoroalkyl substances (PFAS) are ‘Endocrine Disrupting Chemicals’ (EDCs), a group of chemicals that interfere with endocrine processes in the human body and potentially have adverse effects on several developmental domains in children. Particularly when PFAS exposure occurs during susceptive periods, including ‘the first 1000 days’ of life. Human milk is an important PFAS exposure pathway. In contrast to breastfeeding, PFAS have been thought to negatively influence growth, body composition development and metabolic health. However, exact mechanisms are not yet unraveled. Potential pathways might be via appetite regulating hormones (ARHs) and eating behavior. We, therefore, investigated the influence of feeding type (exclusive breastfeeding (EBF), exclusive formula feeding (EFF) or mixed feeding (mix)) on plasma ARHs and eating behavior and also the associations between plasma PFAS levels, ARHs and eating behavior, in infants during the first 2 years of life.</div></div><div><h3>Methods</h3><div>This study was embedded in the Sophia Pluto study. We conducted longitudinal follow-up in 371 healthy term-born infants (150 EBF, 97 EFF and 124 mix) during the first 2 years of life. At age 3 months and 2 years, we studied eating behavior via the Baby Eating Behavior Questionnaire (BEBQ) and Child Eating Behavior Questionnaire (CEBQ), respectively. At these timepoints, fasting blood samples were collected in which plasma levels of 5 individual PFAS and 9 ARHs were determined. The associations of plasma PFAS levels and feeding type with ARHs and eating behavior were studied using multiple regression models, corrected for known confounders, such as sex and fat mass SDS.</div></div><div><h3>Results</h3><div>At age 3 months plasma ARH levels differed between children that were EBF, EFF and mix. With EBF-infants having the highest levels of peptide YY (PYY) and the lowest of insulin, amylin and pancreatic polypeptide (PP). These differences disappeared at age 2 years. Higher plasma PFAS levels, corrected for feeding type, at age 3 months were associated with higher adiponectin and lower leptin levels and at age 2 years with lower leptin and insulin levels<strong>.</strong> When studying eating behavior, we did neither find any differences between EBF, EFF and mix infants at age 3 months nor at age 2 years. At age 3 months, plasma PFAS levels were inversely associated with “food responsiveness”, and positively with “slowness in eating”. At age 2 years, plasma PFAS levels, corrected for feeding type, were inversely associated with all “food approach” subscales.</div></div><div><h3>Conclusion</h3><div>Our findings could indicate that PFAS exposure does not compromise breastfeeding's health benefits on metabolic health and insulin sensitivity until age 2 years and that PFAS exposure probably effects eating behavior via other pathways than ARHs alone, which warrants further research.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"57 ","pages":"Article 106555"},"PeriodicalIF":7.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917349","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":"A reverse J-shaped association between carbohydrate intake and mortality among populations with high carbohydrate diets","authors":"Hyun Jeong Cho ,&nbsp;Woo-Kyoung Shin ,&nbsp;YoonJu Song ,&nbsp;Jong-Koo Lee ,&nbsp;Daehee Kang ,&nbsp;Jung Eun Lee","doi":"10.1016/j.clnu.2025.106549","DOIUrl":"10.1016/j.clnu.2025.106549","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Limited evidence exists on the associations of carbohydrate intake, both in quantity and quality, with mortality in high-carbohydrate populations, particularly in relation to the type of fat replacing carbohydrates. We investigated these associations in relation to all-cause, cancer-specific, and cardiovascular disease (CVD) mortality in a large Korean cohort.</div></div><div><h3>Methods</h3><div>A total of 113,043 participants aged 40–69 years were included from the Health Examinees-Gem (HEXA-G) cohort of the Korean Genome and Epidemiology Study (KoGES). Dietary intake was assessed using a validated food frequency questionnaire (FFQ). Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for all-cause, cancer-specific, and CVD mortality.</div></div><div><h3>Results</h3><div>During a mean follow-up of 9.2 years, 2,009 deaths were documented, including 1035 from cancer and 304 from CVD. When considering isocaloric substitution of fat with carbohydrates, a reverse J-shaped association was observed between carbohydrate intake and mortality from all causes and CVD. Compared with 55-&lt;65 % of energy from carbohydrates, the HRs (95 % CIs) for all-cause mortality were 1.50 (1.09–2.06) for &lt;55 %, 0.90 (0.74–1.08) for 65-&lt;70 %, 0.96 (0.78–1.18) for 70-&lt;75 %, 0.96 (0.76–1.21) for 75-&lt;80 %, and 0.94 (0.71–1.24) for ≥80 % (<em>P</em> for trend = 0.16). Similarly, CVD mortality risk was significantly higher among participants with &lt;55 % of energy intake from carbohydrates (HR: 3.04; 95 % CI: 1.44–6.43), compared with those with 55–&lt;65 %. These findings were consistent across fat subtypes when carbohydrates replaced saturated, monounsaturated, or polyunsaturated fatty acids. No significant associations were observed between carbohydrate intake and cancer mortality. Regarding carbohydrate quality, no clear associations were found between dietary glycemic index or glycemic load and all-cause, cancer, and CVD mortality.</div></div><div><h3>Conclusions</h3><div>In a population with a predominantly high-carbohydrate diet, replacing fat with &lt;55 % of energy from carbohydrates was suggestive of increased risks of all-cause and CVD mortality, and these associations were consistent regardless of the type of fat replaced.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"57 ","pages":"Article 106549"},"PeriodicalIF":7.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917282","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":"Human milk oligosaccharides modulate inflammatory responses and lipid metabolism in a human intestinal organoid model","authors":"Ellie Slater ,&nbsp;Jaesub Park ,&nbsp;Thomas Dennison ,&nbsp;Tim Mak ,&nbsp;Igor Bendik ,&nbsp;Ateequr Rehman ,&nbsp;Bernd Mussler ,&nbsp;Frank Wiens ,&nbsp;Komal Nayak ,&nbsp;Matthias Zilbauer","doi":"10.1016/j.clnu.2025.106557","DOIUrl":"10.1016/j.clnu.2025.106557","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Human milk oligosaccharides (HMOs) are a major component of human breast milk and have significant protective effects on infant gut health. HMOs are also present in the amniotic fluid, exposing the fetal gut epithelium from 10 weeks of gestational age. Prior studies often relied on animal models or cell lines, which limited their relevance to human biology. In this study, we aimed to investigate the direct effect of a blend of HMOs, including 2′-fucosyllactose (2′FL), 3′-sialyllactose (3′SL), and difucosyllactose (DFL), on intestinal epithelial cells, exploring their role under steady-state conditions and during inflammation.</div></div><div><h3>Methods</h3><div>We utilized advanced human intestinal epithelial organoid (IEO) models from three fetal and three pediatric donors. Organoid viability and barrier function were assessed using functional assays. Bulk RNA sequencing was performed on a total of 76 samples to investigate transcriptomic responses to HMOs and interferon gamma (IFN-γ)-induced inflammation.</div></div><div><h3>Results</h3><div>HMO treatment was safe and well-tolerated in both fetal and pediatric IEOs. The HMO blend reduced baseline BAX expression (p-value = 0.027) and attenuated the IFN-γ-induced increase in BAX expression (p-value = 0.002). HMOs induced distinct, developmental-stage-specific transcriptional responses. Only in pediatric IEOs, HMOs significantly upregulated 536 genes and downregulated 270 genes (adjusted p-value &lt;0.05). Notably, lipid metabolic pathways were significantly activated (adjusted p-value &lt;1.0x10-3). Under IFN-γ-induced inflammation, HMOs mitigated the transcriptomic changes in 83.3 % (5 out of 6) of the identified differentially expressed genes in pediatric IEOs. HMOs also attenuated the expression of key inflammation-related genes, reducing PTGES (p-value &lt;0.05) and significantly upregulating SOCS5 (p-value &lt;0.001).</div></div><div><h3>Conclusion</h3><div>By utilizing advanced IEOs derived from fetal and pediatric patients, we reveal that this HMO blend elicits developmental-stage-specific responses. Our study highlights the potential of HMOs to support gut health, demonstrating their ability to enhance lipid metabolism and mitigate inflammatory damage. These findings offer important insights into the role of HMOs in early-life nutrition, lending compelling evidence to support their inclusion as key components in innovative and tailored infant nutrition strategies.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"57 ","pages":"Article 106557"},"PeriodicalIF":7.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145923143","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":"Measuring diet intake in adolescents: Relative validation of an artificial intelligence enhanced, image assisted mobile application","authors":"Audrey Moyen ,&nbsp;Antonio Rossi ,&nbsp;Maurya Hart ,&nbsp;Elinor Simons ,&nbsp;Piushkumar J. Mandhane ,&nbsp;Theo J. Moraes ,&nbsp;Meghan B. Azad ,&nbsp;Stuart E. Turvey ,&nbsp;Padmaja Subbarao ,&nbsp;Anne-Julie Tessier ,&nbsp;Kozeta Miliku","doi":"10.1016/j.clnu.2025.106568","DOIUrl":"10.1016/j.clnu.2025.106568","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Puberty is a critical period of development during which nutritional exposures are known to shape long-term health and the risk of chronic diseases. Current dietary assessment methods have limitations for use in large cohorts of adolescent populations. We aimed to evaluate the relative validity of Keenoa (not an acronym), an artificial intelligence-enhanced image-assisted mobile application, against the validated Automated Self-Administered 24 h recall (ASA24)-Canada web-based platform, among adolescents in the CHILD Cohort Study.</div></div><div><h3>Methods</h3><div>Using a randomized crossover design, participants aged 11–15 years old completed three days (two weekdays and one weekend day) of both Keenoa food tracking and ASA24 food recalls. Differences in reported intakes were analyzed using paired t-tests or Wilcoxon signed-rank test and deattenuated correlations by Spearman's coefficient. Agreement and bias were determined using Bland–Altman's test, and inter-quartile cross-classification agreement was assessed using weighted Cohen kappa.</div></div><div><h3>Results</h3><div>This study included 141 participants with a mean age of 12.2 ± 0.8 years; of them 74 (52.5 %) males; and 88 (62.4 %) identified as Caucasian/White. Mean ± SD reported energy intakes (kcal/d) were 1976 ± 451 and 1978 ± 425, with ASA24 and Keenoa, respectively (P = 0.95). Mean reported macronutrient, iron, and potassium intakes did not significantly differ between tools. Reported fiber intake was higher, while sodium, calcium and vitamin D intakes were lower with Keenoa compared to ASA24 (P values &lt; 0.001–0.025). Deattenuated correlations between tools ranged from r = 0.77 to 1.00 (all p&lt; 0.01) and weighted Cohen κ scores ranged from 0.22 to 0.42 (all p &lt; 0.001). Among all participants, 121 (85.8 %) and 78 (55.3 %) completed all 3 requested days with Keenoa and ASA24, respectively (P&lt; 0.01).</div></div><div><h3>Conclusion</h3><div>The artificial intelligence-enhanced image-assisted Keenoa mobile application showed strong to moderate relative validity against ASA24 for energy, macronutrient, potassium and iron intakes. Vitamin D, calcium, fiber and sodium showed limited relative agreement based on mean differences. This novel tool may facilitate dietary assessment and reduce attrition bias in cohort studies. Future validation using objective biomarker measures will help establish true validity.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"57 ","pages":"Article 106568"},"PeriodicalIF":7.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145923148","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":"Nocturnal enteral feeding and mechanical ventilation risk in intensive care unit patients: A deep Learning–Based causal inference study","authors":"Min Woo Kang ,&nbsp;Soojeong Yun ,&nbsp;Seung Min Song ,&nbsp;Ji Eun Kim ,&nbsp;Hyo Jin Kim ,&nbsp;Eun Jung Cho ,&nbsp;Young Joo Kwon ,&nbsp;Shin Young Ahn","doi":"10.1016/j.clnu.2025.106556","DOIUrl":"10.1016/j.clnu.2025.106556","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Continuous enteral nutrition is widely used in critically ill patients, but its clinical superiority over intermittent feeding remains uncertain. A particular concern is nocturnal feeding, a common component of continuous regimens, which may elevate the risk of aspiration due to diminished airway protective reflexes during sleep. This study investigated whether nocturnal enteral feeding is associated with a higher requirement for mechanical ventilation in intensive care unit (ICU) patients.</div></div><div><h3>Methods</h3><div>We analyzed Medical Information Mart for Intensive Care (MIMIC)-IV (n = 1551) for model development and eICU Collaborative Research Database (eICU) (n = 3394) for external validation, including those who began enteral feeding within 72 h of ICU admission. The exposure was any enteral feeding between 10 PM and 6 AM in the first 72 h; outcomes were mechanical ventilation after 72 h. We used multivariable regression models. Subgroup analyses, including tests for interaction, were performed across patient characteristics, feeding volume, and comorbidities. A deep learning-based causal inference model was developed and estimated average treatment effects, and SHapley Additive exPlanations (SHAP) analysis identified influential predictors.</div></div><div><h3>Results</h3><div>Night-time enteral feeding was associated with higher odds of requiring mechanical ventilation, with an odds ratio (OR) of 1.88 (95 % confidence interval [CI] 1.17–3.01) in the MIMIC-IV cohort and an OR of 2.45 (95 % CI 1.01–5.95) in the eICU cohort. The deep learning–based causal inference model estimated that night-time feeding increased the probability of mechanical ventilation by 7.29 % (95 % CI 5.37–9.37) in MIMIC-IV and by 3.50 % (95 % CI 2.66–4.40) in eICU. SHAP analysis consistently identified total daily enteral feeding volume as the most influential predictor of ventilation risk. Subgroup analysis revealed that patients without cerebrovascular disease experienced higher ventilation risk with night-time feeding, whereas those with cerebrovascular disease did not.</div></div><div><h3>Conclusion</h3><div>Among non-intubated ICU patients, night-time enteral feeding may increase the risk of mechanical ventilation, particularly at very large feeding volumes. These findings suggest reconsidering overnight continuous feeding practices and support prospective trials of circadian-aligned nutrition to reduce respiratory complications.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"57 ","pages":"Article 106556"},"PeriodicalIF":7.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145923142","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}