Clinical nutrition最新文献

{"title":"Quality and quantity of carbohydrates, faecal short-chain fatty acids and gastrointestinal symptoms – results from a randomised, controlled trial (CARBFUNC)","authors":"Caroline Jensen , Cathrine Horn Sommersten , Johnny Laupsa-Borge , Inghild Storås , Jørgen Valeur , Gunnar Mellgren , Jutta Dierkes , Simon N. Dankel , Gülen Arslan Lied","doi":"10.1016/j.clnu.2024.11.041","DOIUrl":"10.1016/j.clnu.2024.11.041","url":null,"abstract":"<div><h3>Background & aims</h3><div>Diet is a key determinant of gastrointestinal (GI) health, in part in association with microbiota-derived short-chain fatty acids (SCFAs). However, we need more knowledge of the relative impact of dietary carbohydrate amount and quality on GI symptoms, GI-associated quality of life (QoL) and faecal SCFAs.</div></div><div><h3>Methods</h3><div>193 males and females with obesity were randomly allocated to follow one of three isocaloric, iso-proteinic dietary patterns (2000 kcal/day for females, 2500 kcal/day for males): a higher-carbohydrate lower-fat diet with refined carbohydrate sources (acellular diet, A-HCLF, comparator arm), a higher-carbohydrate lower-fat diet with minimally refined carbohydrate sources (intact cellular structures, cellular diet, C-HCLF), or a low-carbohydrate high-fat diet (LCHF), all low in added sugars. Secondary outcomes of this randomised controlled trial (CARBFUNC) were assessed, i.e., changes in abdominal symptoms (irritable bowel syndrome severity scoring system (IBS-SSS)), reflux symptoms (gastro-oesophageal reflux disease questionnaire (GerdQ)), GI-related QoL (Short-Form Nepean Dyspepsia Index (SF-NDI)) and fatigue (Fatigue Impact Scale), and faecal SCFAs concentrations after following the diets for 3 and 12 months. Group differences were analysed by constrained linear mixed effect modelling (cLMM).</div></div><div><h3>Results</h3><div>118 and 57 participants completed 3 and 12 months of the dietary intervention, respectively, with no significant group differences in weight loss at 12 months (5–7%). At 12 months, the mean daily fibre intake was 34 ± 7 g/day, 41 ± 14.3 g/day, and 18.5 ± 6 g/day on the A-HCLF, C-HCLF and LCHF diet, respectively, compared to 21 ± 7, 21 ± 7 and 20 ± 6 g/day at baseline. We observed no significant between-group difference in IBS-SSS sum score after 3 and 12 months. We found significant improvement in GerdQ score (change score [95 % CI]: −0.62 [−1.18, −0.048], <em>p</em> = 0.034), and SF-NDI sum score (−1.88 [−3.22, −0.52], <em>p</em> = 0.007) after 3 months on the LCHF diet compared to the A-HCLF diet, and GerdQ remained significant at 12 months (−1.03 [−1.88, −0.19], p = 0.017). Compared to the A-HCLF diet, the concentration of faecal butyric acid increased significantly more after 3 months on the C-HCLF diet (4.97 [1.71, 8.23] p = 0.003) and faecal acetic acid decreased more (−6.41 [−12.8, −0.047]. p = 0.048) on the LCHF diet. At 12 months the greater reduction in faecal acetic acid on the LCHF diet remained significant (−9.82 [−19.0, −0.67], p = 0.036), along with significantly greater reductions also in total SCFAs (−21.3 [−38.0, −4.56], p = 0.013), propionic (−4.42 [−7.79, −1.05], p = 0.010), and butyric acid (−5.05 [−9.60, −0.51], p = 0.030).</div></div><div><h3>Conclusion</h3><div>In this sample of adults with obesity and mild GI symptoms at baseline, modest improvements were observed only for the LCHF diet in QoL (at 3 months) and reflux s","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"44 ","pages":"Pages 54-64"},"PeriodicalIF":6.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indices of healthy and unhealthy plant-based diets and the risk of selected digestive cancers","authors":"Federica Turati ,&nbsp;Silvia Mignozzi ,&nbsp;Giovanna Esposito ,&nbsp;Francesca Bravi ,&nbsp;Angela D'Angelo ,&nbsp;Gianfranco Alicandro ,&nbsp;Werner Garavello ,&nbsp;Livia S.A. Augustin ,&nbsp;Sara Vitale ,&nbsp;Attilio Giacosa ,&nbsp;Ettore Bidoli ,&nbsp;Jerry Polesel ,&nbsp;Eva Negri ,&nbsp;Monica Ferraroni ,&nbsp;Carlo La Vecchia","doi":"10.1016/j.clnu.2024.11.039","DOIUrl":"10.1016/j.clnu.2024.11.039","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>The relation between various types of plant-based diets and cancer risk is still unclear. We examined the association of the overall plant-based diet index (PDI) and healthy (hPDI) and unhealthy plant-based diet indices (uPDI) with the risk of selected digestive cancers.</div></div><div><h3>Methods</h3><div>We used data from a network of hospital-based case–control studies including 942 oral/pharyngeal, 304 esophageal, 230 stomach, 1953 colorectal, and 326 pancreatic cancer cases. We calculated PDI, hPDI, and uPDI from a validated food frequency questionnaire. We used multivariable logistic regression models to estimate the odds ratios (OR) of selected digestive cancers across the three indices (in quintiles, Q, or tertiles, T, and in continuous).</div></div><div><h3>Results</h3><div>The PDI was significantly inversely associated with oral/pharyngeal (OR_{Q5 vs Q1}=0.63, 95% confidence interval, CI, 0.47–0.84) and esophageal cancer risk (OR_{T3 vs T1}=0.47, 95% CI 0.31–0.72). The inverse associations appeared stronger for the hPDI (oral cavity/pharynx: OR_{Q5 vs Q1}=0.52; 95% CI 0.39–0.70; esophagus: OR_{T3 vs T1}=0.59, 95% CI 0.39–0.91; stomach: OR_{T3 vs T1}=0.42, 95% CI 0.27–0.67; colorectum: OR_{Q5 vs Q1}=0.69; 95% CI 0.57–0.84; pancreas: OR_{T3 vs T1}=0.60; 95% CI 0.41–0.89). In contrast, the uPDI was directly associated with the risk of oral/pharyngeal (OR_{Q5 vs Q1}=1.43, 95% CI 1.06-1.94), colorectal (OR_{Q5 vs Q1}=2.28, 95% CI 1.86–2.81), and pancreatic cancer (OR_{T3 vs T1}=1.74, 95% CI 1.14–2.65). Esophageal and stomach cancer risks were non-significantly increased by 34% and 46% respectively in the highest uPDI quantile.</div></div><div><h3>Conclusion</h3><div>A plant-based diet, especially a healthy plant-based diet, may reduce the risk of various digestive cancers, whereas an unhealthy plant-based diet may increase the risk. The quality of plant-based diets is important for digestive cancer risk evaluation and prevention.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"44 ","pages":"Pages 76-85"},"PeriodicalIF":6.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of trimethylamine N-oxide and metabolites with kidney function decline in patients with chronic kidney disease","authors":"Evelyn Cheng ,&nbsp;Szu-Chun Hung ,&nbsp;Ting-Yun Lin","doi":"10.1016/j.clnu.2024.12.001","DOIUrl":"10.1016/j.clnu.2024.12.001","url":null,"abstract":"<div><h3>Background</h3><div>Trimethylamine N-oxide (TMAO) is a gut microbial metabolite derived from dietary <span>l</span>-carnitine and choline. High plasma TMAO levels are associated with cardiovascular disease and overall mortality, but little is known about the associations of TMAO and related metabolites with the risk of kidney function decline among patients with chronic kidney disease (CKD).</div></div><div><h3>Methods</h3><div>We prospectively followed 152 nondialysis patients with CKD stages 3–5 and measured plasma TMAO and related metabolites (trimethylamine [TMA], choline, carnitine, and γ-butyrobetaine) via liquid chromatography‒mass spectrometry. An estimated glomerular filtration rate (eGFR) slope &gt;3 ml/min/per 1.73 m² per year was defined as a rapid decline. We performed logistic regression to determine the probability of rapid or slow eGFR decline, with each metabolite as the main predictor. The gut microbiota was profiled via whole metagenomic sequencing.</div></div><div><h3>Results</h3><div>The participants had a median age of 66 years, 41.4 % were women, 39.5 % had diabetes, and the median eGFR was 23 mL/min/1.73 m². A rapid decrease in the eGFR occurred in 65 patients (42.8 %) over a median follow-up of 3.3 years. After adjustment for baseline eGFR, proteinuria, and clinical factors, plasma TMAO levels were independently associated with increased odds of rapid eGFR decline (odds ratio, 2.42; 95 % CI, 1.36–4.32), whereas plasma TMA, choline, carnitine, and γ-butyrobetaine levels were not. Patients who exhibited rapid eGFR decline had a distinct gut microbial composition characterized by increased α-diversity and an abundance of TMA-producing bacteria, including those of the genera <em>Desulfovibrio</em> and <em>Collinsella tanakaei</em>, as well as increased expression of the TMA-producing enzymes bbuA and cutC.</div></div><div><h3>Conclusion</h3><div>Our findings suggest the relevance of plasma TMAO in the progression of kidney disease among patients with CKD.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"44 ","pages":"Pages 239-247"},"PeriodicalIF":6.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876626","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":"Association between the dietary inflammatory index and the risk of hepatocellular carcinoma in a cirrhotic population","authors":"Maud Rizk ,&nbsp;Cécile Roux-Levy ,&nbsp;Brigitte Bernard-Chabert ,&nbsp;Jean-Pierre Bronowicki ,&nbsp;Carine Richou ,&nbsp;François Habersetzer ,&nbsp;Jean-Louis Jouve ,&nbsp;James R. Hebert ,&nbsp;Nitin Shivappa ,&nbsp;Marie-Christine Boutron-Ruault ,&nbsp;Mona Diab Assaf ,&nbsp;Patrick Hillon ,&nbsp;Vanessa Cottet","doi":"10.1016/j.clnu.2024.11.021","DOIUrl":"10.1016/j.clnu.2024.11.021","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Hepatocellular carcinoma (HCC) is recognized as an inflammation-related cancer. However, the relation between inflammation deriving from the diet and HCC risk among cirrhotic patients has not yet been investigated. This study aimed to examine the association between the dietary inflammatory index (DII®) and HCC risk among cirrhotic patients.</div></div><div><h3>Methods</h3><div>Clinical and dietary data were collected from the French case–control study CiRCE (Cirrhosis and Risk of hepatocellular Carcinoma in the East), which included 401 cirrhotic patients without HCC (controls) and 181 cirrhotic patients with HCC (cases) recruited between 2008 and 2012 in six French university hospitals. DII scores (36 food items and nutrients) were assessed using a validated self-administered diet history questionnaire. Odds ratios (OR) and 95 % confidence intervals (CI) were estimated with logistic regression models (adjusted for age, gender, time from cirrhosis diagnosis, etiology of cirrhosis, Child-Pugh score, and diabetes).</div></div><div><h3>Results</h3><div>The DII scores ranged between −4.77 and +7.59 with a mean value of 1.03 ± 2.87 among cases and 0.83 ± 2.87 among controls, indicating that both groups were following a pro-inflammatory diet. After multi-variable adjustment, there was a positive association between HCC risk and the DII score when considered as a continuous variable (OR_continuous = 1.14 [1.02–1.27], p-value = 0.021) or categorized in tertiles (OR_T3vsT1 = 2.33 [1.16–4.67], p-trend = 0.021). Similar results were found when alcohol was omitted from the DII calculation but considered as a co-variate: OR_continuous = 1.15 [1.03–1.28], p-value = 0.013, and OR_T3vsT1 = 2.35 [1.18–4.68], p-trend = 0.015. A positive correlation was observed between the DII scores and two inflammatory biomarkers (CRP, IL-6) among controls.</div></div><div><h3>Conclusion</h3><div>The present study reported an association between a pro-inflammatory DII score and the risk of HCC in cirrhotic patients. Correlations between the scores and biological parameters support a potential role for inflammation in HCC among cirrhotic. Result should be confirmed in larger prospective studies, and could lead to nutritional prevention in cirrhotic patients.</div></div><div><h3>Clinical Trial Registry</h3><div>This study was registered in <span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span> as NCT01798173.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"44 ","pages":"Pages 65-75"},"PeriodicalIF":6.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renin-independent aldosteronism and metabolic dysfunction-associated steatotic liver disease and cirrhosis: A genetic association study","authors":"Qinglian Zeng ,&nbsp;Xiaolin Luo ,&nbsp;Xiangjun Chen ,&nbsp;Wenjin Luo ,&nbsp;Ruolin Li ,&nbsp;Shumin Yang ,&nbsp;Jun Yang ,&nbsp;Xiaoyu Shu ,&nbsp;Qifu Li ,&nbsp;Jinbo Hu ,&nbsp;Linqiang Ma ,&nbsp;Christos S. Mantzoros","doi":"10.1016/j.clnu.2024.12.011","DOIUrl":"10.1016/j.clnu.2024.12.011","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Renin-independent aldosteronism (RIA) refers to a spectrum of autonomous aldosterone hypersecretion. We aimed to explore the genetical relationship between RIA and metabolic dysfunction-associated steatotic liver disease (MASLD) and cirrhosis.</div></div><div><h3>Methods</h3><div>We included 125357 participants from the cohort of United Kingdom Biobank. We calculated a polygenic risk score (PRS) for RIA on the basis of reported data from genome-wide association studies, and performed an analysis of Phenome Wide Association Studies (PheWAS) on diverse outcomes. We explored the genetical relationship between RIA and MASLD or cirrhosis by using Mendelian randomization analysis.</div></div><div><h3>Results</h3><div>An increased RIA PRS was associated with higher risks of MASLD and MASLD related cirrhosis, and the well-defined RIA related target organ damages such as hypertension or kidney diseases was also significant in the PheWAS analysis. When compared to individuals with low RIA PRS (tertile 1, 0.41–9.89), those with high RIA PRS (tertile 3, 13.58–23.16) showed significantly higher odds ratio (OR) of MASLD (OR 1.28, 95 % confidence interval [CI] 1.09–1.49) and cirrhosis (OR 1.49, 95%CI 1.03–2.16). In analyses of two-sample Mendelian randomization, genetically predicted RIA significantly correlated with elevated risks of MASLD and cirrhosis (inverse variance weighted odds ratio [95 % CI]: 1.05 [1.01–1.09]) for MASLD, 1.08 [1.02–1.13] for cirrhosis), meanwhile we observed no significant directional pleiotropy or heterogeneity.</div></div><div><h3>Conclusion</h3><div>Renin-independent aldosteronism is genetically associated with higher risks of MASLD and cirrhosis. Targeted treatment of autonomous aldosterone secretion may alleviate MASLD progression.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"44 ","pages":"Pages 193-200"},"PeriodicalIF":6.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871650","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":"Characterization of the functional component in human milk and identification of the molecular mechanisms undergoing prematurity","authors":"Rosaura Picáns-Leis ,&nbsp;María E. Vázquez-Mosquera ,&nbsp;María Pereira-Hernández ,&nbsp;Marta Vizoso-González ,&nbsp;Laura López -Valverde ,&nbsp;Sofía Barbosa-Gouveia ,&nbsp;Olalla López-Suárez ,&nbsp;Carolina López-Sanguos ,&nbsp;Susana B. Bravo ,&nbsp;Miguel A. García-González ,&nbsp;María L. Couce","doi":"10.1016/j.clnu.2024.12.013","DOIUrl":"10.1016/j.clnu.2024.12.013","url":null,"abstract":"<div><h3>Background and aims</h3><div>Human milk (HM) is the earliest form of extrauterine communication between mother and infant, that could promote early programming. The aim of this study is to look for specific biological processes, particularly those undergoing prematurity, modulated by proteins and miRNAs of HM that could be implicated in growth and development.</div></div><div><h3>Methods</h3><div>This is a prospective, observational, single center study in which we collected 48 human milk (HM) samples at two distinct stages of lactation: colostrum (first 72–96 h) and mature milk (at week 4 post-delivery) from mothers of very preterm newborns (&lt;32 weeks) and term (≥37 and &lt; 42 weeks). Qualitative and quantitative proteomic and transcriptomic analysis was done in our samples.</div></div><div><h3>Results</h3><div>We performed isolation and characterization of HM extracellular vesicles (EVs) to carry out proteomic and transcriptomic analysis in colostrum (CM) and mature milk (MM). Proteomic analysis revealed a functional role of CM in immunological protection and MM in metabolic processes. TENA, TSP1 and OLF4, proteins with roles in immune response and inflammatory modulation, were upregulated in CM vs MM, particularly in preterm. HM modulation differed depending on gestational age (GA). The miRNAs identified in HM are implicated in structural functions, including growth and neurological development. miRNA-451a was differentially expressed between groups, and downregulated in preterm CM.</div></div><div><h3>Conclusions</h3><div>Because the particularities of each GA are reflected in the EVs content of HM, providing newborns with HM from their own mother is the optimal way for satisfying their specific needs. Although the role of the proteomic profile of CM and MM of different GA in relation to neurodevelopment has been previously described, this is the first study to show a complete functional characterization of HM (proteome, miRNA at the same time), unmasking the molecular mechanisms related to EVs signaling and their functional role in preterm.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"44 ","pages":"Pages 178-192"},"PeriodicalIF":6.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863588","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":"Reply - Letter to the Editor – “The genetically predicted causal associations between circulating 3-hydroxybutyrate levels and malignant neoplasms: A pan-cancer Mendelian randomization study”","authors":"Fanghang Ye,&nbsp;Yucheng Huang,&nbsp;Liang Zeng,&nbsp;Na Li,&nbsp;Liyuan Hao,&nbsp;Jiayun Yue,&nbsp;Shenghao Li,&nbsp;Jiali Deng,&nbsp;Fei Yu,&nbsp;Xiaoyu Hu","doi":"10.1016/j.clnu.2024.11.017","DOIUrl":"10.1016/j.clnu.2024.11.017","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"44 ","pages":"Pages 129-131"},"PeriodicalIF":6.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817438","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 potassium levels as an independent predictor of unplanned enteral nutrition discontinuation in older adults with gastroesophageal reflux disease","authors":"Chisato Okamoto ,&nbsp;Kanako Kawano ,&nbsp;Akina Iguchi ,&nbsp;Akemi Saeki ,&nbsp;Emi Takaoka ,&nbsp;Noriko Tominaga ,&nbsp;Masatoshi Inoue ,&nbsp;Masafumi Kitakaze","doi":"10.1016/j.clnu.2024.11.029","DOIUrl":"10.1016/j.clnu.2024.11.029","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Enteral nutrition in older adults is often associated with intolerance, a phenomenon not well-understood in the context of gastroesophageal reflux disease (GERD). This observational study aimed to evaluate serum potassium levels as an independent prognostic factor for unplanned enteral nutrition discontinuation in older adults with GERD.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of 213 consecutive patients with GERD who received enteral nutrition at our institution from April 2018 to March 2023. The dietary assessment involved extracting relevant nutritional information from the patients' medical records. The incidence of enteral nutrition discontinuation due to complications was monitored over a 30-day period after initiation.</div></div><div><h3>Results</h3><div>Patients were categorized into three groups based on initial serum potassium levels: low (&lt;4.0 mmol/L), intermediate (4.0–4.5 mmol/L), and high (≥4.5 mmol/L). During the follow-up, 35 % of patients experienced events leading to the discontinuation of enteral nutrition. Higher potassium levels correlated with an increased risk of unplanned discontinuation of enteral nutrition (log-rank P = 0.002). Multivariate Cox proportional hazards analysis identified serum potassium level as an independent predictor of unplanned discontinuation (hazard ratio: 1.700 [95 % confidence interval: 1.100–2.627] per 1 mmol/L, P = 0.017).</div></div><div><h3>Conclusions</h3><div>Serum potassium level is a robust independent predictor of unplanned enteral nutrition discontinuation in older adults with GERD. Our findings suggest that monitoring and adjusting potassium levels may be essential for improving outcomes in this vulnerable population.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"44 ","pages":"Pages 46-53"},"PeriodicalIF":6.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766964","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":"The effects of whey protein supplementation on indices of cardiometabolic health: A systematic review and meta-analysis of randomized controlled trials","authors":"Konstantinos Prokopidis ,&nbsp;Paul T. Morgan ,&nbsp;Nicola Veronese ,&nbsp;Jordi Morwani-Mangnani ,&nbsp;Konstantinos K. Triantafyllidis ,&nbsp;Konstantinos S. Kechagias ,&nbsp;Justin Roberts ,&nbsp;Christopher Hurst ,&nbsp;Emma Stevenson ,&nbsp;Dimitris Vlachopoulos ,&nbsp;Oliver C. Witard","doi":"10.1016/j.clnu.2024.12.003","DOIUrl":"10.1016/j.clnu.2024.12.003","url":null,"abstract":"<div><h3>Introduction</h3><div>The increasing prevalence of cardiometabolic diseases highlights the urgent need for practical interventions to mitigate their associated public health burden. Whey protein supplementation has emerged as a potential intervention for improving markers of cardiometabolic health. The aim of this systematic review and meta-analysis was to examine the effect of whey protein ingestion on cardiometabolic profile in adults.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in PubMed, Web of Science, Scopus, and Cochrane Library from inception until June 2024. Eligible RCTs compared the effect of whey protein supplementation compared to placebo or a carbohydrate-based control on markers of cardiometabolic health. Using the random effects inverse-variance model, we estimated the mean difference (MD) in blood pressure, high- and low-density lipoproteins (HDL-cholesterol, LDL-cholesterol), total cholesterol, triglycerides, and homeostatic model assessment for insulin resistance (HOMA-IR) index.</div></div><div><h3>Results</h3><div>This meta-analysis included 21 RCTs. Whey protein supplementation had no effect on HDL-cholesterol concentration but did elicit a reduction in LDL-cholesterol in individuals aged &lt;50 years (P &lt; 0.01) and when combined with exercise (MD: −5.38, 95 % confidence interval (95 % CI): −8.87 to −1.88, I² = 0 %, P &lt; 0.01). Total cholesterol was reduced with interventions that combined whey protein supplementation and exercise (MD: −8.58, −14.32 to −2.83, I² = 55 %, P &lt; 0.01), irrespective of age, protein dose, and body mass index ≥25 kg/m² (MD: −6.71, 95 % CI: −11.60 to −1.83, I² = 74 %, P &lt; 0.01). Whey protein supplementation of ≥12 weeks was associated with reduced triglyceride levels (MD: −6.61, 95 % CI: −11.06 to −2.17, I² = 70 %, P &lt; 0.01). There was no clinically relevant effect of whey protein supplementation on blood pressure and HOMA-IR, however, changes pertinent to HDL-cholesterol, total cholesterol, and triglyceride reduction were primarily displayed in healthy adults.</div></div><div><h3>Conclusions</h3><div>Whey protein supplementation may be an effective intervention for reducing LDL and total cholesterol levels, particularly in healthy, overweight/obese adults aged &lt;50 years, with the greatest benefits observed when combined with exercise. Healthy adults also showed a benefit regarding triglyceride levels.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"44 ","pages":"Pages 109-121"},"PeriodicalIF":6.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor–The genetically predicted causal associations between circulating 3-hydroxybutyrate levels and malignant neoplasms: A pan-cancer Mendelian randomization study","authors":"Qing Zhou","doi":"10.1016/j.clnu.2024.12.005","DOIUrl":"10.1016/j.clnu.2024.12.005","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"44 ","pages":"Pages 122-123"},"PeriodicalIF":6.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812351","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}