<div><h3>Background and aims</h3><div>Cachexia, which is a complex metabolic disorder that is characterized by weight loss, muscle atrophy, and inflammation, is commonly associated with chronic diseases. However, the occurrence of cachexia among community-dwelling, middle-aged and older adults remains underexplored. This study aimed to assess the associations among cachexia, intrinsic capacity (IC) impairment, and mortality in adults aged 50 years and older.</div></div><div><h3>Methods</h3><div>We pooled data from three longitudinal cohort studies, which included 3112 individuals aged 50 years and older. The cachexia phenotype was defined using two algorithms suggested by the Asian Working Group for Cachexia (AWGC), even in the absence of specific index diseases. For Algorithm 1, patients were identified as having cachexia when they presented with weight loss or low body mass index (BMI) combined with one of the following: anorexia, decreased grip strength, or elevated C-reactive protein (CRP) levels. For Algorithm 2, the identification of cachexia required elevated CRP levels, along with weight loss or low BMI, combined with either anorexia or decreased grip strength. Importantly, the presence of a specific index disease was not necessary to define the cachexia phenotype using these criteria. Instead, we screened for the following index diseases as comorbid conditions: malignancy, congestive heart failure, chronic pulmonary disease, chronic kidney disease, severe liver disease, rheumatic or immune diseases, and acquired immunodeficiency syndrome (AIDS). IC was evaluated using the World Health Organization’s ICOPE framework (Step 1 screening; Step 2 in-depth assessment), which includes six domains: locomotor, vitality, vision, hearing, cognition, and psychological capacity. Logistic regression was used to assess the association between cachexia and IC impairment, and Cox proportional hazard models were used to examine the effect of cachexia on all-cause mortality.</div></div><div><h3>Results</h3><div>Among 3112 participants (median age 68.8 years, 43.7 % male) in the three cohorts, 5.4 % of participants were identified as having the cachexia phenotype using Algorithm 1, whereas only 0.4 % met the criteria for Algorithm 2. Notably, only 22 % of the participants with the cachexia phenotype (Algorithm 1) had at least one of the screened index diseases compared with 12 % in the non-cachexia group (<em>p</em> < 0.001). These findings demonstrate that the cachexia phenotype can be identified even in the absence of specific index diseases. The cachexia phenotype was significantly associated with impairments in multiple IC domains, including vitality (Step 1: aOR 8.44 [95 % CI 5.15–13.83], <em>p</em> < 0.001; Step 2: aOR 15.89 [10.72–23.56], <em>p</em> < 0.001), cognition (Step 1: aOR 1.75 [1.17–2.62], <em>p</em> = 0.007), and psychological capacity (Step 2: aOR 2.56 [1.39–4.73], <em>p</em> = 0.003). Individuals with the cachexia phenotype had a
背景和目的苦胆病是一种复杂的代谢紊乱，以体重减轻、肌肉萎缩和炎症为特征，通常与慢性疾病相关。然而，恶病质在社区居民、中老年人中的发生情况仍未得到充分研究。本研究旨在评估50岁及以上成人恶病质、内在能力（IC）损伤和死亡率之间的关系。方法：我们汇集了三项纵向队列研究的数据，其中包括3112名年龄在50岁及以上的个体。使用亚洲恶病质工作组（AWGC）提出的两种算法定义恶病质表型，即使在没有特定指数疾病的情况下。对于算法1，当患者出现体重减轻或低体重指数（BMI）并伴有以下情况之一时，患者被确定为患有恶病质：厌食症、握力下降或c反应蛋白（CRP）水平升高。对于算法2，识别恶病质需要CRP水平升高，同时体重减轻或低BMI，并伴有厌食症或握力下降。重要的是，使用这些标准来定义恶病质表型并不需要特定指数疾病的存在。相反，我们筛选了以下指标疾病作为合并症：恶性肿瘤，充血性心力衰竭，慢性肺病，慢性肾病，严重肝病，风湿病或免疫疾病，以及获得性免疫缺陷综合征（艾滋病）。使用世界卫生组织的ICOPE框架（第1步筛查；第2步深入评估）对IC进行评估，其中包括六个领域：运动、活力、视觉、听觉、认知和心理能力。采用Logistic回归评估恶病质与IC损伤之间的关系，采用Cox比例风险模型检验恶病质对全因死亡率的影响。结果在三个队列的3112名参与者（中位年龄68.8岁，43.7%为男性）中，使用算法1确定5.4%的参与者具有恶病质表型，而只有0.4%的参与者符合算法2的标准。值得注意的是，只有22%的具有恶病质表型（算法1）的参与者至少有一种筛查的指标疾病，而非恶病质组的这一比例为12% （p < 0.001）。这些发现表明，即使在没有特定指数疾病的情况下，恶病质表型也可以被识别。恶病质表型与多个IC领域的损伤显著相关，包括活力（步骤1:aOR 8.44 [95% CI 5.15-13.83], p < 0.001；步骤2:aOR 15.89 [10.72-23.56], p < 0.001）、认知（步骤1:aOR 1.75 [1.17-2.62], p = 0.007）和心理能力（步骤2:aOR 2.56 [1.39-4.73], p = 0.003）。校正混杂因素后，恶病质表型个体的死亡风险显著高于非恶病质组（aHR 1.77 [95% CI 1.15-2.73], p = 0.010）。结论在没有特定指标疾病的情况下，恶病质表型与中老年人IC损伤和死亡率增加有关。早期识别和有针对性的干预对于减轻恶病质表型患者的功能衰退和提高生存率至关重要。
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Pub Date : 2025-11-13DOI: 10.1016/j.clnu.2025.11.001
Tommy Cederholm, Rocco Barazzoni, Elisabet Rothenberg, Kremlin Wickramasinghe, Cristina Cuerda, Stéphane Schneider, Stanislaw Klek
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Pub Date : 2025-11-05DOI: 10.1016/j.clnu.2025.10.022
Kensuke Nakamura , Hidehiko Nakano , Naoki Kanda
Background and aims
One potential adverse effect of protein loading in critically ill patients is elevated blood urea nitrogen (BUN) concentrations. Along with kidney function, we hypothesized that muscle volume also affects the BUN trajectory with protein administration.
Methods
A post-hoc analysis was conducted of a prospective historical control study in which intensive care unit (ICU) patients were assigned to protein delivery targets of 0.9 and 1.8 g/kg/day over 10 days. Patients who received renal replacement therapy were excluded. Femoral muscle volume FMV was evaluated by computed tomography on ICU admission. Daily BUN and protein delivery were recorded throughout the 10 days.
Results
Eighty-two eligible patients were analyzed. The BUN trajectories were slightly higher in patients with a lower muscle volume. The relative ratio of total protein delivery over 10 days to FMV showed a positive correlation with the BUN concentration on day 10 (r = 0.37, p = 0.0007); while this relationship was not significant with protein intake to actual body weight (r = 0.22, p = 0.068). In the linear mixed-effects model, protein intake per FMV was significantly associated with higher blood BUN concentrations (coefficient 0.07, 95 % CI 0.01 to 0.13, p = 0.02). Simultaneously, age and baseline creatinine were also significant predictors of BUN concentrations.
Conclusions
In critically ill patients, the relative ratio of total protein delivery to muscle volume was associated with BUN elevations. Protein targets may be more appropriately set based on muscle volume, for example, by using the grams per fat-free mass calculation.
Registration
The present study is registered at the University Hospital Medical Information Network-clinical trials registry (UMIN000040290, Registration date: May 7, 2020); https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000045970.
背景和目的：危重患者蛋白质负荷的一个潜在不良影响是血尿素氮（BUN）浓度升高。除了肾功能外，我们假设肌肉体积也会影响蛋白质给药后的BUN轨迹。方法：对一项前瞻性历史对照研究进行事后分析，在该研究中，重症监护病房（ICU）患者在10天内被分配到0.9和1.8 g/kg/天的蛋白质递送目标。接受肾脏替代治疗的患者排除在外。在ICU入院时通过计算机断层扫描评估股骨肌体积FMV。在10天内记录每日BUN和蛋白质递送量。结果：分析了82例符合条件的患者。在肌肉体积较小的患者中，BUN轨迹略高。10 d总蛋白递送量与FMV的相对比值与第10 d BUN浓度呈正相关（r = 0.37, p = 0.0007）；而蛋白质摄入量与实际体重之间的关系不显著（r = 0.22, p = 0.068）。在线性混合效应模型中，每FMV蛋白质摄入量与较高的血尿素氮浓度显著相关（系数0.07,95% CI 0.01 ~ 0.13, p = 0.02）。同时，年龄和基线肌酐也是BUN浓度的重要预测因子。结论：危重患者总蛋白递送量与肌肉体积的相对比值与BUN升高有关。蛋白质目标可能更适合根据肌肉体积来设定，例如，通过使用克/无脂质量计算。注册：本研究在大学医院医学信息网临床试验注册中心注册（UMIN000040290，注册日期：2020年5月7日）；https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000045970。
{"title":"Optimizing protein in critical illness: Is g/fat-free mass the key?","authors":"Kensuke Nakamura , Hidehiko Nakano , Naoki Kanda","doi":"10.1016/j.clnu.2025.10.022","DOIUrl":"10.1016/j.clnu.2025.10.022","url":null,"abstract":"<div><h3>Background and aims</h3><div>One potential adverse effect of protein loading in critically ill patients is elevated blood urea nitrogen (BUN) concentrations. Along with kidney function, we hypothesized that muscle volume also affects the BUN trajectory with protein administration.</div></div><div><h3>Methods</h3><div>A post-hoc analysis was conducted of a prospective historical control study in which intensive care unit (ICU) patients were assigned to protein delivery targets of 0.9 and 1.8 g/kg/day over 10 days. Patients who received renal replacement therapy were excluded. Femoral muscle volume FMV was evaluated by computed tomography on ICU admission. Daily BUN and protein delivery were recorded throughout the 10 days.</div></div><div><h3>Results</h3><div>Eighty-two eligible patients were analyzed. The BUN trajectories were slightly higher in patients with a lower muscle volume. The relative ratio of total protein delivery over 10 days to FMV showed a positive correlation with the BUN concentration on day 10 (r = 0.37, p = 0.0007); while this relationship was not significant with protein intake to actual body weight (r = 0.22, p = 0.068). In the linear mixed-effects model, protein intake per FMV was significantly associated with higher blood BUN concentrations (coefficient 0.07, 95 % CI 0.01 to 0.13, p = 0.02). Simultaneously, age and baseline creatinine were also significant predictors of BUN concentrations.</div></div><div><h3>Conclusions</h3><div>In critically ill patients, the relative ratio of total protein delivery to muscle volume was associated with BUN elevations. Protein targets may be more appropriately set based on muscle volume, for example, by using the grams per fat-free mass calculation.</div></div><div><h3>Registration</h3><div>The present study is registered at the University Hospital Medical Information Network-clinical trials registry (UMIN000040290, Registration date: May 7, 2020); <span><span>https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000045970</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"55 ","pages":"Pages 189-195"},"PeriodicalIF":7.4,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145511665","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 : 2025-11-03DOI: 10.1016/j.clnu.2025.10.021
Francesco Campa , A. Sampieri , G. Cerullo , L. Zoffoli , G. Coratella , Antonio Paoli
Background and aims
Disagreement between bioelectrical impedance analysis (BIA) technologies in measuring resistance (R), reactance (Xc), and phase angle (PhA) is well documented and mainly due to device-specific features. Whether such a variability translates into differences in body composition estimates remains uncertain. This study evaluated agreement in fat-free mass (FFM) estimates from different BIA technologies against dual-energy X-ray absorptiometry (DXA), while accounting for the role of predictive equations. Additionally, agreement of BIA-based fat mass (FM), indirectly calculated from FFM, was assessed.
Methods
A total of 288 adults (167 men, 37.2 ± 18.7 y, BMI 23.0 ± 3.1 kg/m2; 121 women, 33.8 ± 16.8 y, BMI 25.1 ± 3.3 kg/m2) participated in this study. Whole-body foot-to-hand and direct segmental BIA at 50 kHz measured R, Xc, and PhA. DXA served as the reference. Predictive equations for FFM were developed by stepwise regression in two-thirds of the sample and validated in the remaining third. Agreement was evaluated between BIA technologies and against DXA using Bland–Altman and Lin's concordance correlation coefficient.
Results
Foot-to-hand BIA yielded lower R (p < 0.001) but higher Xc and PhA (p < 0.001) than direct segmental BIA. Despite these differences, no significant bias (p > 0.05) was observed in FFM estimation across devices. Concordance analyses indicated high agreement without systematic deviations. FM derived from FFM agreed with DXA at a group level but showed systematic trends at the individual level.
Conclusions
Although raw bioelectrical parameters differ between technologies, FFM estimates can be comparable when equations are derived within the same population and reference method. However, FM indirectly obtained from FFM lacks accuracy at the individual level.
背景和目的生物电阻抗分析（BIA）技术在测量电阻(R)、电抗（Xc）和相角（PhA）方面的分歧是有案可查的，主要是由于器件的特定特性。这种差异是否会转化为身体成分估计值的差异仍不确定。本研究评估了不同BIA技术对双能x射线吸收测定法（DXA）的无脂质量（FFM）估计值的一致性，同时考虑了预测方程的作用。此外，评估了从FFM间接计算的基于bia的脂肪量（FM）的一致性。方法共288例成人（男性167例，37.2±18.7 y, BMI 23.0±3.1 kg/m2）；女性121例，33.8±16.8 y, BMI 25.1±3.3 kg/m2)。在50 kHz下，全身脚到手和直接节段BIA测量R， Xc和PhA。DXA作为参考。在三分之二的样本中，通过逐步回归建立了FFM的预测方程，并在其余三分之一的样本中进行了验证。使用Bland-Altman和Lin的一致性相关系数评估BIA技术与DXA的一致性。结果与直接节段BIA相比，脚-手BIA的R值较低（p < 0.001），而Xc和PhA值较高（p < 0.001）。尽管存在这些差异，但在不同设备的FFM估计中未观察到显著偏差（p > 0.05）。一致性分析显示一致性高，无系统偏差。从FFM得到的FM在群体水平上与DXA一致，但在个体水平上表现出系统的趋势。结论虽然不同技术的原始生物电参数不同，但在相同人群和参考方法中推导方程时，FFM估计值是可以比较的。然而，从FFM间接获得的FM在个体层面上缺乏准确性。
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Pub Date : 2025-11-01DOI: 10.1016/j.clnu.2025.10.017
Michelle A.J. van Oeteren , David M. de Groot , Amée M. Buziau , Jean L.J.M. Scheijen , Marjo P.H. van de Waarenburg , Abraham A. Kroon , Simone J.P.M. Eussen , Pieter C. Dagnelie , Marleen M.J. van Greevenbroek , Alfons J.H.M. Houben , Steven J.R. Meex , Casper G. Schalkwijk , Martijn C.G.J. Brouwers
Background and aims
Fruits and sugar-sweetened beverages have opposing effects on cardiometabolic health, despite comparable amounts of fructose per serving. Here, we sought evidence for a role of the food matrix in modifying serum fructose dynamics and blood pressure.
Methods
We first performed multiple linear regression analyses to assess the association between energy-adjusted intake of fructose from different sources (total, fruit, fruit juice and sugar-sweetened beverages) and blood pressure (24-h ambulatory, 7-day ambulatory, and office) using data from The Maastricht Study, a large population-based cohort (n = 5,426–6,471). Next, we conducted a randomized crossover trial in which healthy individuals (n = 21) were exposed to a fixed amount of fructose (20g) from different matrices (apple, mashed apple, apple juice, and fructose dissolved in water), and measured the serum fructose and blood pressure response.
Results
The intake of fructose from sugar-sweetened beverages, but not from fruits or fruit juice, was associated with higher ambulatory 7-day mean blood pressure, higher office blood pressure, and greater risk of hypertension (OR: 1.29, 95%CI 1.12; 1.50 per 10g fructose). In the crossover study, pure fructose intake yielded the greatest serum fructose excursions (p < 0.05 for all comparisons). The systolic blood pressure response was higher after pure fructose compared to the other matrices (+1.8 mmHg, 95%CI 0.02; 3.5).
Conclusions
Here, we provide epidemiological and experimental evidence that highlights the relevance of the food matrix on fructose dynamics and blood pressure, independent of the caloric value of fructose.
{"title":"The effects of dietary fructose on blood pressure are modified by the food matrix","authors":"Michelle A.J. van Oeteren , David M. de Groot , Amée M. Buziau , Jean L.J.M. Scheijen , Marjo P.H. van de Waarenburg , Abraham A. Kroon , Simone J.P.M. Eussen , Pieter C. Dagnelie , Marleen M.J. van Greevenbroek , Alfons J.H.M. Houben , Steven J.R. Meex , Casper G. Schalkwijk , Martijn C.G.J. Brouwers","doi":"10.1016/j.clnu.2025.10.017","DOIUrl":"10.1016/j.clnu.2025.10.017","url":null,"abstract":"<div><h3>Background and aims</h3><div>Fruits and sugar-sweetened beverages have opposing effects on cardiometabolic health, despite comparable amounts of fructose per serving. Here, we sought evidence for a role of the food matrix in modifying serum fructose dynamics and blood pressure.</div></div><div><h3>Methods</h3><div>We first performed multiple linear regression analyses to assess the association between energy-adjusted intake of fructose from different sources (total, fruit, fruit juice and sugar-sweetened beverages) and blood pressure (24-h ambulatory, 7-day ambulatory, and office) using data from The Maastricht Study, a large population-based cohort (n = 5,426–6,471). Next, we conducted a randomized crossover trial in which healthy individuals (n = 21) were exposed to a fixed amount of fructose (20g) from different matrices (apple, mashed apple, apple juice, and fructose dissolved in water), and measured the serum fructose and blood pressure response.</div></div><div><h3>Results</h3><div>The intake of fructose from sugar-sweetened beverages, but not from fruits or fruit juice, was associated with higher ambulatory 7-day mean blood pressure, higher office blood pressure, and greater risk of hypertension (OR: 1.29, 95%CI 1.12; 1.50 per 10g fructose). In the crossover study, pure fructose intake yielded the greatest serum fructose excursions (p < 0.05 for all comparisons). The systolic blood pressure response was higher after pure fructose compared to the other matrices (+1.8 mmHg, 95%CI 0.02; 3.5).</div></div><div><h3>Conclusions</h3><div>Here, we provide epidemiological and experimental evidence that highlights the relevance of the food matrix on fructose dynamics and blood pressure, independent of the caloric value of fructose.</div></div><div><h3>Registration</h3><div><span><span>https://onderzoekmetmensen.nl/en/trial/53397</span><svg><path></path></svg></span>; Unique identifier: NL-OMON53397.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"55 ","pages":"Pages 134-140"},"PeriodicalIF":7.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470672","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 : 2025-11-01DOI: 10.1016/j.clnu.2025.10.020
Lucia Kerkhof, Ronald P. Mensink, Jogchum Plat, Kevin M.R. Nijssen, Peter J. Joris
Background and aims
Reduced brain vascular function contributes to age-related cognitive decline. While peanut consumption may improve cognitive performance, the underlying mechanisms remain unclear. This study aimed to investigate the longer-term effects of skin-roasted peanut consumption on brain vascular function and cognitive performance in older adults.
Methods
In a randomized, single-blind, controlled crossover trial, 31 healthy individuals (age [mean ± SD]: 67 ± 4 years; BMI: 26.7 ± 3.3 kg/m2) consumed 60 g/day of unsalted, skin-roasted peanuts or no peanuts (control) for 16 weeks, separated by an 8-week washout. During follow-up, brain vascular function was assessed by quantifying global cerebral blood flow (CBF) using arterial spin labeling magnetic resonance imaging, which was the primary outcome. Cognitive performance was evaluated using the Cambridge Neuropsychological Test Automated Battery (CANTAB).
Results
The consumption of peanuts was well-tolerated and median compliance was excellent: 100 % (interquartile range [IQR] 99–100 %). Compared with control, peanut consumption significantly increased global CBF by 3.6 % (intervention effect: 1.5 mL/100 g/min, 95 % CI [0.3, 2.6], p = 0.014) and gray matter CBF by 4.5 % (2.2 mL/100 g/min, 95 % CI [0.9, 3.6], p = 0.002). Verbal memory improved by 5.8 % during the delayed recall condition of the verbal recognition memory (VRM) task (+1.4 words correct (95 % CI [0.0, 2.7], p = 0.043). No beneficial effects were found in executive function and psychomotor speed outcomes. Systolic blood pressure (−5 mmHg; 95 % CI [-8, −2], p = 0.004) and pulse pressure (−4 mmHg; 95 % CI [-7, −1], p = 0.006) decreased during the peanut intervention.
Conclusions
Daily consumption of skin-roasted peanuts for 16 weeks improved brain vascular function in healthy older men and women. These favorable effects may underlie the observed improvements in verbal memory, highlighting a potential mechanism by which increased peanut intake beneficially affects cognitive performance.
Clinical trial registry
This trial was registered at clinicaltrial.gov as NCT05724654.
背景和目的脑血管功能的降低会导致与年龄相关的认知能力下降。虽然食用花生可能会提高认知能力，但潜在的机制尚不清楚。本研究旨在探讨皮肤烤花生食用对老年人脑血管功能和认知能力的长期影响。方法在一项随机、单盲、对照交叉试验中，31名健康个体（年龄[mean±SD]: 67±4岁；BMI: 26.7±3.3 kg/m2）连续16周食用60 g/天的无盐、皮烤花生或不食用花生（对照组），并进行8周的洗脱期。在随访期间，通过动脉自旋标记磁共振成像量化脑血流（CBF）来评估脑血管功能，这是主要结果。认知表现采用剑桥神经心理测试自动化电池（CANTAB）进行评估。结果花生耐受良好，中位依从性极好：100%（四分位间距[IQR] 99 - 100%）。与对照组相比，花生摄入显著增加了3.6%（干预效果：1.5 mL/100 g/min, 95% CI [0.3, 2.6], p = 0.014）和4.5% （2.2 mL/100 g/min, 95% CI [0.9, 3.6], p = 0.002）的脑灰质CBF。在言语识别记忆（VRM）任务的延迟回忆条件下，言语记忆提高了5.8%（+1.4个单词正确率）（95% CI [0.0, 2.7], p = 0.043）。在执行功能和精神运动速度方面没有发现有益的影响。收缩压（- 5 mmHg, 95% CI [-8, - 2], p = 0.004）和脉压（- 4 mmHg, 95% CI [-7, - 1], p = 0.006）在花生干预期间下降。结论连续16周每天食用皮烤花生可改善健康老年男女的脑血管功能。这些有利的影响可能是观察到的言语记忆改善的基础，强调了增加花生摄入量有益影响认知表现的潜在机制。临床试验注册本试验在clinicaltrial.gov注册为NCT05724654。
{"title":"Longer-term skin-roasted peanut consumption improves brain vascular function and memory: A randomized, single-blind, controlled crossover trial in healthy older adults","authors":"Lucia Kerkhof, Ronald P. Mensink, Jogchum Plat, Kevin M.R. Nijssen, Peter J. Joris","doi":"10.1016/j.clnu.2025.10.020","DOIUrl":"10.1016/j.clnu.2025.10.020","url":null,"abstract":"<div><h3>Background and aims</h3><div>Reduced brain vascular function contributes to age-related cognitive decline. While peanut consumption may improve cognitive performance, the underlying mechanisms remain unclear. This study aimed to investigate the longer-term effects of skin-roasted peanut consumption on brain vascular function and cognitive performance in older adults.</div></div><div><h3>Methods</h3><div>In a randomized, single-blind, controlled crossover trial, 31 healthy individuals (age [mean ± SD]: 67 ± 4 years; BMI: 26.7 ± 3.3 kg/m<sup>2</sup>) consumed 60 g/day of unsalted, skin-roasted peanuts or no peanuts (control) for 16 weeks, separated by an 8-week washout. During follow-up, brain vascular function was assessed by quantifying global cerebral blood flow (CBF) using arterial spin labeling magnetic resonance imaging, which was the primary outcome. Cognitive performance was evaluated using the Cambridge Neuropsychological Test Automated Battery (CANTAB).</div></div><div><h3>Results</h3><div>The consumption of peanuts was well-tolerated and median compliance was excellent: 100 % (interquartile range [IQR] 99–100 %). Compared with control, peanut consumption significantly increased global CBF by 3.6 % (intervention effect: 1.5 mL/100 g/min, 95 % CI [0.3, 2.6], p = 0.014) and gray matter CBF by 4.5 % (2.2 mL/100 g/min, 95 % CI [0.9, 3.6], p = 0.002). Verbal memory improved by 5.8 % during the delayed recall condition of the verbal recognition memory (VRM) task (+1.4 words correct (95 % CI [0.0, 2.7], p = 0.043). No beneficial effects were found in executive function and psychomotor speed outcomes. Systolic blood pressure (−5 mmHg; 95 % CI [-8, −2], p = 0.004) and pulse pressure (−4 mmHg; 95 % CI [-7, −1], p = 0.006) decreased during the peanut intervention.</div></div><div><h3>Conclusions</h3><div>Daily consumption of skin-roasted peanuts for 16 weeks improved brain vascular function in healthy older men and women. These favorable effects may underlie the observed improvements in verbal memory, highlighting a potential mechanism by which increased peanut intake beneficially affects cognitive performance.</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 NCT05724654.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"55 ","pages":"Pages 170-179"},"PeriodicalIF":7.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145475125","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}
In old adult patients with sarcopenia hospitalized for rehabilitation, the superior clinical benefit of a muscle-targeted formula (MTF; whey protein-based enriched with leucine and vitamin D) over an iso-caloric protein-free one was assessed through the IRIS trial (NCT03120026). The aim of this study is to further evaluate the economic benefit in the Italian context.
Methods
A cost-consequence secondary analysis was developed. Clinical inputs were evaluated over the course of the year in terms of nutrition cost, rehabilitation cost and modality of discharge (cost of staying at home vs institution) in three different payer perspectives: (1) hospital, including only nutrition and rehabilitation costs; (2) third-party payer (TPP), including also the economic consequences of patients discharged to an institution; and (3) societal perspective, including also the economic impact on families due to home assistance. For each one, the mean annual cost per patient was calculated. An estimation of the additional number of patients that could be hospitalized each year in Italy using the MTF was also computed.
Results
The MTF was less expensive in all three perspectives considered. Mean saving per patient by perspective was: hospital, € 1536; TPP, € 10,540; societal, € 14,363. Rehabilitation was faster in patients taking the MTF resulting in lower costs to manage sarcopenia, though savings were mostly driven by patients being discharged at home instead of an institution. Finally, assuming a use of the MTF ranging from 50 % to 80 %, about 495,214–792,342 bed days could be saved meaning that 10,538–18,067 additional patients may be treated every year.
Conclusions
Costs associated with the nutritional support of adult patients with sarcopenia hospitalized for rehabilitation with a MTF were inferior than an iso-caloric formula in all payer perspectives. Furthermore, LOS was shorter and more patients could be hospitalized with the same number of beds.
{"title":"Budget impact analysis of a muscle-targeted nutritional intervention for sarcopenia","authors":"Emanuele Cereda , Massimiliano Povero , Luca Castello , Riccardo Caccialanza , Lorenzo Pradelli , Mariangela Rondanelli","doi":"10.1016/j.clnu.2025.10.019","DOIUrl":"10.1016/j.clnu.2025.10.019","url":null,"abstract":"<div><h3>Background</h3><div>In old adult patients with sarcopenia hospitalized for rehabilitation, the superior clinical benefit of a muscle-targeted formula (MTF; whey protein-based enriched with leucine and vitamin D) over an iso-caloric protein-free one was assessed through the IRIS trial (NCT03120026). The aim of this study is to further evaluate the economic benefit in the Italian context.</div></div><div><h3>Methods</h3><div>A cost-consequence secondary analysis was developed. Clinical inputs were evaluated over the course of the year in terms of nutrition cost, rehabilitation cost and modality of discharge (cost of staying at home vs institution) in three different payer perspectives: (1) hospital, including only nutrition and rehabilitation costs; (2) third-party payer (TPP), including also the economic consequences of patients discharged to an institution; and (3) societal perspective, including also the economic impact on families due to home assistance. For each one, the mean annual cost per patient was calculated. An estimation of the additional number of patients that could be hospitalized each year in Italy using the MTF was also computed.</div></div><div><h3>Results</h3><div>The MTF was less expensive in all three perspectives considered. Mean saving per patient by perspective was: hospital, € 1536; TPP, € 10,540; societal, € 14,363. Rehabilitation was faster in patients taking the MTF resulting in lower costs to manage sarcopenia, though savings were mostly driven by patients being discharged at home instead of an institution. Finally, assuming a use of the MTF ranging from 50 % to 80 %, about 495,214–792,342 bed days could be saved meaning that 10,538–18,067 additional patients may be treated every year.</div></div><div><h3>Conclusions</h3><div>Costs associated with the nutritional support of adult patients with sarcopenia hospitalized for rehabilitation with a MTF were inferior than an iso-caloric formula in all payer perspectives. Furthermore, LOS was shorter and more patients could be hospitalized with the same number of beds.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"55 ","pages":"Pages 162-169"},"PeriodicalIF":7.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145475505","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 : 2025-10-31DOI: 10.1016/j.clnu.2025.10.016
R. Reiter , B. Wernly , J. Oswald , J. Gomahr , J. Eberhardt , D. Schaffler-Schaden , B. Iglseder
<div><h3>Background and aims</h3><div>Current definitions of low muscle mass rely on ratios in combination with gender-specific cut-offs. While these approaches aim to adjust for differences in body metrics, their mathematical validity has not been systematically examined and may introduce bias—not only in relation to muscle mass itself, but also in relation to adiposity.</div></div><div><h3>Methods</h3><div>In the National Health and Nutrition Examination Survey (NHANES) cohort 1999–2006 (n = 8325) DXA-based definitions for low muscle mass of the European Working Group on Sarcopenia in Older People (ALST/height<sup>2</sup>), of the Foundation for the National Institutes of Health sarcopenia project (ALST/BMI) and of the ESPEN and EASO consensus for sarcopenic obesity (ALST/weight) were analyzed for proportional (isometric) scaling by regression analysis, calculation of scaling exponents of the denominators and graphical illustrations. The complex relationship between muscle mass, fat mass and BMI was analyzed and the adiposity related bias, cut-offs entail, explored. To illustrate the clinical relevance, we examined the relationship between low muscle mass and fatty liver disease in a second NHANES cohort (2017–2018, n = 673).</div></div><div><h3>Results</h3><div>While ALST/height<sup>2</sup> approximated isometric scaling, ALST/BMI and ALST/weight showed a major mathematical bias. Instead of the assumed β = 1, BMI scaled to ALST with β = 0.6 and weight with β = 0.7. In addition to the increase with BMI, variation of muscle mass at a given BMI was tightly linked to adiposity: age and BMI adjusted standard deviation scores for muscle and fat mass correlated with r = 0.833 and r = 0.799 in men and women, respectively (p < 0.001). As none of the ratio-based definitions correctly adjusted for these associations, cut-offs unmasked a major, adiposity-related bias. Using ALST/height<sup>2</sup> the group with low muscle mass had a ∼7 kg/m<sup>2</sup> lower BMI, opposed by ALST/BMI and ALST/weight with a ∼6 kg/m<sup>2</sup> and ∼7 kg/m<sup>2</sup> higher BMI. In line, fatty liver disease was less prevalent in subjects with low muscle mass following the ALSTI/height<sup>2</sup> definition (PR = 0.30; CI 0.09–0.97), but more prevalent following the ALST/BMI and ALST/weight definitions (PR = 1.92; CI 1.38–2.67 and PR = 2.20; CI 1.58–3.06). Latter associations were no longer statistically significant when BMI and weight were corrected for β values (BMI<sup>0.6</sup> and weight<sup>0.7</sup>).</div></div><div><h3>Conclusion</h3><div>In contrast to ALST/height<sup>2</sup>, ALST/BMI and ALST/weight were not mathematically valid. Normalization of muscle mass by these ratios cannot correctly account for the complex association of muscle mass with fat mass, BMI and age and therefore potentially confounds results when cut-offs are applied. Reference equations that adjust for age and BMI and yield standard deviation scores may offer a more valid and clinically m
{"title":"How to define low muscle mass: A critical exploration of current definitions supports a reference equation-based approach","authors":"R. Reiter , B. Wernly , J. Oswald , J. Gomahr , J. Eberhardt , D. Schaffler-Schaden , B. Iglseder","doi":"10.1016/j.clnu.2025.10.016","DOIUrl":"10.1016/j.clnu.2025.10.016","url":null,"abstract":"<div><h3>Background and aims</h3><div>Current definitions of low muscle mass rely on ratios in combination with gender-specific cut-offs. While these approaches aim to adjust for differences in body metrics, their mathematical validity has not been systematically examined and may introduce bias—not only in relation to muscle mass itself, but also in relation to adiposity.</div></div><div><h3>Methods</h3><div>In the National Health and Nutrition Examination Survey (NHANES) cohort 1999–2006 (n = 8325) DXA-based definitions for low muscle mass of the European Working Group on Sarcopenia in Older People (ALST/height<sup>2</sup>), of the Foundation for the National Institutes of Health sarcopenia project (ALST/BMI) and of the ESPEN and EASO consensus for sarcopenic obesity (ALST/weight) were analyzed for proportional (isometric) scaling by regression analysis, calculation of scaling exponents of the denominators and graphical illustrations. The complex relationship between muscle mass, fat mass and BMI was analyzed and the adiposity related bias, cut-offs entail, explored. To illustrate the clinical relevance, we examined the relationship between low muscle mass and fatty liver disease in a second NHANES cohort (2017–2018, n = 673).</div></div><div><h3>Results</h3><div>While ALST/height<sup>2</sup> approximated isometric scaling, ALST/BMI and ALST/weight showed a major mathematical bias. Instead of the assumed β = 1, BMI scaled to ALST with β = 0.6 and weight with β = 0.7. In addition to the increase with BMI, variation of muscle mass at a given BMI was tightly linked to adiposity: age and BMI adjusted standard deviation scores for muscle and fat mass correlated with r = 0.833 and r = 0.799 in men and women, respectively (p < 0.001). As none of the ratio-based definitions correctly adjusted for these associations, cut-offs unmasked a major, adiposity-related bias. Using ALST/height<sup>2</sup> the group with low muscle mass had a ∼7 kg/m<sup>2</sup> lower BMI, opposed by ALST/BMI and ALST/weight with a ∼6 kg/m<sup>2</sup> and ∼7 kg/m<sup>2</sup> higher BMI. In line, fatty liver disease was less prevalent in subjects with low muscle mass following the ALSTI/height<sup>2</sup> definition (PR = 0.30; CI 0.09–0.97), but more prevalent following the ALST/BMI and ALST/weight definitions (PR = 1.92; CI 1.38–2.67 and PR = 2.20; CI 1.58–3.06). Latter associations were no longer statistically significant when BMI and weight were corrected for β values (BMI<sup>0.6</sup> and weight<sup>0.7</sup>).</div></div><div><h3>Conclusion</h3><div>In contrast to ALST/height<sup>2</sup>, ALST/BMI and ALST/weight were not mathematically valid. Normalization of muscle mass by these ratios cannot correctly account for the complex association of muscle mass with fat mass, BMI and age and therefore potentially confounds results when cut-offs are applied. Reference equations that adjust for age and BMI and yield standard deviation scores may offer a more valid and clinically m","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"55 ","pages":"Pages 104-112"},"PeriodicalIF":7.4,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470708","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 : 2025-10-31DOI: 10.1016/j.clnu.2025.10.018
Yaling Chen , Xiaohan Xu , Peipei Zhou , Meng Wang , Fang Yao , Liqin Chen , Wei Cheng , Haibo Qu , Changju Liu
Objectives to background and aims
Obesity is a major global health challenge associated with increased risks of diabetes and cardiovascular disease. Although calorie restriction and exercise are cornerstone strategies for weight management, long-term adherence remains difficult in real-world settings. This randomised controlled trial aimed to evaluate the effectiveness of a structured calorie-restricted dietary therapy package combined with exercise in achieving weight loss and improving metabolic and psychological outcomes among obese adults.
Methods
In this 12-month, parallel-group randomised controlled trial, 99 obese adults were randomly assigned to an intervention group (standardised meal kit + exercise) or a control group (standard dietary advice + exercise). Weight, glucose, lipid profiles, and mental health outcomes were assessed at baseline, 3, 6, and 12 months. LASSO regression was used to identify predictors of successful weight loss, and linear mixed-effects models evaluated associations between percentage weight loss and changes in glycaemic, lipid, and psychosocial outcomes.
Results
By month 12, all participants in the intervention group achieved ≥5 % weight loss, with 59.18 % achieving ≥10 %, compared to 38.00 % and 6.00 % in the control group, respectively. Group assignment was the strongest predictor of weight loss success, followed by HDL levels and family history of obesity. Each 1 % reduction in body weight was significantly associated with lower FPG, 2hPG, TC, TG, and LDL-C, as well as improved SDS, SAS, and SF-36 scores. These associations remained significant after adjusting for confounders. However, interaction analyses showed no significant between-group differences in the effect of weight loss on outcomes.
Conclusion
A standardised dietary therapy package combining calorie restriction and exercise is a feasible and effective strategy to achieve clinically meaningful weight loss and improve metabolic and psychological health in obese adults. Although both groups experienced improvements, the structured intervention enhanced adherence and overall effectiveness.
{"title":"Evaluation of the effectiveness of a restricted diet therapy package combining standardised caloric intake with exercise in obese patients: A 12-month randomised controlled trial","authors":"Yaling Chen , Xiaohan Xu , Peipei Zhou , Meng Wang , Fang Yao , Liqin Chen , Wei Cheng , Haibo Qu , Changju Liu","doi":"10.1016/j.clnu.2025.10.018","DOIUrl":"10.1016/j.clnu.2025.10.018","url":null,"abstract":"<div><h3>Objectives to background and aims</h3><div>Obesity is a major global health challenge associated with increased risks of diabetes and cardiovascular disease. Although calorie restriction and exercise are cornerstone strategies for weight management, long-term adherence remains difficult in real-world settings. This randomised controlled trial aimed to evaluate the effectiveness of a structured calorie-restricted dietary therapy package combined with exercise in achieving weight loss and improving metabolic and psychological outcomes among obese adults.</div></div><div><h3>Methods</h3><div>In this 12-month, parallel-group randomised controlled trial, 99 obese adults were randomly assigned to an intervention group (standardised meal kit + exercise) or a control group (standard dietary advice + exercise). Weight, glucose, lipid profiles, and mental health outcomes were assessed at baseline, 3, 6, and 12 months. LASSO regression was used to identify predictors of successful weight loss, and linear mixed-effects models evaluated associations between percentage weight loss and changes in glycaemic, lipid, and psychosocial outcomes.</div></div><div><h3>Results</h3><div>By month 12, all participants in the intervention group achieved ≥5 % weight loss, with 59.18 % achieving ≥10 %, compared to 38.00 % and 6.00 % in the control group, respectively. Group assignment was the strongest predictor of weight loss success, followed by HDL levels and family history of obesity. Each 1 % reduction in body weight was significantly associated with lower FPG, 2hPG, TC, TG, and LDL-C, as well as improved SDS, SAS, and SF-36 scores. These associations remained significant after adjusting for confounders. However, interaction analyses showed no significant between-group differences in the effect of weight loss on outcomes.</div></div><div><h3>Conclusion</h3><div>A standardised dietary therapy package combining calorie restriction and exercise is a feasible and effective strategy to achieve clinically meaningful weight loss and improve metabolic and psychological health in obese adults. Although both groups experienced improvements, the structured intervention enhanced adherence and overall effectiveness.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"55 ","pages":"Pages 152-161"},"PeriodicalIF":7.4,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470677","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 : 2025-10-30DOI: 10.1016/j.clnu.2025.10.012
Nagam A. Yehia , Ingrid Santaren , Luke W. Johnston , John L. Sievenpiper , Adria Giacca , Ravi Retnakaran , Stewart B. Harris , Richard P. Bazinet , Anthony J. Hanley
Background
Dairy derived saturated and trans fatty acids may contribute to inverse associations of dairy intake with type 2 diabetes mellitus (T2DM) risk. Longitudinal studies examining this association are limited. This study investigated longitudinal associations of 15:0, trans-16:1n9, trans-18:1n11, and c9, trans-11 conjugated linoleic acid (CLA) in four serum fractions with insulin sensitivity, beta cell function and glucose concentrations.
Methods
Data were obtained from the Prospective Metabolism Islet Cell Evaluation (PROMISE) cohort (n = 418) from 4 separate evaluations over 9 years. Insulin sensitivity was assessed using Matsuda's insulin sensitivity index (ISI) and the homeostasis model assessment of insulin sensitivity (HOMA2_S). Beta cell function was determined using the insulinogenic index divided by HOMA insulin resistance (IGI/IR) and the Insulin Secretion-Sensitivity Index-2 (ISSI-2). Baseline serum fatty acids (mol%) were analyzed using gas chromatography flame-ionization detection. Longitudinal associations were analyzed using covariate-adjusted generalized estimating equations with false discovery adjusted P values.
Results
In the phospholipid (PL) pool, 15:0 was positively associated with logISSI2 (β = 6.54, CI: [2.84, 10.37], p < 0.01) and logIGI/IR (β = 14.75, CI: [6.92, 23.15], p < 0.01), and significantly inversely associated with logGlucose120 (β = −3.45, CI: [-5.63, −1.22], p < 0.05) and logGlucose Area Under the Curve (AUC) (β = −2.84, CI: [-4.38, −1.40], p < 0.01). Trans-16:1n9was significantly associated with logISI (β = 8.08, CI: [2.06, 14.45], p < 0.05) and inversely associated with logGlucose120 (β = −3.11, CI: [-5.50, −0.66], p < 0.05) and logGlucoseAUC (β = −2.16, CI: [-3.75, −0.55], p < 0.05).
Conclusions
Our findings extend the literature on the potential role of dairy derived saturated and trans conjugate fatty acids in cardiometabolic phenotypes underlying T2DM, specifically in the PL fraction.
背景：乳制品来源的饱和脂肪酸和反式脂肪酸可能有助于乳制品摄入量与2型糖尿病（T2DM）风险呈负相关。检验这种关联的纵向研究是有限的。本研究调查了血清中15:0、反式16:19 9、反式18:1n11和c9、反式11共轭亚油酸（CLA）与胰岛素敏感性、β细胞功能和葡萄糖浓度的纵向关系。方法：数据来自前瞻性代谢胰岛细胞评估（PROMISE）队列（n = 418），来自4个独立的评估，历时9年。胰岛素敏感性采用松田胰岛素敏感性指数（ISI）和胰岛素敏感性稳态模型评估（HOMA2_S）进行评估。用胰岛素生成指数除以HOMA胰岛素抵抗指数（IGI/IR）和胰岛素分泌敏感性指数-2 （isi -2）来测定β细胞功能。采用气相色谱-火焰电离检测法分析基线血清脂肪酸（mol%）。纵向关联分析使用协变量调整广义估计方程与假发现调整P值。结果：在磷脂（PL）池中，15:0与logISSI2 （β = 6.54, CI: [2.84, 10.37], p < 0.01）和logIGI/IR （β = 14.75, CI: [6.92, 23.15], p < 0.01）呈正相关，与loglucose120 （β = -3.45, CI: [-5.63, -1.22], p < 0.05）和logGlucose Curve Area (AUC) （β = -2.84, CI: [-4.38, -1.40], p < 0.01）呈显著负相关。trans -16:1n9与logISI （β = 8.08, CI: [2.06, 14.45], p < 0.05）显著相关，与loglucose120 （β = -3.11, CI: [-5.50, -0.66], p < 0.05）和loglucoseauc （β = -2.16, CI: [-3.75, -0.55], p < 0.05）呈负相关。结论：我们的研究结果扩展了乳制品衍生的饱和脂肪酸和反式共轭脂肪酸在T2DM潜在的心脏代谢表型中的潜在作用，特别是在PL部分。
{"title":"Longitudinal associations of serum fatty acids derived from dairy consumption with early prediabetes phenotypes: The PROspective Metabolism and ISlet cell Evaluation (PROMISE) cohort","authors":"Nagam A. Yehia , Ingrid Santaren , Luke W. Johnston , John L. Sievenpiper , Adria Giacca , Ravi Retnakaran , Stewart B. Harris , Richard P. Bazinet , Anthony J. Hanley","doi":"10.1016/j.clnu.2025.10.012","DOIUrl":"10.1016/j.clnu.2025.10.012","url":null,"abstract":"<div><h3>Background</h3><div>Dairy derived saturated and trans fatty acids may contribute to inverse associations of dairy intake with type 2 diabetes mellitus (T2DM) risk. Longitudinal studies examining this association are limited. This study investigated longitudinal associations of 15:0, <em>trans</em>-16:1n9, <em>trans</em>-18:1n11, and c9, <em>trans</em>-11 conjugated linoleic acid (CLA) in four serum fractions with insulin sensitivity, beta cell function and glucose concentrations.</div></div><div><h3>Methods</h3><div>Data were obtained from the Prospective Metabolism Islet Cell Evaluation (PROMISE) cohort (n = 418) from 4 separate evaluations over 9 years. Insulin sensitivity was assessed using Matsuda's insulin sensitivity index (ISI) and the homeostasis model assessment of insulin sensitivity (HOMA2_S). Beta cell function was determined using the insulinogenic index divided by HOMA insulin resistance (IGI/IR) and the Insulin Secretion-Sensitivity Index-2 (ISSI-2). Baseline serum fatty acids (mol%) were analyzed using gas chromatography flame-ionization detection. Longitudinal associations were analyzed using covariate-adjusted generalized estimating equations with false discovery adjusted <em>P</em> values.</div></div><div><h3>Results</h3><div>In the phospholipid (PL) pool, 15:0 was positively associated with logISSI2 (β = 6.54, CI: [2.84, 10.37], p < 0.01) and logIGI/IR (β = 14.75, CI: [6.92, 23.15], p < 0.01), and significantly inversely associated with logGlucose120 (β = −3.45, CI: [-5.63, −1.22], p < 0.05) and logGlucose Area Under the Curve (AUC) (β = −2.84, CI: [-4.38, −1.40], p < 0.01). <em>Trans</em>-16:1n9was significantly associated with logISI (β = 8.08, CI: [2.06, 14.45], p < 0.05) and inversely associated with logGlucose120 (β = −3.11, CI: [-5.50, −0.66], p < 0.05) and logGlucoseAUC (β = −2.16, CI: [-3.75, −0.55], p < 0.05).</div></div><div><h3>Conclusions</h3><div>Our findings extend the literature on the potential role of dairy derived saturated and trans conjugate fatty acids in cardiometabolic phenotypes underlying T2DM, specifically in the PL fraction.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"55 ","pages":"Pages 124-133"},"PeriodicalIF":7.4,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470735","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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