Clinical nutrition最新文献

{"title":"Using artificial intelligence models to generate dietary recommendations for chronic kidney disease patients: A comparative cross-sectional study","authors":"Binyu Yang ,&nbsp;Wei Wei ,&nbsp;Caihong Liu ,&nbsp;Yongxiu Huang ,&nbsp;Jinglei Ren ,&nbsp;Ya Yuan ,&nbsp;Ping Fu ,&nbsp;Yuliang Zhao","doi":"10.1016/j.clnu.2025.10.014","DOIUrl":"10.1016/j.clnu.2025.10.014","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Artificial intelligence (AI) models are increasingly being used to assist in chronic kidney disease (CKD) dietary guidance, but concerns about their accuracy remain. This study aimed to assess the performance of three AI models (ChatGPT, DeepSeek, Gemini) in accordance with the Kidney Disease: Improving Global Outcomes (KDIGO) 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease.</div></div><div><h3>Methods</h3><div>We compared ChatGPT, DeepSeek, and Gemini with the KDIGO 2024 guidelines through expert and cross-AI assessments. Outputs were scored across five domains: accuracy, clarity, completeness, practicality, and safety.</div></div><div><h3>Results</h3><div>The AI models were able to generate well-structured dietary advice for CKD patients. DeepSeek received a higher score (7.625) for practicality compared to ChatGPT (6.5) and Gemini (7.0) (p = 0.041). ChatGPT showed numerically higher accuracy scores than the other two models, although there was no statistically significant difference (ChatGPT: 7.25, DeepSeek: 6.875, Gemini: 6.875; p = 0.715). Similarly, scores for clarity (p = 0.489), completeness (p = 0.432) and safety (p = 0.413) were not significantly different. The AI models share several common limitations: they might overlook contraindications (such as recommending a low-protein diet for patients with severe hypoalbuminemia), neglect age-specific needs, and lack real-time knowledge updates.</div></div><div><h3>Conclusions</h3><div>While AI shows clinical potential, its outputs still require expert validation, real-time updates, and enhanced safety protocols to ensure reliable clinical integration.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"55 ","pages":"Pages 76-80"},"PeriodicalIF":7.4,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457984","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":"Does Intermittent Nutrition Enterally Normalise hormonal and metabolic responses to feeding in critically ill adults? The DINE-normal proof-of-concept study","authors":"Clodagh E. Beattie ,&nbsp;Borislavova Borislava ,&nbsp;Harry A. Smith ,&nbsp;Michael T. Ambler ,&nbsp;Paul White ,&nbsp;Danielle Milne ,&nbsp;Aravind V. Ramesh ,&nbsp;Alexander Ferriman ,&nbsp;Thomas Fisher ,&nbsp;Charlotte Horsley ,&nbsp;Sherena Jackson ,&nbsp;Chloe Jubainville ,&nbsp;Kate Lobo ,&nbsp;Hannah Maxfield ,&nbsp;Javier T. Gonzalez ,&nbsp;James A. Betts ,&nbsp;Anthony E. Pickering ,&nbsp;Matt Thomas","doi":"10.1016/j.clnu.2025.10.003","DOIUrl":"10.1016/j.clnu.2025.10.003","url":null,"abstract":"<div><h3>Background and aims</h3><div>For intensive care unit (ICU) patients fed via a nasogastric (NG) tube, current guidelines recommend continuous feeding through the day and night. Emerging evidence in healthy individuals shows that NG feeding in an intermittent diurnal pattern promotes phasic hormonal, digestive and metabolic responses vital for effective nutrition, though this has not been studied in the critically ill population. This proof-of-concept study aimed to compare the effect of diurnal intermittent versus continuous enteral feeding on hormonal and metabolic outcomes in ICU patients.</div></div><div><h3>Methods</h3><div>We conducted a single-centre, randomised, open-label trial in the ICU. Adult ICU patients that were anticipated to require NG feeding for &gt;48 h were randomised to an intermittent diurnal regimen (feeds at 8:00, 13:00 and 18:00), or continuous feeding with equivalent nutritional value, for 48 h. The primary outcome was peak plasma insulin within 3 h of delivering the first intermittent feed on the second study day, compared to the same time period in the continuous group. Secondary outcomes included feasibility, tolerability and metabolic profiles.</div></div><div><h3>Results</h3><div>Thirty patients were randomised to intermittent (n = 13) or continuous (n = 17) feeding. Two patients in the intermittent group were excluded from analysis. Both groups achieved their feed targets. Peak plasma insulin concentrations (mean ± SD) were significantly higher in the intermittent group versus continuous (295.1 ± 167.8 vs. 128.1 ± 57.2 pmol/L, p &lt; 0.001). Plasma glucose concentrations were not significantly different between groups. There were no between-group differences in other plasma metabolites and there were no adverse events such as hyper-/hypo-glycaemia. There was evidence of increased bowel motility in the intermittent group.</div></div><div><h3>Conclusion</h3><div>Intermittent diurnal feeding, compared to continuous feeding, preserves the physiological insulin response in critically ill adults. Both regimens were well tolerated, supporting the need for a larger trial to assess other clinically important patient-centred outcomes.</div></div><div><h3>Trial registration</h3><div>This trial was registered prospectively at <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> (study ID NCT06115044).</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"55 ","pages":"Pages 81-89"},"PeriodicalIF":7.4,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457961","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":"Exploring the safety of prolonging the hang time of enteral feeding systems in the intensive care unit","authors":"Michelle Carmen Paulus ,&nbsp;Max Melchers ,&nbsp;Tim den Ruijter ,&nbsp;Marco Reijn ,&nbsp;Marcel H. Zwietering ,&nbsp;Arthur Raymond Hubert van Zanten","doi":"10.1016/j.clnu.2025.10.013","DOIUrl":"10.1016/j.clnu.2025.10.013","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Prolonging the hang time (HT) of administration sets and enteral feeding containers beyond the recommended 24 h may reduce waste, decrease nursing workload and lower hospital costs. The objective of this pilot study was to explore the safety of extending the HT from 24 to 48 h by investigating its impact on the occurrence of diarrhoea and new-onset pneumonia in intensive care unit (ICU) patients.</div></div><div><h3>Methods</h3><div>This monocenter pilot study had a combined retrospective and prospective cohort (24 and 48-h HT, respectively) design and included ICU patients (≥ 18 years) receiving enteral nutrition for at least 48 h. The primary outcome was diarrhoea, defined as (1) ≥ 3 defecations/day with a Bristol Stool Chart score of 6 or 7, or (2) colostomy/ileostomy output ≥1.5 L/24 h. The secondary outcome was new-onset pneumonia ≥48 h after ICU admission. Associations between HT protocol and the onset of outcomes were assessed by Cox regression analyses. Additionally, retrograde bacterial growth was assessed through microbiological analysis in enteral feeding systems.</div></div><div><h3>Results</h3><div>A total of 102 ICU patients were included between December 16, 2023 and October 11, 2024, with 51 in each cohort. Actual median HT was 31 [27–45] hours vs. 56 [37–83] hours in the 24 and 48-h groups, respectively (p &lt; 0.001). In multivariable Cox regression, no significant association was found between prolonged HT and diarrhoea-free survival (HR 0.92, 95 % CI 0.55–1.53, p = 0.746) and new-onset pneumonia (HR 1.33, 95 % CI 0.54–3.24, p = 0.537), respectively. Retrograde bacterial growth did not extend beyond the first 30 cm of the administration set and was not correlated to HT.</div></div><div><h3>Conclusion</h3><div>We observed no association between prolonging the HT of enteral feeding sets from 24 to 48 h and the occurrence of diarrhoea or new-onset pneumonia in ICU patients. However, a substantial, adequately powered, non-inferiority trial must be conducted prior to integrating extended hang times into clinical practice.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"55 ","pages":"Pages 57-65"},"PeriodicalIF":7.4,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145451163","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":"Impacts of minimally-processed omnivorous vs lacto-ovo-vegetarian diets on insulin sensitivity, lipid profile, and adiposity in older adults: Secondary findings from a randomized crossover feeding trial","authors":"Saba Vaezi ,&nbsp;Jessica L. Freeling ,&nbsp;Bruna O. de Vargas ,&nbsp;Lee Weidauer ,&nbsp;Marni E. Shoemaker ,&nbsp;Wade M. Sanders ,&nbsp;Moul Dey","doi":"10.1016/j.clnu.2025.10.010","DOIUrl":"10.1016/j.clnu.2025.10.010","url":null,"abstract":"<div><h3>Background and aims</h3><div>The aging population in the U.S. faces increased cardiometabolic risk, reducing healthspan and increasing public health burden. These vulnerabilities may be compounded by ultra-processed food (UPF). No feeding trial has evaluated UPF reduction in older adults within the framework of Dietary Guidelines for Americans (DGA). This study addressed the gap using representative omnivorous and lacto-ovo vegetarian patterns.</div></div><div><h3>Methods</h3><div>The secondary outcomes of the Protein-Distinct Macronutrient-Equivalent Diet 2 (PRODMED2) trial compared two DGA-aligned, low-UPF diets with each other and with a high-UPF habitual baseline (BSL) diet in 36 community-dwelling older adults. The diets featured minimally processed pork (MPP) and lentils (MPL) as representative animal- and plant-based primary proteins, each provided for 8 weeks without calorie restriction and separated by a 2-week washout. Diet compositions and intakes, body composition, cardiometabolic biomarkers, and hormones linked to nutrient sensing and energy balance were measured before and after interventions, with a subset of measures repeated at ∼1-year post-intervention follow-up (FUP). Data were primarily analyzed using robust linear mixed-effects models adjusted for covariates.</div></div><div><h3>Results</h3><div>Switching from a high-UPF BSL (∼50%E) to either low-UPF diets (∼13%E), unintentionally lowered energy intake (Δ-333 vs Δ-437 kcal/d, MPP vs MPL), resulting in reductions in body weight (Δ-3.8 vs Δ-4.4 kg), and fat mass (Δ-2.6 vs Δ-2.9 kg). Both diets improved HOMA-IR, insulin, C-peptide, total cholesterol, LDL, apolipoprotein B, non-HDL, and CRP relative to BSL (all, <em>p</em> &lt; 0.038 BSL vs post-diet, no significance between diets). Fasting leptin declined (Δ-1.9 vs Δ-2.5 ng/mL MPP vs MPL) and FGF21 increased (Δ+65 vs Δ+88 pg/mL MPP vs MPL) in both diet phases (all, <em>p</em> &lt; 0.026 BSL vs post-diet, no significance between diets). At FUP, as UPF exposure increased to 44 %, dietary intakes, weight, adiposity, and biomarkers returned toward BSL.</div></div><div><h3>Conclusion</h3><div>Results demonstrate that low-UPF eating aligns with DGA pattern and is feasible across both plant- and animal-based diets. Both omnivorous and lacto-ovo vegetarian interventions promoted caloric reduction, weight and visceral fat loss, improved insulin sensitivity and lipid metabolism, and reduced inflammatory markers. These effects may involve nutrient sensing via FGF21 and leptin. Low-UPF diets may provide a practical approach to support healthy aging.</div></div><div><h3>Registration of the clinical trial</h3><div>The trial is registered at <span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span> as NCT05581953 on October 12, 2022.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"55 ","pages":"Pages 90-103"},"PeriodicalIF":7.4,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470718","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":"Associations of plasma inosine with lipid parameters in a biracial community cohort","authors":"Yixi Sun ,&nbsp;Ruiyuan Zhang ,&nbsp;Ling Tian ,&nbsp;Tingting Liu ,&nbsp;Yang Pan ,&nbsp;Xiao Sun ,&nbsp;Zhijie Huang ,&nbsp;Jia Fan ,&nbsp;Jing Chen ,&nbsp;Kai Zhang ,&nbsp;Shengxu Li ,&nbsp;Wei Chen ,&nbsp;Lydia A. Bazzano ,&nbsp;Jiang He ,&nbsp;Joshua D. Bundy ,&nbsp;Tanika N. Kelly ,&nbsp;Changwei Li","doi":"10.1016/j.clnu.2025.10.011","DOIUrl":"10.1016/j.clnu.2025.10.011","url":null,"abstract":"<div><h3>Background</h3><div>Inosine has been investigated as a dietary supplement for athlete performance, inflammation, and neurological disease. A recent study in a hypercholesterolemic rat model has shown its potential for treating atherosclerosis.</div></div><div><h3>Objective</h3><div>This study aimed to investigate the associations between plasma inosine and lipid parameters, and to discover potential mediating pathways.</div></div><div><h3>Methods</h3><div>We profiled inosine and 886 known metabolites in plasma samples from 1,121 participants of a biracial cohort. Linear regression models assessed inosine's association with total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), log transformed triglycerides (log-TG), and TC to HDL-C ratio (TC/HDL-C), adjusting for relevant covariates. Significant findings were replicated in 78 adults from the Protein and Blood Pressure (ProBP) study, a cross-over randomized control trial by testing longitudinal associations between inosine changes and lipid changes after dietary supplementation of soy protein, milk protein, and carbohydrates. For a replicated association, we employed two complementary approaches to identify potential mediators for enrichment analysis.</div></div><div><h3>Results</h3><div>In the discovery cohort, inosine was positively associated with HDL-C (β = 1.77, 95 % confidence interval [CI]: 0.003 to 3.54) and negatively associated with TC/HDL-C (β = −0.24, 95 % CI: −0.41 to −0.08) and log-TG (β = −0.08, 95 % CI: −0.15 to −0.02). These results were replicated in ProBP after soy protein intervention with inosine changes leading to increase of HDL-C (β = 1.82, 95 % CI: 0.36 to 3.27) and decrease of TC/HDL-C (β = −0.14, 95 % CI:-0.28 to −0.002) and TG (β = −12.79, 95 % CI: −21.00 to −4.58). Sex-stratified analyses revealed a more pronounced association in women than men, particularly for HDL-C. Six metabolites and 29 enriched pathways of high confidence were identified.</div></div><div><h3>Conclusion</h3><div>In humans, inosine is associated with better profiles of HDL-C, TC/HDL-C, and log-TG, with more pronounced effects in women for HDL-C.</div><div>The ProBP trial was registered at ClinicalTrials.gov as NCT00107744.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"55 ","pages":"Pages 113-123"},"PeriodicalIF":7.4,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470611","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":"From prediction of personalized metabolic responses to foods to computational nutrition: Concepts of an emerging interdisciplinary field","authors":"Ruixin Zhu ,&nbsp;Yu Dong ,&nbsp;Jie Guo ,&nbsp;Jingjing He ,&nbsp;Huiyu Chen ,&nbsp;Ran Wang ,&nbsp;Fazheng Ren ,&nbsp;Anne Raben ,&nbsp;J. Alfredo Martinez","doi":"10.1016/j.clnu.2025.10.009","DOIUrl":"10.1016/j.clnu.2025.10.009","url":null,"abstract":"<div><div>Recent advances in artificial intelligence, wearable biosensors, and multi-omics technologies, combined with interdisciplinary translational collaborations, are transforming the landscape of nutrition, particularly by enabling precision nutrition. We propose computational nutrition as an emerging interdisciplinary field that aims to address complex challenges in nutrition and health and drive paradigm shifts in nutrition research through computational methods in statistics and computer science (e.g., statistical modeling, simulation, causal inference, machine learning, and deep learning) and multi-modal data. Computational nutrition employs epidemiology and data science as its methodologies and integrates expertise from nutrition, food science, computer science, statistics, systems biology, and public health. The main research directions of computational nutrition are: 1) prediction of personalized metabolic responses to foods and establishment of individualized dietary reference intakes; 2) causal inference in nutrition and diseases and evaluation of individualized treatment effects of nutritional interventions; 3) precise and dynamic assessment and monitoring of diet-related disease risks; 4) simulation and evaluation of public health nutrition policies and sustainability assessment of dietary patterns. Critical challenges such as the reliability of wearable biosensors, trade-offs in feature selection, ethics of algorithms and health equity, and interpretability of algorithms are raised, which must be addressed to ensure human well-being and rights.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"55 ","pages":"Pages 11-23"},"PeriodicalIF":7.4,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145430521","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 JOHAS (Judgement of Objective Hypersteatosis and Atrophy in Sarcopenia) index; an index for sarcopenia or low muscle mass?","authors":"Yuzo Yamamoto ,&nbsp;Kyosuke Agawa,&nbsp;Masahide Awazu,&nbsp;Noriko Omura,&nbsp;Shunji Nakayama,&nbsp;Hiromi Maeda","doi":"10.1016/j.clnu.2025.10.008","DOIUrl":"10.1016/j.clnu.2025.10.008","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"55 ","pages":"Pages 1-2"},"PeriodicalIF":7.4,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415510","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":"Dairy products intake and its association with cognitive function in older adults: A systematic review and dose–response meta-analysis","authors":"Ting Gao ,&nbsp;Yan Li ,&nbsp;Li Niu ,&nbsp;Zihan Wang ,&nbsp;Shenjun Li ,&nbsp;Yunmeng Niu ,&nbsp;Ye Li ,&nbsp;Yuhan Meng ,&nbsp;Xiaohui Gao ,&nbsp;Xinyi Xu","doi":"10.1016/j.clnu.2025.09.020","DOIUrl":"10.1016/j.clnu.2025.09.020","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Emerging evidence suggests a possible association between dairy product intake and cognitive function in older adults; however, previous findings remain inconsistent. This study aimed to systematically evaluate the association between dairy intake and cognitive outcomes in older adults, and explore potential dose-response relationships and regional differences.</div></div><div><h3>Methods</h3><div>We searched PubMed, MEDLINE, Embase, Cochrane Library, Scopus, and CINAHL from their inception to 31 December 2024. Dose–response analysis was performed for cohort studies to assess the impact of different types and quantities of dairy intake on cognitive subdomains. Meta-regression was used to explore sources of heterogeneity. The results were presented as relative risks (RRs), odds ratios (ORs), and mean differences (MDs) with 95 % confidence intervals (CIs). The methodology followed the PRISMA guidelines for systematic reviews and meta-analyses.</div></div><div><h3>Results</h3><div>A total of 38 studies were included, comprising 21 cohort studies, 15 cross-sectional studies, and 2 randomized controlled trials. We stratified dairy products intake levels, and higher total dairy intake was associated with a reduced risk of cognitive decline and improved global cognitive function (Cohort: medium vs low, RR: 0.92, 95 % CI: 0.85, 0.99; high vs low, RR: 0.85, 95 % CI: 0.73, 0.98; Cross-sectional: high vs low, OR: 0.64, 95 % CI: 0.49, 0.82). Fermented dairy products were associated with improved verbal memory and executive function, whereas higher milk intake showed a potential association with poorer verbal memory in certain instances (medium vs low, MD: −0.04; 95 % CI: −0.09, 0.01; high vs low, MD: −0.05; 95 % CI: −0.09, −0.01). Evidence showed nonlinear associations, with the lowest risk of cognitive decline associated with a daily intake of 150 g of dairy products (<em>p</em>-nonlinear = 0.009, RR: 0.86, 95 % CI: 0.78, 0.95), and 30 g/day of whole-fat dairy (<em>p</em>-nonlinear = 0.007, RR: 0.83, 95 % CI: 0.74, 0.94). Regional differences were observed, with cognitive outcomes varying between European and Asian populations, possibly reflecting dietary habits and cultural contexts.</div></div><div><h3>Conclusions</h3><div>Dairy intake, especially fermented products and moderate total intake, may support cognitive health in older adults, though associations vary by region and dairy type. More high-quality studies are needed to clarify these relationships and guide dietary recommendations.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"55 ","pages":"Pages 24-41"},"PeriodicalIF":7.4,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444098","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":"Glucagon-like peptide-1 receptor agonists and sarcopenia-related markers in diabetes: A systematic review and meta-analysis","authors":"Wenjie Chen ,&nbsp;Hongzhuo Qin ,&nbsp;Zhaokai Zhou ,&nbsp;Yun Chen ,&nbsp;Xiaowei Xu ,&nbsp;Yajun Chen ,&nbsp;Jieyu He ,&nbsp;Ran Xu ,&nbsp;Hua Gao ,&nbsp;Qiong Lu","doi":"10.1016/j.clnu.2025.10.006","DOIUrl":"10.1016/j.clnu.2025.10.006","url":null,"abstract":"<div><h3>Aims</h3><div>GLP-1 receptor agonists (GLP-1RAs) are first-line therapies for type 2 diabetes (T2DM) due to their additional weight-lowering and cardiovascular benefits. However, their impact on muscle mass is debated, posing a concern for sarcopenia in older adults with T2DM. This systematic review and meta-analysis aimed to evaluate the effects of GLP-1RAs on body composition and sarcopenia-related markers in diabetic patients and relevant preclinical models, and to explore the underlying mechanisms.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Web of Science, MEDLINE, Cochrane Library, and EMBASE to identify relevant randomized controlled trials and animal studies on the impact of GLP-1 RAs on muscle in diabetic participants. Standardized Mean Difference (SMD) or Mean Difference (MD) with 95 % confidence intervals (CI) were calculated using random-effects or fixed-effect models to synthesize the effects on anthropometric, functional, and molecular endpoints.</div></div><div><h3>Results</h3><div>A total of 254 articles were retrieved, yielding 18 eligible studies after screening against the inclusion criteria. These comprised six human studies measuring lean mass, four clinical trials assessing Skeletal Muscle Mass Index (SMI), and eight animal studies. The animal studies investigated parameters including muscle mass, muscle fiber cross-sectional area, grip strength, lean mass percentage, myogenin, MyoD, Atrogin-1, MuRF-1, myostatin, GLUT4, SIRT1, and inflammatory cytokines (IL-1β, IL-6, TNF-α).</div></div><div><h3>Conclusions</h3><div>GLP-1 RAs were found to increase the percentage of lean body mass in animal models, improve body composition, enhance skeletal muscle strength, elevate concentrations of muscle growth factors, and reduce muscle growth inhibitory factors and inflammatory factors. These effects promote muscle cell proliferation and differentiation, accelerate muscle protein synthesis, leading to better overall muscle function. Confirming these promising preclinical findings requires large-scale randomized controlled trials in humans.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"55 ","pages":"Pages 42-56"},"PeriodicalIF":7.4,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444106","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":"Sarcopenic diabetes is an under-recognized and unmet clinical priority. A call for action from the European Society for Clinical Nutrition and Metabolism and the Diabetes Nutrition Study Group","authors":"Rocco Barazzoni ,&nbsp;John L. Sievenpiper ,&nbsp;Laurence Genton ,&nbsp;Cyril WC. Kendall ,&nbsp;Maria D. Ballesteros-Pomar ,&nbsp;Annalisa Giosuè ,&nbsp;Yves Boirie ,&nbsp;Laura Chiavaroli ,&nbsp;Tommy Cederholm ,&nbsp;Anne-Marie Aas ,&nbsp;Cristina Cuerda ,&nbsp;Charilaos Dimosthenopoulos ,&nbsp;Nicolaas E. Deutz ,&nbsp;Hana Kahleova ,&nbsp;Lorenzo M. Donini ,&nbsp;Ursula Schwab ,&nbsp;Stephane M. Schneider ,&nbsp;Gabriele Riccardi ,&nbsp;Stanislaw Klek ,&nbsp;Jordi Salas-Salvadó ,&nbsp;Jeffrey I. Mechanick","doi":"10.1016/j.clnu.2025.10.007","DOIUrl":"10.1016/j.clnu.2025.10.007","url":null,"abstract":"<div><div>Diabetes mellitus is a systemic chronic disease with growing prevalence and potential multiorgan complications leading to clinical, social, and economic burdens. Nutritional and metabolic derangements are important components of both type 1 (T1DM) and type 2 diabetes (T2DM), but assessment of nutritional state, body composition and muscle function is commonly neglected. Likely reasons include high prevalence of overweight, obesity, or excess visceral fat in highly-prevalent T2DM, potentially diverting attention from undernutrition risk. Diabetes and adiposity are mechanistically related to sarcopenia, defined as reduction of skeletal muscle strength and mass, through complex muscle-catabolic derangements, conferring additional risk for negative outcomes. Awareness of diabetes-induced muscle abnormalities remains low among healthcare professionals, patients and policymakers, contributing to research, knowledge and practice gaps. Lifestyle recommendations and treatments centered on nutritional care and physical activity to preserve and improve muscle mass and function remain poorly implemented. The European Society for Clinical Nutrition and Metabolism (ESPEN) and the Diabetes Nutrition Study Group (DNSG), reference group for the European Association for the Study of Diabetes, recognize sarcopenic diabetes as a distinct clinical condition and priority for research and education, and call for action to enhance awareness, stimulate research and promote consensus on sarcopenic diabetes diagnostic criteria, prevention and management.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"55 ","pages":"Pages 208-218"},"PeriodicalIF":7.4,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145562793","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}