European Journal of Clinical Nutrition最新文献

Limited studies have explored the longitudinal alterations of fat-free mass (FFM), fat mass (FM), and phase angle (PhA) in the motor neuron disease (MND) population. This pilot longitudinal study investigated body composition changes via bioimpedance analysis (BIA) at time of diagnosis and gastrostomy. Nineteen patients (n = 11, 57.9% females) were included. Statistically significant reductions in FFM [median (IQR) 43.0 (17.8) kg to 42.1 (16.7) kg, p < 0.001] and PhA [4.6 (2.0)° to 4.5 (2.1)°, p = 0.012] were found. FFM (p = 0.007, 95% CI 0.505, 1.32) and FM (p = 0.024, 95% CI 0.160, 1.249) were significant predictors of weight change, with FFM accounting for 72% of the change. Larger longitudinal studies are needed to explore the clinical benefit associated with reducing pre-gastrostomy FFM loss in the MND population. In the interim, clinicians should consider monitoring body composition and implementing interventions aimed at preserving body weight and composition, particularly FFM, prior to gastrostomy placement.

Background: Moderate-to-late preterm (MLP) infants (i.e., <37 weeks' gestation) are at risk for suboptimal neonatal nutrition and growth. We compared anthropometry and body composition at 24 months corrected age (CA; i.e., after term equivalent age (TEA)) between MLP infants fed either an isocaloric, protein- and mineral-enriched post-discharge formula (PDF) or standard term formula (STF) between TEA and 6 months CA.

Methods: After enrollment (≤7 d postpartum), MLP infants received PDF if (fortified) mother's own milk was insufficient. At TEA, those receiving >25% of intake as formula were randomized to either continue the same PDF or switch to STF until 6 months CA. At 24 months CA, anthropometry was assessed and air-displacement plethysmography was used to estimate body composition.

Results: From the original study (n = 157), only 64 infants had anthropometry assessed and 34 infants had body composition estimated at 24 months CA. At the follow-up visit, PDF-fed infants had slightly larger head circumference compared to STF-fed infants (49.0 ± 1.5 and 48.3 ± 1.5 cm, p < 0.05). Despite similar total body weight at 24 months CA, PDF-fed infants had lower fat mass and higher fat-free mass compared to STF-fed infants (fat mass: 2392 ± 923 and 3615 ± 1359 g; fat-free mass: 10461 ± 1030 and 10108 ± 1700 g; respectively, p < 0.05).

Conclusions: Providing MLP infants with PDF for 6 months after TEA was associated with lower fat mass and higher fat-free mass, with similar bodyweights at 24 months CA compared to those fed STF. Our findings should be interpreted cautiously, due to high loss-to-follow-up.

Objective: We investigated the association of obesity phenotypes with MetS and components scores, subclinical inflammation, anti- and oxidative markers in children.

Subjects/methods: This is a cross-sectional study with 364 children (8 and 9-year-olds) in Viçosa, Minas Gerais, Brazil. Children were classified as: 1."normal-weight lean" (NWL) when they had normal-weight by BMI and adequate fat percentage assessed by DXA; 2. "normal-weight obesity" (NWO) for those with normal-weight and excess fat; and 3. "excess weight" for those with overweight/obesity and excess fat. The score for the MetS and its components was estimated, and the inflammatory and oxidative stress markers were measured. Multiple linear regression was used.

Results: Of thirteen cardiometabolic risk factors investigated, five were positively associated with the NWO, compared to NWL. Moreover, eleven cardiometabolic risk factors were associated with excess weight, compared to NWL. When the two phenotypes of excess body fat were contrasted, we found eight cardiometabolic risk factors associated with excess weight, compared to NWO.

Conclusion: An intermediate cardiometabolic risk was observed in children with the NWO phenotype when comparing the status of NWL to excess weight. This study reinforces the importance of investigating cardiometabolic risk in early ages, independent of BMI.

The Roma minority is one of Europe's most vulnerable minorities in terms of health status including nutrition-related diseases. A detailed and robust exploration of the dietary behaviors of the Roma population is essential for developing targeted nutrition interventions. This scoping review aims to identify and evaluate the dietary assessment methods used for measuring dietary intake and food consumption among the Roma population. Studies were identified through PubMed, Web of Science, Scopus, and grey literature. Studies written in English that focused on the Roma minority and assessed dietary intake and food consumption were eligible. A qualitative approach was used to summarize the results. Thirteen original studies were reviewed, primarily conducted in Eastern Europe. Nine out of thirteen studies used cross-sectional study designs and quantitative research approaches. The most commonly applied nutritional assessment methods were food frequency questionnaire, 24-h dietary recall, and brief dietary habits questionnaire. Quantitative dietary outcomes were measured through dietary intake, food consumption patterns, and dietary quality, while qualitative dietary outcomes were identified as moderate overconsumption, irregular eating, or the symbolic use of food to denote social status. There was a lack of validity and adaptation of dietary assessment tools for the Roma population. The reviewed studies often did not employ advanced nutritional analysis methods common in the general, non-Roma population. There is a need to develop specific dietary assessment methods for the Roma population. To obtain more reliable results, combining subjective dietary assessment methods with a qualitative, participatory approach may be suitable for this population.

Background and objective: Hypertension is influenced by both genetic and dietary factors. Understanding gene-diet interactions across populations is key to precision prevention.

Objectives: To identify genetic variants associated with hypertension in KoGES and UK Biobank (UKBB), and evaluate their interactions with nutrient intake.

Subjects/methods: Genome-wide association analyses were conducted for hypertension (HTN: SBP ≥ 140 mmHg, DBP ≥ 90 mmHg or taking hypotensive medication) in KoGES (Non-HTN, n = 39,387; HTN, n = 13,727) and replicated in UKBB (Non-HTN, n = 334,785; HTN, n = 132,140). Genetic risk scores (GRS) were constructed from seven common SNPs. Genetic variant or GRS-diet interactions were analyzed via logistic regression.

Results: Common SNPs in genes such as FGF5, CYP17A1, CNNM2, AS3MT, ATP2B1, BORCS7-ASMT, NT5C2, and RGL3 were significantly linked to hypertension in both cohorts (P < 5 × 10⁻⁸). In KoGES, the associated genes were enriched in lipid metabolism pathways. In UKBB, vascular signaling pathways, including AKT1, MAPK, and TGF-β signaling, were predominant based on the selected genetic variants. Despite common variants, distinct biological mechanisms were implicated in Koreans and Caucasians. The GRS of the 6-SNP model, including FGF5, CYP17A1, CNNM2, ATP2B1, BORCS7-ASMT, and RGL3, was associated with hypertension risk. However, this effect was attenuated with high tea and coffee intake only in the low-GRS individuals in both cohorts (P < 0.05). The RGL3 rs167479 variant showed significant interactions with vitamins C, D, B12, and flavonoids in KoGES (P = 0.02-0.002).

Conclusions: Common genetic variants contribute to hypertension across populations but act through divergent molecular pathways. Targeted nutrient intake appears to mitigate genetic risk, underscoring the promise of gene-informed dietary strategies for hypertension prevention.

Malnutrition in Inflammatory Bowel Disease (IBD) is an important medical issue leading to adverse clinical outcomes. The Global Leadership Initiative on Malnutrition (GLIM) criteria provide a common approach for the diagnosis of malnutrition and are proposed to be used in different clinical conditions and environments. The aim of this scoping review was to review the findings of all available studies that have already applied the GLIM criteria in IBD, to explore GLIM prognostic value, to highlight challenges and concerns, and to identify knowledge gaps for further research. A comprehensive literature search strategy using the databases PubMed/MEDLINE and Scopus was conducted. Eligible studies were peer-reviewed articles published until May 2025 in the English language, only conducted in adult people with IBD. Fifteen studies were included in this review. Great heterogeneity was recorded in the way both phenotypic and etiologic GLIM criteria have been evaluated leading to important differences between studies and not allowing comparisons between them, but also to increased risk of bias in many of these studies. The prevalence of malnutrition using GLIM criteria in IBD was medium-to-high (31.7-60.1%) depending on the methodology each study implemented for the assessment of phenotypic and etiologic criteria. Only two of the included studies prospectively assessed the impact of malnutrition on clinical outcomes with conflicting results. Future research should focus both on the implementation of robust methodologies to apply the phenotypic and the etiologic criteria, but also to explore the impact of malnutrition diagnosis on disease-related clinical outcomes.

Objectives: Intermittent fasting (IF) has gained attention for weight management and metabolic health, but detailed trials comparing its efficacy to calorie restriction (CR) in type 2 diabetes mellitus (T2D) are limited. Our aim was to compare the impact of CR diet with or without 12-hour overnight IF regimen on weight loss, glycemic control, and reduction of medication use in T2D.

Methods: This was a 3-month, single-center randomized clinical trial. Participants (N = 99), 21-60 years with T2D, were randomly assigned to Group 1 (12-hour IF + CR, N = 48) or Group 2 (CR alone, N = 51). Anthropometric evaluations included weight, height, waist and hip circumference, and BMI. Body composition analysis was performed, and biochemical analysis included HbA1c, FBG, and fasting insulin levels to calculate the HOMA-IR. Physical activity was assessed using the Global Physical Activity Questionnaire.

Results: Both groups experienced significant weight loss after 12 weeks. The IF + CR group showed a more pronounced weight reduction (-6.51%) compared to the CR group (-4.41%) (P < 0.001) and significant improvements in HbA1c levels, with a reduction to 6.51% compared to 6.86% in the CR group (P = 0.035). The absolute reduction in HbA1c showed a significantly greater median decrease in the IF + CR group [-0.50 (IQR - 0.60 to -0.35)] compared with the CR group [-0.20 (IQR - 0.40 to -0.10)] (P = 0.002). IF + CR demonstrated significant reductions in waist circumference (-4.64%) and hip circumference (-3.12%) compared to the CR (-2.70% and -0.86%, respectively) (P < 0.05). Furthermore, IF + CR showed greater reductions in body fat mass (-9.39%) compared to the CR (-5.32%) (P < 0.001). Physical activity levels were comparable, with average MET of 100 and sedentary hours of 15.7 ( ± 3) for IF + CR and 16.2 ( ± 2.3) for CR, (P = 0.134).

Conclusions: A 12-hour intermittent fasting (IF) regimen combined with calorie restriction (CR) demonstrated superior efficacy in promoting weight loss and improving glycemic control in patients with type 2 diabetes (T2D) compared to CR alone. Integrating IF into clinical nutrition guidelines could offer a practical and effective approach to diabetes management.

Clinical trial registration: The study was registered at the Pan African Clinical Trial Registry (PACTR202411524439559).

Background/objective: Hypercholesterolemia is a well-known risk factor for cardiovascular disease. This clinical trial evaluated the effects of TOTUM-070, a polyphenol-rich blend of plant extracts, on lipid metabolism in individuals with moderate hypercholesterolemia.

Subjects/methods: This was a 6-month, multicenter, randomized, double-blind, placebo-controlled trial. Individuals not receiving lipid-lowering treatment and with fasting low-density lipoprotein cholesterol (LDL-C) between 1.3 and 1.9 g/L received TOTUM-070 (5 g/day) or placebo. The primary outcome was the change in fasting LDL-C. Secondary endpoints included safety, changes in the lipid profile, anthropometric measurements, and gut microbiome composition.

Results: A total of 120 subjects (mean age:53.1 ± 10.3 years; BMI: 25.9 ± 3.7 kg.m²; 69.2% women; baseline LDL-C: 1.44 ± 0.23 g/L) were included and randomized. TOTUM-070 was well tolerated. After 6 months, fasting LDL-C was reduced in the TOTUM-070 group compared with the placebo group (Mean estimate: 1.31 ± 0.03 [1.25 ; 1.37] vs 1.41 ± 0.03 [1.35 ; 1.47], p = 0.0041). Compared with placebo, TOTUM-070 also reduced total cholesterol (p < 0.01), non-high-density lipoprotein cholesterol (non-HDL-C) (p < 0.001), triglycerides (p < 0.05), apolipoprotein (apo)B100 (p < 0.01), the apoB100/apoA1 ratio (p < 0.01), oxidized LDL (p < 0.05), and body weight (-1.4 kg; p < 0.001). Furthermore, a decrease in the abundance of Dorea in fecal samples was observed in the TOTUM-070 group.

Conclusions: This clinical trial showed that supplementation with TOTUM-070 significantly lowers LDL-C and improves other lipid parameters in subjects with moderate hypercholesterolemia. As a polyphenol-rich plant-based blend, TOTUM-070 represents a promising non-pharmacological strategy that could complement lifestyle modifications for the management of early-stage hypercholesterolemia.

Objective: To explore gender disparities in thyroid dysfunction within the elderly population.

Methods: This cross-sectional study was conducted among elderly individuals residing in Longxi County (Dingxi City, Gansu Province), Yuncheng County (Heze City, Shandong Province), and Tianjin, China. Urine and blood samples were collected, and thyroid volume was measured using thyroid ultrasonography to evaluate iodine nutritional status and thyroid function in the elderly.

Results: A total of 3397 elderly individuals were included in the study, comprising 1433 men and 1964 women. The median urinary iodine concentration (UIC) was 253.27  (interquartile range: 126.50-492.66) μg/L. The study revealed that the prevalence of thyroid nodules, goiter, positive thyroid antibodies, and thyroid dysfunction was significantly higher in women than in men (P < 0.05). With the increase in iodine nutrition levels, an upward trend in the prevalence of thyroid dysfunction is observed across both men and women elderly populations (P < 0.001). Logistic regression analysis demonstrated that elderly women had a significantly higher risk of thyroid nodules (OR: 1.79, 95% CI: 1.56-2.06), goiter (OR: 10.67, 95% CI: 5.18-22.01), positive thyroid antibodies (OR: 2.31, 95% CI: 1.90-2.81), and thyroid dysfunction (OR: 1.79, 95% CI: 1.51-2.09) compared with men.

Conclusions: Our findings highlight a significant sexual dimorphism in thyroid health among the elderly. Women consistently exhibited a higher risk of thyroid dysfunction, nodules, and autoimmunity compared to men, with this disparity remaining evident across all levels of iodine nutrition.

Background/objectives: The maternal immune system requires careful regulation during pregnancy to prevent complications such as preeclampsia and prematurity. Inflammatory immune states may be linked to maternal diet throughout pregnancy. Although gestational changes in cytokines are well-documented, the association with the inflammatory potential of diet has not been robustly explored. This study investigates the associations between maternal dietary inflammatory potential, measured by energy adjusted dietary inflammatory index (E-DII) in late pregnancy (28-32 weeks' gestation).

Subjects/methods: E-DII was calculated using 6-month food frequency questionnaires completed by pregnant mothers at 28-32 weeks' gestation. Serum cytokine levels from maternal blood samples were measured using Cobas® and ProteinSimple ELLA immunoassay, while PBMC derived cytokine levels were assessed using BioLegend LEGENDplex™.

Results: The study included 68 pregnant women, with a mean age (SD) at recruitment of 33.01(4.6) years and median BMI (IQR) of 24.95 (21.87, 27.57) kg/m². There was a positive association between E-DII and serum C3 complement protein in late pregnancy [β =0.057, p = 0.043]. A positive association between maternal E-DII and late pregnancy serum IL-17 levels was also observed [β = 0.156, p = 0.011]. A more pro-inflammatory diet in late pregnancy indicated by higher E-DII scores was associated with lower IL-10 secretion from PBMCs stimulated with anti-CD3/28/2 [β = -0.232, p = 0.049].

Conclusions: Diet may hold potential to promote optimal maternal inflammatory states. These data may inform nutritional guidelines to reduce pregnancy related complications, especially for mothers with higher background metabolic risk, such as those living with obesity.