Pub Date : 2025-04-30DOI: 10.1038/s41430-025-01617-x
Suzannah Helps, Gillian Mancz, Taraneh Dean
To describe the introduction of highly allergenic foods in a UK population sample, and to determine whether the introduction of highly allergenic foods differed in infants with family history of allergy. A population birth cohort study recruited eligible pregnant women while they were attending an antenatal ultrasound clinic appointment at a UK city hospital. Parent-reported family history of allergy and infant diet were collected through structured interviews at recruitment and postal questionnaires. Parents reported on their infants’ diet and introduction of highly allergenic foods at around 6 months (n = 216) and around 12 months (n = 193), and infant diet around 24 months of age (n = 139). Most highly allergenic foods were introduced to infants at around 6–9 months. However, nut and egg were introduced much later, and 21% of children had not been exposed to egg and 35% of infants had not been exposed to nuts by 12 months. Family history of allergy did not predict late introduction of any of the highly allergenic foods but infants with a family history of allergy were more likely to have diets that avoided foods due to allergy (most commonly dairy, soya, egg and nuts). The introduction of egg and nuts was delayed beyond one year of age in a large proportion of infants, and infants with a family history of allergy were more likely to have diets that avoided foods due to allergy. These could be modifiable risk factors for allergy development.
{"title":"Introduction time of highly allergenic foods to the infant diet in a UK cohort and association with a family history of allergy","authors":"Suzannah Helps, Gillian Mancz, Taraneh Dean","doi":"10.1038/s41430-025-01617-x","DOIUrl":"10.1038/s41430-025-01617-x","url":null,"abstract":"To describe the introduction of highly allergenic foods in a UK population sample, and to determine whether the introduction of highly allergenic foods differed in infants with family history of allergy. A population birth cohort study recruited eligible pregnant women while they were attending an antenatal ultrasound clinic appointment at a UK city hospital. Parent-reported family history of allergy and infant diet were collected through structured interviews at recruitment and postal questionnaires. Parents reported on their infants’ diet and introduction of highly allergenic foods at around 6 months (n = 216) and around 12 months (n = 193), and infant diet around 24 months of age (n = 139). Most highly allergenic foods were introduced to infants at around 6–9 months. However, nut and egg were introduced much later, and 21% of children had not been exposed to egg and 35% of infants had not been exposed to nuts by 12 months. Family history of allergy did not predict late introduction of any of the highly allergenic foods but infants with a family history of allergy were more likely to have diets that avoided foods due to allergy (most commonly dairy, soya, egg and nuts). The introduction of egg and nuts was delayed beyond one year of age in a large proportion of infants, and infants with a family history of allergy were more likely to have diets that avoided foods due to allergy. These could be modifiable risk factors for allergy development.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 9","pages":"912-920"},"PeriodicalIF":3.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-025-01617-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-28DOI: 10.1038/s41430-025-01622-0
Sara Asadi, Sara Grafenauer, Claire V. Burley, Caroline Fitzgerald, Peter Humburg, Belinda J. Parmenter
This study aimed to evaluate the impact of various dietary interventions on managing osteoarthritis (OA), a condition significantly affecting global health due to joint alterations driven by inflammatory mediators. A systematic review and meta-analysis, adhering to PRISMA guidelines, examined Randomized Controlled Trials (RCTs) investigating dietary interventions in OA. Two reviewers independently conducted study selection, data extraction, and quality assessment. Random effects models calculated standardized mean differences (SMD) and mean differences (MD). Risk of bias was evaluated with the Cochrane Risk of Bias tool (RoB2), and heterogeneity was assessed using I² values. Nine RCTs (898 participants) were identified, assessing various diets: reduced energy (n = 4), Mediterranean (n = 2), low-fat (n = 2), anti-inflammatory (n = 1), low-carbohydrate (n = 1), and plant-based (n = 1). Dietary interventions significantly improved pain (SMD: –0.67; 95% CI: [–1.01, –0.34]; p < 0.0001), and physical function (SMD: –0.62; 95% CI: [–0.94, –0.30]; p = 0.0001) and body weight (MD: –3.18; 95% CI: [–3.52, –2.83], p < 0.0001). Subgroup analyses revealed reduced energy diets improved pain (SMD: –0.85; 95% CI: [–1.15, –0.55], p < 0.0001), physical function (SMD: –0.95; 95% CI: [–1.33, –0.58], p < 0.0001) and body weight (MD: –3.13; 95% CI: [–3.77, –2.49], p < 0.0001). The Mediterranean diet did not significantly impact pain (SMD: –0.27; 95% CI: [–1.14, 0.60], P = 0.54), or physical function (SMD = –0.28; 95% CI: [–0.79, 0.24], p = 0.29). This study emphasizes the significant impact of dietary interventions on pain, physical function, and weight management in people with OA, with reduced energy diets showing the most effectiveness. Specific dietary patterns show promise but require further investigation.
{"title":"The effectiveness of dietary intervention in osteoarthritis management: a systematic review and meta-analysis of randomized clinical trials","authors":"Sara Asadi, Sara Grafenauer, Claire V. Burley, Caroline Fitzgerald, Peter Humburg, Belinda J. Parmenter","doi":"10.1038/s41430-025-01622-0","DOIUrl":"10.1038/s41430-025-01622-0","url":null,"abstract":"This study aimed to evaluate the impact of various dietary interventions on managing osteoarthritis (OA), a condition significantly affecting global health due to joint alterations driven by inflammatory mediators. A systematic review and meta-analysis, adhering to PRISMA guidelines, examined Randomized Controlled Trials (RCTs) investigating dietary interventions in OA. Two reviewers independently conducted study selection, data extraction, and quality assessment. Random effects models calculated standardized mean differences (SMD) and mean differences (MD). Risk of bias was evaluated with the Cochrane Risk of Bias tool (RoB2), and heterogeneity was assessed using I² values. Nine RCTs (898 participants) were identified, assessing various diets: reduced energy (n = 4), Mediterranean (n = 2), low-fat (n = 2), anti-inflammatory (n = 1), low-carbohydrate (n = 1), and plant-based (n = 1). Dietary interventions significantly improved pain (SMD: –0.67; 95% CI: [–1.01, –0.34]; p < 0.0001), and physical function (SMD: –0.62; 95% CI: [–0.94, –0.30]; p = 0.0001) and body weight (MD: –3.18; 95% CI: [–3.52, –2.83], p < 0.0001). Subgroup analyses revealed reduced energy diets improved pain (SMD: –0.85; 95% CI: [–1.15, –0.55], p < 0.0001), physical function (SMD: –0.95; 95% CI: [–1.33, –0.58], p < 0.0001) and body weight (MD: –3.13; 95% CI: [–3.77, –2.49], p < 0.0001). The Mediterranean diet did not significantly impact pain (SMD: –0.27; 95% CI: [–1.14, 0.60], P = 0.54), or physical function (SMD = –0.28; 95% CI: [–0.79, 0.24], p = 0.29). This study emphasizes the significant impact of dietary interventions on pain, physical function, and weight management in people with OA, with reduced energy diets showing the most effectiveness. Specific dietary patterns show promise but require further investigation.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 10","pages":"959-971"},"PeriodicalIF":3.3,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-025-01622-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-25DOI: 10.1038/s41430-025-01626-w
Fatemeh Kazeminasab, Maryam Baharlooie, Reza Bagheri, Sara K. Rosenkranz, Heitor O. Santos
Obesity can impair cardiometabolism, but low-carbohydrate diets (LCDs) may be beneficial for mitigating risk. We aimed to investigate the effects of LCDs versus low-fat diets (LFDs), under hypocaloric conditions, on flow-mediated dilation (FMD) in individuals with overweight/obesity. Secondarily, we assessed other cardiovascular markers (systolic blood pressure, diastolic blood pressure, C-reactive protein [CRP], high-density lipoprotein [HDL], low-density lipoprotein [LDL], triglycerides [TG], total cholesterol [TC]), and anthropometric and body composition measurements. PubMed, Scopus, and Web of Science were searched through May 2023 for studies involving hypocaloric LCDs versus LFDs on FMD. Meta-analyses were conducted for LCDs vs. LFDs to calculate weighted mean differences (WMD), including 10 studies reporting FMD (n = 475). Overall, hypocaloric LCDs resulted in a non-significant decrease in FMD compared with hypocaloric LFDs [WMD = −1.04% (95% CI −2.28 to 0.20), p = 0.10], while very-low-carbohydrate diets (VLCDs) significantly reduced FMD when compared with LFDs [WMD = −2.12% (95% CI: −3.35 to −0.9) p = 0.001]. LCDs did not change anthropometric and body composition measurements, nor CRP, blood pressure, HDL, or TC when compared with LFDs. However, LCDs significantly decreased TG [WMD = −19.94 mg/dL (95% CI −31.83 to −8.06), p = 0.001] and increased LDL [WMD = 20.00 mg/dL (95% CI 14.09 to 25.90), p = 0.001] when compared with LFDs. In conclusion, LCDs did not exert superior effects on cardiovascular markers or body composition when compared with LFDs in individuals with overweight or obesity, but LCDs reduced TG and increased LDL levels more than LFDs. Yet, vascular function (FMD) was reduced primarily for VLCDs.
{"title":"Hypocaloric low-carbohydrate versus low-fat diets on flow-mediated dilation, blood pressure, cardiovascular biomarkers, and body composition in individuals with overweight or obesity: a systematic review and meta-analysis of randomized clinical trials","authors":"Fatemeh Kazeminasab, Maryam Baharlooie, Reza Bagheri, Sara K. Rosenkranz, Heitor O. Santos","doi":"10.1038/s41430-025-01626-w","DOIUrl":"10.1038/s41430-025-01626-w","url":null,"abstract":"Obesity can impair cardiometabolism, but low-carbohydrate diets (LCDs) may be beneficial for mitigating risk. We aimed to investigate the effects of LCDs versus low-fat diets (LFDs), under hypocaloric conditions, on flow-mediated dilation (FMD) in individuals with overweight/obesity. Secondarily, we assessed other cardiovascular markers (systolic blood pressure, diastolic blood pressure, C-reactive protein [CRP], high-density lipoprotein [HDL], low-density lipoprotein [LDL], triglycerides [TG], total cholesterol [TC]), and anthropometric and body composition measurements. PubMed, Scopus, and Web of Science were searched through May 2023 for studies involving hypocaloric LCDs versus LFDs on FMD. Meta-analyses were conducted for LCDs vs. LFDs to calculate weighted mean differences (WMD), including 10 studies reporting FMD (n = 475). Overall, hypocaloric LCDs resulted in a non-significant decrease in FMD compared with hypocaloric LFDs [WMD = −1.04% (95% CI −2.28 to 0.20), p = 0.10], while very-low-carbohydrate diets (VLCDs) significantly reduced FMD when compared with LFDs [WMD = −2.12% (95% CI: −3.35 to −0.9) p = 0.001]. LCDs did not change anthropometric and body composition measurements, nor CRP, blood pressure, HDL, or TC when compared with LFDs. However, LCDs significantly decreased TG [WMD = −19.94 mg/dL (95% CI −31.83 to −8.06), p = 0.001] and increased LDL [WMD = 20.00 mg/dL (95% CI 14.09 to 25.90), p = 0.001] when compared with LFDs. In conclusion, LCDs did not exert superior effects on cardiovascular markers or body composition when compared with LFDs in individuals with overweight or obesity, but LCDs reduced TG and increased LDL levels more than LFDs. Yet, vascular function (FMD) was reduced primarily for VLCDs.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 10","pages":"945-958"},"PeriodicalIF":3.3,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-22DOI: 10.1038/s41430-025-01625-x
Andrea J. Glenn, Anne-Julie Tessier, Meaghan E. Kavanagh, Gloria A. Morgan, Clary B. Clish, Jordi Salas-Salvado, Vasanti S. Malik, Anthony J. Hanley, Richard P. Bazinet, Elena M. Comelli, Ahmed El-Sohemy, Simin Liu, Beatrice A. Boucher, Cyril W. C. Kendall, David J. A. Jenkins, Frank B. Hu, John L. Sievenpiper
Objective biomarkers of diet, such as metabolomics, may improve dietary assessment and provide additional insight into how diet influences disease risk. The portfolio diet, a cholesterol-lowering plant-based diet, is recommended for lowering low-density lipoprotein cholesterol (LDL-C). This diet is low in saturated fat and includes nuts, plant protein (legumes), viscous fiber, and phytosterols. We examined metabolomic profiles in response to the portfolio diet in two randomized controlled trials (RCTs), where all foods were provided to the participants, compared to a control vegetarian diet and the same control diet with a statin. The first RCT included 34 adults (age 58.4 ± 8.6 y) and the second RCT included 25 adults (age 61.0 ± 9.6 y), all with high LDL-C (>4.1 mmol/L). Plasma samples were obtained at baseline, week 2, and week 4 in both RCTs for metabolomics analysis using liquid chromatography–tandem mass spectrometry. Linear mixed models were used to examine effects of the interventions on the metabolites in each RCT, applying a Bonferroni correction. Of 496 known metabolites, 145 and 63 metabolites significantly changed within the portfolio diet interventions in the first and second RCT, respectively. The majority were glycerophosphocholines (32%), triacylglycerols (20%), glycerophosphoethanolamines (14%), sphingomyelins (8%), and amino acids and peptides (8%) in the first RCT, and glycerophosphocholines (48%), glycerophosphoethanolamines (17%), and amino acids and peptides (8%) in the second RCT. Fifty-two metabolites were consistently changed in the same direction with the portfolio diet intervention across both RCTs, after Bonferroni correction. Many of these metabolites likely reflect the plant-based nature, low saturated fat content, and cholesterol-lowering effects of the diet, such as increased N2-acetylornithine, L-pipecolic acid, lenticin, and decreased C18:0 lipids and cholesteryl esters. Further research is needed to validate these metabolites as biomarkers of a plant-based dietary pattern.
{"title":"Metabolomic profiling of a cholesterol lowering plant-based diet from two randomized controlled feeding trials","authors":"Andrea J. Glenn, Anne-Julie Tessier, Meaghan E. Kavanagh, Gloria A. Morgan, Clary B. Clish, Jordi Salas-Salvado, Vasanti S. Malik, Anthony J. Hanley, Richard P. Bazinet, Elena M. Comelli, Ahmed El-Sohemy, Simin Liu, Beatrice A. Boucher, Cyril W. C. Kendall, David J. A. Jenkins, Frank B. Hu, John L. Sievenpiper","doi":"10.1038/s41430-025-01625-x","DOIUrl":"10.1038/s41430-025-01625-x","url":null,"abstract":"Objective biomarkers of diet, such as metabolomics, may improve dietary assessment and provide additional insight into how diet influences disease risk. The portfolio diet, a cholesterol-lowering plant-based diet, is recommended for lowering low-density lipoprotein cholesterol (LDL-C). This diet is low in saturated fat and includes nuts, plant protein (legumes), viscous fiber, and phytosterols. We examined metabolomic profiles in response to the portfolio diet in two randomized controlled trials (RCTs), where all foods were provided to the participants, compared to a control vegetarian diet and the same control diet with a statin. The first RCT included 34 adults (age 58.4 ± 8.6 y) and the second RCT included 25 adults (age 61.0 ± 9.6 y), all with high LDL-C (>4.1 mmol/L). Plasma samples were obtained at baseline, week 2, and week 4 in both RCTs for metabolomics analysis using liquid chromatography–tandem mass spectrometry. Linear mixed models were used to examine effects of the interventions on the metabolites in each RCT, applying a Bonferroni correction. Of 496 known metabolites, 145 and 63 metabolites significantly changed within the portfolio diet interventions in the first and second RCT, respectively. The majority were glycerophosphocholines (32%), triacylglycerols (20%), glycerophosphoethanolamines (14%), sphingomyelins (8%), and amino acids and peptides (8%) in the first RCT, and glycerophosphocholines (48%), glycerophosphoethanolamines (17%), and amino acids and peptides (8%) in the second RCT. Fifty-two metabolites were consistently changed in the same direction with the portfolio diet intervention across both RCTs, after Bonferroni correction. Many of these metabolites likely reflect the plant-based nature, low saturated fat content, and cholesterol-lowering effects of the diet, such as increased N2-acetylornithine, L-pipecolic acid, lenticin, and decreased C18:0 lipids and cholesteryl esters. Further research is needed to validate these metabolites as biomarkers of a plant-based dietary pattern.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 9","pages":"863-875"},"PeriodicalIF":3.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-025-01625-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-18DOI: 10.1038/s41430-025-01621-1
Grace Austin, Jessica J. A. Ferguson, Shaun Eslick, Christopher Oldmeadow, Lisa G. Wood, Manohar L. Garg
Despite the healthful nature of plant-based diets (PBDs) there is potential for nutritional inadequacies. This study aimed to compare dietary intakes and nutritional adequacy in Australians following PBDs compared a regular meat-eating diet. A cross-sectional study of adults (n = 240) aged 30–75 yrs, habitually following dietary patterns for ≥6 months; vegan, lacto-vegetarian, pesco-vegetarian, semi-vegetarian or regular meat-eater (n = 48 per group). Dietary intakes were assessed using validated food frequency questionnaires and dietitian-administered diet histories. Multivariable regression adjusted for sex, age, BMI, race, energy intake and physical activity. Compared to regular meat-eaters, vegans and lacto-ovo vegetarians had significantly lower intakes of protein (4-5 EN%), saturated fat (2-4 EN%), trans fat, cholesterol, vitamin B12, iodine, riboflavin, niacin, sodium, and long-chain omega-3 polyunsaturated fatty acids (LCn-3PUFA), and higher carbohydrate (5-7 EN%), fibre, vitamin E, folate, magnesium, iron, and n-6PUFA, whereas, pesco-vegetarians and semi-vegetarians had intermediate intakes. Individuals following PBDs consumed significantly more daily serves of vegetables (1–1.5 serves), fruit (1 serve, vegan only), legumes/nuts (0.5–1 serves), and less discretionary choices (0.5–1 serves) compared to regular meat-eaters. All dietary patterns were adequate in protein, exceeded in fat, inadequate in carbohydrate and met recommended serves of fruit and vegetables, but not grains. Inadequate serves were observed for meat/poultry/eggs/beans/nuts among PBDs except pesco-vegetarians, and dairy among semi-vegetarians and regular meat-eaters. Vegans and lacto-vegetarians were inadequate in vitamin B12, LCn-3PUFA, iodine, and in addition calcium among vegans, iodine in pesco-vegetarians, and LCn-3PUFA in semi-vegetarians and regular meat-eaters. PBDs, while higher in beneficial nutrients and wholefood groups than regular meat-eaters, may lead to nutritional inadequacies if not planned appropriately.
{"title":"Dietary intakes and nutritional adequacy of Australians consuming plant-based diets compared to a regular meat-eating diet","authors":"Grace Austin, Jessica J. A. Ferguson, Shaun Eslick, Christopher Oldmeadow, Lisa G. Wood, Manohar L. Garg","doi":"10.1038/s41430-025-01621-1","DOIUrl":"10.1038/s41430-025-01621-1","url":null,"abstract":"Despite the healthful nature of plant-based diets (PBDs) there is potential for nutritional inadequacies. This study aimed to compare dietary intakes and nutritional adequacy in Australians following PBDs compared a regular meat-eating diet. A cross-sectional study of adults (n = 240) aged 30–75 yrs, habitually following dietary patterns for ≥6 months; vegan, lacto-vegetarian, pesco-vegetarian, semi-vegetarian or regular meat-eater (n = 48 per group). Dietary intakes were assessed using validated food frequency questionnaires and dietitian-administered diet histories. Multivariable regression adjusted for sex, age, BMI, race, energy intake and physical activity. Compared to regular meat-eaters, vegans and lacto-ovo vegetarians had significantly lower intakes of protein (4-5 EN%), saturated fat (2-4 EN%), trans fat, cholesterol, vitamin B12, iodine, riboflavin, niacin, sodium, and long-chain omega-3 polyunsaturated fatty acids (LCn-3PUFA), and higher carbohydrate (5-7 EN%), fibre, vitamin E, folate, magnesium, iron, and n-6PUFA, whereas, pesco-vegetarians and semi-vegetarians had intermediate intakes. Individuals following PBDs consumed significantly more daily serves of vegetables (1–1.5 serves), fruit (1 serve, vegan only), legumes/nuts (0.5–1 serves), and less discretionary choices (0.5–1 serves) compared to regular meat-eaters. All dietary patterns were adequate in protein, exceeded in fat, inadequate in carbohydrate and met recommended serves of fruit and vegetables, but not grains. Inadequate serves were observed for meat/poultry/eggs/beans/nuts among PBDs except pesco-vegetarians, and dairy among semi-vegetarians and regular meat-eaters. Vegans and lacto-vegetarians were inadequate in vitamin B12, LCn-3PUFA, iodine, and in addition calcium among vegans, iodine in pesco-vegetarians, and LCn-3PUFA in semi-vegetarians and regular meat-eaters. PBDs, while higher in beneficial nutrients and wholefood groups than regular meat-eaters, may lead to nutritional inadequacies if not planned appropriately.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 9","pages":"876-887"},"PeriodicalIF":3.3,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-025-01621-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to investigate the effectiveness of carotenoid-rich red palm olein (RPO) in treating or preventing xerophthalmia among Malaysian rural primary schoolchildren with confirmed vitamin A deficiency (VAD) (plasma retinol <0.70 µmol/L) and marginal vitamin A status (plasma retinol 0.70 to <1.05 µmol/L). A double-blinded, cluster randomized controlled trial was conducted on 504 schoolchildren aged 8–12 years from ten rural primary schools in Malaysia. The selected schools were randomly assigned into two groups: the experimental group (n = 249) received RPO-enriched biscuits (326.3 µg retinol equivalents/day), while the control group (n = 255) received palm olein (PO)-enriched biscuits for 6 months (4 days/week). Chi-square test and mixed effects logistic regression model were applied to examine the effects of supplementation on the resolution or prevention of xerophthalmia. After 6-month supplementation, a higher resolution rate of xerophthalmia (31.2%) was observed in the experimental group compared to the control group (24.1%), but this difference lacked statistical significance (p = 0.11). Nevertheless, the experimental group showed a significantly higher prevention rate of xerophthalmia (81.8%) or conjunctival xerosis (82.5%) than the control group (56.5% or 57.6%, respectively) after 6-month supplementation (p < 0.001). Moreover, schoolchildren in the experimental group were 4.8 times less likely to develop xerophthalmia compared to the control group. A 6-month supplementation of RPO-enriched biscuits demonstrated potential benefits in preventing xerophthalmia or conjunctival xerosis among vitamin A-deficient primary schoolchildren in rural areas of Malaysia. Therefore, RPO may offer a promising preventive solution to xerophthalmia for populations at a high risk of developing VAD. ClinicalTrials.gov (NCT03256123).
{"title":"Red palm olein supplementation as a potential preventive solution for xerophthalmia among vitamin A-deficient primary schoolchildren: a cluster randomized controlled trial","authors":"Pei Yee Tan, Chuan Chun Lim, Katherine Boon Hwei Seng, Radhika Loganathan, Yvonne Ai-Lian Lim, Kim-Tiu Teng, Syahirah Nadiah Mohd Johari, Kanga Rani Selvaduray, Norlina Ramli","doi":"10.1038/s41430-025-01620-2","DOIUrl":"10.1038/s41430-025-01620-2","url":null,"abstract":"This study aimed to investigate the effectiveness of carotenoid-rich red palm olein (RPO) in treating or preventing xerophthalmia among Malaysian rural primary schoolchildren with confirmed vitamin A deficiency (VAD) (plasma retinol <0.70 µmol/L) and marginal vitamin A status (plasma retinol 0.70 to <1.05 µmol/L). A double-blinded, cluster randomized controlled trial was conducted on 504 schoolchildren aged 8–12 years from ten rural primary schools in Malaysia. The selected schools were randomly assigned into two groups: the experimental group (n = 249) received RPO-enriched biscuits (326.3 µg retinol equivalents/day), while the control group (n = 255) received palm olein (PO)-enriched biscuits for 6 months (4 days/week). Chi-square test and mixed effects logistic regression model were applied to examine the effects of supplementation on the resolution or prevention of xerophthalmia. After 6-month supplementation, a higher resolution rate of xerophthalmia (31.2%) was observed in the experimental group compared to the control group (24.1%), but this difference lacked statistical significance (p = 0.11). Nevertheless, the experimental group showed a significantly higher prevention rate of xerophthalmia (81.8%) or conjunctival xerosis (82.5%) than the control group (56.5% or 57.6%, respectively) after 6-month supplementation (p < 0.001). Moreover, schoolchildren in the experimental group were 4.8 times less likely to develop xerophthalmia compared to the control group. A 6-month supplementation of RPO-enriched biscuits demonstrated potential benefits in preventing xerophthalmia or conjunctival xerosis among vitamin A-deficient primary schoolchildren in rural areas of Malaysia. Therefore, RPO may offer a promising preventive solution to xerophthalmia for populations at a high risk of developing VAD. ClinicalTrials.gov (NCT03256123).","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 9","pages":"928-936"},"PeriodicalIF":3.3,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-16DOI: 10.1038/s41430-025-01618-w
Pascal Tribolet, Carla Wunderle, Nina Kaegi-Braun, Lena Buchmueller, Rahel Laager, Zeno Stanga, Beat Mueller, Karl-Heinz Wagner, Philipp Schuetz
Handgrip strength (HGS) is a simple yet effective bed-side tool for assessing muscle strength, which plays an important role in clinical evaluation and monitoring. We hypothesize that repeated measurements of HGS during the hospital stay may serve as a reliable and robust indicator of clinical course and outcomes. We re-analyzed data from 565 out of 2028 patients who had repeated handgrip measurement (on admission and on day 7) included in EFFORT, a Swiss-wide multicenter, randomized controlled trial comparing individualized nutritional support with usual care nutrition in medical inpatients. The primary endpoint was 180-day all-cause mortality. The mean change in HGS from baseline to day 7 was 0.6 kg (SD 4.2) in female and 0.7 kg (SD 3.7) in male patients. Patients with a positive HGS trend had a lower risk of dying within 180 days compared to patients without a positive trend (mortality 11.4% vs. 25.4%, adjusted HR 0.45 [95% CI 0.27 to 0.77], p = 0.003). The change in HGS was also associated with the nutritional intake during the hospitalization in male patients: those who met their energy and protein targets were twice as likely to have an increase in HGS during hospitalization (adjusted OR 2.05 [95% CI 1.23 to 3.42], p = 0.006). Achieving nutritional targets was associated with a short-term increase in HGS during hospitalization, and a positive HGS trend was associated with a lower risk of mortality after 180 days. These data provide evidence that repeated HGS measurements are a robust bedside tool for assessing and monitoring patients receiving nutritional therapy in the hospital. ClinicalTrials.gov Identifier: NCT02517476
背景：握力（Handgrip strength， HGS）是一种简单而有效的床边肌肉力量评估工具，在临床评估和监测中具有重要作用。我们假设在住院期间重复测量HGS可以作为临床过程和结果的可靠和强有力的指标。方法：我们重新分析了2028名患者中的565名患者的数据，这些患者在入院时和第7天进行了反复的握力测量，这是一项瑞士范围内的多中心随机对照试验，比较了住院医疗患者的个性化营养支持和常规护理营养。主要终点为180天全因死亡率。结果：女性患者HGS从基线到第7天的平均变化为0.6 kg (SD 4.2)，男性患者为0.7 kg （SD 3.7）。与无HGS阳性趋势的患者相比，HGS阳性趋势的患者在180天内死亡的风险较低（死亡率11.4% vs. 25.4%，调整HR 0.45 [95% CI 0.27 ~ 0.77], p = 0.003）。HGS的变化还与男性患者住院期间的营养摄入有关：达到能量和蛋白质目标的患者住院期间HGS增加的可能性是男性患者的两倍（调整OR为2.05 [95% CI 1.23至3.42],p = 0.006）。结论：达到营养目标与住院期间HGS的短期升高相关，HGS的阳性趋势与180天后较低的死亡风险相关。这些数据提供了证据，证明重复HGS测量是评估和监测在医院接受营养治疗的患者的有力床边工具。试验注册：ClinicalTrials.gov标识符：NCT02517476。
{"title":"Evaluating repeated handgrip strength measurements as predictors of mortality in malnourished hospitalized patients. Secondary analysis of a randomized controlled trial","authors":"Pascal Tribolet, Carla Wunderle, Nina Kaegi-Braun, Lena Buchmueller, Rahel Laager, Zeno Stanga, Beat Mueller, Karl-Heinz Wagner, Philipp Schuetz","doi":"10.1038/s41430-025-01618-w","DOIUrl":"10.1038/s41430-025-01618-w","url":null,"abstract":"Handgrip strength (HGS) is a simple yet effective bed-side tool for assessing muscle strength, which plays an important role in clinical evaluation and monitoring. We hypothesize that repeated measurements of HGS during the hospital stay may serve as a reliable and robust indicator of clinical course and outcomes. We re-analyzed data from 565 out of 2028 patients who had repeated handgrip measurement (on admission and on day 7) included in EFFORT, a Swiss-wide multicenter, randomized controlled trial comparing individualized nutritional support with usual care nutrition in medical inpatients. The primary endpoint was 180-day all-cause mortality. The mean change in HGS from baseline to day 7 was 0.6 kg (SD 4.2) in female and 0.7 kg (SD 3.7) in male patients. Patients with a positive HGS trend had a lower risk of dying within 180 days compared to patients without a positive trend (mortality 11.4% vs. 25.4%, adjusted HR 0.45 [95% CI 0.27 to 0.77], p = 0.003). The change in HGS was also associated with the nutritional intake during the hospitalization in male patients: those who met their energy and protein targets were twice as likely to have an increase in HGS during hospitalization (adjusted OR 2.05 [95% CI 1.23 to 3.42], p = 0.006). Achieving nutritional targets was associated with a short-term increase in HGS during hospitalization, and a positive HGS trend was associated with a lower risk of mortality after 180 days. These data provide evidence that repeated HGS measurements are a robust bedside tool for assessing and monitoring patients receiving nutritional therapy in the hospital. ClinicalTrials.gov Identifier: NCT02517476","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 9","pages":"897-903"},"PeriodicalIF":3.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Postmenopausal women are often reported to exhibit increased susceptibility to metabolic disorders. Although the consumption of low glycaemic index (LGI) foods before exercise are known to enhance fat oxidation during exercise, the optimal exercise timing has not been evaluated. We investigated the effects of pre-exercise meals with different GI values and exercise timings on substrate metabolism and appetite in postmenopausal women. Fifteen postmenopausal women completed four trials in a random manner. Participants consumed energy-matched high GI (HGI) or LGI meal at 0900 and rested until 1000 (60 min-HGI and -LGI trials) or 1100 (120 min-HGI and -LGI trials). Then, participants performed a 30-min walk at 50% of estimated maximum oxygen uptake and rested until 1300. Expired air, blood samples, ratings of food reward and subjective appetite were collected. No differences in fat oxidation during exercise were observed among trials (P = 0.66). The area under the curve of 3-hydroxybutyrate was higher in the 120 min-LGI trial compared to the 60 min-LGI trial (P = 0.01) after exercise. Relative preference for high-fat foods after exercise and subjective appetite during post-exercise for 1-hour were not different between the 60 min-LGI and 120 min-LGI trials. These findings indicate that a different timing of pre-exercise LGI meal did not influence fat oxidation during exercise, post-exercise food reward or subjective appetite in postmenopausal women. However, a longer interval between meal consumption and subsequent exercise may be effective in enhancing post-exercise hepatic fatty acid oxidation.
{"title":"Acute effects of pre-exercise high and low glycaemic index meals and exercise timings on substrate metabolism and appetite in postmenopausal women","authors":"Miki Sakazaki, Yoshiki Yamada, Yibin Li, Masashi Miyashita","doi":"10.1038/s41430-025-01615-z","DOIUrl":"10.1038/s41430-025-01615-z","url":null,"abstract":"Postmenopausal women are often reported to exhibit increased susceptibility to metabolic disorders. Although the consumption of low glycaemic index (LGI) foods before exercise are known to enhance fat oxidation during exercise, the optimal exercise timing has not been evaluated. We investigated the effects of pre-exercise meals with different GI values and exercise timings on substrate metabolism and appetite in postmenopausal women. Fifteen postmenopausal women completed four trials in a random manner. Participants consumed energy-matched high GI (HGI) or LGI meal at 0900 and rested until 1000 (60 min-HGI and -LGI trials) or 1100 (120 min-HGI and -LGI trials). Then, participants performed a 30-min walk at 50% of estimated maximum oxygen uptake and rested until 1300. Expired air, blood samples, ratings of food reward and subjective appetite were collected. No differences in fat oxidation during exercise were observed among trials (P = 0.66). The area under the curve of 3-hydroxybutyrate was higher in the 120 min-LGI trial compared to the 60 min-LGI trial (P = 0.01) after exercise. Relative preference for high-fat foods after exercise and subjective appetite during post-exercise for 1-hour were not different between the 60 min-LGI and 120 min-LGI trials. These findings indicate that a different timing of pre-exercise LGI meal did not influence fat oxidation during exercise, post-exercise food reward or subjective appetite in postmenopausal women. However, a longer interval between meal consumption and subsequent exercise may be effective in enhancing post-exercise hepatic fatty acid oxidation.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 12","pages":"1218-1226"},"PeriodicalIF":3.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-025-01615-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Glycogen storage diseases type VI (GSD-VI) and type IX (GSD-IX) are rare inherited metabolic disorders caused by enzyme deficiencies that disrupt glycogen metabolism. The aim of this study was to analyze the clinical features, nutritional management and geno-phenotyping of clinical nutrition in a cohort of patients with GSD-VI and GSD-IX. A retrospective cohort study was conducted with 16 patients with GSD-VI and GSD-IX. Demographic characteristics, clinical and laboratory findings, and nutritional treatment outcomes were collected and analyzed. The mean patient age was 10.57 years (±4.81). The distribution of the diagnoses was as follows: GSD-IXa (3), GSD-IXb (6), GSD-IXc (1), and GSD-VI (6). The average age at diagnosis was 36.5 months (±42.2) (13–114 months) in the GSD-VI group. Among the GSD-IX subgroups, the mean age at diagnosis varied: 23.3months (±4.16) for GSD-IXa, 35.7months (±17.5) for GSD-IXb, and 78months for GSD-IXc. Over the course of the study (4.5 ± 1.77 years), protein intake in GSD VI patients increased by 1.05 g/kg/day (91.3% increase), while in GSD IX patients, it rose by 1.09 g/kg/day (94% rise). Uncooked cornstarch (UCS) started at 1 g/kg/day for GSD-VI and 0.85 g/kg/day for GSD-IX, later reduced to 0.71 g/kg/day (29% decrease) and 0.52 g/kg/day (60% reduction), respectively. Overall, this paper provides valuable insights into managing GSDVI and GSDIX patients, emphasizing the role of a high-protein diet aligned with the disease’s pathophysiology and the potential of genotyping to enhance nutritional treatment protocols.
{"title":"Nutritional management and geno-phenotyping of clinical nutrition in patients with glycogen storage diseases type VI and IX","authors":"Sema Kalkan Uçar, Alperen Elek, Havva Yazıcı, Yasemin Atik Altınok, Ayşe Yüksel Yanbolu, Fehime Erdem, Merve Yoldaş Çelik, Ayça Aykut, Asude Durmaz, Ebru Canda, Mahmut Çoker","doi":"10.1038/s41430-025-01614-0","DOIUrl":"10.1038/s41430-025-01614-0","url":null,"abstract":"Glycogen storage diseases type VI (GSD-VI) and type IX (GSD-IX) are rare inherited metabolic disorders caused by enzyme deficiencies that disrupt glycogen metabolism. The aim of this study was to analyze the clinical features, nutritional management and geno-phenotyping of clinical nutrition in a cohort of patients with GSD-VI and GSD-IX. A retrospective cohort study was conducted with 16 patients with GSD-VI and GSD-IX. Demographic characteristics, clinical and laboratory findings, and nutritional treatment outcomes were collected and analyzed. The mean patient age was 10.57 years (±4.81). The distribution of the diagnoses was as follows: GSD-IXa (3), GSD-IXb (6), GSD-IXc (1), and GSD-VI (6). The average age at diagnosis was 36.5 months (±42.2) (13–114 months) in the GSD-VI group. Among the GSD-IX subgroups, the mean age at diagnosis varied: 23.3months (±4.16) for GSD-IXa, 35.7months (±17.5) for GSD-IXb, and 78months for GSD-IXc. Over the course of the study (4.5 ± 1.77 years), protein intake in GSD VI patients increased by 1.05 g/kg/day (91.3% increase), while in GSD IX patients, it rose by 1.09 g/kg/day (94% rise). Uncooked cornstarch (UCS) started at 1 g/kg/day for GSD-VI and 0.85 g/kg/day for GSD-IX, later reduced to 0.71 g/kg/day (29% decrease) and 0.52 g/kg/day (60% reduction), respectively. Overall, this paper provides valuable insights into managing GSDVI and GSDIX patients, emphasizing the role of a high-protein diet aligned with the disease’s pathophysiology and the potential of genotyping to enhance nutritional treatment protocols.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 8","pages":"723-730"},"PeriodicalIF":3.3,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-025-01614-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-08DOI: 10.1038/s41430-025-01616-y
Andrea Tur-Boned, Lars Louis Andersen, Rubén López-Bueno, Rodrigo Núñez-Cortés, Carlos Cruz-Montecinos, Luis Suso-Martí, Ana Polo-López, Joaquín Calatayud
Since muscle strength is modifiable and handgrip strength is a reliable biomarker for strength and mortality, exploring its association with mortality in individuals with severe obesity could help identify protective thresholds. We aimed to examine the dose-response association between handgrip strength and mortality in adults with severe obesity. We retrieved data from the Survey of Health, Ageing and Retirement in Europe (SHARE). Handgrip strength was measured in participants with a body mass index (BMI) higher than 40 kg/m2. We used time-varying Cox proportional hazards regression to assess the association between handgrip strength and all-cause mortality risk. To account for potential non-linearity, we employed restricted cubic splines. We examined a total of 2229 adults (67.9% women; BMI of 43.8 kg/m2). We found an association between handgrip strength and mortality, showing a minimal and optimal dose for a reduced risk with 31 kg (HR 0.97, 95% CI, 0.96–0.99) and 36 kg (HR 0.90, 95% CI, 0.81–0.99), respectively. Additional sex-stratified analysis showed that lower than median levels of handgrip strength were gradually associated with increased risk in both men and women. The association between handgrip strength and all-cause mortality in European adults with severe obesity highlights practical thresholds for risk reduction, with 31 kg as the minimum and 36 kg as the optimal strength level. In both men and women, handgrip strength below the median was linked to a gradual increase in mortality risk, emphasizing the importance of maintaining adequate muscle strength to improve health outcomes.
背景/目的：由于肌肉力量是可改变的，握力是力量和死亡率的可靠生物标志物，探索其与严重肥胖患者死亡率的关系有助于确定保护阈值。我们的目的是研究严重肥胖成人握力与死亡率之间的剂量反应关系。研究对象/方法：我们从欧洲健康、老龄化和退休调查（SHARE）中检索数据。在体重指数（BMI）高于40 kg/m2的参与者中测量握力。我们使用时变Cox比例风险回归来评估握力与全因死亡风险之间的关系。为了考虑潜在的非线性，我们采用了受限三次样条。我们共检查了2229名成年人(67.9%为女性；BMI为43.8 kg/m2)。结果：我们发现握力与死亡率之间存在关联，显示最小和最佳剂量分别为31 kg （HR 0.97, 95% CI, 0.96-0.99）和36 kg （HR 0.90, 95% CI, 0.81-0.99）。另外的性别分层分析显示，握力低于中位数水平与男性和女性的风险增加逐渐相关。结论：握力与欧洲严重肥胖成人全因死亡率之间的关系突出了降低风险的实际阈值，最小握力为31 kg，最佳握力为36 kg。在男性和女性中，低于中位数的握力与死亡风险的逐渐增加有关，这强调了保持足够的肌肉力量对改善健康结果的重要性。
{"title":"Beyond body mass index: the role of muscle strength in reducing mortality risk in older adults with severe obesity – multi-country cohort study","authors":"Andrea Tur-Boned, Lars Louis Andersen, Rubén López-Bueno, Rodrigo Núñez-Cortés, Carlos Cruz-Montecinos, Luis Suso-Martí, Ana Polo-López, Joaquín Calatayud","doi":"10.1038/s41430-025-01616-y","DOIUrl":"10.1038/s41430-025-01616-y","url":null,"abstract":"Since muscle strength is modifiable and handgrip strength is a reliable biomarker for strength and mortality, exploring its association with mortality in individuals with severe obesity could help identify protective thresholds. We aimed to examine the dose-response association between handgrip strength and mortality in adults with severe obesity. We retrieved data from the Survey of Health, Ageing and Retirement in Europe (SHARE). Handgrip strength was measured in participants with a body mass index (BMI) higher than 40 kg/m2. We used time-varying Cox proportional hazards regression to assess the association between handgrip strength and all-cause mortality risk. To account for potential non-linearity, we employed restricted cubic splines. We examined a total of 2229 adults (67.9% women; BMI of 43.8 kg/m2). We found an association between handgrip strength and mortality, showing a minimal and optimal dose for a reduced risk with 31 kg (HR 0.97, 95% CI, 0.96–0.99) and 36 kg (HR 0.90, 95% CI, 0.81–0.99), respectively. Additional sex-stratified analysis showed that lower than median levels of handgrip strength were gradually associated with increased risk in both men and women. The association between handgrip strength and all-cause mortality in European adults with severe obesity highlights practical thresholds for risk reduction, with 31 kg as the minimum and 36 kg as the optimal strength level. In both men and women, handgrip strength below the median was linked to a gradual increase in mortality risk, emphasizing the importance of maintaining adequate muscle strength to improve health outcomes.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 8","pages":"787-792"},"PeriodicalIF":3.3,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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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