The Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT) identifies nutritional risk in patients with liver disease, an important factor in cirrhosis outcomes. Recognizing the gap in existing prognostic models, which often overlook malnutrition, we developed and validated an RFH-NPT-based model for predicting outcomes of patients with cirrhosis. This study included inpatients with cirrhosis from a single center between February and July 2016 (training cohort) and patients from six other medical centers admitted between December 2011 and May 2022 (validation cohort). RFH-NPT assessment was conducted at admission, followed by a 5-year follow-up. A nomogram was created using prognostic variables from Cox modeling, best subset regression (BSR), and least absolute shrinkage and selection operator (LASSO) regression. Its performance was evaluated using various statistical methods and compared with that of existing models such as the Child‒Pugh, MELD, and MELD-Na. A total of 152 patients were included in the training cohort. The nutritional risk was significantly greater in nonsurvivors (81.1%) than in survivors (46.5%). The nomogram showed better accuracy in predicting 1-, 3-, and 5-year survival than traditional methods. The nomogram’s effectiveness was confirmed in the validation cohort of 320 patients. This study re-emphasizes the critical role of malnutrition in patients with liver cirrhosis and establishes an effective RFH-NPT-based model for outcome prediction. This study is registered at Clinicaltrials.gov (NCT05513651).
{"title":"An RFH-NPT-based nomogram for predicting the long-term survival of liver cirrhosis patients: a multicenter study","authors":"Chengbin Zhu, Yuchao Wu, Fulian Zhao, Ruojing Wang, Qijuan Zang, Zhe Jiao, Yage Zhu, Taotao Yan, Juan Du, Li Zhu, Weimin Li, Yongqin Li, Qing Fan, Anping Wu, Xiaodan Liu, Dianzu Liu, Xianmei Tang, Xiaoxiao Xu, Huaying Liao, Yu Li, Yingren Zhao, Yingli He, Yuan Yang","doi":"10.1038/s41430-025-01648-4","DOIUrl":"10.1038/s41430-025-01648-4","url":null,"abstract":"The Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT) identifies nutritional risk in patients with liver disease, an important factor in cirrhosis outcomes. Recognizing the gap in existing prognostic models, which often overlook malnutrition, we developed and validated an RFH-NPT-based model for predicting outcomes of patients with cirrhosis. This study included inpatients with cirrhosis from a single center between February and July 2016 (training cohort) and patients from six other medical centers admitted between December 2011 and May 2022 (validation cohort). RFH-NPT assessment was conducted at admission, followed by a 5-year follow-up. A nomogram was created using prognostic variables from Cox modeling, best subset regression (BSR), and least absolute shrinkage and selection operator (LASSO) regression. Its performance was evaluated using various statistical methods and compared with that of existing models such as the Child‒Pugh, MELD, and MELD-Na. A total of 152 patients were included in the training cohort. The nutritional risk was significantly greater in nonsurvivors (81.1%) than in survivors (46.5%). The nomogram showed better accuracy in predicting 1-, 3-, and 5-year survival than traditional methods. The nomogram’s effectiveness was confirmed in the validation cohort of 320 patients. This study re-emphasizes the critical role of malnutrition in patients with liver cirrhosis and establishes an effective RFH-NPT-based model for outcome prediction. This study is registered at Clinicaltrials.gov (NCT05513651).","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"80 1","pages":"87-95"},"PeriodicalIF":3.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741709","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 : 2025-07-26DOI: 10.1038/s41430-025-01651-9
Ana Nava-Cabrera, Armando Ramírez-Cruz, Araceli Pérez-Bautista, Alan Canul-Ayil, Gloria Chi-Díaz, Elena Flores-Guillén, Miguel Vazquez-Moreno, Miguel Cruz
Serum total antioxidant capacity (sTAC) and uric acid (SUA) levels have been related to oxidative stress in metabolic diseases. Nevertheless, the evidence in epidemiological studies is still scarce and inconsistent. We aimed to evaluate the association between sTAC, SUA, obesity, and cardiometabolic traits in Mexican children. This cross-sectional study analyzed anthropometric data, blood pressure, cardiometabolic traits, and SUA levels of 248 children with normal weight (NW) and 255 with obesity (OB). sTAC was measured with the 2,2-diphenyl-1-picrylhydrazyl (DPPH) method. sTAC was directly related to SUA (β = 0.905 ± 0.358, p = 0.012). Obesity was positively associated with sTAC (β = 0.075 ± 0.020, p < 0.001) and SUA (β = 0.706 ± 0.129, p < 0.001). sTAC was negatively associated with diastolic blood pressure (β = -8.458 ± 3.758, p = 0.026) in NW children and positively associated with insulin (β = 9.511 ± 3.107, p = 0.002) and the homeostatic model assessment of insulin resistance (β = 2.065 ± 0.680, p = 0.003) in OB children. SUA showed negative associations with total cholesterol (β = -4.062 ± 1.340, p = 0.003) and low-density lipoprotein cholesterol (β = -2.470 ± 1.190, p = 0.039) in NW children and high-density lipoprotein cholesterol (β = -1.306 ± 0.409, p < 0.01) in OB children. sTAC and SUA are positively associated and are increased in obesity. According to weight status, sTAC and SUA are associated with blood pressure, insulin resistance markers, and lipid profile.
{"title":"Association of serum total antioxidant capacity and uric acid with obesity and cardiometabolic traits in Mexican children","authors":"Ana Nava-Cabrera, Armando Ramírez-Cruz, Araceli Pérez-Bautista, Alan Canul-Ayil, Gloria Chi-Díaz, Elena Flores-Guillén, Miguel Vazquez-Moreno, Miguel Cruz","doi":"10.1038/s41430-025-01651-9","DOIUrl":"10.1038/s41430-025-01651-9","url":null,"abstract":"Serum total antioxidant capacity (sTAC) and uric acid (SUA) levels have been related to oxidative stress in metabolic diseases. Nevertheless, the evidence in epidemiological studies is still scarce and inconsistent. We aimed to evaluate the association between sTAC, SUA, obesity, and cardiometabolic traits in Mexican children. This cross-sectional study analyzed anthropometric data, blood pressure, cardiometabolic traits, and SUA levels of 248 children with normal weight (NW) and 255 with obesity (OB). sTAC was measured with the 2,2-diphenyl-1-picrylhydrazyl (DPPH) method. sTAC was directly related to SUA (β = 0.905 ± 0.358, p = 0.012). Obesity was positively associated with sTAC (β = 0.075 ± 0.020, p < 0.001) and SUA (β = 0.706 ± 0.129, p < 0.001). sTAC was negatively associated with diastolic blood pressure (β = -8.458 ± 3.758, p = 0.026) in NW children and positively associated with insulin (β = 9.511 ± 3.107, p = 0.002) and the homeostatic model assessment of insulin resistance (β = 2.065 ± 0.680, p = 0.003) in OB children. SUA showed negative associations with total cholesterol (β = -4.062 ± 1.340, p = 0.003) and low-density lipoprotein cholesterol (β = -2.470 ± 1.190, p = 0.039) in NW children and high-density lipoprotein cholesterol (β = -1.306 ± 0.409, p < 0.01) in OB children. sTAC and SUA are positively associated and are increased in obesity. According to weight status, sTAC and SUA are associated with blood pressure, insulin resistance markers, and lipid profile.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"80 1","pages":"73-78"},"PeriodicalIF":3.3,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717750","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 : 2025-07-26DOI: 10.1038/s41430-025-01639-5
Saskia Akyil, Stefanie Winkler, Dorothy Meyer, Eva Kiesswetter, Martin Kussmann, Lukas Schwingshackl, Hans Hauner
Food-based dietary guidelines acknowledge non-fortified dairy foods as a source of multiple essential vitamins and minerals as well as high-quality protein. Considering the cultural significance of dairy foods in our diet and the increasing prevalence of non-communicable diseases, it is essential to continuously evaluate the entirety of data regarding the impact of dairy consumption on various health-related outcomes. A systematic literature search was performed in three databases: Medline, Embase, and Web of Science. Systematic reviews published between January 2014 and February 2024 based on randomized controlled trials (RCTs), prospective cohort studies, case-control studies, and/or cross-sectional studies in adults, focusing on the consumption of bovine dairy products were evaluated for inclusion. Reports from the World Cancer Research Fund on selected cancer outcomes were also included in this review. We identified 95 reports encompassing five dairy exposure categories on 29 different health outcomes. Out of 281 associations identified, 37.7% linked dairy consumption to a reduced risk, while 48.0% showed no association with disease risk. Inconclusive results were found in 10.0% of the associations, and 4.3% indicated an increased risk of adverse health outcomes. Overall, the evidence suggests that consuming dairy is not associated with an increased risk of non-communicable diseases or mortality. In fact, it may moderately reduce the risk of several health outcomes, including adverse cardiovascular outcomes and certain cancers such as bladder, breast, colorectal, liver, oral, and ovarian. Some studies have also linked dairy consumption to improved body composition, lower rates of type 2 diabetes, and better bone health.
以食物为基础的膳食指南承认，非强化乳制品是多种必需维生素和矿物质以及高质量蛋白质的来源。考虑到乳制品在我们饮食中的文化意义以及非传染性疾病的日益流行，有必要持续评估有关乳制品消费对各种健康相关结果影响的全部数据。在三个数据库中进行了系统的文献检索：Medline、Embase和Web of Science。2014年1月至2024年2月间发表的基于随机对照试验（rct）、前瞻性队列研究、病例对照研究和/或成人横断面研究的系统评价，重点是牛乳制品的消费。世界癌症研究基金会关于某些癌症结果的报告也包括在本综述中。我们确定了95份报告，其中包括5种乳制品暴露类别，涉及29种不同的健康结果。在确定的281个关联中，37.7%将乳制品消费与风险降低联系起来，而48.0%显示与疾病风险无关。在10.0%的关联中发现了不确定的结果，4.3%表明不良健康结果的风险增加。总的来说，有证据表明，食用乳制品与非传染性疾病或死亡率的风险增加无关。事实上，它可以适度降低几种健康结果的风险，包括不良心血管结果和某些癌症，如膀胱癌、乳腺癌、结肠直肠癌、肝癌、口腔癌和卵巢癌。一些研究还将乳制品与改善身体成分、降低2型糖尿病发病率和改善骨骼健康联系起来。
{"title":"Association between dairy intake and multiple health outcomes: a scoping review of systematic reviews and meta-analyses","authors":"Saskia Akyil, Stefanie Winkler, Dorothy Meyer, Eva Kiesswetter, Martin Kussmann, Lukas Schwingshackl, Hans Hauner","doi":"10.1038/s41430-025-01639-5","DOIUrl":"10.1038/s41430-025-01639-5","url":null,"abstract":"Food-based dietary guidelines acknowledge non-fortified dairy foods as a source of multiple essential vitamins and minerals as well as high-quality protein. Considering the cultural significance of dairy foods in our diet and the increasing prevalence of non-communicable diseases, it is essential to continuously evaluate the entirety of data regarding the impact of dairy consumption on various health-related outcomes. A systematic literature search was performed in three databases: Medline, Embase, and Web of Science. Systematic reviews published between January 2014 and February 2024 based on randomized controlled trials (RCTs), prospective cohort studies, case-control studies, and/or cross-sectional studies in adults, focusing on the consumption of bovine dairy products were evaluated for inclusion. Reports from the World Cancer Research Fund on selected cancer outcomes were also included in this review. We identified 95 reports encompassing five dairy exposure categories on 29 different health outcomes. Out of 281 associations identified, 37.7% linked dairy consumption to a reduced risk, while 48.0% showed no association with disease risk. Inconclusive results were found in 10.0% of the associations, and 4.3% indicated an increased risk of adverse health outcomes. Overall, the evidence suggests that consuming dairy is not associated with an increased risk of non-communicable diseases or mortality. In fact, it may moderately reduce the risk of several health outcomes, including adverse cardiovascular outcomes and certain cancers such as bladder, breast, colorectal, liver, oral, and ovarian. Some studies have also linked dairy consumption to improved body composition, lower rates of type 2 diabetes, and better bone health.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"80 1","pages":"16-27"},"PeriodicalIF":3.3,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-025-01639-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717749","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 : 2025-07-24DOI: 10.1038/s41430-025-01650-w
Tonghui Shen, Alice E. Thackray, Jack A. Sargeant, Thomas Yates, James A. King, Scott A. Willis, David J. Stensel
{"title":"Correction: The acute effects of moderate-intensity continuous or high-intensity interval exercise on appetite and appetite-related hormones in South Asian and white European adults with non-diabetic hyperglycaemia","authors":"Tonghui Shen, Alice E. Thackray, Jack A. Sargeant, Thomas Yates, James A. King, Scott A. Willis, David J. Stensel","doi":"10.1038/s41430-025-01650-w","DOIUrl":"10.1038/s41430-025-01650-w","url":null,"abstract":"","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 12","pages":"1245-1245"},"PeriodicalIF":3.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-025-01650-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706845","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 : 2025-07-24DOI: 10.1038/s41430-025-01647-5
Daisy H. Coyle, Liping Huang, Monica Hu, Nadine Ghammachi, Simone Pettigrew, Jason H. Y. Wu
Most reformulation initiatives worldwide are implemented through voluntary measures. Despite the reliance on voluntary targets, there is limited evidence of their effectiveness. This study aimed to assess the impact of Australia’s voluntary sodium and saturated fat reformulation policy halfway through its four-year implementation period. The 2019 and 2022 FoodSwitch databases provided data on the nutritional composition of packaged foods sold by major Australian supermarket retailers. For the food categories targeted by the policy, we assessed changes between 2019 and 2022 in (i) the overall proportions of products that met the sodium and saturated fat targets and (ii) changes in the proportion of products meeting the targets across the top 10 leading food manufacturers. Between 2019 and 2022, there was a small increase in the proportion of products meeting the sodium targets (50.0% in 2019 versus 57.5% in 2022, p < 0.001). Across the top 10 manufacturers that sold products subject to a sodium target, seven made progress towards meeting the targets (ranging from +1.6% to +30.2%). For saturated fat, the proportion of products meeting the targets didn’t change (61.1% in 2019 versus 60.2% in 2022, p = 0.74) and nine of the 10 top manufacturers did not make any progress towards meeting the targets. Midway through the implementation period of Australia’s voluntary sodium and saturated fat targets, food manufacturers have made minimal progress towards meeting the targets, especially for saturated fat.
{"title":"Assessing the impact of voluntary food reformulation targets: Mid-point assessment of Australia’s voluntary sodium and saturated fat reduction policy","authors":"Daisy H. Coyle, Liping Huang, Monica Hu, Nadine Ghammachi, Simone Pettigrew, Jason H. Y. Wu","doi":"10.1038/s41430-025-01647-5","DOIUrl":"10.1038/s41430-025-01647-5","url":null,"abstract":"Most reformulation initiatives worldwide are implemented through voluntary measures. Despite the reliance on voluntary targets, there is limited evidence of their effectiveness. This study aimed to assess the impact of Australia’s voluntary sodium and saturated fat reformulation policy halfway through its four-year implementation period. The 2019 and 2022 FoodSwitch databases provided data on the nutritional composition of packaged foods sold by major Australian supermarket retailers. For the food categories targeted by the policy, we assessed changes between 2019 and 2022 in (i) the overall proportions of products that met the sodium and saturated fat targets and (ii) changes in the proportion of products meeting the targets across the top 10 leading food manufacturers. Between 2019 and 2022, there was a small increase in the proportion of products meeting the sodium targets (50.0% in 2019 versus 57.5% in 2022, p < 0.001). Across the top 10 manufacturers that sold products subject to a sodium target, seven made progress towards meeting the targets (ranging from +1.6% to +30.2%). For saturated fat, the proportion of products meeting the targets didn’t change (61.1% in 2019 versus 60.2% in 2022, p = 0.74) and nine of the 10 top manufacturers did not make any progress towards meeting the targets. Midway through the implementation period of Australia’s voluntary sodium and saturated fat targets, food manufacturers have made minimal progress towards meeting the targets, especially for saturated fat.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 10","pages":"1060-1065"},"PeriodicalIF":3.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-025-01647-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706844","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 : 2025-07-24DOI: 10.1038/s41430-025-01644-8
Rohan Singh, Mathieu Théo Eric Verest, Marcel Salathé
Accurate dietary assessment is essential for understanding diet–health relationships, yet day-to-day variability in intake complicates the identification of individuals’ usual consumption. This study aimed to determine the minimum number of days required to obtain reliable estimates of dietary intake across various nutrients and food groups using data from a large digital cohort. We analyzed dietary data from 958 participants of the “Food & You” study in Switzerland, who tracked their meals for 2–4 weeks using the AI-assisted MyFoodRepo app. Over 315,000 meals were logged across 23,335 participant days. We assessed day-of-week intake patterns using linear mixed models and estimated minimum days for reliable measurement using two complementary methods: (1) the coefficient of variation (CV) method based on within- and between-subject variability, and (2) intraclass correlation coefficient (ICC) analysis across all possible day combinations. Our findings indicate that water, coffee, and total food quantity can be reliably estimated (r > 0.85) with just 1–2 days of data. Most macronutrients, including carbohydrates, protein, and fat, achieved good reliability (r = 0.8) within 2–3 days. Micronutrients and food groups like meat and vegetables generally required 3–4 days. Linear mixed models revealed significant day-of-week effects, with higher energy, carbohydrate, and alcohol intake on weekends—especially among younger participants and those with higher BMI. ICC analyses further showed that including both weekdays and weekends increased reliability, and specific day combinations outperformed others. Three to four days of dietary data collection, ideally non-consecutive and including at least one weekend day, are sufficient for reliable estimation of most nutrients. These results support and refine FAO recommendations, offering more nutrient-specific guidance for efficient and accurate dietary assessment in epidemiological research.
{"title":"Minimum days estimation for reliable dietary intake information: findings from a digital cohort","authors":"Rohan Singh, Mathieu Théo Eric Verest, Marcel Salathé","doi":"10.1038/s41430-025-01644-8","DOIUrl":"10.1038/s41430-025-01644-8","url":null,"abstract":"Accurate dietary assessment is essential for understanding diet–health relationships, yet day-to-day variability in intake complicates the identification of individuals’ usual consumption. This study aimed to determine the minimum number of days required to obtain reliable estimates of dietary intake across various nutrients and food groups using data from a large digital cohort. We analyzed dietary data from 958 participants of the “Food & You” study in Switzerland, who tracked their meals for 2–4 weeks using the AI-assisted MyFoodRepo app. Over 315,000 meals were logged across 23,335 participant days. We assessed day-of-week intake patterns using linear mixed models and estimated minimum days for reliable measurement using two complementary methods: (1) the coefficient of variation (CV) method based on within- and between-subject variability, and (2) intraclass correlation coefficient (ICC) analysis across all possible day combinations. Our findings indicate that water, coffee, and total food quantity can be reliably estimated (r > 0.85) with just 1–2 days of data. Most macronutrients, including carbohydrates, protein, and fat, achieved good reliability (r = 0.8) within 2–3 days. Micronutrients and food groups like meat and vegetables generally required 3–4 days. Linear mixed models revealed significant day-of-week effects, with higher energy, carbohydrate, and alcohol intake on weekends—especially among younger participants and those with higher BMI. ICC analyses further showed that including both weekdays and weekends increased reliability, and specific day combinations outperformed others. Three to four days of dietary data collection, ideally non-consecutive and including at least one weekend day, are sufficient for reliable estimation of most nutrients. These results support and refine FAO recommendations, offering more nutrient-specific guidance for efficient and accurate dietary assessment in epidemiological research.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 10","pages":"1007-1017"},"PeriodicalIF":3.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-025-01644-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697897","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 : 2025-07-22DOI: 10.1038/s41430-025-01649-3
Anna Winkvist, Ciara Mangan, Ingegerd Johansson, Annemarie E. Bennett
High dietary diversity is recognized as a crucial element of diet quality because this ensures abundant nutrients. A diverse diet may also provide health benefits beyond nutritional adequacy. Few studies have evaluated associations with lipid profile. The aim of this study was to investigate the association between dietary diversity and metabolic health and common measures of diet quality in a large population-based sample. This was a cross-sectional analysis within the Västerbotten Intervention Programme (VIP). Participants filled out an extensive health questionnaire including a 66-item semi-quantitative food frequency questionnaire (FFQ). The FFQ was used to create dietary diversity scores (DDS) for 5 major and 13 minor food groups. Associations between DDS and concurrent fasting lipid profile and measured body mass index (BMI) were explored with multivariable linear regression. Correlation analyses were used to explore the relationship between DDS and diet quality. The mean age of participants was 51 ± 8.3 years, with females comprising 50.8% of the study population (n = 82,171). Higher DDS was associated with decreased total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglycerides (all p < 0.01). DDS had no significant association with BMI. DDS had a positive correlation with the Relative Mediterranean Diet Score, the Healthy Nordic Food Index and the Healthy Diet Score, and a negative correlation with the Dietary Inflammatory Index (all p < 0.001). The results add to the body of research showing metabolic health benefits of dietary diversity. More consistent methods of measuring dietary diversity should be developed, with careful consideration given to the healthfulness of foods included in the definition.
{"title":"Dietary diversity and metabolic health among people in Västerbotten, Sweden","authors":"Anna Winkvist, Ciara Mangan, Ingegerd Johansson, Annemarie E. Bennett","doi":"10.1038/s41430-025-01649-3","DOIUrl":"10.1038/s41430-025-01649-3","url":null,"abstract":"High dietary diversity is recognized as a crucial element of diet quality because this ensures abundant nutrients. A diverse diet may also provide health benefits beyond nutritional adequacy. Few studies have evaluated associations with lipid profile. The aim of this study was to investigate the association between dietary diversity and metabolic health and common measures of diet quality in a large population-based sample. This was a cross-sectional analysis within the Västerbotten Intervention Programme (VIP). Participants filled out an extensive health questionnaire including a 66-item semi-quantitative food frequency questionnaire (FFQ). The FFQ was used to create dietary diversity scores (DDS) for 5 major and 13 minor food groups. Associations between DDS and concurrent fasting lipid profile and measured body mass index (BMI) were explored with multivariable linear regression. Correlation analyses were used to explore the relationship between DDS and diet quality. The mean age of participants was 51 ± 8.3 years, with females comprising 50.8% of the study population (n = 82,171). Higher DDS was associated with decreased total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglycerides (all p < 0.01). DDS had no significant association with BMI. DDS had a positive correlation with the Relative Mediterranean Diet Score, the Healthy Nordic Food Index and the Healthy Diet Score, and a negative correlation with the Dietary Inflammatory Index (all p < 0.001). The results add to the body of research showing metabolic health benefits of dietary diversity. More consistent methods of measuring dietary diversity should be developed, with careful consideration given to the healthfulness of foods included in the definition.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 10","pages":"1046-1052"},"PeriodicalIF":3.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-025-01649-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689659","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 : 2025-07-21DOI: 10.1038/s41430-025-01646-6
Mette Bohl, Søren Gregersen, Zhihang Li, Andreas Blennow, Kim H. Hebelstrup, Kjeld Hermansen
Genetically modified (GMO) high-amylose barley lowers postprandial glucose. Since certain EU countries do not allow GMO barley, we therefore assessed if high-amylose barley made from traditional breeding (Lean Baking Barley, LBB) lowers postprandial glucose compared to bread made from regular barley (RB) or wheat (WF) in individuals with or without type 2 diabetes (T2D). In a randomised crossover design, 38 participants (18 T2D and 20 non-T2D) consumed 160 g of bread made from 100% LBB, RB, or WF. Postprandial metabolic responses, appetite and bread perception were measured. A mixed model ANOVA was used for analysis. LBB bread reduced 4 h postprandial glucose measured as incremental area under the curve (iAUC) by 41% and 39% vs. WF and RB bread in T2D and by 28% and 32% in non-T2D (all, P < 0.05). In T2D, LBB reduced postprandial insulin (iAUC) by 52% and 38% vs. WF and RB, and by 60% vs. WF in non-T2D (all, P < 0.05). Postprandial GIP (iAUC) was lower after LBB in both groups vs. RB and WF (P < 0.05). GLP-1 (iAUC) and FFA (tAUC) were lower after LBB vs. WF in non-T2D (P < 0.05), but not in T2D. Appetite scores were similar for all breads. Overall liking was higher for WF but did not differ between barley types. LBB breads reduce postprandial glucose and insulin compared to RB and WF bread in individuals irrespective of T2D. LBB may have potential as a functional food in prevention and management of T2D. ClinicalTrails.gov registration: NCT04702672.
{"title":"High-amylose barley bread improves postprandial glycemia compared to regular barley and wheat bread in subjects with or without type 2 diabetes","authors":"Mette Bohl, Søren Gregersen, Zhihang Li, Andreas Blennow, Kim H. Hebelstrup, Kjeld Hermansen","doi":"10.1038/s41430-025-01646-6","DOIUrl":"10.1038/s41430-025-01646-6","url":null,"abstract":"Genetically modified (GMO) high-amylose barley lowers postprandial glucose. Since certain EU countries do not allow GMO barley, we therefore assessed if high-amylose barley made from traditional breeding (Lean Baking Barley, LBB) lowers postprandial glucose compared to bread made from regular barley (RB) or wheat (WF) in individuals with or without type 2 diabetes (T2D). In a randomised crossover design, 38 participants (18 T2D and 20 non-T2D) consumed 160 g of bread made from 100% LBB, RB, or WF. Postprandial metabolic responses, appetite and bread perception were measured. A mixed model ANOVA was used for analysis. LBB bread reduced 4 h postprandial glucose measured as incremental area under the curve (iAUC) by 41% and 39% vs. WF and RB bread in T2D and by 28% and 32% in non-T2D (all, P < 0.05). In T2D, LBB reduced postprandial insulin (iAUC) by 52% and 38% vs. WF and RB, and by 60% vs. WF in non-T2D (all, P < 0.05). Postprandial GIP (iAUC) was lower after LBB in both groups vs. RB and WF (P < 0.05). GLP-1 (iAUC) and FFA (tAUC) were lower after LBB vs. WF in non-T2D (P < 0.05), but not in T2D. Appetite scores were similar for all breads. Overall liking was higher for WF but did not differ between barley types. LBB breads reduce postprandial glucose and insulin compared to RB and WF bread in individuals irrespective of T2D. LBB may have potential as a functional food in prevention and management of T2D. ClinicalTrails.gov registration: NCT04702672.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 10","pages":"1000-1006"},"PeriodicalIF":3.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-025-01646-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682178","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 : 2025-07-21DOI: 10.1038/s41430-025-01637-7
Tingwen Wang, Jiaqing Huang, Zhou Shang, Mai Deng, JiaDun Su, Xuanyu Duan, Derui Kong
The incidence of malnutrition in patients undergoing abdominal surgery exceeds 50%, and postoperative nutritional support is crucial for improving patient outcomes. While Enhanced Recovery After Surgery (ERAS) protocols highlight early nutrition support, their impact on different nutritional strategies remains unclear. This study assessed the effects and safety of enteral nutrition (EN), early-supplemental parenteral nutrition (E-SPN), late-supplemental parenteral nutrition (L-SPN), and total parenteral nutrition (TPN) through network meta-analysis. Three databases were searched to obtain randomized controlled trials involving four interventions for postoperative nutritional supportive therapy in abdominal surgical patients. We used The Cochrane Handbook tool (2.0) to assess the risk bias of included studies. The primary outcome was the occurrence of postoperative adverse events. Network meta-analysis was performed using STATA 14. A total of 48 studies involving 6277 patients were included. Network meta-analysis showed that compared with other nutritional therapy E-SPN was likely more effective than other modalities in terms of reduction of postoperative adverse events (OR = 3.02, 95% CI: 1.81–5.02), infectious adverse events (OR = 3.12, 95% CI: 1.59–6.15), non-infectious adverse events (OR = 2.47, 95% CI: 1.14–5.34), shortening the resumption of exhaust time (SMD = 0.98, 95% CI: 0.59–1.36), and improvement of serum albumin (SMD = −2.74, 95% CI: −4.98–0.50). The final surface under the cumulative ranking curve value indicated that E-SPN achieved the best effect in those outcomes. The obtained results support using E-SPN in patients undergoing abdominal surgery, which might reduce adverse events, shorten recovery time, and improve patient outcomes. However, since serum albumin is primarily an inflammatory marker rather than a direct indicator of nutritional status, its role in evaluating SPN benefits should be interpreted with caution. Further research is needed to assess SPN’s effectiveness in patients undergoing surgery according to an ERAS protocol.
{"title":"Efficacy and safety of nutrition therapy for patients undergoing abdominal surgery: a systematic review and network meta-analysis","authors":"Tingwen Wang, Jiaqing Huang, Zhou Shang, Mai Deng, JiaDun Su, Xuanyu Duan, Derui Kong","doi":"10.1038/s41430-025-01637-7","DOIUrl":"10.1038/s41430-025-01637-7","url":null,"abstract":"The incidence of malnutrition in patients undergoing abdominal surgery exceeds 50%, and postoperative nutritional support is crucial for improving patient outcomes. While Enhanced Recovery After Surgery (ERAS) protocols highlight early nutrition support, their impact on different nutritional strategies remains unclear. This study assessed the effects and safety of enteral nutrition (EN), early-supplemental parenteral nutrition (E-SPN), late-supplemental parenteral nutrition (L-SPN), and total parenteral nutrition (TPN) through network meta-analysis. Three databases were searched to obtain randomized controlled trials involving four interventions for postoperative nutritional supportive therapy in abdominal surgical patients. We used The Cochrane Handbook tool (2.0) to assess the risk bias of included studies. The primary outcome was the occurrence of postoperative adverse events. Network meta-analysis was performed using STATA 14. A total of 48 studies involving 6277 patients were included. Network meta-analysis showed that compared with other nutritional therapy E-SPN was likely more effective than other modalities in terms of reduction of postoperative adverse events (OR = 3.02, 95% CI: 1.81–5.02), infectious adverse events (OR = 3.12, 95% CI: 1.59–6.15), non-infectious adverse events (OR = 2.47, 95% CI: 1.14–5.34), shortening the resumption of exhaust time (SMD = 0.98, 95% CI: 0.59–1.36), and improvement of serum albumin (SMD = −2.74, 95% CI: −4.98–0.50). The final surface under the cumulative ranking curve value indicated that E-SPN achieved the best effect in those outcomes. The obtained results support using E-SPN in patients undergoing abdominal surgery, which might reduce adverse events, shorten recovery time, and improve patient outcomes. However, since serum albumin is primarily an inflammatory marker rather than a direct indicator of nutritional status, its role in evaluating SPN benefits should be interpreted with caution. Further research is needed to assess SPN’s effectiveness in patients undergoing surgery according to an ERAS protocol.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 11","pages":"1078-1086"},"PeriodicalIF":3.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682177","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 : 2025-07-19DOI: 10.1038/s41430-025-01638-6
Maren Wolf, Mónica Mazariegos, Oscar Cordón, Karla Mesarina, Maria Elena D. Jefferds, O. Yaw Addo, Mireya Palmieri
This paper defines the double burden of malnutrition as occurring when over- and undernutrition coexist within a household. It is most common in countries undergoing the nutrition transition where cheap and accessible food is often of poor quality. This brief narrative review examines four cycles of reports from the Epidemiological Health and Nutrition Surveillance System (SIVESNU, Spanish acronym) in Guatemala between 2015–2018/19, examining the following indicators: overall double burden of stunting among children aged ≤59 months and overweight or obesity among women aged 15–49 years in the same household, and individual stunting, overweight, and obesity by indigenous/non-indigenous ethnicity. The review also incorporates double burden prevalence in Guatemala from the literature since 1995. In 1995, the double burden prevalence was 13.4%, and negligible change occurred from 2000 to 2018/19 (18.2% and 17.6%, respectively). Individual level prevalences for stunting, overweight, and obesity were notable, with large disparities in stunting prevalence by ethnicity.
{"title":"Double burden of malnutrition in Guatemala: co-existence of childhood stunting and overweight and obesity within the household","authors":"Maren Wolf, Mónica Mazariegos, Oscar Cordón, Karla Mesarina, Maria Elena D. Jefferds, O. Yaw Addo, Mireya Palmieri","doi":"10.1038/s41430-025-01638-6","DOIUrl":"10.1038/s41430-025-01638-6","url":null,"abstract":"This paper defines the double burden of malnutrition as occurring when over- and undernutrition coexist within a household. It is most common in countries undergoing the nutrition transition where cheap and accessible food is often of poor quality. This brief narrative review examines four cycles of reports from the Epidemiological Health and Nutrition Surveillance System (SIVESNU, Spanish acronym) in Guatemala between 2015–2018/19, examining the following indicators: overall double burden of stunting among children aged ≤59 months and overweight or obesity among women aged 15–49 years in the same household, and individual stunting, overweight, and obesity by indigenous/non-indigenous ethnicity. The review also incorporates double burden prevalence in Guatemala from the literature since 1995. In 1995, the double burden prevalence was 13.4%, and negligible change occurred from 2000 to 2018/19 (18.2% and 17.6%, respectively). Individual level prevalences for stunting, overweight, and obesity were notable, with large disparities in stunting prevalence by ethnicity.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 10","pages":"1066-1068"},"PeriodicalIF":3.3,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667448","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：