Pub Date : 2025-09-13DOI: 10.1038/s41430-025-01659-1
Sugandha Kehar, Surya Prakash Bhatt, Ravindra M. Pandey, Irshad Ahmad Ansari, Rajashekar Reddy Palavalli, Vimal Gupta, Anoop Misra
Mango consumption is often restricted in diet consumed by people with diabetes due to concerns about its glycemic impact. This study aimed to compare the glycemic effects of mango consumption with those of white bread and glucose in subjects with and without type 2 diabetes (T2D). We conducted a two-phase study involving 95 participants (45 with T2D, 50 non-diabetic). Phase 1 employed oral tolerance test (OTT) to assess immediate glycemic responses to mango (Safeda, Dasheri, and Langra), bread, and glucose. Phase 2 utilized continuous glucose monitoring (CGM) to evaluate glycemic profiles over three days. On OTT, in non-diabetic subjects, mango consumption resulted in non-significantly lower postprandial glucose peaks compared to glucose and bread, except Langra variety which showed lowest area under the curve for glucose of borderline significance. In subjects with T2D, mango varieties performed similarly to bread. CGM data revealed that mango consumption over three days resulted in a similar glycemic profile to bread in non-diabetic subjects and a lower glycemic profile in subjects with T2D, though most differences were statistically not significant. Mean Amplitude of Glycemic Excursion (MAGE) was significantly lower after mango ingestion as compared to bread in CGM data in subjects with T2D. Data show limited glycemic impact of tested mango varieties, comparable to or lower than white bread, especially in T2D subjects. The significant reduction in MAGE observed with mango consumption suggests potential benefits for glycemic variability. With portion control in calorie restrictive diets, mango may be suitable for people with T2D.
{"title":"Glycemic responses of three mango varieties in subjects with and without T2D: a pilot crossover study using OTT and CGM","authors":"Sugandha Kehar, Surya Prakash Bhatt, Ravindra M. Pandey, Irshad Ahmad Ansari, Rajashekar Reddy Palavalli, Vimal Gupta, Anoop Misra","doi":"10.1038/s41430-025-01659-1","DOIUrl":"10.1038/s41430-025-01659-1","url":null,"abstract":"Mango consumption is often restricted in diet consumed by people with diabetes due to concerns about its glycemic impact. This study aimed to compare the glycemic effects of mango consumption with those of white bread and glucose in subjects with and without type 2 diabetes (T2D). We conducted a two-phase study involving 95 participants (45 with T2D, 50 non-diabetic). Phase 1 employed oral tolerance test (OTT) to assess immediate glycemic responses to mango (Safeda, Dasheri, and Langra), bread, and glucose. Phase 2 utilized continuous glucose monitoring (CGM) to evaluate glycemic profiles over three days. On OTT, in non-diabetic subjects, mango consumption resulted in non-significantly lower postprandial glucose peaks compared to glucose and bread, except Langra variety which showed lowest area under the curve for glucose of borderline significance. In subjects with T2D, mango varieties performed similarly to bread. CGM data revealed that mango consumption over three days resulted in a similar glycemic profile to bread in non-diabetic subjects and a lower glycemic profile in subjects with T2D, though most differences were statistically not significant. Mean Amplitude of Glycemic Excursion (MAGE) was significantly lower after mango ingestion as compared to bread in CGM data in subjects with T2D. Data show limited glycemic impact of tested mango varieties, comparable to or lower than white bread, especially in T2D subjects. The significant reduction in MAGE observed with mango consumption suggests potential benefits for glycemic variability. With portion control in calorie restrictive diets, mango may be suitable for people with T2D.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 10","pages":"991-999"},"PeriodicalIF":3.3,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058414","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}
Sarcopenia is highly prevalent and associated with poor outcomes in cirrhotic patients. We aimed to evaluate the efficacy of exercise, protein supplementation, and branched-chain amino acid (BCAA) supplementation in treating cirrhotic sarcopenia. PubMed, Embase, Scopus and the Cochrane Library were searched for randomized controlled trials of exercise, protein supplementation, and/or BCAA supplementation on improving at least one of the sarcopenia features: muscle mass, muscle strength and physical performance. Differences in post- and pre-intervention changes between intervention and control arms were calculated as a standardized mean difference (SMD), with 95% confidence interval (CI). A network meta-analysis (NMA), component NMA, pairwise meta-analysis (PW-MA) of 23 trials comprising 1525 participants were performed. By NMA, combined exercise with protein and BCAA supplementations had the greatest effect on increasing muscle mass (SMD 2.12; 95%CI: 0.59–3.65). Exercise alone or with BCAA/protein supplementation also significantly increased muscle mass, but protein or BCAA supplementation alone did not increase muscle mass. By PW-MA, exercise significantly improved physical performance versus control (SMD 1.43; 95%CI: 0.63–2.17; p < 0.01; I² = 59%) and exercise plus protein supplementation was superior to protein alone (SMD 0.66; 95%CI: 0.26–1.06; p = 0.001; I² = 0%). In the systematic review of effects of BCAA supplementation on muscle strength, its impact was inconclusive. Exercise is the mainstay of sarcopenia treatment in cirrhosis and is most effective at improving muscle mass when combined with protein and BCAA supplementation. Nutritional supplementation alone does not enhance muscle mass. Further well-designed studies are needed to identify the most effective type of exercise.
肌肉减少症在肝硬化患者中非常普遍，并与预后不良相关。我们旨在评估运动、补充蛋白质和补充支链氨基酸（BCAA）治疗肝硬化肌肉减少症的疗效。PubMed、Embase、Scopus和Cochrane图书馆检索了运动、补充蛋白质和/或补充BCAA对改善肌肉减少症至少一项特征（肌肉质量、肌肉力量和身体表现）的随机对照试验。干预组和对照组之间干预后和干预前变化的差异以标准化平均差（SMD）计算，置信区间为95%。采用网络元分析（NMA）、成分元分析（component meta- ma）、两两元分析（PW-MA）共23项试验，共1525名受试者。通过NMA，运动结合蛋白质和BCAA补充对肌肉质量的增加效果最大（SMD 2.12; 95%CI: 0.59-3.65）。单独运动或补充BCAA/蛋白质也能显著增加肌肉质量，但单独补充蛋白质或BCAA并不能增加肌肉质量。通过PW-MA，与对照组相比，运动显著改善了身体机能(SMD 1.43; 95%CI: 0.63-2.17; p
{"title":"Exercise and nutrition interventions for sarcopenia in cirrhosis: a systematic review and network meta-analysis of randomized controlled trials","authors":"Sirinda Kittiprachakul, Soe Thiha Maung, Napalai Poorirerngpoom, Asadapong Srinawakul, Merint Numpaisarn, Thodsawit Tiyarattanachai, Nicha Somlaw, Onanong Kulaputana, Prooksa Ananchuensook, Jeerath Phannajit, Sarissa Rangkla, Roongruedee Chaiteerakij","doi":"10.1038/s41430-025-01642-w","DOIUrl":"10.1038/s41430-025-01642-w","url":null,"abstract":"Sarcopenia is highly prevalent and associated with poor outcomes in cirrhotic patients. We aimed to evaluate the efficacy of exercise, protein supplementation, and branched-chain amino acid (BCAA) supplementation in treating cirrhotic sarcopenia. PubMed, Embase, Scopus and the Cochrane Library were searched for randomized controlled trials of exercise, protein supplementation, and/or BCAA supplementation on improving at least one of the sarcopenia features: muscle mass, muscle strength and physical performance. Differences in post- and pre-intervention changes between intervention and control arms were calculated as a standardized mean difference (SMD), with 95% confidence interval (CI). A network meta-analysis (NMA), component NMA, pairwise meta-analysis (PW-MA) of 23 trials comprising 1525 participants were performed. By NMA, combined exercise with protein and BCAA supplementations had the greatest effect on increasing muscle mass (SMD 2.12; 95%CI: 0.59–3.65). Exercise alone or with BCAA/protein supplementation also significantly increased muscle mass, but protein or BCAA supplementation alone did not increase muscle mass. By PW-MA, exercise significantly improved physical performance versus control (SMD 1.43; 95%CI: 0.63–2.17; p < 0.01; I² = 59%) and exercise plus protein supplementation was superior to protein alone (SMD 0.66; 95%CI: 0.26–1.06; p = 0.001; I² = 0%). In the systematic review of effects of BCAA supplementation on muscle strength, its impact was inconclusive. Exercise is the mainstay of sarcopenia treatment in cirrhosis and is most effective at improving muscle mass when combined with protein and BCAA supplementation. Nutritional supplementation alone does not enhance muscle mass. Further well-designed studies are needed to identify the most effective type of exercise.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 11","pages":"1087-1098"},"PeriodicalIF":3.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029138","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 : 2025-09-04DOI: 10.1038/s41430-025-01653-7
Cécile Gras, Victoria De Wit, Nacima Oussedik, Sylvie Daclin, Venceslas Bourdin, Delphine Callot, Ghiles Chegrani, Claire Rives-Lange, Laurent Chouchana
Although GLP-1 receptors analogues (RAs) benefits-risks profile has been largely documented in diabetes, higher dosages recently approved in obesity still require further assessment. We describe here the case of a 49-year-old female patient treated with semaglutide for obesity, who presented with Wernicke encephalopathy in a context of iterative vomiting and reduced food intake. Eighteen other cases of Wernicke encephalopathy were reported in literature and in the WHO global safety database (VigiBase). A context of nausea/vomiting or reduced food intake is described in 68% of cases, with weight loss ranging from −3.5 to −13.3 kg/month over 3 to 6 months. Disproportionality analysis in VigiBase showed that Wernicke encephalopathy was disproportionately reported with semaglutide, tirzepatide and the whole GLP-1RAs group. Altogether, this comprehensive analysis supports a safety signal regarding the risk of Wernicke encephalopathy with GLP-1RAs, which requires a prompt assessment, accounting for the growing use of these drugs.
{"title":"Semaglutide-induced Wernicke encephalopathy: a comprehensive analysis","authors":"Cécile Gras, Victoria De Wit, Nacima Oussedik, Sylvie Daclin, Venceslas Bourdin, Delphine Callot, Ghiles Chegrani, Claire Rives-Lange, Laurent Chouchana","doi":"10.1038/s41430-025-01653-7","DOIUrl":"10.1038/s41430-025-01653-7","url":null,"abstract":"Although GLP-1 receptors analogues (RAs) benefits-risks profile has been largely documented in diabetes, higher dosages recently approved in obesity still require further assessment. We describe here the case of a 49-year-old female patient treated with semaglutide for obesity, who presented with Wernicke encephalopathy in a context of iterative vomiting and reduced food intake. Eighteen other cases of Wernicke encephalopathy were reported in literature and in the WHO global safety database (VigiBase). A context of nausea/vomiting or reduced food intake is described in 68% of cases, with weight loss ranging from −3.5 to −13.3 kg/month over 3 to 6 months. Disproportionality analysis in VigiBase showed that Wernicke encephalopathy was disproportionately reported with semaglutide, tirzepatide and the whole GLP-1RAs group. Altogether, this comprehensive analysis supports a safety signal regarding the risk of Wernicke encephalopathy with GLP-1RAs, which requires a prompt assessment, accounting for the growing use of these drugs.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 11","pages":"1160-1163"},"PeriodicalIF":3.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999920","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 : 2025-08-29DOI: 10.1038/s41430-025-01657-3
Maoyuan Yang, Zengyao Wang, Ke Zhou, Siyi Ren, Yu Cao, Xinglin Jin, Mei Li, Xia Zhou, Guanghui Sui, Yating Ren, Yuyan Zhang, Mengru Chen, Yuyan Gao, Jie Sheng, Sufang Wang
It has been proven that periconceptional folic acid (FA) supplementation could prevent neural tube defects. However, FA supplementation during different stages of pregnancy and its association with the neurobehavioral development of offspring remains unclear, particularly the effects of continued FA supplementation during the second and third trimesters. This study aimed to investigate the relationship between maternal FA supplementation at various stages of pregnancy and infant neurobehavioral development. In a prospective birth cohort study involving 3246 parent-child pairs, 2905 infants completed neurobehavioral development assessments at 6 months and 3005 infants at 18 months. Information regarding micronutrient supplementation at various stages of pregnancy was recorded. Multivariable logistic regression was used to evaluate the association between FA supplementation and infant neurobehavioral developmental delays. In addition, propensity score analysis was performed to correct the potential imbalances in the distribution of related factors between the groups. During the periconceptional period, maternal standardized FA supplementation (taking 0.4 mg FA daily before and in early pregnancy, as officially recommended) was associated with a reduced risk of possible development delays in 18-month-old infants in the communication domain (RR = 0.48, 95% CI: 0.26–0.86; P = 0.015). After the 12th gestational week, maternal continuous FA supplementation in the second and third trimesters was significantly associated with a decreased risk of possible neurobehavioral development delay in 6-month-old infants in fine motor domain (RR = 0.31, 95% CI: 0.12–0.82; P = 0.019) and the problem-solving domain (RR = 0.20, 95% CI: 0.05–0.79; P = 0.022). These associations remained significant after adjusting for confounders and propensity scores. FA supplementation at different stages of pregnancy may enhance neurobehavioral development in offspring. To confirm these findings, additional investigations or trials with larger sample sizes and consistent tracking of folate status throughout pregnancy are recommended.
背景：已证实围孕期补充叶酸（FA）可预防神经管缺损。然而，在怀孕的不同阶段补充FA及其与后代神经行为发育的关系尚不清楚，特别是在妊娠中期和晚期继续补充FA的影响。本研究旨在探讨孕期各阶段母体补充FA与婴儿神经行为发育之间的关系。方法：在一项涉及3246对亲子对的前瞻性出生队列研究中，2905名婴儿在6个月时完成了神经行为发育评估，3005名婴儿在18个月时完成了神经行为发育评估。记录了妊娠各阶段微量营养素补充情况。多变量逻辑回归用于评估补充FA与婴儿神经行为发育迟缓之间的关系。此外，还进行了倾向得分分析，以纠正组间相关因素分布的潜在不平衡。结果：在围孕期，母亲标准化补充FA（在怀孕前和怀孕早期，按照官方建议每天服用0.4 mg FA）与18个月大婴儿在沟通领域可能发生发育迟缓的风险降低相关（RR = 0.48, 95% CI: 0.26-0.86; P = 0.015）。在妊娠第12周后，母亲在妊娠中期和晚期持续补充FA与6个月大婴儿在精细运动领域（RR = 0.31, 95% CI: 0.12-0.82; P = 0.019）和问题解决领域（RR = 0.20, 95% CI: 0.05-0.79; P = 0.022）可能出现的神经行为发育延迟风险降低显著相关。在调整混杂因素和倾向得分后，这些关联仍然显著。结论：在妊娠不同阶段补充FA可促进子代神经行为发育。为了证实这些发现，建议进行更多的调查或试验，样本量更大，并在整个怀孕期间持续跟踪叶酸状态。
{"title":"Association between maternal folic acid supplementation in different pregnancy and infant neurobehavioral development at 6 and 18 months","authors":"Maoyuan Yang, Zengyao Wang, Ke Zhou, Siyi Ren, Yu Cao, Xinglin Jin, Mei Li, Xia Zhou, Guanghui Sui, Yating Ren, Yuyan Zhang, Mengru Chen, Yuyan Gao, Jie Sheng, Sufang Wang","doi":"10.1038/s41430-025-01657-3","DOIUrl":"10.1038/s41430-025-01657-3","url":null,"abstract":"It has been proven that periconceptional folic acid (FA) supplementation could prevent neural tube defects. However, FA supplementation during different stages of pregnancy and its association with the neurobehavioral development of offspring remains unclear, particularly the effects of continued FA supplementation during the second and third trimesters. This study aimed to investigate the relationship between maternal FA supplementation at various stages of pregnancy and infant neurobehavioral development. In a prospective birth cohort study involving 3246 parent-child pairs, 2905 infants completed neurobehavioral development assessments at 6 months and 3005 infants at 18 months. Information regarding micronutrient supplementation at various stages of pregnancy was recorded. Multivariable logistic regression was used to evaluate the association between FA supplementation and infant neurobehavioral developmental delays. In addition, propensity score analysis was performed to correct the potential imbalances in the distribution of related factors between the groups. During the periconceptional period, maternal standardized FA supplementation (taking 0.4 mg FA daily before and in early pregnancy, as officially recommended) was associated with a reduced risk of possible development delays in 18-month-old infants in the communication domain (RR = 0.48, 95% CI: 0.26–0.86; P = 0.015). After the 12th gestational week, maternal continuous FA supplementation in the second and third trimesters was significantly associated with a decreased risk of possible neurobehavioral development delay in 6-month-old infants in fine motor domain (RR = 0.31, 95% CI: 0.12–0.82; P = 0.019) and the problem-solving domain (RR = 0.20, 95% CI: 0.05–0.79; P = 0.022). These associations remained significant after adjusting for confounders and propensity scores. FA supplementation at different stages of pregnancy may enhance neurobehavioral development in offspring. To confirm these findings, additional investigations or trials with larger sample sizes and consistent tracking of folate status throughout pregnancy are recommended.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"80 1","pages":"37-45"},"PeriodicalIF":3.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947540","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 : 2025-08-25DOI: 10.1038/s41430-025-01656-4
Manana Zodeleva, Nino Pochkhua, Maria Sole Rossato, Eka Arziani
The development and implementation of new treatments for knee osteoarthritis in routine practice remains an unmet need. The aim of this study was to assess the efficacy and safety of a Cetylated Fatty Acids (CFA)-based dietary supplement in patients with knee osteoarthritis (OA), a prevalent and difficult-to-treat condition. 60 patients (mean age: 66.0 ± 7.7 years, 85% female) with grade 3–4 knee osteoarthritis and a pain intensity of > 4 cm on the visual analog scale (VAS) were enrolled and randomized in a 1:1 ratio to receive either 1.5 g of oral CFA or a placebo for 60 days. The primary outcome was the change in pain intensity (VAS), secondary outcomes included changes in range of motion (ROM), in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the safety profile of the food supplement. After 60 days of CFA assumption, the mean reduction in pain intensity (VAS) was −1.7 cm (95% CI [−2.0, −1.4]), showing a statistically significant difference compared to placebo (−0.6 cm, 95% CI [−1.0, −0.2]; p < 0.005). The mean decrease in the WOMAC total score was also greater in the CFA group (−19.5 vs. −15.8), although the placebo-corrected effect was not statistically significant (−3.7, 95% CI [−8.3, 0.8]; p = 0.108). Observed improvements in flexion (3.8° [95% CI: 2.6, 5.0]) and external rotation (2.9° [95% CI: 2.1, 3.8]) were both statistically significant in favor of CFA (p ≤ 0.001) compared to placebo. Differences in extension and internal rotation were negligible. The safety profile of the investigational product resulted favorable, considering that only 4 out of 30 patients reported mild adverse events, and none withdrawn from the study due to adverse events. In patients with knee osteoarthritis, incorporating a CFA oral supplement into the treatment regimen provides superior efficacy in pain relief and range of motion improvement compared to placebo, while maintaining a favorable safety profile.
背景/目的：在常规实践中发展和实施膝骨关节炎的新治疗方法仍然是一个未满足的需求。本研究的目的是评估以Cetylated Fatty Acids （CFA）为基础的膳食补充剂对膝关节骨关节炎（OA）患者的疗效和安全性，OA是一种普遍且难以治疗的疾病。受试者/方法：60例（平均年龄：66.0±7.7岁，85%为女性）患有3-4级膝骨关节炎，视觉模拟评分（VAS）疼痛强度为bbb40cm，按1:1的比例随机分配，接受1.5 g口服CFA或安慰剂治疗60天。主要结果是疼痛强度（VAS）的变化，次要结果包括西安大略省和麦克马斯特大学骨关节炎指数（WOMAC）的活动范围（ROM）的变化，以及食品补充剂的安全性。结果：CFA假设60天后，疼痛强度（VAS）平均降低-1.7 cm (95% CI[-2.0, -1.4])，与安慰剂（-0.6 cm, 95% CI[-1.0, -0.2]）相比，具有统计学意义；p结论：在膝关节骨关节炎患者中，与安慰剂相比，将CFA口服补充剂纳入治疗方案在疼痛缓解和活动范围改善方面具有优越的疗效，同时保持良好的安全性。
{"title":"Effects of orally administered cetylated fatty acids on symptoms and functional capacity in patients with knee osteoarthritis: results of a randomized, double-blind, placebo-controlled study","authors":"Manana Zodeleva, Nino Pochkhua, Maria Sole Rossato, Eka Arziani","doi":"10.1038/s41430-025-01656-4","DOIUrl":"10.1038/s41430-025-01656-4","url":null,"abstract":"The development and implementation of new treatments for knee osteoarthritis in routine practice remains an unmet need. The aim of this study was to assess the efficacy and safety of a Cetylated Fatty Acids (CFA)-based dietary supplement in patients with knee osteoarthritis (OA), a prevalent and difficult-to-treat condition. 60 patients (mean age: 66.0 ± 7.7 years, 85% female) with grade 3–4 knee osteoarthritis and a pain intensity of > 4 cm on the visual analog scale (VAS) were enrolled and randomized in a 1:1 ratio to receive either 1.5 g of oral CFA or a placebo for 60 days. The primary outcome was the change in pain intensity (VAS), secondary outcomes included changes in range of motion (ROM), in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the safety profile of the food supplement. After 60 days of CFA assumption, the mean reduction in pain intensity (VAS) was −1.7 cm (95% CI [−2.0, −1.4]), showing a statistically significant difference compared to placebo (−0.6 cm, 95% CI [−1.0, −0.2]; p < 0.005). The mean decrease in the WOMAC total score was also greater in the CFA group (−19.5 vs. −15.8), although the placebo-corrected effect was not statistically significant (−3.7, 95% CI [−8.3, 0.8]; p = 0.108). Observed improvements in flexion (3.8° [95% CI: 2.6, 5.0]) and external rotation (2.9° [95% CI: 2.1, 3.8]) were both statistically significant in favor of CFA (p ≤ 0.001) compared to placebo. Differences in extension and internal rotation were negligible. The safety profile of the investigational product resulted favorable, considering that only 4 out of 30 patients reported mild adverse events, and none withdrawn from the study due to adverse events. In patients with knee osteoarthritis, incorporating a CFA oral supplement into the treatment regimen provides superior efficacy in pain relief and range of motion improvement compared to placebo, while maintaining a favorable safety profile.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 11","pages":"1138-1143"},"PeriodicalIF":3.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-025-01656-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947490","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 : 2025-08-22DOI: 10.1038/s41430-025-01658-2
V. Neuman, K. Maratova, L. Plachy, L. Drnkova, S. Pruhova, S. Kolouskova, B. Obermannova, S. A. Amaratunga, M. Kulich, J. Havlik, O. Cinek, Z. Sumnik
We investigated whether a short period of tightly controlled low-carbohydrate diet (LCD) leads to a change in body weight, body composition, and muscle strength in children and young people with diabetes (CYPwD). Thirty-five CYPwD were recruited into this randomized controlled cross-over study (20 female; age 14.5 ± 2.9 years). The interventions were five and five weeks of ready-made food box deliveries of isocaloric diets in random order: either LCD (94.5 ± 4.7 g/day) or recommended carbohydrate diet (RCD) (191 ± 19.2 g/day). The outcomes were body weight and body mass index (BMI) standard deviation scores (SDS), body fat percentage assessed by bioimpedance and muscle strength assessed by jumping mechanography at the end of each dietary intervention. The Welch two-sample t-tests were used to determine the difference in outcomes. At the end of the LCD period, the participants had significantly lower body weight and BMI SDS than at the end of the RCD period (61.7 kg vs. 62.6 kg, P < 0.001, and 22.3 kg/m2 vs. 22.7 kg/m2, P < 0.001) and (0.84 SD vs. 0.94 SD, P < 0.001, and 0.81 SD vs. 0.91 SD, P < 0.001). The body fat percentage was lower at the end of the LCD period (24.5% vs. 25.3%, P = 0.001). Dynamic muscle functions did not differ significantly at the end of the intervention periods. We demonstrated that a short-term low-carbohydrate diet is able to decrease body weight, BMI, and decrease the percentage of body fat in CYPwD without negatively affecting their muscle function.
目的：我们研究短期严格控制的低碳水化合物饮食（LCD）是否会导致儿童和青少年糖尿病（CYPwD）患者体重、身体成分和肌肉力量的变化。方法：随机对照交叉研究共招募35例CYPwD患者（女性20例，年龄14.5±2.9岁）。干预措施为5周和5周，随机提供等热量饮食的现成食品盒：LCD（94.5±4.7 g/天）或推荐碳水化合物饮食（RCD）（191±19.2 g/天）。结果是每次饮食干预结束时的体重和体重指数（BMI）标准差评分（SDS）、生物阻抗评估的体脂率和跳跃力学评估的肌肉力量。使用Welch双样本t检验来确定结果的差异。结果：在LCD期结束时，参与者的体重和BMI SDS明显低于RCD期结束时（61.7 kg vs. 62.6 kg, P 2 vs. 22.7 kg/m2， P）。结论：我们证明短期低碳水化合物饮食能够降低体重、BMI和CYPwD患者的体脂百分比，而不会对肌肉功能产生负面影响。
{"title":"Short-term low-carbohydrate diet decreases body weight and fat mass but not muscle strength in children and young people with type 1 diabetes","authors":"V. Neuman, K. Maratova, L. Plachy, L. Drnkova, S. Pruhova, S. Kolouskova, B. Obermannova, S. A. Amaratunga, M. Kulich, J. Havlik, O. Cinek, Z. Sumnik","doi":"10.1038/s41430-025-01658-2","DOIUrl":"10.1038/s41430-025-01658-2","url":null,"abstract":"We investigated whether a short period of tightly controlled low-carbohydrate diet (LCD) leads to a change in body weight, body composition, and muscle strength in children and young people with diabetes (CYPwD). Thirty-five CYPwD were recruited into this randomized controlled cross-over study (20 female; age 14.5 ± 2.9 years). The interventions were five and five weeks of ready-made food box deliveries of isocaloric diets in random order: either LCD (94.5 ± 4.7 g/day) or recommended carbohydrate diet (RCD) (191 ± 19.2 g/day). The outcomes were body weight and body mass index (BMI) standard deviation scores (SDS), body fat percentage assessed by bioimpedance and muscle strength assessed by jumping mechanography at the end of each dietary intervention. The Welch two-sample t-tests were used to determine the difference in outcomes. At the end of the LCD period, the participants had significantly lower body weight and BMI SDS than at the end of the RCD period (61.7 kg vs. 62.6 kg, P < 0.001, and 22.3 kg/m2 vs. 22.7 kg/m2, P < 0.001) and (0.84 SD vs. 0.94 SD, P < 0.001, and 0.81 SD vs. 0.91 SD, P < 0.001). The body fat percentage was lower at the end of the LCD period (24.5% vs. 25.3%, P = 0.001). Dynamic muscle functions did not differ significantly at the end of the intervention periods. We demonstrated that a short-term low-carbohydrate diet is able to decrease body weight, BMI, and decrease the percentage of body fat in CYPwD without negatively affecting their muscle function.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 11","pages":"1149-1153"},"PeriodicalIF":3.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-025-01658-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947509","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}
With the increasing burden of metabolic syndrome, it is crucial to focus on lifestyle factors to reduce the risk of metabolic syndrome. This study aims to quantify the associations between dietary diversity and the risk of metabolic syndrome among the Japanese population. This study was conducted using baseline data from the Japan Multi-Institutional Collaborative Cohort (J-MICC) study. The baseline survey was conducted from 2005 to 2014 by recruiting individuals aged 35–69. Information regarding dietary intake and biometric measurements were obtained. Dietary Diversity Score (DDS) was calculated from the data based on the food frequency questionnaire. A multiple logistic regression analysis was conducted to analyze the association between DDS and metabolic syndrome. In total, 75,332 participants were included for analysis. Inverse associations were observed between a high DDS and metabolic syndrome (adjusted odds ratio, 0.83 [95% confidential interval 0.76–0.92]). Likewise, a high DDS was associated with reduced odds of a high body mass index and hypertension. No significant associations were observed between the DDS and serum triglyceride, fasting blood glucose, or high-density lipoprotein cholesterol values. The findings of this study emphasize that dietary diversity has inversed associations with metabolic syndrome. Promoting a diverse and balanced diet can be a potential strategy for mitigating the burden of metabolic syndrome.
{"title":"Dietary diversity and the risk of metabolic syndrome in a Japanese population: an analysis of baseline cross-sectional data from the J-MICC study","authors":"Zin Wai Htay, Nobuaki Michihata, Yohko Nakamura, Yoshitaka Hippo, Jun Otonari, Hiroaki Ikezaki, Yuichiro Nishida, Chisato Shimanoe, Takashi Tamura, Mako Nagayoshi, Yasufumi Kato, Yudai Tamada, Asahi Hishida, Shiroh Tanoue, Daisaku Nishimoto, Teruhide Koyama, Etsuko Ozaki, Kiyonori Kuriki, Naoyuki Takashima, Naoko Miyagawa, Sakurako Katsuura-Kamano, Takeshi Watanabe, Kenji Wakai, Keitaro Matsuo","doi":"10.1038/s41430-025-01654-6","DOIUrl":"10.1038/s41430-025-01654-6","url":null,"abstract":"With the increasing burden of metabolic syndrome, it is crucial to focus on lifestyle factors to reduce the risk of metabolic syndrome. This study aims to quantify the associations between dietary diversity and the risk of metabolic syndrome among the Japanese population. This study was conducted using baseline data from the Japan Multi-Institutional Collaborative Cohort (J-MICC) study. The baseline survey was conducted from 2005 to 2014 by recruiting individuals aged 35–69. Information regarding dietary intake and biometric measurements were obtained. Dietary Diversity Score (DDS) was calculated from the data based on the food frequency questionnaire. A multiple logistic regression analysis was conducted to analyze the association between DDS and metabolic syndrome. In total, 75,332 participants were included for analysis. Inverse associations were observed between a high DDS and metabolic syndrome (adjusted odds ratio, 0.83 [95% confidential interval 0.76–0.92]). Likewise, a high DDS was associated with reduced odds of a high body mass index and hypertension. No significant associations were observed between the DDS and serum triglyceride, fasting blood glucose, or high-density lipoprotein cholesterol values. The findings of this study emphasize that dietary diversity has inversed associations with metabolic syndrome. Promoting a diverse and balanced diet can be a potential strategy for mitigating the burden of metabolic syndrome.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 11","pages":"1106-1113"},"PeriodicalIF":3.3,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854963","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 : 2025-08-14DOI: 10.1038/s41430-025-01652-8
Edward H. Reynolds, Agata Sobczyńska-Malefora, Ralph Green
The benefits of folic acid fortification are well known but less understood or acknowledged is the growing evidence of potential harms to the nervous system from excess folate, primarily because of a combination of fortification and/or high and sustained intake of folic acid supplements. We have summarised the historical, clinical, epidemiological and experimental evidence accumulated over the last 60 years in the pre and postfortification eras, which consistently and substantially suggests that excess folate, in particular in folic acid users, can have direct harms to the nervous system, especially in the presence of vitamin B12 deficiency. The harms are related both to the dose and duration of exposure to excess folic acid. Recent experimental evidence suggests that impaired cortical neurogenesis with excess folic acid is similar to that of folate or vitamin B12 deficiency and greatest when folate excess is present with vitamin B12 deficiency. Excess folate leads to a fall in vitamin B12 levels and aggravation of the block in folate metabolism resulting from vitamin B12 deficiency. The balance between folate and vitamin B12 is crucial to the functioning of one carbon metabolic pathways, the methylation cycle and ultimately to DNA and RNA structure and function, genetic and epigenetic stability. Vitamin B12 deficiency is an independent risk factor for NTDs and accounts for the increased risk of NTDs in some countries where B12 deficiency is more common than folate deficiency. A more prudent and balanced approach to fortification with folic acid, or preferably a natural reduced folate, combined with vitamin B12 would potentially improve the benefits and reduce the harms, including epigenetic and transgenerational risks, associated with current public health policies.
{"title":"Fortification, folate and vitamin B12 balance, and the nervous system. Is folic acid excess potentially harmful?","authors":"Edward H. Reynolds, Agata Sobczyńska-Malefora, Ralph Green","doi":"10.1038/s41430-025-01652-8","DOIUrl":"10.1038/s41430-025-01652-8","url":null,"abstract":"The benefits of folic acid fortification are well known but less understood or acknowledged is the growing evidence of potential harms to the nervous system from excess folate, primarily because of a combination of fortification and/or high and sustained intake of folic acid supplements. We have summarised the historical, clinical, epidemiological and experimental evidence accumulated over the last 60 years in the pre and postfortification eras, which consistently and substantially suggests that excess folate, in particular in folic acid users, can have direct harms to the nervous system, especially in the presence of vitamin B12 deficiency. The harms are related both to the dose and duration of exposure to excess folic acid. Recent experimental evidence suggests that impaired cortical neurogenesis with excess folic acid is similar to that of folate or vitamin B12 deficiency and greatest when folate excess is present with vitamin B12 deficiency. Excess folate leads to a fall in vitamin B12 levels and aggravation of the block in folate metabolism resulting from vitamin B12 deficiency. The balance between folate and vitamin B12 is crucial to the functioning of one carbon metabolic pathways, the methylation cycle and ultimately to DNA and RNA structure and function, genetic and epigenetic stability. Vitamin B12 deficiency is an independent risk factor for NTDs and accounts for the increased risk of NTDs in some countries where B12 deficiency is more common than folate deficiency. A more prudent and balanced approach to fortification with folic acid, or preferably a natural reduced folate, combined with vitamin B12 would potentially improve the benefits and reduce the harms, including epigenetic and transgenerational risks, associated with current public health policies.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 11","pages":"1073-1077"},"PeriodicalIF":3.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854964","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 : 2025-08-13DOI: 10.1038/s41430-025-01655-5
Xu-Wen Wang, Scott T. Weiss, Frank B. Hu, Yang-Yu Liu
Various diet scores have been developed to assess compliance with dietary guidelines. Yet, enhancing those diet scores is very challenging. Here, we tackle this issue by formalizing an optimization problem and solving it with simulated annealing. Our optimization-based dietary recommendation (ODR) approach, evaluated using Diet-Microbiome Association study data, provides efficient and reasonable recommendations for different diet scores. ODR has the potential to enhance nutritional counseling and promote dietary adherence for healthy eating.
{"title":"Optimization-based dietary recommendations for healthy eating","authors":"Xu-Wen Wang, Scott T. Weiss, Frank B. Hu, Yang-Yu Liu","doi":"10.1038/s41430-025-01655-5","DOIUrl":"10.1038/s41430-025-01655-5","url":null,"abstract":"Various diet scores have been developed to assess compliance with dietary guidelines. Yet, enhancing those diet scores is very challenging. Here, we tackle this issue by formalizing an optimization problem and solving it with simulated annealing. Our optimization-based dietary recommendation (ODR) approach, evaluated using Diet-Microbiome Association study data, provides efficient and reasonable recommendations for different diet scores. ODR has the potential to enhance nutritional counseling and promote dietary adherence for healthy eating.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"80 1","pages":"130-134"},"PeriodicalIF":3.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144845012","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 : 2025-07-31DOI: 10.1038/s41430-025-01645-7
Alice Scricciolo, Vincenza Lombardo, Karla Amada Bascuñán, Magdalena Araya, Luca Elli, Andrea Costantino, Rachele Gori, Giulia Gilberti, Flavio Caprioli, Gian Eugenio Tontini, Maurizio Vecchi, Federica Mascaretti, Luisa Doneda, Valentina Meschia, Leda Roncoroni
Ulcerative colitis (UC) and Crohn’s disease (CD) are inflammatory bowel diseases (IBD) with varying clinical presentations. Current literature lacks specific dietary recommendations, though diets may serve as potential tools. This study, conducted at IRCCS Ca’ Granda Foundation Ospedale Maggiore Policlinico of Milan from April 2020 to July 2022, aimed to evaluate the diets of UC and CD patients, focusing on preferred and avoided foods. Results showed 67.4% and 80.9% of participants in remission by Mayo and HBI scores, respectively, with normal nutritional status and higher weight in CD versus UC patients and controls. Lactose-free diets were most common (21.3% UC, 17.4% CD, 11.6% controls), followed by gluten-free diets (23.4% UC, 13.4% CD, 9.3% controls). Low-FODMAPS diet adoption was minimal. Fibre avoidance was notable in CD (52%) and UC (45%) versus controls (5%). Pasta and bread consumption were high across groups. No dietary associations with disease activity or intergroup differences were found. The study population exhibited mild to moderate disease activity, normal nutritional status and prevalent dietary restrictions affecting nutrient intake and quality of life. Lactose-free diets were frequently employed, while gluten-free and low-FODMAPS diets were less common. Encouraging supervised fibre intake is recommended to prevent microbiota alterations negatively impacting intestinal health and homeostasis in IBD patients.
背景和目的：溃疡性结肠炎（UC）和克罗恩病（CD）是具有不同临床表现的炎症性肠病（IBD）。目前的文献缺乏具体的饮食建议，尽管饮食可能作为潜在的工具。方法：本研究于2020年4月至2022年7月在米兰的IRCCS Ca' Granda Foundation Ospedale Maggiore Policlinico进行，旨在评估UC和CD患者的饮食，重点关注首选和避免的食物。结果：结果显示，与UC患者和对照组相比，经Mayo评分和HBI评分，67.4%和80.9%的患者营养状况正常，体重较高。无乳糖饮食最常见（21.3% UC, 17.4% CD， 11.6%对照），其次是无麸质饮食（23.4% UC, 13.4% CD， 9.3%对照）。低fodmaps饮食的采用率最低。与对照组（5%）相比，乳糜泻（52%）和UC（45%）患者对纤维的回避尤为显著。意大利面和面包的消费量在各组中都很高。没有发现饮食与疾病活动性或组间差异有关。结论：研究人群表现出轻度至中度疾病活动，营养状况正常，普遍存在影响营养摄入和生活质量的饮食限制。无乳糖饮食经常被采用，而无麸质和低fodmaps饮食不太常见。建议鼓励有监督的纤维摄入，以防止肠道菌群改变对IBD患者肠道健康和体内平衡产生负面影响。
{"title":"Assessment of nutritional status and eating behaviours in patients with chronic inflammatory bowel disease: a pilot study","authors":"Alice Scricciolo, Vincenza Lombardo, Karla Amada Bascuñán, Magdalena Araya, Luca Elli, Andrea Costantino, Rachele Gori, Giulia Gilberti, Flavio Caprioli, Gian Eugenio Tontini, Maurizio Vecchi, Federica Mascaretti, Luisa Doneda, Valentina Meschia, Leda Roncoroni","doi":"10.1038/s41430-025-01645-7","DOIUrl":"10.1038/s41430-025-01645-7","url":null,"abstract":"Ulcerative colitis (UC) and Crohn’s disease (CD) are inflammatory bowel diseases (IBD) with varying clinical presentations. Current literature lacks specific dietary recommendations, though diets may serve as potential tools. This study, conducted at IRCCS Ca’ Granda Foundation Ospedale Maggiore Policlinico of Milan from April 2020 to July 2022, aimed to evaluate the diets of UC and CD patients, focusing on preferred and avoided foods. Results showed 67.4% and 80.9% of participants in remission by Mayo and HBI scores, respectively, with normal nutritional status and higher weight in CD versus UC patients and controls. Lactose-free diets were most common (21.3% UC, 17.4% CD, 11.6% controls), followed by gluten-free diets (23.4% UC, 13.4% CD, 9.3% controls). Low-FODMAPS diet adoption was minimal. Fibre avoidance was notable in CD (52%) and UC (45%) versus controls (5%). Pasta and bread consumption were high across groups. No dietary associations with disease activity or intergroup differences were found. The study population exhibited mild to moderate disease activity, normal nutritional status and prevalent dietary restrictions affecting nutrient intake and quality of life. Lactose-free diets were frequently employed, while gluten-free and low-FODMAPS diets were less common. Encouraging supervised fibre intake is recommended to prevent microbiota alterations negatively impacting intestinal health and homeostasis in IBD patients.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 11","pages":"1130-1137"},"PeriodicalIF":3.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759531","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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