Post‑stroke dysphagia and malnutrition both compromise recovery. Whether the Geriatric Nutritional Risk Index (GNRI) measured on acute admission predicts swallowing function after convalescent rehabilitation remains unclear.
Methods
This study retrospectively analyzed 254 with ischemic stroke patients aged ≥ 65 y (median age 79.3 y; 141 men) who were admitted within 7 d of stroke onset and subsequently transferred to convalescent rehabilitation hospitals. GNRI was calculated within 3 d of acute admission. Swallowing function was assessed with the Functional Oral Intake Scale (FOIS). Multivariate linear regression analyses with FOIS on convalescent discharge included acute-phase GNRI, age, sex, brainstem lesion, premorbid modified Rankin Scale, National Instituted of Health Stroke Scale, hemoglobin, C-reactive protein, Functional Independence Measure, days to speech therapy initiation, and baseline FOIS, which were assessed at the time of admission to the acute hospital.
Results
Fifty-one (20.1%) had malnutrition for GNRI < 92 on acute admission. Patients with malnutrition were lower FOIS on acute admission (P = 0.002) and convalescent discharge (P < 0.001) than patients without malnutrition. Multivariate linear regression analyses revealed that acute-phase GNRI (β = 0.151; P = 0.019), premorbid modified Rankin Scale (β = –0.149; P = 0.009), C-reactive protein (β = 0.138; P = 0.024), days to speech therapy initiation (β = –0.116; P = 0.031), and baseline FOIS (β = 0.37; P < 0.001) were significantly associated with FOIS on convalescent discharge.
Conclusions
Acute‑phase GNRI may predict swallowing function after convalescent rehabilitation in older patients with ischemic stroke.
卒中后吞咽困难和营养不良都会影响康复。急性入院时测量的老年营养风险指数（GNRI）是否能预测恢复期康复后的吞咽功能尚不清楚。方法回顾性分析254例年龄≥65岁的缺血性脑卒中患者（中位年龄79.3岁，141例男性），这些患者在脑卒中发病后7天内入院，随后转至康复康复医院。急性入院后3 d内计算GNRI。采用功能性口服摄入量表（FOIS）评估吞咽功能。康复出院时FOIS的多变量线性回归分析包括急性期GNRI、年龄、性别、脑干病变、病前改良Rankin量表、国家卒中量表、血红蛋白、c反应蛋白、功能独立性测量、开始言语治疗天数和基线FOIS，这些指标在入院时进行评估。结果51例（20.1%）患者在GNRI期出现营养不良；92例患者在急性入院时出现营养不良。营养不良患者急性入院时的FOIS （P = 0.002）和出院时的FOIS （P < 0.001）均低于非营养不良患者。多元线性回归分析显示，急性期GNRI （β = 0.151, P = 0.019）、病前改良Rankin量表（β = -0.149, P = 0.009）、c反应蛋白（β = 0.138, P = 0.024）、开始言语治疗的天数（β = -0.116, P = 0.031）和基线FOIS （β = 0.37, P < 0.001）与康复出院时的FOIS显著相关。结论急性期GNRI可预测老年缺血性脑卒中患者恢复期康复后吞咽功能。
{"title":"Acute-phase Geriatric Nutritional Risk Index is associated with swallowing function after convalescent rehabilitation in older patients with ischemic stroke: A retrospective cohort study","authors":"Toshiyuki Moriyama M.D. , Fumio Sato S.T. , Nobuyuki Yokomichi P.T. , Kei Yamanaka M.D., Ph.D. , Yoji Yoshikawa M.D., Ph.D. , Masaki Tachibana M.D., Ph.D. , Junya Kuroda M.D., Ph.D. , Eri Tanaka M.D., Ph.D. , Hironori Fukumoto M.D., Ph.D. , Hiroshi Nakane M.D., Ph.D.","doi":"10.1016/j.nut.2025.113061","DOIUrl":"10.1016/j.nut.2025.113061","url":null,"abstract":"<div><h3>Introduction</h3><div>Post‑stroke dysphagia and malnutrition both compromise recovery. Whether the Geriatric Nutritional Risk Index (GNRI) measured on acute admission predicts swallowing function after convalescent rehabilitation remains unclear.</div></div><div><h3>Methods</h3><div>This study retrospectively analyzed 254 with ischemic stroke patients aged ≥ 65 y (median age 79.3 y; 141 men) who were admitted within 7 d of stroke onset and subsequently transferred to convalescent rehabilitation hospitals. GNRI was calculated within 3 d of acute admission. Swallowing function was assessed with the Functional Oral Intake Scale (FOIS). Multivariate linear regression analyses with FOIS on convalescent discharge included acute-phase GNRI, age, sex, brainstem lesion, premorbid modified Rankin Scale, National Instituted of Health Stroke Scale, hemoglobin, C-reactive protein, Functional Independence Measure, days to speech therapy initiation, and baseline FOIS, which were assessed at the time of admission to the acute hospital.</div></div><div><h3>Results</h3><div>Fifty-one (20.1%) had malnutrition for GNRI < 92 on acute admission. Patients with malnutrition were lower FOIS on acute admission (<em>P</em> = 0.002) and convalescent discharge (<em>P</em> < 0.001) than patients without malnutrition. Multivariate linear regression analyses revealed that acute-phase GNRI (<em>β</em> = 0.151; <em>P</em> = 0.019), premorbid modified Rankin Scale (<em>β</em> = –0.149; <em>P</em> = 0.009), C-reactive protein (<em>β</em> = 0.138; <em>P</em> = 0.024), days to speech therapy initiation (<em>β</em> = –0.116; <em>P</em> = 0.031), and baseline FOIS (<em>β</em> = 0.37; P < 0.001) were significantly associated with FOIS on convalescent discharge.</div></div><div><h3>Conclusions</h3><div>Acute‑phase GNRI may predict swallowing function after convalescent rehabilitation in older patients with ischemic stroke.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"144 ","pages":"Article 113061"},"PeriodicalIF":3.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927484","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 : 2025-12-11DOI: 10.1016/j.nut.2025.113065
Muna Saeed Mohammed Ph.D. , Warda Amur Al Amri Ph.D. , Duaa Al-Maghaireh Ph.D. , Shimaa Nabil Ahmed Ph.D.
Objectives
Nutritional care is a crucial aspect of patient well-being, and nurses lie at the heart of its implementation in hospital settings. However, their role as yet remains limited and under-recognized, especially in Saudi tertiary hospitals. This scoping review aims to map the existing literature on the nursing role in nutritional care in Saudi tertiary settings, with findings organized by study design and key themes, and identifying gaps to inform practice, policy, and education.
Methods
A scoping review design was used to conduct this study. The review followed the PRISMA-ScR guidelines within the Arksey & O'Malley framework. Five stages were employed: searching for relevant studies across several databases, screening, charting the data, and thematically synthesizing the findings.
Results
Of the 713 records initially identified through database searches spanning 2014 to 2025, 133 duplicates were removed. This left 580 unique publications for the initial screening phase, during which titles and abstracts were evaluated. Based on this assessment, 535 records were excluded. The full text of the remaining 45 articles was then evaluated for eligibility. Finally, twelve articles were incorporated into the final review, each meeting the inclusion criteria.
Conclusion
The review established that within the context of interdisciplinary collaboration, certain responsibilities of nurses in nutritional care are not clearly outlined.
{"title":"Mapping nursing roles in nutritional care within Saudi tertiary hospitals: A scoping review","authors":"Muna Saeed Mohammed Ph.D. , Warda Amur Al Amri Ph.D. , Duaa Al-Maghaireh Ph.D. , Shimaa Nabil Ahmed Ph.D.","doi":"10.1016/j.nut.2025.113065","DOIUrl":"10.1016/j.nut.2025.113065","url":null,"abstract":"<div><h3>Objectives</h3><div>Nutritional care is a crucial aspect of patient well-being, and nurses lie at the heart of its implementation in hospital settings. However, their role as yet remains limited and under-recognized, especially in Saudi tertiary hospitals. This scoping review aims to map the existing literature on the nursing role in nutritional care in Saudi tertiary settings, with findings organized by study design and key themes, and identifying gaps to inform practice, policy, and education.</div></div><div><h3>Methods</h3><div>A scoping review design was used to conduct this study. The review followed the PRISMA-ScR guidelines within the Arksey & O'Malley framework. Five stages were employed: searching for relevant studies across several databases, screening, charting the data, and thematically synthesizing the findings.</div></div><div><h3>Results</h3><div>Of the 713 records initially identified through database searches spanning 2014 to 2025, 133 duplicates were removed. This left 580 unique publications for the initial screening phase, during which titles and abstracts were evaluated. Based on this assessment, 535 records were excluded. The full text of the remaining 45 articles was then evaluated for eligibility. Finally, twelve articles were incorporated into the final review, each meeting the inclusion criteria.</div></div><div><h3>Conclusion</h3><div>The review established that within the context of interdisciplinary collaboration, certain responsibilities of nurses in nutritional care are not clearly outlined.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"144 ","pages":"Article 113065"},"PeriodicalIF":3.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927486","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 : 2025-12-11DOI: 10.1016/j.nut.2025.113063
Erin Russell , Mary Anne Silvers , Peter Coombs
Objectives
Sarcopenia and malnutrition have detrimental health related outcomes not limited to falls, weakness, fractures, increased hospital length of stay, increased risk of infections, morbidity and mortality. Ultrasound is an establishing imaging modality that can be utilized at point-of care to measure muscle mass and quality. It is cheaper, less invasive, and more accessible than other gold-standard measurements of muscle mass. It is proposed that dietitians can utilize this measurement in clinical practice to support both diagnosis and monitoring of malnutrition and sarcopenia, however current evidence has not been synthesized.
Methods
The search was completed in May 2024. MEDLINE, EMBASE, PubMed and Cochrane databases were searched. Search terms and search procedures were transposed across different databases based on known Booleen operators. Due to paucity of evidence in the area, a broad search strategy was employed. Simply the combination of synonyms of ultrasound and dietitian within any field was used to ensure any kind of ultrasound measured by a dietitian was captured.
Results
The initial search identified 946 titles for review from which 228 duplicates were removed, leaving 718 for screening. After screening, 55 papers remained for full-text review. Ten papers were included for appraisal. All peer-reviewed papers were observational, 441 participants in total were included (both healthy participants and patient cohorts). Study quality was low, with study design, documentation of training, timing of measurement and blinding poorly defined. The reference standard (if any) was inconsistent. All studies were basic research, none were translated into clinical practice. Quad muscle thickness was the most common measurement. Reliability of dietitians was reported in most, with intra-rater ICC ranges from 0.63 to 0.95 between dietitians and ‘experts’ (intensivists, trained clinicians or sonographers). Training undertaken was reported in half the papers reviewed but details were limited.
Conclusion
Emerging evidence suggests dietitians have potential to develop skills in measuring muscles with ultrasound. Overall, there remains a paucity of publications in the area, particularly when considering dietitian training and reliability in various ultrasound measurements. There should be progress in Further studies with regard to verifying necessary training for dietitians to ensure accurate readings as an advanced scope of practice for dietitians.
{"title":"Can dietitians reliably measure muscle mass with ultrasound compared to ‘expert’ clinicians and what sort of training is required?A narrative review","authors":"Erin Russell , Mary Anne Silvers , Peter Coombs","doi":"10.1016/j.nut.2025.113063","DOIUrl":"10.1016/j.nut.2025.113063","url":null,"abstract":"<div><h3>Objectives</h3><div>Sarcopenia and malnutrition have detrimental health related outcomes not limited to falls, weakness, fractures, increased hospital length of stay, increased risk of infections, morbidity and mortality. Ultrasound is an establishing imaging modality that can be utilized at point-of care to measure muscle mass and quality. It is cheaper, less invasive, and more accessible than other gold-standard measurements of muscle mass. It is proposed that dietitians can utilize this measurement in clinical practice to support both diagnosis and monitoring of malnutrition and sarcopenia, however current evidence has not been synthesized.</div></div><div><h3>Methods</h3><div>The search was completed in May 2024. MEDLINE, EMBASE, PubMed and Cochrane databases were searched. Search terms and search procedures were transposed across different databases based on known Booleen operators. Due to paucity of evidence in the area, a broad search strategy was employed. Simply the combination of synonyms of <em>ultrasound</em> and <em>dietitian</em> within <em>any</em> field was used to ensure any kind of ultrasound measured by a dietitian was captured.</div></div><div><h3>Results</h3><div>The initial search identified 946 titles for review from which 228 duplicates were removed, leaving 718 for screening. After screening, 55 papers remained for full-text review. Ten papers were included for appraisal. All peer-reviewed papers were observational, 441 participants in total were included (both healthy participants and patient cohorts). Study quality was low, with study design, documentation of training, timing of measurement and blinding poorly defined. The reference standard (if any) was inconsistent. All studies were basic research, none were translated into clinical practice. Quad muscle thickness was the most common measurement. Reliability of dietitians was reported in most, with intra-rater ICC ranges from 0.63 to 0.95 between dietitians and ‘experts’ (intensivists, trained clinicians or sonographers). Training undertaken was reported in half the papers reviewed but details were limited.</div></div><div><h3>Conclusion</h3><div>Emerging evidence suggests dietitians have potential to develop skills in measuring muscles with ultrasound. Overall, there remains a paucity of publications in the area, particularly when considering dietitian training and reliability in various ultrasound measurements. There should be progress in Further studies with regard to verifying necessary training for dietitians to ensure accurate readings as an advanced scope of practice for dietitians.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"144 ","pages":"Article 113063"},"PeriodicalIF":3.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917989","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 : 2025-12-11DOI: 10.1016/j.nut.2025.113066
Marcus Vinicius de Oliveira Cattem Ph.D., Felipe Olasagasti Machado, Maria Eduarda Guerreiro da Silva M.Sc., Daniela Silva Canella Ph.D., Josely Correa Koury Ph.D.
Objectives
There is growing evidence linking the consumption of ultra-processed foods (UPFs) to adverse health outcomes. Accurate classification of foods according to the extent and purpose of industrial processing is therefore essential for improving dietary assessment and public health strategies. This study aimed to evaluate and compare the performance of two large language models (LLMs), DeepSeek-R1 and ChatGPT o1, in classifying foods according to the NOVA classification system.
Methods
Both LLMs were tasked with categorizing a standardized list of 1,168 food items obtained from the Brazilian Food Composition Table (TBCA, version 7.0). The classifications generated by the models were compared with a reference list manually classified by a trained researcher. Quantitative analyses included the calculation of unweighted Cohen’s kappa between the LLMs, as well as accuracy, sensitivity, specificity, precision, and F1 score for each model. Qualitative analyses were conducted to explore discrepancies in food classification.
Results
ChatGPT o1 demonstrated superior performance across all evaluated metrics, achieving an accuracy of 98.0%, sensitivity of 94.7%, specificity of 99.0%, and an F1 score of 95.6%. In comparison, DeepSeek-R1 achieved an accuracy of 92.6%, sensitivity of 69.8%, specificity of 99.3%, and an F1 score of 81.1%. ChatGPT o1 also produced substantially fewer misclassifications than DeepSeek-R1 (23 versus 86, respectively).
Conclusions
The findings highlight the potential of large language models to support dietary assessment and nutrition research. The development of an automated tool based on the NOVA food classification framework is recommended to assist nutritionists and researchers, enabling faster and more consistent food classification in both clinical and research settings.
{"title":"Comparing ChatGPT and DeepSeek for ultra-processed food classification: AI models for nutritional research and dietary assessment","authors":"Marcus Vinicius de Oliveira Cattem Ph.D., Felipe Olasagasti Machado, Maria Eduarda Guerreiro da Silva M.Sc., Daniela Silva Canella Ph.D., Josely Correa Koury Ph.D.","doi":"10.1016/j.nut.2025.113066","DOIUrl":"10.1016/j.nut.2025.113066","url":null,"abstract":"<div><h3>Objectives</h3><div>There is growing evidence linking the consumption of ultra-processed foods (UPFs) to adverse health outcomes. Accurate classification of foods according to the extent and purpose of industrial processing is therefore essential for improving dietary assessment and public health strategies. This study aimed to evaluate and compare the performance of two large language models (LLMs), DeepSeek-R1 and ChatGPT o1, in classifying foods according to the NOVA classification system.</div></div><div><h3>Methods</h3><div>Both LLMs were tasked with categorizing a standardized list of 1,168 food items obtained from the Brazilian Food Composition Table (TBCA, version 7.0). The classifications generated by the models were compared with a reference list manually classified by a trained researcher. Quantitative analyses included the calculation of unweighted Cohen’s kappa between the LLMs, as well as accuracy, sensitivity, specificity, precision, and F1 score for each model. Qualitative analyses were conducted to explore discrepancies in food classification.</div></div><div><h3>Results</h3><div>ChatGPT o1 demonstrated superior performance across all evaluated metrics, achieving an accuracy of 98.0%, sensitivity of 94.7%, specificity of 99.0%, and an F1 score of 95.6%. In comparison, DeepSeek-R1 achieved an accuracy of 92.6%, sensitivity of 69.8%, specificity of 99.3%, and an F1 score of 81.1%. ChatGPT o1 also produced substantially fewer misclassifications than DeepSeek-R1 (23 versus 86, respectively).</div></div><div><h3>Conclusions</h3><div>The findings highlight the potential of large language models to support dietary assessment and nutrition research. The development of an automated tool based on the NOVA food classification framework is recommended to assist nutritionists and researchers, enabling faster and more consistent food classification in both clinical and research settings.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"144 ","pages":"Article 113066"},"PeriodicalIF":3.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927992","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 : 2025-12-10DOI: 10.1016/j.nut.2025.113052
Tao Ding MCM , Zhongman Zhang MCM , Wei Li MD , Yi Zhu MCM, Yutong Shi MCM, Tianshi Li MCM, Xufeng Chen MD
Objectives
To explore the correlation between the parameters of muscle atrophy assessed by musculoskeletal ultrasound and the clinical outcomes of patients treated with extracorporeal membrane oxygenation (ECMO).
Methods
Patients who received ECMO treatment in the emergency intensive care unit of the First Affiliated Hospital of Nanjing Medical University (Jiangsu Provincial Hospital) from August 2022 to December 2023 were selected as the study subjects. Patients were grouped based on the percentage reduction in the cross-sectional area of the rectus femoris muscle assessed by ultrasound, with a reduction of ≥10% classified into the muscle atrophy group and a reduction of <10% classified into the nonmuscle atrophy group. Basic clinical data, outcome data, clinical laboratory data, and physical measurements of ECMO patients were collected and analyzed to compare the overall clinical outcomes between the two groups.
Results
A total of 45 ECMO patients were included in the study; 30 patients (66.67%) were included in the muscle atrophy group, 15 patients (33.33%) were included in the nonmuscle atrophy group, and the overall 28-day survival rate was 51.11%. The patients in the muscle atrophy group (57 [48.75, 61] years) were significantly older than those in the nonmuscle atrophy group (52 [31, 57] years, P = 0.028), whereas other basic clinical data, including sex, height, weight, body mass index, Acute Physiology and Chronic Health Evaluation II score, and ECMO mode, did not differ. The initial total protein value (56.44 ± 7.304) g/L and albumin value (32.61 ± 4.823) g/L in the muscle atrophy group were significantly lower than those in the nonmuscle atrophy group (total protein [61.44 ± 7.950] g/L, P = 0.041; albumin [37.17 ± 6.653] g/L, P = 0.012). The change in the psoas muscle area at the T3 level in the muscle atrophy group (−136.59 ± 72.950) mm2 was significantly less than that in the nonmuscle atrophy group ([−60.23 ± 26.934] mm2, P = 0.002), and other physical measurement data, including changes in midarm circumference and calf circumference, were not significantly different. There were no significant differences in the 28-day survival rate, ventilator-free time, or ICU stay time between the two groups of patients.
Conclusions
Muscle atrophy is relatively common in ECMO patients, and bedside ultrasound assessment of the muscle atrophy status of ECMO patients has a certain degree of reliability. However, the relationship between the occurrence of muscle atrophy and patient prognosis is not clear and requires further verification.
目的探讨肌骨骼超声评估的肌萎缩指标与体外膜氧合（ECMO）患者临床预后的相关性。方法选择2022年8月至2023年12月在南京医科大学第一附属医院（江苏省附属医院）急诊重症监护室接受ECMO治疗的患者为研究对象。根据超声评估的股直肌横截面积缩小百分比对患者进行分组，缩小≥10%归为肌肉萎缩组，缩小≤10%归为非肌肉萎缩组。收集并分析ECMO患者的基本临床资料、结局资料、临床实验室资料和体格测量，比较两组患者的总体临床结局。结果共纳入45例ECMO患者；肌萎缩组30例（66.67%），非肌萎缩组15例（33.33%），总28天生存率为51.11%。肌萎缩组患者年龄（57[48.75,61]岁）明显大于非肌萎缩组患者年龄（52[31,57]岁，P = 0.028），而其他基本临床资料，包括性别、身高、体重、体质指数、急性生理与慢性健康评估II评分、ECMO模式等均无差异。肌萎缩组的初始总蛋白值（56.44±7.304）g/L和白蛋白值（32.61±4.823）g/L显著低于非肌萎缩组（总蛋白[61.44±7.950]g/L, P = 0.041；白蛋白[37.17±6.653]g/L, P = 0.012）。肌萎缩组T3水平腰肌面积变化（- 136.59±72.950）mm2明显小于非肌萎缩组（[- 60.23±26.934]mm2, P = 0.002），其他物理测量数据，包括上臂围、小腿围变化，差异无统计学意义。两组患者的28天生存率、无呼吸机时间、ICU住院时间均无显著差异。结论ECMO患者肌肉萎缩较为常见，床边超声评估ECMO患者肌肉萎缩状况具有一定的可靠性。然而，肌萎缩的发生与患者预后的关系尚不清楚，需要进一步验证。
{"title":"Ultrasound assessment of muscle mass in extracorporeal membrane oxygenation patients and its correlation with clinical outcomes: A retrospective observational study","authors":"Tao Ding MCM , Zhongman Zhang MCM , Wei Li MD , Yi Zhu MCM, Yutong Shi MCM, Tianshi Li MCM, Xufeng Chen MD","doi":"10.1016/j.nut.2025.113052","DOIUrl":"10.1016/j.nut.2025.113052","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore the correlation between the parameters of muscle atrophy assessed by musculoskeletal ultrasound and the clinical outcomes of patients treated with extracorporeal membrane oxygenation (ECMO).</div></div><div><h3>Methods</h3><div>Patients who received ECMO treatment in the emergency intensive care unit of the First Affiliated Hospital of Nanjing Medical University (Jiangsu Provincial Hospital) from August 2022 to December 2023 were selected as the study subjects. Patients were grouped based on the percentage reduction in the cross-sectional area of the rectus femoris muscle assessed by ultrasound, with a reduction of ≥10% classified into the muscle atrophy group and a reduction of <10% classified into the nonmuscle atrophy group. Basic clinical data, outcome data, clinical laboratory data, and physical measurements of ECMO patients were collected and analyzed to compare the overall clinical outcomes between the two groups.</div></div><div><h3>Results</h3><div>A total of 45 ECMO patients were included in the study; 30 patients (66.67%) were included in the muscle atrophy group, 15 patients (33.33%) were included in the nonmuscle atrophy group, and the overall 28-day survival rate was 51.11%. The patients in the muscle atrophy group (57 [48.75, 61] years) were significantly older than those in the nonmuscle atrophy group (52 [31, 57] years, <em>P</em> = 0.028), whereas other basic clinical data, including sex, height, weight, body mass index, Acute Physiology and Chronic Health Evaluation II score, and ECMO mode, did not differ. The initial total protein value (56.44 ± 7.304) g/L and albumin value (32.61 ± 4.823) g/L in the muscle atrophy group were significantly lower than those in the nonmuscle atrophy group (total protein [61.44 ± 7.950] g/L, <em>P</em> = 0.041; albumin [37.17 ± 6.653] g/L, <em>P</em> = 0.012). The change in the psoas muscle area at the T3 level in the muscle atrophy group (−136.59 ± 72.950) mm<sup>2</sup> was significantly less than that in the nonmuscle atrophy group ([−60.23 ± 26.934] mm<sup>2</sup>, <em>P</em> = 0.002), and other physical measurement data, including changes in midarm circumference and calf circumference, were not significantly different. There were no significant differences in the 28-day survival rate, ventilator-free time, or ICU stay time between the two groups of patients.</div></div><div><h3>Conclusions</h3><div>Muscle atrophy is relatively common in ECMO patients, and bedside ultrasound assessment of the muscle atrophy status of ECMO patients has a certain degree of reliability. However, the relationship between the occurrence of muscle atrophy and patient prognosis is not clear and requires further verification.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"144 ","pages":"Article 113052"},"PeriodicalIF":3.0,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978602","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 : 2025-12-10DOI: 10.1016/j.nut.2025.113060
Juhye Kang M.D. , Audrey Watnick , Djanira Fernandes M.D. , Valeria Ruiz-Santana M.D. , Mark Puder M.D., Ph.D. , Kathleen M. Gura Pharm.D.
Essential fatty acid deficiency (EFAD) is a rare but serious condition with significant consequences including delayed growth and development, decreased immune response and reproductive dysfunction, among others. EFAD is of particular concern in vulnerable populations such as preterm infants and those receiving long-term parenteral nutrition (PN). As essential fatty acids (EFAs) must be supplemented in the diet due to the inability to synthesize these endogenously, EFAD develops secondary to inadequate EFA intake. The Holman Index, defined by the ratio of Mead acid to arachidonic acid (triene: tetraene (T:T)) in the plasma, has historically served as the method for diagnosis, with the threshold diagnostic value at ≥0.20. This index is derived from the body’s natural metabolic response to EFA deprivation, increasing synthesis of Mead acid, and thus remains broadly applicable across various populations. Concerns regarding the established ratio and alternative use of absolute fatty acid values and profiles have been raised that question the utility of the Holman Index. Although recent developments in fatty acid profiling have allowed for increased precision in measurement and development of population-specific reference ranges, reliability of this data in diagnosing EFAD is controversial given variability amongst different studies and population dietary confounders. Data from animal and human studies have demonstrated that the Holman index has continued to reliably detect EFAD even in the era of new lipid emulsions and technological advancements. The Holman Index remains a vital tool in the diagnosis and monitoring of EFAD, offering consistency and early detection capacity in at-risk populations.
{"title":"In defense of the Holman index: Defining fatty acid deficiency","authors":"Juhye Kang M.D. , Audrey Watnick , Djanira Fernandes M.D. , Valeria Ruiz-Santana M.D. , Mark Puder M.D., Ph.D. , Kathleen M. Gura Pharm.D.","doi":"10.1016/j.nut.2025.113060","DOIUrl":"10.1016/j.nut.2025.113060","url":null,"abstract":"<div><div>Essential fatty acid deficiency (EFAD) is a rare but serious condition with significant consequences including delayed growth and development, decreased immune response and reproductive dysfunction, among others. EFAD is of particular concern in vulnerable populations such as preterm infants and those receiving long-term parenteral nutrition (PN). As essential fatty acids (EFAs) must be supplemented in the diet due to the inability to synthesize these endogenously, EFAD develops secondary to inadequate EFA intake. The Holman Index, defined by the ratio of Mead acid to arachidonic acid (triene: tetraene (T:T)) in the plasma, has historically served as the method for diagnosis, with the threshold diagnostic value at ≥0.20. This index is derived from the body’s natural metabolic response to EFA deprivation, increasing synthesis of Mead acid, and thus remains broadly applicable across various populations. Concerns regarding the established ratio and alternative use of absolute fatty acid values and profiles have been raised that question the utility of the Holman Index. Although recent developments in fatty acid profiling have allowed for increased precision in measurement and development of population-specific reference ranges, reliability of this data in diagnosing EFAD is controversial given variability amongst different studies and population dietary confounders. Data from animal and human studies have demonstrated that the Holman index has continued to reliably detect EFAD even in the era of new lipid emulsions and technological advancements. The Holman Index remains a vital tool in the diagnosis and monitoring of EFAD, offering consistency and early detection capacity in at-risk populations.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"144 ","pages":"Article 113060"},"PeriodicalIF":3.0,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927987","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}
Cardiovascular diseases (CVD) are the leading cause of mortality worldwide, with secondary prevention a public health priority. Diet is a modifiable risk factor, and adherence to the Mediterranean diet (MD) has shown benefits in primary prevention. However, its role in patients already affected by CVD remains uncertain. This systematic review and meta-analysis aimed to evaluate the association between adherence to MD and recurrent cardiovascular events, mortality, and intermediate health outcomes in individuals with established CVD.
Methods
This review was conducted in accordance with PRISMA 2020 and MOOSE guidelines. A comprehensive search of PubMed/MEDLINE, Scopus, Embase, and Cochrane Library was performed up to February 28, 2024. The certainty of evidence was evaluated with the NUTRIGRADE approach. Pooled effect sizes were computed using a random-effects model and expressed as risk ratios (RR), hazard ratios, or odds ratios, as appropriate.
Results
Nineteen studies (4 randomized controlled trials—RCTs, 15 cohorts) involving over 91 000 participants were included. Higher adherence to MD was associated with a reduced risk of major adverse cardiovascular events in cohorts (RR 0.95, 95% CI: 0.93–0.97) and RCTs (RR 0.44, 95% CI: 0.20–0.94), and reduced mortality in cohorts (RR 0.96, 95% CI: 0.95–0.98) and RCTs (RR 0.27, 95% CI: 0.13–0.55). Effects on blood pressure and lipid profile were not significant, while effects on body composition were non-significant. Certainty of evidence ranged from low to high depending on the different outcomes.
Conclusions
Higher adherence to the MD is associated with clinically meaningful reductions in recurrent cardiovascular events and mortality among CVD patients. These findings support incorporating MD-based recommendations into secondary prevention guidelines and public health strategies.
{"title":"Efficacy of Mediterranean diet for the prevention in patients affected by cardiovascular diseases: A systematic review and meta-analysis featured in the Italian National Guidelines “La Dieta Mediterranea”","authors":"Roberto Volpe MD, AMS, PhD , Marco Matteo Ciccone MD , Barbara Pala MD , Federico Barbarano MD , Stefania Camastra MD , Massimiliano Caprio MD, PhD , Amanda Casirati PhD , Armando Ferrera MD , Ferruccio Galletti MD , Alessandro Greatti MD , Maria Pina Mollica PhD , Stefania Paolillo MD , Damiano Parretti MD , Daniele Nucci RD , Nicola Veronese MD , Luigi Fontana MD, PhD , Stefania Maggi MD, PhD , Graziano Onder MD, PhD , Marco Silano MD, PhD , Michela Zanetti MD, PhD , Massimo Volpe MD","doi":"10.1016/j.nut.2025.113053","DOIUrl":"10.1016/j.nut.2025.113053","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular diseases (CVD) are the leading cause of mortality worldwide, with secondary prevention a public health priority. Diet is a modifiable risk factor, and adherence to the Mediterranean diet (MD) has shown benefits in primary prevention. However, its role in patients already affected by CVD remains uncertain. This systematic review and meta-analysis aimed to evaluate the association between adherence to MD and recurrent cardiovascular events, mortality, and intermediate health outcomes in individuals with established CVD.</div></div><div><h3>Methods</h3><div>This review was conducted in accordance with PRISMA 2020 and MOOSE guidelines. A comprehensive search of PubMed/MEDLINE, Scopus, Embase, and Cochrane Library was performed up to February 28, 2024. The certainty of evidence was evaluated with the NUTRIGRADE approach. Pooled effect sizes were computed using a random-effects model and expressed as risk ratios (RR), hazard ratios, or odds ratios, as appropriate.</div></div><div><h3>Results</h3><div>Nineteen studies (4 randomized controlled trials—RCTs, 15 cohorts) involving over 91 000 participants were included. Higher adherence to MD was associated with a reduced risk of major adverse cardiovascular events in cohorts (RR 0.95, 95% CI: 0.93–0.97) and RCTs (RR 0.44, 95% CI: 0.20–0.94), and reduced mortality in cohorts (RR 0.96, 95% CI: 0.95–0.98) and RCTs (RR 0.27, 95% CI: 0.13–0.55). Effects on blood pressure and lipid profile were not significant, while effects on body composition were non-significant. Certainty of evidence ranged from low to high depending on the different outcomes.</div></div><div><h3>Conclusions</h3><div>Higher adherence to the MD is associated with clinically meaningful reductions in recurrent cardiovascular events and mortality among CVD patients. These findings support incorporating MD-based recommendations into secondary prevention guidelines and public health strategies.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"144 ","pages":"Article 113053"},"PeriodicalIF":3.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978600","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 : 2025-12-09DOI: 10.1016/j.nut.2025.113059
Gülistan Bahat M.D. , Tuğba Erdoğan M.D. , Ezgi Pınar M.D. , Serdar Özkök M.D. , Mehmet Akif Karan M.D. , Murat Gündüz M.D. , Osman Abbasoğlu M.D.
Background
Malnutrition remains a widespread clinical challenge with significant consequences on morbidity, mortality, and healthcare utilization. Despite evidence-based guidelines, nutritional interventions are often hindered by knowledge gaps among healthcare professionals (HCPs). This study aimed to evaluate HCPs’ knowledge and practices concerning oral nutritional supplements (ONS), based on evidence-based recommendations from the Turkish Clinical Enteral and Parenteral Nutrition Society (KEPAN).
Methods
A cross-sectional online survey was conducted between November 25 and December 26, 2022, using the SurveyMonkey platform. The questionnaire included 22 multiple-choice items derived from the KEPAN ONS consensus guideline, addressing key aspects of ONS use—indication, administration, monitoring, and discontinuation—in different clinical conditions. Demographic data were also collected. The survey was distributed via professional networks and KEPAN’s communication channels, targeting physicians, dietitians, nurses, and pharmacists.
Results
A total of 277 HCPs participated, predominantly dietitians (48.3%) and physicians (37.2%), with most respondents working in metropolitan hospitals. While some questions were answered correctly by the majority, 8 of 22 items were answered incorrectly by more than half of participants. Knowledge gaps were particularly pronounced in ONS use in neurological disorders (80.20% incorrect), dysphagia (78.50%), chronic kidney disease (86.20%), general indications (72.22%), diabetes (68.80%), and geriatric nutrition (73.2%).
Conclusions
Substantial knowledge deficits exist among HCPs regarding optimal ONS use, especially in geriatrics and neurology. These findings underscore the urgent need for structured, interdisciplinary, and practice-oriented education in clinical nutrition. Tailored training, curriculum integration, and collaboration between national and international nutrition societies are essential to improve nutritional care and patient outcomes.
{"title":"Oral nutritional supplements in clinical nutrition: Insights into healthcare professionals’ knowledge and practices","authors":"Gülistan Bahat M.D. , Tuğba Erdoğan M.D. , Ezgi Pınar M.D. , Serdar Özkök M.D. , Mehmet Akif Karan M.D. , Murat Gündüz M.D. , Osman Abbasoğlu M.D.","doi":"10.1016/j.nut.2025.113059","DOIUrl":"10.1016/j.nut.2025.113059","url":null,"abstract":"<div><h3>Background</h3><div>Malnutrition remains a widespread clinical challenge with significant consequences on morbidity, mortality, and healthcare utilization. Despite evidence-based guidelines, nutritional interventions are often hindered by knowledge gaps among healthcare professionals (HCPs). This study aimed to evaluate HCPs’ knowledge and practices concerning oral nutritional supplements (ONS), based on evidence-based recommendations from the Turkish Clinical Enteral and Parenteral Nutrition Society (KEPAN).</div></div><div><h3>Methods</h3><div>A cross-sectional online survey was conducted between November 25 and December 26, 2022, using the SurveyMonkey platform. The questionnaire included 22 multiple-choice items derived from the KEPAN ONS consensus guideline, addressing key aspects of ONS use—indication, administration, monitoring, and discontinuation—in different clinical conditions. Demographic data were also collected. The survey was distributed via professional networks and KEPAN’s communication channels, targeting physicians, dietitians, nurses, and pharmacists.</div></div><div><h3>Results</h3><div>A total of 277 HCPs participated, predominantly dietitians (48.3%) and physicians (37.2%), with most respondents working in metropolitan hospitals. While some questions were answered correctly by the majority, 8 of 22 items were answered incorrectly by more than half of participants. Knowledge gaps were particularly pronounced in ONS use in neurological disorders (80.20% incorrect), dysphagia (78.50%), chronic kidney disease (86.20%), general indications (72.22%), diabetes (68.80%), and geriatric nutrition (73.2%).</div></div><div><h3>Conclusions</h3><div>Substantial knowledge deficits exist among HCPs regarding optimal ONS use, especially in geriatrics and neurology. These findings underscore the urgent need for structured, interdisciplinary, and practice-oriented education in clinical nutrition. Tailored training, curriculum integration, and collaboration between national and international nutrition societies are essential to improve nutritional care and patient outcomes.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"144 ","pages":"Article 113059"},"PeriodicalIF":3.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917955","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}
Nutrition therapy can improve patients’ health outcomes and reduce health care cost. The undergraduate curriculum is often considered inadequate with respect to medical nutrition therapy, resulting in insufficient knowledge of medical nutrition therapy methodology among health care professionals (HCPs). The aim of this study was to evaluate the level of knowledge among HCPs regarding the use of oral nutritional supplements (ONS) in clinical practice.
Methods
An online survey was performed with the use of a validated questionnaire consisting of 33 questions (11 on demographic characteristics and 22 on the use of ONS). HCPs working in Greece with a recognized bachelor's degree and a professional licensewere included in the study.
Results
A total of 159 HCPs (49.1% dietitians – nutritionists, 32.7% physicians, 15.7% nurses and 2.5% pharmacists; 66.0% women; mean age: 40.5 ± 9.5 years) were analyzed. The mean number of correct responses on the use of ONS was 11.4 ± 3.0, with a higher level of knowledge being observed for questions about the principles of ONS administration in relation to their use in specific conditions. The lowest success rates were recorded for questions relating to pressure ulcers (8.2%), hip fracture surgery (13.2%), chronic kidney disease (CKD) (15.1%) and older adult patients (24.5%). Moreover, a knowledge deficit was found to be associated with younger age, role as physician, nurse, or pharmacist, limited working experience, and a lack of interest/experience in clinical nutrition (p < .05).
Conclusions
The results of our study support the need to improve clinical nutrition education, especially for younger HCPs, those with limited experience, physicians, nurses, and pharmacists.
{"title":"Use of oral nutritional supplements in Greece: Examining the effect of the level of knowledge of health care professionals on their use in clinical practice","authors":"Konstantina Nikolakopoulou MSc , Michail Chourdakis MD, PhD , Odysseas Androutsos PhD , Gülistan Bahat MD, PhD , Ezgi Pinar MD, PhD , Tugba Erdogan MD, PhD , Osman Abbasoglu MD, PhD , Kalliopi Anna Poulia PhD","doi":"10.1016/j.nut.2025.113056","DOIUrl":"10.1016/j.nut.2025.113056","url":null,"abstract":"<div><h3>Objectives</h3><div>Nutrition therapy can improve patients’ health outcomes and reduce health care cost. The undergraduate curriculum is often considered inadequate with respect to medical nutrition therapy, resulting in insufficient knowledge of medical nutrition therapy methodology among health care professionals (HCPs). The aim of this study was to evaluate the level of knowledge among HCPs regarding the use of oral nutritional supplements (ONS) in clinical practice.</div></div><div><h3>Methods</h3><div>An online survey was performed with the use of a validated questionnaire consisting of 33 questions (11 on demographic characteristics and 22 on the use of ONS). HCPs working in Greece with a recognized bachelor's degree and a professional licensewere included in the study.</div></div><div><h3>Results</h3><div>A total of 159 HCPs (49.1% dietitians – nutritionists, 32.7% physicians, 15.7% nurses and 2.5% pharmacists; 66.0% women; mean age: 40.5 ± 9.5 years) were analyzed. The mean number of correct responses on the use of ONS was 11.4 ± 3.0, with a higher level of knowledge being observed for questions about the principles of ONS administration in relation to their use in specific conditions. The lowest success rates were recorded for questions relating to pressure ulcers (8.2%), hip fracture surgery (13.2%), chronic kidney disease (CKD) (15.1%) and older adult patients (24.5%). Moreover, a knowledge deficit was found to be associated with younger age, role as physician, nurse, or pharmacist, limited working experience, and a lack of interest/experience in clinical nutrition (<em>p</em> < .05).</div></div><div><h3>Conclusions</h3><div>The results of our study support the need to improve clinical nutrition education, especially for younger HCPs, those with limited experience, physicians, nurses, and pharmacists.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"144 ","pages":"Article 113056"},"PeriodicalIF":3.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927485","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 : 2025-12-05DOI: 10.1016/j.nut.2025.113050
Yong Wu M.Sc. , Fanrui Fu M.D. , Wei Zhang Ph.D.
Objectives
The Mediterranean diet is promising for the reduction of cardiovascular risks, yet certain shortcomings have been noted, including limitations in clinical investigations with regard to follow-up periods, sample sizes, and potential confounding factors and limitations in basic research, such as oversimplification of complex biological pathways and a translational gap between species. The mechanisms are also complicated. Hence, we conducted a comprehensive analysis of the global research landscape and hotspots regarding the Mediterranean diet and atherosclerosis.
Methods
Articles focused on the Mediterranean diet and atherosclerosis published in the Science Citation Index Expanded of Web of Science Core Collection from 2005 to 2025 were retrieved. A total of 503 publications by 3205 authors from 200 journals were included. Data were analyzed and visualized using bibliometrix (R package) and VOSviewer.
Results
In this field, the annual publication number has increased since 2013. Spain and the United States were the dominant countries. The University of Barcelona was the most productive affiliation and Estruch and Martínez-González were the most productive authors. Nutrition, Metabolism and Cardiovascular Diseases was the journal with the highest publication numbers and the American Journal of Clinical Nutrition was the most cited journal. The most popular keywords shifted from “metabolic syndrome” and “olive oil” to “body mass index,” “consumption,” “gut microbiota,” and “intima-media thickness” after 2020. The summarized key mechanisms involved lipid metabolism, inflammation and oxidative stress, endothelial function, and gut microbiota.
Conclusions
The Mediterranean diet and atherosclerosis are gaining increasing attention. There has been a thematic evolution, transitioning from broad cardiovascular and metabolic benefits and key food components to more precise, mechanistic, and personalized understanding.
目的：地中海饮食有望降低心血管风险，但也存在一些缺点，包括临床研究在随访期、样本量、潜在混杂因素方面的局限性，以及基础研究的局限性，如复杂生物学途径的过度简化和物种之间的转化差距。其机制也很复杂。因此，我们对地中海饮食与动脉粥样硬化的全球研究现状和热点进行了综合分析。方法检索Web of Science核心馆藏2005 ~ 2025年科学引文索引扩展中发表的有关地中海饮食与动脉粥样硬化的文章。共收录200种期刊3205位作者的503篇论文。使用bibliometrix （R软件包）和VOSviewer对数据进行分析和可视化。结果自2013年以来，该领域的年度出版物数量有所增加。西班牙和美国是主要国家。巴塞罗那大学是最高产的院校，Estruch和Martínez-González是最高产的作者。《营养、代谢与心血管疾病》是出版数量最多的期刊，《美国临床营养学杂志》是被引用次数最多的期刊。2020年后，最热门的关键词从“代谢综合征”和“橄榄油”变成了“体重指数”、“消费”、“肠道微生物群”和“内膜-中膜厚度”。总结的关键机制涉及脂质代谢、炎症和氧化应激、内皮功能和肠道微生物群。结论地中海饮食与动脉粥样硬化的关系越来越受到重视。有一个主题的演变，从广泛的心血管和代谢益处和关键的食物成分过渡到更精确的，机械的，个性化的理解。
{"title":"Bibliometric analysis of trends and research hotspot shift in the relationship between Mediterranean diet and atherosclerosis since 2005","authors":"Yong Wu M.Sc. , Fanrui Fu M.D. , Wei Zhang Ph.D.","doi":"10.1016/j.nut.2025.113050","DOIUrl":"10.1016/j.nut.2025.113050","url":null,"abstract":"<div><h3>Objectives</h3><div>The Mediterranean diet is promising for the reduction of cardiovascular risks, yet certain shortcomings have been noted, including limitations in clinical investigations with regard to follow-up periods, sample sizes, and potential confounding factors and limitations in basic research, such as oversimplification of complex biological pathways and a translational gap between species. The mechanisms are also complicated. Hence, we conducted a comprehensive analysis of the global research landscape and hotspots regarding the Mediterranean diet and atherosclerosis.</div></div><div><h3>Methods</h3><div>Articles focused on the Mediterranean diet and atherosclerosis published in the Science Citation Index Expanded of Web of Science Core Collection from 2005 to 2025 were retrieved. A total of 503 publications by 3205 authors from 200 journals were included. Data were analyzed and visualized using bibliometrix (R package) and VOSviewer.</div></div><div><h3>Results</h3><div>In this field, the annual publication number has increased since 2013. Spain and the United States were the dominant countries. The University of Barcelona was the most productive affiliation and Estruch and Martínez-González were the most productive authors. <em>Nutrition, Metabolism and Cardiovascular Diseases</em> was the journal with the highest publication numbers and the <em>American Journal of Clinical Nutrition</em> was the most cited journal. The most popular keywords shifted from “metabolic syndrome” and “olive oil” to “body mass index,” “consumption,” “gut microbiota,” and “intima-media thickness” after 2020. The summarized key mechanisms involved lipid metabolism, inflammation and oxidative stress, endothelial function, and gut microbiota.</div></div><div><h3>Conclusions</h3><div>The Mediterranean diet and atherosclerosis are gaining increasing attention. There has been a thematic evolution, transitioning from broad cardiovascular and metabolic benefits and key food components to more precise, mechanistic, and personalized understanding.</div></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":"144 ","pages":"Article 113050"},"PeriodicalIF":3.0,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927993","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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