Clinical nutrition research最新文献

Autism spectrum disorder (ASD) is a multifactorial neurodevelopmental condition often accompanied by metabolic and nutritional imbalances. Conventional dietary interventions, such as the gluten-free, casein-free diet, typically fail to consider individual genetic variations. Nutrigenomics, the study of gene-nutrient interactions, offers a promising framework for exploring personalized dietary interventions that may help address the metabolic and neurological complexities associated with ASD, although current evidence remains preliminary. This research note offers recommendations for integrating nutrigenomics into special education through a multidisciplinary approach that combines clinical nutrition, genetics, and educational practice via a 3-phase agenda. Stage 1 focuses on identifying behavioral subgroups within special education settings and using validated tools such as the Child Behavior Checklist Scale to analyze nutritional intake. Stage 2 involves the development and pilot-testing of behavior-specific nutrition protocols that are tailored to these subgroups, incorporating input from practice experts in nutrigenomics. Lastly, in Stage 3, a personalized nutrition model that incorporates genetic screening and metabolic profiling is constructed in collaboration with dietitians, educators, and caregivers. By bridging clinical and educational domains, this study seeks to establish nutrigenomics-based nutrition therapy as a viable and equitable intervention for improving health and developmental outcomes among students with ASD.

Pressure injuries are common complications in patients with limited mobility, particularly those who are bedridden. These wounds not only cause pain and reduce quality of life but also lead to prolonged hospitalization, increased risk of infection, and higher healthcare costs. Among the various contributing factors, malnutrition plays a crucial role by impairing collagen synthesis, weakening immune function, and delaying tissue repair. Adequate nutritional support-particularly sufficient protein and energy intake-is therefore an essential component of comprehensive pressure injury management. We present the case of a paraplegic patient who developed a vulvar pressure injury. A structured, stepwise nutritional intervention was implemented, including adjustment of meal composition based on appetite, supplementation with high-protein oral nutritional supplements, vitamins and minerals, and the use of probiotics to manage diarrhea. As a result, the patient's daily protein intake increased from less than 10 g to 80-90 g, accompanied by progressive wound improvement. Serial clinical assessments showed reduced slough, increased granulation tissue formation, and epithelialization. This case highlights the vital role of individualized nutritional management within a multidisciplinary approach to pressure injury care. Stepwise nutritional intervention, tailored to the patient's tolerance and clinical status, contributed significantly to wound healing. Nutritional optimization should be considered an integral component of effective pressure injury treatment strategies.

The relationship between vitamin D status and visceral adiposity among older adults remains unclear. This study aimed to investigate the association between serum vitamin D levels and visceral adipose tissue (VAT) among older Iranian adults. This cross-sectional study included older adults aged ≥ 60 years from the Amirkola Health and Aging Project. Serum 25-hydroxyvitamin D levels were measured by enzyme-linked immunosorbent assay. VAT was assessed using dual-energy X-ray absorptiometry. Furthermore, the relationship between vitamin D and VAT was examined through multiple linear regression analysis, adjusting for potential confounders. Of the 600 participants, 345 (57.5%) were males and 255 (42.5%) were females. Their mean age was 68.90 ± 6.97 years, and the mean vitamin D level was 60.50 ± 39.45 ng/mL. Serum vitamin D levels showed a weak negative association with VAT mass (β = -0.062, p = 0.012). In both sexes, VAT mass predictors followed a similar pattern. Body mass index (BMI; β = 0.811, p < 0.001) was identified as a strong predictor, while diabetes status exhibited a positive association with VAT mass (β = 0.078, p = 0.002). Serum vitamin D levels appear to have a weak inverse relationship with visceral adiposity in older Iranian adults. BMI was the most robust predictor of VAT. Further longitudinal research is needed to clarify the causal relationship between vitamin D status and visceral adiposity among older adults.

This study aimed to identify major dietary patterns among Korean adolescents, examine their changes over the past 16 years, and evaluate differences by sex. Data were analyzed from 7,679 adolescents aged 12-18 years who participated in the 2007-2022 Korea National Health and Nutrition Examination Survey and completed health, examination, and nutrition surveys. Dietary intake was assessed using a 24-hour recall, and cluster analysis was performed based on the energy contribution of 26 food groups. Associations between dietary patterns and nutrient intake were examined using survey-weighted linear regression. Three dietary patterns were identified: Bread, Meat, & Dairy (33.1%); Rice-based Diet (45.5%); and Convenient Foods (21.3%). Among boys, the Rice-based Diet group showed the highest prevalence of obesity and the largest proportion of low-income households, whereas the Bread, Meat, & Dairy group exhibited higher rates of supplement use and high-income status (all p < 0.05). Among girls, the Convenient Foods group tended to be older and was more likely to skip breakfast, consume alcohol, eat out daily, and perceive themselves as overweight (all p < 0.05). Over the 16-year period, adherence to the Bread, Meat, & Dairy pattern increased, whereas adherence to the Rice-based Diet pattern declined in both sexes (p < 0.01). These findings highlight a shift toward Westernized dietary patterns among Korean adolescents. Accordingly, nutrition policies and interventions should adopt tailored strategies that account for both sex and socioeconomic differences to promote healthier eating habits and support long-term adolescent health.

The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet is a brain-focused dietary pattern designed to prevent cognitive decline in older adults. This systematic review, conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, aimed to examine the association between the MIND diet and cognitive function in older adults. Relevant studies published between 2015 and 2024 were identified through comprehensive searches of PubMed and the Cochrane Library using keywords including "MIND diet," "cognitive performance," and "older adults." From a total of 138 records screened, 11 studies met the inclusion criteria after excluding reviews, meta-analyses, editorials, and those incorporating other lifestyle interventions such as physical activity or education. These studies included 7 prospective cohort studies, 2 cross-sectional studies, 1 randomized controlled trial (RCT), and 1 case-control study, comprising a total of 17,201 participants aged 57-91 years. Across studies, at least 57% of participants were women, and in the 5 studies reporting race, more than 75% were White. Dietary intake and MIND adherence were assessed primarily via food frequency questionnaires, while cognitive outcomes were evaluated using validated instruments including the Montreal Cognitive Assessment, global cognition scores, Consortium to Establish a Registry for Alzheimer's Disease tests, and magnetic resonance imaging. Six cohort and two cross-sectional studies reported significant associations between higher MIND adherence and better cognitive outcomes. One cohort study and the single RCT showed no effect. Excluding 2 studies with short durations (≤ 3 years), the remaining nine studies suggest consistent cognitive benefits of MIND adherence. Future studies should include systematic reviews and large-scale RCTs focusing on Asian populations.

This study provides the first national update on phase angle (PhA) as a biomarker of body composition, nutritional status, and health outcomes in Korean adults. Using data from 5,035 adults aged 20-80 years from the 2023 Korea National Health and Nutrition Examination Survey (KNHANES), we analyzed age-related variations in PhA, body composition, metabolic diseases, and nutrient intake. The mean PhA declined from 5.57° in participants aged 20-39 to 4.23° in those aged 80+, corresponding with decreases in height and weight. Individuals with higher PhA exhibited significantly greater lean body mass and lower body fat; for example, among those aged 20-39, the high PhA group showed 56.02 kg of lean mass versus 40.71 kg in the low group (p < 0.001) and total body water of 41.07 L versus 29.84 L (p < 0.001). Regarding metabolic diseases, 35.2% of the high PhA group aged 20-39 had grade 1 obesity compared with 17.4% in the low group, with similar associations observed for diabetes and hypertension across age groups. Nutritional intake was also higher in the high PhA group, with mean energy intake of 2,180.84 versus 1,710.16 kcal (p < 0.001). Overall, PhA was positively associated with favorable body composition, nutritional intake, and metabolic profiles across all age groups, suggesting its potential as a comprehensive biomarker for assessing physiological health and guiding nutritional interventions in the Korean population.

Cataracts are a major cause of visual impairment worldwide, particularly among older adults, with an increasing prevalence due to population aging. Surgery is the primary treatment; however, preventive strategies are crucial for reducing the disease burden. This study aimed to investigate dietary and health-related factors associated with cataract occurrence and develop a predictive model using machine learning. Data were derived from the Korea National Health and Nutrition Examination Survey 2015-2017. The study included 190 women aged 60-79 years: 124 with cataracts and 66 controls. Analyzed variables included sociodemographic, behavioral, chronic disease, and dietary intake factors. After data preprocessing, 4 machine learning algorithms: support vector machine (SVM), random forest (RF), eXtreme gradient boosting, and multilayer perceptron were used. Model performance was evaluated using accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUROC) and precision-recall curves. Among the tested models, the SVM achieved the best performance under stratified 10-fold cross-validation, with 71% accuracy, 86% precision, 73% recall, 79% F1-score, 65% AUROC, and 81% AUPRC. According to our findings, the odds of having cataracts can be effectively predicted using dietary and health data without relying on specialized ophthalmic equipment. The proposed model demonstrates the potential of machine learning-based tools for early identification and prevention of cataracts. Future studies with larger and more diverse samples, as well as integrating additional data sources such as genomics and lifestyle factors, are warranted to refine predictive accuracy and enhance personalized nutrition-based interventions.

Adequate nutrition reportedly can help reduce the degree of muscle loss and improve muscle quality in hospitalized patients recovering from trauma. This study investigated the association between nutritional intake and changes in muscle quality and quantity in these patients. The handgrip strength (HGS) and body composition of 52 patients admitted to the trauma ward were measured at 1-week intervals. According to their dietary intake, they were categorized into the hypocaloric nutrition group (HNG; < 70% of recommended caloric intake) and the isocaloric nutrition group (ING; ≥ 70% of recommended caloric intake). Within one week, body mass index (24.3 ± 4.4 kg/m² vs. 23.4 ± 4.5 kg/m²), body fat percentage (24.1% ± 9.8% vs. 17.2% ± 9.2%), and skeletal muscle mass (28.6 ± 4.9 kg vs. 27.5 ± 4.3 kg) significantly decreased in the ING compared with those in the HNG. Although the skeletal muscle mass decreased, the ING's left HGS significantly increased (26.6 ± 9.6 kg vs. 28.5 ± 10.1 kg). The ING also consumed a significantly greater amount of protein (beyond the recommended amount) than the HNG (72.6 ± 43.2 → 100.8 ± 27.0% vs. 58.6 ± 25.9 → 49.5 ± 20.1%; p = 0.039). In bioelectrical impedance vector analysis, the vectors of the ING shifted more within the normal range of the 75% tolerance ellipse than those of the HNG (23% vs. 10%). These results suggest that, although the muscle mass quantitatively decreased during trauma recovery, adequate nutritional support helps preserve muscle quality.

This study examined meal patterns and protein-rich food utilization in the foodservice practices of public and private geriatric long-term care hospitals in South Korea. Over a period of 6 months, a total of 612 daily menus (306 from each hospital type, breakfast, lunch, and dinner) were collected from four hospitals (two public, two private). Each menu was categorized by meal composition, included staple food, soup, main dish, side dishes, and kimchi. The most common meal pattern consisted of a staple food, soup, main dish, two side dishes, and kimchi. Compared with private hospitals, public hospitals offered a greater variety in meal composition, staple foods, soups, and main dishes. However, no significant differences were observed in protein foods of main dishes. Overall, meat accounted for about half, whereas fish accounted for one-third. Approximately 30% of protein foods in main dishes were processed. In side dish 1, the proportion of protein-rich foods was lower in public than in private hospitals, whereas the proportion of processed foods exceeded two-thirds in both hospital, but was significantly higher in public hospitals. Soup was the second most important protein source after the main dish, with fish as the most often used; however, processed protein foods were also common. These findings indicate that the main dish and soup are the principal protein sources, and the relatively high inclusion of fish reflects a favorable pattern. However, to ensure intake of high-quality proteins by older adults, the high reliance on processed protein foods highlights the need to reconsider foodservice practices.

This study evaluated the effects of replacing skipped meals with oral nutritional supplements (ONS) on the nutritional status and functional health of older adults. A total of 29 participants aged ≥ 65 years who regularly skipped at least one meal per day were included in this single-arm study. For 8 weeks, participants consumed two packs of ONS daily (150 mL each, providing 400 kcal and 18 g of protein) as a substitute for skipped meals. Nutritional status, nutrient intake, body composition, and physical function were assessed before and after the intervention. The Nutrition Quotient for the Elderly score significantly increased from 58.97 to 63.62 (p = 0.014). Total nutrient intake, including ONS, significantly improved compared with baseline (p < 0.01). Body weight and body mass index increased significantly from 58.87 to 59.47 kg (p = 0.028) and from 23.9 to 24.18 kg/m² (p = 0.016), respectively. Calf circumference decreased significantly from 34.1 to 33.39 cm (p = 0.010). Physical function, assessed using the Short Physical Performance Battery, showed significant improvement (p = 0.003). In conclusion, replacing skipped meals with ONS may enhance nutritional status and support functional health in older adults.

Trial registration: Clinical Research Information Service Identifier: KCT0010184.