Nutrition (Burbank, Los Angeles County, Calif.)[JOURNAL]
Sun
200 papers
Trends and predictors of malnutrition during chemotherapy among adults with cancer in Ethiopia: A prospective longitudinal study.
Seid A, Debebe Z, Ayelign A … +3 more , Endris BS, Assefa M, Jemal A
Nutrition · 2026 Apr · PMID 41570588 · Publisher ↗
BACKGROUND: The aim of this study was to investigate the trajectory of malnutrition and predictors during chemotherapy among adults with cancer. METHODS: A prospective longitudinal study was conducted on 400 adults from...
BACKGROUND: The aim of this study was to investigate the trajectory of malnutrition and predictors during chemotherapy among adults with cancer. METHODS: A prospective longitudinal study was conducted on 400 adults from February 2024 to April 2025. Measurements were taken at three intervals: prior to initiation of chemotherapy (T), midcycle (T), and upon completion of treatment (T). Nutritional status was evaluated using the Patient-Generated Subjective Global Assessment. A mixed-effects ordinal regression was employed to identify the trend and predictors of malnutrition. RESULTS: Overall, 38% of patients did not complete chemotherapy. Among the sub-cohorts that completed treatment, severe malnutrition was 39% at baseline (T), 37.5% midcycle (T), and 31.7% end-cycle (T), showing no significant change (P = 0.867). However, the prevalence of underweight (BMI < 18.5 kg/m²) and thinness (midupper arm circumference [MUAC] < 24 cm) declined significantly during chemotherapy. Severe malnutrition was associated with lack of physical activity (AOR = 1.95), low MUAC (AOR = 3.26), upper GI cancer (AOR = 11.3), comorbidities (AOR = 2.93), poor dietary diversity (AOR = 2.62), anemia (AOR = 1.86), and poor ECOG (AOR = 2.28). Conversely, prior surgery (AOR = 0.37) reduced the odds of severe malnutrition. Moreover, severe malnutrition at chemotherapy initiation increased the risk of dropout from treatment (AOR = 2.0). CONCLUSIONS: Given the attrition among nutritionally vulnerable groups, it was observed that within the sub-groups that completed treatment, nutritional status remained stable, while BMI and MUAC showed improvements. These findings underscore the critical importance of early and regular nutritional assessments and addressing modifiable risk factors.
Association between sarcopenia index based on the serum creatinine to cystatin C ratio and cancer incidence in middle-aged and older adults in China: A nationwide cohort study.
Luo P, Cai S, Zhou H … +3 more , Zhu J, Yang Y, Lian Y
Nutrition · 2026 May · PMID 41564837 · Publisher ↗
OBJECTIVES: To examine the association between a novel sarcopenia index and cancer incidence among Chinese adults aged ≥45 y. METHODS: Data were derived from the China Health and Retirement Longitudinal Study. The sarcop...
OBJECTIVES: To examine the association between a novel sarcopenia index and cancer incidence among Chinese adults aged ≥45 y. METHODS: Data were derived from the China Health and Retirement Longitudinal Study. The sarcopenia index was calculated as the ratio of serum creatinine (mg/L) to serum cystatin C (mg/L), multiplied by 100. Incident cancer was identified through self-reported physician diagnosis. Cox proportional hazards models were used to estimate the association between the sarcopenia index and cancer risk, evaluated both continuously and by tertiles. Dose-response and linearity were assessed using restricted cubic spline regression and likelihood ratio tests, respectively. RESULTS: A total of 10 446 participants (median age, 59 y) were included. During a median follow-up of 8.92 y, 248 participants developed cancer. The sarcopenia index was linearly associated with cancer risk. Each 1.0-SD increase in the index was associated with a 2% reduction in cancer risk. Compared with the lowest tertile (T1), adjusted hazard ratios (HRs) were 0.97 (95% CI, 0.73-1.29; P = 0.83) for T2 and 0.58 (95% CI, 0.41-0.83; P < 0.01) for T3 (P for trend < 0.01). Using T3 as the reference, HRs were 1.67 (95% CI, 1.18-2.36; P < 0.01) for T2 and 1.72 (95% CI, 1.21-2.46; P < 0.01) for T1 (P for trend < 0.01). CONCLUSIONS: A significant inverse association was observed between the sarcopenia index and incident cancer risk in middle-aged and older adults, highlighting the potential role of skeletal muscle health in cancer prevention.
Short-term effects of routine nutritional care on dietary patterns and biochemical parameters in non-dialysis chronic kidney disease patients.
Lisboa LB, da Silva LP, Brum ISC … +4 more , Ribeiro-Alves M, Cardozo LF, Mafra D, Alvarenga L
Nutrition · 2026 Apr · PMID 41564753 · Publisher ↗
BACKGROUND AND AIMS: Nutritional therapy is crucial for managing chronic kidney disease (CKD), with protein restriction in the non-dialysis stages being vital for slowing disease progression. Moreover, limiting ultra-pro...
BACKGROUND AND AIMS: Nutritional therapy is crucial for managing chronic kidney disease (CKD), with protein restriction in the non-dialysis stages being vital for slowing disease progression. Moreover, limiting ultra-processed foods (UPF) is necessary due to the health risks associated with these foods, including the advancement of CKD. This study aims to evaluate the impact of routine nutritional care on UPF intake and biochemical markers in non-dialysis CKD patients. METHODS: Dietary intake, anthropometric, and biochemical data were measured at baseline and post-1 mo of routine nutritional care for patients with non-dialysis CKD patients. Dietary intake data were collected using a 24-h dietary recall and a Food Frequency Questionnaire. NOVA classification was used to evaluate UPF intake. RESULTS: The study included 83 participants (53% men; 62 [25.5] years old; body mass index 29 [6.77] kg/m; estimated glomerular filtration rate of 36 [25.6] mL/min/1.73 m). After 1 mo of the nutritional intervention, there was significantly decreased caloric intake from UPF (P = 0.011) globally. In addition, patients with adequate protein intake showed decreased UPF intake and increased intake of in natura and minimally processed foods compared to those with inadequate protein intake (P < 0.05). There was an increase in the estimated glomerular filtration rate (P < 0.001) and albumin (P = 0.009) after 1 mo. A reduction in serum potassium levels (P = 0.013), sodium (P = 0.007), glucose (P = 0.018), and glycated hemoglobin (P = 0.021) was also observed. CONCLUSIONS: The 1-mo nutritional intervention reduced the intake of UPF and increased intake of in natura and minimally processed foods, improving biochemical parameters in non-dialysis CKD patients.
Reformulation without substitution as a strategy to reduce children's free sugar intake in Uruguay: A simulation study.
Alcaire F, Natero V, Ares G
Nutrition · 2026 Apr · PMID 41544555 · Publisher ↗
OBJECTIVE: Product reformulation is a promising strategy to address excessive free sugar consumption among children, yet mandatory programs remain rare across the globe. This study explores reformulation scenarios to red...
OBJECTIVE: Product reformulation is a promising strategy to address excessive free sugar consumption among children, yet mandatory programs remain rare across the globe. This study explores reformulation scenarios to reduce free sugar in processed foods without using nonsugar sweeteners in Uruguay, a high-income Latin American country. METHODS: A two-stage approach was applied: 1) development of reformulation policy scenarios, and 2) simulation of their potential impact on children's free sugar intake. First, analysis of 2 national dietary surveys (24-h recalls) identified key product categories contributing to free sugar intake among children aged 6-59 mo and 4-13 y. A market database of processed and ultra-processed foods was then used to examine sugar content distribution. Second, the impact of each scenario was modelled by simulating changes in product sugar content within these categories and applying them to intake data. RESULTS: Two policy options, inspired by sodium reduction strategies, were tested: maximum sugar levels and percentage reductions. Simulations indicated that percentage reductions would require reformulation of a larger proportion of products, resulting in greater decreases in average sugar content and higher effectiveness. Only this scenario yielded a statistically significant reduction in modelled free sugar and energy intake among children aged 6-59 mo. For both age groups, reductions approached 10%. CONCLUSION: Sugar reformulation can lead to meaningful public health gains in the Uruguayan context. However, post-reformulation sugar intake remained above recommendations, highlighting the need for complementary measures to further discourage excessive consumption.
Avoiding the collapse of the Tower of Babel in nutritional care.
Correia MITD, Laviano A
Nutrition · 2026 Apr · PMID 41544554 · Publisher ↗
Abstract loading — click title to view on PubMed.
Adherence to the Mediterranean diet and depressive symptoms. A cross-sectional study among Italian university students: The UniFoodWaste study.
Pennisi F, Nucci D, Pinto A … +6 more , Stacchini L, Veronese N, Maggi S, Signorelli C, Baldo V, Gianfredi V
Nutrition · 2026 Apr · PMID 41539167 · Publisher ↗
BACKGROUND: Depression is a major global health issue and is particularly prevalent among university students. Emerging evidence suggests that dietary patterns, especially the Mediterranean diet (MD), may influence menta...
BACKGROUND: Depression is a major global health issue and is particularly prevalent among university students. Emerging evidence suggests that dietary patterns, especially the Mediterranean diet (MD), may influence mental health. This study aimed to examine the association between adherence to the MD and depressive symptoms among Italian university students. STUDY DESIGN: Cross-sectional study. METHODS: A cross-sectional, web-based survey was conducted among students aged ≥18 y enrolled at the University of Milan (N = 2697). Adherence to the MD was assessed using the validated Medi-Lite score (range 0-18), while depressive symptoms were measured with the Patient Health Questionnaire-9 (PHQ-9), analyzed both as a continuous variable and using established cut-offs (≥5 and ≥10). Multivariable logistic and linear regression models were used to assess associations between MD adherence, individual dietary components, and depressive symptoms, adjusting for age and sex. RESULTS: Higher MD adherence was significantly associated with fewer depressive symptoms. Each one-point increase in the Medi-Lite score was linked to lower odds of PHQ-9 ≥ 10 (aOR = 0.91, 95% confidence interval [CI]: 0.88-0.95; P = 0.001), PHQ-9 ≥ 5 (aOR = 0.89, 95% CI: 0.85-0.93; P < 0.001), and reduced PHQ-9 scores (β = -0.02, 95% CI: -0.03 to -0.01; P = 0.001). Consuming >2 portions/d of fruit (aOR = 0.60, 95% CI: 0.45-0.80; P = 0.001) and >2.5 portions/d of vegetables (aOR = 0.62, 95% CI: 0.45-0.85; P = 0.003) was associated with lower odds of depressive symptoms; vegetable intake also correlated with lower PHQ-9 scores (β = -0.14, 95% CI: -0.23 to -0.06; P = 0.001). Reduced meat intake (<1 portion/d) and regular olive oil use were further linked to lower depressive symptomatology. In contrast, alcohol consumption of 1 to 2 units/d (aOR = 1.41, 95% CI: 1.10-1.79; P = 0.006) and frequent use of food waste apps (≥1/wk: aOR = 4.26, 95% CI: 1.18-15.34; P = 0.027; β = 0.38, 95% CI: 0.00-0.76; P = 0.049) were associated with increased depressive symptoms. CONCLUSIONS: Greater adherence to the MD was associated with lower depressive symptoms among university students. Promoting MD adherence in student health programs may offer a useful non-pharmacological strategy to support mental well-being.
Efficacy of Mediterranean diet for the prevention of cardiovascular disease in patients: A systematic review and meta-analysis featured in the Italian National Guidelines "La Dieta Mediterranea".
Volpe R, Ciccone MM, Pala B … +21 more , Barbarano F, Camastra S, Caprio M, Casirati A, Ferrera A, Galletti F, Greatti A, Mollica MP, Paolillo S, Parretti D, Nucci D, Veronese N, Fontana L, Maggi S, Onder G, Silano M, Zanetti M, Gianfredi V, Ricci M, Volpe M, Mediterranean Diet Guideline Group
Nutrition · 2026 Apr · PMID 41539166 · Publisher ↗
BACKGROUND: 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) h...
BACKGROUND: 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.
Ultrasound assessment of muscle mass in extracorporeal membrane oxygenation patients and its correlation with clinical outcomes: A retrospective observational study.
Ding T, Zhang Z, Li W … +4 more , Zhu Y, Shi Y, Li T, Chen X
Nutrition · 2026 Apr · PMID 41539165 · Publisher ↗
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). METHOD...
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) mm was significantly less than that in the nonmuscle atrophy group ([-60.23 ± 26.934] mm, 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.
The role of the MIND diet in Alzheimer's disease patients: A case-control study on malnutrition and depression.
Öztürk NK, Akünal C
Nutrition · 2026 Apr · PMID 41539164 · Publisher ↗
OBJECTIVE: The aim of this study was to examine the association between depression, malnutrition, and the Mediterranean-DASH Diet Intervention for Neurodegenerative Delay (MIND) diet in Alzheimer's disease patients. METH...
OBJECTIVE: The aim of this study was to examine the association between depression, malnutrition, and the Mediterranean-DASH Diet Intervention for Neurodegenerative Delay (MIND) diet in Alzheimer's disease patients. METHODS: This study included 30 patients with Alzheimer's disease (AD) and 30 healthy controls. A questionnaire form including sociodemographic characteristics was applied to the individuals. In addition, anthropometric measurements, biochemical parameters, nutritional status (Food Frequency Questionnaire (FFQ), Mini Nutritional Assessment-Short Form (MNA-SF), Geriatric Nutritional Risk Index (GNRI) and MIND diet scores) and mental health status [Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI)]. RESULTS: BDI and BAI scores were significantly higher in the AD group compared to the control group. MIND diet score was found to be significantly lower in the AD group compared to the control group (independent t-tests, P < 0.05). Higher adherence to the MIND diet was significantly associated with lower malnutrition and depression scores among Alzheimer's disease patients (correlation analyses, P < 0.05). The risk of developing AD was found to be 2.034 times higher in those with high malnutrition status (logistic regression analysis, 95% CI; 1.143-3.621; P = 0.016, R: 44.2%). Those with a high MIND diet score had an approximately 2.879-fold increased chance of being healthy (logistic regression analysis, 95% CI; 1.506-5.503; P = 0.001, R: 44.2%). According to ROC analysis, the area under the curve (AUC) for the depression score was 0.946 (P < 0.001). CONCLUSIONS: These findings suggest that adherence to the MIND diet may support nutrition and psychological well-being in AD and highlight the value of integrating nutrition-based approaches into dementia care.
Mapping nursing roles in nutritional care within Saudi tertiary hospitals: A scoping review.
Mohammed MS, Amri WAA, Al-Maghaireh D … +1 more , Ahmed SN
Nutrition · 2026 Apr · PMID 41520388 · Publisher ↗
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...
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.
NRS2002 outperforms GNRI and PG-SGA SF in GLIM-based malnutrition identification among elderly patients with gastrointestinal malignancy: A multicenter diagnostic study with calibration and net benefit assessment.
Xu C, Xu J, Shan B … +2 more , Chen Z, Wang C
Nutrition · 2026 Apr · PMID 41520387 · Publisher ↗
OBJECTIVES: In this study we systematically assessed the diagnostic accuracy, calibration, and clinical utility of three study tools-the Nutritional Risk Screening 2002 (NRS2002), the Geriatric Nutritional Risk Index (GN...
OBJECTIVES: In this study we systematically assessed the diagnostic accuracy, calibration, and clinical utility of three study tools-the Nutritional Risk Screening 2002 (NRS2002), the Geriatric Nutritional Risk Index (GNRI), and the Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF)-against the Global Leadership Initiative on Malnutrition (GLIM) criteria for identifying malnutrition in elderly patients with gastrointestinal malignancy. The aim was to determine their potential as pragmatic surrogates for the full GLIM diagnostic process. METHODS: 412 patients (aged ≥ 60 y) with gastrointestinal malignancies from two hospitals in Shanghai were enrolled in this multicenter cross-sectional study. Diagnostic performance was assessed using GLIM criteria as the reference standard, evaluating the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. Calibration was tested with the Hosmer-Lemeshow test, clinical net benefit was analyzed through decision curve analysis, and cross-center consistency was measured using the I² statistic. RESULTS: The NRS2002 exhibited superior overall performance, characterized by high diagnostic accuracy (AUC = 0.85), the highest sensitivity (81%), excellent cross-center stability (I² = 0%), no significant calibration deviation (P = 0.415), and a clinical net benefit across a 0-96% risk threshold. The PG-SGA SF showed a comparable AUC (0.86), yet was accompanied by high specificity (87%), lower sensitivity (70%), significant calibration bias (P < 0.001), and notable inter-center heterogeneity (I² = 81.5%). The GNRI presented weaker diagnostic accuracy (AUC = 0.79) and significant calibration error (P = 0.039), though it maintained good cross-center stability (I² = 0%). All tools achieved an AUC > 0.70 across key clinical subgroups. CONCLUSION: The NRS2002 is recommended as the primary surrogate diagnostic tool for GLIM-defined malnutrition in elderly patients with gastrointestinal malignancies, due to its balanced diagnostic accuracy and robust performance across settings. The GNRI offers an alternative based on objective parameters, while the PG-SGA SF is suitable for confirming malnutrition in low-risk outpatients. Future research should be focused on multicenter validation and examining the prognostic associations of these tools.
Dairy intake and risk of type 2 diabetes and metabolic syndrome: A narrative review.
Vimaleswaran KS, Mohan V
Nutrition · 2026 Apr · PMID 41518731 · Publisher ↗
Dairy products are important components of human health. While some studies claim that dairy increases the risk of type 2 diabetes (T2D) and metabolic syndrome (MetS), several large studies have shown the beneficial impa...
Dairy products are important components of human health. While some studies claim that dairy increases the risk of type 2 diabetes (T2D) and metabolic syndrome (MetS), several large studies have shown the beneficial impact of dairy consumption. The objective of this review is to highlight the effect of dairy intake on T2D and MetS using recent evidence (published within the last decade) from large epidemiological studies, meta-analyses, randomized controlled trials (RCTs), and Mendelian randomization (MR) and multi-omics studies, and to provide plausible underlying biological mechanisms linking dairy consumption with the risk of T2D and MetS. Given the increasing prevalence of T2D and MetS, it is important to understand the benefits and/or risks of milk and dairy products in the diet. Based on all available evidence from large-scale epidemiological studies, MR analyses, and RCTs, the beneficial impact of dairy products as part of a healthy diet plan appears to be an additional way of mitigating the risk of T2D and MetS. The evidence for a protective effect appears to be undisputed for fermented dairy products like yogurt. For milk, most studies were either protective or neutral, with very few showing a deleterious effect, and with respect to cheese and butter, there were studies showing a deleterious effect, but the grade of evidence was weak. Further mechanistic studies combined with large prospective studies and RCTs in ethnically diverse populations, taking into account sufficient dose and duration, are warranted to get a more complete understanding of dairy consumption and T2D risk.
Understanding the needs and preferences of oncology dietitians for mobile health apps.
Solano O, Morris G, Stump T … +4 more , Colvin C, Tan G, Chang JS, Lin AW
Nutrition · 2026 Apr · PMID 41518730 · Publisher ↗
OBJECTIVES: Mobile health (mHealth) apps are increasingly used to deliver nutrition care to cancer patients and survivors, yet little is known about how to design them for effective integration into supportive care. This...
OBJECTIVES: Mobile health (mHealth) apps are increasingly used to deliver nutrition care to cancer patients and survivors, yet little is known about how to design them for effective integration into supportive care. This study examined registered dietitians' current mHealth practices and app preferences for supporting nutrition care for the oncology population, as well as most commonly suggested behavioral change techniques specific to cancer apps. METHODS: A 17-item online questionnaire was distributed through the Oncology Dietetics Practice Group, Reddit and LinkedIn in a cross-sectional study. Surveys were filtered for complete and human-verified responses. Descriptive statistics were applied to closed-ended items, while content analysis was conducted for open-ended responses between three coders. RESULTS: The final sample included 50 oncology dietitians, Ninety percent of whom were interested in recommending mHealth apps as a nutrition resource for cancer patients and survivors despite 32% not using an app in practice. Dietitians expressed interest in features to deliver behavior change prompts to patients and to increase self-monitoring of dietary habits (72%). Participants also indicated interest in features that allow them to view dietary data to facilitate discussions on diet quality (78%) and energy adequacy (82%). In response to a question about preferred data types, dietitians preferred access to information about gastrointestinal symptoms (98%), macro- and micronutrient intake (90%), nutrition goal completion (84%), and food group intake (82%). Self-monitoring, goals and planning, and providing feedback to the patient were the most common features requested for a cancer app. CONCLUSIONS: Oncology dietitians are interested in using and recommending apps to support nutrition care for cancer patients and survivors. The study findings can inform future efforts to tailor mHealth app features and data to support oncology nutrition care and workflow.
In defense of the Holman index: Defining fatty acid deficiency.
Kang J, Watnick A, Fernandes D … +3 more , Ruiz-Santana V, Puder M, Gura KM
Nutrition · 2026 Apr · PMID 41512429 · Full text
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...
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.
Handgrip strength and body composition in children and adolescents with acute lymphoblastic leukemia: A cross-section study.
Bastos EB, Afonso WV, Dias GNDC … +6 more , Pimentel IF, Pinto MVA, Ued FDV, Marchesi JCLS, Silva SD, Padilha PC
Nutrition · 2026 Apr · PMID 41512428 · Publisher ↗
We hypothesized that body mass index (BMI) deviation, low muscle mass, and low quality of life (QoL) are associated with low handgrip strength (HGS) in patients with acute lymphoblastic leukemia. Thus, our aim was to eva...
We hypothesized that body mass index (BMI) deviation, low muscle mass, and low quality of life (QoL) are associated with low handgrip strength (HGS) in patients with acute lymphoblastic leukemia. Thus, our aim was to evaluate the association between BMI, body composition measurements, QoL, and HGS in this population. This was a cross-sectional, multicenter study with patients diagnosed at least 1 mo ago, aged 5 to 18 y. Multiple quantile regression models were performed to evaluate the relationships between the independent variables and HGS. Associations with P < 0.05 were considered significant. Forty-four patients with a median age of 10.1 (8.5-11.9) y were evaluated. The presence of excess weight (overweight and obesity) by BMI/age was 54.5%, and the median HGS and QoL assessment were 14 (9.1-18) kgf and 75 (66.3-81.2) points, respectively. The medians of age, weight, height, arm perimeter, arm muscle area (AMA), arm muscle perimeter (AMP), and BMI/age differed significantly according to the lowest tertile of HGS. There was a strong positive correlation between HGS and the variables arm perimeter (r = 0.703; P < 0.001), AMA (r = 0.814; P < 0.001), and AMP (r = 0.815; P < 0.001). There was no correlation between HGS and the QoL score (r = 0.059; P = 0.704). AMA, AMP, and age showed positive associations in all quantiles analyzed. However, BMI showed a negative association with the HGS outcome in all quantiles. It was possible to understand the influence of AMP and AMA at different levels of HGS, highlighting the importance of body composition and age as factors associated with muscular performance.
Comparing ChatGPT and DeepSeek for ultra-processed food classification: AI models for nutritional research and dietary assessment.
Cattem MVO, Machado FO, da Silva MEG … +2 more , Canella DS, Koury JC
Nutrition · 2026 Apr · PMID 41505813 · Publisher ↗
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 t...
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.
Bibliometric analysis of trends and research hotspot shift in the relationship between Mediterranean diet and atherosclerosis since 2005.
Wu Y, Fu F, Zhang W
Nutrition · 2026 Apr · PMID 41505812 · Publisher ↗
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, samp...
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.
Acute-phase Geriatric Nutritional Risk Index is associated with swallowing function after convalescent rehabilitation in older patients with ischemic stroke: A retrospective cohort study.
Moriyama T, Sato F, Yokomichi N … +7 more , Yamanaka K, Yoshikawa Y, Tachibana M, Kuroda J, Tanaka E, Fukumoto H, Nakane H
Nutrition · 2026 Apr · PMID 41505811 · Publisher ↗
INTRODUCTION: Post‑stroke dysphagia and malnutrition both compromise recovery. Whether the Geriatric Nutritional Risk Index (GNRI) measured on acute admission predicts swallowing function after convalescent rehabilitatio...
INTRODUCTION: 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.
Measuring muscle and subcutaneous adipose tissue: agreement and reliability between dietetic-led ultrasound and magnetic resonance imaging.
Chand SK, Plank LD, Lambell K … +4 more , Windsor JA, Earthman CP, Vaughan W, Braakhuis AJ
Nutrition · 2026 Apr · PMID 41505810 · Publisher ↗
BACKGROUND: Low muscle mass is prevalent and has detrimental effects on morbidity and mortality. Body composition assessment is essential for early detection of muscle loss and malnutrition, yet reference methods such as...
BACKGROUND: Low muscle mass is prevalent and has detrimental effects on morbidity and mortality. Body composition assessment is essential for early detection of muscle loss and malnutrition, yet reference methods such as magnetic resonance imaging (MRI) are costly and routinely inaccessible in clinical practice. Ultrasound has emerged as a promising noninvasive, bedside tool for body composition assessment. AIM: To assess the agreement between ultrasound and MRI-measured muscle thickness and cross-sectional area (CSA) and subcutaneous adipose thickness at the bicep and quadriceps. To investigate inter- and intra-operator reliability of ultrasound measurements. DESIGN: A cross-sectional study was conducted with 35 healthy participants. Ultrasound images were taken by two researchers. An MRI scan was conducted during the same research visit. Intraclass correlation coefficient (ICC) and Bland-Altman analyses were performed to test agreement of ultrasound against MRI, as well as inter- and intra-operator reliability. RESULTS: The mean difference between measures was 0.04 mm (SD = 2.68 mm) at the right quadricep 2/3 point, showing minimal bias. The mean differences for quadricep muscle thickness ranged from -1.41 to 0.04 mm and CSA -0.07 to 0.05 cm. High ICC of >0.90 were obtained for muscle and subcutaneous adipose thickness at all 5 sites when comparing ultrasound with MRI, and for the inter- and intra-operator reliability of ultrasound. CONCLUSIONS: In healthy participants, ultrasound measures of muscle and subcutaneous adipose thickness had a high level of agreement compared with MRI measures. This highlights the potential to use ultrasound for body composition assessment in clinical practice and research.
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.
Nikolakopoulou K, Chourdakis M, Androutsos O … +5 more , Bahat G, Pinar E, Erdogan T, Abbasoglu O, Poulia KA
Nutrition · 2026 Apr · PMID 41505809 · Publisher ↗
OBJECTIVES: 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 insuffi...
OBJECTIVES: 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.
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