OBJECTIVES: A vegan diet may lead to certain nutritional deficiencies that could potentially affect muscle mass and strength. Nevertheless, strength training serves as a natural anabolic stimulus that promotes increases...OBJECTIVES: A vegan diet may lead to certain nutritional deficiencies that could potentially affect muscle mass and strength. Nevertheless, strength training serves as a natural anabolic stimulus that promotes increases in skeletal muscle mass and reductions in fat mass. OBJECTIVE: To evaluate the effectiveness of a 16-week resistance training program in adults following a vegan diet compared with those following an omnivorous diet, focusing on changes in musculoskeletal mass and muscular capacity. METHODS: A nonrandomized controlled clinical trial with four parallel groups compared baseline and postintervention measurements in individuals aged 18-60 years from the Biobío and La Araucanía regions of Chile who had maintained either diet for at least six months. RESULTS: The vegan diet intervention group increased right-hand grip strength by 4 kg (P < 0.001) and left-hand grip strength by 2 kg (P < 0.001). They gained 0.50 kg in one-repetition-maximum (1RM) strength (P < 0.001) and improved vertical jump height by 3 cm (P < 0.01). The omnivorous diet intervention group increased right-hand grip strength by 2 kg (P < 0.001) and left-hand grip strength by 5 kg (P < 0.001), gained 0.45 kg in 1RM (P < 0.001), and improved vertical jump height by 0.75 cm (P < 0.04). CONCLUSIONS: No significant changes in musculoskeletal mass were observed in any of the groups. Resistance training significantly improved muscle strength regardless of diet type, suggesting that a vegan diet did not compromise adaptations to strength training.
PURPOSE: Malnutrition and sarcopenia are critical geriatric syndromes sharing risk factors with oral health deficits. This study aimed to investigate the association between the accumulation of multiple oral problems and...PURPOSE: Malnutrition and sarcopenia are critical geriatric syndromes sharing risk factors with oral health deficits. This study aimed to investigate the association between the accumulation of multiple oral problems and the prevalence of malnutrition and sarcopenia in older outpatients visiting a frailty clinic. METHODS: This cross-sectional study analyzed registry data from 505 patients (mean age, 77.9 ± 6.2 years). Malnutrition and sarcopenia were diagnosed using the Global Leadership Initiative on Malnutrition and Asian Working Group for Sarcopenia 2025 criteria, respectively. We assessed three oral problems: oral frailty (Oral Frailty Five-item Checklist ≥2), low tongue pressure (<30 kPa), and poor oral hygiene (Tongue Coating Index ≥9). Associations between these oral problems-both individually and cumulatively-and nutritional or sarcopenic status were analyzed using multivariable logistic regression models. RESULTS: The prevalence of malnutrition and sarcopenia was 20% and 16%, respectively. Participants with low tongue pressure or oral frailty exhibited significantly higher rates of both conditions. A higher prevalence of malnutrition and sarcopenia was observed in patients with a greater number of co-existing oral problems. In the adjusted multivariate analysis, the number of oral problems was a factor independently associated with malnutrition (adjusted odds ratio [OR], 1.33; 95% CI, 1.03-1.71) and sarcopenia (adjusted OR, 1.64; 95% CI, 1.23-2.20). CONCLUSION: The accumulation of multiple oral problems was a significant factor associated with malnutrition and sarcopenia in older outpatients. The implementation of comprehensive oral assessments, including objective tongue pressure measurement and oral frailty screening, is crucial for identifying high-risk patients and facilitating early multidisciplinary interventions.
OBJECTIVES: While the nutrient patterns among populations and their major components have been studied, their links to obesity and chronic diseases have not. This study is unique in its focus on detecting the nutrient in...OBJECTIVES: While the nutrient patterns among populations and their major components have been studied, their links to obesity and chronic diseases have not. This study is unique in its focus on detecting the nutrient intake patterns among Jordanians and determining their relationships with obesity indices. METHODS: A substantial dataset of 1647 participants was extracted from a survey on household food consumption patterns (for individuals aged 8 or older). Age groups were classified into children, adolescents, and adults. Food intake was analyzed, and nutrient patterns were determined. Anthropometric measurements were assessed, and obesity indices (BMI, BRI, WWI, ABSI, and WHtR) were calculated. RESULTS: three major nutrient patterns were extracted (PCA1: Energy and types of fat nutrient pattern, PCA2: Low fiber and plant sources nutrient pattern, and PCA3: riboflavin, niacin, potassium, and magnesium nutrient pattern). Among adolescent girls, a one standard deviation (SD) increase in PCA1 was associated with a significant decrease of 1.2 kg/m in BMI, 3.89 cm in WC, 0.03 in WHtR, 0.37 in WWI, 0.04 in CI, 0.49 in BRI, and 0.61 in ABSI. However, an increase in PCA2 was associated with significant increases in WC by 2.19 cm, WHtR by 0.01, WWI by 0.17, CI by 0.02, BRI by 0.25, and ABSI by 0.35; the same significant findings were observed in female adults for both patterns. CONCLUSIONS: Among adolescent girls and adult women, but not in males, the "Energy and types of fat" nutrient pattern was inversely associated with obesity indices, whereas the "Low fiber and plant sources" nutrient pattern was positively associated with adiposity measures. This indicates a sex-specific, heterogeneous relationship between nutrient intake patterns and obesity-related indices across population subgroups.
BACKGROUND: This study sought to assess the effectiveness of PG-SGA, mPG-SGA and GLIM criteria for diagnosing malnutrition in individuals with gastric cancer (GC). METHODS: A total of 906 patients with confirmed GC diagn...BACKGROUND: This study sought to assess the effectiveness of PG-SGA, mPG-SGA and GLIM criteria for diagnosing malnutrition in individuals with gastric cancer (GC). METHODS: A total of 906 patients with confirmed GC diagnosis were recruited for this study. Nutritional screening and diagnosis were performed using NRS2002, AIWW, the PG-SGA, modified PG-SGA (mPG-SGA) and the GLIM criteria. The effectiveness of these instruments was evaluated through multiple metrics, encompassing sensitivity, specificity, positive and negative predictive values along with Kappa (κ) values. Kaplan-Meier and multivariable Cox analyses were used to assess survival. RESULTS: Among 906 patients, the diagnosis of malnutrition was made in 76.7% of the patients using the PG-SGA, 73.2% using the mPG-SGA, 55.5% using the GLIM with NRS2002, and 65.3% using the GLIM with AIWW. In the mPG-SGA, GLIM with NRS2002, and GLIM with AIWW, sensitivity was 94.7%, 68.1%, and 78.0%, while specificity was 97.60%, 85.8%, and 76.30%. When comparing malnutrition identification against PG-SGA, the mPG-SGA demonstrated nearly perfect agreement with PG-SGA (κ = 0.88), while the GLIM criteria displayed fair agreement with PG-SGA, revealing a κ value of 0.41 for PG-SGA versus GLIM with NRS2002 and 0.46 (P < 0.001) for PG-SGA versus GLIM with AIWW (P < 0.001). Adjusted hazard ratios for mortality ranged from 1.49 to 1.73 across the four malnutrition assessment tools (all P < 0.05). CONCLUSIONS: The mPG-SGA exhibited comparable prognostic performance to PG-SGA and GLIM in individuals with GC and may function as a practical alternative for rapid nutritional assessment in clinical environments.
BACKGROUND: Cardiovascular disease (CVD) is a leading global cause of mortality, strongly influenced by diet. Research in this field has evolved from the analysis of nutrients to the evaluation of dietary patterns (DP),...BACKGROUND: Cardiovascular disease (CVD) is a leading global cause of mortality, strongly influenced by diet. Research in this field has evolved from the analysis of nutrients to the evaluation of dietary patterns (DP), with the aim of more accurately reflecting real eating behaviors. A variety of statistical methods are employed to identify DP, leading to heterogeneous results. This variability highlights the need for methodological standardization to improve comparability and evidence synthesis. OBJECTIVE: The aim of this study was to evaluate the statistical methodologies used to identify a posteriori DP and determine their relationship with CVD. METHODS & PROCEDURES: A systematic search of the PubMed, Scopus and Web of Science databases was carried out, including observational studies conducted on adults aged 18 years and over. The review protocol was registered in PROSPERO (CRD4202525642904). The analysis of 18 studies that identified a posteriori DP related to CVD was conducted. RESULTS: Across the included studies, DP were mainly derived using principal component analyses (PCA), although variability existed in component selection and factor loading thresholds. Most studies assessed sampling adequacy, applied Varimax orthogonal rotation, and selected components based on eigenvalue thresholds >1, although cut-offs varied. A small number of studies combined PCA with other multivariate approaches. Despite heterogeneity in identified patterns, Western, traditional, animal-based, and Mediterranean DP were most frequently reported. Western patterns were associated with increased CVD, whereas Mediterranean patterns showed a protective effect. CONCLUSIONS: CVD-related DP are highly variable, depending on factors such as sex, culture and socio-economic status. This underlines the importance of standardizing dietary collection and assessment methods.
BACKGROUND: Numerous patients encounter unexplained abdominal pain following Roux-en-Y gastric bypass, for which standard dietary treatments prove ineffective. Therefore, a step-by-step dietary approach was developed: 1)...BACKGROUND: Numerous patients encounter unexplained abdominal pain following Roux-en-Y gastric bypass, for which standard dietary treatments prove ineffective. Therefore, a step-by-step dietary approach was developed: 1) treatment of dumping syndrome, 2) elimination and reintroduction of lactose and fructose, 3) exclusion products with added sugar, 4) exclusion artificial sweeteners. The aim of this study is to examine the effect of this approach on abdominal pain. METHODS: This retrospective study analyzed all patients treated with the step-by-step approach. Group 1 (n = 31) consisted of patients who were pain-free after the step-by-step approach, and compared with group 2 (n = 36), consisting of patients with persistent abdominal pain. RESULTS: All patients in group 1 were pain-free after the step-by-step approach, compared to 0% in group 2 (P ≤ 0.001). Remarkably, patient adherence to dietary treatment via the step-by-step approach, in group 1, was 100%, in comparison to group 2, where it was 8.3% (P ≤ 0.001). Additionally, there was a significant difference in psychological issues at baseline (P = 0.032) in favor of the patients in group 1. CONCLUSIONS: The step-by-step dietary approach seems to be effective in managing abdominal pain after Roux-en-Y gastric bypass. Notably, significant differences were observed in patient adherence to the dietary approach and the presence of psychopathology, which unfavorably affects patients with persistent complaints. This implies that patient adherence and psychopathology likely influence the impact on abdominal discomfort. Further research is necessary to validate these findings.
Nutrition students are more prone to binge eating disorder (BED), due to aesthetic pressures and extensive knowledge about food. In this context, the COVID-19 pandemic may have impacted signs of BED. This study aims to a...Nutrition students are more prone to binge eating disorder (BED), due to aesthetic pressures and extensive knowledge about food. In this context, the COVID-19 pandemic may have impacted signs of BED. This study aims to assess the prevalence of BED symptoms in nutrition students during remote (1st stage) and in-person learning (2nd stage). This is a cross-sectional study with a sample formed by students from 29 (1st stage) and 24 (2nd stage) undergraduate nutrition programs in public and private institutions in one city. Data were collected online using the Binge Eating Scale (BES) questionnaire and nutritional and sociodemographic characteristics. Descriptive and comparative analyses were conducted using SPSS v21.0 (p < 0.05). A total of 141 students answered the questionnaires, 24 fitting into some degree of the BED signs, 12 on each stage of data collection. All individuals with BED symptoms were female. In remote learning, three (25%) students with signs of BED were in their first year of graduation, while in in-person learning, four (33.3%) were in their first year. Except for one student with BED, all (95.8%) exhibited variations in body weight in the last 12 months. Greater signs of BED were observed in last-year students (18%) during remote learning, with questions related to binge eating and post-binge guilt contributing more to BED symptom in remote learning. A higher prevalence of BED symptoms was observed in nutrition students during remote learning. The data indicate a greater prevalence in female students, and a connection between weight variation.
BACKGROUND: Patients with head and neck cancer (HNC) are at high nutritional risk, and accurate assessment is critical to guide interventions and predict outcomes. The Patient-Generated Subjective Global Assessment (PG-S...BACKGROUND: Patients with head and neck cancer (HNC) are at high nutritional risk, and accurate assessment is critical to guide interventions and predict outcomes. The Patient-Generated Subjective Global Assessment (PG-SGA) is a validated malnutrition assessment tool, while computed tomography (CT)-derived skeletal muscle measures also support risk stratification. This exploratory retrospective study compared the PG-SGA with thoracic skeletal muscle index (SMI) in newly diagnosed HNC patients who had completed radiotherapy (RT) and had an analyzable CT scan. METHODS: The PG-SGA was completed pre-RT, with patients classified as well nourished (PG-SGA-A) or moderately malnourished (PG-SGA-B). T2SMI (cm²/m²) was assessed at the second thoracic vertebra (T2) and categorized as high or low. Associations with critical weight loss (CWL; ≥5% during RT), overall survival (OS), and cancer-specific survival (CSS) were explored. RESULTS: Among 117 patients (72% oropharyngeal cancer), 38% had low T2SMI and 16% were moderately malnourished. Of those classified as well nourished (n = 98), 37% had low T2SMI. Predictors of CWL included PG-SGA-B, concurrent chemoradiotherapy, and body mass index ≥25 kg/m². Low T2SMI (P = 0.04) and PG-SGA-B (P = 0.028) were associated with poorer OS. Moderate malnutrition was associated with worse OS regardless of T2SMI, and well-nourished patients with low T2SMI had worse CSS (P = 0.028). CONCLUSION: These findings support the integration of the PG-SGA with muscle mass assessment to provide a comprehensive evaluation of nutritional status and prognostic accuracy in HNC. This combined approach may improve identification of those at risk of adverse outcomes and guide targeted nutritional interventions.
Nucci D, Ragusa FS, Mazza E
… +14 more, Veronese N, Gianfredi V, Volpe M, Maggi S, Onder G, Sieber C, Zanetti M, Silano M, Chernykh A, Lorenzo FD, Romiti GF, Schirò P, Ungar A, Mediterranean Diet Guideline Group
BACKGROUND: The Mediterranean diet (MD) is a dietary pattern associated with reduced chronic disease risk and increased longevity. This systematic review and meta-analysis aimed to evaluate the association between adhere...BACKGROUND: The Mediterranean diet (MD) is a dietary pattern associated with reduced chronic disease risk and increased longevity. This systematic review and meta-analysis aimed to evaluate the association between adherence to the MD and all-cause mortality in adult populations. METHODS: A comprehensive literature search was conducted in PubMed/MEDLINE, Cochrane Library, Embase, and Scopus (search date: February 28, 2024) without date restrictions. Prospective and retrospective cohort studies examining the association between MD adherence (measured by any validated score) and all-cause mortality were included. Study selection and data extraction were performed independently by pairs of reviewers using Covidence. Risk of bias was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analysis was conducted, estimating pooled relative risks (RRs) per 1-point increment in MD adherence score. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated by funnel plot. Certainty of evidence was graded using the NUTRIGRADE approach. RESULTS: Out of 5229 screened records, 54 cohort studies were included, comprising 1 833 267 participants and 346 034 deaths. Studies spanned diverse populations and geographic regions, with follow-up ranging from 2 to 60 y. The pooled RR for all-cause mortality per 1-point increase in MD adherence was 0.96 (95% CI: 0.95-0.97), indicating a statistically significant protective effect. The overall certainty of evidence was rated as moderate. CONCLUSIONS: Higher adherence to the MD is associated with a reduced risk of all-cause mortality. These findings support public health strategies promoting the MD as a sustainable dietary model for longevity.
UNLABELLED: A variety of factors can contribute to muscular performance, including diet. Vegetarian diets are characterized by higher intakes of carbohydrates, micronutrients, and bioactive compounds, which are known to...UNLABELLED: A variety of factors can contribute to muscular performance, including diet. Vegetarian diets are characterized by higher intakes of carbohydrates, micronutrients, and bioactive compounds, which are known to act as antioxidants and have vasodilatory effects, potentially positively impacting muscle performance. OBJECTIVES: The aim of this study is to evaluate muscle performance across dietary patterns with varying levels of exclusion of animal-based foods. METHODS: Thirty-six trained men were divided into three groups based on their responses to the Food Frequency Questionnaire: 13 omnivores, 10 lacto-ovo-vegetarians, and 13 strict vegetarians. An exhaustive exercise protocol was performed on an isokinetic dynamometer, involving the quadriceps of the dominant leg, and the performance outcomes were recorded. A covariance analysis was performed to describe the independent effect of dietary patterns on isokinetic muscle performance, using 17 isokinetic parameters as dependent variables, dietary patterns as independent factors, and age, body composition, and training level as covariates. RESULTS: Most parameters showed statistically significant differences, with P < 0.01. No significant differences were observed in the parameters deceleration time (msec) (P = 0.138) and repetition number that requires more work (P = 0.496). The peak torque at 30 degrees showed a large effect size, and the other parameters showed medium or small effect sizes. CONCLUSIONS: The results of this study indicate that vegetarian dietary patterns are associated with greater isokinetic muscle strength and faster movement speed. Omnivorous individuals showed better muscle power. Muscle resistance demonstrated homogeneous results among dietary patterns. Although the effects observed were of small to moderate magnitude, vegetarian individuals showed an advantage in parameters related to strength and movement speed compared with omnivores.
BACKGROUND AND AIMS: Cancer-related factors can negatively affect nutritional status and impact disease trajectory. Prognostic biomarkers such as bioelectrical impedance-derived phase angle (PhA) may help identify patien...BACKGROUND AND AIMS: Cancer-related factors can negatively affect nutritional status and impact disease trajectory. Prognostic biomarkers such as bioelectrical impedance-derived phase angle (PhA) may help identify patients at higher risk of adverse outcomes. This study aimed to determine optimal PhA cut-off points associated with short-term mortality across different cancer stages. METHODS: This multicenter cohort included 1121 adult patients with cancer in Brazil (≥18 y; 51.2% females; mean age 60 ± 13 y; 43.6% colorectal cancer; 34.3% tumor, node, metastasis [TNM] IV). PhA was derived from raw bioelectrical impedance values: resistance (R) and reactance (Xc) from a tetrapolar single-frequency device (50 kHz). The primary outcome was 6-mo mortality. PhA's predictive accuracy was estimated using receiver operating characteristic (ROC) curves, and cut-off points were estimated using the Youden index. Cox regression models examined crude and adjusted associations between PhA and mortality across TNM stages (I-IV). RESULTS: PhA values were significantly lower in non-survivors (mean difference: -1.02° in males; -1.21° in females). ROC analyses demonstrated fair predictive performance, with optimal thresholds of ≤ 5.43° for males (AUROC 0.74) and ≤ 4.22° for females (AUROC 0.77). Across TNM stages, PhA consistently predicted mortality, with highest accuracy in stage IV (AUROC 0.75; criterion ≤ 4.72°). In multivariate Cox models, PhA remained independently associated with 6-mo mortality after adjustment for confounders. Stepwise analyses confirmed these findings across all stages. CONCLUSION: PhA is an independent predictor of short-term mortality in cancer across all TNM stages. Identified thresholds (consistently < 5.5°) may guide risk stratification and support clinical decision-making, although external validation is required.
BACKGROUND: Gestational diabetes mellitus (GDM) adversely impacts maternal and fetal health. This study analyzed the effects of dietary supplements on birth outcomes in GDM pregnancies and offspring. METHODS: PubMed, Emb...BACKGROUND: Gestational diabetes mellitus (GDM) adversely impacts maternal and fetal health. This study analyzed the effects of dietary supplements on birth outcomes in GDM pregnancies and offspring. METHODS: PubMed, Embase, Cochrane, and Web of Science were searched until August 30, 2024, and the search was updated on January 10, 2026. Cochrane's risk of bias tool assessed study quality; Stata17 performed analyses. RESULTS: A total of 11 randomized controlled trials (RCTs) were included, with 1431 pregnant women with GDM. Probiotics significantly reduced the incidence of macrosomia compared to placebos (risk ratio [RR] = 5.98, 95% credible interval [CrI][1.11, 43.42]). No other significant differences were found for primary outcomes. Surface under the cumulative ranking curve (SUCRA) probabilities indicated that synbiotic was ranked best for reducing cesarean delivery (SUCRA = 78.20%), and probiotic plus vitamin D was best for lowering preeclampsia risk (SUCRA = 78.64%). In newborns, ω3 was best for reducing preterm birth (SUCRA = 72.08%), high-dose vitamin D for increasing birth length (SUCRA = 87.15%), probiotic plus vitamin D for increasing head circumference (SUCRA = 84.08%) and reducing macrosomia (SUCRA = 78.92%), and L-ascorbic acid for lowering neonatal hypoglycemia (SUCRA = 98.99%). CONCLUSION: No single intervention had a significant effect on all outcomes in both mothers and newborns. Notable among the interventions were vitamin D and its combination with other dietary supplements, especially probiotic plus vitamin D. Further confirmation is expected from larger-sample multicenter RCTs in the future.
OBJECTIVES: In this study we evaluated the effects of an extruded parboiled brown rice and cowpea bean snack (RBS) and an extruded cowpea bean snack (BS) on protein quality in vitro and in vivo, biochemical profile, and...OBJECTIVES: In this study we evaluated the effects of an extruded parboiled brown rice and cowpea bean snack (RBS) and an extruded cowpea bean snack (BS) on protein quality in vitro and in vivo, biochemical profile, and intestinal health. METHODS: Twenty-nine male Wistar rats were randomized into four groups: a casein control (CC) group (n = 8), a parboiled brown rice and cowpea bean snack (RBS) group (n = 8), and a cowpea bean snack (BS) group (n = 8), for 30 days. A protein-free diet group (n = 5) was used to calculate true digestibility and net protein ratio. RESULTS: The RBSs and BSs exhibited distinct chemical compositions and antioxidant profiles. In Wistar rats, compared with the BS group, the RBS group showed lower glucose concentration and lower circular muscle thickness in the colon, higher acetic acid production, and higher peptide transporter 1 and aminopeptidase gene expression. In relation to the CC group, the RBS and BS groups demonstrated a similar protein efficiency ratio, net protein ratio, and in vivo and in vitro protein digestibility as well as similar reductions in triglyceride levels, increases in fecal moisture, and increases in the number of goblet cells in the colon. The BS group showed higher reductions in total cholesterol, colon crypt depth, and duodenal crypt thickness and depth and a higher increase in colon longitudinal muscle thickness compared with the RBS group. CONCLUSIONS: Our results showed in the RBS-fed group good protein quality and improved lipid and glycemic profiles, as well as intestinal health.
OBJECTIVES: Emerging evidence highlights the role of diet in modulating the disease course of ulcerative colitis (UC). This prospective study investigated the association between diet quality, dietary inflammatory index...OBJECTIVES: Emerging evidence highlights the role of diet in modulating the disease course of ulcerative colitis (UC). This prospective study investigated the association between diet quality, dietary inflammatory index (DII), and short-term clinical outcomes in UC patients. METHODS: A total of 108 UC patients in remission or with mild disease activity were recruited. Dietary intake over 6 wk was prospectively recorded using a digital health management platform to assess nutrient composition and calculate DII scores. Subsequently, a cluster-controlled intervention was implemented using a modified antiinflammatory diet tailored to UC-specific needs. Clinical outcomes and fecal microbiota were evaluated. RESULTS: Findings revealed that the majority of patients had inadequate intake of staple foods (78.7%) and vegetables (69.4%). Higher DII scores were significantly associated with an increased risk of relapse or persistent disease activity (OR = 5.82, 95% CI: 1.75-19.39, P = 0.004) and reduced abundance of butyrate-producing gut bacteria. After 6 wk, the intervention group achieved a greater reduction in DII scores (median change -1.31, P = 0.019) and demonstrated improved nutritional intake. Compared with general dietary advice, the structured intervention significantly reduced the risk of short-term adverse outcomes (OR = 0.022, 95% CI: 0.001-0.629, P = 0.026). CONCLUSIONS: This study underscores the significant role of diet quality and DII in predicting UC prognosis. A targeted, digitally delivered antiinflammatory diet improved nutrient intake, modulated gut microbiota, and reduced short-term relapse risk. These findings support the integration of structured dietary strategies into UC management and suggest the feasibility of digital platforms in guiding personalized nutrition therapy.
BACKGROUND: Individuals with Down syndrome (DS) are at increased risk for obesity, sarcopenia, and metabolic disorders, highlighting the need for safe and effective strategies to improve body composition. OBJECTIVE: To e...BACKGROUND: Individuals with Down syndrome (DS) are at increased risk for obesity, sarcopenia, and metabolic disorders, highlighting the need for safe and effective strategies to improve body composition. OBJECTIVE: To evaluate the effects of creatine supplementation on body composition and metabolic safety markers in individuals with DS. METHODS: In this prospective, randomized, double-blind study, 50 participants with DS received either oral creatine supplementation (20 g/d for 5 d, followed by 5 g/d for 6 mo) or placebo (dextrose). Dual-energy x-ray absorptiometry (DXA) was used to assess body composition, and laboratory tests monitored renal and hepatic function at baseline and after six months. RESULTS: After 6 mo, the creatine group exhibited a significant reduction in regional fat percentage in the arms and legs compared with placebo, particularly among females, without adverse effects on renal or hepatic biomarkers. No significant changes were observed in total fat or lean mass. CONCLUSION: During the study, creatine supplementation was found to be safe and to promote a selective reduction in regional adiposity in individuals with DS. These results indicate that creatine is a promising, low-cost way of improving body composition in this vulnerable group. However, further research combining supplementation with exercise interventions is recommended.