Nutrition In Clinical Practice[JOURNAL]
Sun
200 papers
Assessment of sarcopenia in patients with Takayasu arteritis: A prospective cross-sectional observational study.
Selcuk ZD, Can B, Senturk-Durmus N … +3 more , Tufan A, Direskeneli H, Alibaz-Oner F
Nutr Clin Pract · 2026 Jul · PMID 42387913 · Publisher ↗
BACKGROUND: We aimed to evaluate muscle mass, muscle function, and sarcopenia prevalence in patients with Takayasu arteritis (TAK), and to explore associations with disease activity and vascular involvement. METHODS: A t...
BACKGROUND: We aimed to evaluate muscle mass, muscle function, and sarcopenia prevalence in patients with Takayasu arteritis (TAK), and to explore associations with disease activity and vascular involvement. METHODS: A total of 103 TAK patients and 75 age- and sex-matched healthy controls (HC) were included. The muscle strength of the participants was assessed using handgrip and chair-stand tests, while muscle mass was evaluated through two separate measurement methods: bioelectrical impedance analysis (BIA) and ultrasonography (US). For US measurement, the quadriceps and the biceps muscle were measured. Prevalence of sarcopenia was defined using the updated European Working Group on Sarcopenia in Older People (EWGSOP2) and International Society of Physical and Rehabilitation Medicine (ISarcoPRM) algorithm. Probable, confirmed and severe sarcopenia were collectively categorized as sarcopenia. RESULTS: Sarcopenia prevalence was 29.1% in TAK and 12% in HC by ISarcoPRM (P < 0.001), and 59.2% versus 26.7% by EWGSOP2 (P < 0.001). Agreement between the EWGSOP2 and ISarcoPRM definitions for sarcopenia were poor (P = 0.062, ĸ = 0.153). No difference in BIA-based muscle mass was observed between the TAK and HC groups; however, quadriceps muscle thickness (MT) and Sarcopenia Thigh Adjusted Ratio (STAR) index were significantly lower in TAK (P < 0.001). CONCLUSION: This first study of sarcopenia in TAK shows that the prevalence of sarcopenia is higher in TAK compared with HC. US-based measurements were more sensitive than BIA, suggesting US may be a practical screening tool in TAK, detecting regional changes due to combined systemic inflammation and vasculitic arterial involvement.
Timing It Right theory-based staged video education for patients on home enteral nutrition: A randomized controlled trial.
Li Y, Liu M, Yang Y … +3 more , Zhu D, Ni J, Chen C
Nutr Clin Pract · 2026 Jun · PMID 42374803 · Publisher ↗
BACKGROUND: Home enteral nutrition (HEN) is life-sustaining but poses long-term management challenges. One-time discharge education often fails to meet patients' evolving post-discharge needs. Video support offers a prom...
BACKGROUND: Home enteral nutrition (HEN) is life-sustaining but poses long-term management challenges. One-time discharge education often fails to meet patients' evolving post-discharge needs. Video support offers a promising solution, yet its application in HEN rarely rests on a theoretical foundation to guide when and how support is delivered. METHODS: This prospective, two-arm randomized controlled trial randomly assigned 100 eligible patients in a 1:1 ratio to Timing It Right (TIR)-based staged video education (intervention) or video access at discharge (control). Outcomes (quality of life as the primary outcome; anxiety, depression, functional status, patient satisfaction, complications, readmissions as secondary outcomes) were assessed at baseline, 1 and 3 months. Data were analyzed with generalized estimating equations. RESULTS: The intervention group demonstrated significantly greater improvements in functional status (KPS) and reductions in anxiety (SAS) and depression (SDS) scores over time compared with the control group (all P ≤ 0.001), as well as an improvement in patient satisfaction (PSQ-18, P < 0.05). No significant differences were found in quality of life (NutriQoL), readmission rates, or complication incidence. Video engagement data indicated high interest in self-management and complication content. CONCLUSION: A TIR-based staged video intervention is feasible and effective for improving key patient-centered outcomes in HEN. Tailored information at critical post-discharge timepoints addresses evolving needs. Future research should include multicenter trials with longer follow-up and integrate multidimensional support to enhance quality of life.
Feeding practices and nutritional management of infants with transient and congenital hyperinsulinism: A tertiary single-center retrospective study.
Cheng L, O'Connor G, Harris E … +2 more , Cunjamalay A, Dastamani A
Nutr Clin Pract · 2026 Jun · PMID 42370820 · Publisher ↗
BACKGROUND AND AIMS: Hyperinsulinism (HI) is the most common cause of persistent neonatal hypoglycemia and requires careful nutritional management to maintain glycemic stability. Infants with transient hyperinsulinism (T...
BACKGROUND AND AIMS: Hyperinsulinism (HI) is the most common cause of persistent neonatal hypoglycemia and requires careful nutritional management to maintain glycemic stability. Infants with transient hyperinsulinism (THI) often recover within months, whereas congenital hyperinsulinism (CHI) frequently requires prolonged medical and nutritional support. This study aimed to compare feeding practices and nutritional management of infants with THI and CHI. METHODS: This single-center retrospective study included infants diagnosed with HI under 12 months of age between January 2020 and January 2023. Infants were classified as THI if diazoxide was discontinued within six months and as CHI if treatment continued beyond six months. Data was collected at baseline and at one, three, and six months post-diagnosis, with an additional one-year follow-up for the CHI group. RESULTS: Ninety-six infants were included (THI n = 74, CHI n = 22). 78% of the THI group and all infants with CHI required support from intravenous dextrose and/or parenteral nutrition at diagnosis. The CHI group demonstrated greater use of glucose polymers, high-energy and hydrolyzed formulas by six months. By six months, 95% of the THI group were exclusively orally fed compared with 59% in the CHI group. Breastfeeding rates were low in both groups, declined over time and did not recover after medication was stopped. CONCLUSIONS: Infants with CHI require more prolonged and complex nutritional management, characterized by sustained reliance on tube feeding and higher carbohydrate feeds. Early optimization of nutritional intake and clearer strategies to support breastfeeding are areas for improving clinical management and feeding outcomes of infants with THI and CHI.
Late-onset copper and zinc deficiency following Roux-en-Y gastric bypass (RYGB): A case report and review of the literature.
Flores-Patiño JJ, Maya-Salazar C, Vera-Ibarra RD … +6 more , Hernández-Ayala K, Arízaga-Berber JA, Gastélum-Cano JM, Delgado-Zaldívar D, Gil-Lopez F, Torruco-Sotelo C
Nutr Clin Pract · 2026 Jun · PMID 42347905 · Publisher ↗
Roux-en-Y gastric bypass (RYGB) surgery is a highly effective technique for treating obesity. However, it may result in nutritional deficiencies. Here we report the case of a 55-year-old woman presenting with chronic dia...
Roux-en-Y gastric bypass (RYGB) surgery is a highly effective technique for treating obesity. However, it may result in nutritional deficiencies. Here we report the case of a 55-year-old woman presenting with chronic diarrhea lasting 2 years, accompanied by lower limb paresthesia, macrocytic anemia, leukopenia, and thrombocytopenia. Her medical history included hypothyroidism treated with levothyroxine, and RYGB surgery performed in 2014, with intermittent micronutrient supplementation. The patient developed copper and zinc deficiencies. To our knowledge, this is the first report of a patient presenting with both deficiencies simultaneously with pancytopenia 10 years after RYGB. This case underscores the need to verify adherence to existing preoperative screening recommendations involving preoperative micronutrient measurements to assess micronutrient deficiency risks and multidisciplinary postoperative follow-up, the importance of monitoring micronutrient levels, close follow-up of both symptomatic and asymptomatic patients and evaluating adherence to supplementation regimens.
Impact of body mass index on length of stay in patients with inflammatory bowel disease: A retrospective study.
Xiang Y, Zhou Y, Xu R … +1 more , Feng Y
Nutr Clin Pract · 2026 Jun · PMID 42332933 · Publisher ↗
BACKGROUND: The association between body mass index (BMI) and clinical outcomes in inflammatory bowel disease (IBD) remains controversial. We aimed to investigate whether BMI independently predicts length of stay (LOS) o...
BACKGROUND: The association between body mass index (BMI) and clinical outcomes in inflammatory bowel disease (IBD) remains controversial. We aimed to investigate whether BMI independently predicts length of stay (LOS) or if its impact is mediated by nutritional and inflammatory markers. METHODS: This retrospective study included 2545 patients hospitalized with Crohn's disease (CD) and 721 with ulcerative colitis (UC). Patients were categorized into four groups: underweight, normal weight, overweight, and obese. Restricted cubic splines were used to visualize the non-linear relationship between BMI and LOS. Multivariable linear regression models were applied to identify independent predictors of LOS. RESULTS: Univariate analysis showed that in patients with CD, both underweight and obese patients had longer hospital stays than those with normal weight (P = 0.009). BMI showed a U-shaped correlation with serum albumin (ALB) and hemoglobin (Hb). However, in the multivariate model, after adjusting for ALB, Hb, C-reactive protein (CRP), and comorbidities, BMI was no longer a significant predictor of LOS in patients with CD (P = 0.082 to 0.4) or UC (P = 0.2 to 0.9). Instead, lower ALB (P < 0.001) and higher CRP (P < 0.001) were significantly associated with prolonged hospital stays. CONCLUSION: While BMI is associated with LOS in IBD patients, it is not an independent driver. BMI serves as a phenotypic reflection of the underlying inflammatory status. Clinical management should prioritize the correction of inflammation rather than focusing solely on BMI.
Malnutrition and clinical correlates in dementia with Lewy bodies: A retrospective cross-sectional study.
Totuk O, Gonul Oner O
Nutr Clin Pract · 2026 Jun · PMID 42324708 · Publisher ↗
BACKGROUND: Dementia with Lewy bodies (DLB) is a multisystem neurodegenerative disorder often accompanied by autonomic and neuropsychiatric symptoms. Nutritional impairment is increasingly recognized yet under-characteri...
BACKGROUND: Dementia with Lewy bodies (DLB) is a multisystem neurodegenerative disorder often accompanied by autonomic and neuropsychiatric symptoms. Nutritional impairment is increasingly recognized yet under-characterized in DLB. DLB was chosen due to its early multisystem involvement, including brainstem-mediated autonomic and sleep disturbances, which may uniquely affect nutrition. This study evaluated nutritional status and its associations with cognitive, mood, autonomic, and sleep-related features. METHODS: Seventy patients with probable DLB (2017 McKeith criteria) were retrospectively included. Cases of Parkinson's disease dementia or other Lewy body-related conditions were excluded. Nutritional status was assessed with the Mini Nutritional Assessment-Short Form (MNA-SF). Cognitive function (Addenbrooke's Cognitive Examination, ACE-III), depressive symptoms (Geriatric Depression Scale, GDS), motor severity (Hoehn and Yahr staging), sleep disturbances (Rapid Eye Movement Sleep Behavior Disorder, RBD, insomnia), and autonomic symptoms (urinary incontinence, constipation, orthostatic hypotension) were extracted from clinical records. Multivariable logistic, ordinal regression, and hierarchical cluster analyses were performed. RESULTS: Normal nutrition was observed in 14.3% of patients, 60.0% were at risk, and 25.7% were malnourished. Malnutrition was significantly associated with lower ACE-III and higher GDS scores (p < 0.05). RBD and urinary incontinence differed across nutritional groups. Ordinal regression showed age and female sex independently associated with worse nutritional status. Cluster analysis identified a high-risk phenotype with greater cognitive, depressive, autonomic, and sleep-related burden linked to malnutrition. CONCLUSION: Malnutrition is highly prevalent in DLB and correlates with cognitive, psychiatric, autonomic, and sleep-related features. These associations support that nutritional impairment reflects the multisystem disease burden. Early identification of patients with combined deficits may help target those at risk and guide comprehensive management.
The associations between sarcopenia risk, malnutrition, and mortality in adults admitted to an intensive care unit: A prospective, cohort study.
Wedemire C, Jamieson J, Ng N … +4 more , Louie B, Finlay A, Hawkins A, Sandhu R
Nutr Clin Pract · 2026 Jun · PMID 42324702 · Publisher ↗
BACKGROUND: Sarcopenia and malnutrition are associated with mortality, including in adults admitted to an intensive care unit. However, their relationships with each other and with intensive care unit mortality, independ...
BACKGROUND: Sarcopenia and malnutrition are associated with mortality, including in adults admitted to an intensive care unit. However, their relationships with each other and with intensive care unit mortality, independently, in mechanically ventilated adults are unclear. This study explored the prevalence and relationships between sarcopenia risk and malnutrition and their association with intensive care unit mortality. METHODS: This was a pilot, prospective, observational study of adults requiring mechanical ventilation in an intensive care unit. Sarcopenia risk and malnutrition were assessed within 96 h of mechanical ventilation, and participants were followed prospectively until intensive care unit discharge. Three multivariable logistic regression models were developed for the dependent outcome of intensive care unit mortality. RESULTS: In total, 127 participants were included. Most were admitted with a medical diagnosis (88.2%). The mean APACHE II score was 25.2 ± 7.4, and intensive care unit mortality was 33.9%. Sarcopenia risk was present in 40.2% of participants, while 33.9% were mild to moderately malnourished and 4.7% were severely malnourished. Co-existing sarcopenia risk and malnutrition was present in 22.8% of participants. Participants with sarcopenia risk had a significantly higher prevalence of malnutrition (56.9%) than patients without sarcopenia risk (26.3%, P < 0.001). There were no significant associations between sarcopenia risk or malnutrition and intensive care unit mortality in the crude and adjusted logistic regression models. CONCLUSION: Malnutrition and sarcopenia risk are prevalent in mechanically ventilated adults and co-exist in almost a quarter of patients. Malnutrition and sarcopenia risk were not independently associated with intensive care unit mortality.
Incidence of unplanned gastrostomy tube replacements and associated complications in people with motor neurone disease and other conditions: A retrospective audit of an Australian dietitian-led clinic.
Farrugia E, Bailey S, Semciw AI … +4 more , Suleiman M, Tacey M, Tuck CJ, Hannan LM
Nutr Clin Pract · 2026 Jun · PMID 42324684 · Publisher ↗
BACKGROUND: Gastrostomy tube placement is a common intervention for long-term nutrition in people with dysphagia. Minimising complications such as tube dislodgement is integral in gastrostomy management, as unplanned rep...
BACKGROUND: Gastrostomy tube placement is a common intervention for long-term nutrition in people with dysphagia. Minimising complications such as tube dislodgement is integral in gastrostomy management, as unplanned replacements may require urgent care to prevent stoma closure. Anecdotally, people living with motor neurone disease (plwMND) have frequent complications, although the frequency compared to other conditions remains unknown. This single-centre retrospective audit aimed to quantify and compare gastrostomy-related complications between MND and other conditions. METHODS: All adults managed with a gastrostomy from 2016 to 2021 attending a single centre, dietitian-led gastrostomy service were included. The service database and medical records were screened for complications including unplanned tube replacements, infection, hypergranulation tissue, compromised tube integrity or dislodgement and their frequency was compared in those with MND and in those with other conditions. RESULTS: In total, n = 193 replacement gastrostomy tubes were required in n = 51 individuals. People living with MND had a statistically nonsignificantly lower rate and likelihood of first unplanned replacement compared to other conditions after adjustment for age (HR 0.42). Modelling demonstrated a reduced risk of unplanned replacement with a history of previous infection and hypergranulation tissue, and an increased risk with a history of compromised tube integrity and previous displacement in plwMND. Of unplanned replacements, 48% occurred between 90 to 180 days, with tube integrity the most frequently associated complication. CONCLUSION: People living with MND were more likely to experience hypergranulation tissue but did not have a higher rate of unplanned tube replacements compared to those with other conditions. People experiencing higher rates of unplanned gastrostomy replacements may benefit from strategies to reduce complications.
Common food allergen education and exposure in infants with feeding tubes: A single-center retrospective study highlighting an educational gap.
Misner N, Yavelow M, Sriaroon P … +2 more , Tsalatsanis A, Khalaf RT
Nutr Clin Pract · 2026 Jun · PMID 42324654 · Publisher ↗
BACKGROUND: The timing of allergenic food introduction is a recognized modifiable risk factor for the development of IgE-mediated food allergy. There is a paucity of data on the implementation of early introduction of co...
BACKGROUND: The timing of allergenic food introduction is a recognized modifiable risk factor for the development of IgE-mediated food allergy. There is a paucity of data on the implementation of early introduction of common food allergens in infants fed via feeding tubes. We aimed to compare the characteristics and common food allergen exposure of patients with feeding tubes who received education during their gastroenterology visit versus those who did not. METHODS: We conducted a retrospective chart review of patients aged 4 to 24 months with a feeding tube between September 2020 and July 2024. Differences between patients who received education for common food allergen exposure and those who did not were analyzed using Student's t-test for continuous variables and chi-square test for categorical variables. RESULTS: Seventy-seven patients met the inclusion criteria, contributing a total of 349 visits. Education was associated with younger age (p = 0.01), atopic dermatitis (p = 0.02), English as the primary language (p = 0.02), and non-Hispanic/Latino ethnicity (p < 0.001). Education was frequently missed in infants wholly reliant on their feeding tube (p = 0.01). Although caregivers reported exposure to at least one common food allergen in 63% of all visits, documented exposure to the key allergens, peanut (8%) and egg (12%), was notably low. CONCLUSIONS: These findings suggest the need for improved and targeted education. Future research may aim to establish evidence-based guidelines for introducing allergenic foods to infants fed via feeding tube.
Unique causes of exocrine pancreatic insufficiency: When to consider pancreatic enzyme supplementation: A narrative review.
Williams V, Funk S
Nutr Clin Pract · 2026 Jun · PMID 42319011 · Publisher ↗
Exocrine pancreatic insufficiency (EPI) is a clinically significant disorder characterized by inadequate secretion or activity of pancreatic digestive enzymes, leading to maldigestion, malabsorption, and adverse nutritio...
Exocrine pancreatic insufficiency (EPI) is a clinically significant disorder characterized by inadequate secretion or activity of pancreatic digestive enzymes, leading to maldigestion, malabsorption, and adverse nutritional and metabolic consequences. The causes of EPI can be divided into loss of pancreatic parenchyma, inhibition or inactivation of pancreatic secretion, and postcibal pancreatic asynchrony. Although most associated with intrinsic pancreatic diseases such as cystic fibrosis, chronic pancreatitis or pancreatic cancer, EPI is increasingly recognized in a range of other conditions including diabetes, inflammatory bowel disease, celiac disease, hypersecretory states, gastrointestinal surgeries, small intestinal bacterial overgrowth, drug side effects and aging. This narrative review summarizes the diagnosis and treatment of EPI along with a focused review of the pathophysiology, clinical consequences, diagnostic approaches, and treatment principles of EPI for a variety of conditions.
Association of handgrip strength with nutritional and clinical parameters in ICU patients with acute exacerbation of COPD: A prospective cross-sectional study.
Aslan S, Aslan M, Kartal FT
Nutr Clin Pract · 2026 Jun · PMID 42234545 · Publisher ↗
BACKGROUND: Malnutrition and muscle dysfunction frequently coexist in critically ill patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). This study aimed to evaluate the association between...
BACKGROUND: Malnutrition and muscle dysfunction frequently coexist in critically ill patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). This study aimed to evaluate the association between handgrip strength (HGS) and nutritional, clinical, and biochemical parameters in this population. METHODS: In this prospective study, 44 patients admitted to the intensive care unit with acute COPD exacerbation were evaluated. Nutritional assessment included mid-upper arm circumference (MUAC), body mass index (BMI), Nutritional Risk Screening 2002 (NRS-2002), modified Nutrition Risk in the Critically Ill (m-NUTRIC) score, and dietary intake. Serum albumin levels were evaluated as a laboratory parameter. Correlation analyses and linear regression analyses were performed to identify associations with HGS. RESULTS: HGS was markedly reduced compared with reference values reported in healthy individuals and stable COPD populations. In correlation analyses, HGS showed significant positive associations with serum albumin levels, MUAC, and daily protein intake, and a significant negative association with NRS-2002 scores, while no significant associations were observed with BMI or m-NUTRIC scores. In the linear regression model, serum albumin remained independently associated with HGS (B = 0.781, p = 0.003), while MUAC, NRS-2002 score, and protein intake were not independently associated. CONCLUSION: Handgrip strength was associated with serum albumin and selected nutritional parameters. It reflects functional status influenced by both nutritional and clinical factors and may complement conventional nutritional assessment in critically ill patients with acute COPD exacerbation.
Unclogging enteral feeding tubes: A systematic review.
Chaiyapak P, Siritientong T
Nutr Clin Pract · 2026 May · PMID 42153429 · Publisher ↗
BACKGROUND: Enteral feeding tube occlusion is a significant complication that impairs treatment efficacy and increases patient risk. Although various interventions exist, a gap remains regarding their comparative effecti...
BACKGROUND: Enteral feeding tube occlusion is a significant complication that impairs treatment efficacy and increases patient risk. Although various interventions exist, a gap remains regarding their comparative effectiveness. This systematic review synthesizes evidence on the relative efficacy of water flushes, enzymatic agents, and mechanical devices for resolving occlusions. MATERIALS AND METHODS: A search of PubMed, Cochrane Library, Scopus, ScienceDirect, and ClinicalTrials.gov was conducted following PRISMA 2020 guidelines to identify relevant in vivo and in vitro studies. RESULTS: Of 1845 records identified, eight studies were included. Mechanical interventions demonstrated high rates of success; an actuated mechanical device cleared 93% of in vitro clogs, significantly outperforming enzyme treatments (33%) and warm water flushes (20%). A non-actuated Fogarty catheter also cleared 100% of resistant clogs in a case series. Regarding enzymes, alkalinized non-enteric-coated pancreatic enzyme solutions achieved a 63.5% success rate, significantly superior to enteric-coated granules (48.2%) and reaching 96% for formula-based clogs. Conversely, warm water flushes demonstrated limited efficacy (20%-27%). CONCLUSION: While actuated mechanical devices demonstrate the highest in vitro efficacy, alkalinized non-enteric-coated pancreatic enzymes are highly effective, particularly for formula clogs. Despite the low certainty of evidence, results support a sequential algorithm: a first-line attempt with warm water, followed by escalation to an actuated mechanical device or an alkalinized non-enteric-coated pancreatic enzyme solution.
Exclusive enteral nutrition improves radiological outcomes in adults with perianal fistulizing Crohn's disease: A real-world retrospective cohort study.
Deng X, Huang Z, Xia Q … +11 more , Huang Z, Wu Y, Wu Y, Li Q, Diao N, Li M, Tang J, Guo Q, Gao X, Yang QF, Chao K
Nutr Clin Pract · 2026 May · PMID 42143570 · Publisher ↗
BACKGROUND: Exclusive enteral nutrition (EEN) is effective in luminal Crohn's disease (CD). However, its role in perianal fistulizing Crohn's disease (PFCD) remains unclear. This study aimed to evaluate the radiological...
BACKGROUND: Exclusive enteral nutrition (EEN) is effective in luminal Crohn's disease (CD). However, its role in perianal fistulizing Crohn's disease (PFCD) remains unclear. This study aimed to evaluate the radiological and clinical outcomes of EEN in adult patients with PFCD. METHODS: This retrospective real-world cohort study included adult CD patients with draining perianal fistulas, as confirmed by magnetic resonance imaging (MRI). All patients received EEN for 8-12 weeks between January 2015 and December 2024. Pelvic MRI was performed before and after EEN. The primary endpoint was radiological healing. The secondary endpoints included radiological improvement, clinical fistula response and remission, overall clinical response and remission, endoscopic response and remission, C-reactive protein (CRP) remission, and reductions in Van Assche Index (VAI) and modified VAI (m-VAI) from baseline. RESULTS: Among 152 patients, radiological healing was observed in 12.5% of patients, with radiological improvement in 77.6% of cases. Clinical fistula response and remission were achieved in 55.9% and 47.4% of patients, respectively. After treatment, both VAI (12.0 [8.0, 15.0] vs 8.0 [6.0, 11.0], p < 0.001) and m-VAI (9.0 [7.0, 12.8] vs 7.0 [4.3, 9.0], p < 0.001) significantly decreased. Overall clinical response and remission were observed in 73.0% and 24.3% of patients, respectively. Endoscopic response and remission occurred in 79.6% and 40.8% of patients, respectively. CRP remission was observed in of 77.6% patients. Concomitant antibiotics (odds ratio, 3.06; 95% confidence interval, 1.21-7.72; p = 0.018) were independently associated with radiological improvement. CONCLUSIONS: EEN treatment was associated with improved radiological and clinical outcomes in patients with PFCD.
Malnutrition, sarcopenia, and quality of life among older adults receiving home healthcare services: A cross-sectional study.
Arikan S, Yilmaz M
Nutr Clin Pract · 2026 May · PMID 42143568 · Publisher ↗
BACKGROUND: Older adults receiving home healthcare services represent a highly vulnerable group for functional decline. This study aimed to determine the prevalence of malnutrition and sarcopenia in this population, inve...
BACKGROUND: Older adults receiving home healthcare services represent a highly vulnerable group for functional decline. This study aimed to determine the prevalence of malnutrition and sarcopenia in this population, investigating their relationship with quality of life (QoL). METHODS: This cross-sectional study was conducted between February 2024 and February 2025 among 254 older adults (≥65 years) receiving home healthcare in Balıkesir, Türkiye. The region was selected for its high elderly population ratio (16.9%), significantly exceeding the national average (10.6%). Nutritional status was assessed using the Mini Nutritional Assessment-Short Form (MNA-SF), sarcopenia risk with the SARC-F (Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls) scale, and QoL with the CASP-19 (Control, Autonomy, Self-realization, and Pleasure) scale. Anthropometric measurements (Body Mass Index [BMI], mid-upper arm circumference [MUAC], and calf circumference [CC]) were recorded. RESULTS: Malnutrition was identified in 32.7% of participants, while 58.3% were at risk. The risk of sarcopenia was high at 90.2%. Participants with malnutrition and sarcopenia risk had significantly lower QoL scores (p < 0.001). Better nutritional status, higher BMI, and greater MUAC and CC measurements were positively associated with higher QoL (all p < 0.001). Correlation analysis revealed significant negative relationships between nutritional status and sarcopenia risk (r = -0.33, p < 0.001) and between sarcopenia risk and QoL (r = -0.46, p < 0.001). CONCLUSIONS: Malnutrition and sarcopenia risk frequently coexist in home healthcare settings and are strongly associated with lower QoL. Routine nutritional and functional screening are essential in home care to facilitate early intervention and improve well-being in this vulnerable population.
Microbiological safety in the reuse of materials in home enteral nutrition: A quantitative in vitro experimental study.
Marioti RT, Rabito EI, Costa RLD … +3 more , Jovinski LG, Beux MR, Stangarlin-Fiori L
Nutr Clin Pract · 2026 May · PMID 42132096 · Publisher ↗
INTRODUCTION: In home enteral nutrition (HEN), the reuse of packaging and administration materials beyond the recommended period, combined with inadequate hygiene practice, increase the risk of microbiological contaminat...
INTRODUCTION: In home enteral nutrition (HEN), the reuse of packaging and administration materials beyond the recommended period, combined with inadequate hygiene practice, increase the risk of microbiological contamination. This study assessed the risk through a simulation that reproduced real-world usage conditions and hygiene practices adopted in the home environment. METHODS: A quantitative experimental study evaluated bottles, feeding sets, and bags applied to 3 categories of HEN: enteral preparation with food (EPF); mixed enteral preparation (MEP), and commercial powdered enteral formula (CEF). Over 3 days, 4 hygiene practices were tested: water (WAT); detergent (DET); detergent + boiling water (DET + BW); detergent + chlorine sanitizing solution (DET + CS). Enteral formulas were prepared daily under safe conditions, and microbiological analyses were performed in triplicate before and after use. RESULTS: Results suggest that reusing bottles and feeding sets for up to 3 days may be microbiologically safe with MEP or CEF when food safety are followed. With EPF, microbial growth increased from the 2nd day, especially under WAT. DET + CS performed best, ensuring safety for up to 3 days (bottles and feeding sets) and 2 days (feeding bags), which were more prone to contamination. CONCLUSION: Reuse for up to 3 days may be microbiologically safe for bottles and feeding sets with MEP or CEF when food safety practices are followed, with DET + CS being the most effective method. In contrast, materials associated with EPF, especially feeding bags, show greater microbial growth from the 2nd day onward, requiring caution.
Efficacy of combined supplementation of vitamins A/D/K1/K2 on the growth and development of preterm infants: A randomized controlled trial.
Ding Y, Du H
Nutr Clin Pract · 2026 May · PMID 42125969 · Publisher ↗
OBJECTIVE: This study elucidates the effects of additional supplementation of vitamins A and K2 on skeletal development and growth in preterm infants. METHODS: This study was a single-center, single-blind, randomized con...
OBJECTIVE: This study elucidates the effects of additional supplementation of vitamins A and K2 on skeletal development and growth in preterm infants. METHODS: This study was a single-center, single-blind, randomized controlled trial. Eighty-six preterm infants were randomized into the control group (who received vitamin D 400 IU/day and K1 20 μg/day) and intervention group (who additionally received vitamin A 1500 IU/day and K2 (MK-7) 50 μg/day for 12 months). Bone mineral density (BMD), height standard deviation score (HtSDS), serum vitamin levels, and adverse events were assessed. RESULTS: After 12 months, the intervention group had higher lumbar spine and femur BMD, greater HtSDS, and higher serum vitamin A, D, K1, K2, and 25-OH-D levels, with statistically significant differences (all P < 0.05). There was no statistically significant difference in the incidence of adverse reactions between groups (P > 0.05). CONCLUSION: Supplementing vitamins A and K2 alongside routine vitamin D/K1 was associated with significant improvements in skeletal maturity, bone mineral density, and micronutrient status in preterm infants, without affecting safety.
Incorporating GLIM criteria to operationalize the malnutrition-based chronic disease framework.
Russell LA, Patel J, Mundi M … +2 more , Stoppe C, Mechanick JI
Nutr Clin Pract · 2026 Jun · PMID 42121387 · Publisher ↗
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Analysis of factors driving variations in neonatal parenteral nutrition over a decade: A retrospective study.
Phongpreecha T, Sin LWY, Gaskari S … +1 more , Aghaeepour N
Nutr Clin Pract · 2026 May · PMID 42106975 · Publisher ↗
BACKGROUND: Parenteral nutrition (PN) is essential for supporting preterm and critically ill neonates who are unable to tolerate adequate enteral feeds. However, PN composition remains highly variable due to differences...
BACKGROUND: Parenteral nutrition (PN) is essential for supporting preterm and critically ill neonates who are unable to tolerate adequate enteral feeds. However, PN composition remains highly variable due to differences in guidelines, institutional practices, prescriber discretion, and more. This lack of standardization contributes to inconsistent nutrient delivery and may affect clinical outcomes. A deeper understanding of the sources of variation is needed to inform efforts toward more consistent and evidence-aligned prescribing. METHODS: This retrospective study analyzed 54,464 neonatal PN prescriptions issued between 2011 and 2021 to 5052 infants. Patient demographics, prescriber identifiers, and prescription year were linked through electronic health records. Temporal trends in nutrient composition were evaluated using linear mixed-effects models, with covariate adjustment. Dimensionality reduction with t-distributed Stochastic Neighbor Embedding (t-SNE) was applied to visualize temporal clustering of prescriptions and prescriber-level similarity in dosing patterns. RESULTS: PN composition demonstrated clear temporal variability across the decade. Macronutrient shifts diminished after adjusting for patient demographics, indicating that changes were primarily driven by shifts in the NICU population. In contrast, most micronutrients retained significant year effects. Variance partitioning revealed that prescriber identity explained substantially more variability than prescription year for nearly all electrolytes. Guideline updates also shaped certain changes, such as Selenium, which shifted in line with a specific update rather than prescriber preference. CONCLUSION: Neonatal PN is influenced by multiple factors, with prescriber-level differences emerging as a dominant driver for micronutrients. These findings highlight the need for targeted standardization efforts that reduce unnecessary heterogeneity while preserving flexibility for clinical judgment.
Agreement between predictive equations and indirect calorimetry in estimating resting metabolic rate among free-living older adults with sarcopenia: A prospective observational study.
Dong Q, Wu L, Liu J … +10 more , Wang L, Niu D, Li N, Zheng Y, Ding L, Ma Y, Liu J, Wang B, Wang H, Zhou M
Nutr Clin Pract · 2026 May · PMID 42095278 · Publisher ↗
Resting metabolic rate (RMR) accounts for the largest proportion of daily total energy expenditure. The purpose of this study is to systematically evaluate the agreement of predictive equations for RMR and indirect calor...
Resting metabolic rate (RMR) accounts for the largest proportion of daily total energy expenditure. The purpose of this study is to systematically evaluate the agreement of predictive equations for RMR and indirect calorimetry (IC) in a population with sarcopenia. The study included 43 individuals with sarcopenia aged 60 and above (diagnosed according to the AWGS 2019 criteria for sarcopenia). One-on-one measurements and questionnaires were used to obtain information including height, weight, body composition, gait speed, and grip strength. A total of 11 different predictive equations were used to estimate RMR and were compared with the IC in multiple dimensions. The RMR of the study participants ranged from 652 to 1244 kcal/day, with an average of 920.5 ± 150.3 kcal/day. All predictive equations exhibited an accuracy rate of less than 40%, with the Mifflin equation based on body weight (Mifflin_W) showing the lowest bias (16.54%), the lowest root mean square error (RMSE) value (216.51 kcal/day), the highest Lin's Concordance Correlation Coefficient (CCC) value (0.40) and the lowest median absolute percentage error (MAPE) (16.52%). The predictions of the Porter equations were not influenced by age or body mass index (BMI), making its predictions more stable, whereas the biases of other equations were significantly affected by age or BMI. Despite overall poor performance by all equations, the Mifflin_W equation showed the best agreement with IC measurements and may be used with caution when IC is unavailable, noting its tendency to overestimate RMR.
Survey to assess the economic stability and mental health of households with people receiving enteral and parenteral nutrition.
Gardner G, Butcher R, Cash BD
Nutr Clin Pract · 2026 May · PMID 42095238 · Publisher ↗
BACKGROUND: The landscape of nutrition support faces challenges, including rising costs, product shortages, reimbursement gaps, and infusion providers closing. This nationwide survey aimed to describe the perceptions and...
BACKGROUND: The landscape of nutrition support faces challenges, including rising costs, product shortages, reimbursement gaps, and infusion providers closing. This nationwide survey aimed to describe the perceptions and attitudes related to costs, therapy access, and mental health among households with at least one family member requiring enteral nutrition, parenteral nutrition, or a combination of the two. METHODS: A 10-item online survey was available for 8 weeks to households of adult (>18 years old) and pediatric patients (1-17 years old) currently receiving or who had received enteral or parenteral nutrition at home within the past 12 months. The survey explored beliefs and attitudes regarding financial impact, access to care, food security, coping mechanisms, and mental health. RESULTS: Of the 182 participants, 42.9% were on enteral nutrition, 32.4% were on parenteral nutrition, and 24.7% were both. Overall, 52% reported a degree of financial concern due to nutrition therapy costs. About 51% of families described difficulties obtaining nutrition therapy related to cost or insurance coverage. A total of 52.7% of households reported worrying about food security. Over half, 63.7%, reported an impact on their mental health. CONCLUSION: Our findings support that various factors, including the cost of therapy, can negatively impact the economic stability and mental health of families with a member on enteral or parenteral nutrition. These findings highlight the importance of screening for social determinants of health to identify opportunities for intervention through the provision of additional resources and patient advocacy.
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