Nutrition In Clinical Practice[JOURNAL]
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200 papers
Effect of total gastrectomy on weight and body composition: A retrospective study.
Tadicherla T, Sinnamon AJ, Thomas R … +6 more , Mok S, Dineen S, Gurd EN, Parker NH, Mehta RJ, Pimiento JM
Nutr Clin Pract · 2026 May · PMID 42083129 · Publisher ↗
BACKGROUND: Patients undergoing total gastrectomy (TG) for gastric cancer experience significant weight loss and are at risk for nutritional deficiencies. This study aimed to assess body composition changes following TG,...
BACKGROUND: Patients undergoing total gastrectomy (TG) for gastric cancer experience significant weight loss and are at risk for nutritional deficiencies. This study aimed to assess body composition changes following TG, focusing on contribution of skeletal muscle mass loss versus adipose loss. METHODS: This retrospective analysis examines patients who underwent TG at a major cancer center (2014-2021). Longitudinal analysis with regression identified factors associated with rate of body mass index (BMI) change. Cross-sectional CT scan imaging quantified body mass loss, including skeletal muscle area (SMA), skeletal muscle index (SMI), subcutaneous fat area (SFA), and visceral fat area (VFA). RESULTS: Fifty-two TG patients were identified (median age 63 y; 54% male). Higher preoperative BMI predicted greater postoperative weight loss, with BMI > 30 losing more than BMI < 30 (P < 0.001). Weight loss was non-linear, peaking at 6 months (-17%), stabilizing by 12 months, then gradually increasing (P = 0.039). SMA and SMI decreased by 11% at 6 months for both, respectively, with gradual recovery after 12 months. SFA and VFA decreased significantly over 3 years, with peak fat loss evident at 12 months post-surgery, SFA decreased 64% from baseline and VFA decreased 95% from baseline, with minimal recovery thereafter. Skeletal muscle loss peaked 12 months post-TG, including 66% of males and 77% of females, with slight decreases in low skeletal muscle rates at 24 months. CONCLUSION: Weight loss post-TG follows a non-linear pattern, with peak loss at 6 months and stabilization at 12 months. Most weight loss is due to loss of visceral and subcutaneous adipose with substantially less muscle loss. Nevertheless, ongoing monitoring for sarcopenia is warranted in both sexes post-TG.
A skeleton in the closet has become an elephant in the exam room: Rethinking our diagnosing of malnutrition in 2026.
Seres DS
Nutr Clin Pract · 2026 Jun · PMID 42071274 · Publisher ↗
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Comparative effectiveness of different nutrition assessment tools (MNA, NRS 2002, MUST) in identifying pressure injury risk among patients who had a stroke: A retrospective cohort study.
Yin L, Kong J, Liu J
Nutr Clin Pract · 2026 Jun · PMID 42056839 · Publisher ↗
BACKGROUND: This study aimed to compare effectiveness of the Mini Nutritional Assessment (MNA), Nutritional Risk Screening 2002 (NRS 2002), and Malnutrition Universal Screening Tool (MUST) in identifying pressure injury...
BACKGROUND: This study aimed to compare effectiveness of the Mini Nutritional Assessment (MNA), Nutritional Risk Screening 2002 (NRS 2002), and Malnutrition Universal Screening Tool (MUST) in identifying pressure injury risk among patients who had a stroke. METHODS: This retrospective cohort study collected demographic characteristics MNA, NRS 2002, MUST scores, and key nutritional parameters measured within 24 h of admission. High-risk groups are defined as MUST scores ≥1 point, NRS 2002 scores ≥3 points, and MNA scores <17 points. Pressure injury diagnosis adhered to National Pressure Injury Advisory Panel/European Pressure Ulcer Advisory Panel criteria. RESULTS: A total of 505 patients who had a stroke were included of which 85 developed a pressure injury. There was no difference in age, sex or type of stroke between the two groups. MUST high-risk group had the highest pressure injury incidence (35.1%) and Kappa value (0.350). The NRS 2002 and MNA high-risk group showed pressure injury incidences of 27.1% and 26.2%, with Kappa values of 0.202 and 0.175. Receiver operating characteristic (ROC) curve analysis confirmed MUST had optimal predictive performance (0.877, 95% CI: 0.833-0.921) and specificity (93.6%). The area under the curve (AUC) values for NRS 2002 and MNA were 0.760 (95% CI: 0.703-0.816) and 0.732 (95% CI: 0.679-0.786) with specificities of 66.7% and 64.7%. CONCLUSION: MUST demonstrates superior predictive performance (highest AUC and specificity) and risk stratification consistency, outperforming the NRS 2002 and MNA. Therefore, MUST appears to be the most useful among the three tools evaluated, but further research is needed to confirm its predictive ability.
Growth and human milk intake outcomes from postdischarge feedings among very-low-birth-weight preterm infants: A systematic review.
Rebele T, Gomes A, Newkirk M … +3 more , Ghajar M, Byham-Gray L, Ziegler J
Nutr Clin Pract · 2026 Apr · PMID 42051106 · Publisher ↗
BACKGROUND: Preterm infants of <34 weeks gestation or <1500 g are at risk for postnatal growth failure and often require nutrition support after discharge. Despite expert recommendations for postdischarge human milk (HM)...
BACKGROUND: Preterm infants of <34 weeks gestation or <1500 g are at risk for postnatal growth failure and often require nutrition support after discharge. Despite expert recommendations for postdischarge human milk (HM) fortification or nutrient-enriched formula feeding, the effects of current feeding strategies on growth and HM intake remain unclear. This systematic review evaluated the impact of postdischarge fortified expressed HM or direct breastfeeding (BF) with postdischarge formula (PDF) bottle feeds compared to unfortified HM or BF with standard term formula bottle feeds on growth and HM intake outcomes through 6 and 12 months corrected age (CA). METHODS: A systematic search of eight databases and grey literature sources was conducted for studies published in English since 2012 identifying 3146 studies. Risk of bias was assessed using standardized Cochrane RoB 2 and ROBINS-I tools. Meta-analysis was not conducted due to heterogeneity in interventions, outcome timing, and outcome metrics; results were narratively synthesized. RESULTS: Four studies (n = 2 randomized controlled trials, n = 2 cohorts), including 548 preterm infants, met eligibility criteria. Two studies showed significantly greater weight gain, and one showed significantly greater head circumference in the fortified groups at 6 months CA compared to the unfortified groups. Length differences were not significant. Three studies reporting HM intake found comparable or greater HM intake in the fortified groups. CONCLUSION: Current evidence suggests that postdischarge fortified HM or direct BF with supplemental PDF bottle feeds may support improved weight and head circumference outcomes without compromising HM intake. However, methodological variability highlights the need for standardized, prospective studies.
Implementing the Global Leadership Initiative on Malnutrition framework for diagnosing malnutrition by registered dietitians: A quality improvement project.
Pelekhaty S, Winter-Lai A
Nutr Clin Pract · 2026 Jun · PMID 42045950 · Publisher ↗
Malnutrition presents a significant burden to healthcare organizations, and worsens clinical outcomes. Despite this, the frequency of malnutrition diagnosis remains far below known prevalence. Multiple validated framewor...
Malnutrition presents a significant burden to healthcare organizations, and worsens clinical outcomes. Despite this, the frequency of malnutrition diagnosis remains far below known prevalence. Multiple validated frameworks for diagnosing malnutrition exist, the most recent being the Global Leadership Initiative on Malnutrition (GLIM). The purpose of this article is to describe the implementation of the GLIM framework using a multi-disciplinary co-documentation process at one institution. Preimplementation analyses were conducted demonstrating wide discrepancy in frequency and severity of malnutrition diagnoses made by registered dietitian nutritionists (RDNs) and licensed independent practitioners in a one month period with minimal overlap. This was associated with coding capture in the lowest quartile compared with like organizations. Institutional support was obtained for a co-documentation process to include all required elements identified by the coding team. Nutrition leadership reviewed malnutrition frameworks and identified that transition to GLIM would streamline diagnosis in many cases. Education of RDNs focused on interprofessional collaboration and transition to the new framework. Post-implementation, monthly monitoring of co-signature rates on malnutrition notes improved from 72% initially to 90% one year after implementation. Coding capture of malnutrition diagnoses doubled from 4.8% of admissions in January of 2020 to 10% of admissions in mid 2021, increasing institutional performance to the median compared with like organizations. This has been sustained for over 5 years, as demonstrated by 2025 data, and denials remain low. Implementation of GLIM was well accepted by practicing RDNs and supported a collaborative process that improved multi-professional malnutrition documentation.
Micronutrient deficiencies in hepatic cirrhosis: Navigating challenges to assessment and implications for clinical management: A narrative review.
Estes-Doetsch H, Wellner M, Ziegler J
Nutr Clin Pract · 2026 Apr · PMID 42017443 · Publisher ↗
Patients with cirrhosis are prone to malnutrition and a range of micronutrient deficiencies, which carry adverse health effects and the potential to worsen liver-specific outcomes. Clinicians may rely heavily on serum or...
Patients with cirrhosis are prone to malnutrition and a range of micronutrient deficiencies, which carry adverse health effects and the potential to worsen liver-specific outcomes. Clinicians may rely heavily on serum or plasma concentrations of micronutrients for information regarding nutritional status. However, these values can be skewed due to factors such as inflammation as well as the underlying liver dysfunction, affecting the accuracy of interpretation and posing concern for overtreatment. This review summarizes the risk factors for vitamin and mineral deficiencies in patients with cirrhosis, describes the challenges associated with micronutrient assessment, and discusses considerations for initiating micronutrient replacement therapy.
Comparative five-year mortality risk in older adults with sarcopenia and sarcopenic obesity: A retrospective cohort analysis.
Barlas EA, Akın S, Doğan N … +2 more , Şahin GG, İpekten F
Nutr Clin Pract · 2026 Jun · PMID 42001256 · Publisher ↗
BACKGROUND: Sarcopenia and sarcopenic obesity (SO) are increasingly prevalent among older adults and are associated with elevated mortality risk. However, the prognostic differences between these phenotypes remain unclea...
BACKGROUND: Sarcopenia and sarcopenic obesity (SO) are increasingly prevalent among older adults and are associated with elevated mortality risk. However, the prognostic differences between these phenotypes remain unclear. This study aimed to compare five-year all-cause mortality between older adults with isolated sarcopenia and those with SO. METHODS: In this retrospective cohort study, we analyzed 730 community-dwelling individuals aged ≥60 years who attended a geriatrics outpatient clinic between 2018 and 2023. Participants were categorized as having sarcopenia, having SO, or controls based on EWGSOP2 criteria and BMI ≥ 30 kg/m². Comprehensive geriatric assessments-including evaluations of nutrition, cognition, function, and frailty-were performed at baseline. Mortality data were obtained from institutional records. Survival outcomes were assessed using Kaplan-Meier analysis and Cox proportional hazards models. RESULTS: Of the participants, 123 had sarcopenia and 174 had sarcopenic obesity (SO). Over a median follow-up of five years, both groups exhibited significantly higher mortality rates than controls. Individuals with isolated sarcopenia showed the lowest survival probability (log-rank p < 0.001). In multivariable Cox analysis, chronic kidney disease, lower BMI, and older age were independent predictors of mortality. CONCLUSION: Both individuals with sarcopenia and those with SO are associated with increased five-year mortality in older adults. However, individuals with isolated sarcopenia have a higher risk than those with SO, suggesting that excess adiposity may partially mitigate the adverse effects of muscle loss.
A micro-costing analysis of standardized versus individualized parenteral nutrition in preterm neonates.
Castellana E, Cresi F, Coscia A … +4 more , Limone M, Vaudano G, Campagnoli MF, Chiappetta MR
Nutr Clin Pract · 2026 Apr · PMID 41988827 · Publisher ↗
BACKGROUND: The main aim of this study was to compare the costs of using standardized parenteral nutrition (PN) bags versus individualized PN bags for very low birth weight and extremely low birth weight preterm infants...
BACKGROUND: The main aim of this study was to compare the costs of using standardized parenteral nutrition (PN) bags versus individualized PN bags for very low birth weight and extremely low birth weight preterm infants in the neonatal intensive care unit. METHODS: A micro-costing analysis was conducted from November 1, 2022 through October 31, 2023 on both individualized and standard PN bags. RESULTS: During the analysis period, 660 individual bags and 3700 standard bags were used. The average cost per individualized PN bag versus standardized bag was $160.92 versus $62.92 respectively. Standard bags were found to be 60.9% more cost-effective. CONCLUSION: The study concluded that standard PN bags are more cost-effective for very low birth weight and extremely low birth weight preterm patients. These findings support the potential shift towards using standardized PN in hospitals to manage resources effectively. Pharmacists can utilize these results to promote guideline-based use of standardized PN.
Single-center experience of the Crohn's disease exclusion diet in the United States: A retrospective study.
Greenfield M, Salozzo C, Chen W … +3 more , Strople J, Brown J, Runde J
Nutr Clin Pract · 2026 Apr · PMID 41982152 · Publisher ↗
BACKGROUND: The Crohn's Disease Exclusion Diet (CDED) offers a dietary means of inducing and maintaining remission for patients with Crohn's disease (CD). Descriptions of efficacy have emerged primarily from Israel, Euro...
BACKGROUND: The Crohn's Disease Exclusion Diet (CDED) offers a dietary means of inducing and maintaining remission for patients with Crohn's disease (CD). Descriptions of efficacy have emerged primarily from Israel, Europe, and Canada. Here, we offer real-world experience, from a tertiary care center in the United States. METHODS: We conducted a retrospective chart review of patients receiving education on the CDED and those adopting the diet. Demographics, medication exposure, disease-related complications, and reported side effects were collected. Corticosteroid-free clinical remission (SF-CR) was measured at weeks 6, 12, and 24 via the pediatric Crohn's Disease Activity Index (PCDAI). Biomarkers were collected at baseline and while on the diet. RESULTS: Only 8% (n = 32) of children with CD had met with a dietitian regarding the CDED. Of those, 75% (n = 24) adopted the diet. A statistically significant change in PCDAI from baseline to weeks 6, 12, and 24 (χ(3) = 9.61, P = 0.02) was observed. At 24 weeks, SF-CR was achieved in 9/11 subjects who remained on the diet, with a significant decrease in fecal calprotectin (Wilcoxon signed-rank test p < 0.01, 95% CI). In seven subjects with pre/post endoscopic assessment, endoscopic response was demonstrated in 71%. Side effects were mild and included increased abdominal pain, diarrhea, and weight loss (37.5%, n = 9). CONCLUSION: In this single-center experience of children with mild to moderate CD who adopted the CDED, adherence was a challenge. However, for those who were able to sustain the diet, the CDED offered a safe and effective means of clinical remission.
Intensive multidisciplinary intervention while on nasogastric tube feeding prevents the need for gastrostomy tube placement: A retrospective study.
Dempster R, Evenson E, Gentile M … +8 more , Arand B, Ahmed R, Garbacz L, Peters B, Neary M, Stefan B, Schellhaas S, Goday PS
Nutr Clin Pract · 2026 Apr · PMID 41930617 · Publisher ↗
Intensive multidisciplinary intervention (IMI) can reduce dependence on gastrostomy tube (G-tube) feeding in children with pediatric feeding disorder. However, there are no data on using IMI to prevent G-tube placement i...
Intensive multidisciplinary intervention (IMI) can reduce dependence on gastrostomy tube (G-tube) feeding in children with pediatric feeding disorder. However, there are no data on using IMI to prevent G-tube placement in children with nasogastric tubes (NGTs). This study describes outcomes of patients with an NGT in place admitted to IMI with the goal of prevention of G-tube placement. Retrospective data from 2017 to 2022 including demographics, anthropometric data, and energy intake were assessed for children with NGT completing an 8-week IMI (at intake, discharge, and 1-year follow-up). Success was defined as taking 100% energy orally and improving nutrition status or maintaining weight-for-length/body mass index z-score > -2. Thirty patients (11 females) with mean age of 21.8 months (SD: 15.4) and with NGT in place for a mean of 7.1 months (SD: 4.7) and mean oral energy consumption of 18.1% (SD: 20.9) were included. At 1-year follow-up, 23 patients (76%) successfully had their NGT removed and maintained nutrition status. Successful children were likely to be older (average: 24.2 vs 14 months; P = 0.03) and consuming a greater proportion of energy orally at discharge (mean: 88.6% vs 42.0%; P = 0.001). No differences were seen between the groups in anthropometric measurements, length of NGT placement, or percentage of energy consumed orally at admission. IMI is a potentially useful tool to help increase oral intake and prevent the need for G-tube placement. Future research is needed to demonstrate who benefits the most from this type of approach and to understand the ideal treatment methodology to optimize outcomes.
Prehabilitation combined with early oral nutrition reduces postoperative complications and hospital stay in older patients undergoing colorectal cancer surgery: A retrospective propensity score-matched analysis.
Shimamura Y, Honma S, Nakajima S … +4 more , Akazawa N, Kobayashi Y, Aoi W, Kuwahata M
Nutr Clin Pract · 2026 Mar · PMID 41902576 · Publisher ↗
BACKGROUND: Prehabilitation and early oral nutrition have been shown to improve postoperative outcomes in colorectal cancer (CRC). However, their combined effects remain unexamined. This study evaluates the effects of a...
BACKGROUND: Prehabilitation and early oral nutrition have been shown to improve postoperative outcomes in colorectal cancer (CRC). However, their combined effects remain unexamined. This study evaluates the effects of a perioperative support (POS) program, integrating prehabilitation and early oral nutrition, on postoperative outcomes in older patients with CRC using propensity score matching (PSM). METHODS: We conducted a retrospective cohort study comparing patients with stage I-III CRC aged ≥75 years undergoing curative surgery before (April 2019 to March 2021; control group) and after (April 2021 to March 2023; POS group) POS program implementation. Patients were matched for baseline characteristics and perioperative variables using 1:1 nearest-neighbor PSM. The primary outcome was the 30-day postoperative complication rate according to the Clavien-Dindo classification (Grade ≥II). The secondary outcome was length of hospital stay (LOS). RESULTS: A total of 155 patients were included (POS group: n = 73; control group: n = 82). After PSM, each variable was well balanced between the two groups, with 48 pairs successfully matched. The rate of postoperative complications was significantly lower in the POS group than in the control group (16.7% vs 37.5%, P = 0.038), and the median LOS was significantly shorter in the POS group (8 vs 11 days, P = 0.005) after PSM. CONCLUSION: The POS program may reduce postoperative complications and shorten LOS in older patients with CRC.
Outpatient preoperative parenteral nutrition in malnourished surgical patients: A feasibility study (the OPPORTUNITY study).
Lakananurak N, Gramlich L
Nutr Clin Pract · 2026 Mar · PMID 41845940 · Publisher ↗
Preoperative parenteral nutrition (PN) improves outcomes in malnourished surgical patients. Traditionally, this requires hospital admission, increasing length of stay and costs-challenges worsened by limited hospital bed...
Preoperative parenteral nutrition (PN) improves outcomes in malnourished surgical patients. Traditionally, this requires hospital admission, increasing length of stay and costs-challenges worsened by limited hospital bed availability. Outpatient PN may offer a feasible alternative. This study evaluates the feasibility of administering preoperative PN in an outpatient setting. Malnourished patients scheduled for major surgery, identified using subjective global assessment, received outpatient PN for a median of 5 days (range: 5-8) at an infusion clinic. A multichamber, ready-to-use PN solution was infused via a peripherally inserted central catheter (PICC) over 4-6 h, delivering 1 L volume, 75.9 g protein, and 950 kcal daily. Feasibility and nutrition outcomes were assessed, along with safety metrics including refeeding syndrome, hyperglycemia, volume overload, and catheter-related complications. Eight patients (four males, four females) participated, with pancreatic cancer being the most common diagnosis (n = 3). All patients completed 100% of planned PN infusions. Median scores reported by patients and nurses for acceptability, appropriateness, and feasibility were consistently high (patients (n = 7): acceptability 4.9/5, appropriateness 4.6/5, feasibility 4.9/5; nurses (n = 3): acceptability 4.3/5, appropriateness 5.0/5, feasibility 4.0/5). Nutritional intake improved with median energy increased from 18.3 to 36.0 kcal/kg/day, and protein from 0.90 to 1.5 g/kg/day. No complications were reported. Outpatient preoperative PN using multichamber, ready-to-use PN was feasible. This novel approach has the potential to reduce the need for preoperative hospital admission for PN infusion in malnourished surgical patients. Future studies involving larger populations are needed to evaluate the efficacy of outpatient PN.
Association between malnutrition diagnosed by GLIM criteria and one-year mortality in hospitalized elderly patients: A prospective observational study.
Yürüyen M, Geçmez G, Güven HND … +7 more , Deniz H, Yıldırım HG, Yücel MH, Erişmiş B, Yılmaz D, Polat Ö, Hurşitoğlu M
Nutr Clin Pract · 2026 Jun · PMID 41840869 · Publisher ↗
BACKGROUND: Malnutrition is a major geriatric syndrome frequently observed in hospitalized elderly patients, leading to adverse clinical outcomes. This study aimed to evaluate the prevalence of malnutrition using the Glo...
BACKGROUND: Malnutrition is a major geriatric syndrome frequently observed in hospitalized elderly patients, leading to adverse clinical outcomes. This study aimed to evaluate the prevalence of malnutrition using the Global Leadership Initiative on Malnutrition (GLIM) criteria in hospitalized patients and to assess the predictive value of these criteria on one-year mortality. METHODS: This cross-sectional and prospective study was conducted at Health Sciences University Bakirkoy Dr. Sadi Konuk Training and Research Hospital-a tertiary center-between July 2019 and December 2019. Patients aged ≥65 years who were admitted to the Department of Internal Medicine (General Internal Medicine) were included in the study. Patients identified as malnourished or at risk according to the NRS-2002 were further evaluated with the GLIM criteria (requiring at least one phenotypic and one etiologic criterion). RESULTS: A total of 200 patients were enrolled, of whom 101 (50.5%) were female, with a mean age of 74.72 ± 9.39 years. According to the NRS-2002, 81% of patients were at risk for malnutrition, while the prevalence of malnutrition based on the GLIM criteria was 73.5% (49% classified as moderate malnutrition and 24.5% as severe malnutrition). Patients with moderate malnutrition, defined by the GLIM criteria, had a 2.2-fold increased risk of one-year mortality (hazard ratio [HR] = 2.2, 95% confidence interval [CI]: 1.28-3.89, P = 0.005), while those with severe malnutrition had a 2.5-fold increased risk (HR = 2.5, 95% CI: 1.34-4.5, P = 0.004). CONCLUSIONS: The results obtained in the present study demonstrated that the presence of moderate-to-severe malnutrition determined by the GLIM criteria in a two-step process is associated with an increased one-year mortality rate among hospitalized elderly patients.
Crossing borders with parenteral nutrition: A pediatric case of international travel on home parenteral nutrition.
Personius K, Grguric L, Stoyanova E … +2 more , Hobson B, Mercer D
Nutr Clin Pract · 2026 Mar · PMID 41840820 · Publisher ↗
International travel poses unique challenges for patients with intestinal failure who require home parenteral nutrition (HPN) support, particularly in pediatric populations. Differences in healthcare infrastructure, prod...
International travel poses unique challenges for patients with intestinal failure who require home parenteral nutrition (HPN) support, particularly in pediatric populations. Differences in healthcare infrastructure, product availability, and care coordination across countries may further complicate travel. This case report describes the multidisciplinary planning and support that enabled a child who was dependent on HPN to safely travel to Europe for a family vacation. Coordination between nutrition, surgery, pharmacy, and nursing ensured continuity of care. This case report highlights best practices for enabling international travel for the pediatric patient with medical complexity.
Relationship between acute nutritional goal achievement and outcomes in critically ill pediatric patients: A single-center retrospective cohort study.
Nakano S, Niitsu T, Ueta I … +2 more , Kuchiba A, Ohwaki K
Nutr Clin Pract · 2026 Mar · PMID 41832767 · Publisher ↗
BACKGROUND: Although malnutrition in critically ill children is linked to poor outcomes, the impact of achieving guideline-recommended nutritional goals remains unclear. We examined the association between achievement of...
BACKGROUND: Although malnutrition in critically ill children is linked to poor outcomes, the impact of achieving guideline-recommended nutritional goals remains unclear. We examined the association between achievement of American Society for Parenteral and Enteral Nutrition (ASPEN) goals via enteral nutrition (EN) and clinical outcomes in a Japanese pediatric intensive care unit (PICU). METHODS: This single-center, retrospective cohort study included patients aged <16 years admitted between July 2022 and December 2024 who required mechanical ventilation and had a PICU/high care unit (HCU) stay of ≥7 days. We compared patients who achieved the ASPEN goal (≥2/3 of resting energy expenditure and ≥1.5 g/kg/day protein via EN) within 7 days with those who did not. Multivariable Cox proportional hazards models were used to evaluate the association between nutritional goal achievement and the primary outcome of total length of stay (LOS). RESULTS: Of the 110 patients, 80 (72.7%) achieved their nutritional goals. The achievement group had a significantly shorter total LOS (median 12 vs 20 days; P < 0.001). After multivariable adjustment, meeting the nutritional target was independently associated with a higher likelihood of discharge (adjusted hazard ratio: 2.41; 95% confidence interval: 1.45-4.02; P < 0.001). The achievement group also had fewer new-onset infections (8.8% vs 40%) and more ventilator-free days. CONCLUSION: Achievement of ASPEN-recommended nutritional targets through EN within the first week is strongly associated with short LOS and reduced complications in critically ill children. Although early EN is a potential marker of better prognosis, our findings support its optimization in this vulnerable population.
The Forgotten Phase: Nutrition in the Post ICU Patient.
DePriest A, Chotiwat C, Chupp A … +2 more , Roberts D, Porter S
Nutr Clin Pract · 2026 Apr · PMID 41821172 · Publisher ↗
Transitions of care from the intensive care unit (ICU) are high-risk periods for interruptions in nutrition therapy and inadequate nutrient delivery, which may impair recovery following critical illness. As patients leav...
Transitions of care from the intensive care unit (ICU) are high-risk periods for interruptions in nutrition therapy and inadequate nutrient delivery, which may impair recovery following critical illness. As patients leave the ICU, changes in metabolic demand, functional status, feeding tolerance, and discharge setting necessitate deliberate reassessment and coordinated nutrition planning. This narrative review outlines practical strategies to optimize nutrition support during ICU transitions, including reassessment of nutrition status, reevaluation of energy and protein needs, selection of appropriate feeding routes and schedules, and early integration of nutrition into transition of care and discharge planning. We present four patient cases to illustrate application of these strategies across diverse clinical scenarios and discharge destinations including a lung transplant recipient, a patient in a medical ICU, a patient in a neuro ICU, and a patient in a trauma ICU. Collectively, these cases demonstrate that proactive reassessment, timely adjustment of feeding regimens, and early discharge planning can reduce avoidable interruptions in nutrition therapy and support continuity of care across ICU transitions.
Exploring the disease burden and quality of life in patients with short bowel syndrome with intestinal failure: Insights from exit interviews in the glepaglutide EASE SBS-1 phase 3 trial.
Mercer DF, Mubekapi-Musadaidzwa C, Kloster B … +3 more , Berner-Hansen M, Rydén A, Jeppesen PB
Nutr Clin Pract · 2026 Mar · PMID 41816796 · Publisher ↗
BACKGROUND: A randomized, double-blind, placebo-controlled trial was conducted to evaluate efficacy and safety of glepaglutide in patients who have short bowel syndrome with intestinal failure (SBS-IF). At the end of the...
BACKGROUND: A randomized, double-blind, placebo-controlled trial was conducted to evaluate efficacy and safety of glepaglutide in patients who have short bowel syndrome with intestinal failure (SBS-IF). At the end of the trial, exit interviews were conducted to explore participants' experiences and to assess the impact of the disease and treatment during the trial. METHODS: Thirty patients from four countries were interviewed over the phone. Data were collected using a semistructured interview manual, and interviews were recorded and transcribed for analysis. RESULTS: Patients reported that SBS-IF negatively impacted their lives before the trial, causing loss of freedom, disrupted sleep, limited physical activity, and pain. During the interviews, patients reported that the treatment improved their well-being across multiple domains. Seventy-three percent of the patients receiving glepaglutide (n = 16/22) reported positive changes in health-related quality of life compared with 25% receiving placebo (n = 2/8). Twenty-six patients reported experiencing a reduction in parenteral support (PS) volume. Of these, 21 patients (18 glepaglutide, three placebo) reported a change in overall status, with 94% receiving glepaglutide (n = 17/18) and 67% (n = 2/3) receiving the placebo finding this change meaningful. Although descriptive, these findings should be interpreted cautiously given the small number of patients. CONCLUSION: During exit interviews, patients receiving glepaglutide reported improvements in well-being across multiple domains, noting meaningful reductions in PS volume and a reduced impact of SBS-IF on daily life, which was proportionally greater than in those receiving placebo. These findings underscore the patient-reported positive experiences of glepaglutide and its beneficial effects.
Feeding the hospitalized large-for-gestational-age infant: Clinical dilemmas and the need for growth standards.
Cortez NR, Hull HR, Christifano DN … +2 more , Carlson SE, Goday PS
Nutr Clin Pract · 2026 Jun · PMID 41813643 · Full text
Infants born large-for-gestational-age (LGA) are increasingly common because of the rising rates of maternal obesity and diabetes. Some infants born LGA require hospitalization and nutrition support, yet no specific grow...
Infants born large-for-gestational-age (LGA) are increasingly common because of the rising rates of maternal obesity and diabetes. Some infants born LGA require hospitalization and nutrition support, yet no specific growth standards exist to guide nutrition management. Feeding practices based on weight-based guidelines for infants born at appropriate weight for gestational age may unintentionally promote overfeeding and increase long-term obesity risk. This Clinical Dilemma explores the challenges of feeding hospitalized infants born LGA and highlights the urgent need for research to develop evidence-based growth standards for this at-risk population.
Review of nutrition management of pediatric intestinal pseudo-obstruction.
Sankararaman S, James RR, El-Amaireh B … +3 more , Adler A, Radhakrishnan K, Velayuthan S
Nutr Clin Pract · 2026 Mar · PMID 41802989 · Publisher ↗
Chronic intestinal pseudo-obstruction (CIPO) is a rare, heterogeneous, and debilitating disorder characterized by profound intestinal dysmotility and severe nutrition challenges. Its presentation resembles that of mechan...
Chronic intestinal pseudo-obstruction (CIPO) is a rare, heterogeneous, and debilitating disorder characterized by profound intestinal dysmotility and severe nutrition challenges. Its presentation resembles that of mechanical bowel obstruction, but CIPO occurs in the absence of luminal obstruction. Pediatric-onset CIPO has higher morbidity and mortality and is termed pediatric intestinal pseudo-obstruction (PIPO) to differentiate it from adult-onset CIPO. PIPO often presents with vague abdominal symptoms such as abdominal pain, distension, bloating, constipation, and diarrhea. Nutrition therapy is the mainstay of the management of PIPO. The main management goals include maintaining an adequate caloric intake, avoiding fluid and electrolyte imbalance, minimizing/managing malnutrition, treating gastrointestinal symptoms, enhancing intestinal motility using pharmacological interventions, and managing complications such as small intestinal bacterial overgrowth. Surgical interventions are reserved for severe cases. Various modalities of nutrition intervention include modification of oral diet, enteral feeding, and parenteral nutrition. Most children with PIPO have a poor quality of life, and the prognosis is variable based on the underlying condition. Prognosis is better in an interdisciplinary team setting in specialized centers of excellence.
Endoscopic small bowel therapies for type 2 diabetes.
Patel R, Naseem Z, Gattu P … +2 more , Firkins S, Simons-Linares R
Nutr Clin Pract · 2026 Mar · PMID 41773651 · Publisher ↗
Type 2 diabetes is a global epidemic despite current medical treatments. Many patients are not responsive to medications, and patients with obesity are hesitant about bariatric surgery. Studies investigating the metaboli...
Type 2 diabetes is a global epidemic despite current medical treatments. Many patients are not responsive to medications, and patients with obesity are hesitant about bariatric surgery. Studies investigating the metabolic effects of Roux-en-Y gastric bypass have increasingly demonstrated that the duodenum plays a key role in the pathophysiology of type 2 diabetes. This has led to the emergence of small bowel endoscopic therapies for type 2 diabetes. These therapies include procedures such as duodenal ablation, luminal liners, endoscopic bypasses, and endoscopic injections.
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