Nutrition In Clinical Practice[JOURNAL]
Sun
200 papers
Continuation of enteral nutrition in critically ill patients with nonclinically important nonvariceal upper gastrointestinal bleeding: A retrospective cohort study.
Luo J, Yao Z, Xia X … +10 more , Li T, Fu X, Wang L, Wang Y, Yang J, Wang B, Yang H, Lei Z, Zhang Y, Wu Q
Nutr Clin Pract · 2026 Jan · PMID 41581006 · Publisher ↗
BACKGROUND: Enteral nutrition (EN) is the preferred method of nutrition support for critically ill patients, but its continuation during nonclinically important nonvariceal upper gastrointestinal bleeding (NVUGIB) remain...
BACKGROUND: Enteral nutrition (EN) is the preferred method of nutrition support for critically ill patients, but its continuation during nonclinically important nonvariceal upper gastrointestinal bleeding (NVUGIB) remains controversial. METHODS: This retrospective cohort study was conducted in patients in an intensive care unit (ICU) who developed nonclinically important NVUGIB while receiving EN. Patients were categorized into two groups: continued EN group and suspended EN group after the bleeding episode. The primary outcome was progression to clinically important GIB. Secondary outcomes included mortality and being mechanical ventilation free at 28 days. Propensity score matching (PSM) was performed to account for potential confounding variables. RESULTS: Among 590 eligible patients, 400 (67.8%) continued EN and 190 (32.2%) had EN suspended. Progression to clinically important GIB was similar between groups (6.0% vs 6.3%, P = 0.88), a finding confirmed after PSM (7.3% vs 7.3%, P > 0.99). Patients continuing EN had more ventilation-free days (9 vs 6 days, P < 0.001; matched: 10 vs 6 days, P = 0.005). Unmatched analysis showed higher in-hospital mortality in the suspension group (45.5% vs 54.7%, P = 0.036), but this was nonsignificant post-PSM (53.3% vs 46.7%, P = 0.12). Continuation of EN was not found to be significantly associated with clinically important GIB (odds ratio = 1.913, P = 0.30). CONCLUSION: Continuing EN in critically ill patients with nonclinically important NVUGIB appears to be safe and may be associated with a reduced duration of mechanical ventilation. These findings suggest that EN can be safely continued in patients with nonclinically important NVUGIB, potentially offering benefits in terms of respiratory outcomes and nutrition support.
Balancing access to donor human milk: Rationing vs expanding use.
Fu TT, Merlino-Barr S, Roy M … +2 more , Hannan K, McNelis K
Nutr Clin Pract · 2026 Jan · PMID 41581004 · Publisher ↗
Human milk is the optimal source of nutrition for infants; when mother's own milk (MOM) is unavailable, pasteurized donor human milk (DHM) is the preferred feeding alternative. DHM does not confer the same benefits as MO...
Human milk is the optimal source of nutrition for infants; when mother's own milk (MOM) is unavailable, pasteurized donor human milk (DHM) is the preferred feeding alternative. DHM does not confer the same benefits as MOM, but as a human milk substrate, it remains distinctly unique from infant formulas. Although the evidence for DHM use is strong for high-risk preterm infants, especially very low birth weight infants, DHM's superiority over infant formula in improving clinical outcomes is less clear for other infant populations. Regardless, for some institutions, DHM use has been inconsistently extended to infants with congenital heart disease, gastrointestinal anomalies, neonatal opioid withdrawal syndrome, and other term or moderate and late preterm infants. Here, we describe the potential benefits and limitations to the expanded use of DHM as well as controversies related to access to DHM, including regulatory, financial, logistical, and distribution barriers.
Interrelationships among handgrip strength, body composition, physical activity, and quality of life in adults with cystic fibrosis: A cross-sectional study.
Crain BH, Harris C, Bellissimo MP … +7 more , Gonzalez Ramirez LA, Ivie EA, Hunt WR, Tangpricha V, Ziegler TR, Harris RA, Alvarez JA
Nutr Clin Pract · 2026 Jun · PMID 41540714 · Full text
BACKGROUND: In individuals with cystic fibrosis (CF), lean mass and muscle strength are important predictors of clinical outcomes. This study evaluated associations among body composition, handgrip strength, muscle quali...
BACKGROUND: In individuals with cystic fibrosis (CF), lean mass and muscle strength are important predictors of clinical outcomes. This study evaluated associations among body composition, handgrip strength, muscle quality, physical activity, and health-related quality of life in CF. METHODS: This observational, cross-sectional study included 27 adults with CF and 24 age-matched healthy controls. Body composition was assessed using dual-energy x-ray absorptiometry, physical activity by self-reported questionnaire, strength by handgrip dynamometry, and quality of life by the CF Quality of Life-Revised (CFQ-R) questionnaire. Muscle quality was defined as handgrip strength divided by appendicular lean mass. Analyses included t- tests and Pearson or Spearman correlations. RESULTS: Demographics, body composition, handgrip strength, and muscle quality were similar between those with CF and controls. Among those with CF, muscle quality was positively associated with total physical activity score (r = 0.49, P = 0.009). Handgrip strength was positively associated with lean mass (r = 0.86, P < 0.001) and bone mineral density (r = 0.64, P < 0.001). Regarding CFQ-R, lean mass was positively associated with body image and emotion (r = 0.41, P = 0.03), and body fat was associated with lower physical functioning (r = -0.63, P = 0.004), greater treatment burdens (r = -0.49, P = 0.01), and worse digestive health (r = -0.45, P = 0.02). CONCLUSION: As the CF population ages, these data support continued efforts to promote physical activity and improve body composition for enhanced quality of life while also highlighting the value of integrating accessible measures of muscle function and quality into routine clinical care.
Rehabilitation effects of whole-body vibration training combined with blood flow restriction training on sarcopenia in older adults: A randomized prospective study.
Zhu Q, Zhang P, Cui T … +3 more , Yang M, Lu M, Pu X
Nutr Clin Pract · 2026 Apr · PMID 41485118 · Publisher ↗
OBJECTIVE: Considering sarcopenia's major health threat to older adults and the limited efficacy of current treatments, this study aims to unveil the rehabilitation effects of whole-body vibration training (WBVT) combine...
OBJECTIVE: Considering sarcopenia's major health threat to older adults and the limited efficacy of current treatments, this study aims to unveil the rehabilitation effects of whole-body vibration training (WBVT) combined with blood flow restriction (BFR) training on older patients with sarcopenia. METHODS: This study is a randomized controlled experiment. Seventy-four older patients with sarcopenia were randomly split into observation and control groups (37 each). Both groups received nutrition support; the control group underwent conventional rehabilitation, whereas the observation group underwent an additional 6-week WBVT and BFR training. Outcomes included skeletal muscle mass index (SMI), appendicular SMI (ASMI), grip strength, 6-min walk test (6MWT), self-care ability (Short Physical Performance Battery Score [SPPB]), and daily living ability (Activity of Daily Living Scale [ADL]). RESULTS: After the intervention, SMI and ASMI increased, with higher values in the observation group (P < 0.05); 6MWT and grip strength improved in both groups, with higher values in the observation group (P < 0.05); and SPPB and ADL scores increased in both groups, with higher scores in the observation group (P < 0.05). CONCLUSION: WBVT combined with BFR training effectively enhances muscle strength, improves motor function, and increases the quality of life in older patients with sarcopenia.
Malnutrition by GLIM and its overlap with sarcopenic obesity in older adults with elevated body mass index: A retrospective cross-sectional study.
Kayhan Kocak FO, Altın Z, Kızıltaş A
Nutr Clin Pract · 2026 Jun · PMID 41459811 · Publisher ↗
BACKGROUND: This study examined the overlap of sarcopenic obesity and malnutrition using the 2025 Global Leadership Initiative on Malnutrition (GLIM) criteria and their impact on geriatric outcomes. METHODS: In this cros...
BACKGROUND: This study examined the overlap of sarcopenic obesity and malnutrition using the 2025 Global Leadership Initiative on Malnutrition (GLIM) criteria and their impact on geriatric outcomes. METHODS: In this cross-sectional study, 264 geriatric outpatients (body mass index [BMI] ≥ 25 kg/m²) were assessed. Sarcopenia and sarcopenic obesity were diagnosed using the European Working Group on Sarcopenia in Older People 2 and the European Society for Clinical Nutrition and Metabolism (ESPEN) and The European Association for the Study of Obesity (EASO) consensus definitions. Malnutrition was diagnosed using the GLIM criteria, applied regardless of their Mini Nutritional Assessment Short Form (MNA-SF) results to detect overlooked cases. Outcomes included frailty, disability, incontinence, and falls. RESULTS: Sarcopenic obesity prevalence was 15.9%, and GLIM-defined malnutrition was 30.3%. More than half (58.8%) of patients with GLIM-defined malnutrition were not at risk per the MNA-SF. In patients without MNA-defined malnutrition risk, GLIM malnutrition was more frequent in patients with sarcopenic obesity than without (42.9% vs 18.7%, P = 0.002). The co-occurrence of sarcopenic obesity and GLIM-defined malnutrition showed a synergistic effect on frailty (odds ratio [OR] = 5.11) and Instrumental Activities of Daily Living disability (OR = 3.74), independent of age and comorbidity. CONCLUSION: Standard tools like the MNA-SF markedly underdetect malnutrition in older adults with BMI ≥ 25 kg/m, including those with sarcopenic obesity. Because GLIM's two-step process depends on initial screening, many patients at risk may not proceed to full GLIM assessment. Our findings demonstrate that GLIM, supported by body composition analysis, more accurately identifies malnutrition and highlights the added harm of coexisting sarcopenic obesity.
Low calf circumference is associated with higher plasma N-terminal pro-B-type natriuretic peptide in hospitalized heart failure patients: A retrospective study.
Cruz-Sánchez JJ, González-Ruiz FJ, Aguilar-Rodríguez CG … +5 more , Acosta-Osuna MG, Osuna-Padilla IA, Tovar-Hernández ML, Arias-Mendoza A, Baranda-Tovar FM
Nutr Clin Pract · 2026 Jun · PMID 41414917 · Publisher ↗
BACKGROUND: Heart failure (HF) affects millions of persons worldwide, with malnutrition and sarcopenia as prevalent complications. Both are characterized by low muscle mass (MM), which can be estimated using Body mass in...
BACKGROUND: Heart failure (HF) affects millions of persons worldwide, with malnutrition and sarcopenia as prevalent complications. Both are characterized by low muscle mass (MM), which can be estimated using Body mass index (BMI)-adjusted calf circumference (CC). Although CC is a simple and practical surrogate for MM, it is not routinely included in standard nutrition screening tools, despite recommendations from the Global Leadership Initiative on Malnutrition. In patients with HF, low MM has been linked to elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, a marker of cardiac stress. Including CC in nutrition screening may improve detection of malnourished patients. This study aimed to assess the association between BMI-adjusted CC and NT-proBNP levels in hospitalized patients with HF. METHODS: This retrospectively conducted cross-sectional study included 202 patients with HF across different ejection fraction categories. Data on demographics, anthropometry, and biochemical markers were collected. The association between BMI-adjusted CC and NT-proBNP were analyzed using Spearman correlation and multivariate linear regression. RESULTS: Low BMI-adjusted CC was prevalent in 74.8% of patients, with higher NT-proBNP levels compared with those with normal CC (11,970 vs 5621 pg/ml, P < 0.001). BMI-adjusted CC was inversely associated with NT-proBNP concentrations (β = -927, 95% CI: -1543 to -311) after adjusting for confounders. CONCLUSION: A high prevalence of low MM was detected in patients with HF. Low BMI-adjusted CC is associated with elevated NT-proBNP, highlighting the link between muscle depletion and cardiac stress. Incorporating BMI-adjusted CC into nutrition assessment may improve the identification of malnutrition in patients with HF and enable more targeted nutrition risk stratification and intervention strategies.
ASPEN's global influence in the dissemination of parenteral and enteral nutrition.
Sriram K
Nutr Clin Pract · 2026 Feb · PMID 41404653 · Publisher ↗
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"I Never Heard of It…".
Barrocas A, Baumgartner TG, Jastram CW
Nutr Clin Pract · 2026 Feb · PMID 41392835 · Publisher ↗
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Supplementary parenteral arginine corrects hypoargininaemia and rebalances plasma amino acid profiles in very preterm infants receiving parenteral nutrition: A prospective study.
Callaghan F, Burgess L, Menon Premakumar C … +4 more , McCarter D, Gutièrrez EC, Hawcutt DB, Morgan C
Nutr Clin Pract · 2026 Apr · PMID 41392819 · Full text
BACKGROUND: Plasma amino acid (AA) profiles in parenteral nutrition (PN)-dependent very preterm infants (VPIs) consistently show overprovision of essential AA (EAA) and arginine deficiency. This may have implications for...
BACKGROUND: Plasma amino acid (AA) profiles in parenteral nutrition (PN)-dependent very preterm infants (VPIs) consistently show overprovision of essential AA (EAA) and arginine deficiency. This may have implications for growth and immune/inflammatory responses. AIM: To compare plasma AA profiles on day 3 and day 10 in VPIs receiving standard PN (6.3 g/100 g AA arginine) and arginine-supplemented PN (18 g/100 g AA) in VPIs at <30 weeks' gestation. METHODS: VPIs were allocated (according to intervention PN availability) in a series of separate physiological studies to receive standard PN or arginine-supplemented PN. This approach led to a final PN AA formulation design containing 18 g/100 g AA. Clinical, nutrition intake, and biochemical data were collected. Point-of-care testing was used to measure ammonia levels. Plasma AA levels were measured on days 3, 10 and 30 using ion exchange chromatography. RESULTS: The highest mean daily arginine intake was on day 7: 521 mg/kg/day (142 mg/kg/day) at a dose of 18 g arginine/100 g parenteral AA. The median day 10 plasma arginine level was 85 (52-146) vs 41 (28-54) µmol/L for 18 g/100 g AA arginine vs control, respectively (P < 0.0001) The equivalent data for total EAA were 896 (750-1142) vs 1220 (1031-1428) µmol/L (P < 0.05) and blood ammonia levels were 46 (24-65) vs 51 (40-62) µmol/L (P = 0.28). CONCLUSION: In VPIs, PN arginine supplementation of 18 g/100 g AA increases arginine concentrations and reduces provision of EAA as demonstrated in the plasma AA profile. Higher plasma arginine levels are not sustained once parenteral arginine is discontinued. Blood ammonia levels were not useful in identifying individual arginine deficiency.
Comparison of fat-free mass adjusted for overhydration obtained by bioelectrical impedance and computed tomography in critically ill patients with COVID-19: A secondary analysis of a prospective cohort.
García-Grimaldo A, Rodríguez-Moguel NC, Hernández-Cárdenas CM … +1 more , Osuna-Padilla IA
Nutr Clin Pract · 2026 Jun · PMID 41387340 · Publisher ↗
BACKGROUND: Muscle mass is a strong predictor of clinical outcomes. However, its continuous monitoring is not always feasible in critically ill patients. Surrogate methods, such as bioelectrical impedance analysis (BIA),...
BACKGROUND: Muscle mass is a strong predictor of clinical outcomes. However, its continuous monitoring is not always feasible in critically ill patients. Surrogate methods, such as bioelectrical impedance analysis (BIA), may be affected by overhydration (OH). The aim of this study was to evaluate the agreement of BIA-derived fat-free mass (FFM) adjusted for hydration status in comparison with muscle mass assessed by computed tomography (CT) in critically ill patients with pneumonia due to COVID 19. METHODS: This secondary analysis includes patients with a CT scan of the third lumbar vertebra (L3) and a BIA performed within the first 24 to 48 h of hospital admission. FFM and hydration status were estimated using BIA (FFM), and then adjusted to OH (FFM). Images from the skeletal muscle area obtained from L3 were used to calculate the FFM derived from CT (FFM). The concordance between FFM derived from CT and BIA was analyzed using Bland-Altman and Student t test. RESULTS: Seventy-four patients were included. FFM overestimated compared with CT (54.6 ± 10.3 kg vs 47.4 ± 10.9 kg) with a mean difference of 7.2 kg (limits of agreement, -5.1 to 19.5; P < 0.01). Overestimation decreased by FFM, with a mean difference of 3.5 kg (limits of agreement, -9.6 to 16.8; P = 0.06). CONCLUSION: FFM assessed by BIA shows a better agreement with FFM in comparison with FFM.
Comprehensive obesity care: Leveraging lifestyle modifications, obesity medications, and bariatric procedures to improve clinical and nutrition outcomes.
Ezenekwe L, Newberry C
Nutr Clin Pract · 2026 Feb · PMID 41351318 · Publisher ↗
Obesity is common, affecting >40% of Americans and increasing at rapid rates worldwide. Defined by the presence of excess body fat, obesity is tied to a multitude of poor health conditions, including cardiovascular disea...
Obesity is common, affecting >40% of Americans and increasing at rapid rates worldwide. Defined by the presence of excess body fat, obesity is tied to a multitude of poor health conditions, including cardiovascular disease, insulin resistance, and malignancy. Although lifestyle modifications such as diet and physical activity are cornerstones of management and crucial to enhance the health benefits achieved via targeted treatment plans, highly efficacious obesity medications are also now available. In particular, glucagon-like peptide-1 receptor agonists, have been found to be safe and efficacious, inducing clinically significant weight loss that is sustainable. Their effect on nutrition status is still being defined. In addition to medications, bariatric endoscopy and bariatric surgery are also highly effective options for durable weight loss, although these treatments are associated with malnutrition if they are not appropriately monitored. This review aims to define the current landscape of obesity medicine today, highlighting both current therapies and discussing their associated nutrition considerations, to educate the nutrition-focused provider. Multimodal therapies, combining medications and procedures, are an active area of research and will likely define care in future years.
Development and validation of a nutrition risk screening for patients with childhood cancer in Brazil (NUTRICCAN).
Marçon CF, Santos CAD, Oliveira FLC
Nutr Clin Pract · 2026 Jun · PMID 41346195 · Full text
BACKGROUND: Diagnosing malnutrition in patients with pediatric cancer is challenging because tumor masses can interfere with anthropometric measurements. STRONGkids considers cancer a general risk factor, whereas Screeni...
BACKGROUND: Diagnosing malnutrition in patients with pediatric cancer is challenging because tumor masses can interfere with anthropometric measurements. STRONGkids considers cancer a general risk factor, whereas Screening Tool for Childhood Cancer (SCAN) classifies patients as at risk or not, potentially missing those who need nutrition monitoring. This study describes development and validation of a new nutrition risk screening tool for childhood cancer in Brazil. METHODS: Nutrition Risk Screening for Childhood Cancer (NUTRICCAN) underwent online expert content validation. Twelve nutritionists applied it to oncology inpatients (0-19 years old) at the Pediatric Oncology Institute at Federal University of São Paulo from June to August 2024. Nutrition risk was assessed using NUTRICCAN, STRONGkids, and SCAN. Logistic regression identified screening variables associated with malnutrition (body mass index-for-age z score < -2, mid-upper arm circumference [MUAC] <5 percentile, calf circumference below cutoff, or met any of the criteria for malnutrition). Receiver operating characteristic analysis determined cutoff scores, and sensitivity/specificity analyses allowed comparisons among instruments. RESULTS: Patients not receiving intensive care were almost three times more likely to have an inadequate MUAC (odds ratio [OR], 4.505; 95% confidence interval [CI], 1.446-14.033; P = 0.009). Low socioeconomic status or caregiver education increased the risk of malnutrition (OR, 2.845; 95% CI, 1.070-7.566; P = 0.036). Dietitians' subjective assessments were associated with a fourfold increased risk of malnutrition. NUTRICCAN was 70% accurate (area under the curve, 0.701; 95% CI, 0.617-0.785), outperforming the other tools. CONCLUSION: NUTRICCAN better stratifies nutritional risk, considering clinical and socioeconomic factors, and may allow for more targeted interventions, especially in resource-limited settings.
Assessing the growth of children with spinal muscular atrophy using specific curves: A retrospective cohort study.
Barja S, Aranda C, Franulic Y
Nutr Clin Pract · 2026 Jun · PMID 41342476 · Publisher ↗
BACKGROUND: Children with spinal muscular atrophy (SMA) do not follow standard anthropometric growth trajectories; disease-specific curves were published in 2021. Our aim was to apply these in SMA children comparing thei...
BACKGROUND: Children with spinal muscular atrophy (SMA) do not follow standard anthropometric growth trajectories; disease-specific curves were published in 2021. Our aim was to apply these in SMA children comparing their growth and body composition longitudinally, relative to the World Health Organization (WHO) standard. METHODS: This was a retrospective cohort of 19 SMA pediatric patients in a long-stay hospital with monthly anthropometric measurements from admission to discharge. We calculated body mass index) and length‑for‑age z scores (BMIz and LAzs) using WHO and SMA‑specific curves. Triceps skinfold and mid-upper arm circumference z scores (TSFz and MUACz) used WHO reference. RESULTS: Participants had a median age of 9 (IQR, 7-14) months, followed up for 19 months (IQR, 6.5-32). At admission, BMIz was -1.31 ± 0.66 by WHO and 0.77 ± 0.50 by SMA curves (P < 0.01). According to WHO, 11 (57.9%) were malnourished, 8 (42.1%), eutrophic, and 0 overweight, but with SMA curves the comparable values were 2 (10.5%), 9 (47.4%), and 8 (42.1%), respectively. MUACz was -0.3 ± 0.7 and TSFz 2.01 ± 0.84. TSFz correlated better with BMIz based on SMA (R = 0.46) than with WHO curves (R = 0.27). Over time, BMIz remained stable, HAz rose slightly by both curves, MUACz showed a declining trend, and TSFz increased 0.38 annually (R = 0.34; 95% CI, 0.11-0.63; P = 0.006). CONCLUSION: SMA‑specific growth curves assess better the nutrition status in children with SMA compared with WHO standards, aligning more closely with body composition. The cohort demonstrated increased fat accretion, normal length growth, and stable BMI over time.
Patterns of parenteral nutrition use in the inpatient setting: A retrospective cohort study.
Romain M, Weissman C, Abu-Tair K … +5 more , Aldin AA, Harari R, Bitner O, Furmanov A, Yaari S
Nutr Clin Pract · 2026 Apr · PMID 41330874 · Full text
BACKGROUND: Parenteral nutrition (PN) supports patients unable to absorb sufficient nutrients from their gastrointestinal tracts. Yet, information about the patterns and extent of PN's in-hospital use is lacking. Data on...
BACKGROUND: Parenteral nutrition (PN) supports patients unable to absorb sufficient nutrients from their gastrointestinal tracts. Yet, information about the patterns and extent of PN's in-hospital use is lacking. Data on this topic should provide comparison points for nutrition support teams and hospital administrators examining PN use in their institutions. METHODS: A retrospective cohort study using 9 years of routinely collected administrative data from a healthcare system with tertiary care and community hospitals explored the extent, patterns, and trends of PN use in hospitals and individual clinical departments. RESULTS: PN was administered to 2984 patients during 4121 admissions to the tertiary facility for 68,047 days and to 298 patients on 367 admissions to the community hospital for 4925 days. Both hospitals' general surgery, surgical intensive care unit, and other surgical services accounted for half the patients receiving PN. The tertiary care hospital's adult and pediatric oncology/hematology/bone marrow transplantation services, services not provided in the community hospital, accounted for 29% of the hospital's patients receiving PN. Fifty-two percent of surgical patients accounted for 46% of PN-days, whereas the 29% of patients from the hematology/oncology/bone marrow transplantation services utilized 39% of PN-days, with longer durations of PN administration reflected in the latter group. Adult oncology admissions involving PN tripled (from 38 to 116 patients) between the first and last 3 years. CONCLUSION: Different case mixes in the tertiary and community hospitals affected the extent and patterns of PN use. Dataset analysis provided an analytic framework for examining PN usage within and among hospitals.
Barriers to timely nutrition support in patients with cancer: A scoping review.
Tabacchi F, Mitaras T, Iatridi V … +3 more , Tammam J, Watson E, Coe S
Nutr Clin Pract · 2026 Apr · PMID 41318972 · Full text
In clinical cancer settings, malnutrition can go undiagnosed and patients often receive nutrition care only after they have lost substantial weight or developed severe side effects. Neglecting to provide nutrition care t...
In clinical cancer settings, malnutrition can go undiagnosed and patients often receive nutrition care only after they have lost substantial weight or developed severe side effects. Neglecting to provide nutrition care to a patient in a timely manner can lead to increased difficulties in supporting them and to poorer clinical outcomes. The aim of this review was to identify the barriers to timely nutrition support for patients with cancer before and during medical treatment. PubMed and CINAHL platforms were used to search for relevant published literature in June 2022. The search was updated in January 2025. Advanced search was used using the terms "cancer," "malnutrition," "nutritional support," and their synonyms in combination with "under-recognition" and associated synonyms. The protocol was prospectively registered on OSF Open Science. A total of 4584 records were identified in the databases, and 41 abstracts were selected for full article screening. A total of 19 articles were included in the review. Evidence from the studies indicates that malnutrition identification and dietetic support are not always implemented in current practice. Identified barriers were grouped into four interconnected macro themes: educational barriers, communication barriers, resource barriers, and sociocultural barriers. This scoping review identifies four barriers to early nutrition support in oncological settings and discusses their implications and how they influence each other. Clinical governance should consider and look to address all barriers when trying to implement dietetic support or design pathways in a timely and efficient manner.
Working under pressure and fragmentation: How clinical nutrition professionals in Latin America navigated nutrition assessment during COVID-19: A cross-sectional survey.
Fuchs-Tarlovsky V, Díaz G, Álvarez-Altamirano K … +1 more , Vedrenne-Gutiérrez F
Nutr Clin Pract · 2026 Jun · PMID 41291368 · Publisher ↗
BACKGROUND: COVID-19 significantly affected traditional nutrition assessment methods, forcing experts to quickly adjust to new constraints. This study examined practices in clinical nutrition during the pandemic in Latin...
BACKGROUND: COVID-19 significantly affected traditional nutrition assessment methods, forcing experts to quickly adjust to new constraints. This study examined practices in clinical nutrition during the pandemic in Latin America based on professional background or experience. METHODS: A cross-sectional survey from July to November 2021 involved clinical nutrition experts from 18 Latin American countries. A 70-item questionnaire assessed anthropometric, biochemical, and dietetic indicators; screening and diagnostic tools; and methods for estimating nutrient requirements. For statistical analyses we used nonparametric tests and latent profile analyses. RESULTS: Among the 398 participants, the sample included dietitians/nutritionists (63%), physicians (25%), and nurses (12%). Biochemical indicators were used by 87%, dietetic indicators by 71%, and anthropometric measurements by 65%. Only one-third used GLIM criteria, whereas nearly 30% indicated that they did not use any screening tools. Variations in professional practices were observed regarding laboratory test requisitions and dietary assessment methodologies. Dietitians favored the use of recalls, whereas physicians generally ordered a greater number of biochemical tests. There was a significant variation in the estimation of protein and energy requirements, particularly outside of critical care environments. The influence of seniority on assessment practices was negligible. CONCLUSION: Nutrition evaluation throughout the pandemic has demonstrated considerable variability with an individual's profession demonstrating a more substantial impact than their level of seniority. The limited utilization of standardized tools highlights continued fragmentation and emphasizes the necessity for interprofessional education and institutional policies to ensure consistent, evidence-based nutrition care.
Impact of viscosity on tube clogging incidence in straight vs right-angle tube feeding extension sets: An in vitro study.
Carter H, Walker S, Spurlock AY … +1 more , Johnson TW
Nutr Clin Pract · 2025 Nov · PMID 41287955 · Publisher ↗
BACKGROUND: Blenderized tube feeding (BTF) use has increased in patient populations requiring enteral nutrition support, and healthcare providers need to be well-informed on the nuances of BTF-including administration. P...
BACKGROUND: Blenderized tube feeding (BTF) use has increased in patient populations requiring enteral nutrition support, and healthcare providers need to be well-informed on the nuances of BTF-including administration. Patients and caregivers frequently prefer right-angle extension sets but are encouraged to use straight sets to avoid a potential clog at the right angle. The purpose of this study was to compare clog occurrences in straight and right-angle extension tubes between standard commercial formula (SCF) and all viscosity levels of BTF. The accuracy of formula volume delivered was also explored. METHODS: A home-prepared and a commercial product were manipulated such that all four viscosity levels were achieved and delivered by pump and syringe through right-angle and straight extension sets in mock tube feedings. A comparison SCF was also delivered via pump without adjusting the viscosity. All 1-h feedings were observed for any clogs at the right-angle or in the straight extension set. RESULTS: No clogs were observed at any viscosity level in pump delivery for right-angle or straight extension sets. One clog was observed in a single-observation syringe feeding. The volume delivered was more consistent at all viscosity levels through the right-angle sets, compared with straight set tubes delivering the 200-ml volume in 1 h. CONCLUSION: Patient preference for right-angle extension sets may be honored for BTF delivered via new-generation feeding pumps.
Thiamin supplementation on mitigating kidney injury and mortality in patients with septic shock: A systematic review and meta-analysis of randomized controlled trials.
Wang G, Liao X, Liao Y … +1 more , Han D
Nutr Clin Pract · 2026 Apr · PMID 41277404 · Publisher ↗
BACKGROUND: The effectiveness of thiamin supplementation in mitigating renal injury and mortality outcomes in patients with septic shock remains uncertain. This systematic review and meta-analysis aimed to determine the...
BACKGROUND: The effectiveness of thiamin supplementation in mitigating renal injury and mortality outcomes in patients with septic shock remains uncertain. This systematic review and meta-analysis aimed to determine the efficacy of thiamin in patients with septic shock. MATERIALS AND METHODS: A systematic search was made of PubMed, Embase, Cochrane Library, and clinicaltrials.gov, without language restrictions. Randomized controlled trials (RCTs) on treatment of septic shock with thiamin, compared with placebo or blank, were reviewed. Studies were pooled to risk ratios (RRs) and weighted mean differences, with 95% confidence intervals (CIs). Six RCTs (enrolling 438 patients) met the inclusion criteria. RESULTS: Thiamin showed significant effects on in-hospital mortality (RR 0.80, 95% CI 0.65-0.99; P = 0.04) and renal replacement therapy (RR 0.48, 95% CI 0.31-0.74; P = 0.0009). CONCLUSION: Thiamin was associated with a reduction in in-hospital mortality and the use of renal replacement therapy in patients with septic shock. Thiamin should be considered for patients with septic shock.
Assessing the reliability of interprofessional raters on peripheral muscle ultrasonography in pediatric oncology: A prospective observational study.
Hawes C, González-Seguel F, Horikawa-Strakovsky A … +3 more , Wen Y, Munnikhuysen S, Mayer KP
Nutr Clin Pract · 2026 Jun · PMID 41241827 · Full text
BACKGROUND: Skeletal muscle is critical for functional status, quality of life, and treatment tolerance in pediatric patients with cancer. Traditional assessments of muscle mass involve radiation and are often unsuitable...
BACKGROUND: Skeletal muscle is critical for functional status, quality of life, and treatment tolerance in pediatric patients with cancer. Traditional assessments of muscle mass involve radiation and are often unsuitable for frequent monitoring. Ultrasound (US) is noninvasive and radiation-free; however, its reliability in pediatric patients with cancer, who experience rapid changes in body composition, is not well established. This study aimed to determine the interrater reliability of US for measuring key muscle parameters. METHODS: A novice and an expert sonographer blindly measured muscle thickness (mT), cross-sectional area (CSA), and echo intensity (EI) for the quadriceps femoris (QF) and tibialis anterior (TA) muscles in an oncology group and a healthy group. Interclass correlation coefficients were calculated to assess interrater reliability. RESULTS: A total of 27 participants were included (n = 14 oncology and n = 13 healthy). All quadriceps measures had good reliability, with QF mT = 0.895 (95% CI, 0.77-0.952), rectus femoris (RF) mT = 0.881 (95% CI, 0.74-0.946), CSA = 0.801 (95% CI, 0.563-0.909), and EI = 0.839 (95% CI, 0.647-0.927). All TA measures had excellent reliability: mT = 0.968 (95% CI, 0.929-0.985), CSA = 0.925 (95% CI, 0.835-0.966), and EI = 0.909 (95% CI, 0.801-0.959). The oncology group's reliability remained high. Key results included RF mT = 0.906 (95% CI, 0.706-0.970), QF mT = 0.887 (95% CI, 0.646-0.964), TA mT = 0.972 (95% CI, 0.912-0.991), CSA = 0.947 (95% CI, 0.836-0.983), and EI = 0.943 (95% CI, 0.822-0.982). CONCLUSION: Point-of-care US is a reliable method to measure muscle in pediatric oncology patients. Moreover, novice sonographers can be trained to perform these measurements reliably.
Effects of comprehensive care combined with nutrition and exercise interventions on nutrition parameters and balance ability in older adult patients with sarcopenia: A randomized controlled trial.
Zhang L, Qin J, Wan C … +6 more , Li Q, Li L, Chen S, Wan T, Yu K, Hu W
Nutr Clin Pract · 2026 Feb · PMID 41241825 · Publisher ↗
BACKGROUND: We aim to explore the impacts of comprehensive nursing care combined with nutrition and exercise interventions on nutrition parameters and balance ability in older adult patients with sarcopenia. METHODS: Thi...
BACKGROUND: We aim to explore the impacts of comprehensive nursing care combined with nutrition and exercise interventions on nutrition parameters and balance ability in older adult patients with sarcopenia. METHODS: This was a randomized controlled trial with 100 older adult patients with sarcopenia split into control (underwent routine nursing) and intervention (received comprehensive nursing plus nutrition and exercise interventions) groups (n = 50 each). Preintervention and postintervention bone metabolism markers, physical function, grip strength, appendicular skeletal muscle mass index, balance and gait ability, nutrition status, and quality of life were assessed. Patient satisfaction with nursing care was compared between groups. RESULTS: Primary indicators: postintervention, both groups improved in gait/balance and nutrition, with the intervention group excelling. Significant group × time interactions were found (gait/balance: F = 39.640-303.484, P < 0.001, ηP = 0.288-0.756; nutrition: F = 14.855-107.323, P < 0.001, ηP = 0.132-0.523). Secondary indicators: both groups improved in bone metabolism (25-hydroxyvitamin D and alkaline phosphatase), physical function, and quality of life, with the intervention group showing superior results. Significant group × time interactions were also observed (bone metabolism: F = 72.721-18.673, P < 0.001, ηP = 0.426-0.160; physical function: F = 866.322-168.097, P < 0.001, ηP = 0.898-0.632; quality of life: F = 907.259-570.078, P < 0.001, ηP = 0.903-0.853). The intervention group had higher patient satisfaction with nursing (χ = 14.581, P < 0.05). CONCLUSION: Comprehensive nursing care combined with nutrition and exercise interventions effectively improves nutrition parameters and balance ability in older adult patients with sarcopenia.
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