Nutrition In Clinical Practice[JOURNAL]
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200 papers
The use of octreotide in pediatric patients: Practical applications for gastrointestinal disorders and beyond: A narrative review.
Dunn B, Foxe M, Sprott KH … +2 more , Hook JE, Jump C
Nutr Clin Pract · 2025 Oct · PMID 40629899 · Full text
Somatostatin is a naturally occurring polypeptide hormone that exerts its effect on the gastrointestinal tract by reducing exocrine and endocrine secretion, resulting in decreased motility, gastric emptying, splanchnic b...
Somatostatin is a naturally occurring polypeptide hormone that exerts its effect on the gastrointestinal tract by reducing exocrine and endocrine secretion, resulting in decreased motility, gastric emptying, splanchnic blood flow, fat absorption, lymphatic flow, and gallbladder contraction. Octreotide is a synthetic somatostatin analogue that has a variety of clinical applications in the gastrointestinal tract, including in the treatment of gastrointestinal bleeding, motility disorders, lymphatic disorders, pancreatic disorders, and high-output states. Clinicians may hesitate to use octreotide because of its potential side effects and the lack of robust pediatric data. Here we describe potential side effects of the drug and review the use of octreotide in the above pediatric indications.
Vitamin D and COVID-19: How much more evidence do we need?
Kow CS, Hasan SS, Thiruchelvam K
Nutr Clin Pract · 2025 Oct · PMID 40618279 · Publisher ↗
Abstract loading — click title to view on PubMed.
Calf circumference predicts sarcopenia and all-cause mortality in older patients undergoing maintenance hemodialysis: A prospective cohort study.
Shen Y, Qin H, Liu X … +5 more , Liu L, Chen S, Yang Y, Yuan J, Zha Y
Nutr Clin Pract · 2026 Feb · PMID 40618278 · Full text
BACKGROUND: The role of calf circumference (CC) in predicting sarcopenia and mortality of patients undergoing maintenance hemodialysis (MHD) remains debated. This study assessed CC's predictive value, optimal threshold,...
BACKGROUND: The role of calf circumference (CC) in predicting sarcopenia and mortality of patients undergoing maintenance hemodialysis (MHD) remains debated. This study assessed CC's predictive value, optimal threshold, and mortality association in older patients undergoing MHD. METHODS: An observational cohort study was conducted on older adult patients undergoing MHD. Sarcopenia was defined by European Working Group on Sarcopenia in Older People. Logistic regression and receiver operating characteristic (ROC) analysis were used to explore the relationship between CC and sarcopenia. Kaplan-Meier and Cox regression analyses assessed survival over 2 years. RESULTS: A total of 979 older adult patients undergoing MHD treatment, with an average age of 73.4 years, were included in this study. The prevalence of sarcopenia was 61.1%. Male sex (odds ratio [OR], 0.17; 95% confidence interval [CI], 0.04-0.45; P = 0.017) and CC (OR, 0.38; 95% CI, 0.26-0.56; P < 0.001) were identified as independent risk factors for sarcopenia through multifactorial logistic regression analysis. ROC curves for CC and sarcopenia indicated that the optimal cutoff value for men was 32.5 cm (area under the curve [AUC], 0.904; sensitivity, 0.958; specificity, 0.841), whereas for women, it was 31.9 cm (AUC, 0.884; sensitivity, 0.922; specificity: 0.756). Kaplan-Meier survival analysis demonstrated lower survival probabilities in patients with sarcopenia and low CC. After adjustment for multiple factors, Cox regression analysis revealed that patients in the sarcopenia group (hazard ratio [HR] = 2.411; P = 0.017) and those in the low-CC group (HR = 2.045; P = 0.046) had significantly shorter overall survival. CONCLUSIONS: CC is an independent predictor of sarcopenia and mortality in older patients undergoing MHD.
Does lower dietary protein intake result in lower muscle mass in patients with end-stage kidney failure treated by peritoneal dialysis? A retrospective study.
Davenport A
Nutr Clin Pract · 2026 Apr · PMID 40605430 · Publisher ↗
BACKGROUND: Patients with end-stage kidney disease (ESKD) are at risk of sarcopenia. To determine whether dietary protein intake (DPI) affects changes in body composition, changes in body composition of patients receivin...
BACKGROUND: Patients with end-stage kidney disease (ESKD) are at risk of sarcopenia. To determine whether dietary protein intake (DPI) affects changes in body composition, changes in body composition of patients receiving peritoneal dialysis (PD) were reviewed. METHODS: A retrospective analysis of the association between DPI, estimated from the normalized protein nitrogen appearance rate (nPNA), and changes in body composition measured by bioimpedance in a cohort of established PD outpatients who had been treated with PD for >9 months, attending for routine peritoneal membrane assessments was undertaken. Patients with hospitalizations, peritonitis, and variable DPI between measurements were excluded. RESULTS: A total of 260 PD patients, mean age 61.6 ± 14.7 years, 58.9% male, 39.2% diabetic with a nPNA of 0.92 ± 0.25 g/kg/day were followed for a median of 13 (interquartile range, 12-15) months. Patients were divided into nPNA terciles, and whereas 56% in the highest nPNA group (nPNA >1 g/kg/day) gained lean body mass, >70% of patients in the two lower nPNA terciles lost lean body mass (P < 0.001). The annualized median change in lean body mass increased from the lowest to highest group (-3.1 to -1.0 to +0.6 kg/year; P < 0.01). On multivariable testing, the nPNA group remained independently associated with gains in lean body mass (relative risk, 2.1; P = 0.001). CONCLUSION: The majority of patients with ESKD treated with PD with a nPNA of <1.0 g/kg/day lost lean body mass, whereas more than half with an nPNA of >1.0 g/kg/day had a gain. Thus, ensuring an adequate DPI is an important factor in preventing lean body mass loss in patients receiving PD.
Central line-associated bloodstream infections and complications in adult home parenteral nutrition: Observations from a quality improvement initiative.
Fessler TA, Crandall MB, Schumacher SE … +1 more , Martin DN
Nutr Clin Pract · 2025 Dec · PMID 40583336 · Full text
The literature is inconsistent regarding differences in infection risk between central venous catheter types used for home parenteral nutrition (HPN). Our goal was to determine if significant differences exist in rates o...
The literature is inconsistent regarding differences in infection risk between central venous catheter types used for home parenteral nutrition (HPN). Our goal was to determine if significant differences exist in rates of infection and other complications between peripherally inserted central catheters, tunneled central venous catheters, and implanted ports, as well as between single and multiple lumen catheters used for HPN. Data were collected for 141 central venous catheters placed in 89 adults receiving HPN provided by Continuum home health company affiliated with University of Virginia health system. The catheters were 63% peripherally inserted, 27% tunneled, and 10% implanted ports, with 25,273 total catheter days and 15,474 HPN days. Central line-associated bloodstream infection (CLABSI) rates were 0.91 episodes per 1000 total catheter days overall, 1.91 for peripherally inserted, 0.63 for tunneled, and zero for ports. CLABSI rates per 1000 HPN days were 1.49 overall, 2.61 for peripherally inserted, and 0.76 for tunneled catheters. CLABSI rates were significantly greater for peripherally inserted than for tunneled catheters per total (P = 0.023) and per HPN (P = 0.011) catheter days. CLABSI rates were greater, but not significantly so, for multiple than for single lumen catheters. The rate of noninfectious complications was not significantly different between tunneled and peripherally inserted central catheters and was zero for ports. HPN CLABSI rates were significantly lower with implanted ports and tunneled central venous catheters as compared with peripherally inserted central catheters.
Advanced nutrition support therapy practices of registered dietitian nutritionists: A survey of the Academy of Nutrition and Dietetics' Dietitians in Nutrition Support Dietetics Practice Group and the American Society for Parenteral and Enteral Nutrition Dietetics Practice Section.
Lessar S, Brody RA, Dobak S … +5 more , Foley S, Malone A, Peterson SJ, Yaceczko S, Price K
Nutr Clin Pract · 2026 Feb · PMID 40574545 · Publisher ↗
Nutrition support therapy (NST) requires continuous monitoring and interdisciplinary collaboration to optimize nutrition status and prevent complications. Registered dietitian nutritionists (RDNs) are pivotal in managing...
Nutrition support therapy (NST) requires continuous monitoring and interdisciplinary collaboration to optimize nutrition status and prevent complications. Registered dietitian nutritionists (RDNs) are pivotal in managing NST, using their expertise to assess malnutrition risk, evaluate suitable nutrition routes, and lead teams in evidence-based nutrition care. However, not all RDNs operate at an expert level owing to varying education, training, and clinical experiences. A survey to determine expert-level RDN NST practices was created and distributed through the Dietitians in Nutrition Support Dietetic Practice Group of the Academy of Nutrition and Dietetics and the Dietetics Practice Section of the American Society for Parenteral and Enteral Nutrition. The survey gathered data on demographics, practice characteristics, and frequency of and barriers to performing select expert-level practice indicators using the Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: Revised 2021 Standards of Practice and Standards of Professional Performance for RDNs (competent, proficient, and expert) in Nutrition Support. A total of 668 RDNs completed the survey (12.4% response). Findings revealed that RDNs frequently performed nutrition-focused physical examinations (83%) and determined micronutrient supplementation (59%). RDNs performed the following activities less frequently: evaluating body composition using diagnostic results (9%), inserting nasogastric/nasoenteric tubes (19%), and leading quality-improvement initiatives (30%). Key barriers identified included lack of training/experience and institutional support, and regulatory constraints. These results underscore the need for enhanced professional development, including training programs and interprofessional collaboration, to promote RDN expert-level NST practice and advance the dietetics profession.
Interinstrument agreement of hand dynamometer measurement in hospitalized children.
Kangalgil M, Meral B, Tiryaki BK
Nutr Clin Pract · 2026 Jun · PMID 40556079 · Publisher ↗
BACKGROUND: Handgrip is a simple and useful parameter used in the diagnosis and follow-up of nutrition disorders and a prognostic indicator for health status. However, data on the measurement of handgrip strength in the...
BACKGROUND: Handgrip is a simple and useful parameter used in the diagnosis and follow-up of nutrition disorders and a prognostic indicator for health status. However, data on the measurement of handgrip strength in the pediatric population are limited. The aim of this study was to investigate the inter-instrument agreement and validity of commonly used hand dynamometers in hospitalized children. METHODS: This is a cross-sectional study comparing handgrip strength measurement with Jamar and Takei dynamometers in hospitalized children aged 6-16 years. Intraclass correlations, Pearson correlation, and Bland-Altman analyses were used to assess validity as the level of agreement between devices. RESULTS: Twenty-nine children with a median age of 9 years, 62.1% of whom were male, with metabolic-endocrine and infectious diseases as the main reason for hospital admission were included in the study. The intraclass correlations values between the two devices are 0.928 and 0.872 in the dominant and nondominant hands, respectively. Handgrip strength measured with Takei was greater than Jamar for both the dominant and nondominant hands (P < 0.001) per Bland-Altman analysis. CONCLUSION: Our results show that despite good or excellent reliability, there is poor agreement between devices, indicating a lack of validity. There is a need for improved methods and standardization specific to this population for the use of handgrip strength in pediatric hospitalized patients.
Prevalence and prognostic implications of malnutrition according to GLIM criteria in hospitalized heart failure patients: Reduced muscle mass and inflammation as predominant criteria identified in a prospective cohort study.
Hu Y, Zhang C, Li Y … +6 more , Zhang Y, Zou C, Yang H, Lu W, Zhang X, Liang T
Nutr Clin Pract · 2026 Feb · PMID 40551558 · Publisher ↗
BACKGROUND: This study aims to evaluate the Global Leadership Initiative on Malnutrition (GLIM) criteria for nutrition assessment in hospitalized heart failure (HF) patients, consider the performance of various combinati...
BACKGROUND: This study aims to evaluate the Global Leadership Initiative on Malnutrition (GLIM) criteria for nutrition assessment in hospitalized heart failure (HF) patients, consider the performance of various combinations of phenotypic and etiologic criteria, and assess their predictive validity for adverse health outcomes. METHODS: A total of 216 patients, consecutively enrolled from June 2022 to October 2022, participated in this prospective cohort study and underwent assessments with 21 GLIM combinations. The 1-year all-cause mortality or HF-related readmission was used as the composite clinical outcome. For testing criterion validity, agreement and accuracy tests and Cox regression analyses were conducted. RESULTS: The detected prevalence of malnutrition across 21 GLIM criteria combinations reached 26.9%. The GLIM combinations containing reduced muscle mass, inflammation, and/or reduced food intake showed acceptable sensitivity and satisfactory predictive validity (with HRs ranging from 2.043 [95% CI: 1.087-3.837], P = 0.026 to 3.367 [95% CI: 1.652 - 6.863], P = 0.001). CONCLUSION: Malnutrition identified by the GLIM criteria was associated with 1-year all-cause mortality or HF-related readmission. Muscle mass is the core GLIM phenotype criterion for identifying hospitalized HF patients at higher risk of adverse outcomes, and it is strongly suggested that relevant assessment be conducted without omission. The occurrence of reduced food intake may fulfill the GLIM etiology criteria, and if testing is available, inflammation levels should be measured to confirm the etiologic criteria.
The impact of nutrition status on the quality of life of patients with advanced cancer treated in a multidisciplinary palliative care unit: A longitudinal study.
Santos LP, Calixto-Lima L, Wiegert EVM
Nutr Clin Pract · 2026 Feb · PMID 40545762 · Publisher ↗
BACKGROUND: Nutrition impairment negatively affects quality of life (QoL). METHODS: A longitudinal cohort study was carried out with patients with advanced cancer evaluated in the palliative care unit of a reference cent...
BACKGROUND: Nutrition impairment negatively affects quality of life (QoL). METHODS: A longitudinal cohort study was carried out with patients with advanced cancer evaluated in the palliative care unit of a reference center for cancer in Brazil. Nutrition risk (NR) was evaluated using the Patient-Generated Subjective Global Assessment Short Form score (≥9 points) (PG-SGA SF), and QoL was assessed using the Quality-of-Life Questionnaire Core 15. Data were collected at baseline (T0) and during follow-up periods up to 40 days (T1). The association between the PG-SGA SF score and QoL changes over time was analyzed using generalized estimating equations (GEEs), adjusted for covariates. RESULTS: A total of 160 patients were included. The prevalence of NR at baseline (T0) was 55.6%, decreasing significantly to 36.3% at follow-up (T1) (P < 0.001). Most QoL symptom domain scores worsened over time. Patients with NR experienced significantly greater declines in mean scores compared with those without NR (P < 0.001 for all). In the multivariate GEE model, NR was a significant negative predictor for physical function (β: -0.227, 95% confidence interval [95% CI]: -0.322 to -0.133), emotional function (β: -0.181, 95% CI: -0.267 to -0.096), pain (β: 0.185, 95% CI: 0.073 to 0.296), and global health (β: -0.100, 95% CI: -0.173 to -0.026). CONCLUSION: NR prevalence significantly decreased during follow-up. However, NR had a persistent negative impact on multiple QoL domains, including physical and emotional function, pain, and global health. These findings underscore the critical role of nutrition status in maintaining QoL in palliative care patients receiving nutrition support therapy.
Evolving nutrition therapy in cystic fibrosis: Adapting to the CFTR modulator era.
Vavrina K, Griffin TB, Jones AM … +3 more , Schindler T, Bui TN, Sankararaman S
Nutr Clin Pract · 2025 Aug · PMID 40533897 · Full text
Cystic fibrosis transmembrane regulator (CFTR)-directed therapies, such as modulators, have transformed the medical management of people with CF, resulting in better lung function, weight, and body mass index in recent y...
Cystic fibrosis transmembrane regulator (CFTR)-directed therapies, such as modulators, have transformed the medical management of people with CF, resulting in better lung function, weight, and body mass index in recent years. With improved nutrition status in people on CFTR modulators, the emphasis on a high-energy, high-fat diet (the legacy CF diet) is declining, with an increased focus on a healthy diet. The increased survival and median predicted age of people with CF have created a need for more attention to metabolic diseases, including hypertension, dyslipidemia, and cardiovascular diseases. The effects of modulators on extrapulmonary manifestations associated with CF, such as CF-related diabetes, CF hepatobiliary involvement, gastrointestinal tract disorders, and pancreatic manifestations, are currently unknown. Approximately 95% of people with CF qualify for treatment with a CFTR modulator. This review discusses the basics of CFTR gene mutations and changes in nutrition status related to treatment with CFTR modulators.
Assessing nutrition risk and malnutrition rates in patients with chronic obstructive pulmonary disease: A cross-sectional study.
Sarıkaya B, Aktaç Ş, Çetinkaya E
Nutr Clin Pract · 2025 Aug · PMID 40533882 · Publisher ↗
BACKGROUND: Nutrition screening is crucial in chronic obstructive pulmonary disease (COPD) management. This study aimed to assess the nutritional status of patients with COPD at different severity levels. METHODS: This c...
BACKGROUND: Nutrition screening is crucial in chronic obstructive pulmonary disease (COPD) management. This study aimed to assess the nutritional status of patients with COPD at different severity levels. METHODS: This cross-sectional study included 52 patients with COPD aged 50-80 years. COPD severity was classified according to forced expiratory volume in 1 s (FEV) using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. Nutritional status was assessed using a two-step approach: initial screening with the Mini Nutritional Assessment-Short Form (MNA-SF), followed by malnutrition diagnosis in at-risk individuals according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Body composition was assessed using the bioelectrical impedance analysis (BIA) method. RESULTS: The MNA-SF identified 23.1% of patients as at risk, whereas GLIM diagnosed malnutrition in 13.5%. Compared to the well-nourished group, malnourished patients had significantly lower body mass index (BMI) (21.4 ± 3.7 vs 26.8 ± 3.2 kg/m; P < 0.05) and skeletal muscle mass (22.3 ± 3.3 vs 27.7 ± 3.2 kg; P < 0.05). Patients with severe COPD had lower BMI and fat-free mass index (FFMI) than those with moderate COPD (P < 0.05). Malnutrition was associated with prolonged hospital stays (7.7 ± 5.7 vs 5.8 ± 3.2 days; P < 0.05) and lower FEV values (P < 0.05). CONCLUSIONS: The MNA-SF does not consider disease-specific factors, whereas GLIM, despite incorporating muscle mass evaluation, is influenced by COPD-related complications. A comprehensive approach that accounts for COPD-related physiological changes is needed for accurate malnutrition assessment.
Relevance of standardized phase angle and bioelectrical impedance vectors in hospitalized older patients: A cohort study.
Diniz NOLDS, Costa-Pereira JP, Ramiro CPSP … +6 more , de Lemos MDCC, Gonçalves FCLDSP, Diniz ADS, Lopes MMGD, Fayh APT, de Arruda IKG
Nutr Clin Pract · 2026 Feb · PMID 40528541 · Full text
BACKGROUND: The prognostic significance of standardized phase angle (StPhA) and bioelectrical impedance vector analysis (BIVA) remains unclear among hospitalized older individuals. Our study aimed to investigate the prog...
BACKGROUND: The prognostic significance of standardized phase angle (StPhA) and bioelectrical impedance vector analysis (BIVA) remains unclear among hospitalized older individuals. Our study aimed to investigate the prognostic significance of StPhA and BIVA patterns concerning overall survival in hospitalized older patients. METHODS: A prospective cohort study was conducted among older adults hospitalized in medical or surgical wards. Single-frequency bioelectrical impedance analysis (BIA) was conducted. Using the raw BIA measurements (resistance and reactance), BIVA plots were graphed and StPhA was calculated. In addition, patients underwent assessments for anthropometry, malnutrition, and muscle strength via handgrip strength test. Follow-up was conducted for up to 24 months after the initial data collection to determine the incidence of mortality as the outcome. RESULTS: A total of 168 patients were included in this analysis. They were mostly men, with a median age of 68 years. Onco-hematological diagnoses were the most frequent. Patients with low StPhA exhibited significantly lower body mass index and fat mass (%) (P < 0.05). Analysis of BIVA confidence showed that patients with low StPhA and nonsurvivors exhibited a significant downward shift along the y-axis, indicating less cell mass. BIVA ellipses demonstrated that patients with low StPhA and nonsurvivors were mainly concentrated in the cachexia and anasarca quadrants. Low StPhA was an independent predictor of mortality (hazard ratio = 2.28; 95% CI, 1.05-4.97). CONCLUSION: Our study highlights the prognostic significance of StPhA and demonstrates the clinical relevance of using BIVA to estimate body composition/nutrition phenotypes in hospitalized older patients.
Physiological barriers to oral intake in survivors of critical illness: A scoping review.
Teleki BJ, Smith EV, Freeman-Sanderson A … +2 more , Yandell R, Chapple LS
Nutr Clin Pract · 2026 Apr · PMID 40528512 · Full text
Oral nutrition is the predominant mode of nutrition delivery on the post-Intensive Care Unit (ICU) ward; yet, it is associated with lower intake than via enteral or parenteral nutrition. There are limited data on barrier...
Oral nutrition is the predominant mode of nutrition delivery on the post-Intensive Care Unit (ICU) ward; yet, it is associated with lower intake than via enteral or parenteral nutrition. There are limited data on barriers that influence oral intake in ICU survivors. Therefore, we conducted a scoping review to map and describe physiological nutrition-impacting symptoms following ICU discharge. Database searches of MEDLINE, Emcare, and CINAHL identified primary research in English that included adult patients eating orally throughout the post-ICU period. Data were extracted on study design, aim, population, post-ICU setting, and the physiological nutrition-impacting symptoms reported, including method of reporting and symptom prevalence. Twenty-nine studies comprising between 11 and 357 participants were included, most of which were prospective and observational in design. Post-ICU settings varied and were inclusive of acute care wards (n = 7, 23%), rehabilitation facilities (n = 5, 16%), and various timepoints following hospital discharge (n = 19, 61%). Key physiological nutrition-impacting symptoms reported were dysphagia (n = 25, 86%) and poor appetite (n = 10, 34%). Other common symptoms included early satiety, fatigue, and nausea. Variations occurred in both the method used to quantify symptoms and the prevalence of each symptom across isolated timepoints. The proportion of patients reporting at least one nutrition-impacting symptom at each time point was 16%-78% on the acute care ward, 29%-95% in rehabilitation facilities, and 10%-71% following hospital discharge. Further studies are required to determine which symptoms ICU survivors experience and their trajectory and impact on oral intake.
Response to Comment on "Challenges in estimating skeletal muscle mass using anthropometric equations".
Okada G, Matsumoto Y, Habu D … +3 more , Matsuda Y, Lee S, Osugi H
Nutr Clin Pract · 2025 Oct · PMID 40524499 · Publisher ↗
Abstract loading — click title to view on PubMed.
Systematic inflammation burdens improve the survival prediction value of nutrition assessment in postoperative patients with recurrent or metastatic cancer: A retrospective observational study.
Song G, Dai T, Min Y … +8 more , Liu X, Yang Q, Li X, Liu Z, Yang Q, Jia R, Zhou J, Peng X
Nutr Clin Pract · 2026 Feb · PMID 40524493 · Publisher ↗
BACKGROUND: The prognostic value of nutrition status assessed by the Patient-Generated Subjective Global Assessment (PG-SGA) in postoperative patients with recurrent or metastatic (R/M) cancer remains unclear. This study...
BACKGROUND: The prognostic value of nutrition status assessed by the Patient-Generated Subjective Global Assessment (PG-SGA) in postoperative patients with recurrent or metastatic (R/M) cancer remains unclear. This study assessed whether combining PG-SGA-defined malnutrition with systemic inflammation indices improves mortality prediction accuracy. METHODS: Nutrition status was evaluated via PG-SGA, with systemic inflammation assessed by systemic immune-related inflammation index (SII), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and monocyte to lymphocyte ratio (MLR). Kaplan-Meier and Cox regression analyses examined associations （individual/combined) of PG-SGA-defined malnutrition and systemic inflammation with all-cause mortality. Receiver operating characteristic curves and concordance index (C index) evaluated accuracy. RESULTS: Among 537 postoperative patients with R/M cancer, multivariable Cox regression analysis showed malnutrition significantly increased mortality risk (malnourished: hazard ratio [HR] = 1.82 [95% CI, 1.23-2.72; P < 0.001]; severely malnourished: HR = 2.46 [95% CI, 1.67-3.62; P < 0.001]). In joint analysis, severely malnourished patients with high systemic inflammation burden had the highest overall mortality risks. The C index was 0.626 for PG-SGA-SII, 0.630 for PG-SGA-NLR, 0.618 for PG-SGA-PLR, and 0.630 for PG-SGA-MLR. Subgroup analyses revealed amplified composite risks in women, older adults, and those with chemotherapy history. CONCLUSION: This study highlights the synergistic prognostic impact of PG-SGA-assessed malnutrition and systemic inflammation in postoperative R/M cancer, identifying a high-risk subgroup requiring prioritized nutrition and immunomodulatory interventions. Prospective multi-center validition is warranted.
Biological sex and age-associated changes in muscle and brain health in Chronic Obstructive Pulmonary Disease: A large cross-sectional study.
Kang MC, Deutz NEP, Haines KL … +1 more , Engelen MPKJ
Nutr Clin Pract · 2025 Aug · PMID 40524405 · Full text
BACKGROUND: Biological sex plays a role in systemic features of patients with Chronic Obstructive Pulmonary Disease (COPD). We investigated whether male and female COPD patients show distinct trajectories in muscle and b...
BACKGROUND: Biological sex plays a role in systemic features of patients with Chronic Obstructive Pulmonary Disease (COPD). We investigated whether male and female COPD patients show distinct trajectories in muscle and brain health decline during aging. METHODS: In total 228 patients (age >50 years) with stable COPD (GOLD: II-IV) were stratified into four groups based on their sex and age (50-70 years vs ≥70 years). Body composition (DXA), muscle strength (dynamometry), cognitive function and well-being (assessments and questionnaires), and risk factors of poor systemic health were analyzed in these groups. RESULTS: Body weight and lean mass remain unchanged with aging. The ≥70 years males showed higher visceral adipose tissue and lower muscle strength whereas females showed lower fat mass and fat-free mass index, and worse cognitive performance compared with their younger counterparts (P < 0.04). In males, lower physical activity was associated with higher visceral adipose tissue and lower muscle function, whereas poor cognition was associated with low O saturation. In females, lower muscle function was associated with higher age, dyspnea and lower caloric intake and physical activity, whereas mood disturbance and poor cognition were associated with smoking pack years (P < 0.05). CONCLUSION: Aging in male COPD patients is characterized by metabolic syndrome features and muscle weakness whereas aging in female COPD patients is associated with weight loss, sarcopenia, and cognitive decline. The observed systemic changes were influenced by different combinations of risk factors in male and female COPD patients. Our findings indicate that sex-specific therapies need to be considered when treating older patients with COPD.
Challenges in estimating skeletal muscle mass using anthropometric equations.
Sah R, Mathur A, Veldi VDK
Nutr Clin Pract · 2025 Oct · PMID 40511741 · Publisher ↗
Abstract loading — click title to view on PubMed.
Nutrition management of the postoperative lung transplant recipient.
Doyle B, Sirandas B
Nutr Clin Pract · 2025 Aug · PMID 40511615 · Publisher ↗
Management of the post-lung transplant recipient can be difficult because of the heterogeneity of recipients, intraoperative surgical challenges, and postoperative complications. Up to 55% of lung transplant recipients a...
Management of the post-lung transplant recipient can be difficult because of the heterogeneity of recipients, intraoperative surgical challenges, and postoperative complications. Up to 55% of lung transplant recipients are malnourished or at risk for malnutrition going into surgery, which is likely to worsen postoperatively. Nutrition support is often inhibited by hemodynamic variability, laboratory abnormalities, and gastrointestinal complications. While these findings are uncommon in other solid organ transplants, lung transplant recipients may experience gastroparesis, esophageal dysfunction, and severe gastroesophageal reflux, among other conditions, that affect the ability to provide adequate nutrition in a timely manner. The lung transplant dietitian must be able to understand and recognize these potential risks and modify the nutrition care plan as appropriate. This review will focus on best practice recommendations to navigate these challenges and optimize nutrition status during hospitalization after lung transplantation.
Medical nutrition therapy in chronic obstructive pulmonary disease: A narrative review.
Savino-Lloreda P, López-Daza D, Casas-Herrera A
Nutr Clin Pract · 2025 Aug · PMID 40500248 · Full text
Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous lung condition characterized by persistent airflow obstruction, associated with cardiovascular, metabolic and musculoskeletal comorbidities. In...
Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous lung condition characterized by persistent airflow obstruction, associated with cardiovascular, metabolic and musculoskeletal comorbidities. In 2022, approximately 480 million people were affected by this disease, making it the third leading cause of mortality worldwide. Projections indicate that by 2050, this number could rise to 600 million. Nutrition status is a fundamental component in managing COPD patients, as it is a critical prognostic factor for morbidity and mortality. Patients with COPD may display different body composition phenotypes, ranging from cachexia to obesity to sarcopenia. Assessing body composition is essential to determine muscle mass, the latter crucial for respiratory function, and also to identify potential health risks and complications. Likewise, involuntary weight loss and decreased fat-free mass are associated with increased mortality. COPD should be viewed as a syndrome, or as a multimorbidity coexisting with other conditions, requiring comprehensive clinical and nutrition assessment for effective management. Nutrition intervention, including oral supplements, is crucial to preserve muscle mass and weight. Supplementation with protein, ω-3 fatty acids, and antioxidants, along with pulmonary rehabilitation, improves muscle strength and exercise tolerance. This narrative review examines nutrition phenotypes and highlights the importance of nutrition interventions in patients with COPD. A multimodal approach combining nutrition support, physical exercise, and pharmacological treatments is essential for managing COPD and its associated comorbidities.
Use of technology to educate patients with celiac disease.
Basil A, Littlejohn B, Perl J … +1 more , Adams DW
Nutr Clin Pract · 2025 Oct · PMID 40497411 · Full text
Celiac disease is an autoimmune disorder with no treatment outside of strict dietary avoidance of gluten, which makes effective patient education essential for appropriate disease management. Use of technology to deliver...
Celiac disease is an autoimmune disorder with no treatment outside of strict dietary avoidance of gluten, which makes effective patient education essential for appropriate disease management. Use of technology to deliver patient information has advanced over the past decade to include virtual visits (telehealth), easy-to-use information platforms (mobile devices), timely updates with online support (social media), and patient-driven gluten-detection devices. Information delivery through technology platforms needs to be curated by professionals to provide accurate healthcare advice. Lastly, the benefits of technology are still being investigated, and further trials are needed to outline how these new platforms should be incorporated into the standard of care.
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