Publicaties

@article{pmid41731274,

title = {Changes in Functional Capacity and Body Composition After a Multimodal Prehabilitation Program in Patients with Cancer undergoing Abdominal Surgery.},

author = {Luuk D Drager and Baukje Heuvel and Dieuwke Strijker and Cornelis J H M Laarhoven and Laurien M Buffart and Sjors Verlaan},

doi = {10.1245/s10434-026-19173-4},

issn = {1534-4681},

year  = {2026},

date = {2026-06-01},

journal = {Ann Surg Oncol},

volume = {33},

number = {6},

pages = {5714–5725},

abstract = {BACKGROUND: Preoperative functional capacity and body composition are associated with postoperative outcomes in patients undergoing abdominal surgery for cancer. Long-term effects of multimodal prehabilitation and exercise dose-response associations remain unclear. This study aimed to investigate changes in functional capacity and body composition during and after prehabilitation and evaluate exercise dose-response associations. METHODS: Data from 816 patients who participated in the monocenter stepped wedge F4S PREHAB trial (March 2021-April 2024) and underwent elective abdominal surgery for gastrointestinal, gynecological, or urological cancers were included. Functional capacity measures included estimated peak oxygen uptake, maximum short exercise capacity, muscle strength (leg press, handgrip), and five-times sit-to-stand test. Body composition measures included weight, fat-free mass, percentage body fat, and phase angle. Assessments occurred at baseline, after prehabilitation, and 3 months postoperatively. Changes over time and dose-response associations were evaluated with linear mixed models. RESULTS: Maximum proportions of missing data ranged from 12.9% at preintervention and 24.9% at postintervention to 62.4% after surgery. Significant improvements over time were observed in estimated peak oxygen uptake (β=0.6 mL/kg/min, 95% confidence interval [CI] 0.4-0.8), maximum short exercise capacity (β=17.5 Watt, 95% CI 13.8-21.2), leg press (β=18.9 kg, 95% CI 15.9-21.9), handgrip (β=1.1 kg, 95% CI 0.6-1.6), sit-to-stand time (β=0.9 seconds, 95% CI -1.1 to -0.6), body weight (β=1.1 kg, 95% CI 0.7-1.4), and fat-free mass (β=0.5 kg), 95% CI 0.1-0.8). Some exercise dose-response associations were found. Functional capacity measures returned to or declined below baseline value. Sensitivity analyses with complete data at follow-up yielded comparable findings with attenuated associations. Associations varied by tumor type, neoadjuvant therapy, malnutrition risk, and training compliance. CONCLUSIONS: Functional capacity and body composition improved after prehabilitation, although gains were generally not sustained postoperatively. Associations may vary between patient subgroups. Future research should focus on targeted approaches and integration with improved postoperative rehabilitation. TRIAL REGISTRATION: The F4S PREHAB trial is registered in the International Clinical Trials Registry Platform, NL8699. Registered on 05-06-2020.},

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pubstate = {published},

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@article{pmid42030900,

title = {Shaping the future of muscle health: A clinical nutrition perspective and research agenda.},

author = {Arthur R H Zanten and Nicolaas E Deutz and Ana-Marija Liberati Prso and Carla M Prado and Marieke G Schooneman and Maarten R Soeters and Marian A E Schueren and Peter J M Weijs and Harriët Jager-Wittenaar},

doi = {10.1016/j.clnu.2026.106652},

issn = {1532-1983},

year  = {2026},

date = {2026-06-01},

journal = {Clin Nutr},

volume = {61},

pages = {106652},

abstract = {Muscle health, encompassing muscle mass, composition, strength, physical performance and patient-reported outcomes, is a key determinant of clinical outcomes across the life course and a wide range of disease states. Despite growing recognition of its importance, muscle health remains insufficiently integrated into routine clinical nutrition practice, and nutritional recommendations often rely on population averages rather than individual muscle status, disease phase or metabolic context. This narrative review, developed by an international multidisciplinary expert group, synthesises current evidence on muscle health and clinical nutrition across major clinical domains, including ageing, cancer, metabolic disease, obesity, weight loss interventions and acute illness. We critically appraise methods for assessing muscle mass, function, and patient-reported outcomes, highlighting their strengths, limitations, and feasibility for clinical practice and research. In doing so, we highlight marked heterogeneity in metabolic and functional responses to nutrition and exercise interventions, underscoring the need for phenotyping, endotyping and precision nutrition to individualise protein and energy requirements. Beyond biological mechanisms, we address key implementation challenges limiting translation into practice, including inequities in access to dietetic and other rehabilitation services, variability in health system organisation and underuse of functional and patient-centred outcomes in trials and routine care. Finally, we propose a translational research agenda to harmonise outcome measures, improve trial design and support integration of muscle health assessment and personalised nutritional strategies into clinical care pathways. By positioning muscle health as a central and actionable outcome of clinical nutrition, this review supports a shift from uniform recommendations towards more personalised and effective nutrition care.},

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@article{pmid42135539,

title = {Human whole-blood NAD levels do not vary with age or lifestyle interventions.},

author = {Maria M Trętowicz and Angelique M L Scantlebery and Bauke V Schomakers and Kaan D Eroğlu and Michel Weeghel and Vera Spek and Kasper T Vinten and Luc Legon and Evrim Coskun and Fernando Millan-Domingo and Gloria Olaso-Gonzalez and Maria Carmen Gomez-Cabrera and Silvia Montoro-García and Clara Noguera-Navarro and André B P Kuilenburg and Sofia Moco and Juliette C Hattum and Harald T Jørstad and Mohammed Benali and Jantine Helder and Esmee J M Biersteker and Maheswary Muniandy and Kirsi H Pietiläinen and Eija Pirinen and P Eline Slagboom and Marian Beekman and Joris Deelen and Rubén Zapata-Pérez and Peter J M Weijs and Michael Tieland and Georges E Janssens and Riekelt H Houtkooper},

doi = {10.1038/s42255-026-01537-5},

issn = {2522-5812},

year  = {2026},

date = {2026-05-14},

journal = {Nat Metab},

abstract = {Nicotinamide adenine dinucleotide (NAD) levels in blood and tissues are widely proposed to decline with age, yet evidence in human blood is inconsistent. Using a rigorously validated ultra-high-performance liquid chromatography coupled with high-resolution mass spectrometry system that accounts for real-world analytical variability, we quantify NAD across seven independent human cohorts. We find that whole-blood NAD levels remain remarkably stable with age and across lifestyle interventions, but change in response to nicotinamide riboside supplementation, as expected. Our results challenge the utility of blood NAD levels as a biomarker of ageing or lifestyle factors.},

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@article{pmid41931963,

title = {Effect of a protein intervention during resistance training with varying training intensities on muscle outcomes in frail community-dwelling older adults: a randomized controlled trial.},

author = {Esmée J M Biersteker and Mohammed Benali and Jantine van Helder and Jos Twisk and Michael Tieland and Peter J M Weijs and Josje D Schoufour},

doi = {10.1016/j.jnha.2026.100838},

issn = {1760-4788},

year  = {2026},

date = {2026-04-02},

journal = {J Nutr Health Aging},

volume = {30},

number = {6},

pages = {100838},

abstract = {OBJECTIVES: Optimising nutritional and exercise strategies is essential to preserve muscle health and physical function in frail older adults. This study aims to investigate the effects of a protein intervention during progressive resistance training (PRT) with varying training intensities on muscle strength, muscle mass, and physical performance in frail community-dwelling older adults. We were particularly interested in whether these effects differed according to variations in habitual protein intake and resistance training intensity. DESIGN: Secondary analysis of a randomized controlled trial. PARTICIPANTS: This 12-week RCT randomized 295 frail community-dwelling older adults into PRT-only or PRT with a protein intervention (PRT-Pro). Frailty was defined by receipt of in-home care services or a Tilburg Frailty Indicator score ≥5. INTERVENTION: All participants performed under one-to-one supervision, twice-weekly full-body resistance training performed until muscle failure with varying training intensities (20-80% of one-repetition maximum (1RM)). Participants in the protein intervention group received dietary counselling and tailored daily provision of whey protein supplements (20 g) to support achieving a protein intake of 1.2-1.5 g/kg/day. To prevent over-feeding, for participants with a BMI > 30 kg/m, bodyweight was adjusted using a BMI of 27.5 kg/m. MEASUREMENTS: Primary outcome was leg press muscle strength (1RM). Secondary outcomes included appendicular lean mass and physical performance. RESULTS: Participants had a mean age of 73.9 ± 6.0, with 69% being female. Protein intake increased in PRT-Pro compared to PRT-only (0.4 g/kg, 95%CI: 0.3-0.5, p < 0.001). Overall, the protein intervention did not result in significantly greater gains in leg press muscle strength, appendicular lean mass, or physical performance compared to PRT-only (p > 0.05). In exploratory subgroup analyses, participants with baseline habitual protein intake <1.2 g/kg showed greater improvements in leg press strength with protein intervention (6.4 kg, 95% CI: 1.3-11.4},

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pubstate = {published},

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@article{pmid41916635,

title = {Feasibility and effectiveness of a multicomponent and multilevel personalised lifestyle intervention for adults with intellectual disabilities: protocol for a feasibility and multiple baseline one-arm effectiveness study.},

author = {Bas Valentin and Josje D Schoufour and Annelies Overwijk and Kirsten A Lamberts and Tim Pelle and Rianne H A Steenbergen and Peter J M Weijs and Aly Waninge and Alyt Oppewal},

doi = {10.1136/bmjopen-2025-114209},

issn = {2044-6055},

year  = {2026},

date = {2026-03-30},

journal = {BMJ Open},

volume = {16},

number = {3},

pages = {e114209},

abstract = {INTRODUCTION: The LIFE-ID (lifestyle interventions for adults with intellectual disabilities) intervention, a multicomponent and multilevel lifestyle programme, was developed to improve the lifestyle of adults with ID and the support provided by their interpersonal and organisational environment. This paper describes the protocol of a multiple baseline one-arm feasibility and effectiveness study of the LIFE-ID intervention. METHOD AND ANALYSIS: To evaluate the effectiveness of the LIFE-ID intervention for adults with ID, alongside an embedded assessment of feasibility, we employ a one-arm multiple-baseline trial in the Netherlands, in collaboration with healthcare organisations providing support to adults with ID. The LIFE-ID intervention intervenes at intrapersonal, interpersonal and organisational levels and uses a tailored approach to improve both physical activity and dietary quality in adults with ID. To support healthcare professionals in selecting interventions, the lifestyle support tool was developed, including existing, effective, and ID-specific nutrition and physical activity interventions. The lifestyle support tool takes into account intrapersonal, interpersonal and organisational characteristics and considers the participants' wishes and needs related to their personal lifestyle goals. An embedded feasibility evaluation of the LIFE-ID intervention is conducted with the first 15 participants in the study and their involved healthcare professionals. Information on dose delivered, dose received, acceptability and fidelity of the intervention performance compared with the description is retrieved through biweekly reflection forms obtained from direct support professionals. Group interviews are conducted to collect feedback on the experiences with the LIFE-ID intervention discussing the following topics: acceptance and suitability of the intervention, and barriers and facilitators during execution. Outcomes related to the lifestyle support tool include usability, usefulness and ease of use. To evaluate the effectiveness of the 6-month LIFE-ID intervention, 80 adults (≥18 years) with ID are included (including 15 participants from the feasibility evaluation). The primary outcome is physical activity. Secondary outcomes on the intrapersonal level include dietary quality, physical fitness, body composition, calf circumference, blood pressure, heart rate, frailty, anxiety, depression, behavioural problems and goal attainment. On the interpersonal level, outcomes include attitude of professionals towards support in healthy exercise and nutrition. On the organisational level, outcomes are barriers and facilitators associated with creating a healthy living environment, and determinants that affect the implementation of the LIFE-ID intervention. ETHICS AND DISSEMINATION: The study protocol is approved by the Medical Ethics Review Board of the University Medical Center Groningen (METc 2023-520). Written consent is obtained from all participants who are capable to provide consent, and from legal representatives when they are not. Study findings will be disseminated through peer-reviewed publications, conference presentations and accessible summaries for participants, families and healthcare organisations. TRIAL REGISTRATION NUMBER: The study has been registered in the Overview of Medical Research in the Netherlands (OMON; NL85438), which is linked to the International Clinical Trial Registry Platform (ICTRP).},

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pubstate = {published},

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@article{pmid41699919,

title = {Effects of multimodal prehabilitation on surgery outcomes: prospective stepped-wedge, hospital-wide implementation study.},

author = {Luuk D Drager and Femke Atsma and Dieuwke Strijker and Linda A G Heusden-Scholtalbers and Monique J M D Asseldonk and Jonas Rosenstok and Joost P H Seeger and Sjors Verlaan and Laurien M Buffart and Cornelis J H M Laarhoven and Baukje Heuvel and F4S PREHAB Collaborative Group},

doi = {10.1093/bjs/znag013},

issn = {1365-2168},

year  = {2026},

date = {2026-03-04},

journal = {Br J Surg},

volume = {113},

number = {3},

abstract = {BACKGROUND: Multimodal prehabilitation may improve surgical outcomes in selected populations, but its real-world effectiveness remains unclear. The aim of this study was to evaluate the effect of hospital-wide implementation of multimodal prehabilitation on postoperative complications and length of hospital stay in a diverse surgical population. METHODS: This single-centre, non-randomized stepped-wedge study (F4S PREHAB) was conducted at Radboudumc, Nijmegen, The Netherlands from March 2019 to April 2024. Patients who underwent elective surgery across 20 clinical pathways received either standard preoperative care or multimodal prehabilitation comprising supervised exercise, nutritional support, psychological counselling, and smoking and alcohol cessation support. The primary outcome was the incidence and severity of postoperative complications within 30 days, with assessment of Clavien-Dindo (CD) grade ≥II complications and the dichotomized Comprehensive Complication Index (CCI). The secondary outcome was the length of hospital stay. Analyses used generalized linear models adjusted for time of inclusion and clinical pathway, as well as other confounders in some models. Subgroup analyses focused on patients who underwent high-risk gastrointestinal (GI) oncological surgery. RESULTS: During the study interval, 4131 patients received usual care (2660 patients) or prehabilitation (1471 patients). A total of 367 patients (24.9%) attended at least nine exercise sessions, indicating partial adherence. No significant differences between groups were found with regard to postoperative CD grade ≥II complications (adjusted risk ratio 1.02 (95% c.i. 0.90 to 1.16)) and CCI >22.6 (adjusted risk ratio 1.03 (95% c.i. 0.86 to 1.23)) or length of hospital stay (adjusted incidence rate ratio 1.04 (95% c.i. 0.92 to 1.18)). In the high-risk GI oncological surgery subgroup (1230 patients), the relative reduction in CD grade ≥II complication risk was 9%, but this was not statistically significant (adjusted risk ratio 0.91 (95% c.i. 0.75 to 1.10)). CONCLUSION: Hospital-wide implementation of multimodal prehabilitation did not reduce postoperative complications or length of hospital stay. A greater effect in high-risk patients suggests a targeted approach may be more effective. Future research should identify such patients and evaluate effectiveness of prehabilitation in this population.},

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pubstate = {published},

tppubtype = {article}

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@article{pmid41732742,

title = {Differences in Protein Quantity and Quality Across a Spectrum of Plant-Based Meals: Analysis of a Large National Dietary Survey.},

author = {Sophie L Oppenraaij and Sjors Verlaan and Peter Jm Weijs},

doi = {10.1016/j.cdnut.2026.107641},

issn = {2475-2991},

year  = {2026},

date = {2026-02-01},

journal = {Curr Dev Nutr},

volume = {10},

number = {2},

pages = {107641},

abstract = {BACKGROUND: Current recommendations encourage consuming sufficient intake of high-quality protein, with ≥60% derived from plant-based sources, to support both nutritional requirements and sustainability goals. OBJECTIVES: This observational study assessed protein intake, quality, and sources in predominantly plant-based meals and diets using a national survey, offering insights to support a more sustainable and nutritionally adequate dietary transition. METHODS: In the Dutch National Food Consumption Survey (2019-2021), protein intake was assessed using 24-h recalls in adults aged 18 to 79 y. Total, plant-based, and animal-based protein intake were analyzed per meal and per day. Protein quality per meal was evaluated using the Meal Protein Quality Score (MPQS). The association between protein quantity and the proportion of plant-based protein was evaluated based on how often meals reached adequate protein quality (MPQS >100). Furthermore, protein sources across food groups in diets with ≥60% and <60% plant-based protein were compared. RESULTS: Among 1747 adults [57 (44-68) y, 50% male], the median protein intake was 0.93 (0.75-1.13) g/kg/d. Only 8% ( = 147) had a diet comprising ≥60% plant-based protein, with a median intake of 0.83 (0.63-1.05) g/kg/d. As the proportion of plant-based protein increased, both protein quantity and quality decreased. When protein quality was low, lysine was the most common limiting amino acid. Only 3% of all meals achieved ≥20 g protein, ≥60% plant-based protein, and optimal protein quality, with dairy as key protein source at breakfast and lunch, meat alternatives at dinner, and grains at all meals. CONCLUSIONS: This study shows that only a small proportion of Dutch adults met both protein-related recommendations and sustainability goals, due to lower protein quantity and quality in more plant-based diets. This study emphasizes the need for professional guidance, especially in individuals with higher protein requirements, to facilitate a successful transition to a more plant-based diet.},

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pubstate = {published},

tppubtype = {article}

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@article{pmid41572290,

title = {Is higher protein intake during weight loss interventions in older adults associated with improved outcomes? A secondary data analysis of three randomised controlled trials.},

author = {Doris Eglseer and Lea Reiter and Josje D Schoufour and Tereza Vágnerová and Robert G Memelink and Amely M Verreijen and Andrea Borenich and Silvia Bauer and Peter Jm Weijs},

doi = {10.1186/s12937-025-01279-2},

issn = {1475-2891},

year  = {2026},

date = {2026-01-22},

journal = {Nutr J},

volume = {25},

number = {1},

pages = {24},

abstract = {BACKGROUND: Weight loss interventions can exacerbate sarcopenia and sarcopenic obesity in older individuals. Increasing protein intake, alongside resistance training, is suggested to help preserve muscle mass, strength, and function during energy-restricted diets, but the benefits are not consistently supported by all studies in older adults. OBJECTIVE: To investigate the relationship between protein intake and body composition, muscle strength, and function in weight loss programs with energy restriction, with or without increased protein intake (through supplementation or dietary counseling) and combined with resistance training in older adults with overweight or obesity. METHODS: A secondary data analysis of three randomized controlled trials was conducted, including participants aged ≥ 55 with a BMI ≥ 25 kg/m². Data on protein intake at baseline and follow-up were analyzed. The follow-up period was 10 weeks in one study and 13 weeks in the other two studies.Outcomes included body weight, body fat, appendicular lean soft tissue mass (ALST), handgrip strength (HGS), gait speed, chair stand test (CST), and short physical performance battery (SPPB). Linear mixed models were used to identify associations between protein intake and outcomes. RESULTS: A total of 191 older adults (mean age 65.1 years, mean BMI 32.9 kg/m²) were included. Protein intake significantly increased from 0.87 to 1.06 g/kg BW/day ( < 0.001) in participants receiving protein supplementation or dietary advice. Higher protein intake was significantly associated with increased ALST (beta = 1.0, = 0.047), but no associations were found with body weight, body fat, HGS, gait speed, CST, or SPPB. CONCLUSIONS: Increasing protein intake during weight loss interventions may help preserve ALST in older adults with overweight or obesity, potentially reducing the risk of sarcopenia. These findings suggest that incorporating protein strategies in weight loss programs is beneficial for muscle health in older adults. Further high-quality studies are needed to determine the optimal protein intake for this population. TRIAL REGISTRATION: Trial registration in the Dutch Trial Register: MPS: NL2623, https://www.onderzoekmetmensen.nl/en/trial/24688, registration date 11022011 WelPrex NL4434 https://www.onderzoekmetmensen.nl/en/trial/29590, registration date 01052014 PROBE NL4357, https://www.onderzoekmetmensen.nl/en/trial/21917), registration date 08042014.},

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@article{pmid41211752,

title = {A multidisciplinary lifestyle programme for patients with rheumatoid arthritis and metabolic syndrome-associated osteoarthritis: economic evaluation alongside the 'Plants for Joints' randomized controlled trials.},

author = {J M Dongen and L Bernaers and C A Wagenaar and M Leeden and F Turkstra and M Boers and H Middendorp and Pjm Weijs and D Schaardenburg and W Walrabenstein},

doi = {10.1080/03009742.2025.2550133},

issn = {1502-7732},

year  = {2026},

date = {2026-01-01},

journal = {Scand J Rheumatol},

volume = {55},

number = {1},

pages = {21–31},

abstract = {OBJECTIVE: To evaluate the cost-effectiveness of the 'Plants for Joints' intervention for rheumatoid arthritis (RA) and metabolic syndrome-associated osteoarthritis (MSOA) patients over 16 weeks. METHOD: Data from two randomized controlled trials were analysed. The first included 77 RA patients (intervention = 40; control = 37) and the second 64 MSOA patients (intervention = 32; control = 32). The intervention comprised a 16 week lifestyle programme including a whole-food plant-based diet, exercise, and stress management; control participants received usual care. Data from both trials were analysed together and separately. Costs were measured from societal and healthcare perspectives. Effects were expressed in quality-adjusted life-years (QALYs). RESULTS: The intervention cost €886/patient. Intervention group participants gained more QALYs than the control group (0.009; 95% confidence interval -0.004 to 0.023), equivalent to 3.3 additional days in 'perfect health' (0.009 × 365). Healthcare costs were higher in the intervention group, while societal costs were lower. None of these differences was statistically significant. From a societal perspective, the intervention had a moderate to high probability of being cost-effective compared with usual care, while the probability was low from a healthcare perspective. Stratified analyses indicated that the probability of cost-effectiveness was higher in RA than in MSOA patients. This difference became less pronounced after excluding outliers. CONCLUSION: The Plants for Joints intervention demonstrated a relatively high probability of cost-effectiveness from a societal perspective, although this was lower from a healthcare perspective. If these benefits are sustained in the long term, this intervention may reduce the disease and economic burden of arthritic conditions.},

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@article{pmid41252315,

title = {The Integration of Lifestyle Modification Advice and Diet and Physical Exercise Interventions: Cornerstones in the Management of Obesity with Incretin Mimetics.},

author = {Marianna Minnetti and Rocco Barazzoni and John A Batsis and Luca Busetto and Volkan Yumuk and Eleonora Poggiogalle and Peter J M Weijs and Lorenzo M Donini},

doi = {10.1159/000548370},

issn = {1662-4033},

year  = {2026},

date = {2026-01-01},

journal = {Obes Facts},

volume = {19},

number = {3},

pages = {310–326},

abstract = {<p>Background: The introduction of incretin mimetics (IMs), including glucagon-like peptide-1 receptor agonists (GLP-1 RAs) such as liraglutide and semaglutide, as well as dual GLP-1/glucose-dependent insulinotropic polypeptide receptor co-agonists (GLP-1/GIP RAs) like tirzepatide, has revolutionized obesity treatment. These obesity management medications promote significant weight loss with metabolic and cardiovascular improvements. However, pharmacotherapy alone seems insufficient to address the multifactorial nature of obesity. While IMs suppress appetite and reduce caloric intake, they do not prevent potential nutrient deficiencies and possible loss of skeletal muscle mass, nor do they guarantee lasting behavioral changes necessary for long-term weight management, particularly in the absence of other complementary interventions. Summary: In this context, a clear distinction must be made between general lifestyle modification advice (Ls-M) and personalized and structured dietetic and physical exercise interventions (D-PE-Is). Ls-M, including a balanced diet and regular physical activity, is essential for preventing obesity and reducing the risk of weight gain and associated metabolic disorders. However, once obesity is established, D-PE-I becomes necessary. Unlike Ls-M, D-PE-I integrates personalized nutritional strategies with structured exercise to maximize fat loss, preserve skeletal muscle mass and function, and enhance metabolic health. This narrative and concept-driven review aimed to delineate key areas for future clinical trials and meta-analyses. Key Messages: IMs have brought important progress in the management of obesity, contributing meaningfully to current therapeutic approaches. However, pharmacotherapy alone is not sufficient to ensure long-term success. While lifestyle advice may aid in prevention, structured and personalized dietetic and physical exercise interventions are essential once obesity is established. Their integration with IMs is crucial to support long-term weight maintenance and improve overall health and quality of life. </p>.},

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@article{pmid41449692,

title = {Plant-based protein for older adults with obesity.},

author = {Sophie L Oppenraaij and Susanne Wildemast and Esmee M Reijnierse and Josje D Schoufour and Sjors Verlaan and Peter J M Weijs},

doi = {10.1017/S0029665125102085},

issn = {1475-2719},

year  = {2025},

date = {2025-12-26},

journal = {Proc Nutr Soc},

pages = {1–6},

abstract = {The global syndemic of obesity, undernutrition and climate change - three interconnected challenges - threatens both human and planetary health. This review focuses on one critical intersection: older populations living with overweight and obesity in the context of sustainable nutrition. Obesity and sarcopenia, particularly the co-occurrence called sarcopenic obesity, are often overlooked until the onset or exacerbation of other diseases necessitates secondary care. Preventing sarcopenic obesity requires reducing excess fat mass while preserving muscle mass and function. This involves lowering total energy intake while ensuring adequate protein intake in terms of quantity, quality and distribution, combined with physical activity, particularly resistance exercise. Short-term studies show that both the source and dose of dietary protein significantly influence muscle protein synthesis rates. Longer-term studies examining the impact of plant-based diets on muscle health in older adults with or without overweight or obesity remain limited. Animal protein have shown a modest advantage over most plant-based protein in supporting muscle mass. Qualitative studies suggest that emphasising both the health benefits and palatability of plant-based protein sources is key to promoting dietary changes in older adults. In older adults with obesity, it is challenging to combine energy restriction with higher protein intake, especially when protein sources are plant-based. To prevent and treat sarcopenic obesity in older adults and support planetary health, a shift toward more plant-based protein sources is required, while ensuring sufficient protein quantity and quality to preserve muscle health during weight loss.},

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pubstate = {published},

tppubtype = {article}

}

@article{pmid41397687,

title = {Tailoring mHealth for Healthy Aging: Focus Group Study With Retirement-Age Adults.},

author = {Paula Collazo-Castiñeira and Rocío Rodríguez-Rey and Alfonso J Cruz-Jentoft and Somaya Ben Allouch and Doris Eglseer and Josje Schoufour and Eva Topinková and Peter J M Weijs and Yves Boirie and Macarena Sánchez-Izquierdo},

doi = {10.2196/70051},

issn = {2291-5222},

year  = {2025},

date = {2025-12-15},

journal = {JMIR Mhealth Uhealth},

volume = {13},

pages = {e70051},

abstract = {BACKGROUND: The adoption of mobile health (mHealth) technologies among older adults remains significantly lower than in younger populations, despite their potential to promote healthier lifestyles and mitigate age-related health risks. OBJECTIVE: This study aims to explore the perspectives of retirement-age adults on mHealth interventions, identifying factors that influence their adoption, such as persuasive elements in the app design and psychological techniques. METHODS: A qualitative focus group study was conducted with 19 Spanish participants recruited from urban community settings in Madrid, Spain (mean age 61.5 years; 15/19, 79% women). Participants discussed their attitudes, barriers, and preferences for mHealth tools. Focus groups were recorded, transcribed, and coded using an iterative process to ensure rigorous data analysis. An abductive approach was followed, using the persuasive design principles framework and the behavior change techniques' taxonomy, and representing any theme outside those frameworks. RESULTS: Participants expressed generally positive attitudes toward mHealth tools, favoring intuitive, user-friendly designs that are minimally time-demanding. However, significant barriers also emerged, such as low digital literacy and concerns about technology dependence. Key design preferences (persuasive design principles) and psychological techniques (behavior change techniques) were deemed beneficial, with preferred features such as tailored and meaningful goal-setting, self-monitoring, positive feedback (eg, congratulating messages after achieving a goal; social rewards), and a moderated use of notifications and prompts. Participants also stressed the importance of age-appropriate recommendations (eg, suggested diets for their age and characteristics) and design (eg, accessible, easy-to-use interfaces and human-like communication). Additionally, some preferences appeared to be culturally grounded (eg, rejection of anglicisms and the desire for locally relevant content, such as suggested activities specific to Madrid). Social support mechanisms, such as group activities and peer interactions through mHealth, were seen as critical for fostering motivation and engagement. CONCLUSIONS: mHealth interventions for this population should offer accessible and easy-to-use interfaces along with initial tutorials, facilitating an easy onboarding to overcome low digital literacy, thereby enhancing both usability and initial adoption. Furthermore, by providing meaningful, tailored content (eg, personalized diets and goals) and social features that foster peer connection (eg, user chats or organized activities), these tools may better support sustained engagement over time.},

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pubstate = {published},

tppubtype = {article}

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@article{pmid41398571,

title = {Perspectives and Experiences of Adult Patients With Obesity in Dietetic Primary Health Care: A Qualitative Study in the Netherlands.},

author = {Annemieke Riet and Rebecca S Otte and Lotte Maree-Hulsbergen and Elke Naumann and Marian A E Schueren and Harriët Jager-Wittenaar and Dietetics Building consortium},

doi = {10.1111/jhn.70179},

issn = {1365-277X},

year  = {2025},

date = {2025-12-01},

journal = {J Hum Nutr Diet},

volume = {38},

number = {6},

pages = {e70179},

abstract = {BACKGROUND: Obesity is defined as a chronic, relapsing disease, characterised by its persistence and the frequent recurrence of weight gain following weight loss. It is linked to chronic diseases and reduced quality of life. Sustainable weight loss requires long-term dietary and behavioural changes. Dietetic treatment outcomes vary per patient, leading to differing success rates and effectiveness. Although understanding patient experiences is crucial for designing effective, patient-centered strategies, little is known about their lived experiences. This study aimed to obtain a better understanding of the perspectives and experiences of patients with obesity receiving dietetic treatment in primary health care in the Netherlands. METHODS: This qualitative interpretive study included 26 patients with obesity who were consulting or had consulted a dietitian. We performed purposeful sampling to ensure a sample diverse in socio-cultural background, region, age and health literacy. Semi-structured interviews were conducted using a predefined topic guide, with room for flexibility to explore emerging topics. We analysed the interview data using reflexive thematic analysis as described by Braun and Clarke. RESULTS: Four interconnected themes were constructed from what patients named to be important in dietetic treatment: (1) personalised treatment as a foundation for success, including feeling heard and receiving responsive and adaptive treatment (2) the personal impact of the dietitian on treatment, through the dietitian's attitude, professionalism, and background; (3) a personalised and holistic approach for lasting change, including clarity about the dietitian's ways of working, motivational and emotional support, attention to life context and guidance in developing sustainable habits; and (4) tailored and accessible advice, focusing on practical tools, understandable information, and consistency of advice. CONCLUSION: This study highlights that successful dietetic treatment for adults with obesity depends on personalised support, a strong patient-dietitian relationship, and holistic attention to psychological and behavioural factors. Clear communication, involvement from the start, and practical, tailored advice help patients comply with treatment and apply recommendations in daily life. Findings emphasise the importance of aligning dietetic treatment with individual patient needs and expectations.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40400461,

title = {Cardiovascular Biomarkers in Nocturnal Hemodialysis and Their Association With Physical Performance.},

author = {Manouk Dam and Laura M M Haan and Tiny Hoekstra and Marc Vervloet and Frans J Ittersum and Peter J M Weijs and Brigit C Jaarsveld},

doi = {10.1111/hdi.13265},

issn = {1542-4758},

year  = {2025},

date = {2025-10-01},

journal = {Hemodial Int},

volume = {29},

number = {4},

pages = {519–529},

abstract = {INTRODUCTION: The cardiovascular biomarkers troponin T, N-terminal pro-B-type natriuretic peptide, and fibroblast growth factor 23 are elevated in hemodialysis patients and associated with an increased cardiovascular mortality risk. Nocturnal hemodialysis improves the fluid status in hemodialysis patients. Therefore, we investigated whether nocturnal hemodialysis (7-8 h sessions) was associated with lower levels of troponin T, N-terminal pro-B-type natriuretic peptide, and fibroblast growth factor 23 in comparison to conventional hemodialysis. Second, we investigated whether these biomarkers were independently associated with physical performance in hemodialysis patients. METHODS: A prospective cohort of 33 hemodialysis patients was compared to 32 patients who voluntarily switched from conventional hemodialysis to nocturnal hemodialysis. First, we studied the difference between the two cohorts in change over 12 months of troponin T, N-terminal pro-B-type natriuretic peptide, and fibroblast growth factor 23 with linear mixed models. Second, the associations between these biomarkers and physical-activity monitor, six minute walk test, and physical component summary score were assessed at baseline, 6 and 12 months. FINDINGS: N-terminal pro-B-type natriuretic peptide increased 122% during conventional hemodialysis, whereas it decreased 31% during nocturnal hemodialysis (p = 0.001). In conventional hemodialysis, fibroblast growth factor 23 rose numerically by 19% (23%-66%) in 12 months, while a decline of 44% (21%-58%) was found in nocturnal hemodialysis patients (p = 0.17). Troponin T did not differ between groups. Regarding physical performance, a higher N-terminal pro-B-type natriuretic peptide (per 1000 ng/L) and fibroblast growth factor 23 (per 1000 RU/mL) were associated with lower physical component summary scores of -0.02 (p = 0.02) and -0.04 (p = 0.05), respectively. Troponin T was not associated with physical performance. DISCUSSION: Our findings showed that nocturnal hemodialysis was associated with a decrease in N-terminal pro-B-type natriuretic peptide. This suggested that nocturnal hemodialysis diminished volume overload and thereby myocardial stretch. Additionally, lower levels of N-terminal pro-B-type natriuretic peptide and fibroblast growth factor 23 were found to be associated with better self-reported physical performance scores.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40845421,

title = {Dietary protein intake and body composition, sarcopenia and sarcopenic obesity: A prospective population-based study.},

author = {Yahong Wu and Tosca O E Crom and Zhangling Chen and Elizabeth Benz and Niels Schaft and Alexandre Pinel and Yves Boirie and Doris Eglseer and Eva Topinkova and Josje D Schoufour and Peter J M Weijs and Fernando Rivadeneira and Cindy G Boer and Joyce B J Meurs and Trudy Voortman},

doi = {10.1016/j.clnu.2025.07.033},

issn = {1532-1983},

year  = {2025},

date = {2025-10-01},

journal = {Clin Nutr},

volume = {53},

pages = {26–34},

abstract = {BACKGROUND&AIMS: Obesity and sarcopenia are major health concerns, particularly among older populations. Dietary protein may help preserve muscle mass and function, but high-protein diets, especially from animal sources, may also increase adipose mass. We investigated associations of total, animal, and plant protein intake with body composition trajectories, sarcopenia, and sarcopenic obesity. METHODS: We included 4576 participants (mean age 65.1 years, 56 % women) from the population-based Rotterdam Study. Dietary protein was measured using food-frequency questionnaires at baseline (2004-2009). Body composition was measured every 4-5 years using dual X-ray-absorptiometry. Handgrip strength (HGS) was assessed starting 2006 using a hydraulic dynamometer. Sarcopenia was determined based on low appendicular skeletal muscle and HGS; and sarcopenic obesity risk based on measures of lean mass, HGS and body fat. Analyses used linear mixed models and generalized estimate equation models. RESULTS: Higher total protein intake was associated with increased BMI over time (mean difference [95 %-confidence interval (CI)]: 0.86 kg/m [0.01,1.71] per 5E% increase), and increased fat-mass index (1.33 [0.67,1.99]), body-fat-percentage (4.54[2.76,6.31]), and both gynoid and android fat percentage. Higher protein intake was also associated with a higher sarcopenic obesity risk (-0.85[-1.5,-0.2]), but with a lower sarcopenia risk (odds ratio: 0.62 [0.43,0.90]). These associations were mainly driven by animal protein. CONCLUSION: Higher protein intake, particularly from animal food sources, is protective against sarcopenia but also linked to a higher obesity risk. A balanced protein intake advice for older persons should be formulated based on individual needs and health status to prevent sarcopenia, obesity, and sarcopenic obesity.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid41097857,

title = {Sarcopenic Obesity Phenotype Index (SOPi): A Population-Based Study.},

author = {Elizabeth Benz and Alexandre Pinel and Christelle Guillet and Frederic Capel and Bruno Pereira and Dimitris Rizopoulos and Alfonso J Cruz-Jentoft and Doris Eglseer and Eva Topinkova and Rocco Barazzoni and Lorenzo M Donini and Fernando Rivadeneira and Marinka Steur and Trudy Voortman and Peter J M Weijs and Josje D Schoufour and Yves Boirie},

doi = {10.1002/jcsm.70099},

issn = {2190-6009},

year  = {2025},

date = {2025-10-01},

journal = {J Cachexia Sarcopenia Muscle},

volume = {16},

number = {5},

pages = {e70099},

abstract = {BACKGROUND: Sarcopenic obesity (SO) is a clinical condition defined by the coexistence of high body fat mass and low muscle function and mass, which increases the risk of adverse health outcomes, including disability and mortality. Early detection and frequent monitoring of SO are essential for preventive interventions and management strategies. The current binary approach for SO diagnosis is limited in capturing the spectrum of SO or its progression over time. The main objective of this study was to develop a continuous SOPi that integrates diagnostic criteria such as muscle function and body composition. We aimed to evaluate the association between SOPi and all-cause mortality, to identify baseline-related factors with SOPi and to assess changes in the SOPi over time. METHODS: Participants from the Rotterdam Study with baseline and follow-up measures of handgrip strength (HGS), dual-energy X-ray absorptiometry-measured appendicular lean mass index (ALM/kg) and body fat percentage (BF%) were included. SOPi was calculated as a sex-specific equation integrating z-scores (Z) of (BF%)-(HGS)-(ALM/kg). Cox regression and multivariable linear regression models were fitted to evaluate mortality risk and associated factors with SOPi, respectively. Subgroup analysis of SOPi changes was performed by linear mixed-effects models. RESULTS: In the total population (n = 5888, age 69.5 ± 9.1 years, BMI 27.5 ± 4.3 kg/m, 56.8% females) and over the 9.9-year median follow-up period, 1538 (26.1%) participants died. Each standard deviation (SD) increase in sex-specific SOPi was associated with a 10% higher risk of premature death (HR = 1.10 [95%CI: 1.07; 1.13]). Thirteen factors were associated with high SOPi, such as reduced physical activity, higher triglyceride-glucose index, HOMA-IR, systemic inflammation, osteopenia, hypertension, liver steatosis, asthma, coronary heart disease, oral corticosteroid use, lower protein intake, lower quality of life and lower educational status. In participants with obesity, lower physical activity and/or insulin resistance (n = 1682), a significantly higher and faster increase in SOPi was observed compared to participants without these factors (males: β = 2.63 [95%CI: 2.22; 3.03]; females: β = 2.90 [95%CI: 2.58; 3.23]). CONCLUSION: SOPi is a significant predictor of premature death and can identify associated factors, particularly useful among persons at risk of SO. SOPi is higher and increases faster in individuals with specific phenotypes. SOPi integrates prognosis information, which could be used as a risk indicator and for prevention of SO.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40866478,

title = {Perspectives of adults aged 55+ on plant-based diets rich in protein.},

author = {Sophie L Oppenraaij and Marije Putker and Anne Schaik and Peter J M Weijs and Sjors Verlaan},

doi = {10.1038/s41598-025-17087-x},

issn = {2045-2322},

year  = {2025},

date = {2025-08-27},

journal = {Sci Rep},

volume = {15},

number = {1},

pages = {31537},

abstract = {An increased protein intake is required during aging to preserve muscle mass. A predominantly plant-based diet is beneficial for the climate and may lower the risk of certain non-communicable diseases, but could also lead to protein below recommendations. This study seeks to elucidate facilitators and barriers in adults aged 55+ adopting a diet that is both predominantly plant-based and provides sufficient protein to preserve muscle mass. Three focus groups were conducted with 30 Dutch adults, aged 55-74 years. The focus groups explored participants' views on protein-rich, (predominantly) plant-based diets. Participants discussed a range of topics, including perceptions of protein needs, attitudes toward plant-based foods, social influences, and practical considerations such as taste, cost, and habits. Three researchers independently thematically analysed the data and facilitators and barriers were mapped to the Capability (C), Opportunity (O), Motivation (M) - Behaviour (B) model. Health effects (M) and taste (M) were both the most dominant facilitators and barriers regarding transition towards a more plant-based, protein-rich diet. Knowledge (C) and social influences (O) were important factors that influence dietary choices regarding the other COM-B model components. Environmental benefits (M) and animal welfare (M) were mentioned as additional benefits rather than as main facilitator. Participants expressed a clear need for enhanced knowledge and tools about the health and environmental benefits of plant-based, protein-rich diets. Improving taste and highlighting health benefits are key to fostering positive attitudes and encouraging the adoption of protein-rich, plant-based diets among adults aged 55+.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40825805,

title = {Estimating vastus lateralis muscle volume from a single ultrasound image.},

author = {Moritz Eggelbusch and Guido Weide and Michael Tieland and Renske N Vergeer and Luuk Vos and Jantine Helder and Stephan Zwaard and Richard T Jaspers and Peter J M Weijs and Rob C I Wüst},

doi = {10.1038/s41598-025-11437-5},

issn = {2045-2322},

year  = {2025},

date = {2025-08-18},

journal = {Sci Rep},

volume = {15},

number = {1},

pages = {30186},

abstract = {The assessment of skeletal muscle volume is valuable for fundamental research and clinical practice, but remains limited in larger cohorts due to its time-consuming nature. Here, we developed a method to accurately estimate vastus lateralis (VL) muscle volume based on a single measurement of anatomical cross-sectional area (ACSA) or tissue thickness. Sixty-nine healthy participants (20-91 years) volunteered. In a subgroup (n = 34) we measured VL volume and ACSAs at 10% intervals along the muscle length to derive a VL muscle shape factor. We subsequently estimated VL volume by multiplying this muscle shape factor with muscle length and a single measure of ACSA at 50% muscle length (ACSA) or an estimated ACSA from a single ultrasound scan of tissue thickness in an independent cohort (n = 35). VL muscle shape factor was determined by integrating a fourth-order polynomial of muscle length and ACSA, and was dependent on muscle size. Estimating muscle volume had a high accuracy (R²=0.976},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40783689,

title = {Efficacy of progressive resistance training intensities and adequate dietary protein intake for community-dwelling frail older adults (TEAMS study), protocol for a randomised controlled trial.},

author = {M Benali and J Helder and E J M Biersteker and J D Schoufour and P J M Weijs and M Tieland},

doi = {10.1186/s12877-025-06209-9},

issn = {1471-2318},

year  = {2025},

date = {2025-08-09},

journal = {BMC Geriatr},

volume = {25},

number = {1},

pages = {609},

abstract = {BACKGROUND: Progressive Resistance Training (PRT) and adequate dietary protein are crucial for preventing and managing sarcopenia and frailty in older adults. To date, the optimal intensity of PRT and the added value of dietary protein for enhancing muscle mass, strength, and physical performance in frail older adults remain unclear. This randomised controlled trial aims to determine the efficacy of various PRT intensities and adequate dietary protein intake in improving muscle mass, strength and physical performance in frail, community-dwelling older adults. METHODS: This study is a two-step randomised clinical trial involving 300 frail older adults. Participants will engage in a 12-week PRT twice weekly. Initially, participants will be randomised to specific training intensities, ranging from 20 to 80% of their one-repetition maximum (1-RM). Subsequently, participants will be further randomised into two groups: an intervention group receiving a dietary intervention targeting a daily protein intake of 1.2-1.5 g/kg/day (PRT-Pro), and a control group with no dietary intervention (PRT-only). The dietary protein intervention will include counselling sessions and the provision of protein-rich foods. DISCUSSION: This study aims to elucidate the effect of various PRT intensities and the supplementary effects of adequate dietary protein intake on muscle mass, muscle strength, and physical performance in frail older adults. The results will provide critical insights for scientists and healthcare professionals, facilitating the development of more effective strategies to combat sarcopenia and frailty in this population. TRIAL REGISTRATION: The trial is registered at the ICTRP (OMON trial ID NL8785).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40490222,

title = {Navigating complexity: The challenge of reaching consensus on the diagnosis of malnutrition in patients with obesity via a modified delphi study.},

author = {Natasha Nalucha Mwala and Jeanne J F A In 't Hulst and Barbara S Meij and Emmelyne Vasse and Jos W Borkent and Carliene Dronkelaar and Patty L M Lakenman and Esmee M Reijnierse and Josje D Schoufour and Peter J M Weijs and Renate Winkels and Maarten R Soeters and Marian A E Schueren},

doi = {10.1016/j.clnesp.2025.05.043},

issn = {2405-4577},

year  = {2025},

date = {2025-08-01},

journal = {Clin Nutr ESPEN},

volume = {68},

pages = {591–601},

abstract = {BACKGROUND & AIM: Diagnosing (disease-related) malnutrition in patients with obesity is challenging due to the complex interplay between excess body weight and physiological changes associated with illness and inadequate dietary intake, factors often overlooked in clinical assessments. Current global definitions of malnutrition do not adequately account for the distinctive characteristics of patients with obesity. This study aimed to develop a working definition of malnutrition in this population. METHODS: A modified three-round Delphi method was conducted between March and July 2024, involving 25 experts to achieve consensus on diagnosing malnutrition in obesity. In Round 1, participants evaluated 45 statements using a 5-point Likert scale. Feedback from this round guided revisions for Round 2, which focused on the Global Leadership Initiative on Malnutrition (GLIM) criteria and introduced nine revised statements. Round 3 further refined these statements, with the final consensus assessed using a binary agree/disagree scale. A threshold of ≥70 % agreement was set to define consensus in all rounds, with statements not meeting this threshold left undecided. RESULTS: Participation rates were 88 % (n = 22) in Round 1, 77 % (n = 17) in Round 2, and 50 % (n = 11) in Round 3. Of the 45 statements assessed in Round 1, 11 were accepted, 32 were undecided, and two were rejected. Round 2 introduced nine revised statements, of which seven were accepted and two remained undecided. In Round 3, nine statements were assessed, of which six were accepted, and three remained undecided. Consensus supported adopting the GLIM criteria as the foundation for the working definition. However, thresholds for weight loss and muscle mass and the relevance of functional parameters remained unresolved. C-reactive protein thresholds were agreed upon, but their relevance was debated due to the challenges in interpreting chronic low-grade inflammation in obesity. Participants emphasised the importance of assessing dietary quality and quantity, recommending dietitian involvement for improved accuracy. CONCLUSION: Although a working definition for diagnosing malnutrition in patients with obesity was not achieved, this study lays a crucial foundation for further research. Key areas for future investigation include refining and validating parameters related to involuntary weight loss, muscle mass, inflammatory markers and dietary intake.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40409139,

title = {Culture-sensitive lifestyle intervention tailored to non-Western migrant older adults improves physical performance: A randomized controlled trial.},

author = {Esmée J M Biersteker and Jantine Helder and Nannette Spek and Mieke Holwerda and Hinke Kruizenga and Peter J M Weijs and Michael Tieland},

doi = {10.1016/j.jnha.2025.100584},

issn = {1760-4788},

year  = {2025},

date = {2025-08-01},

journal = {J Nutr Health Aging},

volume = {29},

number = {8},

pages = {100584},

abstract = {OBJECTIVES: To counteract sarcopenia in non-Western migrant older adults, lifestyle interventions with increased physical activity and adequate dietary protein intake are promising. However, regular community-based lifestyle interventions often lack a culture-sensitive approach. The aim of this study was to assess the effects of a newly developed culture-sensitive lifestyle intervention on physical performance in non-Western Surinamese older adults. DESIGN: A randomized controlled trial. PARTICIPANTS: This study was conducted with 65 non-Western migrant participants (Surinamese, 65 ± 7 y, 91% female, 82% overweight or obese). INTERVENTION: The participants were allocated to the culture-sensitive lifestyle intervention (n = 35) or control group (n = 30). The six-month intervention consisted of an exercise training program and a nutritional program, both adapted to the cultural and personal needs of the participants. MEASUREMENTS: The primary outcome was physical performance, measured by 6-minute walking test. Secondary outcomes were timed-up-and-go, 30-seconds chair stand, knee-extension strength, single leg stand tests, appendicular lean soft tissue mass, fat mass, protein intake and daily physical activity. Linear mixed models were performed to assess intervention effects with significance set at p < 0.05. RESULTS: The intervention group improved physical performance by 12% from baseline 440 ± 62 m to 6 months 492 ± 73 m compared to 8% in control group from 438 ± 93 m to 471 ± 66 m (+25.5 m, 95%CI (3.2;47.9)},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40461646,

title = {In vitro and in vivo muscle mass and strength during the first week of critical illness.},

author = {Wout J Claassen and Isabel M Ruijven and Marloes Berg and Rianne J Baelde and Alexcia Fortes Monteiro and Rajvi M N Balesar and Sylvia W Hania and Donald L Peet and Peter J M Weijs and Coen A C Ottenheijm and Sandra N Stapel},

doi = {10.1186/s40635-025-00755-7},

issn = {2197-425X},

year  = {2025},

date = {2025-06-03},

journal = {Intensive Care Med Exp},

volume = {13},

number = {1},

pages = {57},

abstract = {BACKGROUND: Loss of muscle mass and strength is provoked by critical illness. Our primary aim was to study the development of muscle atrophy and weakness in vitro in isolated myofibers and in vivo muscle mass and in vitro muscle strength during the first week of critical illness. Furthermore, we explored how in vitro muscle strength compares to healthy controls. Finally, we studied correlations between in vitro muscle mass and strength and in vivo muscle mass in critically ill patients. METHODS: We performed a secondary analysis using data from a randomized controlled trial. We studied contractile force of single myofibers isolated from muscle biopsies around admission (day 1-3) and around 1 week after inclusion (day 8-10). Furthermore, we studied myofiber cross-sectional area (CSA), proportion of fast-twitch myofibers, bio-electrical impedance analysis-derived fat-free mass index (FFMI), ultrasound-derived quadriceps muscle layer thickness (QMLT) and diaphragm thickness. In the control group, only contractile force outcomes were available. RESULTS: In total, ten ICU patients had two muscle biopsies taken. Maximum force of both fast and slow-twitch myofibers was reduced at day 8-10 compared to day 1-3, even though there were no differences in normalized force and calcium sensitivity. FFM and QMLT did not change over time, nor were there differences between groups. Compared to healthy controls, maximum force of myofibers was lower in the ICU group at day 8-10 in both slow and fast-twitch myofibers, while the calcium sensitivity of force was lower in slow-twitch myofibers. We found a significant correlation between myofiber CSA vs. FFMI (r = 0.68) and maximum force of the fast-twitch fibers vs. QMLT (r = 0.72). CONCLUSIONS: During the first week of critical illness, maximum force declined over time, while no other in vitro parameters changed. We found a moderate correlation between myofiber CSA vs. FFMI and maximum force of the fast-twitch fibers vs. QMLT.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40154078,

title = {The effect of 12-weeks Nutritional supplementation on Nutritional Intake and Status among Indonesian Older Outpatients with Malnutrition Risk, the Prolansia study: a randomized controlled trial.},

author = {Esthika Dewiasty and Sjors Verlaan and Rahmi Istanti and Fariza Rahmah and Eugene Satryo and Lisette Cpgm Groot and Siti Setiati},

doi = {10.1016/j.jnha.2025.100548},

issn = {1760-4788},

year  = {2025},

date = {2025-06-01},

journal = {J Nutr Health Aging},

volume = {29},

number = {6},

pages = {100548},

abstract = {BACKGROUND: Standard care for older outpatients who are at risk of malnutrition in Indonesia is still based on the 2017's recommendations of the Indonesian Geriatrics Society. and does not provide nutritional supplementation as recommended by ESPEN guidelines 2019/2022. OBJECTIVE: We compared the effects of supplementation of at least 400 kcal/day including 30 g or more of protein/day as nutritional intervention as recommended by the ESPEN Guideline with standard care recommended by The Indonesian Geriatrics Society, in Indonesian older adults who are at risk of malnutrition. METHODS: Older outpatients (60 years or older) at a geriatric clinic of the national referral hospital with or at risk of malnutrition were recruited. They were randomly allocated to 12 weeks of supplementation with a nutrient dense drink twice a day on top of standard care compared to standard care only. We assessed energy and nutrient intake at baseline, after 6 and 12 weeks and nutritional status, physical performance, and vitamin D level at baseline and after 12 weeks. Data analyses were blinded. RESULTS: As many as 105 older outpatients (65 % women, mean age 72.5 years},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40254971,

title = {Two-Year Follow-Up of a Multidisciplinary Lifestyle Intervention for Rheumatoid Arthritis and Osteoarthritis.},

author = {Carlijn A Wagenaar and Wendy Walrabenstein and Marike Leeden and Franktien Turkstra and Martijn Gerritsen and Jos W R Twisk and Maarten Boers and Martin Esch and Henriët Middendorp and Peter J M Weijs and Dirkjan Schaardenburg},

doi = {10.1002/acr.25553},

issn = {2151-4658},

year  = {2025},

date = {2025-04-20},

journal = {Arthritis Care Res (Hoboken)},

volume = {77},

number = {9},

pages = {1141–1148},

abstract = {OBJECTIVE: The Plants for Joints (PFJ) intervention, including a whole-food plant-based diet, exercise, and stress reduction, reduced signs and symptoms of rheumatoid arthritis (RA) or metabolic syndrome-associated hip or knee osteoarthritis (MSOA) compared to usual care. This study aimed to examine outcomes two years after the PFJ intervention. METHODS: After two 16-week randomized controlled trials in people with (1) RA or (2) MSOA, control groups received the active PFJ intervention. All participants were then observed in a two-year observational extension study. Primary outcomes were Disease Activity Score in 28 joints (DAS28) (RA) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (MSOA). Secondary outcomes included body composition, metabolic outcomes, medication changes, and adherence to intervention recommendations. Within-group differences were assessed using linear mixed models, comparing the start and end of the intervention to two years after intervention. RESULTS: A total of 48 of 77 participants with RA (62%) and 44 of 64 participants with MSOA (69%) completed the extension study. Two years after the intervention, the DAS28 in participants with RA (-0.9 points, 95% confidence interval [CI] -1.2 to -0.6 points) and WOMAC score in participants with MSOA (-8.8 points, 95% CI -12.6 to -5.1 points) were significantly lower than start intervention. In addition, C-reactive protein in the RA group and weight, body mass index, waist circumference, and diastolic blood pressure in the MSOA group were significantly lower compared to start intervention. Primary end points remained similar from the end of the intervention to the end of the extension study. During the extension study, medication use decreased slightly, and participants continued to follow the intervention recommendations. CONCLUSION: Two years after the PFJ intervention, improvements in RA disease activity, MSOA symptoms and functioning, and intervention adherence were sustained.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40023943,

title = {Dietary protein intake, protein sources & distribution patterns in community-dwelling older adults: A harmonized analysis of eight studies.},

author = {Lotte Koopmans and Sophie Oppenraaij and Maartje W F Heijmans and Sjors Verlaan and Josje D Schoufour and Dominique S M Ten Haaf and Cindy M T Avoort and Jantine Helder and Robert Memelink and Amely Verreijen and Peter J M Weijs and Thijs M H Eijsvogels and Maria T E Hopman},

doi = {10.1016/j.clnu.2025.02.022},

issn = {1532-1983},

year  = {2025},

date = {2025-04-01},

journal = {Clin Nutr},

volume = {47},

pages = {177–184},

abstract = {OBJECTIVES: Sufficient protein intake is important for older adults to prevent sarcopenia. Better insight into dietary characteristics may be helpful to improve daily protein intake. Therefore, this study aimed to compare characteristics of community-dwelling older adults with distinct amounts of daily protein intake. METHODS: Baseline data of older adults (age >55 years) from eight intervention studies were pooled. Protein intake was measured using 24-h recalls or 3-day food records. Participants were stratified into one of four different groups based on their habitual protein intake (<0.8 g per kilogram bodyweight per day (g/kg/d), 0.8-0.99 g/kg/d, 1.0-1.2 g/kg/d and >1.2 g/kg/d). Protein intake per meal, animal-versus plant-based protein intake, daily protein distribution patterns (e.g. spread or pulse) and the protein intake from distinct protein-rich food categories (meat, fish, dairy, grains and others) were assessed. RESULTS: Among 814 participants (69 ± 9 years, 54 % male), mean protein intake was 0.98 ± 0.30 g/kg/d. 28 % (n = 227) of the population had a protein intake <0.8 g/kg/d, 29 % (n = 240) 0.8-0.99 g/kg/d, 22 % (n = 179) 1.0-1.2 g/kg/d and 21 % (n = 168) >1.2 g/kg/d. Higher protein intake groups had a lower body weight and BMI and a higher energy intake per day. Although protein intake distribution patterns did not differ across groups, meals with >20 g or >0.4 g protein per kilogram bodyweight per meal more often occurred in the higher protein intake groups. Protein intake was the lowest at breakfast followed by lunch and dinner, in all groups. Higher protein intake groups consumed a higher proportion of animal-based protein sources. CONCLUSION: Distinct protein intake groups showed comparable intake distribution patterns, with lowest protein consumption at breakfast and highest at dinner. Nevertheless, the highest protein intake group more often consumed >20 gr of protein per meal, indicating that a focus on the absolute amount of protein per meal, particularly at breakfast, could further optimize daily protein intake in older adults.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39667560,

title = {Intensified dietetic care during and up to three months after hospital admission in older patients at risk of malnutrition, a randomised controlled trial.},

author = {Carliene Dronkelaar and Hinke Kruizenga and Moritz Eggelbusch and Peter J M Weijs and Michael Tieland},

doi = {10.1016/j.clnesp.2024.12.008},

issn = {2405-4577},

year  = {2025},

date = {2025-02-01},

journal = {Clin Nutr ESPEN},

volume = {65},

pages = {315–323},

abstract = {BACKGROUND: Inadequate protein intake is associated with poor physical functioning and suboptimal recovery in hospitalised older adults. Despite standard dietetic care, dietary protein intakes falls well below the recommended levels. To address this problem, we developed an intensified trans-sectorial dietetic intervention that targets hospitalised older adults. This study aims to evaluate its impact on physical functioning and dietary protein intake during and post hospitalisation. METHODS: This multicentre individually randomised controlled trial was conducted in five hospitals from January 2021 until December 2022. Hospitalised older adults, aged ≥55 years and at risk of malnutrition were randomised to receive regular care (CON) or intensive dietetic intervention (INT). The intervention consisted of personalized, intensive care, including trans-sectorial guidance by trained dietitians, increased consultations, and supportive materials focused on protein intake. Additionally, the intervention emphasized engagement in dietary behaviour and physical activity during hospitalisation and continued for three months post-discharge. The primary outcome was change in physical functioning measured by the Short Physical Performance Battery (SPPB) from admission to three months post-discharge, analysed with linear mixed models for repeated measures. Secondary outcomes included protein intake, body composition, muscle strength, physical activity, activities of daily living, fear of falling, pain, fatigue, appetite and quality of life. RESULTS: A total of 76 hospitalised older adults were included in the study of which 38 were in CON and 38 received INT. The overall drop-out was 30 % (CON 26 %; INT 34 %). The participants had a median age 73 y (Inter Quartile Range: 62-78 y) with 50 % females. Overall, Physical functioning improved from 6 points (IQR: 1-9 points) at baseline to 9 points (IQR: 7-11) at three months post-discharge (p < 0.0001). Likewise, protein intake increased from 0.8 g/kg bodyweight (IQR: 0.6-1.0) to 1.0 g/kg bodyweight (IQR: 0.8-1.2) (p < 0.0001). There were no significant differences between intervention and control group. All secondary outcomes improved over time, except for fear of falling, leg extension strength, and body composition, with no significant differences between intervention and control group. CONCLUSIONS: Hospitalised older patients improved their physical functioning and protein intake after three months post-discharge, although the majority not to recommended levels. No effects of the intensive dietetic treatment could be detected due to low intervention adherence and a small sample size. Future research should be conducted with an intervention consisting of a strong combination of nutritional support and exercise with a successful implementation and a flexible study design catered to the needs of the older patient. TRIAL REGISTRATION: Landelijk Trial Register (NL8041; NL72069.029.19) www.onderzoekmetmensen.nl; registered 2019-09-23; covering all WHO Trial Registration Data Set items.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39875946,

title = {Exploring motivation, goals, facilitators, and barriers to adopt health behaviors at retirement age: a focus group study.},

author = {Paula Collazo-Castiñeira and Rocío Rodríguez-Rey and Gisela I Delfino and Alfonso J Cruz-Jentoft and Eva Topinková and Peter J M Weijs and Josje D Schoufour and Macarena Sánchez-Izquierdo},

doi = {10.1186/s12889-025-21377-4},

issn = {1471-2458},

year  = {2025},

date = {2025-01-28},

journal = {BMC Public Health},

volume = {25},

number = {1},

pages = {348},

abstract = {BACKGROUND: This study qualitatively investigates retirement-age adults' perspectives on engaging in health behaviors such as physical activity or a healthy diet, distinguishing facilitators, barriers, goals, and motivations (the two later in line with Self-Determination Theory). METHODS: Two clinical psychologists conducted four focus groups with Spanish adults around retirement age. We conducted inductive and deductive content analysis. RESULTS: The main facilitators and barriers identified were the presence and absence of social support/social network, mental health, willpower, time, and motivation. Participants reported different types of motivation (e.g., intrinsic motivation in the enjoyment of the activity of exercise or cooking) and goals (intrinsic and extrinsic); except for the goal of health management, which presented both types of motivation, participants regulated intrinsic goals autonomously, and extrinsic ones with controlled motivation. A process of internalizing the source of motivation was identified inductively by participants. CONCLUSIONS: Facilitating social networks and addressing mental health issues could aid engagement in health behaviors among this population. Additionally, health management appeared as a significant goal, where autonomous motivation can develop even if the behavior initially arises from controlled motivation or external triggers, such as medical advice.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39514335,

title = {Protein requirement in obesity.},

author = {Peter J M Weijs},

doi = {10.1097/MCO.0000000000001087},

issn = {1473-6519},

year  = {2025},

date = {2025-01-01},

journal = {Curr Opin Clin Nutr Metab Care},

volume = {28},

number = {1},

pages = {27–32},

abstract = {PURPOSE OF REVIEW: The combined obesity and ageing pandemic require action to avoid a total health system infarct. Obesity is largely challenged with caloric restriction and endurance exercise, likely to be assisted by drugs. The older adults with the highest obesity levels may face extreme loss of muscle mass and increased risk of sarcopenic obesity.Within this context the question of what is the protein requirement is extremely urgent. RECENT FINDINGS: While the topic is essential, no trials have directly assessed protein requirements for obesity. Therefore, we will have to deal with more indirect evidence. Several systematic reviews have appeared for obesity treatment involving protein and a few randomized controlled trials during weight loss are worth mentioning considering the amount of protein needed, especially with increasing age. SUMMARY: Protein requirements are hard to derive for obesity defined by BMI over 30 perse. During weight loss the rebuilding of the body is likely to need at least 1.2 g/kg body weight/d with a maximum weight of BMI 30, especially in the aged. Obesity might increase protein requirements, however being obese with a healthy and active lifestyle might result in normal protein requirements.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40354783,

title = {32nd European Congress on Obesity (ECO 2025).},

author = {Tuba Avcilar},

doi = {10.1159/000545547},

issn = {1662-4033},

year  = {2025},

date = {2025-01-01},

journal = {Obes Facts},

volume = {18},

number = {Suppl 1},

pages = {1–656},

abstract = {Book.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Wagenaar2024-rdb,

title = {Effect of a multidisciplinary lifestyle intervention on body 

 composition in people with osteoarthritis: Secondary analysis of 

 the ``Plants for Joints'' randomized controlled trial},

author = {C A Wagenaar and W Walrabenstein and C S Jonge and M Bisschops and M Leeden and M Esch and P J M Weijs and M A Troelstra and M A Korteweg and A J Nederveen and D Schaardenburg},

year  = {2024},

date = {2024-12-01},

journal = {Osteoarthr. Cartil. Open},

volume = {6},

number = {4},

pages = {100524},

publisher = {Elsevier BV},

abstract = {Objective: The Plants for Joints (PFJ) intervention 

 significantly improved pain, stiffness, and physical function, 

 and metabolic outcomes, in people with metabolic 

 syndrome-associated osteoarthritis (MSOA). This secondary 

 analysis investigated its effects on body composition. Method: 

 In the randomized PFJ study, people with MSOA followed a 16-week 

 intervention based on a whole-food plant-based diet, physical 

 activity, and stress management, or usual care. For this 

 secondary analysis, fat mass, muscle mass, and bone mineral 

 density were measured using dual-energy X-ray absorptiometry (DEXA) for all participants. Additionally, in a subgroup (n = 

 32), hepatocellular lipid (HCL) content and composition of 

 visceral adipose tissue (VAT) were measured using magnetic 

 resonance spectroscopy (MRS). An intention-to-treat analysis 

 with a linear-mixed model adjusted for baseline values was used 

 to analyse between-group differences. Results: Of 66 people 

 randomized, 64 (97%) completed the study. The PFJ group 

 experienced significant weight loss (-5.2 kg; 95% CI -6.9, 

 -3.6) compared to controls, primarily from fat mass reduction 

 (-3.9 kg; 95% CI -5.3 to -2.5). No significant differences 

 were found in lean mass, muscle strength, or bone mineral 

 density between groups. In the subgroup who underwent MRI scans, 

 the PFJ group had a greater reduction in HCL (-6.5%; 95% CI 

 -9.9, 3.0) compared to controls, with no observed differences in 

 VAT composition. Conclusion: The PFJ multidisciplinary 

 intervention positively impacted clinical and metabolic 

 outcomes, and appears to significantly reduce body fat, 

 including liver fat, while preserving muscle mass and strength.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Wagenaar2024-rd,

title = {Effect of a multidisciplinary lifestyle intervention on body 

 composition in people with osteoarthritis: Secondary analysis of 

 the ``Plants for Joints'' randomized controlled trial},

author = {C A Wagenaar and W Walrabenstein and C S Jonge and M Bisschops and M Leeden and M Esch and P J M Weijs and M A Troelstra and M A Korteweg and A J Nederveen and D Schaardenburg},

year  = {2024},

date = {2024-12-01},

journal = {Osteoarthr. Cartil. Open},

volume = {6},

number = {4},

pages = {100524},

publisher = {Elsevier BV},

abstract = {Objective: The Plants for Joints (PFJ) intervention 

 significantly improved pain, stiffness, and physical function, 

 and metabolic outcomes, in people with metabolic 

 syndrome-associated osteoarthritis (MSOA). This secondary 

 analysis investigated its effects on body composition. Method: 

 In the randomized PFJ study, people with MSOA followed a 16-week 

 intervention based on a whole-food plant-based diet, physical 

 activity, and stress management, or usual care. For this 

 secondary analysis, fat mass, muscle mass, and bone mineral 

 density were measured using dual-energy X-ray absorptiometry (DEXA) for all participants. Additionally, in a subgroup (n = 

 32), hepatocellular lipid (HCL) content and composition of 

 visceral adipose tissue (VAT) were measured using magnetic 

 resonance spectroscopy (MRS). An intention-to-treat analysis 

 with a linear-mixed model adjusted for baseline values was used 

 to analyse between-group differences. Results: Of 66 people 

 randomized, 64 (97%) completed the study. The PFJ group 

 experienced significant weight loss (-5.2 kg; 95% CI -6.9, 

 -3.6) compared to controls, primarily from fat mass reduction 

 (-3.9 kg; 95% CI -5.3 to -2.5). No significant differences 

 were found in lean mass, muscle strength, or bone mineral 

 density between groups. In the subgroup who underwent MRI scans, 

 the PFJ group had a greater reduction in HCL (-6.5%; 95% CI 

 -9.9, 3.0) compared to controls, with no observed differences in 

 VAT composition. Conclusion: The PFJ multidisciplinary 

 intervention positively impacted clinical and metabolic 

 outcomes, and appears to significantly reduce body fat, 

 including liver fat, while preserving muscle mass and strength.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Weijs2024-ldb,

title = {Protein requirement in obesity},

author = {Peter J M Weijs},

year  = {2024},

date = {2024-11-01},

journal = {Curr. Opin. Clin. Nutr. Metab. Care},

publisher = {Ovid Technologies (Wolters Kluwer Health)},

abstract = {PURPOSE OF REVIEW: The combined obesity and ageing pandemic 

 require action to avoid a total health system infarct. Obesity 

 is largely challenged with caloric restriction and endurance 

 exercise, likely to be assisted by drugs. The older adults with 

 the highest obesity levels may face extreme loss of muscle mass 

 and increased risk of sarcopenic obesity.Within this context the 

 question of what is the protein requirement is extremely urgent. 

 RECENT FINDINGS: While the topic is essential, no trials have 

 directly assessed protein requirements for obesity. Therefore, 

 we will have to deal with more indirect evidence. Several 

 systematic reviews have appeared for obesity treatment involving 

 protein and a few randomized controlled trials during weight 

 loss are worth mentioning considering the amount of protein 

 needed, especially with increasing age. SUMMARY: Protein 

 requirements are hard to derive for obesity defined by BMI over 

 30 perse. During weight loss the rebuilding of the body is 

 likely to need at least 1.2 g/kg body weight/d with a maximum 

 weight of BMI 30, especially in the aged. Obesity might increase 

 protein requirements, however being obese with a healthy and 

 active lifestyle might result in normal protein requirements.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Weijs2024-ld,

title = {Protein requirement in obesity},

author = {Peter J M Weijs},

year  = {2024},

date = {2024-11-01},

journal = {Curr. Opin. Clin. Nutr. Metab. Care},

publisher = {Ovid Technologies (Wolters Kluwer Health)},

abstract = {PURPOSE OF REVIEW: The combined obesity and ageing pandemic 

 require action to avoid a total health system infarct. Obesity 

 is largely challenged with caloric restriction and endurance 

 exercise, likely to be assisted by drugs. The older adults with 

 the highest obesity levels may face extreme loss of muscle mass 

 and increased risk of sarcopenic obesity.Within this context the 

 question of what is the protein requirement is extremely urgent. 

 RECENT FINDINGS: While the topic is essential, no trials have 

 directly assessed protein requirements for obesity. Therefore, 

 we will have to deal with more indirect evidence. Several 

 systematic reviews have appeared for obesity treatment involving 

 protein and a few randomized controlled trials during weight 

 loss are worth mentioning considering the amount of protein 

 needed, especially with increasing age. SUMMARY: Protein 

 requirements are hard to derive for obesity defined by BMI over 

 30 perse. During weight loss the rebuilding of the body is 

 likely to need at least 1.2 g/kg body weight/d with a maximum 

 weight of BMI 30, especially in the aged. Obesity might increase 

 protein requirements, however being obese with a healthy and 

 active lifestyle might result in normal protein requirements.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Van_Erck2024-bsb,

title = {Low muscle quality on a procedural computed tomography scan 

 assessed with deep learning as a practical useful predictor of 

 mortality in patients with severe aortic valve stenosis},

author = {Dennis Erck and Pim Moeskops and Josje D Schoufour and Peter J M Weijs and Wilma J M Scholte Op Reimer and Martijn S Mourik and R Nils Planken and Marije M Vis and Jan Baan and Ivana Išgum and José P Henriques and Bob D Vos and Ronak Delewi},

year  = {2024},

date = {2024-10-01},

journal = {Clin. Nutr. ESPEN},

volume = {63},

pages = {142–147},

publisher = {Elsevier BV},

abstract = {BACKGROUND & AIMS: Accurate diagnosis of sarcopenia requires 

 evaluation of muscle quality, which refers to the amount of fat 

 infiltration in muscle tissue. In this study, we aim to 

 investigate whether we can independently predict mortality risk 

 in transcatheter aortic valve implantation (TAVI) patients, 

 using automatic deep learning algorithms to assess muscle 

 quality on procedural computed tomography (CT) scans. METHODS: 

 This study included 1199 patients with severe aortic stenosis 

 who underwent transcatheter aortic valve implantation (TAVI) 

 between January 2010 and January 2020. A procedural CT scan was 

 performed as part of the preprocedural-TAVI evaluation, and the 

 scans were analyzed using deep-learning-based software to 

 automatically determine skeletal muscle density (SMD) and 

 intermuscular adipose tissue (IMAT). The association of SMD and 

 IMAT with all-cause mortality was analyzed using a Cox 

 regression model, adjusted for other known mortality predictors, 

 including muscle mass. RESULTS: The mean age of the participants 

 was 80 $±$ 7 years, 53% were female. The median observation 

 time was 1084 days, and the overall mortality rate was 39%. We 

 found that the lowest tertile of muscle quality, as determined 

 by SMD, was associated with an increased risk of mortality (HR 

 1.40 [95%CI: 1.15-1.70], p < 0.01). Similarly, low muscle 

 quality as defined by high IMAT in the lowest tertile was also 

 associated with increased mortality risk (HR 1.24 [95%CI: 1.01-1.52},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Bauer2024-hwb,

title = {Adherence to resistance training and hypocaloric diet among 

 persons near retirement age - A secondary data analysis of three 

 randomized controlled trials},

author = {S Bauer and L Reiter and Peter J M Weijs and J D Schoufour and Y Boirie and E Topinková and R G Memelink and A M Verreijen and A Borenich and D Eglseer and SO-NUTS consortium},

year  = {2024},

date = {2024-10-01},

journal = {J. Nutr. Health Aging},

volume = {28},

number = {10},

pages = {100344},

publisher = {Elsevier BV},

abstract = {OBJECTIVES: Adherence to lifestyle interventions is crucial for 

 the treatment of obesity. However, there is little research 

 about adherence to lifestyle interventions in persons around 

 retirement age. The objectives of this study are (1) to identify 

 factors associated with the adherence to resistance training and 

 a hypocaloric diet and (2) to describe the association between 

 adherence and changes in body composition outcome parameters. 

 DESIGN: This secondary data analysis included three randomized 

 controlled trials. SETTING & PARTICIPANTS: The inclusion 

 criteria of the participants were an age of 55-75 years, a BMI 

 $geq$ 25 kg/m2 and receiving both a hypocaloric diet and 

 resistance training. All participants were residing in the 

 community. MEASUREMENTS: Adherence to hypocaloric diet was 

 measured through the mean dietary intake on the basis of a 3-day 

 dietary record. If the participant consumed at least 600 kcal 

 less than the individual caloric requirements, they were 

 considered adherent. Adherence to resistance training was 

 achieved if $geq$67% of the recommended training sessions were 

 attended over the course of the study periods. RESULTS: 232 

 participants were included, 47.0% female, mean age 64.0 

 ($±$5.5) years. 80.2% adhered to resistance training and 

 51.3% adhered to a hypocaloric diet. Older age (Beta 0.41; 95% CI 0.05, 0.78; p = 0.028) and male sex (Beta 7.7; 95% CI 3.6, 

 11; p < 0.001) were associated with higher resistance training 

 adherence. A higher BMI at baseline (Beta 6.4; 95% CI 3.6, 9.2; 

 p < 0.001) and male sex (Beta 65; 95% CI 41, 88; p < 0.001) 

 were associated with higher adherence to hypocaloric diet. 

 CONCLUSION: We identified several associated factors (sex, age 

 and BMI at baseline) that should be considered to promote 

 adherence in future lifestyle intervention studies in persons 

 around retirement age. We recommend including behavior change 

 techniques in lifestyle interventions and consider sex-specific 

 interventions to improve the adherence of women.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Van_Erck2024-bs,

title = {Low muscle quality on a procedural computed tomography scan 

 assessed with deep learning as a practical useful predictor of 

 mortality in patients with severe aortic valve stenosis},

author = {Dennis Erck and Pim Moeskops and Josje D Schoufour and Peter J M Weijs and Wilma J M Scholte Op Reimer and Martijn S Mourik and R Nils Planken and Marije M Vis and Jan Baan and Ivana Išgum and José P Henriques and Bob D Vos and Ronak Delewi},

year  = {2024},

date = {2024-10-01},

journal = {Clin. Nutr. ESPEN},

volume = {63},

pages = {142–147},

publisher = {Elsevier BV},

abstract = {BACKGROUND & AIMS: Accurate diagnosis of sarcopenia requires 

 evaluation of muscle quality, which refers to the amount of fat 

 infiltration in muscle tissue. In this study, we aim to 

 investigate whether we can independently predict mortality risk 

 in transcatheter aortic valve implantation (TAVI) patients, 

 using automatic deep learning algorithms to assess muscle 

 quality on procedural computed tomography (CT) scans. METHODS: 

 This study included 1199 patients with severe aortic stenosis 

 who underwent transcatheter aortic valve implantation (TAVI) 

 between January 2010 and January 2020. A procedural CT scan was 

 performed as part of the preprocedural-TAVI evaluation, and the 

 scans were analyzed using deep-learning-based software to 

 automatically determine skeletal muscle density (SMD) and 

 intermuscular adipose tissue (IMAT). The association of SMD and 

 IMAT with all-cause mortality was analyzed using a Cox 

 regression model, adjusted for other known mortality predictors, 

 including muscle mass. RESULTS: The mean age of the participants 

 was 80 $±$ 7 years, 53% were female. The median observation 

 time was 1084 days, and the overall mortality rate was 39%. We 

 found that the lowest tertile of muscle quality, as determined 

 by SMD, was associated with an increased risk of mortality (HR 

 1.40 [95%CI: 1.15-1.70], p < 0.01). Similarly, low muscle 

 quality as defined by high IMAT in the lowest tertile was also 

 associated with increased mortality risk (HR 1.24 [95%CI: 1.01-1.52},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Bauer2024-hw,

title = {Adherence to resistance training and hypocaloric diet among 

 persons near retirement age - A secondary data analysis of three 

 randomized controlled trials},

author = {S Bauer and L Reiter and Peter J M Weijs and J D Schoufour and Y Boirie and E Topinková and R G Memelink and A M Verreijen and A Borenich and D Eglseer and SO-NUTS consortium},

year  = {2024},

date = {2024-10-01},

journal = {J. Nutr. Health Aging},

volume = {28},

number = {10},

pages = {100344},

publisher = {Elsevier BV},

abstract = {OBJECTIVES: Adherence to lifestyle interventions is crucial for 

 the treatment of obesity. However, there is little research 

 about adherence to lifestyle interventions in persons around 

 retirement age. The objectives of this study are (1) to identify 

 factors associated with the adherence to resistance training and 

 a hypocaloric diet and (2) to describe the association between 

 adherence and changes in body composition outcome parameters. 

 DESIGN: This secondary data analysis included three randomized 

 controlled trials. SETTING & PARTICIPANTS: The inclusion 

 criteria of the participants were an age of 55-75 years, a BMI 

 $geq$ 25 kg/m2 and receiving both a hypocaloric diet and 

 resistance training. All participants were residing in the 

 community. MEASUREMENTS: Adherence to hypocaloric diet was 

 measured through the mean dietary intake on the basis of a 3-day 

 dietary record. If the participant consumed at least 600 kcal 

 less than the individual caloric requirements, they were 

 considered adherent. Adherence to resistance training was 

 achieved if $geq$67% of the recommended training sessions were 

 attended over the course of the study periods. RESULTS: 232 

 participants were included, 47.0% female, mean age 64.0 

 ($±$5.5) years. 80.2% adhered to resistance training and 

 51.3% adhered to a hypocaloric diet. Older age (Beta 0.41; 95% CI 0.05, 0.78; p = 0.028) and male sex (Beta 7.7; 95% CI 3.6, 

 11; p < 0.001) were associated with higher resistance training 

 adherence. A higher BMI at baseline (Beta 6.4; 95% CI 3.6, 9.2; 

 p < 0.001) and male sex (Beta 65; 95% CI 41, 88; p < 0.001) 

 were associated with higher adherence to hypocaloric diet. 

 CONCLUSION: We identified several associated factors (sex, age 

 and BMI at baseline) that should be considered to promote 

 adherence in future lifestyle intervention studies in persons 

 around retirement age. We recommend including behavior change 

 techniques in lifestyle interventions and consider sex-specific 

 interventions to improve the adherence of women.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38944828c,

title = {Low muscle quality on a procedural computed tomography scan assessed with deep learning as a practical useful predictor of mortality in patients with severe aortic valve stenosis},

author = {Dennis van Erck and Pim Moeskops and Josje D Schoufour and Peter J M Weijs and Wilma J M Scholte Op Reimer and Martijn S van Mourik and R Nils Planken and Marije M Vis and Jan Baan and Ivana Išgum and José P Henriques and Bob D de Vos and Ronak Delewi},

doi = {10.1016/j.clnesp.2024.06.013},

issn = {2405-4577},

year  = {2024},

date = {2024-10-01},

journal = {Clin Nutr ESPEN},

volume = {63},

pages = {142--147},

abstract = {BACKGROUND & AIMS: Accurate diagnosis of sarcopenia requires evaluation of muscle quality, which refers to the amount of fat infiltration in muscle tissue. In this study, we aim to investigate whether we can independently predict mortality risk in transcatheter aortic valve implantation (TAVI) patients, using automatic deep learning algorithms to assess muscle quality on procedural computed tomography (CT) scans.nnMETHODS: This study included 1199 patients with severe aortic stenosis who underwent transcatheter aortic valve implantation (TAVI) between January 2010 and January 2020. A procedural CT scan was performed as part of the preprocedural-TAVI evaluation, and the scans were analyzed using deep-learning-based software to automatically determine skeletal muscle density (SMD) and intermuscular adipose tissue (IMAT). The association of SMD and IMAT with all-cause mortality was analyzed using a Cox regression model, adjusted for other known mortality predictors, including muscle mass.nnRESULTS: The mean age of the participants was 80 ± 7 years, 53% were female. The median observation time was 1084 days, and the overall mortality rate was 39%. We found that the lowest tertile of muscle quality, as determined by SMD, was associated with an increased risk of mortality (HR 1.40 [95%CI: 1.15-1.70], p < 0.01). Similarly, low muscle quality as defined by high IMAT in the lowest tertile was also associated with increased mortality risk (HR 1.24 [95%CI: 1.01-1.52], p = 0.04).nnCONCLUSIONS: Our findings suggest that deep learning-assessed low muscle quality, as indicated by fat infiltration in muscle tissue, is a practical, useful and independent predictor of mortality after TAVI.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39191118c,

title = {Adherence to resistance training and hypocaloric diet among persons near retirement age - A secondary data analysis of three randomized controlled trials},

author = {S Bauer and L Reiter and P J M Weijs and J D Schoufour and Y Boirie and E Topinková and R G Memelink and A M Verreijen and A Borenich and D Eglseer and },

doi = {10.1016/j.jnha.2024.100344},

issn = {1760-4788},

year  = {2024},

date = {2024-10-01},

journal = {J Nutr Health Aging},

volume = {28},

number = {10},

pages = {100344},

abstract = {OBJECTIVES: Adherence to lifestyle interventions is crucial for the treatment of obesity. However, there is little research about adherence to lifestyle interventions in persons around retirement age. The objectives of this study are (1) to identify factors associated with the adherence to resistance training and a hypocaloric diet and (2) to describe the association between adherence and changes in body composition outcome parameters.nnDESIGN: This secondary data analysis included three randomized controlled trials.nnSETTING & PARTICIPANTS: The inclusion criteria of the participants were an age of 55-75 years, a BMI ≥ 25 kg/m and receiving both a hypocaloric diet and resistance training. All participants were residing in the community.nnMEASUREMENTS: Adherence to hypocaloric diet was measured through the mean dietary intake on the basis of a 3-day dietary record. If the participant consumed at least 600 kcal less than the individual caloric requirements, they were considered adherent. Adherence to resistance training was achieved if ≥67% of the recommended training sessions were attended over the course of the study periods.nnRESULTS: 232 participants were included, 47.0% female, mean age 64.0 (±5.5) years. 80.2% adhered to resistance training and 51.3% adhered to a hypocaloric diet. Older age (Beta 0.41; 95% CI 0.05, 0.78; p = 0.028) and male sex (Beta 7.7; 95% CI 3.6, 11; p < 0.001) were associated with higher resistance training adherence. A higher BMI at baseline (Beta 6.4; 95% CI 3.6, 9.2; p < 0.001) and male sex (Beta 65; 95% CI 41, 88; p < 0.001) were associated with higher adherence to hypocaloric diet.nnCONCLUSION: We identified several associated factors (sex, age and BMI at baseline) that should be considered to promote adherence in future lifestyle intervention studies in persons around retirement age. We recommend including behavior change techniques in lifestyle interventions and consider sex-specific interventions to improve the adherence of women.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38944828,

title = {Low muscle quality on a procedural computed tomography scan assessed with deep learning as a practical useful predictor of mortality in patients with severe aortic valve stenosis},

author = {Dennis van Erck and Pim Moeskops and Josje D Schoufour and Peter J M Weijs and Wilma J M Scholte Op Reimer and Martijn S van Mourik and R Nils Planken and Marije M Vis and Jan Baan and Ivana Išgum and José P Henriques and Bob D de Vos and Ronak Delewi},

doi = {10.1016/j.clnesp.2024.06.013},

issn = {2405-4577},

year  = {2024},

date = {2024-10-01},

journal = {Clin Nutr ESPEN},

volume = {63},

pages = {142--147},

abstract = {BACKGROUND & AIMS: Accurate diagnosis of sarcopenia requires evaluation of muscle quality, which refers to the amount of fat infiltration in muscle tissue. In this study, we aim to investigate whether we can independently predict mortality risk in transcatheter aortic valve implantation (TAVI) patients, using automatic deep learning algorithms to assess muscle quality on procedural computed tomography (CT) scans.nnMETHODS: This study included 1199 patients with severe aortic stenosis who underwent transcatheter aortic valve implantation (TAVI) between January 2010 and January 2020. A procedural CT scan was performed as part of the preprocedural-TAVI evaluation, and the scans were analyzed using deep-learning-based software to automatically determine skeletal muscle density (SMD) and intermuscular adipose tissue (IMAT). The association of SMD and IMAT with all-cause mortality was analyzed using a Cox regression model, adjusted for other known mortality predictors, including muscle mass.nnRESULTS: The mean age of the participants was 80 ± 7 years, 53% were female. The median observation time was 1084 days, and the overall mortality rate was 39%. We found that the lowest tertile of muscle quality, as determined by SMD, was associated with an increased risk of mortality (HR 1.40 [95%CI: 1.15-1.70], p < 0.01). Similarly, low muscle quality as defined by high IMAT in the lowest tertile was also associated with increased mortality risk (HR 1.24 [95%CI: 1.01-1.52], p = 0.04).nnCONCLUSIONS: Our findings suggest that deep learning-assessed low muscle quality, as indicated by fat infiltration in muscle tissue, is a practical, useful and independent predictor of mortality after TAVI.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Rashid2024-ahb,

title = {Dietary patterns by level of maternal education and their 

 contribution to BMI, fat mass index, and fat-free mass index at 

 age 5 and the longitudinal association with BMI at age 10},

author = {Viyan Rashid and Mary Nicolaou and Arnoud P Verhoeff and Peter J M Weijs and Martinette T Streppel},

year  = {2024},

date = {2024-09-01},

journal = {Nutrients},

volume = {16},

number = {19},

abstract = {BACKGROUND: Our aim was to identify dietary patterns by the level 

 of maternal education that contribute to BMI, fat mass index 

 (FMI), and fat-free mass index (FFMI) in children at age 5 and to 

 assess if these dietary patterns are related to BMI at age 10. 

 METHODS: Per group (low/middle/high level), Reduced Rank 

 Regression (RRR) was used to derive dietary patterns for the 

 response variables BMI z-score, FMI, and FFMI in 1728 children at 

 age 5 in the Amsterdam Born Children and their Development (ABCD) 

 cohort. Regression analyses were then used to determine the 

 association with BMI at age 10. RESULTS: In each group, pattern 1 

 was characterized by its own cluster of food groups. Low: 

 water/tea, savory snacks, sugar, low-fat meat, and fruits; 

 middle: water/tea, low-fat cheese, fish, low-fat dairy, fruit 

 drink, low-fat meat, and eggs; and high: low-fat cheese, fruits, 

 whole-grain breakfast products, and low-fat and processed meat. 

 Additionally, in each group, pattern 1 was positively associated 

 with BMI z-scores at age 10 (low: β $łeq$ 0.43 [95% CI 

 $łeq$ 0.21; 0.66], p < 0.001, middle: β $łeq$ 0.23 [0.09; 

 0.36], p $łeq$ 0.001, and high: β $łeq$ 0.24 [0.18; 

 0.30], p < 0.001). CONCLUSIONS: The dietary patterns stratified 

 by the level of maternal education are characterized by different 

 food groups. But in all the groups, pattern 1 is positively 

 associated with BMI at age 10.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Rashid2024-ah,

title = {Dietary patterns by level of maternal education and their 

 contribution to BMI, fat mass index, and fat-free mass index at 

 age 5 and the longitudinal association with BMI at age 10},

author = {Viyan Rashid and Mary Nicolaou and Arnoud P Verhoeff and Peter J M Weijs and Martinette T Streppel},

year  = {2024},

date = {2024-09-01},

journal = {Nutrients},

volume = {16},

number = {19},

abstract = {BACKGROUND: Our aim was to identify dietary patterns by the level 

 of maternal education that contribute to BMI, fat mass index 

 (FMI), and fat-free mass index (FFMI) in children at age 5 and to 

 assess if these dietary patterns are related to BMI at age 10. 

 METHODS: Per group (low/middle/high level), Reduced Rank 

 Regression (RRR) was used to derive dietary patterns for the 

 response variables BMI z-score, FMI, and FFMI in 1728 children at 

 age 5 in the Amsterdam Born Children and their Development (ABCD) 

 cohort. Regression analyses were then used to determine the 

 association with BMI at age 10. RESULTS: In each group, pattern 1 

 was characterized by its own cluster of food groups. Low: 

 water/tea, savory snacks, sugar, low-fat meat, and fruits; 

 middle: water/tea, low-fat cheese, fish, low-fat dairy, fruit 

 drink, low-fat meat, and eggs; and high: low-fat cheese, fruits, 

 whole-grain breakfast products, and low-fat and processed meat. 

 Additionally, in each group, pattern 1 was positively associated 

 with BMI z-scores at age 10 (low: β $łeq$ 0.43 [95% CI 

 $łeq$ 0.21; 0.66], p < 0.001, middle: β $łeq$ 0.23 [0.09; 

 0.36], p $łeq$ 0.001, and high: β $łeq$ 0.24 [0.18; 

 0.30], p < 0.001). CONCLUSIONS: The dietary patterns stratified 

 by the level of maternal education are characterized by different 

 food groups. But in all the groups, pattern 1 is positively 

 associated with BMI at age 10.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Collazo-Castineira2024-pzb,

title = {Analysis of behavioral change techniques used in exercise and 

 nutritional interventions targeting adults around retirement age 

 with sarcopenic obesity in a systematic review},

author = {Paula Collazo-Castiñeira and Macarena Sánchez-Izquierdo and Lea Joanne Reiter and Silvia Bauer and Alfonso J Cruz-Jentoft and Josje D Schoufour and Peter J M Weijs and Doris Eglseer},

year  = {2024},

date = {2024-08-01},

journal = {Arch. Gerontol. Geriatr.},

volume = {123},

number = {105437},

pages = {105437},

publisher = {Elsevier BV},

abstract = {BACKGROUND: Sarcopenic obesity significantly burdens health and 

 autonomy. Strategies to intervene in or prevent sarcopenic 

 obesity generally focus on losing body fat and building or 

 maintaining muscle mass and function. For a lifestyle 

 intervention, it is important to consider psychological aspects 

 such as behavioral change techniques (BCTs) to elicit a 

 long-lasting behavioral change. PURPOSE: The study was carried 

 out to analyze BCTs used in exercise and nutritional 

 interventions targeting community-dwelling adults around 

 retirement age with sarcopenic obesity. METHODS: We conducted an 

 analysis of articles cited in an existing systematic review on 

 the effectiveness of exercise and nutritional interventions on 

 physiological outcomes in community-dwelling adults around 

 retirement age with sarcopenic obesity. We identified BCTs used 

 in these studies by applying a standardized taxonomy. RESULTS: 

 Only nine BCTs were identified. Most BCTs were not used 

 intentionally (82 %), and those used derived from the 

 implementation of lifestyle components, such as exercise classes 

 (``instructions on how to perform a behavior,'' ``demonstration 

 of the behavior,'' ``behavioral practice/rehearsal,'' and ``body 

 changes''). Only two studies used BCTs intentionally to 

 reinforce adherence in their interventions. CONCLUSIONS: Few 

 studies integrated BCTs in lifestyle interventions for 

 community-dwelling persons around retirement age with sarcopenic 

 obesity. Future studies on interventions to counteract 

 sarcopenic obesity should include well-established BCTs to 

 foster adherence and, therefore, their effectiveness.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Bels2024-qcb,

title = {Effect of high versus standard protein provision on functional 

 recovery in people with critical illness (PRECISe): an 

 investigator-initiated, double-blinded, multicentre, 

 parallel-group, randomised controlled trial in Belgium and the 

 Netherlands},

author = {Julia L M Bels and Steven Thiessen and Rob J J Gassel and Albertus Beishuizen and Ashley De Bie Dekker and Vincent Fraipont and Stoffel Lamote and Didier Ledoux and Clarissa Scheeren and Elisabeth De Waele and Arthur R H Zanten and Laura Bormans-Russell and Bas C T Bussel and Marlies M J Dictus and Tom Fivez and Ingeborg Harks and Iwan C C Horst and Joop Jonckheer and Hugues Marechal and Paul B Massion and Ingrid Meex and Michelle C Paulus and Martin Rinket and Susanne Santen and Katrien Tartaglia and Adam M Deane and Frieda Demuydt and Zudin Puthucheary and Lilian C M Vloet and Peter J M Weijs and Sander M J Kuijk and Marcel C G Poll and Dieter Mesotten and PRECISe team},

year  = {2024},

date = {2024-08-01},

journal = {Lancet},

volume = {404},

number = {10453},

pages = {659–669},

publisher = {Elsevier BV},

abstract = {BACKGROUND: Increased protein provision might ameliorate muscle 

 wasting and improve long-term outcomes in critically ill 

 patients. The aim of the PRECISe trial was to assess whether 

 higher enteral protein provision (ie, 2·0 g/kg per day) would 

 improve health-related quality of life and functional outcomes 

 in critically ill patients who were mechanically ventilated 

 compared with standard enteral protein provision (ie, 1·3 g/kg 

 per day). METHODS: The PRECISe trial was an 

 investigator-initiated, double-blinded, multicentre, 

 parallel-group, randomised controlled trial in five Dutch 

 hospitals and five Belgian hospitals. Inclusion criteria were 

 initiation of invasive mechanical ventilation within 24 h of 

 intensive care unit (ICU) admission and an expected duration of 

 invasive ventilation of 3 days or longer. Exclusion criteria 

 were contraindications for enteral nutrition, moribund 

 condition, BMI less than 18 kg/m2, kidney failure with a no 

 dialysis code, or hepatic encephalopathy. Patients were randomly 

 assigned to one of four randomisation labels, corresponding with 

 two study groups (ie, standard or high protein; two labels per 

 group) in a 1:1:1:1 ratio through an interactive web-response 

 system. Randomisation was done via random permuted-block 

 randomisation in varying block sizes of eight and 12, stratified 

 by centre. Participants, care providers, investigators, outcome 

 assessors, data analysts, and the independent data safety 

 monitoring board were all blinded to group allocation. Patients 

 received isocaloric enteral feeds that contained 1·3 kcal/mL and 

 0·06 g of protein/mL (ie, standard protein) or 1·3 kcal/mL and 

 0·10 g of protein/mL (ie, high protein). The study-nutrition 

 intervention was limited to the time period during the patient's 

 ICU stay in which they required enteral feeding, with a maximum 

 of 90 days. The primary outcome was EuroQoL 5-Dimension 5-level 

 (EQ-5D-5L) health utility score at 30 days, 90 days, and 180 

 days after randomisation, adjusted for baseline EQ-5D-5L health 

 utility score. This trial was registered with ClinicalTrials.gov 

 (NCT04633421) and is closed to new participants. FINDINGS: 

 Between Nov 19, 2020, and April 14, 2023, 935 patients were 

 randomly assigned. 335 (35·8%) of 935 patients were female and 

 600 (64·2%) were male. 465 (49·7%) of 935 were assigned to the 

 standard protein group and 470 (50·3%) were assigned to the 

 high protein group. 430 (92·5%) of 465 patients in the standard 

 protein group and 419 (89·1%) of 470 patients in the high 

 protein group were assessed for the primary outcome. The primary 

 outcome, EQ-5D-5L health utility score during 180 days after 

 randomisation (assessed at 30 days, 90 days, and 180 days), was 

 lower in patients allocated to the high protein group than in 

 those allocated to the standard protein group, with a mean difference of -0·05 (95% CI -0·10 to -0·01; p=0·031). Regarding 

 safety outcomes, the probability of mortality during the entire 

 follow-up was 0·38 (SE 0·02) in the standard protein group and 

 0·42 (0·02) in the high protein group (hazard ratio 1·14, 95% CI 0·92 to 1·40; p=0·22). There was a higher incidence of 

 symptoms of gastrointestinal intolerance in patients in the high protein group (odds ratio 1·76, 95% CI 1·06 to 2·92; p=0·030). 

 Incidence of other adverse events did not differ between groups. 

 INTERPRETATION: High enteral protein provision compared with 

 standard enteral protein provision resulted in worse 

 health-related quality of life in critically ill patients and 

 did not improve functional outcomes during 180 days after ICU 

 admission. FUNDING: Netherlands Organisation for Healthcare 

 Research and Development and Belgian Health Care Knowledge 

 Centre.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Collazo-Castineira2024-pz,

title = {Analysis of behavioral change techniques used in exercise and 

 nutritional interventions targeting adults around retirement age 

 with sarcopenic obesity in a systematic review},

author = {Paula Collazo-Castiñeira and Macarena Sánchez-Izquierdo and Lea Joanne Reiter and Silvia Bauer and Alfonso J Cruz-Jentoft and Josje D Schoufour and Peter J M Weijs and Doris Eglseer},

year  = {2024},

date = {2024-08-01},

journal = {Arch. Gerontol. Geriatr.},

volume = {123},

number = {105437},

pages = {105437},

publisher = {Elsevier BV},

abstract = {BACKGROUND: Sarcopenic obesity significantly burdens health and 

 autonomy. Strategies to intervene in or prevent sarcopenic 

 obesity generally focus on losing body fat and building or 

 maintaining muscle mass and function. For a lifestyle 

 intervention, it is important to consider psychological aspects 

 such as behavioral change techniques (BCTs) to elicit a 

 long-lasting behavioral change. PURPOSE: The study was carried 

 out to analyze BCTs used in exercise and nutritional 

 interventions targeting community-dwelling adults around 

 retirement age with sarcopenic obesity. METHODS: We conducted an 

 analysis of articles cited in an existing systematic review on 

 the effectiveness of exercise and nutritional interventions on 

 physiological outcomes in community-dwelling adults around 

 retirement age with sarcopenic obesity. We identified BCTs used 

 in these studies by applying a standardized taxonomy. RESULTS: 

 Only nine BCTs were identified. Most BCTs were not used 

 intentionally (82 %), and those used derived from the 

 implementation of lifestyle components, such as exercise classes 

 (``instructions on how to perform a behavior,'' ``demonstration 

 of the behavior,'' ``behavioral practice/rehearsal,'' and ``body 

 changes''). Only two studies used BCTs intentionally to 

 reinforce adherence in their interventions. CONCLUSIONS: Few 

 studies integrated BCTs in lifestyle interventions for 

 community-dwelling persons around retirement age with sarcopenic 

 obesity. Future studies on interventions to counteract 

 sarcopenic obesity should include well-established BCTs to 

 foster adherence and, therefore, their effectiveness.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Bels2024-qc,

title = {Effect of high versus standard protein provision on functional 

 recovery in people with critical illness (PRECISe): an 

 investigator-initiated, double-blinded, multicentre, 

 parallel-group, randomised controlled trial in Belgium and the 

 Netherlands},

author = {Julia L M Bels and Steven Thiessen and Rob J J Gassel and Albertus Beishuizen and Ashley De Bie Dekker and Vincent Fraipont and Stoffel Lamote and Didier Ledoux and Clarissa Scheeren and Elisabeth De Waele and Arthur R H Zanten and Laura Bormans-Russell and Bas C T Bussel and Marlies M J Dictus and Tom Fivez and Ingeborg Harks and Iwan C C Horst and Joop Jonckheer and Hugues Marechal and Paul B Massion and Ingrid Meex and Michelle C Paulus and Martin Rinket and Susanne Santen and Katrien Tartaglia and Adam M Deane and Frieda Demuydt and Zudin Puthucheary and Lilian C M Vloet and Peter J M Weijs and Sander M J Kuijk and Marcel C G Poll and Dieter Mesotten and PRECISe team},

year  = {2024},

date = {2024-08-01},

journal = {Lancet},

volume = {404},

number = {10453},

pages = {659–669},

publisher = {Elsevier BV},

abstract = {BACKGROUND: Increased protein provision might ameliorate muscle 

 wasting and improve long-term outcomes in critically ill 

 patients. The aim of the PRECISe trial was to assess whether 

 higher enteral protein provision (ie, 2·0 g/kg per day) would 

 improve health-related quality of life and functional outcomes 

 in critically ill patients who were mechanically ventilated 

 compared with standard enteral protein provision (ie, 1·3 g/kg 

 per day). METHODS: The PRECISe trial was an 

 investigator-initiated, double-blinded, multicentre, 

 parallel-group, randomised controlled trial in five Dutch 

 hospitals and five Belgian hospitals. Inclusion criteria were 

 initiation of invasive mechanical ventilation within 24 h of 

 intensive care unit (ICU) admission and an expected duration of 

 invasive ventilation of 3 days or longer. Exclusion criteria 

 were contraindications for enteral nutrition, moribund 

 condition, BMI less than 18 kg/m2, kidney failure with a no 

 dialysis code, or hepatic encephalopathy. Patients were randomly 

 assigned to one of four randomisation labels, corresponding with 

 two study groups (ie, standard or high protein; two labels per 

 group) in a 1:1:1:1 ratio through an interactive web-response 

 system. Randomisation was done via random permuted-block 

 randomisation in varying block sizes of eight and 12, stratified 

 by centre. Participants, care providers, investigators, outcome 

 assessors, data analysts, and the independent data safety 

 monitoring board were all blinded to group allocation. Patients 

 received isocaloric enteral feeds that contained 1·3 kcal/mL and 

 0·06 g of protein/mL (ie, standard protein) or 1·3 kcal/mL and 

 0·10 g of protein/mL (ie, high protein). The study-nutrition 

 intervention was limited to the time period during the patient's 

 ICU stay in which they required enteral feeding, with a maximum 

 of 90 days. The primary outcome was EuroQoL 5-Dimension 5-level 

 (EQ-5D-5L) health utility score at 30 days, 90 days, and 180 

 days after randomisation, adjusted for baseline EQ-5D-5L health 

 utility score. This trial was registered with ClinicalTrials.gov 

 (NCT04633421) and is closed to new participants. FINDINGS: 

 Between Nov 19, 2020, and April 14, 2023, 935 patients were 

 randomly assigned. 335 (35·8%) of 935 patients were female and 

 600 (64·2%) were male. 465 (49·7%) of 935 were assigned to the 

 standard protein group and 470 (50·3%) were assigned to the 

 high protein group. 430 (92·5%) of 465 patients in the standard 

 protein group and 419 (89·1%) of 470 patients in the high 

 protein group were assessed for the primary outcome. The primary 

 outcome, EQ-5D-5L health utility score during 180 days after 

 randomisation (assessed at 30 days, 90 days, and 180 days), was 

 lower in patients allocated to the high protein group than in 

 those allocated to the standard protein group, with a mean difference of -0·05 (95% CI -0·10 to -0·01; p=0·031). Regarding 

 safety outcomes, the probability of mortality during the entire 

 follow-up was 0·38 (SE 0·02) in the standard protein group and 

 0·42 (0·02) in the high protein group (hazard ratio 1·14, 95% CI 0·92 to 1·40; p=0·22). There was a higher incidence of 

 symptoms of gastrointestinal intolerance in patients in the high protein group (odds ratio 1·76, 95% CI 1·06 to 2·92; p=0·030). 

 Incidence of other adverse events did not differ between groups. 

 INTERPRETATION: High enteral protein provision compared with 

 standard enteral protein provision resulted in worse 

 health-related quality of life in critically ill patients and 

 did not improve functional outcomes during 180 days after ICU 

 admission. FUNDING: Netherlands Organisation for Healthcare 

 Research and Development and Belgian Health Care Knowledge 

 Centre.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38653002c,

title = {Analysis of behavioral change techniques used in exercise and nutritional interventions targeting adults around retirement age with sarcopenic obesity in a systematic review},

author = {Paula Collazo-Castiñeira and Macarena Sánchez-Izquierdo and Lea Joanne Reiter and Silvia Bauer and Alfonso J Cruz-Jentoft and Josje D Schoufour and Peter J M Weijs and Doris Eglseer},

doi = {10.1016/j.archger.2024.105437},

issn = {1872-6976},

year  = {2024},

date = {2024-08-01},

journal = {Arch Gerontol Geriatr},

volume = {123},

pages = {105437},

abstract = {BACKGROUND: Sarcopenic obesity significantly burdens health and autonomy. Strategies to intervene in or prevent sarcopenic obesity generally focus on losing body fat and building or maintaining muscle mass and function. For a lifestyle intervention, it is important to consider psychological aspects such as behavioral change techniques (BCTs) to elicit a long-lasting behavioral change.nnPURPOSE: The study was carried out to analyze BCTs used in exercise and nutritional interventions targeting community-dwelling adults around retirement age with sarcopenic obesity.nnMETHODS: We conducted an analysis of articles cited in an existing systematic review on the effectiveness of exercise and nutritional interventions on physiological outcomes in community-dwelling adults around retirement age with sarcopenic obesity. We identified BCTs used in these studies by applying a standardized taxonomy.nnRESULTS: Only nine BCTs were identified. Most BCTs were not used intentionally (82 %), and those used derived from the implementation of lifestyle components, such as exercise classes ("instructions on how to perform a behavior," "demonstration of the behavior," "behavioral practice/rehearsal," and "body changes"). Only two studies used BCTs intentionally to reinforce adherence in their interventions.nnCONCLUSIONS: Few studies integrated BCTs in lifestyle interventions for community-dwelling persons around retirement age with sarcopenic obesity. Future studies on interventions to counteract sarcopenic obesity should include well-established BCTs to foster adherence and, therefore, their effectiveness.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}