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Cited by 65Clinical Nutrition and GastroenterologyNutrition and Health in AgingNutritional Studies and Diet

Inflammation and response to nutrition interventions

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Wunderle, Carla, Stumpf, Franziska, Schuetz, Philipp·2024·Journal of Parenteral and Enteral Nutrition
DOI 10.1002/jpen.2534
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Abstract

The complex interplay between nutrition and inflammation has become a major focus of research in recent years across different clinical settings and patient populations. Inflammation has been identified as a key driver for disease‐related malnutrition promoting anorexia, reduced food intake, muscle loss, and on a cellular level, insulin resistance, which together stimulate catabolism. However, these effects may well be bidirectional, and there is strong evidence showing that nutrition influences inflammation. Several single nutrients and dietary patterns with either proinflammatory or anti‐inflammatory properties have been studied, such as the long‐chain ω‐3 fatty acids eicosapentaenoic acid or docosahexaenoic acid. The Mediterranean diet combines several such nutrients and has been shown to improve medical outcomes in the outpatient setting. In addition, there is increasing evidence suggesting that inflammation affects the metabolism and modulates the response to nutrition support interventions. In fact, recent studies from the medical inpatient setting suggest that inflammation, mirrored by high levels of C‐reactive protein, diminishes the positive effects of nutrition support. This may explain the lack of positive effects of some nutrition trials in severely ill patients, whereas similar approaches to nutritional support have shown positive results in less severely ill patients. The use of biomarkers, such as C‐reactive protein, may help to identify patients with a lower response to nutrition, in whom other treatment options need to be used. There is need for additional research to understand how to best address the malnourished patient with inflammation by specifically lowering inflammation through anti‐inflammatory medical treatments and/or nutrition interventions.

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  • C-reactive protein is used in combination with albumin and prealbumin to assess chronic inflammation and its impact on nutritional status.

    “C-Reactive Protein (<0.3 mg/dL) Used in combination with albumin and prealbumin to assess chronic inflammation and its impact on nutritional status.”

    From The Seven Methods for the Evaluation of Nutritional Status—ABCDEFG: Narrative Review (2026) · cites this paper as [21]

    In “Personalized Nutrition and the Use of Biomarkers” (page not provided), the paper describes CRP as a marker of acute inflammation and discusses albumin and prealbumin as nutritional biomarkers. It does not describe using the three together to assess chronic inflammation; it says high CRP values are difficult to distinguish as reflecting acute or chronic inflammation. The stated <0.3 mg/dL threshold is also not supported by these passages. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Current research supports the integration of inflammatory and protein markers such as CRP, albumin, and prealbumin to improve sensitivity in detecting protein-energy malnutrition and systemic inflammation.

    “Current research supports the integration of inflammatory and protein markerssuch as CRP, albumin, and prealbumin-to improve sensitivity in detecting protein-energy malnutrition and systemic inflammation [21,152].”

    From The Seven Methods for the Evaluation of Nutritional Status—ABCDEFG: Narrative Review (2026) · cites this paper as [21]

    The 'Personalized Nutrition and the Use of Biomarkers' section identifies CRP as a marker of acute inflammation and discusses albumin and prealbumin as markers associated with nutritional status. It does not report that combining these three markers improves sensitivity for detecting protein-energy malnutrition and systemic inflammation; instead, it emphasizes their limitations and the need for further validation. Page numbers were not provided in our copy. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

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Cited by

Sorted by citations

Authors
Wunderle, C., Stumpf, F., & Schuetz, P.
Affiliations
  • Kantonsspital Aarau (CH)
  • University of Hohenheim (DE)
  • Medical University Department, Division of General Internal and Emergency Medicine Cantonal Hospital Aarau Aarau Switzerland
ORCID
Venue
Journal of Parenteral and Enteral Nutrition
Publisher
Wiley
Published
2024-01
Volume
48
Issue
1
Pages
27-36
ISSN
  • 0148-6071 (ISSN-L)
  • 1941-2444
DOI
10.1002/jpen.2534
OpenAlex
W4390706190
Cited by
65
References
10
Citations by year
2026: 24 · 2025: 29 · 2024: 12
FWCI
3.82
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Parenteral and Enteral Nutrition (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Funders
Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (SNSF Professorship, PP00P3_150531)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Keywords
inflammation, nutritional support, disease-related malnutrition, C-reactive protein, omega-3 fatty acids, eicosapentaenoic acid, docosahexaenoic acid, Mediterranean diet, insulin resistance, muscle mass loss, anorexia, inpatient nutrition, critically ill patients
MeSH terms
Anti-Inflammatory Agents, C-Reactive Protein, Humans, Inflammation, Inpatients, Nutritional Status, Malnutrition

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