Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 4 appraisals
Current opinion in critical care
Smart feeding: the role of artificial intelligence and integrated nutrition platforms in the ICU
PURPOSE OF REVIEW: Tremendous improvement in the use of artificial intelligence has opened new opportunities to analyze the data obtained from electronic health records and imaging. New technologies have tried to overcome obstacles to implement guidelines and recommendations. This review aims to describe the recent progress in the use of machine learning and new technologies in the field of nutrition of the critically ill. RECENT FINDINGS: Increase in data availability, ability to extract these data and analyze them using machine learning has allowed data scientists together with ICU specialists to improve nutritional screening and assessment and to predict occurrence of obstacles like enteral feeding intolerance or refeeding hypophosphatemia. In addition, new technologies can ensure nasogastric tube positioning and enteral feeding efficacy. Integrated platforms can integrate nutritional needs with most adequate prescriptions and modulate the nutritional administration according to the patient's tolerance and requirements. Analysis of continuous recording of imaging obtained from ultrasound can also predict gastric intolerance. SUMMARY: Using machine learning, numerous algorithms and nomograms have been suggested to predict enteral feeding intolerance but validation of these predictions is still required. New technologies integrating energy requirements and delivery of the optimal enteral feeding are very promising.
2 Aug 2026
Read appraisal →Journal of food science
Artificial Intelligence in Food-Nutrition-Health Research: From Multimodal Data Integration to Precision Intervention
Artificial intelligence (AI) is transforming food-nutrition-health research by enabling pattern recognition in complex, high-dimensional datasets that traditional hypothesis-driven approaches cannot address. This review systematically synthesizes research progress of AI across the food-nutrition-health continuum from 2020 to 2025. By examining 181 systematic reviews through PRISMA-guided selection, we provide a comprehensive overview and prospects across four dimensions: technical foundation, application scenarios, existing challenges, and future prospects. We propose a tripartite framework comprising (1) a data layer enabling multisource fusion of food composition, health monitoring, and individual characteristic data; (2) a technological layer of nondestructive testing (spectroscopy, nuclear magnetic resonance [NMR], imaging); and (3) an algorithmic layer progressing from machine learning to deep learning architecture. Key applications include food component analysis and safety detection; nutrition-disease association modeling; pathogen identification; and personalized dietary intervention systems. Despite rapid progress, critical challenges persist, insufficient model generalization across populations, algorithmic opacity limiting clinical trust, data privacy vulnerabilities, and lack of standardized multi-omics integration protocols. Future directions emphasize multimodal fusion models, explainable artificial intelligence (XAI), federated learning for privacy-preserving collaboration, gene-guided precision nutrition, and development of intelligent wearable devices and functional food. This review provides a roadmap for transitioning from population-averaged guidelines to dynamic, individualized health optimization through AI-enabled food system.
1 Aug 2026
Read appraisal →Nutricion hospitalaria
Immunonutrition in surgical patients with colorectal cancer: a systematic review
Introduction: surgery in patients with colorectal cancer often leads to complications, affecting recovery, prolonging hospital stay, and impacting quality of life. Immunonutrition plays an important role by modulating the immune system and may contribute to the reduction of these complications. Objective: to assess the effect of immunonutrient supplementation on complications in surgical patients with colorectal cancer. Materials and methods: a literature search was conducted in PubMed, Web of Science, Embase, and Cochrane, following the PRISMA model. A total of 20 clinical trials and two observational studies published between 2000 and 2025 were selected, analyzing postoperative complications, physical or nutritional status, immune response, and length of hospital stay. Results: a reduction in postoperative complications was observed with combined immunonutrient supplementation (arginine, omega-3 fatty acids, nucleotides, L-alanine, and L-glutamine), particularly in wound infections. No benefits were found with isolated supplementation. Conclusion: combined immunonutrient administration may improve postoperative complications, especially wound infections, although results regarding hospital stay are inconsistent. Isolated supplementation with omega-3 fatty acids shows no benefit. Introducción: la cirugía en pacientes con cáncer colorrectal conlleva complicaciones, alterando la recuperación, alargando la estancia hospitalaria y afectando a la calidad de vida. La inmunonutrición ejerce una acción importante al modular el sistema inmunológico y podría mejorar estas complicaciones. Objetivo: evaluar el efecto de la suplementación con inmunonutrientes en las complicaciones en pacientes quirúrgicos por cáncer colorrectal. Material y métodos: se realizó una búsqueda bibliográfica en PubMed, Web of Science, Embase y Cochrane, siguiendo el modelo PRISMA. Se seleccionaron 20 ensayos clínicos y dos observaciones, publicados entre 2000 y 2025, que analizaron complicaciones posoperatorias, el estado físico o nutricional, la respuesta inmune y la duración de estancia hospitalaria. Resultados: se halló una reducción de las complicaciones posoperatorias con una suplementación combinada de inmunonutrientes como arginina, ácidos grasos omega-3, nucleótidos, L-alanina y L-glutamina, especialmente en infecciones de herida, sin beneficios en la administración aislada. Conclusión: la administración combinada podría mejorar las complicaciones posquirúrgicas, especialmente de la infección de la herida, con resultados contradictorios para estancia hospitalaria. La suplementación aislada de ácidos grasos n-3 no aporta beneficios.
15 July 2026
Read appraisal →Food & function
Apples and apple-based products in the modulation of cardiometabolic and functional markers: a systematic review of human intervention studies.
Apple is one of the most widely consumed fruits worldwide, yet its effects on human health remain the subject of ongoing debate. The aim of the present review was to examine evidence from human intervention studies evaluating the impact of apples and apple-based products on functional and metabolic health markers. A total of 38 studies were included: 13 postprandial interventions, 22 medium- or long-term interventions, and 3 assessing both postprandial and chronic effects. Postprandial studies predominantly investigated the effects of apple consumption on blood glucose levels and plasma antioxidant capacity, whereas medium- or long-term interventions assessed a broader range of biomarkers related to cardiometabolic health, oxidative stress, vascular function, inflammation, and gut function. Overall, the findings suggest that apples and apple-based products may beneficially modulate glycaemia, antioxidant capacity, and vascular endothelial function mainly in short-term interventions, while medium/long-term studies reported an apparent improvement in gut microbiota composition. However, the current evidence remains insufficient to draw definitive conclusions. Additionally, substantial heterogeneity in study design, populations, and products tested limits the ability to generalize results. Nonetheless, apple consumption, consistent with fruit intake in general, represents an important component of a healthy and balanced diet, providing valuable nutrients and bioactive compounds whose intake should be encouraged. Therefore, further well-designed intervention studies, particularly in populations with cardiometabolic risk factors, are warranted to better clarify the role of apples and apple-derived products in human health. Future research should also aim to identify the effective amounts and specific bioactive components responsible for the observed effects, as well as to determine whether these benefits may vary according to the health status of the target population.
6 July 2026
Read appraisal →