Extra virgin olive oil (EVOO) is a cornerstone of the Mediterranean diet (MedD). In this narrative review, we synthesize and illustrate the various characteristics and clinical applications of EVOO and its components—such as oleic acid, hydroxytyrosol, and oleuropein—in the field of clinical nutrition and dietetics. The evidence is split into diet therapy, oleic acid-based enteral nutrition formulations and oral supplementation formulations, oleic acid-based parenteral nutrition, and nutraceutical supplementation of minor components of EVOO. EVOO has diverse beneficial health properties, and current evidence supports the use of whole EVOO in diet therapy and the supplementation of its minor components to improve cardiovascular health, lipoprotein metabolism, and diabetes mellitus in clinical nutrition. Nevertheless, more intervention studies in humans are needed to chisel specific recommendations for its therapeutic use through different formulations in other specific diseases and clinical populations.

Background: Reduced muscle strength (dynapenia) and mass (atrophy) are prognostic factors in oncology. Measuring maximal handgrip strength with dynamometers is feasible but limited by the cost of the reference device (JAMAR). Methods: A cross-sectional study was conducted on colorectal cancer outpatients treated with chemotherapy or under active surveillance in our center from September 2022 to July 2023. Accuracy, reliability, and concordance were compared for two handheld dynamometers: the JAMAR Plus (the gold-standard device) and the Camry EH101 (a low-cost index device). A simultaneous nutritional diagnosis with GLIM criteria and bioelectrical impedance analysis (BIA) was carried out. Results: A total of 134 participants were included. The median of maximal strength for the JAMAR Plus had a non-significant difference of 1.4 kg from the Camry EH101. The accuracy and reliability of the devices were high. Bland–Altman analysis showed a 0.8 kg bias and −4.1 to 5.6 kg limits of agreement (LoA); a 0.1 kg bias and −5.3 to 5.4 kg LoA in men; a 1.5 kg bias and −2.2 to 5.3 kg LoA in women. In total, 29.85% of the participants were malnourished. Prevalence of dynapenia increased from 3.67% with the JAMAR Plus to 5.14% with the Camry EH101. Both devices had a moderate and significant correlation with BIA-estimated muscle mass. Conclusions: The Camry EH101 was a cost-effective alternative to JAMAR Plus in our sample.

Introduction: Acromegaly is an uncommon disease with important comorbidity and economic cost. Although the pharmacological cost of second-line treatment for refractory acromegaly has been theoretically analyzed, real-life studies are needed.Objectives: To assess the use of pasireotide and pegvisomant in a third-level center under routine clinical practice.Methods: Acromegaly patients that had been treated with pasireotide and/or pegvisomant were included in (A) a cross-sectional study (two years after starting these drugs) to analyze the cost of acromegaly, hormone replacement, and type 2 diabetes mellitus (T2DM) treatments, and the cost of surgery and radiotherapy; and (B) a retrospective cohorts study (May 2006—October 2024) to analyze efficacy, safety (adverse events, fasting glucose, glycated hemoglobin, and T2DM diagnosis), and dose evolution. Descriptive statistics were 10% trimmed means and standard deviation. Two-tailed hypothesis testing with Yuen’s t and Fisher’s test had a P < 0.05 significance.Results: 25 participants were included in the transversal study and 31 participants in the longitudinal study. A typical patient with a poorly granulated GH-producing adenoma underwent in-center surgery once and received radiotherapy. In the transversal study, total pharmacological cost was 34,139.29 (13,472.09) €/person/year, with 33,874.88 (13,468.36) €/person/year for second-line acromegaly drugs. Pasireotide displayed 9,423.26 €/person/year worth of savings (P = .12), reaching 30,415.98 €/person/year at high dose (P < 0.001). In the longitudinal study, pasireotide dose was reduced (P = .06) regardless of treatment modality. Pasireotide affected carbohydrate metabolism (P = .001), but the effect was generally mild.Conclusions: Pasireotide was found to be a more cost-effective option in patients with first-line treatment failure.

Hip fracture due to fragility (HFF) has a high mortality rate and leads to a decline in quality of life due to advanced age and compromised nutritional status, among others. The aim of this study was to evaluate the impact of early nutritional intervention (hyperproteic and hypercaloric oral nutritional supplement; HP/HC-ONS) on the nutritional and functional recovery of older patients with HFF. Double-blind, placebo-controlled clinical trial in patients >65 years old with scheduled HFF surgery (≤72 h). Patients were randomly assigned to HP/HC-ONS or placebo group (two doses/day) for 4 months. Nutritional diagnosis was based on Mini Nutritional Assessment (MNA), and "morphofunctional assessment": a combination of body composition techniques, such as bioelectrical impedance analysis (BIA) with phase angle (PhA), and nutritional ultrasound (US) with rectus femoris cross-sectional area (RF-CSA) and circumference; and muscle function measured using handgrip strength (HGS). Primary statistical analysis endpoints were changes between baseline and 4-month PhA and HGS. Laboratory parameters (C reactive protein and prealbumin, amongst others), dependency (Barthel index), and disease burden (Charlson Comorbidity Index, CCI) were registered. All measurements took place at baseline, 2-month (except for BIA), and 4-month on-site visits. Hospital length of stay (LoS) was extracted from health records. Adverse events (AEs) were reported, and product tolerability was assessed by stool frequency and the Bristol Stool Form Scale (BSFS). 85 patients were included (HP/HC-ONS, n = 45; placebo, n = 40); 75.9% women. Final PhA displayed a significant interaction between treatment group and baseline PhA (ANCOVA, p = 0.002): the HP/HC-ONS group developed a significantly higher 4-month PhA if basal PhA was >4°. Significantly higher increases of RF-CSA and circumference were observed in the HP/HC-ONS group. HGS and MNA improved, yet without significant differences between groups. No statistically significant differences between groups were noted in LoS, BSFS, Barthel Index, CCI, and laboratory parameters at 4-month. AEs reported at 4-month: placebo, 14 (70%) and HP/HC-ONS, 6 (30%); with 3 serious AEs related with the product (HP/HC ONS, 2 [diarrhea], and placebo, 1 [vomits]). In older adults recovering from HFF, an early 4-month HP/HC-ONS intervention was well tolerated, safe, and demonstrated a beneficial impact on body composition outcomes.

Background: Muscle quality and mass in cancer patients have prognostic and diagnostic importance. Objectives: The objectives are to analyze agreement between gold-standard and bedside techniques for morphofunctional assessment. Methods: This cross-sectional study included 156 consecutive colorectal cancer outpatients that underwent computed tomography (CT) scanning at lumbar level 3 (L3), whole-body bioelectrical impedance analysis (BIA), point-of-care nutritional ultrasound^® (US), anthropometry, and handgrip strength in the same day. Measured muscle biomarkers were stratified by sex, age, BMI-defined obesity, and malnutrition using Global Leadership in Malnutrition (GLIM) criteria. Whole-body estimations for muscle mass (MM) and fat-free mass were calculated using two different equations in CT (i.e., Shen, and Mourtzakis) and four different equations for BIA (i.e., Janssen, Talluri, Kanellakis, and Kotler). Muscle cross-sectional area at L3 was estimated using the USVALID equation in US. Different cut-off points for muscle atrophy and myosteatosis were applied. Sarcopenia was defined as muscle atrophy plus dynapenia. Intra-technique and inter-technique agreement were analyzed with Pearson, Lin (ρ), and Cohen (k) coefficients, Bland–Altman analyses, and hypothesis tests for measures of central tendency. Results: Intra-technique agreements on muscular atrophy (CT k = 0.134, BIA k = −0.037, US k = 0.127) and myosteatosis (CT k = 0.122) were low, but intra-technique agreement on sarcopenia in CT was fair (k = 0.394). Inter-technique agreement on muscular atrophy and sarcopenia were low. Neither CT and BIA (ρ = 0.468 to 0.772 depending on equation), nor CT and US (ρ = 0.642), were interchangeable. Amongst the BIA equations, MM by Janssen proved the best, with a 1.5 (3.6) kg bias, (−5.6, 8.6) kg LoA, and 9/156 (5.7%) measurements outside the LoA. Muscle biomarkers in all techniques were worse in aged, female, or malnourished participants. Obesity was associated with higher muscle mass or surface biomarkers in all techniques. Conclusions: Bedside techniques adequately detected patterns in skeletal muscle biomarkers, but lacked agreement with a reference technique in the study sample using the current methodology.

Background: Body composition assessment using computed tomography (CT) scans may be hampered by software costs. To facilitate its implementation in resource-limited settings, two open-source segmentation programs (Horos and CoreSlicer) were transversally validated in colorectal cancer patients. Methods: Contrast-enhanced abdominal CT scans were analyzed following the Alberta protocol. The Cross-Sectional Area (CSA) and intensities of skeletal muscle tissue (MT), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and intramuscular adipose tissue (IMAT) were measured. The Skeletal Muscle Index (SMI) was calculated. Cutoff points were applied to the SMI, MT intensity, and VAT CSA to define muscle atrophy, myosteatosis, and abdominal obesity. The inter-software agreement was evaluated using different statistical tools. Results: A total of 68 participants were measured. The MT CSA and SMI displayed no differences. The MT CSA agreement was excellent, and both programs provided equal muscle atrophy prevalences. CoreSlicer underestimated the MT intensity, with a non-significant myosteatosis prevalence increase (+5.88% and +8.82%) using two different operative definitions. CoreSlicer overestimated the CSA and intensity in both VAT and SAT, with a non-significant increase (+2.94%) in the abdominal obesity prevalence. Conclusions: Both software programs were feasible tools in the study group. The MT CSA showed great inter-software agreement and no muscle atrophy misdiagnosis. Segmentation differences in the MT intensity and VAT CSA caused limited diagnostic misclassification in the study sample.