← Issue №10/ week of Sep 6, 2026/ the whole section, in full

Nutrition, in full.

All 2 Nutrition papers in this issue, as full cards, ranked by clinical utility. The issue page carries the strongest few; this is the section, whole.

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most clinically useful first · the 1 the issue led with is ruled in green
Nutrition rct · n=163 · Sep 3, 2026 · Clin Gastro Hep · IF 16.2

STARS Phase 3 Trial: Once-Weekly Apraglutide Reduces Parenteral Support in Short Bowel Syndrome-Intestinal Failure.

New therapyshort bowel syndromeparenteral nutritionenteral nutrition
Clinical takeawayConsider once-weekly subcutaneous apraglutide for SBS-IF patients, particularly those with stoma anatomy, to reduce PS dependence, noting its favorable safety profile.
What it foundApraglutide significantly reduced weekly PS volume by 25.5% vs 12.5% with placebo at 24 weeks in SBS-IF patients, with a greater effect in the stoma subgroup (-25.6% vs -7.8%).
ContextConfirms and extends phase 2 findings, showing apraglutide's efficacy in reducing PS requirements in a larger, global phase 3 trial.
Refinessuggested applicable standard· ESPEN (European Society for Clinical Nutrition and Metabolism), "ESPEN guideline on chronic intestinal failure in adults, Update 2023," Clinical Nutrition, 2023

Decision at stakeconsidering GLP-2 analogs to reduce parenteral support in SBS-IF

In carefully selected PN-dependent patients, and only when prescribed by clinicians experienced in SBS/IF management (generally once the adaptation phase is complete), consider the GLP-2 analog teduglutide (0.05 mg/kg/day subcutaneously) to promote intestinal adaptation and reduce PN volume, but only after baseline screening to exclude neoplasia and contraindications (colonoscopy with removal of any polyps when colon and/or rectum is present, and assessment for active or recent [within 5 years] gastrointestinal, hepatobiliary, or pancreatic malignancy, which contraindicate its use) and with mandatory ongoing safety monitoring (surveillance colonoscopy after 1-2 years then every 5 years, plus vigilance for colorectal/GI polyps and neoplasia, intestinal obstruction, biliary/gallbladder and pancreatic disease, and fluid overload); add antimotility agents (loperamide, then codeine/opium tincture) for high-output stoma, and provide lifelong nutrient surveillance/supplementation (notably B12) plus monitoring for CRBSI, IFALD, oxalate stones, and refeeding syndrome.

From our summary of this standard, unedited — the part the paper bears on. marks omitted text. Our wording, not the guideline's; read the source for its own text.

Our full summary of this standard

Manage short bowel syndrome / intestinal failure with a multidisciplinary IF team using a three-phase nutrition strategy: initiate TPN with IV hydration and electrolyte replacement in the acute hypersecretory phase, progressively advance enteral feeds and wean PN during the 1-2 year adaptation phase, then maintain an oral diet with selective PN as needed. In carefully selected PN-dependent patients, and only when prescribed by clinicians experienced in SBS/IF management (generally once the adaptation phase is complete), consider the GLP-2 analog teduglutide (0.05 mg/kg/day subcutaneously) to promote intestinal adaptation and reduce PN volume, but only after baseline screening to exclude neoplasia and contraindications (colonoscopy with removal of any polyps when colon and/or rectum is present, and assessment for active or recent [within 5 years] gastrointestinal, hepatobiliary, or pancreatic malignancy, which contraindicate its use) and with mandatory ongoing safety monitoring (surveillance colonoscopy after 1-2 years then every 5 years, plus vigilance for colorectal/GI polyps and neoplasia, intestinal obstruction, biliary/gallbladder and pancreatic disease, and fluid overload); add antimotility agents (loperamide, then codeine/opium tincture) for high-output stoma, and provide lifelong nutrient surveillance/supplementation (notably B12) plus monitoring for CRBSI, IFALD, oxalate stones, and refeeding syndrome.

ESPEN (European Society for Clinical Nutrition and Metabolism), "ESPEN guideline on chronic intestinal failure in adults, Update 2023," Clinical Nutrition, 2023 · reviewed 2026-07-23 ↗
Joly F … STARS Investigators · Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association · IF 16.2 · PubMed ↗Permalink
Nutrition prospective cohort · n=758 · Sep 1, 2026 · Am J Clin Nutrition · IF 6.5

Serum-based biomarker development for dietary macronutrient densities and their association with breast and colorectal cancer risk in a cohort of postmenopausal females.

New evidencebiomarkerepidemiologybasic sciencediet therapy
Clinical takeawayConsider discussing dietary MUFA intake with postmenopausal females, particularly from dairy and meat products, as part of broader CRC risk reduction strategies, though causality is not established.
What it foundDietary MUFA density was associated with a 46% higher CRC risk (HR 1.46, 95% CI 1.10-1.93) in postmenopausal U.S. females.
ContextChallenges reliance on self-reported dietary data by using serum-based biomarkers, aligning with prior evidence linking MUFA intake to CRC risk.
Emergingsuggested applicable standard· U.S. Multi-Society Task Force on Colorectal Cancer (Rex DK, Boland CR, Dominitz JA, et al.), "Colorectal Cancer Screening: Recommendations for Physicians and Patients From the U.S. Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2017

Decision at stakewhether dietary macronutrient composition influences colorectal cancer risk in postmenopausal women

Begin average-risk colorectal cancer screening at age 45 using a patient-centered shared-decision modality choice, colonoscopy every 10 years (preferred) or annual FIT as Tier 1 options, with multi-target stool DNA every 3 years, CT colonography every 5 years, or flexible sigmoidoscopy every 5 to 10 years as Tier 2 alternatives. A positive stool-based test requires diagnostic colonoscopy, and stool tests should not be ordered for patients who would decline follow-up colonoscopy. Generally stop at age 75 with individualized decisions for ages 76-85 and no screening beyond 85.

U.S. Multi-Society Task Force on Colorectal Cancer (Rex DK, Boland CR, Dominitz JA, et al.), "Colorectal Cancer Screening: Recommendations for Physicians and Patients From the U.S. Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2017 · reviewed 2026-07-23 ↗
Prentice RL … Zheng C · American Journal of Clinical Nutrition · IF 6.5 · PubMed ↗Permalink
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