Background:Intestinal permeability is an important determinant in intensive care unit patients. Enteral nutrition is vital for nutritional supplementation in critically ill ICU patients. The amount of Enteral nutrition protein and its impact on intestinal barrier permeability and function are challenging issues. Zonulin is a protein that regulates intestinal epithelial cell tight junction permeability and has the potential to be used as a biomarker for assessing the integrity of the intestinal barrier. However, there are few data from studies on intestinal permeability and the effects of enteral feeding of protein on zonulin levels in critically ill patients. This study was conducted to investigate the effect of high-protein enteral nutrition on intestinal permeability in ICU patients. Methods:Participants were selected from 88 adult patients with critical illness aged 18-65 years who were admitted to the ICU of Hazrat Rasoul Akram Hospital in Tehran. In this randomized controlled clinical trial, patients will be allocated randomly into two groups of 44. The intervention group will receive high-protein (HP) enteral nutrition (1.6 g/kg/day), and the control group will receive conventional-protein (CP) enteral nutrition (1.2 g/kg/day) for 10 days. The primary outcome will be the change in serum Zonulin levels during the intervention period. Zonulin will be measured on days 0, 5, and 10. The SOFA, APACHE II, and mNUTRIC scores will also be assessed. Mortality will be calculated at 30 and 60 days after the intervention. The secondary outcomes will be SOFA score and 30- and 60-day mortality. Discussion:Our study aims to present new evidence about the role of protein in enteral nutrition on intestinal permeability in critically ill patients in the ICU. Trial registrations:The clinical trial was registered on December 11, 2024 in the Iranian Registry of Clinical Trials (IRCT) (IRCT20241129063891N1).

Background: Research has shown that disordered eating behaviors-including binge eating, night eating syndrome, and food addiction-contribute to the heterogeneity of obesity and assist in phenotyping patients for more tailored interventions. The Eating Behavior Assessment for Obesity (EBA-O) is a recently developed 18-item questionnaire that assesses five pathological eating-behavior domains among individuals with obesity (night eating, food addiction, sweet eating, hyperphagia, and binge eating). The present study aimed to translate, culturally adapt, and validate the Persian (Farsi) version of the EBA-O. Methods: The original English EBA-O was translated into Persian following a standardized forward-backward translation procedure, with cultural adaptations implemented to ensure linguistic accuracy and conceptual clarity. A cross-sectional sample of 278 Iranian adults with overweight or obesity (body mass index [BMI] ≥ 25 kg/m2) completed the Persian EBA-O. Confirmatory factor analysis (CFA) was conducted to verify the five-factor model in the Persian sample. Internal consistency was evaluated using Cronbach's alpha and composite reliability (CR). Convergent validity was assessed using the average variance extracted (AVE), and discriminant validity was examined with the Heterotrait-Monotrait ratio (HTMT). Model fit indices, including the Comparative Fit Index [CFI], Tucker-Lewis Index [TLI], Normed Fit Index [NFI], Goodness-of-Fit Index [GFI], the Standardized Root Mean Square Residual [SRMR] and relative chi-square value [χ2/df] were used to determine the adequacy of the factor structure. Results: The Persian EBA-O demonstrated a clear and stable five-factor structure consistent with the original instrument. CFA indicated good model fit (CFI = 0.95, TLI = 0.94, NFI = 0.91, GFI = 0.92, SRMR = 0.05, χ2/df = 1.94), confirming the presence of the intended domains. Internal consistency was acceptable to high across all subscales (Cronbach's α = 0.78-0.86; CR > 0.70), and the total scale showed strong reliability. Three of the five factors demonstrated acceptable convergent validity (AVE = 0.54-0.68), while Food Addiction (AVE = 0.46) and Night Eating (AVE = 0.43) fell slightly below the 0.50 threshold; however, their adequate CR and α values indicate that these constructs remain coherent and psychometrically sound. All inter-factor correlations satisfied discriminant validity criteria (HTMT < 0.90), with the highest association observed between the Binge Eating and Hyperphagia factors. Overall, the psychometric properties of the Persian EBA-O were comparable to those reported in the original validation and subsequent translations. Conclusions: The Persian version of the EBA-O is a valid and reliable instrument for assessing pathological eating behaviors among individuals with obesity. It preserves the original questionnaire's five-factor structure and demonstrates acceptable internal consistency and construct validity in a Persian-speaking population. This validated tool will support both clinical assessment and research on eating-behavior phenotypes and may contribute to the development of more personalized and effective obesity-management strategies among Persian-speaking individuals.

Delayed recognition and management of severe obesity and obesity hypoventilation syndrome may result in life-threatening respiratory failure and multi-organ complications requiring prolonged intensive care. In metabolically unstable patients, pre-existing obesity-related malnutrition may worsen despite obesity itself and contribute to increased mortality. Early multidisciplinary intervention is essential to reduce morbidity and healthcare burden.

Controlling appetite during the postprandial phase is proposed to be an effective strategy for preventing and managing obesity, therefore, considering the conflicting results of previous studies, we aimed, in this pilot study, to explore the feasibility of assessing postprandial appetite responses to meals with different macronutrient compositions in both normal-weight and obese men. In this randomized crossover clinical trial, two groups of obese (n = 10) and normal-weight (n = 10) men received each test meal, which included high protein (30

Brain-derived neurotrophic factor (BDNF) is crucial for brain development, neuronal function, and metabolism. This systematic review aims to comprehensively examine the impact of various diets on BDNF levels, addressing gaps in understanding diet’s influence on BDNF’s role in neuroprotection and metabolism. This systematic review was conducted in accordance with PRISMA 2020 guidelines. An extensive search was conducted in PubMed, Web of Science, and Scopus up to April 2024, using terms related to diet and BDNF. Relevant clinical trials involving adults were included. Data extraction covered study design, participant details, and outcomes, with quality assessed using the Cochrane method. Clarifications from authors were sought as needed to ensure comprehensive analysis. This review examined 7633 articles to assess the impact of various diets on BDNF levels, narrowing down to 13 studies. The study found varying effects: intermittent fasting and ketogenic diets generally increased BDNF, while other diets showed minimal or no impact. The review highlights diverse outcomes and the need for further research on dietary effects on BDNF. The review found that fasting and calorie restriction diets generally increase BDNF levels, while other dietary interventions showed inconsistent effects. Further research is needed to better understand these dietary impacts on BDNF and to develop optimized strategies for enhancing cognitive health and managing obesity.

Due to inconsistency in the available evidence regarding the association of adherence to dietary phytochemical index (DPI) and hypertension, this study aimed to assess this relationship by conducting a meta-analysis. A comprehensive search was performed in PubMed, Scopus, Web of Science ISI databases, as well as Google Scholar search engine to find eligible studies, including observational studies investigating the association between the score of phytochemical index and odds of hypertension in adults, and reported this association as relative effect measures, up to March 2025. The odds ratio (OR) with 95

INTRODUCTION:Abnormalities of the coronary arteries, including abnormal origins, are often detected in heart patients who undergo coronary angiography. Although only a small percentage of these abnormalities lead to serious complications, the consequences can be extremely fatal. CASE PRESENTATION:We report the case of a 62-year-old woman who presented with chest pain. The patient has a history of hypertension and complains of chest pain that worsens with walking and improves with rest. A basic electrocardiogram (ECG) showed sinus rhythm with no signs of arrhythmia or ischemic changes. Coronary angiography revealed an anomalous left coronary artery originating from the right sinus of Valsalva (RSoV). CONCLUSIONS:We report a rare case of an anomalous left coronary artery originating from the RSoV without specific clinical symptoms. The patient presented with unstable angina, and after further investigation, this anomaly was diagnosed. Investigating these abnormalities, especially in young individuals with cardiac symptoms, should be prioritized. Cardiologists should also be aware of this rare condition that can have fatal consequences.

Background: Chronic low-grade inflammation is implicated in the development of various metabolic and cardiovascular disorders. Sumac (Rhus coriaria L.) is a medicinal plant with potential anti-inflammatory properties. However, the effects of sumac supplementation on inflammatory biomarkers, particularly high-sensitivity C-reactive protein (hs-CRP), remain controversial. Objectives: This systematic review and meta-analysis aimed to evaluate the effect of sumac supplementation on hs-CRP concentrations in adults. Methods: A systematic search was performed in PubMed, Scopus, Web of Science, and the Cochrane Library databases up to February 2025 to identify RCTs examining the impact of sumac supplementation on hs-CRP concentrations. Screening, data extraction, and risk of bias assessment were conducted independently. A random-effects model was used to calculate the overall effect size as the SMD with 95% CIs. Results: Seven RCTs were eligible for inclusion in this review. The pooled analysis demonstrated a significant reduction in hs-CRP concentrations following sumac supplementation compared with that in the control groups (SMD: −0.33; 95% CI: −0.64, −0.02; P = 0.03). Moreover, a significant heterogeneity was detected among the pooled effect sizes (P = 0.02; I2 = 60.2%). Subgroup analyses revealed that sumac supplementation led to a significant reduction in hs-CRP concentrations in trials that included both genders or in studies conducted on patients with nonalcoholic fatty liver disease, individuals with overweight, or those aged ≥45 y. Conclusions: Sumac supplementation may significantly reduce hs-CRP concentrations in adults. Further high-quality, large-scale trials in various populations in terms of areas or health conditions are required to confirm these findings and determine the optimal dosage and duration for sumac supplementation to reduce inflammation.This trial is registered at PROSPERO database as CRD420251016622.

Objective:This systematic review and meta-analysis aimed to assess the impact of strawberry (Fragaria x ananassa) consumption on systolic (SBP) and diastolic blood pressure (DBP). Materials and Methods:PubMed, Web of Science, Scopus, and Google Scholar were searched to find relevant randomized controlled trials (RCTs). Meta-analysis was carried out by using the random effect model, and the I2 index was used to assess heterogeneity among included trials. Results:Out of the 81 studies obtained, eight were eligible to be included in this review. The pooled effect size of 12 effect sizes indicated that strawberry consumption had no significant effect on SBP (WMD: 0.96 mmHg, 95% CI -0.26 to 2.20, p = 0.12), or DBP levels (WMD: -0.33 mmHg, 95% CI -1.31 to 0.65, p = 0.50). Subgroup analysis showed that consumption of freeze-dried strawberry powder at a dose of ≤ 25 g/day or strawberry intake in people under the age of 50 significantly increased SBP levels. Also, strawberry intake in individuals aged 50 or older led to a significant decrease in DBP levels. Conclusion:This review suggests that strawberry consumption may not be an effective strategy for hypertension management. However, more RCTs are needed to draw a definite conclusion.

This study aimed to investigate the erythrocyte Omega-3 fatty acid index as a potential biomarker for clinical severity, nutritional status, and mortality risk in critically ill patients admitted to the intensive care unit (ICU). Using a case-control design, we evaluated 86 ICU patients with severe clinical conditions, including cardiovascular, respiratory, and oncological complications. Blood samples were analyzed to quantify eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) levels in erythrocyte membranes. Clinical outcomes were assessed at 28 and 60 days to determine correlations with fatty acid profiles. Our findings showed no significant differences in EPA, DHA, or combined Omega-3 index levels between survivors and non-survivors. Additionally, no meaningful correlations were found between Omega-3 indices and clinical severity scores (APACHE II, SOFA) or nutritional assessments. These results suggest that erythrocyte Omega-3 fatty acid levels may not be reliable prognostic markers of mortality or clinical trajectory in critically ill ICU patients. Although Omega-3 fatty acids play a role in inflammatory modulation, their membrane concentrations do not appear to reflect patient outcomes in this setting. Further research is warranted to explore alternative biomarkers or to incorporate broader inflammatory indices in critical care prognostication.

Animal proteins (APs) and plant proteins (PPs) seem to exhibit different thermic and metabolic effects, which may be attributed to differences in amino acid profiles, bioavailability, and digestibility. In this study, we aimed to investigate and compare the postprandial effects of AP and PP meals on energy metabolism parameters, including resting energy expenditure (REE) and substrate oxidation (SO), in overweight and obese men. This acute randomized crossover clinical trial involved forty-eight overweight and obese men, with a mean age of 33.48 ± 8.35 years and an average BMI of 29.15 ± 2.33 kg/m2. Participants consumed two high-protein test meals with different protein sources (AP and PP) on separate days, with a washout period of 7 to 10 days between them. On each test day, energy metabolism parameters were measured in both the fasting state and postprandial phase using indirect calorimetry. Statistical analysis was conducted using SPSS version 25 and R programs, evaluating the effects of carry-over, treatment, time, and treatment × time interaction through generalized estimating equations (GEE) analysis. After controlling for baseline values, there was a significant effect of time (P < 0.05), protein source (P < 0.05), and protein source × time (P < 0.05) on REE, TEF, and carbohydrate oxidation. REE showed an increase following the consumption of both meals; however, the rise observed after AP (14.2

BACKGROUND:The two-step Global Leadership Initiative on Malnutrition (GLIM) approach was recently introduced to malnutrition diagnosis in a hospital setting. This study compares the diagnostic performance of this approach that uses the Nutritional Risk Screening-2002 (NRS-2002) as a screening tool and the direct application of GLIM malnutrition diagnostic criteria in hospitalized patients. METHODS:This cross-sectional study involved 290 adult and older adult patients who were hospitalized. A trained nutritionist implemented the two-step GLIM approach, including NRS-2002 (in the first step) and GLIM criteria (in the second step) for each patient. Then, the accuracy, kappa index, area under the receiver operating characteristic curve (AUC ROC), sensitivity, and specificity of malnutrition diagnostic performance of the two-step GLIM approach and NRS-2002 were evaluated compared to the direct use of GLIM criteria. RESULTS:The NRS-2002 identified 145 (50.0%) patients as at risk of malnutrition. The prevalence of malnutrition using the two-step GLIM approach and GLIM malnutrition diagnosis criteria were 120 (41.4%) and 141 (48.6%), respectively. The kappa index showed substantial and almost perfect agreement for NRS-2002 (κ = 68%) and the two-step GLIM approach (κ = 85%) with GLIM malnutrition diagnostic criteria, respectively. Furthermore, the AUC ROC (0.926; 95% confidence interval (CI): 0.89-0.96) and accuracy (92.8%) of the two-step GLIM approach compared to the GLIM criteria indicated an acepptable ability to distinguish between malnourished and well-nourished patients. CONCLUSION:The two-step GLIM approach using NRS-2002 as a screening tool (in step one) had acceptable malnutrition diagnostic performance compared to the direct application of GLIM criteria in hospitalized patients.

Background and aim The Global Leadership Initiative on Malnutrition (GLIM) recently proposed a new malnutrition diagnostic tool known as the GLIM criteria. The GLIM criteria need confirmed validation before being widely used in each population or healthcare system. This study aimed to investigate the validation of the GLIM criteria for malnutrition diagnosis in hospitalized patients. Methods The content validity was assessed by calculating the content validity ratio (CVR) and content validity index (CVI). Subjective global assessment (SGA) is considered the reference tool to diagnose malnutrition in concurrent validation. In addition, the Kuder-Richardson 20 was used to evaluate the reliability of the GLIM criteria. Furthermore, hospital mortality, length of hospitalization (LOS), prolonged hospital stays (LOS >6 days), 30-day hospital readmission, and 30- and 60-day mortality were identified as malnutrition-related outcomes in predictive validity. Results A total of 332 adult/elderly hospitalized patients (median age: 58 (IQR: 24.7), 60.5% men) were enrolled to present the study. Appling GLIM criteria by considering the calf circumference < 31 cm in both genders or mid-upper arm (MUAC) < 23 cm in men and MUAC <22 cm in women as reduced muscle mass had an appropriate accuracy (84.6 and 83.4%, respectively), good ability to distinguish malnourished patients (AUC ROC: 0.85 and 0.83, respectively), satisfactory sensitivity (89.58 and 84.02%, respectively), and satisfactory specificity (81 and 83%, respectively) compared to the SGA tool. Furthermore, the reliability of the GLIM criteria for malnutrition diagnosis in hospitalized patients was acceptable in all 3 applied approaches (KR-20 > 0.5). The malnutrition diagnosed by GLIM criteria could significantly predict the odds of prolonged hospital stays, 30-day hospital readmission, and 60-day mortality, while it had no significant association with the risk of hospital mortality. Conclusion The current study revealed that applying GLIM criteria had satisfactory validity in diagnosing hospital malnutrition in non-critically ill hospitalized patients.

Background:The macronutrient composition of daily meals plays a crucial role in influencing the body's metabolic responses during the postprandial phase. However, existing research on the effects of macronutrients, particularly fats and carbohydrates, has produced inconsistent findings. Objectives:This study aims to evaluate the postprandial effects of two high-protein meals-one low in fat and high in carbohydrates (HP-LF-HC) and the other high in fat and low in carbohydrates (HP-HF-LC)-on energy metabolism, appetite response, and blood markers in overweight and obese men and women without underlying health conditions. Methods:This study was conducted as an acute randomized crossover clinical trial at the Health Monitoring Center of Mashhad University of Medical Sciences (MUMS) within Imam Reza Hospital, Mashhad, Iran. A total of 30 overweight and obese men and women, meeting the eligibility criteria and free of underlying diseases, were recruited through a public call. Participants were randomly assigned to receive both intervention meals, with a washout period of at least one week between each trial. Results:The primary outcomes focused on the acute effects of the two dietary interventions on energy metabolism, particularly resting metabolic rate (RMR), and appetite response. Secondary outcomes included changes in lipid profiles, insulin, blood glucose levels, thyroid hormones, and epinephrine. Conclusions:This study aims to identify which macronutrient composition most effectively enhances resting energy expenditure. The findings could provide valuable insights for dietitians in developing more efficient dietary plans, helping overweight and obese individuals maintain an ideal weight or achieve weight loss by modifying food composition without altering meal volume.

Spontaneous Coronary Artery Dissection (SCAD) is an acute coronary event of uncertain origin. SCAD occurs when the coronary artery wall dissects non-traumatically and non-atherosclerotically, leading to the formation of an intramural hematoma or intimal tear, ultimately compressing and restricting the true lumen, or even occluding it. The management of SCAD remains controversial despite modern imaging techniques. In addition to supportive drug therapy, percutaneous coronary intervention (PCI) is another option that can be used as an effective treatment modality. We describe A 50-year-old male with SCAD presented to the hospital emergency department complaining of chest pain. Coronary angiography incidentally showed spiral dissection from the proximal to distal right coronary artery (RCA). Three overlapping coroflex stents were deployed from the distal to the proximal RCA. To stabilize the coronary artery in Acute Coronary Syndrome (ACS) patients due to SCAD, prompt interventions such as stenting and angioplasty are needed. However, it is necessary to pay attention to the clinical condition of patients and quick diagnosis for the recovery of patients and reduction of complications.

AbstractBackground and AimsAlternative therapies, such as zinc supplementation, have been explored as potential interventions for sleep disorders. However, the efficacy of zinc supplementation in improving sleep quality remains uncertain. This systematic review aims to examine the impacts of zinc supplementation on sleep quality in humans.MethodsThe Web of Science, Medline, Scopus, and Google Scholar databases were comprehensively searched to find studies investigating the effect of zinc supplementation on sleep quality. After identifying relevant studies by screening, relevant data were extracted from them. The quality assessment was conducted using the Cochrane quality assessment tool.ResultsThis systematic review included eight studies. The interventions ranged from 4 to 48 weeks, with a daily dose of zinc supplementation varying between 10 and 73.3 mg. The majority of the evidence examined in this review pointed to the significant improvement effect of zinc supplementation on sleep quality in adults compared to the control groups. Furthermore, zinc supplementation did not have a significant effect on sleep disorders. However, there was no consensus about these findings. Also, the effect of supplementation on sleep duration in nonadults was contradictory.ConclusionsThis systematic review suggests that zinc supplementation may lead to improvements in sleep quality. However, more research, primarily clinical trials, is needed to clarify the beneficial effects of zinc supplementation on sleep quality with consideration of dietary zinc intake and the Recommended Dietary Allowances of zinc (RDA) in the different populations. It is also recommended to investigate the effect of zinc supplementation on sleep quality in people with zinc deficiency in future studies.

BackgroundTraumatic brain injury (TBI) is the most common cause of cognitive and behavioral deficits, disability, and mortality worldwide. Trehalose is a natural non-reducing disaccharide of glucose which its anti-inflammatory and anti-oxidative stress effects have been proven in past in vivo and in vitro studies. This study aims to evaluate the effect of oral trehalose on inflammatory biomarkers, oxidative stress indices and clinical outcomes in hospitalized traumatic brain injury patients.MethodsTwenty participants with traumatic brain injury were randomly assigned to the intervention or control group in order to evaluate the effect of oral trehalose (30g instead as a part of the daily carbohydrate of enteral feeding) or placebo groups (standard isocaloric hospital enteral feeding) using 12-day parallel study. Inflammatory and oxidative stress biomarkers such as interleukin-6 (IL-6), C-reactive protein (CRP), pro-oxidant-antioxidant balance (PAB), superoxide dismutase (SOD), glutathione (GSH), and malondialdehyde (MDA), clinical outcomes, including APACHE II, SOFA scores, NUTRIC score, GCS, ICU discharge time, mechanical ventilator duration, 28-day and 60-day mortality rate were measured at the beginning and end of the study.ResultsThe trehalose intake could significantly improve CRP (mean change: −30±25mg/l, P˂0.001) and NUTRIC score (mean change: 0(−2,0), P=0.04). In addition, a marginally significant decrease in APACHE II score (mean change: −3±5, P=0.07) and 28-day mortality (0 vs. 30%; P=0.06, {NNT}=3) was observed. Moreover, among anthropometric indicators, only a marginally decrease in MAC (mean change: −0.5(−1,0) was shown. No considerable effect was observed on other biomarkers, anthropometric indices and clinical outcomes in the intervention group as well as the control group.ConclusionThis trial provided some evidences that trehalose administration improved CRP and marginally improved some clinical outcomes, such as NUTRIC score and 28-day mortality in TBI patients in ICU.

Aim: The research is a prospective cohort study focusing on assessing intestinal permeability in critically ill individuals. The primary aim of the study is to investigate the impact of intestinal permeability on disease severity and the 28-day and 60-day mortality rates among critically ill patients. Introduction: Preserving the integrity of the gastrointestinal (GI) tract is essential for maintaining intestinal barrier function, as its compromise can result in the translocation of detrimental substances, such as bacteria. Critically ill patients are particularly vulnerable to changes in intestinal permeability (IP), which can elevate the chances of developing severe conditions like sepsis, multiple organ dysfunction syndrome (MODS), and systemic inflammatory response syndrome (SIRS), ultimately leading to mortality. Method: The research will involve 73 ICU patients needing enteral feeding for a minimum of one day, who will undergo screening based on specific criteria for inclusion and exclusion. Small-bowel permeability will be assessed using the dual-sugar absorption method (lactulose and mannitol), a prevalent noninvasive technique in critically ill individuals, to determine their small-bowel permeability accurately. Conclusion: Consequently, addressing altered intestinal permeability becomes a critical focus for therapeutic interventions and a pivotal factor influencing the outcomes of patients in the intensive care unit (ICU). Its straightforwardness, consistency, and reliability of this measuring make it ideal for routine clinical applications, enabling the quantification of intestinal permeability with ease and accuracy.

Background and Objectives: Failure to thrive (FTT) is a common developmental disorder in infants. Although the improvement effect of zinc supplementation in these patients was reported in some past studies, the results were conflicting. Accordingly, this study investigates the effect of zinc supplementation on factors related to growth in infants with FTT by conducting a meta-analysis. Methods: Medline, Web of Science, and Scopus databases were comprehensively searched to find randomized controlled trials investigating the effect of zinc on growth-related factors in infants with FTT. Eligible studies were extracted after screening their relevant information. The pooled effect size was estimated as a weighted mean difference with a 95% confidence interval (CI) using the random effect model method. Results: Out of 85 reviewed papers, 4 studies were eligible to enter this review. The present meta-analysis revealed that zinc supplementation in infants with FTT led to a significant increase in weight (weighted mean difference (MD)=-0.25 kg; 95% CI, 0.02%-0.49%), weight-for-age Z-score (weighted MD=0.16; 95% CI, 0.03%, 0.28%), and height-for-age Z-score (weighted MD=0.15, 95% CI, 0.001%, 0.30%), compared to control groups. In contrast, zinc supplementation had no significant effect on height and insulin-like growth factor 1 serum level. Conclusions: The findings of the current meta-analysis indicated the effectiveness of zinc supplementation in improving the developmental status of infants with FTT; however, due to the small number of included trials, it was impossible to draw definitive conclusions, and conducting randomized controlled trials with larger sample size and higher sensitivity is needed.

Abstract In traumatic brain injury (TBI) patients, a complex cascade of inflammatory responses are frequently observed following trauma. Numerous dietary agents have long been found to have potential in modulating inflammatory responses. This pilot study, designed an enteral formula with low inflammatory properties based on the dietary inflammatory index (DII®) and evaluated its effect on inflammatory and metabolic factors in critically ill TBI patients. This single‐blind randomized controlled pilot study was conducted at the Neurosurgical ICU of Shahid Kamyab Hospital (Mashhad, Iran). A total of 20 TBI patients were randomly assigned to receive either low‐DII score or standard formula at the intensive care unit (ICU). The primary outcomes of the study included clinical status, inflammatory biomarkers, APACHE II, SAPS II, SOFA, and NUTRIC scores. The trial groups did not differ significantly in baseline values. Following 14 days of intervention, there was a statistically significant decrease in the APACHE II, SAPS II, and NUTRIC scores and a significant increase in the GCS score in the low‐DII score formula group compared to the standard formula group. Over 2 weeks, high sensitivity C‐reactive protein (hs‐CRP) values of −2.73 (95% CI: −3.67, −1.79) mg/dL in the low‐DII score formula group versus 0.65 (95% CI: −0.29, 1.58) mg/dL in controls were obtained. Moreover, the length of hospital stay was longer for the standard formula group than for the low‐DII score formula group. The low‐DII score formula improves inflammatory factors (serum hs‐CRP) and metabolic biomarkers (LDL‐c and FBS). Furthermore, clinical outcomes, including the length of hospital stay and disease severity, appear to be enhanced.