Official Journal of ESPEN, The European Society for Clinical Nutrition and Metabolism

Guide for Authors
Clinical Nutrition & e-SPEN

Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.

Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism.

Being the journal of ESPEN with members from various interests, either focused on basic research or clinical disciplines, the journal reflects the scientific nature of this multidisciplinary background and encourages the coordination of investigation and research from these disciplines. The journal publishes guidelines, consensus statements, review papers, original articles, short communications, and letters to the Editor on those factors in acute and chronic diseases, which have metabolic and nutritional implications. It also publishes scientific works related to the development of new techniques and their application in the field of clinical nutrition.

e-SPEN Journal, the European eJournal of Clinical Nutrition and Metabolism, is the electronic-only companion publication to Clinical Nutrition. e-SPEN Journal will be available to all members of ESPEN and to all subscribers to Clinical Nutrition. Also published bimonthly, e-SPEN Journal will focus on publishing articles, which address the educational aspects of nutritional and metabolic care and the relationship between nutrition and disease in the setting of basic science and clinical practice (educational papers). The journal will also publish the abstracts of the annual ESPEN meeting. Should the Editor in Chief feel that a paper which has been submitted to Clinical Nutrition is more suitable for publication in the e-SPEN Journal, the author will be advised by the Editorial Office and will then have the choice whether to proceed with publishing their paper in the e-SPEN Journal or to withdraw their paper. Manuscript submission directly to the e-SPEN Journal should be clearly indicated in the covering letter.

Manuscript submissions
Authors are requested to submit their original manuscript and figures online, via http://ees.elsevier.com/yclnu/ together with a covering letter which should be signed by the corresponding author on behalf of all authors, and should include:
* A statement that all authors have made substantial contributions to all of the following: (1) the conception and design of the study, or acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, (3) final approval of the version to be submitted. The specific contribution of each author to the work should also be listed in the Acknowledgement section. All contributors who do not meet the criteria for authorship as defined above should also be listed in the Acknowledgements section. Examples of those who might be acknowledged include a person who provided purely technical help, writing assistance, or a department chair who provided only general support. Authors should disclose whether they had any writing assistance and identify the entity that paid for this assistance.
* A statement that the manuscript, including related data, figures and tables has not been previously published and that the manuscript is not under consideration elsewhere.


Role of the funding source All sources of funding should be declared as an acknowledgement at the end of the text. Authors should declare the role of study sponsors, if any, in the study design, in the collection, analysis and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication. If the study sponsors had no such involvement, the authors should so state. Please see http://www.elsevier.com/funding.

Randomised controlled trials All randomised controlled trials submitted for publication in Clinical Nutrition should include a completed Consolidated Standards of Reporting Trials (CONSORT) flow chart. Please refer to the CONSORT statement website at http://www.consort-statement.org for more information. Clinical Nutrition and e-SPEN Journal have adopted the proposal from the International Committee of Medical Journal Editors (ICMJE) which require, as a condition of consideration for publication of clinical trials, registration in a public trials registry. Trials must register at or before the onset of patient enrolment. The clinical trial registration number should be included at the end of the abstract of the article. For this purpose, a clinical trial is defined as any research project that prospectively assigns human subjects to intervention or comparison groups to study the cause-and-effect relationship between a medical intervention and a health outcome. Studies designed for other purposes, such as to study pharmacokinetics or major toxicity (e.g. phase I trials) would be exempt. Further information can be found at www.icmje.org.

Ethics Work on human beings that is submitted to Clinical Nutrition or e-SPEN Journal should comply with the principles laid down in the Declaration of Helsinki; Recommendations guiding physicians in biomedical research involving human subjects. Adopted by the 18th World Medical Assembly, Helsinki, Finland, June 1964, amended by the 29th World Medical Assembly, Tokyo, Japan, October 1975, the 35th World Medical Assembly, Venice, Italy, October 1983, and the 41st World Medical Assembly, Hong Kong, September 1989. The manuscript should contain a statement that the work has been approved by the appropriate ethical committees related to the institution(s) in which it was performed and that subjects gave informed consent to the work. Studies involving experiments with animals must state that their care was in accordance with institution guidelines. Patients' and volunteers' names, initials, and hospital numbers should not be used.

Full instructions for manuscript submission are on http://ees.elsevier.com/yclnu/ - a Guide for Authors and a Guide for Online Submission. Please follow these guidelines. A checklist for submitting manuscripts is available and needs to be completed during manuscript submission. A PDF proof is generated from the uploaded files and this is then used for reviewing. Please note that even though manuscript source files are converted to PDF at submission for the review process, the source files are needed for further processing after acceptance. All correspondence, including notification of the Editor's decision and requests for revisions, will be managed via this system, and authors will also be notified via e-mail, removing the need for a hard-copy paper trail.

If you have any problems submitting your paper through this system, please contact the Editorial Office on: e-mail: espenjournals@espen.org. You may also contact the Author Support Department at Elsevier: authorsupport@elsevier.com.

Manuscript preparation and format
Manuscripts may be submitted from any country and must be written in clear, concise English. Manuscripts should be double-spaced (including references, tables, and figure legends). Pages should be numbered in succession in the upper right-hand corner, beginning in the title page. Lines should be numbered continuously, beginning in the title page. Each section in the manuscript should start on a separate page. When applicable refer to Clinical Nutrition papers from the last 2 years. The number of figures and tables should be in balance with the length of the manuscript, and carefully prepared to avoid duplication of data in the text, tables and figures. Standard abbreviation may be used without definition, while non-standardized abbreviations should be explained in the text (as well as tables and figures) and should be listed on the title page.

Original articles should be organized in the following successive sections: Title Page, Abstract, Introduction, Materials and Methods (including statistical considerations and ethicalstatement), Results, Discussion, Acknowledgements, References, Figure Legends, Tables, Figures. Original manuscripts should not include more than 30 references.

Short communications should be organized in the following successive sections: Title Page, Abstract, main text (maximum 1500 words), Acknowledgements, References, Figure Legends, Tables, Figures. Short communications should not include more than 10 references.

Letters to the Editor are considered for publication provided they do not contain material that has been submitted or published elsewhere. The text, not including references, must not exceed 450 words. The letter must have no more than five references and one figure or small table and should not be signed by more than three authors. When a letter refers to an article recently published in Clinical Nutrition, the opportunity for reply will be given to the authors of the original article. Such a reply will be published along with the letter.

Review papers should be organized in the following successive sections: Title Page, Abstract, main text, Acknowledgements, References, Figure Legends, Tables, Figures. At least 2 figures (colour figures encouraged at no extra charge for the author) and 2 tables must be proposed to summarize the most important data and/or concepts.

Educational papers should be organized in the following successive sections: Title Page, Abstract, main text, Acknowledgements, References, Figure Legends, Tables, Figures. At least 2 figures (colour figures encouraged at no extra charge for the author) and 2 tables must be proposed to summarize the most important data and/or concepts.

Title Page
The title page must include the following elements:
Title. It should be brief (no more than 25 words) and specific and must not include abbreviations or trade names.
Authors. Include first name of the author(s) and name of the institution(s) where the work was performed. Omit degrees of the authors. Provide contact details for all authors.
Short title. A short title (no more than 50 characters) for the purposes of running head must be provided.
Non-standard abbreviations. Define abbreviations that are not standard in the field at their first occurrence in the article and ensure consistency of abbreviations throughout the article. List all non-standard abbreviations on the title page.
Address for correspondence. Give the name, complete address, telephone and fax numbers, and E-mail address of the corresponding author (to whom requests for reprints should be addressed).
Conference presentation. When applicable, indicate the conference (name, location and year) where (part of) the work was presented.

Abstract
This should be typed, double-spaced on a separate page and must not exceed 200 words. The abstract must be organized to the following headings: Background & Aims, Methods, Results, and Conclusions. No abbreviations and references should be used in the abstract. For randomized controlled trials, the clinical trial registration number should be included at the end of the abstract.

Keywords
Immediately after the abstract, provide a maximum of six keywords for indexing purposes.

Text
See Manuscript preparation and format

Acknowledgements
The acknowledgment section should be included at the end of the manuscript text, just before the list of references and should include:
* Acknowledgement to all sources of funding and the role of the funding source. Authors should declare the role of study sponsors, if any, in the study design, in the collection, analysis and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication. If the study sponsors had no such involvement, the authors should so state.
* Acknowledgement to all contributors who do not meet the criteria for authorship. Examples of those who might be acknowledged include a person who provided purely technical help, writing assistance, or a department chair who provided only general support. Authors should disclose whether they had any writing assistance and identify the entity that paid for this assistance.
* Statement of authorship: each author must have participated sufficiently, intellectually or practically, in the work to take public responsibility for the content of the article, including the conception, design, and conduct of the experiment and for data interpretation (authorship). Therefore, each author is required to list his or her specific contribution to the work (such as design of the experiment, collection of data, analysis of data, writing of the manuscript, or provision of significant advice or consultation), according to the Vancouver rules: http://www.icmje.org/#author. We suggest the following format, using initials to refer to each author's contribution: "AA carried out the studies and data analyses and drafted the manuscript. BB carried out the samples analyses. CC participated in the design of the study and performed the statistical analysis. DD conceived of the study, and participated in its design and coordination and helped to draft the manuscript. All authors read and approved the final manuscript".

Reference Format
References have to be cited in the text by Arabic numerals in superscript, and numbered in the order in which they are cited. The reference section should be typed double-spaced at the end of the text, following the sample format given below. Abbreviate journal titles according to the List of Journals Indexed in Index Medicus (available from the Superintendent of Documents, US Government Printing Office, Washington, D.C. 20402, USA, DHEW Publication No. (NIH) 91-267; ISSN 0093-3821. Provide all authors' names. Provide article titles and inclusive pages. 'Unpublished data' and 'personal communications' do not qualify as References and should be placed in parentheses in the text. Accuracy of reference data is the responsibility of the author.

Sample References
Article in a journal:
1. Cummings J H, MacFarlane G T. Role of intestinal bacteria in nutrient metabolism. Clin Nutr 1997; 16: 3-11.
Book:
1. McLaren D S, Meguid M M. Nutrition and its disorders, 4th edn. Edinburgh: Churchill Livingstone, 1988.
Chapter in a book:
1. Goodwin S C, Liu S. Radiologic techniques for enteral access. In: Rombeau J L, Rolandelli R H, Eds. Enteral and tube feeding, 3rd edn. Philadelphia: W B Saunders, 1997: 193-206.
Website:
1. U.S. positions on selected issues at the third negotiating session of the Framework Convention on Tobacco Control. Washington, D.C.: Committee on Government Reform, 2002. (Accessed March 4, 2002, at http://www.house.gov/reform/min/inves_tobacco/index_accord.htm.)
Online journal article:
Tenesa A, Noble C, Satsangi J et al. Association of DLG 5 and inflammatory bowel disease across human populations. Eur Journal Hum Genet 2006: published online Jan 4. DOI:10.1038/sj.ejhg.5201516

Figure legends
Legends should be typed double-spaced in consecutive order on a separate sheet, using Arabic numbers (for example, Figure 1). Provide a short title (in the legends, not on the figure itself) and brief but sufficient information to permit interpretation of figures without reference to text. Do not exceed 250 words for each legend and provide a key for each symbol used.

Tables
Tables should be typed double-spaced, each on a separate sheet, and contain only horizontal rules. The tables should be numbered in Arabic numerals and contain a brief specific title. Data presented in tables must be logically and clearly organized; they should be self-explanatory and should supplement, not duplicate the text. Use superscript capitals starting from "a" and in alphabetical order for footnotes and provide a key for each symbol used.

Figures
Figures and photographs should be submitted online as separate files. Photographs, photomicrographs, electron micrographs, roentgenograms, and (professionally drawn) drawings are not required to accompany online submission, but should be submitted as black-and-white high-quality glossy prints once the manuscript is accepted for publication. A detailed guide on electronic artwork is available on our website: http://www.elsevier.com/artworkinstructions.

General points:
* Make sure you use uniform lettering and sizing of your original artwork.
* Only use the following fonts in your illustrations: Arial, Courier, Helvetica, Times, Symbol.
* Number the illustrations according to their sequence in the text.
* Use a logical naming convention for your artwork files.
* Provide all illustrations as separate files.

Formats: Regardless of the application used, when your electronic artwork is finalised, please "save as" or convert the images to one of the following formats (Note the resolution requirements for line drawings, halftones, and line/halftone combinations given below.):
EPS: Vector drawings. Embed the font or save the text as "graphics".
TIFF: Colour or greyscale photographs (halftones): always use a minimum of 300 dpi.
TIFF: Bitmapped line drawings: use a minimum of 1000 dpi.
TIFF: Combinations bitmapped line/half-tone (colour or greyscale): a minimum of 500 dpi is required.
DOC, XLS or PPT: If your electronic artwork is created in any of these Microsoft Office applications please supply "as is".
Captions: Ensure that each illustration has a caption. Supply captions separately (in figure legends), not attached to the figure. A caption should comprise a brief title (not on the figure itself) and a description of the illustration. Keep text in the illustrations themselves to a minimum but explain all symbols and abbreviations used.
Line drawings: The lettering and symbols, as well as other details, should have proportionate dimensions, so as not to become illegible or unclear after possible reduction; in general, the figures should be designed for a reduction factor of two to three. The degree of reduction will be determined by the Publisher. Illustrations will not be enlarged. Consider the page format of the journal when designing the illustrations. Do not use any type of shading on computer-generated illustrations.
Colour illustrations: Please make sure that artwork files are in an acceptable format (TIFF, EPS or MS Office files) and with the correct resolution. If, together with your accepted article, you submit usable colour figures then Elsevier will ensure, at no additional charge, that these figures will appear in colour on the Web (e.g., ScienceDirect and other sites) regardless of whether or not these illustrations are reproduced in colour in the printed version. For colour reproduction in print, you will receive information regarding the costs from Elsevier after receipt of your accepted article. Please indicate your preference for colour in print or on the Web only. For further information on the preparation of electronic artwork, please see http://www.elsevier.com/artworkinstructions. Please note: Because of technical complications which can arise by converting colour figures to "grey scale" (for the printed version should you not opt for colour in print) please submit in addition usable black and white versions of all the colour illustrations.

Units & Abbreviations
Headings in the body of the paper should be appropriate to the nature of the paper and enhance readability. Usually, only two categories of heading should be used, but not be numbered. Abbreviations may be used when the term is used at least three times in the text, but the full term for which an abbreviation stands should precede its first use unless it is a standard unit of measurement. Abbreviations used only in a table or figure may be defined in the legend. Identify drugs and chemicals used by generic name (if trademarks are mentioned, manufacturer name and city should be given). The metric system should be used for all measurements (weight, length, etc.). Temperatures should be expressed as Celsius (centigrade). Metric abbreviations should be expressed in lower case without periods and with no distinction between singular and plural. Both SI and traditional units may be used.

Supplementary data
We accept supplementary electronic material to support and enhance the paper. Supplementary files offer additional possibilities to publish supporting applications, animation sequences, high-resolution images, background datasets, sound clips and more. Supplementary files supplied will be published online, alongside the electronic version of your article in Elsevier web products, including ScienceDirect: http://www.sciencedirect.com/. In order for your submitted material be directly usable, please ensure that data is provided in one of our recommended file formats. Authors should submit the material in electronic format, together with the article, and supply a concise and descriptive caption for each file. For more detailed instructions please visit our Author Gateway at http://www.elsevier.com/authors.

Review of manuscripts
The Editorial office assigns each submitted manuscript to an Associate Editor with expertise in the field; all manuscripts that are not prepared according to the Instructions to authors are returned to the author to make the requested adaptations. The Editorial Board may reject papers without external review when the subject is out of the scope of the journal, when the study has major methodological problems or when the manuscript cannot be assigned a high enough priority for further review. External review implies that at least two expert reviewers are asked to review the manuscript in a timely manner and to assign a priority based on content, originality, quality, relevance and interest. Authors are informed of the final decision by e-mail, with Reviewers' comments enclosed. Confidentiality is considered for all manuscripts during the peer-review process.
Only previously unpublished work should be submitted; all text, including requested material, will be subject to editorial review and revision. Only manuscripts in English will be accepted. The manuscripts become the property of the journal and may not be published elsewhere without written permission from the publisher.

Accepted manuscripts
Copyright Information
Copyright of the papers published in Clinical Nutrition is shared by the publisher (Elsevier Ltd) and ESPEN, copyright of the papers published in e-SPEN Journal is with ESPEN.

Upon acceptance of an article, authors will be asked to sign a 'Journal Publishing Agreement' (for more information on this and copyright see http://www.elsevier.com/copyright). Acceptance of the agreement will ensure the widest possible dissemination of information. An e-mail will be sent to the corresponding author confirming receipt of the manuscript together with a 'Journal Publishing Agreement' form or a link to the online version of this agreement. Subscribers may reproduce tables of contents or prepare lists of articles including abstracts for internal circulation within their institutions. Permission of the Publisher is required for resale or distribution outside the institution and for all other derivative works, including compilations and translations (please consult http://www.elsevier.com/permissions). If excerpts from other copyrighted works are included, the author(s) must obtain written permission from the copyright owners and credit the source(s) in the article. Elsevier has preprinted forms for use by authors in these cases: please consult http://www.elsevier.com/permissions.

Proofs
One set of page proofs in PDF format will be sent by e-mail to the corresponding author (if we do not have an e-mail address then paper proofs will be sent by postal mail). Elsevier now sends PDF proofs which can be annotated; for this you will need to download Adobe Reader version 7 available free from http://www.adobe.com/products/acrobat/readstep2.html. Instructions on how to annotate PDF files will accompany the proofs. The exact system requirements are given at the Adobe site: http://www.adobe.com/products/acrobat/acrrsystemreqs.html#70win.
If you do not wish to use the PDF annotations function, you may list the corrections (including replies to the Query Form) and return to Elsevier in an e-mail. Please list your corrections quoting line number. If, for any reason, this is not possible, then mark the corrections and any other comments (including replies to the Query Form) on a printout of your proof and return by fax, or scan the pages and e-mail, or by post.
Please use this proof only for checking the typesetting, editing, completeness and correctness of the text, tables and figures. Significant changes to the article as accepted for publication will only be considered at this stage with permission from the Editor. We will do everything possible to get your article published quickly and accurately. Therefore, it is important to ensure that all of your corrections are sent back to us in one communication: please check carefully before replying, as inclusion of any subsequent corrections cannot be guaranteed. Proofreading is solely your responsibility. Note that Elsevier may proceed with the publication of your article if no response is received.

Offprints
The corresponding author, at no cost, will be provided with a PDF file of the article via e-mail or, alternatively, 25 free paper offprints. The PDF file is a watermarked version of the published article and includes a cover sheet with the journal cover image and a disclaimer outlining the terms and conditions of use. Additional paper offprints can be ordered by the authors. An order form with prices will be sent to the corresponding author.

Revisions, rejections
Revision should be resubmitted within three months of the initial decision and are carefully re-examined. However, no guarantee can be made about the final acceptability. If authors of a rejected manuscript are able to make new advances that go far beyond the original submission, they may consider submitting the manuscript again as a new submission, referring to the original submission in the cover letter.

Funding body agreements and policies
Elsevier has established agreements and developed policies to enable authors whose articles appear in journals published by Elsevier, to comply with potential manuscript archiving requirements as specified as conditions of their grant awards. To learn more about existing agreements and policies please visit http://www.elsevier.com/fundingbodies.

Authors' rights
As an author you (or your employer or institution) retain certain rights; for details you are referred to: http://www.elsevier.com/wps/find/authorshome.authors/authorsrights.

Author enquiries
For enquiries relating to the submission of articles (including electronic submission where available) please visit this journal's homepage at http://www.elsevier.com/locate/clnu. You can track accepted articles at http://www.elsevier.com/trackarticle and set up e-mail alerts to inform you of when an article's status has changed. Also accessible from here is information on copyright, frequently asked questions and more.

Contact details for questions arising after acceptance of an article, especially those relating to proofs, will be provided by the publisher. Checklist for submitting manuscripts:
Use separate documents for Cover letter - Conflict of Interest - Author Agreement - 3 Potential Reviewers - Manuscript - Tables - Figures and upload in this order during submission

Cover letter:
* Requested statements regarding (1) contribution authors, specific contribution of each author, (2) final approval of the version to be submitted (3) previous publication presented data.
* Statement drafting the article
* A statement that the manuscript, including related data, figures and tables has not been previously published and that the manuscript is not under consideration elsewhere.

Conflict of Interest:
At the end of the text, under a subheading "Conflict of interest statement" all authors must disclose any financial and personal relationships with other people or organisations that could inappropriately influence (bias) their work. Examples of potential conflicts of interest include employment, consultancies, stock ownership, honoraria, paid expert testimony, patent applications/registrations, and grants or other funding.

Author Agreement:
A statement that all authors have made substantial contributions and final approval of the conceptions, drafting, and final version. 3 Potential Reviewers:
The name and contact addresses (Including e-mail) of 3 potential reviewers that have not been involved in the design, performance and discussion of the data and are not a co-worker.

Opposed Reviewers:
You may also mention opposed reviewers who you would prefer not to review your paper, this is optional.

Manuscript:
* Double-spaced and spell checked
* Line numbers in left margin and page numbers in upper right corner
* Title page: All requested elements: title - authors - short title - non-standard abbreviations - address for correspondence - conference presentation (when applicable)
* Abstract: Background & Aims - Methods - Results - Conclusions (except for reviews)
* Keywords: max 6
* Main text: use sections as instructed
* Acknowledgments: including: (1) grants/funding, (2) acknowledgement to contributors who do not meet authorship criteria , (3) statement of authorship
* References: according to requested format
* Figure legends

Tables:
* Double spaced, each table on separate page
* Only horizontal rules

Figures:
* Each figure on separate sheet, indicating figure number
* Colour figures in original articles can be printed in black and white (and appear in colour online), but are charged when printed in colour; 1-2 colour figures in review articles at no charge.