Dietary Protein Intake Research Articles

Longitudinal association between dietary protein intake and survival in peritoneal dialysis patients

Background Decreased dietary protein intake (DPI) may lead to protein-energy malnutrition and may be associated with increased mortality risk. We hypothesized that longitudinal changes in dietary protein intake have independent associations with survival in peritoneal dialysis (PD) patients. Methods 668 stable PD patients were selected in the study from January 2006 to January 2018 and were followed up until December 2019. Their three-day dietary records were collected at the baseline (the sixth month after PD) and thereafter every 3 months for two and a half years. The latent class mixed models (LCMM) were used to identify subgroups of PD patients with similar longitudinal trajectories of DPI. The relation between DPI (baseline and longitudinal data) and survival was examined using Cox model to estimate death hazard ratios. Meanwhile, different formulae were used to assess nitrogen balance. Results The results showed that baseline DPI ≤ 0.60g/kg/day was associated with the worst outcome in PD patients. Patients with DPI 0.80–0.99g/kg/day and DPI ≥ 1.0g/kg/day both presented positive nitrogen balance; patients with DPI 0.61–0.79g/kg/day presented obviously negative nitrogen balance. Longitudinal association between time-dependent DPI and survival was found in PD patients. The consistently low DPI' (0.61–0.79g/kg/d) group was correlated with increased death risk as compared with the 'consistently median DPI' group (0.80–0.99g/kg/d, HR = 1.59, p = 0.008), whereas there was no difference in survival between 'consistently median DPI' group and 'high-level DPI' group (≥1.0 g/kg/d, p > 0.05). Conclusion Our study revealed that DPI ≥ 0.8 g/kg/day was beneficial to the long-term outcome for the PD population.

Association of a low protein diet with depressive symptoms and poor health-related quality of life in CKD

ObjectivesA low protein diet (LPD) for chronic kidney disease (CKD) is a core dietary therapy to slow CKD progression. A study showed depressive symptoms are more common in populations with an LPD. In this cross-sectional study, we evaluated depressive symptoms and health-related quality of life (HRQOL) in patients with CKD. MethodsA total of 571 CKD patients were enrolled in this study. The LPD was defined with dietary protein intake ≤0.8 g/kg/day. We divided the CKD into mild CKD and advanced CKD according to severity, as well as diabetic kidney disease (DKD) and non-DKD according to DM. The logistic regression analysis was performed to evaluate the association between an LPD and depressive symptoms as well as HRQOL in CKD patients and each subgroup. ResultsAn LPD had significantly higher unadjusted Odds Ratio (OR) (1.81, [95% for Confidence Interval (CI), 1.18–2.76]) and multivariate-adjusted OR (1.80, [1.15–2.81]) for depressive symptoms. Moreover, an LPD showed significantly higher unadjusted OR (2.08, 1.44–3.01]) and multivariate OR (2.04, [1.38–3.02]) for poor HRQOL. In DKD subgroups, an LPD had a significant increase in unadjusted OR (2.00, [1.12–3.57]) and multivariate OR (1.99, [1.01–3.44]) for depressive symptoms. The advanced CKD group also showed that an LPD had significantly higher unadjusted OR (1.97, [1.13–3.42]) and multivariate OR (2.03, [1.12–3.73]) for depressive symptoms. ConclusionsAn LPD for CKD patients was significantly associated with depressive symptoms and poor HRQOL. Subgroup analysis indicated that DKD and advanced CKD are more predisposed to depressive symptoms and poor HRQOL.

Protein intake and postprandial hyperglycemia in children and adolescents with type 1 diabetes mellitus, a pilot study

Background and aimsTo describe the change in glucose and the resulting postprandial hyperglycemia (PPH) that occurs after dietary protein intake (PI) in children with type 1 diabetes (T1D). MethodsWe conducted a self-controlled, non-randomized, prospective pilot study in children with T1D who were given whey protein isolate drinks (carbohydrate-free, fat-free) of increasing protein amounts (0, 12.5, 25, 37.5, 50, and 62.5 gm) on 6 sequential nights. The glucose levels were monitored with continuous glucose monitors (CGM) and glucometers for 5 h after PI. PPH was defined as glucose elevations over baseline of ≥50 mg/dL. ResultsThirty-eight subjects were recruited, and eleven subjects (6 females, 5 males) completed the intervention. Subjects had a mean (range) age of 11.6 (6–16) years, diabetes duration of 6.1 (1.4–15.5) years, HbA1c of 7.2 (5.2–8.6) % and weight of 44.5 (24.3–63.2) kg. PPH was detected in 1/11, 5/11, 6/10, 6/9, 5/9, and 8/9 subjects after receiving 0, 12.5, 25, 37.5, 50, and 62.5 gm of protein, respectively. ConclusionsIn children with T1D, the association between PPH and PI was observed at smaller protein amounts compared to studies done in adults.

Correlation of Dietary Protein Intake with Body Composition and Physical Status in Patients with Knee Osteoarthritis

Correlation of Dietary Protein Intake with Body Composition and Physical Status in Patients with Knee Osteoarthritis

Abstract P212: Plasma Metabolomics of Dietary Intake of Protein-Rich Foods and Kidney Disease Progression in Children

Introduction: There is inconsistent evidence on the efficacy of a low-protein diet for patients with chronic kidney disease (CKD) and there is a lack of objective biomarkers of dietary intake. The purpose of this study was to identify plasma metabolites associated with dietary intake of protein among children with CKD and to assess whether protein-related metabolites are associated with CKD progression. Methods: We conducted non-targeted metabolomics using plasma samples from 484 Chronic Kidney Disease in Children (CKiD) participants. Multivariable linear regression estimated the cross-sectional association between 949 known, non-drug metabolites and dietary intake of dairy, nuts and beans, red and processed meat, fish, chicken, and eggs, adjusting for demographic, clinical, and dietary covariates. Cox proportional hazards regression models assessed the prospective association between protein-related metabolites and CKD progression defined as kidney replacement therapy or 50% eGFR reduction, adjusting for demographic and clinical covariates. We used a false discovery rate <0.05 as the statistical significance threshold to account for multiple comparisons. Results: Fifty-seven unique metabolites were significantly associated with dietary protein intake (dairy: n=21; nuts and beans: n=13; red and processed meat: n=20; fish: n=2; chicken: n=3; eggs: n=0). Among them, ten metabolites were significantly associated with CKD progression (TABLE) , including one amino acid, one cofactor and vitamin, four lipids, two nucleotides, one peptide, and one xenobiotic. 1-(1-enyl-palmitoyl)-2-oleoyl-GPE (P-16:0/18:1) was positively associated with dietary intake of red and processed meat and CKD progression, and 3-ureidopropionate was inversely associated with dietary intake of red and processed meat and CKD progression. Conclusion: Untargeted plasma metabolomic profiling revealed metabolites associated with dietary intake of protein and CKD progression in a pediatric population.

Abstract 65: DNA Methylation at ABCG1 and Long-Term Changes in Adiposity in Response to Diet Interventions: The POUNDS Lost Trial

Introduction: Epigenome-wide association studies identified that DNA methylation (DNAm) at the ABCG1 gene (cg06500161) was associated with obesity. However, little is known about whether DNAm at ABCG1 is associated with long-term changes in adiposity and body fat distribution in response to dietary weight-loss interventions. Hypothesis: We hypothesized that participants with varying DNAm at ABCG1 might respond differently to dietary weight-loss interventions on long-term changes in adiposity and body fat distribution. Methods: The current study included 673 participants with overweight/obesity, who were randomly assigned to 1 of 4 diets varying in macronutrient components. Blood DNAm level was profiled by a high-resolution methylC-capture sequencing at baseline. The regional DNAm at ABCG1 was defined as the average methylation level over CpGs within ± 250 bp of cg06500161. Two-year changes in adiposity and Computed Tomography (CT)-measured body fat distribution were calculated. Results: We found that regional DNAm at ABCG1 significantly interacted with dietary protein intake on long-term changes in body weight and waist circumference (WC) at 6 months and 2 years (P-interaction<0.05 for all, Figure ). Among participants assigned to an average-protein (15%) diet, lower regional DNAm at ABCG1 was associated with greater reductions in body weight and WC at 6 months and 2 years, while opposite associations were found among those assigned to a high-protein (25%) diet. Similar interactions were also observed for body fat distribution, including visceral adipose tissue, subcutaneous adipose tissue, deep subcutaneous adipose tissue, and total adipose tissue at 6 months and 2 years (P-interaction<0.05 for all). Conclusion: Our data indicate that DNAm at ABCG1 interacted with dietary protein intake on long-term changes in adiposity and body fat distribution. Participants with hypomethylation at ABCG1 benefited more in long-term improvement in adiposity and body fat distribution by consuming an average-protein diet.

Short-term Changes in Calcium but not Protein Intake Alter the Rate of Bone Resorption in Healthy Subjects as Assessed by Urinary Pyridinium Cross-Link Excretion

This study was conducted to determine whether the markers of bone resorption, pyridinium cross-links of collagen, are sensitive to changes in dietary protein and calcium intake. Fifteen young healthy subjects (7 males and 8 females) participated in three 5-d diet periods. Dietary intake during each dietary period consisted of: 1) low nitrogen and low calcium [0.49 ± 0.11 g protein/ (kg·d), 429 ± 190 mg calcium/d]; 2) low nitrogen and high calcium [0.44 ± 0.08 g protein/ (kg·d), 1643 ± 171 mg calcium/d]; and 3) a high nitrogen and high calcium [2.71 ± 0.75 g protein/(kg·d), 1589 ± 633 mg calcium/d] diet, and this was compared with subjects' baseline dietary intake [0.99 ± 0.51 g protein/(kg·d), 589 ± 152 mg calcium/d]. The order of these diets was randomly assigned. Twenty-four-hour and 3-h urine samples were collected before and during each dietary period and were analyzed for pyridinium cross-links (pyridinoline, deoxypyridinoline), nitrogen and creatinine. The rate of pyridinium cross-link excretion did not vary with protein intake but was ∼33% lower (P < 0.01) during periods of high compared with low calcium intake. These data indicate that a short-term increase in calcium intake is accompanied by a reduced rate of bone resorption and that this effect is independent of dietary protein intake.

Net Renal Arginine Flux in Rats is Not Affected by Dietary Arginine or Dietary Protein Intake

Kidneys of adult animals serve as a major biosynthetic source of arginine. Recently, we demonstrated that kidneys of rats infused with citrulline responded to the elevated plasma citrulline concentrations by increasing citrulline uptake and producing greater quantities of arginine. The objective of the present study was to determine the effects of feeding adult male rats different levels of arginine or protein on renal arginine synthesis. Feeding arginine (0, 0.5 and 2.0%) for 1 wk increased circulating plasma concentrations of arginine 2.5-fold (196 mumol/L) in the 2.0% arginine group compared with the 0 and 0.5% arginine groups (73 and 81 mumol/L, respectively). However, the plasma citrulline concentration was unchanged. The renal uptake of citrulline and release of arginine were similar in all the three groups fed different levels of arginine. Feeding diets containing 5, 12 and 50% protein for 1 wk did not alter the circulating plasma concentrations of either citrulline or arginine, and there were no significant differences in the renal release of arginine. These results suggest that renal arginine synthesis is independent of dietary arginine or protein intake.

Association of Protein Intake with Handgrip Strength and Its Relation to Strength Exercise in Korean Adults Aged over 60 Years in the KNHANES (2014-18).

Weak handgrip strength (HGS) is associated with many negative health outcomes in older adults. There is evidence that with strength exercise, high protein intake leads to increased HGS. The goal of this study was to examine the relationship between weak HGS in older adults and dietary protein and it's relation to resistance exercise. Data on 8497 Korean adults aged over 60 years from the Korea National Health and Nutrition Examination Survey (2014-18) were analyzed. Dietary protein intake measured by 24-h recall were categorized as three levels: low (<0.8 g/kg body weight (BW)), adequate (≥0.8 g/kg BW and <1.2 g/kg BW), and high (≥1.2 g/kg BW). Complex sample multiple logistic regression analyses were carried out. The prevalence of weak HGS was 18.3 (0.7)% in men and 28.8 (0.9)% in women. In a multiple logistic regression analysis, low protein intake was significantly associated with higher risk of weak HGS in men, as compared with adequate protein intake, but this relationship was not statistically significant in women. The risk of weak HGS was significantly reduced for both men and women who engaged in strength exercise and increased their dietary protein intake. In this study, based on a representative sample of Koreans aged over 60, men with low protein intake had a higher risk of weak HGS than did men with adequate protein intake. Men and women with a higher protein intake who also engaged in strength exercises had a lower risk of weak HGS. Increasing protein intake and engaging in strength exercises may be an effective way to preserve muscle strength in older men and women.

Plant-Dominant Low Protein Diet: A Potential Alternative Dietary Practice for Patients with Chronic Kidney Disease.

Dietary protein restriction has long been a cornerstone of nutritional therapy for patients with chronic kidney diseases (CKD). However, the recommended amount of dietary protein intake is different across guidelines. This is partly because previous randomized controlled trials have reported conflicting results regarding the efficacy of protein restriction in terms of kidney outcomes. Interestingly, a vegetarian, very low protein diet has been shown to reduce the risk of kidney failure among patients with advanced CKD, without increasing the incidence of hyperkalemia. This finding suggests that the source of protein may also influence the kidney outcomes. Furthermore, a plant-dominant low-protein diet (PLADO) has recently been proposed as an alternative dietary therapy for patients with CKD. There are several potential mechanisms by which plant-based diets would benefit patients with CKD. For example, plant-based diets may reduce the production of gut-derived uremic toxins by increasing the intake of fiber, and are useful for correcting metabolic acidosis and hyperphosphatemia. Plant proteins are less likely to induce glomerular hyperfiltration than animal proteins. Furthermore, plant-based diets increase magnesium intake, which may prevent vascular calcification. More evidence is needed to establish the efficacy, safety, and feasibility of PLADO as a new adjunct therapy in real-world patients with CKD.

Protein Intake in NCAA Division 1 Soccer Players: Assessment of Daily Amounts, Distribution Patterns, and Leucine Levels as a Quality Indicator

Dietary protein is required to support recovery and adaptation following exercise training. While prior research demonstrates that many athletes meet total daily protein needs, intake seems to be predominantly skewed toward the evening meal. An even distribution of protein doses of ≥0.24 g/kg BW consumed throughout the course of a day is theorized to confer greater skeletal muscle anabolism outcomes compared to a skewed pattern of intake. Protein quality is also an important dietary consideration for athletes, with the amino acid leucine seemingly serving as the primary driver of the postprandial anabolic response. The present study investigates protein consumption characteristics among a cohort of NCAA D1 soccer players and evaluates differences between male and female athletes. Athletes were instructed to complete 3-day food diaries, which were subsequently analyzed and compared to UEFA expert group-issued nutrition guidelines for soccer players. Breakfast, lunch, and dinner accounted for 81.4% of the total daily dietary protein intake. Most athletes (77.8%) ingested optimum amounts of protein at dinner but not at breakfast (11.1%) or lunch (47.2%). In addition, statistically significant sex-based differences in daily dietary protein intake, meal-specific protein amounts, and protein quality measures were detected. Findings indicate suboptimal dietary protein intake practices among the collegiate soccer athletes.

Dynamic Metabolic Signatures of Choline and Carnitine across Healthy Pregnancy and in Cord Blood: Association with Maternal Dietary Protein

BackgroundIn pregnancy, choline is deemed an essential nutrient and carnitine needs are increased, but amounts remain undefined. ObjectivesWe aimed to measure choline and total dietary protein and dairy protein intake from food and supplements across pregnancy and the response to intake by profiling choline and carnitine metabolites across pregnancy and in cord blood. MethodsAn exploratory analysis of choline and protein intake from 3-d diet records and measures of 36 serum choline and carnitine metabolites in early (12–17 wk) and late (36–38 wk) pregnancy was conducted in participants from the Be Healthy in Pregnancy study randomized to high dairy protein+walking exercise or usual care. Metabolites were measured in fasted maternal and cord serum using multisegment injection-capillary electrophoresis-mass spectrometry. Mixed ANOVA adjusted for body mass index was performed for comparison of metabolites across pregnancy and between intervention and control. ResultsIn 104 participants, the median (Q1, Q3) total choline intake was 347 (263, 427) mg/d in early and 322 (270, 437) mg/d in late pregnancy. Only ∼20% of participants achieved the recommended adequate intake (450 mg/d) and ∼10% consumed supplemental choline (8–200 mg/d). Serum-free choline (μmol/L) was higher in late compared with early pregnancy [12.9 (11.4, 15.1) compared with 9.68 (8.25, 10.61), P < 0.001], but choline downstream metabolites were similar across pregnancy. Serum carnitine [10.3 (9.01, 12.2) compared with 15.9 (14.1, 17.9) μmol/L, P < 0.001] and acetylcarnitine [2.35 (1.92, 2.68) compared with 3.0 (2.56, 3.59), P < 0.001] were significantly lower in late pregnancy. High cord:maternal serum metabolite ratios were found in most measured metabolites. ConclusionsDespite inadequate choline intake, serum-free choline was elevated in late pregnancy and enriched in cord blood compared with maternal serum. Serum carnitine declined in late pregnancy despite a high protein diet. The higher cord:maternal concentrations in choline and carnitine metabolites suggest active uptake in late pregnancy, reflecting the importance of these circulating metabolites in fetal development.This trial was registered at clinicaltrials.gov as NCT01689961.

Low selenium intake is associated with risk of all-cause mortality in kidney transplant recipients.

Deficiency of the essential trace element selenium is common in kidney transplant recipients (KTR), potentially hampering antioxidant and anti-inflammatory defence. Whether this impacts the long-term outcomes of KTR remains unknown. We investigated the association of urinary selenium excretion, a biomarker of selenium intake, with all-cause mortality; and its dietary determinants. In this cohort study, outpatient KTR with a functioning graft for longer than 1 year were recruited (2008-11). Baseline 24-h urinary selenium excretion was measured by mass spectrometry. Diet was assessed by a 177-item food frequency questionnaire, and protein intake was calculated by the Maroni equation. Multivariable linear and Cox regression analyses were performed. In 693 KTR (43% men, 52±12 years), baseline urinary selenium excretion was 18.8 (interquartile range 15.1-23.4) μg/24-h. During a median follow-up of 8 years, 229 (33%) KTR died. KTR in the first tertile of urinary selenium excretion, compared with those in the third, had over a 2-fold risk of all-cause mortality [hazard ratio 2.36 (95% confidence interval 1.70-3.28); P<.001], independent of multiple potential confounders including time since transplantation and plasma albumin concentration. The most important dietary determinant of urinary selenium excretion was protein intake (Standardized β 0.49, P<.001). Relatively low selenium intake is associated with a higher risk of all-cause mortality in KTR. Dietary protein intake is its most important determinant. Further research is required to evaluate the potential benefit of accounting for selenium intake in the care of KTR, particularly among those with low protein intake.

Is It Time to Reconsider the U.S. Recommendations for Dietary Protein and Amino Acid Intake?

Since the U.S. Institute of Medicine's recommendations on protein and amino acid intake in 2005, new information supports the need to re-evaluate these recommendations. New lines of evidence include: (1) re-analysis/re-interpretation of nitrogen balance data; (2) results from indicator amino acid oxidation studies; (3) studies of positive functional outcomes associated with protein intakes higher than recommended; (4) dietary guidance and protein recommendations from some professional nutrition societies; and (5) recognition that the synthesis of certain dispensable amino acids may be insufficient to meet physiological requirements more often than previously understood. The empirical estimates, theoretical calculations and clinical functional outcomes converge on a similar theme, that recommendations for intake of protein and some amino acids may be too low in several populations, including for older adults (≥65 years), pregnant and lactating women, and healthy children older than 3 years. Additional influential factors that should be considered are protein quality that meets operational sufficiency (adequate intake to support healthy functional outcomes), interactions between protein and energy intake, and functional roles of amino acids which could impact the pool of available amino acids for use in protein synthesis. Going forward, the definition of "adequacy" as it pertains to protein and amino acid intake recommendations must take into consideration these critical factors.

Dietary Protein Modifies the Effect of the MC4R Genotype on 2-Year Changes in Appetite and Food Craving: The POUNDS Lost Trial

Background: The melanocortin-4 receptor (MC4R) plays a pivotal role in the regulation of appetite and eating behavior. Variants in the MC4R gene have been related to appetite and obesity.Objective: We aimed to examine whether weight-loss diets modified the effect of the "obesity-predisposing" MC4R genotype on appetite-related measures in a randomized controlled trial.Methods: A total of 811 overweight and obese subjects [25 ≤ body mass index (BMI; kg/m2) ≤ 40] aged 30-70 y were included in the 2-y POUNDS Lost (Preventing Overweight Using Novel Dietary Strategies) trial. We genotyped MC4R rs7227255 in 735 overweight adults and assessed appetite-related characteristics, including craving, fullness, hunger, and prospective consumption, as well as a composite appetite score. We examined the effects of the genotype-by-weight-loss diet intervention interaction on appetite variables by using general linear models in both the whole population and in white participants only.Results: We found that dietary protein intake (low compared with high: 15% of energy compared with 25% of energy, respectively) significantly modified MC4R genetic effects on changes in appetite score and craving (P-interaction = 0.03 and 0.02, respectively) at 2 y, after adjustment for age, sex, ethnicity, baseline BMI, weight change, and baseline perspective phenotype. The obesity-predisposing A allele was associated with a greater increase in overall appetite score (β = 0.10, P = 0.05) and craving (β = 0.13, P = 0.008) compared with the non-A allele among participants who consumed a high-protein diet. MC4R genotype did not modify the effects of fat or carbohydrate intakes on appetite measures. Similar interaction patterns were observed in whites.Conclusion: Our data suggest that individuals with the MC4R rs7227255 A allele rather than the non-A allele might experience greater increases in appetite and food craving when consuming a high-protein weight-loss diet. This trial was registered at clinicaltrials.gov as NCT00072995.

Dietary Protein Intake in Young Children in Selected Low-Income Countries Is Generally Adequate in Relation to Estimated Requirements for Healthy Children, Except When Complementary Food Intake Is Low

Background Previous research indicates that young children in low-income countries (LICs) generally consume greater amounts of protein than published estimates of protein requirements, but this research did not account for protein quality based on the mix of amino acids and the digestibility of ingested protein.Objective: Our objective was to estimate the prevalence of inadequate protein and amino acid intake by young children in LICs, accounting for protein quality.Methods: Seven data sets with information on dietary intake for children (6–35 mo of age) from 6 LICs (Peru, Guatemala, Ecuador, Bangladesh, Uganda, and Zambia) were reanalyzed to estimate protein and amino acid intake and assess adequacy. The protein digestibility–corrected amino acid score of each child's diet was calculated and multiplied by the original (crude) protein intake to obtain an estimate of available protein intake. Distributions of usual intake were obtained to estimate the prevalence of inadequate protein and amino acid intake for each cohort according to Estimated Average Requirements.Results The prevalence of inadequate protein intake was highest in breastfeeding children aged 6–8 mo: 24% of Bangladeshi and 16% of Peruvian children. With the exception of Bangladesh, the prevalence of inadequate available protein intake decreased by age 9–12 mo and was very low in all sites (0–2%) after 12 mo of age. Inadequate protein intake in children <12 mo of age was due primarily to low energy intake from complementary foods, not inadequate protein density.Conclusions Overall, most children consumed protein amounts greater than requirements, except for the younger breastfeeding children, who were consuming low amounts of complementary foods. These findings reinforce previous evidence that dietary protein is not generally limiting for children in LICs compared with estimated requirements for healthy children, even after accounting for protein quality. However, unmeasured effects of infection and intestinal dysfunction on the children's protein requirements could modify this conclusion.

Progressionshemmung bei chronischen Nierenerkrankungen

Chronic kidney disease (CKD) affects about 10-15% of the German population with asteady increase. It is assumed that CKD will become the 5th most common cause of death worldwide in 2040. CKD is associated with high risk of mortality, morbidity, related in particular to cardiovascular disease, as well as high healthcare costs. Clinical strategies to manage CKD should encompass extensive life-style modification including weight normalization, reduction of dietary protein and salt intakes, regular exercise and avoidance of nicotine. Pharmacologically it includes inhibition of the renin-angiotensin-aldosterone system (RAAS), sodium-glucose co-transporter‑2 (SGLT-2) inhibitors in both diabetes-related and non-diabetic CKD and strategies to control other risk factors such as proteinuria, hyperglycemia and lipid disturbances. Among the various measures aimed at slowing CKD progression, blood pressure control and in particular RAAS inhibitors have received the most attention. Another therapeutic option includes aldosterone inhibition, be it via classical aldosterone-antagonists or the new mineralocorticoid-receptor antagonists. Avoidance of nephrotoxic agents (e.g. non-steroidal anti-inflammatory drugs) seems self-explanatory. Overall, given the often asymptomatic course of CKD in particular in early phases, patient education and self-empowerment as well as treatment in amultidisciplinary team appear essential to stem the tide of patients with advanced kidney damage.

Higher dietary protein intake is associated with sarcopenia in older British twins.

Sarcopenia, characterised by an accelerated loss of skeletal muscle mass and function, is associated with negative outcomes. This study aimed to evaluate factors associated with skeletal muscle strength, mass and sarcopenia, particularly protein intake, and to assess whether shared twin characteristics are important. This study utilised cross-sectional data from a study of community-dwelling twins aged ≥60years. Multivariable logistic regression and between- and within-twin pair regression modelling were used. Participants (n = 3,302) were 89% female (n = 2,923), aged a mean of 72.1 (±7.3) years and composed of 858 (55%) monozygotic, 709 (45%) dizygotic twin pairs and 168 individual lone twins. Using optimal protein intake as the reference group (1.0-1.3g/kg/day), there was no significant association between protein intake (neither high nor low) and low muscle strength, or between low protein intake and sarcopenia (odds ratio (OR) 0.7; 95% confidence interval (CI) 0.39-1.25; P = 0.229) in unadjusted models. High protein intake (>1.3g/kg/day) was associated with low muscle mass (OR 1.76; 95% CI 1.39-2.24; P < 0.0001), while low protein intake was protective (OR 0.52; 95% CI 0.40-0.67; P < 0.0001). High protein intake was associated with sarcopenia (OR 2.04; 95% CI 1.21-3.44; P = 0.008), and this was robust to adjustment for demographic, anthropometric and dietary factors. The association between muscle strength and weight, body mass index, healthy eating index, protein intake and alpha diversity was not significantly influenced by shared twin factors, indicating greater amenability to interventions. High protein intake is associated with sarcopenia in a cohort of healthy older twins.

Contribution of Proteins to the Latin American Diet: Results of the ELANS Study.

Dietary protein intake is vital to life. Here we sought to characterize dietary sources of protein in eight Latin American countries. Survey data were collected for Estudio Latinoamericano de Nutrición y Salud (ELANS); participants were from Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela (n = 9218, 15-65 years old). The primary aim of this analysis was to quantify per-person daily protein consumption by country and sociodemographic factors. Secondary aims: to quantify proportional intake of proteins by source, amount and processing, and to determine the adequacy of protein/essential amino acid intake. Younger groups (adolescents 15-19 years, adults 20-33 years) had the highest intake of proteins; middle-aged adults (34-49 years) had a lower intake, and older adults (50-65 years) had a strikingly lower intake. Protein consumption was higher in men than women. Animal proteins comprised nearly 70% of total daily protein intake in Argentina and Venezuela, contrasting with <60% in Peru, Chile, and Costa Rica. Brazil and Venezuela showed the highest protein intake within the highest education level. The higher the socioeconomic level, the higher the protein intake, except for Argentina, Chile, and Peru. Proportional intake of animal- and plant-based protein generally reflected the food availability by country. This study presents a pre-pandemic regional baseline and offers a perspective for future studies of changes related to government policies, climate, and dietary practices.

Curcumin-resveratrol nano-formulation counteracting hyperammonemia in rats

Malnutrition and low dietary protein intake could be risk factors for developing peripheral and central hyperammonemia, especially in pediatrics. Both curcumin and resveratrol proved to be effective against several hepatic and cerebral injuries. They were reported to be beneficial in lowering circulating ammonia levels, yet both are known for their low bioavailability. The use of pharmaceutical nano-formulations as delivery systems for these two nutraceuticals could solve the aforementioned problem. Hence, the present study aimed to investigate the valuable outcome of using a combination of curcumin and resveratrol in a nanoemulsion formulation, to counteract protein-deficient diet (PDD)-induced hyperammonemia and the consequent complications in male albino rats. Results revealed that using a nanoemulsion containing both curcumin and resveratrol at a dose of (5 + 5 mg/kg) effectively reduced hepatic and brain ammonia levels, serum ALT and AST levels, hepatic and brain nitric oxide levels, oxidative DNA damage as well as disrupted cellular energy performance. In addition, there was a substantial increase in brain levels of monoamines, and a decrease in glutamate content. Therefore, it can be concluded that the use of combined curcumin and resveratrol nanoemulsion is an effective means of ameliorating the hepatic and cerebral adverse effects resulting from PDD-induced hyperammonemia in rats.