Effect Of Low Protein Diet Research Articles

236 Increased dietary protein supports key metabolic and intestinal tissue functions in weaned pigs, without increasing gastrointestinal pathogen abundance

Abstract A common dietary strategy to prevent diarrhea in weaned pigs is feeding low protein diets in the period immediately following weaning. The goal of this intervention is to decrease dietary protein sufficiently to reduce pathogen proliferation and protein fermentation without negatively impacting growth performance. One potential alternative to low protein diets is provision of dietary fiber. However, many studies examining the role of protein and fiber on gastrointestinal microbiota and post-weaning diarrhea are complicated by the presence of other substrates, including polyphenols and antinutritional factors in complex ingredients. To assess the role of increased protein and fiber on gut microbiota and host metabolism, semi-purified diets differing in crude protein (CP) and crude fiber (CF) were fed to weaned pigs (n = 40; 28 d of age). Diets with high protein (HP; CP 24.3%, CF 6.4%), high fiber (HF; CP 18.9%, CF 9.4%), or both (HFHP; CP 24.9%, CF 9.5%) were compared with a control (CON; CP 18.1%, CF 6.3%) diet with industry standard crude protein and fiber levels (n = 10/group). Growth performance and diarrhea prevalence were measured alongside gut microbiota composition and metabolites. Pigs fed the HP and HFHP diets had significantly improved feed efficiency compared with both CON and HF diets. Increased protein fermentation, measured through production of biogenic amines, was observed in HP fed animals (P < 0.001). These effects were mitigated by addition of fiber in the HFHP fed pigs. Despite increased markers of protein fermentation, post-weaning diarrhea incidence was not greater in HP fed animals and no increases in gastrointestinal pathogen abundance were detected. Metabolomic and transcriptomic analyses identified critical alterations in host metabolism and cecal transcriptome in the CON compared with the HP fed animals. While all diets were formulated to meet the dietary requirements of weaned pigs, diets with lower protein levels (CON and HF) induced alteration in transcripts from the serine synthesis pathways (P < 0.001) and integrated stress response (P < 0.001) in cecal tissue alongside increases in metabolic pathways related to lysine degradation (P = 0.005). These results challenge the current practice of low protein feeding following weaning by demonstrating a detrimental effect of low protein diets on intestinal cell function and muscle accretion. This suggests that with careful ingredient selection, increased dietary protein post-weaning could better support pig health and performance compared with current industry standard diets.

Effect of Low Protein Diet on Patients with Cardiovascular Disease: A Systematic Review and Meta-Analysis.

Low protein diet plays an important role in cardiovascular diseases. However, exact role is unclear so far. We aimed to find out the effect of low protein diet on patients with cardiovascular disease. The PRISMA guidelines were followed throughout the research project until 10th Apr 2023. MeSH phrases and Boolean operators were used to search PubMed for suitable studies. The entire estimate was expressed as a 95% confidence interval around the mean difference. The model was picked because of the discrepancies found in the research. Choi's Q test and I2 statistics were used to determine the degree of variation between experiments. The funnel plot was used to qualitatively examine the publishing bias. Low-protein diets have a greater impact on waist circumference [-8.82 (-9.51, -8.13), P<0000.1] and high-density lipoprotein (HDL) [-0.05 (-0.07, -0.03), P<0000.1] alteration than non-LPD diets, as measured by the standard mean difference (SMD). Further, significant changes were observed in weight loss [1.51 (1.25, 1.77), P<0.00001], BMI, [0.46 (0.25, 0.67), P<0.0001], change systolic [2.48 (1.20, 3.77), P=0.0002] and diastolic blood pressure [1.49 (0.72, 2.26), P=0.0002], low density lipoprotein [0.09 (0.06, 0.12), P<0.00001], triglyceride [0.52 (0.49, 0.55), P<0.00001], in non-LPD group as compared to LPD group. The results indicated the role of low protein diet on patients with cardiovascular disease.

Effects of Low Protein Diet on Body Weight and Hematological Parameters in Rats

Malnutrition is a condition in which the body is deficient or excessive in macronutrients and micronutrients such as carbohydrates, fats, proteins and vitamins. Malnutrition causes changes in body weight and blood tissue that inhibit the development of hematopoietic cells, resulting in anemia, leukopenia and bone marrow hypoplasia. This study aimed to examine the effect of feeding a diet with a protein level of 12% and 20 % for 6-week to Wistar rats. The parameters seen are the impact on body weight and selected hematological parameters included white blood cell, monocyte, lymphocyte, granulocyte, hemoglobin and mean corpuscular volume. This study found that rats fed with 12% protein showed significant differences in body weight and several hematological parameters such as monocytes, lymphocytes, hemoglobin and mean corpuscular volume compared to normal.

Inclusion of slowly digestible starch source is a promising strategy than reducing starch to protein ratio in low protein broiler diets

The present study investigated the effects of low protein diets with different starch sources and starch to protein ratio on growth, digestibility, intestinal health, caecal short chain fatty acids (SCFAs), serum cholesterol and triglycerides in broiler chickens. Eight hundred one-day-old male broiler chicks (Ross 308) were randomly allotted to one of 4 dietary treatments with 10 repeats and 20 birds in each repeat. The dietary treatment included 1) a standard protein corn-SBM based diet (SP), 2) a low protein corn-SBM based diet (LPI) without reduced starch: protein ratio, 3) a low protein corn-SBM based diet (LPII) with reduced starch: protein ratio, and 4) a low protein corn-SBM-peas based diet (LPP) and reduced starch: protein ratio. Soy hulls were added in the LPII and LPP diets to reduce starch: protein ratio. During the experiment period from 11-24 d, FI was not affected by the dietary treatments (P > 0.05). The BWG was significantly reduced in the LPI diet compared to the SP diet (P < 0.05). Likewise, FCR deteriorated in LPI and LPII but was better in the SP diet followed by the LPP diet (P < 0.05). The apparent total tract digestibility (ATTD) of dry matter (DM) varied significantly among the dietary treatments (P < 0.01). While ATTD of starch was similar for all the diets except the LPP diet wherein the ATTD of starch was significantly lower (P < 0.001). Ether extract digestibility was also significantly different between the SP and LPII dietary treatments (P < 0.01). The AME and AMEn values were also significantly lower in the LPP diet compared with other dietary treatments (P < 0.001). Nitrogen retention (%) was increased in all the LP diets compared with the SP diet (P < 0.001), but it was significantly better in both LPII and LPP diets compared to the LPI diet. The data showed that cecal short chain fatty acids (SCFAs) production was increased in the LPII and LPP compared to the SP and LPI diets (P < 0.001). Further, the production of acetic, butyric, and propionic acids was substantially higher in the LPP diet (P < 0.001). There was no significant difference in gene expression of Claudin-1 and ZO-1 (P > 0.05). However, MUC-2 and GLUT-1 gene expression were significantly downregulated in the LPI diet (P < 0.05). The concentration of cholesterol and triglycerides was significantly increased in the LPI diet (P < 0.001). In conclusion, the addition of peas as a slowly digestible starch source combined with soy hulls in low protein diet helped to partly recover the growth performance and improved cecal SCFAs production compared to other low protein diets with and without reduced starch: protein ratio in broiler chickens.

145 Performance, postweaning diarrhea, and apparent total tract nutrient digestibility responses of weanling pigs to nucleotide supplementation of low-protein diets

Abstract Feeding low protein (LP) diets to nursery pigs has been reported to improve intestinal health, reduce incidence of post-weaning diarrhea (PWD) and nitrogen excretion. However, these benefits are often undermined by significant reduction in growth performance. This study evaluated the effects of low protein diets supplemented with dietary nucleotides on growth performance, post weaning diarrhea and nitrogen utilization. A total of 210 piglets (Duroc × Landrace × Yorkshire) were weaned at 21 d of age and allowed a 3-d adaptation to a common solid post weaning diet. At 24 d old, pigs were reweighed (6.02 ± 0.05 kg) and allocated to 5 dietary treatments in a completely randomized block design to give 7 replicates per treatment (n = 6 piglets per replicate). The 5 dietary treatments included i) a high protein positive control diet (PC) with 24% crude protein (CP); ii) a low protein negative control (NC) with 16% CP; iii) NC with 0.1% dietary nucleotide inclusion (NC01); iv) NC with 0.3% dietary nucleotide inclusion (NC03); and v) NC with 0.9% dietary nucleotide inclusion (NC09). All diets were corn-soybean meal based, supplemented with lysine, methionine, tryptophan, and threonine, with all low protein diets (LP) additionally fortified with crystalline isoleucine, and valine to meet the ideal amino acid requirements. Diets were provided ad libitum for 35 d and weekly feed intake (FI) and body weight (BW) were measured. On d 35, blood and fecal samples were collected to determine serum metabolites and nutrient digestibility respectively. Data were analyzed by PROC GLM and orthogonal polynomial contrast of SAS. Comparison between positive and negative control diets and nucleotide levels were performed with orthogonal contrast analysis. Relative to PC, NC diet had decreased overall average daily gain (343.5 vs. 305.5 g/d), incidence of PWD (2.5 vs. 1.2 fecal consistency score), blood urea nitrogen (BUN; 11.3 vs. 3.4 mg/dL) and total tract digestibility of energy (81.3 vs. 80.1 %; P &amp;lt; 0.05, P &amp;lt; 0.05, P &amp;lt; 0.0001 and P &amp;lt; 0.1, respectively). Relative to PC, the NC01, NC03 and NC09 treatments had comparable average daily gain (P &amp;gt; 0.05) while maintaining reduced (P &amp;lt; 0.05) BUN and incidence of PWD. Total tract digestibility of dry matter (83.1 vs. 82.1%) and energy (81.3 vs. 80.1%) were similar between PC and NC09 treatments (P &amp;gt; 0.05). Crude protein reduction decreased serum glutathione (P &amp;lt; 0.05), but without an effect of nucleotide supplementation. Serum glucose and insulin concentrations were not different across treatments (P &amp;gt; 0.05). Results suggest that feeding LP diets supplemented with dietary nucleotide after weaning can increase protein utilization efficiency, reduce incidence of PWD while partially ameliorating the negative effects of LP diets on growth performance.

Effects of low protein diets on acid-base balance, electrolyte balance, intestinal structure, and amino acid transport in piglets.

Reducing the dietary crude protein (CP) could effectively reduce pressure on protein ingredient supplies. However, few data have been reported about the extent to which CP can be reduced and whether limiting the use of soybean meal leads to electrolyte imbalance. In this experiment, using the low protein (LP) diet [2% lower than NRC (2012)], seventy-two piglets (35 days old) were randomly divided into 2 groups with 6 replicates of 6 piglets each: CON group (CP = 18.5%) and LP group (CP = 16.5%), to investigate the effect of the LP diet on electrolyte balance, acid-base balance, intestinal structure and amino acid transport in piglets. The results revealed that the LP diet decreased the average daily gain and dietary CP digestibility, and damaged the villi structure of the small intestine. Compared with the CON diet, the potassium content decreased and the chlorine content increased in the LP diet, and similar trends were shown in piglet serum. The arterial pH, pCO2, HCO3 -, and base excess of piglets in the LP group were lower than those in the CON group, while pO2 was higher than those in the CON group. Interestingly, the LP diet significantly increased the lysine content in piglet serum and significantly decreased the levels of arginine, leucine, and glutamic acid. Furthermore, the LP diet significantly affected the expression of some amino acid transport vectors (B0AT1, EAAC1, and y+LAT1). In summary, these findings suggested that the LP diet leads to acid-base imbalance, amino acid transport disorder and amino acids imbalance in piglets, and the dietary electrolyte may be a key factor in the impact of the LP diet on piglet growth performance and intestinal health.

Effect of Low Protein Diet on Bone Structure of Young Wistar Mice.

&lt;b&gt;Background and Objective:&lt;/b&gt; Malnutrition and stunting are major unresolved problems in Indonesia. Protein deficiency can cause stunted growth, as well as make physical and cognitive abilities cannot reach their maximum potential. During childhood the need for protein must be fulfilled so that the peak of bone formation during adolescence can be perfect. In malnourished children, a low protein diet will lead to thinning of the bone cortex. Due to the high rate of stunting and malnutrition in children due to protein deficiency, a study was conducted on the effects of feeding low protein diet on rat bones. &lt;b&gt;Materials and Methods:&lt;/b&gt; Male Wistar rats (n = 10) at 6-8 weeks old (body weight around 250 g), control groups were fed a normal chow diet and low protein diet groups were given low protein chow diet (protein 5%) for 18 weeks, then the rats were sacrificed and the femoral bones were isolated. Body weight, femur weight, femur length were checked and bone density was examined using X-ray. &lt;b&gt;Results:&lt;/b&gt; The body proportions of the low protein group rats were smaller and thinner than those of the control group. This difference is supported by the significant weight loss starting from the sixth week after low protein feeding. There are significant differences in body weight and femur weight between the control and low protein diet groups. Bone density decreases significantly in low protein diet group. Macroscopically, the femur length of the low protein group was shorter than the control group, however the femur length did not show significant differences statistically between the two groups. &lt;b&gt;Conclusion:&lt;/b&gt; A low protein diet decreased the body weight of the rats, also causing impaired bone growth characterized by decreasing femur weight. The low protein diet also caused osteoporosis in the bones.

Effect of low protein diets on production performance, egg quality and serum biochemical parameters of gramapriya laying hens

Effect of low protein diets on production performance, egg quality and serum biochemical parameters of gramapriya laying hens

Effect of Low Protein Diets Supplemented with Sodium Butyrate, Medium-Chain Fatty Acids, or n-3 Polyunsaturated Fatty Acids on the Growth Performance, Immune Function, and Microbiome of Weaned Piglets.

This study aimed to investigate the effects of low-protein (LP) diets supplemented with sodium butyrate (SB), medium-chain fatty acids (MCT), or n-3 polyunsaturated fatty acids (n-3 PUFA) on the growth performance, immune function, and the microbiome of weaned piglets. A total of 120 healthy weaned piglets ((Landrace × Large White × Duroc); 7.93 ± 0.7 kg initial body weight), were randomly divided into five groups. Each group consisted of six replications with four piglets per replication. Dietary treatments included control diet (CON); LP diet (LP); LP + 0.2% SB diet (LP + SB); LP + 0.2% MCT diet (LP + MCT); and LP + PUFA diet (LP + PUFA). The experimental period lasted for 4 weeks. Compared with the CON diet, LP, LP + SB, LP + MCT, and LP + PUFA diets decreased the final weight and average daily gain (ADG) of piglets (p < 0.05). There were lower (p < 0.05) concentrations of IL-8 and higher (p < 0.05) Glutathione peroxidase (GSH-Px) activity in the plasma of piglets fed with LP + SB, LP + MCT, and LP + PUFA diets than those fed with the LP diet. The piglets in the LP + SB and LP + PUFA groups had lower IKK-alpha (IKKa) mRNA expression in the colonic mucosa compared with those in the CON and LP groups (p < 0.05). The mRNA expression of TLR4 in the colonic mucosa of piglets in the LP + SB, LP + MCT, and LP + PUFA groups was decreased when compared with the CON and LP groups (p < 0.05). The LP + MCT diets increased the gene expression of nuclear factor erythroid 2-related factor 2 (Nrf2) in the colonic mucosa of piglets compared with CON, LP, and LP + SB diets (p < 0.05). The abundance of Erysipelotrichaceae in the colonic microbiome of piglets in the LP group was higher than that in the other four groups (p < 0.05). Collectively, this study showed that LP diets supplemented with SB, MCT, or n-3 PUFA reduced plasma inflammatory factor levels, increased plasma GSH-Px activity, and declined mRNA expression of TLR4 and IKKa in the colonic epithelium, whereas it reduced the abundance of Erysipelotrichaceae in the colon of piglets.

Effects of Low Protein Diet on Production Performance and Intestinal Microbial Composition in Pigs.

In order to study the effects of a low protein diet on the production performance and intestinal microbiota composition of Hexi pigs, twenty-seven Hexi pigs with an initial body weight of 60.50 ± 2.50 kg were randomly divided into three groups (control group (CG), group 1 (G1), and group 2 (G2)) and participated in a 60-day finishing trial. The CG was fed a normal protein level diet with a protein level of 16.0%, and G1 and G2 were fed a low protein level diet with protein levels of 14.0% and 12.0%, respectively. The results showed that the low protein level diet had no significant effect on the production performance of Hexi pigs, compared with the CG, the slaughter rate of G1 and G2 increased by 2.49% (p > 0.05) and 6.18% (p > 0.05), the shear force decreased by 2.43% (p > 0.05) and 15.57% (p > 0.05), the cooking loss decreased by 24.02% (p < 0.05) and 21.09% (p > 0.05), and the cooking percentage increased by 13.20% (p > 0.05) and 11.59% (p > 0.05). From 45 min to 24 h and 48 h after slaughter, each group of pH decreased by 1.02, 0.66, and 0.42. For muscle flesh color, the lightness (L) increased by 13.31% (p > 0.05) and 18.01% (p > 0.05) in G1 and G2 and the yellowness (b) increased by 7.72% (p > 0.05) and 13.06% (p > 0.05). A low protein level diet can improve the intestinal flora richness and diversity of growing and finishing pigs. In the jejunum, the ACE index (899.95), Simpson index (0.90), and Shannon (4.75) index were higher in G1 than in the other groups, but the Chao1 index (949.92) was higher in G2 than in the remaining two groups. Proteobacteria, Actinobacteria, Euryarchaeota, and Verrucomicrobia were significantly higher in G1 than in the CG. The relative abundances of Lactobacillus, Terrisporobacter, and Megasphaera in G1 was significantly higher than in the CG (p < 0.05). In the cecum, the ACE index (900.93), Chao1 index (879.10), Simpson index (0.94), and Shannon (5.70) index were higher in G1 than in the remaining groups. The Spirochaetes in G2 were significantly higher than in the other groups, but the Verrucomicrobia was significantly lower than in the other groups. The relative abundances of Lactobacillus were higher in G1 and G2 than in the CG (p > 0.05). The relative abundances of unidentified_Clostridiales and Terrisporobacter in G2 were significantly lower than in the CG (p < 0.05). The relative abundance of Turicibacter in G1 was significantly lower than in the CG (p < 0.05). The relative abundances of other bacterial genera in G1 and G2 were increased by 30.81% (p > 0.05) and 17.98% (p > 0.05).

Amino acid supplementation counteracts negative effects of low protein diets on tail biting in pigs more than extra environmental enrichment

Low protein (LP) diets may increase the occurrence of damaging behaviours, like tail biting, in pigs. We investigated the effect of supplementing a LP diet with indispensable amino acids (IAA) or environmental enrichment on tail biting. Undocked pigs (n = 48 groups of 12) received either a normal protein diet (NP), a LP, LP with supplemented IAA (LP+), or LP diet with extra environmental enrichment (LP-E+) during the starter, grower, and finisher phase. Performance, activity, behaviour, and body damage were recorded. LP and LP-E+ had a lower feed intake, growth, and gain-to-feed ratio, and were more active than NP and LP+ pigs. LP-E+ pigs interacted most often with enrichment materials, followed by LP, LP+, and NP pigs. LP pigs showed more tail biting than all other groups during the starter phase and the finisher phase (tendency) compared to NP and LP+ pigs. Thus, LP-E+ only reduced tail biting in the starter phase, whereas LP+ tended to do so throughout. Tail damage was more severe in LP pigs than in NP and LP+, with LP-E+ in between. In conclusion, IAA supplementation was more effective than extra environmental enrichment in countering the negative effects of a low protein diet on tail biting in pigs.

PSII-15 Effect of Low Protein Diets Fed to Weanling Pigs on Growth Performance, Fecal Score, and Carcass Characteristics

Abstract Two experiments were conducted to test the hypothesis that feeding low protein diets to weanling pigs reduces diarrhea with no effects on growth performance from wean to finish or on carcass characteristics. In Exp. 1, 160 pigs (BW: 6.88 ± 0.36 kg) were allotted to 5 diets with 4 pigs/pen and 8 pens/diet. Five phase 1 diets were fed from d 1 to 14 and included the positive control (PC; CP = 23%) with an antibiotic growth promoter (AGP), the negative control (NC; CP = 23%) without the AGP, the NC containing 25% rolled oats (RO), and 2 diets containing 17% CP and 0 or 25% RO. Phase 2 diets were fed from d 14 to 35 and included the PC (CP =21 %) with an AGP, the NC (CP = 21%) without the AGP, the NC containing 20% RO, and 2 diets containing 19% CP and 0 or 25% RO. The statistical model included diet as fixed effect and replicate as random effect. Results from Exp. 1 indicated that pigs fed the 17% CP diet without RO had decreased (P &amp;lt; 0.05) diarrhea scores compared with the NC diet containing RO. Pigs fed the 17% CP diet containing RO had reduced (P &amp;lt; 0.05) G:F compared with the NC diet, but there was no difference among pigs fed the other 4 diets. In Exp. 2, 160 pigs (BW: 6.29 ± 1.00 kg) were allotted to 4 diets with 5 pigs/pen and 8 pens/diet in a wean to finish experiment with 6 phases. Phase 1 and 2 diets were fed for 14 d each, phase 3 was fed for 18 d, and phase 4, 5, and 6 diets were each fed for 35 d. In Phase 1, four diets included the PC diet (CP = 23%) with an AGP, the NC diet (CP = 23%) without the AGP, and 2 diets containing 19% CP or 17% CP and no AGP. In Phase 2, four diets included the PC diet (CP = 22%) with an AGP, the NC diet (CP = 22%) without the AGP, and 2 diets containing 20% CP or 19% CP and no AGP. All pigs were fed common conventional diets from Phase 3 to market. Data were analyzed as in Exp 1. Overall results from Exp. 2 indicated that there were no differences among treatments in the growth performance and carcass characteristics of pigs from wean to finish. In conclusion, feeding low protein diets to weanling pigs reduced post-weaning diarrhea and may replace antibiotic growth promoters without affecting growth performance or carcass characteristics at the time of marketing of pigs although slight reductions in growth performance in the nursery phase may be observed.

208 Effect of SID LYS Level with Constant Non-Essential Amino Acids

Abstract Many investigations on the effect of low protein diets reduce crude protein (CP) and have a constant standardized ileal digestible (SID) LYS resulting in reductions in ADG, ADFI, and gain:feed is some cases. This experiment was conducted to determine the impact of maintaining constant non-essential amino acids and changing SID LYS and other essential amino acids. For the experiment, 288 pigs (~22 d of age, 6.61 ± 0.95 kg, 8 replicates/treatment, 6 pigs/pen) were stratified by body (BW) and randomly allotted to one of 6 treatments in a randomized complete block design. Non-essential amino acids were fixed in all diets and synthetic amino acids were added to increase SID LYS from 1.15% to 1.4% while maintaining constant ratios of MET+CYS, THR, TRP, VAL, and ILE to LYS. Diets were corn, wheat, barley, and soy based with 1.1% corn starch in the least SID LYS diet. Synthetic amino acids were added to the diet at the expense of corn starch to maintain non-essential amino acid levels. The CP ranged from 17.8% when SID LYS was 1.15% and 18.6% when SID LYS was 1.4%. Experimental diets were fed for 21 d. Body weight, feed disappearance, visual fecal scores, and visual piglet scores were measured. Visual fecal scores (1 = normal to 4 = watery) and visual pig appearance scores (1 = pale and hairy to 4 = normal color and well-rounded muscle) were assessed on ordered likert scales to determine the probabilities of observing a more normal stool quality and a worse visual appearance, respectively. Performance data were analyzed as a general linear model. Stool quality and visual appearance were analyzed as a generalized linear mixed model. Contrasts were used to test linear and quadratic effects of dietary SID LYS. Results of the experiment are presented in Table 1. Increasing SID LYS with constant non-essential amino acids did not affect ADG or BW. The ADFI was linearly decreased (P &amp;lt; 0.1) and gain:feed was linearly increased (P &amp;lt; 0.0001) with increasing SID LYS (Table 1). Stool quality was not affected. Visual appearance of the pigs was quadratically affected (P &amp;lt; 0.05) by changing SID LYS. Pigs that had consumed diets with the lowest or highest SID LYS had the best visual appearance (lowest probability). The results of the current experiment differ suggest SID LYS may regulate feed intake and nutrient efficiency, but BW gain is not affected when non-essential amino acids are held constant. This differs from cases where CP is reduced, which results are decreased growth in many cases.

Effect of Nonsupplemented Low-Protein Diet on the Initiation of Renal Replacement Therapy in Stage 4 and 5 Chronic Kidney Disease: A Retrospective Multicenter Cohort Study in Japan

In subjects with chronic kidney disease (CKD), the effect of low-protein diet (LPD) is expected to alleviate uremic symptoms. However, whether LPD is effective in preventing loss of kidney function is controversial. The aim of this study was to evaluate the association between LPD and renal outcomes. We conducted a multicenter cohort study of 325 patients who suffered CKD stage 4 and 5 with eGFR ≥ 10ml/min/1.73m2, between January 2008 and December 2014. The primary diseases of the patients were chronic glomerulonephritis (47.7%), nephrosclerosis (16.9%), diabetic nephropathy (26.2%) and others (9.2%). The patients were divided into four groups, based on the mean protein intake (PI) /day, group 1 (n =76): PI < 0.5 g/kg ideal body weight/day, group 2 (n=56): 0.5 ≤ PI < 0.6 g/kg/day, group 3 (n=110): 0.6 ≤ PI < 0.8 g/kg/day, group 4 (n=83): PI ≥ 0.8 g/kg/day. Dietary supplementation with essential amino acids and ketoanalogues was not used. The outcome measure was occurrence of renal replacement therapy (RRT) (hemodialysis, peritoneal dialysis, renal transplantation (excluding preemptive transplantation)) and all-cause mortality until December 2018. Cox regression models were used to examine whether LPD was associated with the risk of outcomes. During a mean follow-up of 4.1 ± 2.2 years. 33 patients (10.2%) died of all causes, 163 patients (50.2%) needed to start RRT and 6 patients (1.8%) received a renal transplant. LPD therapy of 0.5 g/kg/day or less was significantly related to a lower risk of RRT and all-cause mortality [Hazard ratio = 0.656; 95% confidence interval, 0.438 to 0.984, p=0.042]. These results suggest that non-supplemented LPD therapy of 0.5 g/kg/day or less may prolong the initiation of RRT in stage 4 and 5 CKD patients.

Effect of Low Protein Diet Supplemented with Ketoanalogs on Endothelial Function and Protein-Bound Uremic Toxins in Patients with Chronic Kidney Disease.

Studies have demonstrated that a low-protein diet supplemented with ketoanalogs (KAs) could significantly retard progression of renal function in patients with chronic kidney disease (CKD) stages 3-5. However, its effects on endothelial function and serum levels of protein-bound uremic toxins remain elusive. Therefore, this study explored whether a low-protein diet (LPD) supplemented with KAs affects kidney function, endothelial function, and serum uremic toxin levels in a CKD-based cohort. In this retrospective cohort, we enrolled 22 stable CKD stage 3b-4 patients on LPD (0.6-0.8 g/day). Patients were categorized into control (LPD only) and study groups (LPD + KAs 6 tab/day). Serum biochemistry, total/free indoxyl sulfate (TIS/FIS), total/free p-cresyl sulfate (TPCS/FPCS), and flow-mediated dilation (FMD) were measured before and after 6 months of KA supplementation. Before the trial, there were no significant differences in kidney function, FMD, or uremic toxin levels between the control and study groups. When compared with the control group, the paired t-test showed a significant decrease in TIS and FIS (all p < 0.05) and a significant increase in FMD, eGFR, and bicarbonate (all p < 0.05). In multivariate regression analysis, an increase in FMD (p < 0.001) and a decrease in FPCS (p = 0.012) and TIS (p < 0.001) remained persistent findings when adjusted for age, systolic blood pressure (SBP), sodium, albumin, and diastolic blood pressure (DBP). LPD supplemented with KAs significantly preserves kidney function and provides additional benefits on endothelial function and protein-bound uremic toxins in patients with CKD.

Protein restriction for diabetic kidney disease.

Diabetic kidney disease (DKD) continues to be the leading cause of kidney failure across the world. For decades dietary protein restriction has been proposed for patients with DKD with the aim to retard the progression of chronic kidney disease (CKD) towards kidney failure. However, the relative benefits and harms of dietary protein restriction for slowing the progression of DKD have not been addressed. To determine the efficacy and safety of low protein diets (LPD) (0.6 to 0.8 g/kg/day) in preventing the progression of CKD towards kidney failure and in reducing the incidence of kidney failure and death (any cause) in adult patients with DKD. Moreover, the effect of LPD on adverse events (e.g. malnutrition, hyperglycaemic events, or health-related quality of life (HRQoL)) and compliance were also evaluated. We searched the Cochrane Kidney and Transplant Register of Studies up to 17 November 2022 through contact with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, EMBASE, conference proceedings, the International Clinical Trials Register (ICTRP) Search Portal and ClinicalTrials.gov. We included randomised controlled trials (RCTs) or quasi-RCTs in which adults with DKD not on dialysis were randomised to receive either a LPD (0.6 to 0.8 g/kg/day) or a usual or unrestricted protein diet (UPD) (≥ 1.0 g/kg/day) for at least 12 months. Two authors independently selected studies and extracted data. Summary estimates of effect were obtained using a random-effects model. Results were summarised as risk ratios (RR) with 95% confidence intervals (CI) for dichotomous outcomes and mean difference (MD) or standardised MD (SMD) with 95% CI for continuous outcomes. Confidence in the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. We identified eight studies involving 486 participants with DKD. The prescribed protein intake in the intervention groups ranged from 0.6 to 0.8 g/kg/day. The prescribed protein intake in the control groups was ≥ 1.0 g/kg/day, or a calculated protein intake ≥ 1.0 g/kg/day if data on prescribed protein intake were not provided. The mean duration of the interventions was two years (ranging from one to five years). Risks of bias in most of the included studies were high or unclear, most notably for allocation concealment, performance and detection bias. All studies were considered to be at high risk for performance bias due to the nature of the interventions. Most studies were not designed to examine death or kidney failure. In low certainty evidence, a LPD may have little or no effect on death (5 studies, 358 participants: RR 0.38, 95% CI 0.10 to 1.44; I² = 0%), and the number of participants who reached kidney failure (4 studies, 287 participants: RR 1.16, 95% CI 0.38 to 3.59; I² = 0%). Compared to a usual or unrestricted protein intake, it remains uncertain whether a LPD slows the decline of glomerular filtration rate over time (7 studies, 367 participants: MD -0.73 mL/min/1.73 m²/year, 95% CI -2.3 to 0.83; I² = 53%; very low certainty evidence). It is also uncertain whether the restriction of dietary protein intake impacts on the annual decline in creatinine clearance (3 studies, 203 participants: MD -2.39 mL/min/year, 95% CI -5.87 to 1.08; I² = 53%). There was only one study reporting 24-hour urinary protein excretion. In very low certainty evidence, a LPD had uncertain effects on the annual change in proteinuria (1 study, 80 participants: MD 0.90 g/24 hours, 95% CI 0.49 to 1.31). There was no evidence of malnutrition in seven studies, while one study noted this condition in the LPD group. Participant compliance with a LPD was unsatisfactory in nearly half of the studies. One study reported LPD had no effect on HRQoL. No studies reported hyperglycaemic events. Dietary protein restriction has uncertain effects on changes in kidney function over time. However, it may make little difference to the risk of death and kidney failure. Questions remain about protein intake levels and compliance with protein-restricted diets. There are limited data on HRQoL and adverse effects such as nutritional measures and hyperglycaemic events. Large-scale pragmatic RCTs with sufficient follow-up are required for different stages of CKD.

Effects of Dietary Protein Restriction on Colonic Microbiota of Finishing Pigs.

This study is aimed at the effects of low-protein diets with four amino acids balanced on serum biochemical parameters and colonic microflora of finishing pigs. Fifty-four healthy (Duroc × Landrace × Yorkshire) hybrid barrows with an average body weight of 70.12 ± 4.03 kg were randomly assigned to one of three dietary treatments with three barrows per pen and six pens per treatment. The barrows were fed a normal protein diet (NP), a low-protein diet (LP), and a very low-protein diet (VLP). Compared with the NP diet, reduced dietary protein did not influence serum biochemical parameters (p > 0.05). The valeric acid was significantly increased with the VLP diet (p < 0.05). Compared with the NP diets, the abundance of Terrisporobacter (13.37%) Clostridium_sensu_stricto_1 (23.37%) and Turicibacter (2.57%) increased to 21.04, 33.42 and 13.68% in LP diets and 16.72, 43.71 and 14.61% in VLP diets, while the abundance of Lactobacillus (9.30%) and Streptococcus (25.26%) decreased to 3.57 and 14.50% in LP diets and 1.86 and 4.07% in VLP diets. Turicibacter and Clostridium_sensu_stricto_6 had a powerful negative correlation with the content of valeric acid (p < 0.01), while Peptococcus and Clostridia_UCG-014 had a very solid positive correlation (p < 0.01). In conclusion, reducing dietary protein level can improve colon microbiota composition, especially reducing the abundance of bacteria related to nitrogen metabolism, but has no significant effect on SCFA except valeric acid. In addition, reduction in the dietary protein level by 5.48% had more different flora than that of 2.74% reduction in dietary CP level.

Effects of low protein diet with a balanced amino acid pattern on growth performance, meat quality and cecal microflora of finishing pigs.

The present study aimed to investigate the effects of low protein diets balanced with four amino acids on growth performance, meat quality and cecal microflora of finishing pigs. Fifty-four healthy hybrid barrows (Duroc × Landrace × Yorkshire) with an average body weight of 70.12 ± 4.03 kg were randomly assigned to one of the three dietary treatments with six replicate pens per treatment (three barrows per pen). The three dietary treatments included a normal protein diet (NP), a low protein diet (LP) and a very low protein diet (VLP). The average daily gain, average daily feed intake and feed conversion ratio of pigs were not significantly changed with the LP and VLP diets compared to the NP diet (P > 0.05). The water holding capacity and shear force of longissimus dorsi muscle were decreased, whereas the intramuscular fat content of the longissimus dorsi muscle was increased (P < 0.05) in pigs fed with the LP and VLP diets compared to the NP diet. The contents of saturated fatty acids in muscle were decreased (P < 0.05), whereas the content of polyunsaturated fatty acids in muscle was increased (P < 0.01) with the VLP diet compared to the NP diet. The contents of histamine, spermidine, spermine and tyramine of muscle were decreased with the VLP diet compared to the NP diet (P < 0.05). The relative abundance of Turicibacter, Terrisporobacter, Clostridium_sensu_stricto_1 and UCG-005 was higher (P < 0.05), whereas the relative abundance of Lactobacillus and Streptococcus was lower (P < 0.05) in pigs fed with the LP and VLP diets compared to the NP diet. Based on the correlation of cecal microbiota and cecal biogenic amine, the contents of tyramine, spermidine and histamine were negatively correlated with the abundance of Terrisporobacter (P < 0.01) and the content of histamine was positively correlated with the abundance of Lactobacillus (P < 0.01). Balanced with four essential amino acids, the VLP diet with crude protein levels decreased by > 4% increased the intramuscular fat content, changed the fatty acid and amino acid composition of longissimus dorsi muscle and the profile of cecum microbiota, and reduced the content of cecum bioamine, with no negative effect on the growth performance of pigs. © 2022 Society of Chemical Industry.

284 Gut and Skeletal Muscle Control the Effect of low Protein Diets on Feed Intake and Thermal Radiation of Broilers During Experimentally Induced Heat Stress

Abstract The objective of this study was to assess the effects of low protein diets on feed intake (FI), heat production and markers of FI and thermogenesis regulation in broilers under experimentally induced heat stress. Two-hundred-day-old broiler chicks were weight-matched and assigned into 36 pens (5-6 chicks/pen) followed by assigning them into two treatments (18 pens/treatment): 1) thermoneutral (TN), 2) heat stress (HS). Within each treatment, the pens were randomized to receive two diets (9 pens/diet): 1) normal protein (NP), 2) low protein (LP). The study lasted 6 weeks with 2 weeks of acclimation and 4 weeks of data collection. On week 6, birds were euthanized, and blood and tissue samples collected. All data were analyzed with either GLM or mixed procedure (SPSS). The student’s t-test was used to separate means between NP and LP diets within each treatment. There was no difference in average daily gain between NP and LP diets in the TN group, but LP decreased that during HS (P&amp;lt; 0.05). In TN condition, LP tended to increase the average daily feed intake (ADFI) compared to NP (P&amp;lt; 0.1), while during HS, LP was not different from NP in terms of ADFI (P&amp;gt;0.05). In TN condition, LP had a higher thermal radiation than NP, but LP had less thermal radiation than NP during HS (P&amp;lt; 0.05). In support of ADFI data, LP had a greater ghrelin transcript in the duodenum than NP in TN condition (P&amp;lt; 0.05). However, during HS, LP tended to decrease the plasma ghrelin concentration compared with NP (P&amp;lt; 0.1). Unlike TN condition, LP had a decreased muscle sirtuin and cytochrome c oxidase transcript than NP during HS (P&amp;lt; 0.05). Our data provide evidence that low protein diets mitigate the negative outcome of heat stress by reducing feed intake and heat production, which are regulated through genes expressed in the gut and skeletal muscle.

1353-P: Activation of Brown Adipose Tissue by Low-Protein Diet Ameliorates Hyperglycemia in Lipodystrophic Diabetic Mice Model

Long-term ad libitum dietary restriction such as low-protein diet (LPD) improves metabolic health and extends the life span of mice and possibly humans. However, most studies conducted thus far have focused on the preventive, but not therapeutic, potential of LPDs. Previously we shown that LPD (5.1% kcal from protein) was able to improve postprandial blood glucose values of the lipodystrophic IRFKO (adipose-specific insulin receptor knockout) mice after 14 days with strong activation of interscapular brown adipose tissue (iBAT) and increase energy expenditure. To determine whether iBAT activation was responsible for the hyperglycemia normalization after the LPD treatment, we surgically denervated iBAT of IRFKO mice before LPD treatment. Blood glucose were measured twice a week for up to 4 weeks, at the end of the monitoring mice were subjected to indirect calorimetry assessment (Promethion, Sable Systems) . Our data showed that surgical denervation of iBAT abolished the hyperglycemia normalization effect of LPD in the IRFKO mice. Morphologically, surgical denervation also prevented the ‘browning’ effect of LPD on the whitening iBAT observed in IRFKO mice. In line with the morphological data, LPD failed to induce thermogenic markers including UCP1 and BMP8b in denervated iBAT. In contrast, iBAT denervation has lesser effects on the LPD-induced energy expenditure and circulating FGF21 level, possibly due to compensation by beige fat formation in the inguinal WAT. Together, our data confirms that hyperglycemia normalization caused by LPD on IRFKO is iBAT activation dependent. Our observation suggests that blood glucose could be utilized to fuel LPD-induced iBAT activation as a mechanism for amino acid homeostasis. Further experimentation needs to be done in order to narrow down the mechanism driving this phenomenon. Taken together, our data suggest that short-term LPD could be a potential strategy for the treatment of metabolic syndrome. Disclosure M.D.Munoz: None. A.Zamudio: None. M.A.Mccann: None. C.Liew: None. Funding NIH RDK109015A1