Essential Amino Acid Supplementation Research Articles

Effects of essential amino acids supplementation in a low-protein diet on growth performance, intestinal health and microbiota of juvenile blotched snakehead (Channa maculata)

Developing a low-protein feed is important for the sustainable advancement of aquaculture. The aim of this study was to investigate the effects of essential amino acid (EAA) supplementation in a low-protein diet on the growth, intestinal health, and microbiota of the juvenile blotched snakehead, Channa maculata in an 8-week trial conducted in a recirculating aquaculture system. Three isoenergetic diets were formulated to include a control group (48.66 % crude protein (CP), HP), a low protein group (42.54 % CP, LP), and a low protein supplementation EAA group (44.44 % CP, LP-AA). The results showed that significantly lower weight gain (WG), specific growth rate (SGR), protein efficiency ratio (PER), and feed efficiency ratio (FER) were observed in fish that were fed LP than in the HP and LP-AA groups (P < 0.05). The HP and LP-AA groups exhibited a significant increase in intestinal villus length, villus width, and muscular thickness compared to the LP group (P < 0.05). Additionally, the HP and LP-AA groups demonstrated significantly higher levels of intestinal total antioxidant capacity (T-AOC), catalase (CAT), and superoxide dismutase (SOD) and lower levels of malondialdehyde (MDA) compared to the LP group (P < 0.05). The apoptosis rate of intestinal cells in the LP group was significantly higher than those in the LP and HP groups (P < 0.05). The mRNA expression levels of superoxide dismutase (sod), nuclear factor kappa B p65 subunit (nfκb-p65), heat shock protein 70 (hsp70), and inhibitor of NF-κBα (iκba) in the intestine were significantly higher in the LP group than those in the HP and LP-AA groups (P < 0.05). The 16s RNA analysis indicated that EAA supplementation significantly increased the growth of Desulfovibrio and altered the intestinal microflora. The relative abundances of Firmicutes and Cyanobacteria were positively correlated with antioxidant parameters (CAT and T-AOC), whereas Desulfobacterota was negatively correlated with sod and T-AOC. The genera Bacillus, Bacteroides, and Rothia were associated with the favorable maintenance of gut health. In conclusion, dietary supplementation with EAAs to achieve a balanced amino acid profile could potentially reduce the dietary protein levels from 48.66 % to 44.44 % without adversely affecting the growth and intestinal health of juvenile blotched snakeheads.

Enhanced gut microbiome supplementation of essential amino acids in Diploptera punctata fed low-protein plant-based diet.

Building on our previous work, we investigate how dietary shifts affect gut microbial essential amino acid (EAA) provisioning in the lactating cockroach Diploptera punctata. To that end, we fed cockroaches three distinct diets: a plant-only Gari diet composed of starchy and granulated root tuber Yucca (Manihot esculenta), a dog food diet (DF), and a cellulose-amended dog food (CADF) diet. We anticipated that the high carbohydrate, low protein Gari would highlight increased microbial EAA supplementation to the host. By day 28, we observed distinct profiles of 14 bacterial families in the insect gut microbiomes of the three dietary groups. CADF-fed insects predominantly harbored cellulolytic and nitrogen-fixing bacteria families Streptococcaceae and Xanthomonadaceae. In contrast, Gari-fed insects were enriched in anaerobic lignocellulolytic bacteria families Paludibacteraceae andDysgonomonadaceae, while DF-fed insects had a prevalence of proteolyticanaerobes Williamwhitmaniaceae and sulfate-reducing bacteria Desulfovibrionaceae. Furthermore, we confirmed significantly higher EAA supplementation in Gari-fed insects than in non-Gari-fed insects based on δ13C-EAA offsets between insect and their diets. The δ13C-EAA offsets between DF and CADF were nearly indistinguishable, highlighting the relevance of using the plant-based Gari in this experiment to unequivocally demonstrate this function in this insect. These results were underscored by lower standard metabolic rate (SMR) relative to the DF insect in Gari-fed (intermediate SMR and dietary quality) and CADF (least SMR and dietary quality) insects. The influence of diet on EAA provisioning and SMR responses in insects underscores the need for further exploration into the role of gut microbial functions in modulating metabolic responses.

Effects of Individual Essential Amino Acids on Growth Rates of Young Rats Fed a Low-Protein Diet.

To investigate the effects of individual essential amino acids (EAA) on growth and the underlying mechanisms, EAA individually supplemented a low-protein (LP) diet fed to young rats in the present study. Treatments were an LP diet that contained 6% crude protein (CP), a high-protein (HP) diet that contained 18% CP, and 10 LP diets supplemented with individual EAA to achieve an EAA supply equal to that of the HP diet. The CP concentration of the LP diet was ascertained from the results of the first experiment, which examined the effects of dietary CP concentrations on growth rates, with CP ranging from 2% to 26%. Weight gain was increased with the supplementation of His, Ile, Lys, Thr, or Trp as compared to the LP diet (p < 0.05). Feed intake was greater for the His-, Lys-, and Thr-supplemented treatments as compared to the LP group (p < 0.05). Protein utilization efficiency was lower for the HP group than other groups (p < 0.01). The supplementation of Leu, Lys, and Val led to reduced protein utilization efficiency (p < 0.05), but the supplementation of Thr and Trp led to greater efficiency than the LP group (p < 0.05). Compared to the LP group, plasma urea concentrations were elevated with individual EAA supplementation, with the exception of the Thr addition. The added EAA resulted in increased concentrations of the corresponding EAA in plasma, except for Arg and Phe supplementation. The supplementation of Arg, His, Leu, Lys, and Met individually stimulated mTORC1 pathway activity (p < 0.05), and all EAA resulted in the decreased expression of ATF4 (p < 0.05). In summary, the supplementation of His, Ile, Lys, Thr, or Trp to an LP diet improved the growth performance of young rats. Responses to His and Lys additions were related to the activated mTORC1 pathway and feed intake increases. The improved growth performance resulting from the addition of a single EAA is not solely attributed to the increased plasma availability of EAA. Rather, it may be the consequence of a confluence of factors encompassing signaling pathways, the availability of amino acids, and other associated elements. The additivity of these factors results in independent responses to several EAA with no order of limitation, as is universally encoded in growth models for all production animal species.

Evaluation of Dietary Essential Amino Acid Supplementation on Growth, Digestive Capacity, Antioxidant, and Intestine Health of the Juvenile Redclaw Crayfish, Cherax quadricarinatus.

The present study was an 8-week feeding trial investigating the effects of lysine and threonine supplementation in vegetable-based diets on growth, antioxidative capacity, and gut microbiota of juvenile redclaw crayfish, Cherax quadricarinatus (initial weight 11.52 ± 0.23 g). The lysine and threonine were supplemented to formulate five isonitrogenous (37%) and isolipidic (9%) diets containing 0% (control), 0.2% lysine (L0.2), 0.2% threonine (T0.2), 0.4% lysine (L0.4), and 0.4% threonine (T0.4), respectively. Compared to the control, weight gain rate (WGR) and specific growth rate (SGR) of C. quadricarinatus significantly increased with increasing dietary lysine and threonine supplementation from 0.2% to 0.4% (P < 0.05). Hepatopancreas trypsin activity significantly increased with increasing levels of lysine and threonine in diets (P < 0.05). However, the pepsin, lipase, and amylase activities were not affected by dietary levels of lysine and threonine (P > 0.05). Compared with the control, crayfish in T0.4 and L0.4 showed significantly higher glutathione peroxidase (GPx) activity (P < 0.05), lower alanine aminotransferase (ALT) activity, and lower malondialdehyde (MDA) content (P < 0.05). Supplementation with 0.4% lysine significantly changed the composition of the gut microbiota (P < 0.05), which showed a significantly increased relative abundance of Proteobacteria and decreased Firmicutes, Actinomycetes, and Pontomyces (P < 0.05). The PICRUSt analysis demonstrated that the abundance of the metabolism and cellular processes pathways in the L0.4 group were markedly decreased compared with the control (P < 0.05). Meanwhile, a tighter interaction of the microbiota community in crayfish was observed in the T0.4 experimental group. In conclusion, these results suggested that dietary supplementation with 0.4% threonine could significantly promote growth and improve microbial health in juvenile C. quadricarinatus.

Enhancing bovine immune, antioxidant and anti-inflammatory responses with vitamins, rumen-protected amino acids, and trace minerals to prevent periparturient mastitis.

Mastitis, the inflammatory condition of mammary glands, has been closely associated with immune suppression and imbalances between antioxidants and free radicals in cattle. During the periparturient period, dairy cows experience negative energy balance (NEB) due to metabolic stress, leading to elevated oxidative stress and compromised immunity. The resulting abnormal regulation of reactive oxygen species (ROS) and reactive nitrogen species (RNS), along with increased non-esterified fatty acids (NEFA) and β-hydroxybutyric acid (BHBA) are the key factors associated with suppressed immunity thereby increases susceptibility of dairy cattle to infections, including mastitis. Metabolic diseases such as ketosis and hypocalcemia indirectly contribute to mastitis vulnerability, exacerbated by compromised immune function and exposure to physical injuries. Oxidative stress, arising from disrupted balance between ROS generation and antioxidant availability during pregnancy and calving, further contributes to mastitis susceptibility. Metabolic stress, marked by excessive lipid mobilization, exacerbates immune depression and oxidative stress. These factors collectively compromise animal health, productive efficiency, and udder health during periparturient phases. Numerous studies have investigated nutrition-based strategies to counter these challenges. Specifically, amino acids, trace minerals, and vitamins have emerged as crucial contributors to udder health. This review comprehensively examines their roles in promoting udder health during the periparturient phase. Trace minerals like copper, selenium, and calcium, as well as vitamins; have demonstrated significant impacts on immune regulation and antioxidant defense. Vitamin B12 and vitamin E have shown promise in improving metabolic function and reducing oxidative stress followed by enhanced immunity. Additionally, amino acids play a pivotal role in maintaining cellular oxidative balance through their involvement in vital biosynthesis pathways. In conclusion, addressing periparturient mastitis requires a holistic understanding of the interplay between metabolic stress, immune regulation, and oxidative balance. The supplementation of essential amino acids, trace minerals, and vitamins emerges as a promising avenue to enhance udder health and overall productivity during this critical phase. This comprehensive review underscores the potential of nutritional interventions in mitigating periparturient bovine mastitis and lays the foundation for future research in this domain.

The effects of resistance exercise and leucine-enriched essential amino acid supplementation on muscle mass and physical function in post-gastrectomy patients: a pilot randomized controlled trial.

[Purpose] In gastric cancer patients, low muscle mass decreases overall survival and quality of life (QOL). Resistance exercise with leucine-enriched essential amino acid (LEAA) supplementation may prevent muscle mass loss. This study was aimed at determining whether resistance exercise with LEAA supplementation prevents muscle mass loss in post-gastrectomy patients. [Participant and Methods] We conducted a single-center, open-label, randomized controlled pilot trial. Ten participants who underwent gastrectomy were divided into two groups. The intervention group underwent resistance exercise at 70% of one repetition maximum and received a supplement of 3 g of LEAA twice daily for 15 days, while the control group received standard care. We compared changes in muscle mass, physical function (muscle strength and continuous walking distance), and QOL between the groups. [Results] We found good adherence and participation rates in both groups. We failed to detect a significant difference in muscle mass between the groups. The intervention group showed significant improvements in muscle strength and QOL, while the control group showed no significant changes. [Conclusion] We failed to detect a significant difference in muscle mass due to resistance exercise with LEAA supplementation in post-gastrectomy patients. However, resistance exercise with LEAA supplementation might be beneficial for muscle strength recovery and QOL improvements.

Essential amino acid supplements ingestion has a positive effect on executive function after moderate-intensity aerobic exercise

Aerobic exercise acutely improves cognitive function (e.g., executive function (EF); memory recognition (MR)) and increases circulating brain-derived neurotrophic factor (BDNF). In addition, branched-chain amino acids (BCAA) ingestion acutely shortens the choice reaction time and increases brain BDNF. We examined whether the ingestion of essential amino acid (EAA) supplements (mainly composed of BCAA) would positively impact on cognitive function and circulating BDNF after moderate-intensity aerobic exercise. Twenty-two healthy young men received either an EAA supplements or the placebo (PL) 30 min before undergoing aerobic exercise. The participants performed a cycling exercise at 60% of peak oxygen uptake for 30 min. EF after aerobic exercise was better after the EAA treatment than after the PL treatment (P = 0.02). MR (P = 0.38 for response accuracy; P = 0.15 for reaction time) and circulating BDNF (P = 0.59) were not altered by EAA supplements. EF improvement was correlated with increases in some amino acids (leucine, isoleucine, valine, lysine, phenylalanine; all Ps < 0.05) that are potential substrates for synthesizing neurotransmitters in the brain. These results suggest that EAA supplements ingestion had a positive effect on EF after moderate-intensity aerobic exercise, while MR and BDNF were not altered.

Interaction of anti-inflammatory drug naproxen with essential amino acids: Quantitative thermodynamic insights

A combination of ultrasensitive isothermal titration calorimetry and uv–visible spectroscopy has been employed to unravel interaction of anti-inflammatory drug naproxen with five essential amino acids L-arginine, L-lysine, L-phenylalanine, L-valine and L-tryptophan. The nature of interaction in each case has been examined based on standard molar enthalpy of interaction ΔHmo and changes in the spectral properties. The values and sign of ΔHmo have been related with the nature of interacting groups and solvent reorganization as a result of drug-amino acid association. Exothermic standard molar enthalpy of interaction of naproxen with L-arginine indicated significant of polar interactions, and endothermic heat effects with all other amino acids suggested dominance of hydrophobic effect and desolvation penalty in the association process. The overall value of enthalpy of interaction for all the studied amino acids is less than 2 kJmol-1 suggesting that these interactions are not very strong. The uv–visible results provided support to ITC results in obtaining mechanistic insights into the nature of interactions. The results derive significance from the fact that sometimes anti-inflammatory drug naproxen may be administrated along with supplements of essential amino acids. In case there is a strong drug-amino acids interaction, efficacy of each one may be affected.

209 Lowering Dietary Crude Protein Concentration Decreases Nitrogen Excretion and pH of Urine and Slurry in 15-kg Nursery Pigs

Abstract The objective of the present work was to determine the effects of reucing dietary crude protein (CP) concentrations with essential amino acid (EAA) supplementation on nitrogen balance, urinary pH, and slurry pH in nursery pigs. Twelve barrows with an initial body weight of 15.2 kg (standard deviation = 0.7) were individually housed in metabolism crates. A quadruplicated 3 × 2 incomplete Latin square design with 3 experimental diets and 2 periods per square was employed. Experimental diets based on corn, soybean meal, whey powder, fish meal, and blood plasma were formulated to contain 19.4% CP, 17.5% CP, and 15.7% CP by reducing inclusion rates of soybean meal. All experimental diets were supplemented with EAA to meet all EAA requirements. Each period consisted of a 4-day adaptation period and a 24-hour collection period followed by a 4-day collection period. On day 5, feces and urine were collected for 24 h and the feces and urine were mixed in a ratio of fecal weight and urine weight at the end of collection to obtain slurry samples. Then, pH of urine and slurry samples was measured immediately. On days 6 and 10, chromic oxide was added at 0.5% in morning meals as a marker and the marker-to-marker procedure was used for the quantitative collection of feces. Urine collection was initiated at 1000 h on day 6 and terminated at 1000 h on day 10. Orthogonal polynomial contrasts were performed to test linear and quadratic effects of dietary CP concentrations on the response variables. Daily N intake was linearly decreased with decreasing dietary CP concentrations (P &amp;lt; 0.05). Daily fecal and urinary N excretions linearly decreased with decreasing dietary CP concentrations (P &amp;lt; 0.05), whereas N retention rate as % of intake was linearly increased with decreasing dietary CP concentrations (P &amp;lt; 0.05). The urine pH and slurry pH were linearly decreased with decreasing dietary CP concentrations (P &amp;lt; 0.05). In conclusion, lowering dietary CP concentrations decreased N excretion and pH of urine and slurry.

International Society of Sports Nutrition Position Stand: Effects of essential amino acid supplementation on exercise and performance.

Position Statement: The International Society of Sports Nutrition (ISSN) presents this position based on a critical examination of literature surrounding the effects of essential amino acid (EAA) supplementation on skeletal muscle maintenance and performance. This position stand is intended to provide a scientific foundation to athletes, dietitians, trainers, and other practitioners as to the benefits of supplemental EAA in both healthy and resistant (aging/clinical) populations. EAAs are crucial components of protein intake in humans, as the body cannot synthesize them. The daily recommended intake (DRI) for protein was established to prevent deficiencies due to inadequate EAA consumption. The following conclusions represent the official position of the Society: 1. Initial studies on EAAs' effects on skeletal muscle highlight their primary role in stimulating muscle protein synthesis (MPS) and turnover. Protein turnover is critical for replacing degraded or damaged muscle proteins, laying the metabolic foundation for enhanced functional performance. Consequently, research has shifted to examine the effects of EAA supplementation - with and without the benefits of exercise - on skeletal muscle maintenance and performance. 2. Supplementation with free-form EAAs leads to a quick rise in peripheral EAA concentrations, which in turn stimulates MPS. 3. The safe upper limit of EAA intake (amount), without inborn metabolic disease, can easily accommodate additional supplementation. 4. At rest, stimulation of MPS occurs at relatively small dosages (1.5-3.0 g) and seems to plateau at around 15-18 g. 5. The MPS stimulation by EAAs does not require non-essential amino acids. 6. Free-form EAA ingestion stimulates MPS more than an equivalent amount of intact protein. 7. Repeated EAA-induced MPS stimulation throughout the day does not diminish the anabolic effect of meal intake. 8. Although direct comparisons of various formulas have yet to be investigated, aging requires a greater proportion of leucine to overcome the reduced muscle sensitivity known as "anabolic resistance." 9. Without exercise, EAA supplementation can enhance functional outcomes in anabolic-resistant populations. 10. EAA requirements rise in the face of caloric deficits. During caloric deficit, it's essential to meet whole-body EAA requirements to preserve anabolic sensitivity in skeletal muscle.

Parenteral Nutrition in the Pediatric Oncologic Population: Are There Any Sex Differences?

Gender-based medicine is attracting increasing interest every day, but studies on pediatric populations are still limited. In this setting, sex differences among patients undergoing total parenteral nutrition (TPN) have not been previously reported. This study investigated the presence of sex differences in parenteral nutrition composition and outcomes among a cohort of pediatric patients admitted at the Oncohematology and Bone Marrow Transplant Unit of the Institute for Maternal and Child Health "Burlo Garofolo" of Trieste, Italy. For all 145 recruited patients (87 males, 58 females), the following data were collected: age, sex, volume and duration of TPN, macro- and micronutrient composition of TPN bags, electrolytic or blood gases imbalance, glycolipid alterations, liver damage during TPN, and the incidence of sepsis and thrombosis. The analysis showed that females required higher daily phosphate intake (p = 0.054) and essential amino acid supplementation (p = 0.07), while males had a higher incidence of hypertriglyceridemia (p < 0.05) and cholestasis. A higher incidence of sepsis was found in the non-transplanted male population (p < 0.05). No significant differences were appreciable in other analyzed variables. This study aims to create a basis for future gender-based nutritional recommendations in the pediatric field.

Effect of low crude protein breeder diets with balanced limiting amino acids on progeny chick quality and juvenile growth performance in Swarnadhara birds

A study was carried out to evaluate the effects of low crude protein diets supplemented with limiting amino acids on progeny chick quality and growth performance utilizing Swarnadhara laying hens. The feeding trial was done in 240 Swarnadhara layers from 29 to 40 weeks in a completely randomized design in five treatment groups with six replications of eight birds. The first treatment consisted of control diet (T1) based on corn soybean meal formulated at 16% CP and 2700 kcal ME meeting the ICAR (2013) requirements for CP and ME and also for the first four limiting amino acids at the following concentrations: methionine 0.35%, lysine 0.75%, threonine 0.52%, and tryptophan 0.16%. The other treatment diets (T2 to T5) were made isocaloric with control while reducing CP content to 15.5, 15, 14.5, and 14%, respectively, incorporating synthetic amino acids in sufficient quantities to match control amino acid levels. Chick quality was evaluated by grading chicks for appearance, activity and down conditions replicate-wise and individual chick hatch weights were recorded in 5 different breeder diet groups. The chicks in all the replicates were fed with the same basal diet containing 21% CP and 2800 kcal/kg ME as per ICAR (2013) requirements during first six weeks of age. The data on chick quality, body weight, feed consumption and feed efficiency showed no significant difference. Hence it can be concluded that the crude protein content of the Swarnadhara breeder diet could be reduced to 14% with essential amino acid supplementation without affecting the progeny performance.

Theoretical and electrochemical studies of host-guest inclusion complexes formed between L-Tryptophan with α- and β-cyclodextrins

L-Tryptophan (L-Trp) is an essential amino acid supplement that plays a role in regulating the physiological functions of the body. Inclusion complexes of cyclodextrins (CDs) with organic biomolecules are widely used for biomedicine, pharmaceutical applications, and drug delivery. So, the formation of inclusion complexes of amino acid L-Trp with α- and β-CDs was theoretically investigated using AutoDock Vina 1.1.2, two-hybrid ONIOM method [ONIOM2 (B3LYP/321-G and PM6)], molecular dynamic simulation (MD), and electrochemically using cyclic voltammetry (CV). The free energy of binding values for α- and β-CDs/L-Trp inclusion complexes obtained using AutoDock Vina 1.1.2 and ONIOM2 are -4.6 & -5.5 kcal mol−1 and -684.34 & -685.09 kcal mol−1, respectively. From the binding energy values, the inclusion complexes of β-CD/L-Trp are more stable than α-CD/L-Trp. The MD simulations for 2 ns were further performed to calculate the hydrogen (H) bonding interaction process of the α- and β-CDs molecules with the L-Trp. Also, the electrochemical responses to the variations of α- and β-CDs concentrations with fixed L-Trp and vice versa were measured using CV. The formation of stable inclusions of L-Trp in α- and β-CDs causes significant changes in L-Trp redox properties. The binding constant values of α-CD/L-Trp (370 M-1) and β-CD/L-Trp (434 M-1) inclusion complexes at 298 K and thermodynamic parameters (∆G) were calculated from the above CV data using a Benesi–Hildebrand linear plot. The α- and β-CDs/L-Trp inclusion complexes binding energies from theoretical studies are in good agreement with the results obtained through experimental methods. These results clearly revealed the formation of inclusion complexes in which the guest molecule L-Trp, was tightly entrapped inside the cavity of the host β-CD than α-CD molecules.

Benefits of essential amino acid supplementation in patients following total knee arthroplasty

Benefits of essential amino acid supplementation in patients following total knee arthroplasty

The Effect of Intravenous Essential Amino Acid Supplementation on Recovery of Kidney Function in Acute Kidney Injury Patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia

Background: Acute kidney injury (AKI) is a clinical condition characterized by a rapid decline in kidney function that causes homeostatic failure in regulating fluid, electrolyte, and acid-base balance within hours to days. Nutritional supplementation is effective in replacing lost protein and as an energy reserve. This study aimed to determine the effect of intravenous essential amino acid supplementation on the recovery of kidney function in acute kidney injury patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia.&#x0D; Methods: This study is an open clinical trial of experimental research. A total of 34 research subjects participated in this study, where the subjects were grouped into treatment (IV amino acid supplementation) and placebo groups. Data analysis was carried out using STATA in univariate and bivariate.&#x0D; Results: Administration of amino acid supplements can reduce creatinine by 1.36. Meanwhile, the placebo was unable to reduce creatinine levels and even caused an increase in creatinine by 0.26.&#x0D; Conclusion: Intravenous administration of essential amino acid supplements has an effect on the recovery of kidney function in acute kidney injury patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia.

Perioperative Essential Amino Acid Supplementation Facilitates Quadriceps Muscle Strength and Volume Recovery After TKA: A Double-Blinded Randomized Controlled Trial.

Perioperative essential amino acid (EAA) supplementation suppresses lower-limb muscle atrophy and promotes functional improvement in the first 4 weeks after total knee arthroplasty (TKA). However, its effect on the recovery of muscle volume and strength in the intermediate term is unclear. The aim of this study was to evaluate the effect of perioperative EAA supplementation on the recovery of lower-limb muscle volume and strength in the 2 years after TKA. Sixty patients who underwent unilateral TKA for primary knee osteoarthritis were included in this double-blinded randomized controlled trial. After excluding dropouts, 26 patients assigned to the EAA group (9 g/day) and 26 assigned to the placebo group (powdered lactose, 9 g/day) were available for analysis. Patients received EAA supplementation or a placebo from 1 week prior to surgery to 2 weeks after it. The rectus femoris muscle area was measured using ultrasonography and quadriceps muscle strength was measured isometrically with a handheld dynamometer, preoperatively and periodically up to 2 years postoperatively. Knee pain, knee range of motion, functional mobility, and Knee Society Score 2011 subjective scores were measured at each time point. Perioperative management, except for supplementation, was identical in the 2 groups. Taking the baseline as 100%, the mean values in the EAA and placebo groups were 134% ± 31% and 114% ± 27%, respectively, for the rectus femoris muscle area and 159% ± 54% and 125% ± 40% for the quadriceps muscle strength, respectively, at 2 years after surgery. The differences were significant (p < 0.05). Clinical outcomes were not significantly different between the 2 groups. Perioperative EAA supplementation contributes to the recovery of rectus femoris muscle volume and quadriceps muscle strength in the 2 years after TKA. The EAA supplementation did not impact clinical outcomes. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Weight Management, Micronutrients, and Supplements in Diabetes

This year’s 39th International Symposium on Diabetes and Nutrition in Anavyssos, Greece, hosted a series of presentations and plenary lectures with a focus on the effects of weight loss, micronutrients, nutritional supplements, and alternative dietary patterns in the prevention and management of Type 2 diabetes (T2D) and cardiovascular risk reduction. Michael Lean discussed how diabetes remission can be achieved through weight loss using a low-energy diet (LED) or very low-energy diet (VLED), accompanied by continued long-term support from specialised healthcare professionals. Jeffrey Mechanick discussed the importance and impact of early intervention on T2D and cardiovascular disease (CVD). He emphasised that T2D should be seen not just at the point of disease, but on a spectrum from prediabetes to complications, with early interventions having significant impact on not only the progression of T2D, but also into the latter stages.Simin Liu presented an integrative multilevel framework for causal inference to personalise cardiometabolic health, highlighting recent work investigating the roles of dietary minerals, environment metals, and genomics in relation to cardiovascular disease and diabetes. Several of the presentations included discussion of specific interventions. Daniel West discussed the use of whey protein (WP) and how it can help control postprandial glycaemic excursions (PGE) in people with T2D controlled on oral antihyperglycaemic drugs. Following this, Andrea Hawkinson discussed how a new supplement, mulberry leaf (Morus alba) extract (MLE), can significantly lower postprandial glucose response, as well as early insulin response, highlighting the need for further studies to evaluate its efficacy in people with T2D. Philip Atherton showed studies providing evidence that protein and essential amino acid (EAA) supplementation can help support muscle mass, which is especially essential for older people with T2D and sarcopenia. Finally, Jose-María López-Pedrosa spoke about how a supplement containing slow digestible carbohydrates (SDC), arginine, lysine, and β-hydroxy-β-methylbutyric acid (HMB) can help preserve muscle mass, as well as improve insulin resistance, in a rat model of diabetes.

Balanced Free Essential Amino Acids and Resistance Exercise Training Synergistically Improve Dexamethasone-Induced Impairments in Muscle Strength, Endurance, and Insulin Sensitivity in Mice.

Our previous study shows that an essential amino acid (EAA)-enriched diet attenuates dexamethasone (DEX)-induced declines in muscle mass and strength, as well as insulin sensitivity, but does not affect endurance. In the present study, we hypothesized that the beneficial effects will be synergized by adding resistance exercise training (RET) to EAA, and diet-free EAA would improve endurance. To test hypotheses, mice were randomized into the following four groups: control, EAA, RET, and EAA+RET. All mice except the control were subjected to DEX treatment. We evaluated the cumulative rate of myofibrillar protein synthesis (MPS) using 2H2O labeling and mass spectrometry. Neuromuscular junction (NMJ) stability, mitochondrial contents, and molecular signaling were demonstrated in skeletal muscle. Insulin sensitivity and glucose metabolism using 13C6-glucose tracing during oral glucose tolerance tests were analyzed. We found that EAA and RET synergistically improve muscle mass and/or strength, and endurance capacity, as well as insulin sensitivity, and glucose metabolism in DEX-treated muscle. These improvements are accomplished, in part, through improvements in myofibrillar protein synthesis, NMJ, fiber type preservation, and/or mitochondrial biogenesis. In conclusion, free EAA supplementation, particularly when combined with RET, can serve as an effective means that counteracts the adverse effects on muscle of DEX that are found frequently in clinical settings.

Responses of Combined Non-starch Polysaccharide Enzymes and Protease on Growth Performance, Meat Quality, and Nutrient Digestibility of Yellow-Feathered Broilers Fed With Diets With Different Crude Protein Levels.

The aim of this study was to investigate the responses of non-starch polysaccharide (NSP) enzymes and protease combination on growth performance, meat quality, and nutrients digestibility of yellow-feathered broilers fed with corn-soybean meal basal diets with normal and subnormal crude protein (CP) levels. The experimental design was completely randomized with a 2 × 2 factorial arrangement of treatments, including six replicates of 20 birds per pen. Two basal diets were formulated with normal CP level as positive control (PC) and subnormal CP level without extra essential amino acid (AA) supplementation as negative control (NC). The basal diets were supplemented without or with NSP enzymes and protease. Broilers fed with the NC diet had lower (P < 0.05) final body weight (BW), average daily weight gain (ADG) on days 1–21, 22–56 and 1–56 and higher (P < 0.05) feed-to-gain ratio (F/G) on day 22–56 than those fed with PC diet. The broilers fed with the NC diet had higher (P < 0.05) L* and b* values in thigh muscle, crypt depth in the duodenum, and dry matter (DM) digestibility as well as lower (P < 0.05) villus height, musculature thicknesses, and villus height: crypt depth in the duodenum than those fed with the PC diet. Dietary NSP enzymes and protease combination increased (P < 0.05) the ADG and F/G of the broilers on days 1–56, and pH values in breast and thigh muscles as well as the digestibility of DM, gross energy (GE), CP and most AAs of the broilers on day 56. Compared with the PC diet, the combination of NSP enzymes and protease exhibited greater (P < 0.05) improvements in the digestibility of DM, CP, and some AAs (Asp, Ile, and Leu) in the broilers fed with the NC diet. In conclusion, reducing CP diet without essential AA supplementation impaired the growth performance and meat color of the thigh muscles of the broilers. The combination of NSP enzymes and protease effectively improved the growth performance, meat quality, and nutritional values of the broilers. In terms of the digestibility of DM, CP, and some AAs, the magnitude of response to the addition of NSP enzymes and protease was greater in the low nutritional-quality diet with a subnormal CP level.

Considerations for prenatal and postpartum management of a female patient with ornithine transcarbamylase deficiency

We report on pregnancy management and outcomes in a 27-year-old female patient with ornithine transcarbamylase (OTC) deficiency, the most common inherited enzyme deficiency in the urea cycle. Our patient was diagnosed during childhood after hyperammonemia associated with surgery and steroid treatment and was well-controlled with nitrogen scavenger treatment, low-protein diet, and L-citrulline supplementation. OTC gene sequencing identified a variant of unknown significance that has more recently been classified as likely pathogenic. Women with OTC deficiency are at increased risk of hyperammonemia during pregnancy and the postpartum period, therefore monthly follow up and laboratory assessments are critical in management decision making. Our patient was maintained on glycerol phenylbutyrate, L-citrulline and essential amino acid supplements, along with restricted protein intake during pregnancy. A multidisciplinary approach with the obstetrics, prenatal genetics, high risk obstetric, and anesthesia teams was also necessary for optimal management during pregnancy, throughout labor and delivery, and during the postpartum period. After successful childbirth and discharge, our patient experienced a hyperammonemic crisis related to poor enteral nutrition, and acute management protocols were implemented to stabilize her. For her newborn son, acute hyperammonemia protocols were on standby, and newborn screening and laboratory testing were expedited to assess his risk. He was healthy and did not experience symptoms of concern. In this case report, we emphasize the importance of close collaboration with maternal-fetal medicine team members during and immediately after pregnancy to ensure successful management of a female patient with OTC deficiency and her newborn.