Protein Intake Research Articles

Exploring Emotional, Restrained, and External Eating Behaviors: Impacts on Energy and Nutrient Intakes Among Korean Adults

Background/Objectives: This study aimed to investigate the levels of emotional, restrained, and external eating behaviors (EBs) among adults, categorize them, and analyze their energy and nutrient intake. Methods: A self-reported survey was administered to 522 Korean adults aged 19–64 years to evaluate their emotional, restrained, and external EBs. They were categorized into five types: Non-specific (NS), Emotional (Emo), Restrained (Res), External (Ext), and Combined (Com) EB types. Subsequently, energy intake, intake ratios and levels, and vitamin and mineral intakes were compared after adjusting for sex and age. Results: The Ext type participants consumed energy and an average of 3003.01 kcal per day, while those with Res type consumed 2415.77 kcal. Notably, both the Ext and Com types had higher proportions of excessive energy intake, while the NS and Res types displayed higher proportions of insufficient energy intake. The Emo type yielded a high ratio of lipid intake, while the Com type exhibited high ratios of both lipid and protein intakes. Furthermore, the Res type demonstrated lower vitamin E, niacin, and potassium intakes than the other types. Conclusions: Since the Ext type suggests excessive energy intake, and the Res type suggest intake of vitamin E, niacin, and potassium, identifying EB types provides a novel perspective for nutritional improvement strategies.

Dietary acidity and bone mass in minority children and adolescents: a cross-sectional analysis from the MetA-Bone trial.

Childhood/adolescence is key for developing strong bones. With the continuing rise in osteoporosis rates in Western societies, attention has turned to the possible impact of diets that create high levels of acid in the body. Some studies have shown an association between dietary acid load and bone mass, but there are limited studies in children/adolescents and none in Hispanics. This study aimed to evaluate the associations between dietary acid load (assessed as dietary potential renal acid load, PRAL, and protein to potassium ratio) and whole-body bone mineral content (BMC) and density (BMD) in a sample of 123 children and adolescents of predominantly Hispanic ethnicity. This study is a secondary cross-sectional analysis. Dietary PRAL was positively associated with BMC and BMD overall (p < 0.05) and with BMC in boys (p < 0.05) when adjusted for energy misreporting only. The vegetable protein to potassium ratio was inversely associated with BMC (p = 0.004) in boys only, after adjusting for important factors. Dietary acid load seems to be associated with BMC in boys in this sample of primarily Hispanic children. Long-term studies are needed to confirm these results and to understand the importance of protein intake in relation to other key nutrients in bone mass acquisition among Hispanic boys.

Dietary protein intake and PM2.5 on ovarian cancer survival: A prospective cohort study.

Evolving evidence suggests both protein consumption and particulate matter less than 2.5 micrometers (PM2.5) might be related to ovarian cancer (OC) mortality. However, no epidemiological studies have explored their potential interaction. The objective of this study was to explore the association of dietary protein, PM2.5, and their interaction with the survival of OC patients. A prospective cohort study was carried out, which encompassed 658 newly diagnosed OC patients (18-79 years) residing in China. Dietary protein intakes were collected through a food frequency questionnaire examination, including total protein and protein from diverse sources. Average residential PM2.5 concentrations were evaluated using satellite-derived models. We calculated the hazard ratio (HR) and its 95 % confidence interval (CI) by adjusting for multiple variables using Cox proportional risk models. By assessing the relative excess risk due to interaction (RERI) arising from the interplay between PM2.5 exposure and dietary protein intake, we explored the additive interaction between the two. Multiplicative interaction was assessed through a cross-product interaction term. During a median follow-up of 37.60 months, 123 deaths were documented. As for all-cause mortality, the multivariate-adjusted HRs (95 % CIs) in the highest vs. the lowest tertile were 0.57 (0.35-0.93), 0.60 (0.36-0.99), and 0.58 (0.37-0.90) for intakes of fish, egg, as well as fruit/vegetable protein, respectively (all P for trend < 0.05). A positive association between PM2.5 exposure and all-cause mortality was observed (HR=1.52; 95 % CI: 1.13-2.05, per interquartile range increment). Notably, dietary fish, egg, and fruit/vegetable protein modified these associations, as patients with lower intakes had significantly higher PM2.5-related mortality in the cohort (all P for interaction < 0.05). This study provides evidence linking the potential interactions between dietary fish, egg, and fruit/vegetable protein intake and PM2.5 exposure on all-cause mortality of OC patients. Our study demonstrates the importance of adherence to a certain protein diet in reducing PM2.5-related mortality risk for OC patients.

Physical Activity and Eating Habits Are Related to Chronic Disease in the Basic Livelihood Security Program

Objectives: Chronic diseases are a significant public health issue, especially for socioeconomically vulnerable population groups. The purpose of this study is to compare the prevalence of chronic diseases in people receiving and not receiving BLS and to determine the prevalence of chronic diseases according to the physical activity and dietary habits of people receiving BLS. Methods: Data were derived from the sixth to ninth waves (2014–2022) of the Korea National Health and Nutrition Examination Survey (KNHANES), focusing on 15,041 participants aged 65 and older. Demographic characteristics, dietary intake, physical activity, and chronic disease status were assessed. Multivariate logistic regression analysis was used to calculate odds ratios for chronic diseases according to physical activity and dietary habits. Results: The BLS group exhibited higher prevalence rates of hypertension and diabetes, along with lower dietary intake of energy, protein, fat, carbohydrates, dietary fiber, and vitamin C, compared to the non-BLS group. A below-average intake of energy and carbohydrates was associated with increased odds of hypertension and diabetes, particularly in the BLS group. For dietary fiber, a significant association with diabetes was found only in the BLS group. Sedentary behavior exceeding 9 h per day was linked to higher odds of chronic diseases in both groups, with stronger associations in the BLS group. Limited walking frequency (less than 1 day per week) further exacerbated risks. Conclusions: BLS recipients demonstrated higher chronic disease prevalence, poorer dietary habits, and more sedentary behavior compared to non-recipients. The associations between lifestyle factors and chronic diseases were generally more substantial in the BLS group, suggesting the need for targeted interventions to improve dietary quality and physical activity patterns in this vulnerable population.

Neonatal Nutrition and Brain Structure at 7 Years in Children Born Very Preterm

Neonatal protein intake following very preterm birth has long lasting effects on brain development. However, it is uncertain whether these effects are associated with improved or impaired brain maturation. To assess the association of neonatal protein intake following very preterm birth with brain structure at 7 years of age. This cohort study involved children born very preterm before or after a change in neonatal intensive care unit nutritional protocol that increased protein intake at the National Women's Hospital in Auckland, New Zealand. The children completed magnetic resonance imaging (MRI) scanning at 7 years. There were 128 children who were initially eligible. MRI data were ineligible for analysis if excessive head motion or clinical brain abnormalities were present. Data were collected from July 2012 to January 2016, and data analysis took place from January 2017 to March 2024. Neonatal intensive care unit nutritional protocol. Those who were born before the protocol change took place (July 2005 to December 2006) were in the old protocol group, while those who were born after the protocol change (January 2007 to October 2008) were in the new protocol group. Observers were blind to participant grouping. All actual enteral and parenteral intakes of protein, fat, energy, and breast milk for days 1 to 7 and days 1 to 14, and growth velocity to postnatal day 28 were calculated for each infant. Preplanned outcomes were group comparisons between regional brain volumes and diffusion parameters of major white matter tracts along with analyses with both groups combined exploring associations of nutrition with brain metrics. Data from 99 children were analyzed, including 42 in the old protocol group (26 female [55%]; mean [SD] gestational age at birth, 27 [2] weeks) and 57 in the new protocol group (27 female [47%]; mean [SD] gestational age at birth, 26 [2] weeks). Protein intake differed between the groups at both 7 days (old protocol: mean [SD] intake, 17 [2] g/kg-1; new protocol: mean [SD] intake, 21 [2] g/kg-1) and 14 days after birth (old protocol: mean [SD] intake, 41 [6] g/kg-1; new protocol: mean [SD] intake, 45 [7] g/kg-1). The new protocol group had smaller brain volume as a percentage of intercranial volume than the old protocol group (mean [SD], 80% [4%] vs 86% [7%]) but absolute brain volumes were similar. The new protocol group had significantly thinner lateral occipital and lateral parietal cortices than the old protocol group. With both groups combined, those with greater protein, fat, energy, and breast milk intake had more mature diffusion tensor metrics (higher fractional anisotropy and less diffusion) across multiple tracts, although this finding did not reach statistical significance for every tract. In this cohort of children born very preterm, children with greater neonatal protein intake had a more mature profile of brain metrics assessed with MRI at 7 years of age. These results contribute to the ongoing evaluation of optimal nutrition for infants born very preterm and suggest that the protein intake experienced by the new protocol group may promote brain maturation in a way that is still observable at 7 years of age.

The Essential Role of Right Amount and Quality of Protein for Ensuring Child Growth and Maintenance of Bone and Muscle Mass

Protein is a vital macronutrient, essential for growth, tissue repair, and immune function. However, the impact of elevated protein intake during childhood and adolescence remains controversial. While high protein intake in older adults is often recommended for maintaining muscle mass and preventing frailty, excessive intake in younger populations has raised concerns about potential health risks, particularly related to obesity. This review aims to update current literature on the long-term effects of protein consumption in children and adolescents (ages 4-18) and to explore emerging methods for evaluating protein metabolism in this age group. The RDA for protein varies based on age, sex, and activity level. Generally, it is suggested that children consume about 0.95-1.3 grams of protein per kilogram of body weight per day, depending on age and specific requirements. In many developed countries, children and adolescents often consume protein at levels 2-3 times higher than the RDA, potentially leading to both positive and negative health outcomes. Protein is critical for normal growth and development during childhood and adolescence. Adequate intake supports muscle development, immune function, and the production of hormones. Studies suggest that elevated protein intake may be linked to increased Fat-Free Mass Index (FFMI), which is beneficial for muscle development and overall body composition. High protein diets have been associated with increased satiety, which can help in managing appetite and potentially reducing overall caloric intake, thus contributing to healthier weight maintenance. Some evidence suggests a correlation between high protein intake in infancy and childhood and increased risk of obesity later in life. This association may be due to the overactivation of growth pathways and increased insulin-like growth factor-1 (IGF-1) levels. Excessive protein intake has been hypothesized to strain kidney function, especially in individuals with pre-existing kidney conditions. However, current evidence in healthy children and adolescents is inconclusive. This narrative review emphasizes the need for a nuanced understanding of protein intake in children and adolescents, considering both the benefits and potential risks associated with high protein consumption. As research evolves, dietary guidelines may need to be adjusted to reflect the latest findings.

Does physical activity level and total energy expenditure relate to food intake, appetite, and body composition in healthy older adults? A cross-sectional study

PurposeWith ageing, older adults (≥ 65 years) may experience decreased appetite, contributing to declines in body weight and muscle mass, potentially affecting physical capabilities. Physical activity (PA) has been suggested as a potential strategy to enhance appetite in older adults, but evidence supporting this is insufficient. This study aimed to investigate the relationship between PA levels, total energy expenditure (TEE), body composition, energy intake (EI) and appetite in older adults.MethodsOne hundred and eight healthy older adults (age 70 ± 4 years; BMI 24.3 ± 2.6 kg/m2) were categorised into three groups (low, medium, high) based on accelerometer-measured PA level (AMPA) and TEE from 7-day PA diaries. Body composition was measured using bioelectrical impedance. Energy and nutrient intakes were assessed using 3-day weighed food diaries. Appetite was assessed using the visual analogue scales at 30-min intervals throughout 1 day.ResultsTEE was positively correlated with EI and % muscle mass (p < 0.05), with higher % muscle mass and TEE associated with higher EI. Energy and protein intake were significantly higher in the high TEE group than the low group (p = 0.03, p = 0.01; respectively). No significant differences in energy and macronutrient intake were observed across AMPA groups, and appetite components (hunger, fullness, desire to eat, prospective consumption) did not differ significantly in either the AMPA or TEE groups.ConclusionsHigher TEE is associated with higher energy and protein intake, with body composition playing a crucial role. These findings highlight the importance of considering PA, TEE, and body composition in interventions aimed at improving EI in older adults.Clinical Trail registration: clinicaltrials.gov as NCT05067036. Registered 2 October 2021, https://classic.clinicaltrials.gov/ct2/show/NCT05067036

Effect of optimized food-based recommendations on nutrient intakes, hemoglobin levels, and memory performance of adolescent girls in East Java, Indonesia

BackgroundFAO/WHO introduced food-based dietary guidelines (FBDG) to promote healthy dietary habits. To translate the FBDG, optimized food-based recommendations (FBR) can be developed using linear programming (LP) to address problem nutrients. Despite the importance of local-specific FBR for anemia prevention, no study has reported the effect of nutrition education which promoted FBR in adolescent girls. Therefore, this study aimed to investigate the effect of optimized FBR in adolescent girls in improving dietary and nutrient intakes, hemoglobin levels, and memory performance.MethodsThe intervention study was carried out in Malang District, Indonesia amongst 14–18 year adolescent girls. The study’s Indonesian slogan was Remaja which meant Active, Healthy, Smart, and Creative adolescents. The optimized FBR was developed using LP and translated into six key messages. Twenty-week nutrition education was integrated into the weekly school’s system.ResultsAfter 20 weeks, a significant increase in dietary practices (animal protein, liver, plant protein, vegetables), nutrient intakes (protein, fat, iron), and memory performance (digit span forward and backward) were found in the intervention group. In contrast, there was decreases in the control group’s intakes of animal and plant protein.ConclusionsThis finding shows that nutrition education with optimized FBR increased intakes of nutrient-dense food, protein, fat, iron, and memory performance (concentration). Nutrition education with optimized FBR should be integrated into the school system together with weekly iron supplementation for anemia prevention among these adolescent girls.Trial registrationThe study was registered on ClinicalTrials.gov (ID No: NCT03946475).

Failure to thrive: A proposed diagnostic approach.

Failure to thrive is a general term describing infants who do not reach weight, length, or body mass index expected for their age. It can be related often to malnutrition due to inadequate caloric and protein intake, but also to excessive loss of nutrients, inadequate metabolism, inadequate absorption, or excessive caloric and energy expenditure. It may be either organic or inorganic in origin, and in most cases, does not require investigation through complementary examinations. It is associated with social and health detrimental outcomes. Most cases of failure to thrive are of non-organic etiology, thus clinical history evaluation and physical examination are of utmost importance in the management of these patients. Therapeutics includes behavioral or nutritional interventions, as well as treatment of possible underlying diseases. The treatment approach is more effective in improving clinical outcomes if applied as early as possible.

Association of early nutrition with bronchopulmonary dysplasia severity and MRI lung characteristics in preterm infants.

Restricted fetal and neonatal growth is a known risk factor for bronchopulmonary dysplasia (BPD) in premature infants. However, the impact of nutrition and infant growth specifically on lung growth in BPD in unknown. Moreover, whether all lung growth in BPD is beneficial is unclear. We hypothesized that lung growth and development and severity of BPD directly relate to caloric and protein intake, weight gain, and linear growth of premature neonates. In this retrospective study, caloric and protein intake for the first four weeks of life, growth parameters along with lung volume, mass, density, and BPD severity obtained by ultrashort echo time (UTE) MRI, were analyzed. The cohort included 95 neonates with mean GA 26.1 weeks and BW 790 g. Infants with Grade 2 and 3 BPD had less caloric and protein intake during first 4 weeks of life vs Grade 1 BPD (96/98 vs 106 kcal/kg/d; 3.79/3.75 vs 3.99 g protein/kg/d; p< 0.05). UTE MRI showed that lung mass per body surface area increased with increasing BPD severity (237, 311, 384 g/m2 for Grade 1, 2, and 3, respectively, p< 0.05). Increased caloric intake was associated with decreased lung mass (p=0.02) and improved BPD score on MRI (p=0.04) Discussion/Conclusion: Decreased nutritional intake during the first four weeks of life appears to be associated with more severe BPD, increased lung mass and more severe lung disease on MRI.

Effect of Dietary Protein on Fat-Free Mass in Energy Restricted, Resistance-Trained Individuals: An Updated Systematic Review With Meta-Regression

ABSTRACT Individuals often restrict energy intake to lose fat mass (and body mass [BM]) while performing resistance training (RT) to retain fat-free mass (FFM). Therefore, the aim of the present systematic review with meta-regression was to explore (a) the pattern and strength of the dose-response relationship between daily dietary protein intake and FFM change, and (b) whether intervention duration, energy deficit magnitude, baseline body fat percentage (BF%), and participant sex influence this relationship. Studies were included if they involved a standardized RT protocol with nonobese, energy-restricted (experiencing fat mass loss) individuals with a minimum of 3 months RT experience. Of 916 retrieved studies, data were extracted from a total of 29 studies. Bayesian methods were used to fit linear and nonlinear meta-regression models and estimate effect sizes, highest density credible intervals, and probabilities. Results suggest a &gt;97% probability of a linear dose-response relationship between daily protein intake [g/kgBM: β = 0.07 (95% highest density interval [HDI]: −0.01 to 0.14), and g/kg/FFM: β = 0.06 (95% HDI: 0.01 to 0.12)] and favorable FFM changes. The relationship is stronger when protein intake is expressed relative to FFM, in interventions longer than 4 weeks, in men, and when BF% is lower. Overall, the heterogeneity between studies renders our findings exploratory.

P0816 Dietary habits of ulcerative colitis patients under follow-up in a Pediatric Inflammatory Bowel Disease Unit

Abstract Background A Western dietary pattern characteristics was suggested to have a role in the pathogenesis of ulcerative colitis (UC). Poor dietary pattern can exacerbate the patients’ symptoms and lead to significant nutrient deficiencies. However, data regarding dietary habits and nutritional needs are scarce. Our study aimed to prospectively evaluate dietary intake and habits in peadiatric patients with UC at a Spanish tertiary hospital. Methods In this prospective observational study, peadiatric UC patients were followed up, during which their dietary habits were collected. Patients were asked to complete the KIDMED questionnaire for adherence to the Mediterranean diet (MD) and a 3-day food diary. The degree of food processing was assessed using the NOVA classification system, which classifies all food products into four main groups. Results A total of 47 patients were included, with a mean age of 11.9±3.3 years (57% female), and a median follow-up of 2.8±5.4 years. The mean caloric intake was 1919.07 ± 292.8 kcal, and 55.31% of patients did not cover their energy requeriments. Protein and saturated fat intake exceeded the recommended daily intake (RDI): mean protein intake was 2.13±0.8g/kg (239.06% of RDI), and saturated fatty acids was 31.65±7.9% of total fat. In contrast, fiber, calcium and iron intake were below recommendations: mean fiber was 13.44±2.9g (75.1±24.7% of RDI), calcium was 457.7±239.3mg (41.6±26.2% of RDI) and iron 8.3±3.4mg (75.3±37.2% of RDI). The average KIDMED score was 6.2 points, with only 15 patients (31.9%) presenting high adherence to the MD. Of the remaining patients, 26 (55.3%) needed to improve their diet quality, and 6 (12.7%) had very low diet quality. Regarding the NOVA classification, 7 patients (14.9%) consumed more than 40% of their total energy from ultra-processed foods (NOVA 4), while 23 (48.9%) had less than 40% of their energy intake coming from unprocessed or minimally processed foods (NOVA 1). Conclusion Our results highlight that a substantial proportion of pediatric UC patients have suboptimal dietary patterns, characterized by high intake of UPF and saturated fats, alongside low intake of fiber, calcium, and iron. These findings suggest a need for tailored follow-up with a specialized dietitian within the multidisciplinary care team. Further research is essential to clarify the impact of diet on UC.

P0018 Fat rich dietary habits: Further increasing IBD risk in first degree relatives

Abstract Background Western diets characterised by high intake of meat and processed food, are implicated in IBD development1. Dietary habits are often shared amongst family members however, where familial diets diverge a difference in IBD risk may arise, compounding in members adhering to western diets. In this study, we compared macronutrient intake and dietary patterns between unaffected first degree relatives (FDRs), their IBD relatives and healthy controls (HCs). Methods 70 FDRs were recruited within the Australian IBD Microbiome (AIM) study. FDRs were matched ~1:3 to healthy participants (HC; n=200), IBD relatives (adult; n=25 and paediatric; n=25; no other groups contained paediatric participants) were also included for comparison. Macronutrient intake was assessed from 3-day food records. Dietary patterns were computed using principal component analysis (PCA) of food frequency questionnaires (FFQ). Results There was no difference in mean daily energy (KJ), total fat or protein intake (g/day) between groups. Paediatric IBD patients matched FDRs in energy intake (8031KJ; □□□□=2788 and 8046KJ; □□□□= 2741 respectively, p&amp;gt;0.9999). Carbohydrate intake (g/day) was significantly higher in the paediatric IBD group than FDRs (p=0.0408), however variance in daily intake was high (paediatric IBD; 210g, □□□□=108g). FDRs had the lowest percentage of energy from carbohydrate intake compared to all other groups (36.4%, p&amp;lt;0.0004). Energy contribution from total fat was highest in FDRs (38.2%); significantly higher than HCs (35.1%, p=0.0063). Energy from protein consumption was consistent among groups (~20%). PCA of FFQs (all participants) produced 5 distinct dietary patterns from 27 food groups, explaining 47.6% of the total variance. These patterns were described as ‘Ultra-Processed’, ‘Balanced Whole Foods’, ‘Processed High Fat’, ‘Meat Centric’, and ‘Sweetened Beverages &amp; Low Fibre’. Adherence to the ‘Processed High Fat’ dietary pattern was significantly higher in paediatric IBD patients and FDRs than HCs (p&amp;lt;0.0362). This dietary pattern was characterised by high consumption of butters/creams, processed meats, pizzas, savoury pastries, sauces/condiments and red meat. Conclusion FDRs have unique macronutrient intake and habitual dietary pattern adherence, diverging significantly from HCs. Similarity in adherence to the ‘Processed High Fat’ dietary pattern between paediatric IBD and FDR cohorts may reflect food decision-making by parental FDRs. Macronutrient and dietary pattern analysis indicate fat-rich dietary habits in FDRs; Increased IBD risk may in part be due to fat rich dietary habits.

Associations Between Carbohydrate Intake Behaviours and Glycaemia in Gestational Diabetes: A Prospective Observational Study

Carbohydrate intake (CI) has the largest impact on the short-term glycaemia of all nutrients, yet optimal CI management in gestational diabetes remains unclear. Objective: To examine CI behaviours in individuals with recently diagnosed gestational diabetes and their association with self-monitored blood glucose. Methods: Data from 97 individuals were collected using food and blood glucose diaries. CI (including amounts, types, and timing) was manually assessed using 15 g servings over 5–8 days, while a 3-day computerised analysis examined a broader intake of macro- and micronutrients. Results: Elevated fasting glycaemia (EFG) was associated with lower total CI (Mdn 10.8 vs. 12.5 servings/day, p = 0.006), missed meals (Mdn 1.4 vs. 0.0/week, p = 0.007), missed snacks (Mdn 10.5 vs. 7.5/week, p = 0.038), low-carbohydrate meals (&lt;30 g; Mdn 4.3 vs. 2.0/week, p = 0.004), and a higher proportion of energy intake from fat (Mdn 35% vs. 33%, p = 0.047), as compared with in-target fasting glycaemia. In contrast, elevated postprandial glycaemia (EPG) was not significantly associated with total CI, low-carbohydrate meals (&lt;30 g), low-carbohydrate snacks (&lt;15 g), or high-carbohydrate loads (&gt;50 g). EPG was instead associated with high-glycaemic index meals (Mdn 1.6 vs. 0.9 lunch meals/week, p = 0.026; Mdn 0.9 vs. 0.0 dinner meals/week, p = 0.023); and a lower intake of energy (Mdn 7650 kJ vs. 9070 kJ/day, p = 0.031), protein (Mdn 91 g vs. 109 g/day, p = 0.015), fat (Mdn 61 g vs. 84 g/day, p = 0.003), and multiple micronutrients (p &lt;0.05), as compared with in-target postprandial glycaemia. Conclusions: CI profiles differed for individuals with EFG, as compared with EPG, emphasising the need for dietary guidelines tailored for gestational diabetes subtypes. Further interventional studies are needed to explore these findings, particularly the associations between EFG and low CI behaviours.

P0757 Emulsifier restriction does not impair nutrient intake and improves food-related quality of life in active Crohn’s disease: dietary analysis of the ADDapt randomised controlled trial

Abstract Background Food additive emulsifiers are prevalent in the food supply1 and have been implicated in the development of intestinal inflammation2. A novel low-emulsifier diet (LED) has been tested for its effect in managing active Crohn’s disease (CD), however, it is crucial to consider the impact of dietary restrictions on nutrient intake and food-related quality of life (FRQoL). The aim of this study was to investigate whether dietary counselling can reduce emulsifier intake and whether this impacts dietary intake or FRQoL. Methods The ADDapt trial (NCT04046913) is a randomised, double-blind, placebo-controlled, re-supplementation trial in 154 patients with active CD, the clinical results of which are presented separately. Participants followed either a LED (LED group) or a LED with emulsifier re-supplementation (control). Both groups were provided dietary counselling from a dietitian as well as 25% of their foods from grocery deliveries and 3 daily trial snacks, which either did (control) or did not (LED) contain emulsifiers. Outcomes were measured at baseline and at week-8. Intake was measured using gold-standard 7-day food records which were coded using Nutritics software combined with an in-house emulsifier database1. FRQoL was measured using the validated FR-QoL-293. Outcomes at week-8 were compared between groups using unpaired tests and between baseline and week-8 in the LED group using paired tests. Results 113 participants completed the trial with 102 submitting both baseline and week-8 food records. Patients in the LED group reduced emulsifier intake from median 30.0 (IQR 33.0) to 2.5 (6.0) emulsifiers per week (p&amp;lt;0.001) (Figure 1). Patients in the control group consumed on average 2.5 g/d (±1.1) carrageenan, 3.6 g/d (±1.6) carboxymethyl cellulose and 0.8 g/d (±0.3) polysorbate-80 from re-supplemented trial snacks (all zero in the LED group). At week-8, energy and nutrient intakes were similar between groups, with only protein and calcium intake from trial snacks being different (Table 1). In the LED group, there were no major reductions in nutrient intake except for a small reduction in protein (Figure 1). FR-QoL-29 score significantly increased in the LED group (66.0 (IQR 20.0) to 76.0 (19.0), p=0.001) but not in the control group (67.0 (22.0) to 69.0 (15.3), p=0.09). Conclusion Dietary counselling significantly reduced emulsifier intake but did not result in major impairments in energy or nutrient intake. While the LED group had a reduction in protein, intake remained above the reference nutrient intake, indicating overall little negative impact of a LED on dietary intake. FRQoL improved on the LED. A LED is feasible and nutritionally safe in patients with active CD. Funding The Leona M. and Harry B. Helmsley Charitable Trust

Association of dietary intake with cancer of the digestive system: a cross-sectional study.

In recent years, the incidence of cancers of the digestive system has been increasing, posing a severe threat to the lives and health of people around the world, and has become one of the leading causes of cancer deaths worldwide. The three most common cancers of the digestive system include gastric, colorectal, and liver cancers, and attention has been paid to the role of diet in the progression of these cancers. However, the relationship between dietary factors and cancers of the digestive system remains to be investigated. This study included 30,789 adults aged 20 years or older from the National Health and Nutrition Examination Survey (NHANES), conducted from 2007 to 2018. It assessed the association between 30 dietary factors and digestive system cancers. Descriptive analysis was used to explore the demographic characteristics of the participants and p-values were calculated using a weighted linear regression model. Categorical variables were described as percentages, and p-values were calculated using weighted chi-square tests. We found that protein, vitamin B1, calcium, and iron intake were positively associated with colorectal cancer; vitamin B2 and phosphorus intake were negatively related to colorectal cancer; dietary folate and vitamin B12 intake were negatively associated with gastric cancer; vitamin D and copper intake were positively associated with gastric cancer; vitamin E intake was negatively related to the development of hepatocellular carcinoma; and lycopene, vitamin B2, calcium, iron, and zinc intake was positively associated with the development of liver cancer. Other than that, we did not observe any correlation between other dietary factors and cancers of the digestive system. Dietary intake is associated with digestive system cancers, and more epidemiologic studies are needed to validate our results.

Evaluating protein SUPPLEMENTation in Ulcerative Colitis (SUPPLEMENT-UC)

Abstract Background and aims A higher dietary protein intake has overall health and body composition benefits but also has the propensity to drive inflammation in ulcerative colitis (UC). This study aims to investigate whether recreational animal-based protein supplementation affects ability to maintain remission in adults with clinically quiescent UC. Methods Twenty-four adults with quiescent UC (Simple Clinical Colitis Activity Index (SCCAI) ≤2) on stable therapy will be randomised to a 24-week double blind, parallel, placebo-controlled protein supplement intervention in addition to habitual diet. The primary outcome is maintenance of remission (defined as SCCAI ≤2) at 24 weeks, relapse being defined as an increase in SCCAI ≥2 points and/or escalation of medical therapy. Disease activity will be assessed using clinical, biochemical and sonographic indices. Adherence, tolerability and safety will be measured using pre-defined categories and 100-mm visual analogue scales. Dietary intake and change in body composition will be measured along with biomarkers and metabolites of fermentation in faecal, blood and urine specimens. Anticipated impact This trial addresses one of the top three international IBD research priorities - the role of diet to induce/maintain remission in UC. It will be the first ever study to investigate whether animal-based protein supplements influence the ability of adults with quiescent UC to maintain remission, and to explore the mechanistic basis and relationship between dietary substrate, gut microbiota, and disease activity. The trial results are anticipated to inform UC treatment paradigms by demonstrating dietary factors influence disease activity and dietary advice can be readily incorporated into current UC treatment paradigms as a cost neutral, adjunctive therapy to optimise response to existing therapies. The ultimate goal is to optimise therapeutic outcomes and improve quality of life for people with UC.

Relationship between sleep quality and dietary nutrients in rural elderly individuals: a latent class analysis.

This study sought to identify sleep patterns in older adults residing in rural regions, as well as investigate the potential influence of dietary nutrient intake on these patterns. Data were collected from a cross-sectional sample of Qingdao Town, Shandong Province, China. The study investigated 1,167 elderly participants using a general questionnaire, the Pittsburgh Sleep Quality Index, the simplified Food Frequency Questionnaire, and 24-h dietary recall methods. Latent profile analysis and binary logistic regression were applied for data analysis. Two sleep categories were identified as "Quick falling asleep, long time, high efficiency group," Class 1(89.1%) and "Difficult falling asleep, short time, low efficiency group," Class 2(10.9%). In comparison to Class 1, individuals in Class 2 exhibited a higher likelihood of experiencing difficulties in falling asleep quickly and having poor sleep efficiency when consuming less than 50 g/d of potatoes (OR = 1.863, p = 0.034). Conversely, a daily protein intake of 60 g or more (OR = 0.367, p = 0.007), a daily intake of retinol of 700 equivalents or more (OR = 0.212, p = 0.002), and a daily milk intake of 300 g or more (OR = 0.295, p = 0.035) were associated with a greater probability of falling asleep quickly, having longer sleep duration, and experiencing higher sleep efficiency. Our analysis identified two distinct sleep quality patterns among elderly individuals in rural areas. The sleep quality of rural elderly individuals is influenced by their dietary habits. The findings demonstrated a positive association between enhanced sleep quality and higher intake of dairy products, potatoes, and foods containing retinol and protein. Therefore, we propose increased consumption of these nutritional sources for the elderly population.

Impact of protein intake from a caloric-restricted diet on liver lipid metabolism in overweight and obese rats of different sexes

In addition to being linked to an excess of lipid accumulation in the liver, being overweight or obese can also result in disorders of lipid metabolism. There is limited understanding regarding whether different levels of protein intake within an energy-restricted diet affect liver lipid metabolism in overweight and obese rats and whether these effects differ by gender, despite the fact that both high protein intake and calorie restriction can improve intrahepatic lipid. The purpose of this study is to explore the effects and mechanisms of different protein intakes within a calorie-restricted diet on liver lipid metabolism, and to investigate whether these effects exhibit gender differences. The Sprague-Dawley rats, which were half female and half male, were used to construct a rat model of overweight and obesity attributed to a high-fat diet. They were then split up into five groups: the normal control (NC) group, the model control (MC) group, the calorie-restricted low protein (LP) group, the calorie-restricted normal protein (NP) group, and the calorie-restricted high protein (HP) group. Body weight was measured weekly. Samples of plasma and liver were obtained after eight weeks and analyzed for glucose, triglycerides, cholesterol, and hormones in the plasma as well as the liver fat and factors involved in the liver’s synthesis and degradation. For the male rats, compared to the HP group, the weight of liver fat in the LP and NP group was significantly higher (P < 0.05). However, for the female rats, there was no significant variation among the three calorie-restricted groups (P > 0.05). There was no significant variation in the concentration of total cholesterol (TC), very low density lipoprotein (VLDL), low density lipoprotein (LDL), and high density lipoprotein (HDL) among the three male calorie-restricted groups (P > 0.05), while the TC and VLDL concentrations in the female LP and NP group were significantly higher compared to those in the HP group (P < 0.05). Moreover, the trend of expression in the signaling pathways of adiponectin/phosphorylated AMP-activated protein kinase (p-AMPK) and adiponectin/peroxisome proliferators-activated receptor alpha (PPARα) in the liver was consistent with that of the liver fat content, and leptin acted in the same way as adiponectin. Compared with the three calorie-restricted groups, the expressions of nuclear sterol-regulatory element-binding protein-2 (nSREBP-2) and 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG-CoA reductase) involved in cholesterol synthesis and low-density lipoprotein receptor (LDLR) and cholesterol 7-alpha hydroxylase (CYP7A1) involved in cholesterol clearance in the MC group were significantly lower (P < 0.05). A 40% energy restriction can significantly reduce the body weight, body fat, liver fat, and the blood concentration of TG in both male and female overweight and obese rats, but it can significantly increase the blood concentration of TC in overweight and obese male rats. At the same time of 40% calorie restriction, increasing dietary protein intake to twice the normal protein intake has a stronger effect on promoting hepatic triglyceride oxidation and reducing liver fat content in the male overweight and obese rats by increasing the levels of adiponectin and leptin in the blood, and can also significantly reduce the plasma cholesterol concentration in the female overweight and obese rats through inhibiting cholesterol synthesis most likely by increasing glucagon level in the blood.

Beneficial Effects of a Moderately High-Protein Diet on Telomere Length in Subjects with Overweight or Obesity.

Telomere length (TL) is a key biomarker of cellular aging, with shorter telomeres associated with age-related diseases. Lifestyle interventions mitigating telomere shortening are essential for preventing such conditions. This study aimed to examine the effects of two weight loss dietary strategies, based on a moderately high-protein (MHP) diet and a low-fat (LF) diet on TL in individuals with overweight or obesity. A total of 164 participants, aged 18-65 years from the OBEKIT trial received the MHP (n = 83) or the LF diet (n = 81) for 4 months and had TL data for analyses. TL was measured at baseline and after 4 months of the intervention using monochrome multiplex quantitative polymerase chain reaction (MMqPCR). Both groups experienced significant improvements in anthropometric and biochemical parameters after the dietary intervention (p < 0.001). The MHP group showed an increase in TL (+0.16 ± 0.13) compared to the LF group (-0.05 ± 0.13) in multiple-adjusted models (p = 0.016). An interaction was observed between the sex and dietary group, where women in the MHP group had increased TL (+0.23 ± 0.16) after 4 months compared to women in the LF group (-0.13 ± 0.15; p = 0.001); no differences between dietary groups were found in men. This increase in TL for women was associated with an increase in protein intake (p = 0.006), measured through dietary questionnaires. This study shows that a MHP diet may have a protective effect on TL during weight loss, particularly in women, potentially contributing to healthier aging. These results highlight the importance of considering macronutrient composition in dietary interventions aimed at preserving TL.