Low Protein Intake Research Articles

Is underweight associated with poorer diet, nutrient status, bone and cardiometabolic health, and school performance in Danish 8-11-year-olds?

Underweight, i.e. low body mass index for age and sex, may indicate undernutrition, but despite high prevalence, this aspect is largely overlooked in children in high-income countries. We explored if dietary intake, nutrient status, body composition, bone mineralization, cardiometabolic markers and school performance differed in schoolchildren with underweight compared to normal- and overweight. We used cross-sectional data from 815 Danish 8-11-year-old children collected in 2011. Intake of foods, macronutrients and key micronutrients (vitamin D, vitamin B12, calcium, iron, zinc and selenium) was assessed by 7-day dietary records. Measurements included anthropometry, dual-energy X-ray absorptiometry and tests of attention and reading skills. Fasting blood samples were analyzed for biomarkers of iron, long-chain n-3 fatty acids and vitamin D status as well as blood lipids, insulin and growth markers. Eighty-three (10.2%) children had underweight and were shown to have a lower intake of energy, red meat, protein and zinc and higher intake of added sugar than children with normal- and overweight. They also had higher fish intake relative to overweight, but blood biomarkers did not differ between groups. Children with underweight had lower fat percent and bone mineralization compared to peers with normalweight, but apart from lower insulin, they did not differ in overall cardiometabolic health or school performance. Although we found some differences in diet, there were no considerable differences in nutrient status, cardiometabolic health or school performance between children with underweight and their normalweight peers. However, the lower bone mineralization is a concern and needs further investigation.

A Systematic Review Exploring Dietary Behaviors, Psychological Determinants and Lifestyle Factors Associated with Weight Regain After Bariatric Surgery

Background: Weight regains after bariatric surgery presents a significant challenge to long-term weight management and overall health outcomes. While clinical and surgical factors influencing bariatric outcomes have been extensively reviewed, there remains a notable gap in understanding how behavioral factors—specifically dietary habits, psychological influences, and lifestyle choices—impact long-term weight maintenance. This systematic review addresses this gap, highlighting the unique role of these behavioral factors in sustaining weight loss post-bariatric surgery. Aim: This systematic review aims to explore the behavioral factors—including dietary, psychological, and lifestyle influences—associated with weight regain after bariatric surgery. Methods: A comprehensive search was conducted across multiple databases, focusing on peer-reviewed articles published in English. We included observational studies exclusively focused on adults who experienced weight regain after bariatric surgery, with an emphasis on behavioral factors. Searches were conducted in MEDLINE via PubMed, Embase, Web of Science, Scopus, and Google Scholar, with the last search completed on 10 July 2024. Studies published within the past 10 years were considered. The Joanna Briggs Institute (JBI) critical appraisal tool for cross-sectional studies was used to assess the risk of bias. A total of 16 studies met the inclusion criteria: 12 cross-sectional studies, 3 cohort studies, and 1 in-depth interview study. Results: The review found inconsistencies in the definitions of weight regain across studies. Nonetheless, three primary behavioral factors were identified as potentially contributing to weight regain: dietary non-adherence and eating patterns, psychological determinants, and lifestyle behaviors. Dietary non-adherence included high-calorie food consumption, excessive intake of sweets, carbohydrates, and sweetened beverages, and low protein intake. Psychological factors such as depression, anxiety, emotional eating, and binge eating were prevalent among individuals experiencing weight regain. Lifestyle behaviors, including physical inactivity, smoking, and sedentary habits, also played significant roles. Conclusions: Post-bariatric weight management is multifaceted, necessitating a comprehensive approach that addresses dietary, psychological, and lifestyle factors. Most studies on behavioral factors linked to weight regain were cross-sectional with small sample sizes, limiting the ability to infer causality. Future research should include detailed information on dietary adherence, standardized tools to assess physical activity and sedentary behavior, and validated measures for psychological health. Tailored interventions and continuous support from healthcare professionals are essential for maximizing the effectiveness of bariatric surgery, promoting sustainable weight loss, and enhancing overall health outcomes.

Early Adequate Nutrition in ICU is Associated with Survival Gain : Retrospective Cohort Study in Patient with Traumatic Brain Injury.

Patients with traumatic brain injury (TBI) commonly exhibit a poor mental health status and can easily develop aspiration pneumonia. Thus, early proper nutrition through oral or tube feeding is difficult to achieve, leading to malnutrition. However, evidence regarding early nutritional support in the intensive care unit (ICU) is lacking. We aimed to assess the effect of early nutrition in patients with TBI admitted to the ICU. Data of adult patients with TBI admitted to the trauma ICU of a regional trauma center in Korea between 2022 and 2023 were retrospectively analyzed. Those with ICU stay <7 days, younger than 18 years, and with underlying diseases that could alter baseline metabolism, were excluded. Nutritional support on day 4 of ICU admission was measured. The patients were classified into mortality and survival groups, and risk factors for mortality were evaluated. Subgroup analyses were performed based on TBI severity. Overall, 864 patients were diagnosed with acute TBI, of whom 227 were included in this study. The mortality rate in the study population was 15% (n=34). Those in the survival group were younger, had longer hospital stays, had a higher initial Glasglow Coma Scale (GCS) score, and had a higher intake of calorie supplements than those in the mortality group. In a subgroup analysis of patients with non-severe TBI (GCS>8), total calorie intake (751.4 vs 434.2 kcal, p=0.029), total protein intake (37.5 vs. 22.1 g, p=0.045), and ratio of supplied to target calories (0.49 vs 0.30, p=0.047) were higher in the survival group than in the mortality group. Logistic regression analysis revealed that calorie intake (B=-0.002, p=0.040) and initial hemoglobin level (B=-0.394, p=0.005) were risk factors for mortality in patients with non-severe TBI. More calories were supplied to the survival group than the mortality group among patients with TBI. Additionally, logistic regression analysis showed that increased calorie supply was associated with reduced mortality in patients with non-severe TBI. The mortality group had low protein intake; however, this did not emerge as a risk factor for mortality. Early sufficient nutritional support improves the prognosis of patients with TBI.

Low protein diet influences mineral absorption and utilization in medium-growing yellow-feathered broilers from 1 to 30 days of age

Reduced-protein diet can save protein ingredients and reduce nitrogen (N) losses. However, the effect of low protein diet on the mineral uptake and utilization in broilers needs to be explored. The aim of this study was to investigate the effect of low-protein diet on the growth performance, N deposition, mineral contents in serum, tissues and excreta, and the activities and gene expression of related enzymes in tissues of medium-growing yellow-feathered broilers, so as to elucidate the relationship between dietary protein level and the absorption and utilization of minerals in broilers. A total of 72 1-d-old Spotted-Brown male broilers were randomly allotted to 1 of 2 treatments with 6 replicate cages of 6 birds per cage for each treatment. The dietary crude protein (CP) levels for the two treatments were 21 % (the control treatment) and 19 % (low protein treatment), respectively. The experimental period was 30 d. The results showed that no differences (P > 0.05) were detected in average daily gain, average daily feed intake and feed: gain ratio of broilers during 1 to 30 d between the two treatments. However, low protein intake increased (P < 0.05) N retention rate, serum P, Cu and Mn, and excreta Cu, Mn and Zn, and decreased (P < 0.05) liver P and excreta P. In addition, birds fed low protein diet had higher (P < 0.05) manganese superoxide dismutase, and total superoxide dismutase activities in liver, and total antioxidant capacity and malondialdehyde content in heart, and lower (P < 0.05) copper-zinc superoxide dismutase (CuZnSOD) and succinate dehydrogenase activities in liver and CuZnSOD mRNA level in heart. In conclusion, the reduction of dietary CP content from 21 % to 19 % improved N retention, the absorption of P, Cu and Mn, as well as the antioxidant ability of liver and heart, and influenced metabolic utilization of P, Cu, Zn, Fe and Mn in medium-growing yellow-feathered broilers from 1 to 30 d of age.

Metabolic biomarkers of appetite control in Parkinson's disease patients with and without cognitive impairment

BackgroundAppetite dysregulation in Parkinson’s Disease (PD) appears to be linked to physical and cognitive deterioration. PD patients with and without cognitive impairment (CI) were compared to an age-matched control group to explore predictors of appetite control in fasting and post-prandial conditions. MethodsFifty-five patients were recruited and divided into three groups: twenty controls (age: 74y, BMI: 25.8kg/m2), nineteen PD patients without CI (72.5y, 25.1kg/m2) and sixteen PD patients with CI (74.3y, 24.0kg/m2). Self-reported appetite perception and circulating blood metabolic biomarkers were measured in fasting and over a three-hour post-prandial period. Biomarkers included glucose, insulin, tumour necrosis factor alpha (TNF-α), leptin, acyl-ghrelin, total ghrelin, peptide YY (PYY), glucagon like peptide 1 (GLP-1), insulin growth factor 1 (IGF-1), growth factor (GF) and triglycerides. Patients were then provided with a mixed meal to eat ad libitum with the aim to evaluate links between metabolic biomarkers and control of energy intake. ResultsPD patients with CI had a significant lower protein intake (7.4±2.5g, p=0.01) compared to controls (21.9±3.1g) and PD patients without CI (14.3±3.0g). Post-prandial plasma GLP-1 concentrations were associated with decreased hunger perception (B±SE, -5.3±2.4mm·hour-1, p=0.04). PYY concentrations were significantly associated with GLP-1 in fasting (r=0.40, p=0.005) and post-prandial (r=0.46, p<0.001) conditions. In a multivariate model, post-prandial PYY concentrations were a significant predictor of ad libitum energy intake in all subjects (B±SE, -87.5±34.9kcal, p=0.01) and in patients with PD (B±SE, -106.8±44.9kcal, p=0.04). ConclusionsPYY and GLP-1 appeared to influence appetite control in PD patients and their roles merit further investigation.

Avoiding hedonic contrast to increase acceptance of healthy sustainable school meals

Abstract To promote sustainable eating in schools, new approaches for embracing plant-based (PB) meals are needed. Hedonic contrast (HC) describes how liking for one item is influenced by the recent experience of other items of different hedonic valence. Despite its established impact on liking, HC’s effect on intake, particularly in repeated exposure experiments, is limited. Moreover, its effect on food-related emotions remains largely unexplored. Hence, this study investigated how HC influences liking, emotions and intake of an innovative co-created PB dish, served as part of a course meal, at school in a repeated exposure study. Two groups of students (N (HC) =71, mean age=14.5 and N (control) =57, mean age=15.3) were served the same neutrally liked main PB dish (pumpkin stuffed lentils balls (LPA)) after a starter dish (rice with vegetables) which was altered in taste through seasoning and cooking methods to be more (HC) or less (control) tasty. The exposure was repeated once/week for 5 consecutive weeks. Liking and emotional responses for the dishes were recorded through a questionnaire and food consumption by weighting plate waste. HC led to lower liking (p = 0.037) and lower positive emotions (cheerful, pleasure) with high arousal (surprise) for LPA, while increasing negative valence emotions (disappointed). Moreover, LPA consumption was significantly lower in the HC group vs the control (45% vs 60% respectively, p = 0.040), resulting in lower protein intake in the HC group (p = 0.029). The effects of HC remained stable with time. This study, for the first time, reveals a sustained rise in food-related positive high arousal emotions, when foods are presented following less liked food. Since new foods evoking positive valence and high arousal emotions have higher chances to be appreciated than foods evoking positive valence and low arousal emotions, this work opens new perspectives on how to propose new, healthier and more sustainable PB dishes in school canteens. Key messages • Avoiding negative contrast between school meals is a promising strategy to ensure higher liking, intake and increased positive emotions over repeated exposure for innovative plant-based dishes. • To enhance adolescent’s acceptance and uptake of new plant-based dishes in school canteens, it is better to serve them after less tasty options.

Distinct genetic signals at the FGF21 locus complicate studies of FGF21's role in diet regulation using human cohort data

ObjectivesExperimental and genetic studies suggest that fibroblast growth factor 21 (FGF21) modulates macronutrient and alcohol preferences, but evidence of such regulation in humans remains scarce. To address this gap in translation, we aimed to map the relationships between plasma FGF21 levels, FGF21 genetic variation and habitual macronutrient intake in a large human population. MethodsWe fine-mapped and performed colocalization of the FGF21 genetic region in GWAS summary statistics of plasma FGF21 levels and macronutrient intake. UK Biobank data were used to investigate the associations between FGF21 genetic variants, plasma FGF21 protein levels, and macronutrient intake (including alcohol) assessed with repeated 24-hour recalls. One- and two-sample mendelian randomization were performed to estimate the effects of plasma FGF21 on macronutrient intake. ResultsWe show that the main macronutrient-associated variant rs838133 and the FGF21 cis-pQTL rs838131, both in the FGF21 gene, are distinct genetic signals. Effect directions also suggest that the influence of FGF21 variation on macronutrient intake appear more complex than by direct mediation through plasma FGF21. Only when considering this complexity at FGF21, is plasma FGF21 estimated to reduce alcohol and increase protein and fat intake using mendelian randomization. Importantly, plasma FGF21 levels also appear markedly elevated by primarily high alcohol and low protein intake. ConclusionsThese findings support the feedback diet-regulatory mechanism of FGF21 in humans, but highlights the need for mechanistic characterization of the complex FGF21 genetic region.

Longitudinal comparison of the relationship of energy intake with body composition and physical performance in elite female basketball and volleyball players

Abstract Purpose To maximise sporting success, disciplines such as basketball and volleyball need to improve their methods of analysing the sporting performance and fitness of their athletes. Although energy intake quantities have been established at a theoretical level for women to perform at a sporting level, it has been found that these energy intake levels are not met or followed and that, despite this, the performance of female players is not diminished. Thus, the purpose of this research study was to describe and compare the anthropometric characteristics of these two disciplines and to identify the differences in actual and theoretical energy intake, as well as to observe physical performance in both disciplines. Methods Anthropometric data, continuous quantitative data, training time and characteristics, and energy intake data were collected. Performance tests included upper and lower body strength, speed, agility, and endurance tests. Dietary monitoring showed lower intakes of total energy, carbohydrate and protein than theoretically recommended. However, the athletes experienced overall improvements in performance and body composition. Results The mean total energy intake was 20.2 ± 4.3 kcal·kg−1·day−1. The minimum individual mean intake was 9.8 kcal·kg−1·day−1 and the maximum was 25.95 kcal·kg−1·day−1. Carbohydrates accounted for 54.3% ± 8.8% of the energy intake; 20.3% ± 6.5% from fats; 25.4% ± 5.7% from proteins. Conclusions Current data suggest that, although a cause-effect relationship between dietary intake and BC performance cannot be determined, elite athletes in these sports disciplines may experience beneficial outcomes despite having lower total energy, CHO, protein, and fat intakes than previously recommended in the literature.

Dietary protein intake and the tubular handling of indoxyl sulfate.

Chronic kidney disease (CKD) patients are advised to limit their protein intake. A high protein diet is known to induce glomerular hyperfiltration, as well as hypertrophy of the remnant kidney, and glomerulosclerosis. Whether the diet causes changes in kidney tubule transport via gut microbiome metabolites is still unknown. We hypothesized that protein intake affects not only the intestinal generation and absorption, but also the kidney disposal of microbial amino acid metabolites. We combined data from animal models and human studies. 5/6th nephrectomy rats were administered a high (HP) or low-protein (LP) diet for 7 weeks. Plasma and urine concentration of the uremic toxins (UTs) indoxyl sulfate (IS), p-cresyl sulfate (PCS), and p-cresyl glucuronide (PCG) were measured. Their fractional excretion (FE) was calculated. The expression of kidney membrane transporters OAT1, OAT3, BCRP, OCT2 and MRP4 was analyzed. Differences in FE of UTs between individuals with higher and lower protein intake in two CKD cohorts were sought. CKD rats on an HP diet showed increased plasma levels of PCS and PCG but not IS compared to rats on a LP diet. Conversely, urinary excretion and FE of IS were higher in the HP CKD group. BCRP, MRP4 and OCT2 were not influenced by the diet. OAT1 and OAT3 were upregulated in the HP CKD group. In two independent cohorts of CKD patients, individuals with a high dietary protein intake showed a significantly higher FE of IS. A HP diet leads to a higher generation and/or absorption of aminoacid-derived UT precursors in CKD rodent models and humans, most likely via gut microbiome modulation. We demonstrate that dietary protein intake modulates transcription and expression of OAT1 and OAT3, corroborating the existence of the remote sensing and signaling hypothesis. Dietary protein intake influences kidney physiology beyond glomerular filtration.

Predictors Of Handgrip Strength And Its Relationship To Physical Performance In Older Irish Adults

Abstract Background Handgrip strength declines with age and predicts poor physical performance and increased risk of falls and mortality. However, the strength of the relationship between handgrip strength and other physical measures is less well studied. We aimed to explore the predictors of handgrip strength in older Irish adults and its relationship to the Timed and Up and Go (TUG). Methods Study participants were from a longitudinal cohort of Irish adults aged &amp;gt;60 years; Trinity Ulster University Department of Agriculture (TUDA) study. Participants on current or long-term steroids, a history of stroke and with MMSE &amp;lt;24 were excluded. Handgrip strength was assessed with a dynamometer and defined as &amp;lt;27 kg for males and &amp;lt;16 kg for females. Abnormal performance in the TUG was defined as &amp;gt;12 seconds. Predictors of impaired handgrip were explored in multivariate logistic regression. Results There were 748 participants (68.9% female, mean age 70.2 years), of whom 33.4% had abnormal handgrip strength, which was more common in female’s vs males (39.4 vs 20.2%, p&amp;lt;0.001). Both abnormal handgrip strength and TUG was present in 13.6%. Normal handgrip strength had a negative predictive value of 76.0% for ruling out poor TUG, while abnormal handgrip had a positive predictive value of 62% for poor TUG. Predictors of impaired handgrip strength were older age (P&amp;lt;0.0001), female sex (p&amp;lt;0.0001), lower protein intake (P=0.024) and higher waist hip ratio (p=0.014). Conclusion Handgrip strength had a modest correlation with TUG A significant proportion had abnormal TUG but normal handgrip. Changes in lower limb muscle strength (affecting TUG) precede muscle loss in the upper limb. Higher protein intake predicted greater grip strength and supports the recommendation to maintain adequate intakes to prevent sarcopenia. Greater waist hip ratio is associated with reduced lean muscle mass which may explain the negative relationship we identified with handgrip strength.

Dietary factors and DNA methylation-based markers of ageing in 5310 middle-aged and older Australian adults

AbstractThe role of nutrition in healthy ageing is acknowledged but details of optimal dietary composition are still uncertain. We aimed to investigate the cross-sectional associations between dietary exposures, including macronutrient composition, food groups, specific foods, and overall diet quality, with methylation-based markers of ageing. Blood DNA methylation data from 5310 participants (mean age 59 years) in the Melbourne Collaborative Cohort Study were used to calculate five methylation-based measures of ageing: PCGrimAge, PCPhenoAge, DunedinPACE, ZhangAge, TelomereAge. For a range of dietary exposures, we estimated (i) the ‘equal-mass substitution effect’, which quantifies the effect of adding the component of interest to the diet while keeping overall food mass constant, and (ii) the ‘total effect’, which quantifies the effect of adding the component of interest to the current diet. For ‘equal-mass substitution effects’, the strongest association for macronutrients was for fibre intake (e.g. DunedinPACE, per 12 g/day − 0.10 [standard deviations]; 95%CI − 0.15, − 0.05, p &lt; 0.001). Associations were positive for protein (e.g. PCGrimAge, per 33 g/day 0.04; 95%CI 0.01–0.08, p = 0.005). For food groups, the evidence tended to be weak, though sugar-sweetened drinks showed positive associations, as did artificially-sweetened drinks (e.g. DunedinPACE, per 91 g/day 0.06, 95%CI 0.03–0.08, p &lt; 0.001). ‘Total effect’ estimates were generally very similar. Scores reflecting overall diet quality suggested that healthier diets were associated with lower levels of ageing markers. High intakes of fibre and low intakes of protein and sweetened drinks, as well as overall healthy diets, showed the most consistent associations with lower methylation-based ageing in our study.

What is the dietary intake and nutritional status of defence members: a systematic literature review.

Optimal diet and nutrition is vital for military readiness, performance and recovery. Previous research on military diets has primarily focused on the nutritional composition of field/combat rations and dietary intake during deployment. There is accumulating research exploring the usual free-living dietary intake and nutritional status of defence members in garrison (i.e. military bases on which personnel are stationed). However, no comprehensive review has been conducted to assess the overall dietary quality of defence members internationally. Therefore, this review assessed the diets of military populations against national nutritional guidelines and Military Dietary Reference Intakes (MDRI). A systematic literature review of original research was conducted. CINAHL, Medline (EBSCO), Scopus (Elsevier), PubMed and AMED databases were searched up to the 20/02/2023. A total of thirty-six studies met the inclusion criteria. The overall quality of included studies was high, with a low risk of bias. The diet quality scores indicate poor to fair diet quality among defence members. Defence members display low intakes of fruits, vegetables, wholegrains, seafood, plant protein and nuts and high intakes of added sugars, trans fat and processed meat. Results also indicated suboptimal intake of fibre, essential fatty acids, vitamin A, vitamin E, folate, Mg, Zn and iodine. This may lead to reduced performance, increased risk of chronic diseases and mental health disorders. More research is needed to assess the long-term consequences of poor diet quality in defence members. These results require the attention of policymakers to ensure that military education and food environment is supportive of healthy eating.

Dietary protein intake and its association with physical fitness test among older adults with pre-sarcopenia and sarcopenia: A cross-sectional study.

Low protein intake and physical inactivity are factors that associated with muscle deterioration and poor physical performance among older adults. To assess the association between dietary protein intake and physical fitness tests among older adults with pre-sarcopenia and sarcopenia. A total of 110 older adults were recruited through a convenience sampling method. Data including sociodemography, anthropometry, body composition, medical history, and dietary protein intake were obtained through the interview-administered method. Most of the subjects have low household income (<RM 3030) (90%), Malay ethnicity (66.4%), and are married (64.5%). 74.55% of the subjects were pre-sarcopenic, whereas 25.45% were sarcopenic. Those with sarcopenia were mostly underweight (± 21.78 kg/m2), whereas those with pre-sarcopenia had a slightly higher Body Mass Index (BMI) (± 27.30 kg/m2). Both men and women did not meet the dietary protein requirement (± 43.86 g/ day) based on the Recommended Nutrient Intake (RNI) of 2017. Moreover, both pre-sarcopenic and sarcopenic subjects have reduced functional ability. Although no significant differences were found in the Short Physical Performance Battery (SPPB) score, those with sarcopenia had poorer physical performance than those with pre-sarcopenia (82.1% versus 69.5%). Apart from that, there was a significant association between the 2-min step test (2MST) and dietary protein intake among those with pre-sarcopenia (r-value = 0.252). In conclusion, lifestyle interventions among older adults are important, including ensuring adequate protein intake and encouraging appropriate physical activity to enhance muscle mass, strength, and performance to improve their daily life efficiency and quality of life.

Association of dietary habits with general and abdominal obesity in Korean children and adolescents: cluster analysis of nationwide population survey data.

Childhood obesity is a growing global health concern, but few studies have investigated dietary factors specifically related to obesity and abdominal obesity in children and adolescents. Herein, we aimed to identify the dietary factors affecting childhood obesity in Korean children and adolescents. Data from the Korea National Health and Nutrition Survey (KNHANES) VIII were analyzed using K-means clustering analysis to identify distinct clusters based on nine variables related to dietary habit, nutritional status, and nutritional education. Multiple logistic regression analysis was used to examine the association between incident obesity risk and the different clusters. We enrolled 2,290 participants aged 6-18 years, and separated them into two distinct clusters; Healthy and Unhealthy Dietary Habit Groups, clusters 1 and 2, respectively. Cluster 1 was characterized by a lower obesity prevalence, healthier dietary habits (regular breakfast consumption; fruit and vegetable, reduced total energy, and lower protein and fat intakes), and greater nutritional education than Cluster 2. After adjusting for confounders, compared with Cluster 1, Cluster 2 demonstrated a significantly higher prevalence (OR [95% CI]) of both general and abdominal obesity (1.49 [1.05-2.13], p=0.027 and 1.43 [1.09-1.88], p=0.009). Maintaining optimal dietary quality and patterns are crucial to prevent childhood obesity. Further research is warranted to explore specific dietary interventions tailored to different clusters to effectively address childhood obesity.

Diet Quality of Stroke Survivors Versus Neurologically Intact US Adults

Stroke is a leading cause of disability in the US, often altering one’s ability to access and consume food. The aim of the present study was to characterize and evaluate predictors of stroke survivors’ diet quality (DQ). A cross-sectional evaluation of 2011-2018 National Health and Nutrition Examination Survey data is presented. Stroke survivors (n = 632) were matched for age, gender, and race with neurologically intact controls (n = 913). Food group intake, key nutrient intake, and Healthy Eating Index (HEI)-2015 scores were calculated from two 24-hour recalls and evaluated in relation to history of stroke, education, presence of a partner in the home, and income. Group differences in and predictors of DQ were evaluated with weighted independent samples t-tests and linear regression. Stroke survivors had lower intakes of vegetables, dairy, seafood and plant proteins, and unsaturated fats, and lower total HEI-2015 scores ( P &lt; 0.05). Having more education, a partner in the home, and higher income were overall positive predictors of DQ. DQ factors emphasized in heart-healthy diets were low in stroke survivors. Interventions may better address barriers to healthy eating post-stroke by incorporating educational, financial, and social support components.

Association between objectively measured protein intake and muscle status, health-related quality of life, and mortality in hemodialysis patients

Protein intake is known to be associated with muscle mass, health-related quality of life (HRQoL), and mortality in patients with stage 5 chronic kidney disease undergoing dialysis. However, most studies evaluated protein intake based on 24h dietary recall or food frequency questionnaire, and these methods are prone to bias. Therefore, this study aimed to evaluate the association of objectively measured protein intake with muscle mass and strength, HRQoL, and mortality. Dietary protein intake was calculated based on the combined (urinary and dialysate) urea excretion rate according to the Maroni formula and indexed to body weight. Muscle mass was calculated based on the combined dialysate and urinary creatinine excretion rate, and muscle strength was assessed by handgrip strength. HRQoL was based on the Short Form 36. Linear and Cox regression were used for the analyses. We included 59 hemodialysis patients (mean age 65±15 years, 37% female, median hemodialysis vintage 15 [6-39] months). Mean protein intake was 0.82±0.23g/kg/day, and 76% had a low protein intake (<1.0g/kg/day). Higher protein intake was independently associated with higher muscle mass (Standardized beta (St. β) [95% confidence interval (95%CI)=0.56 [0.34 to 0.78]) and higher scores on the physical functioning domain of HRQoL (St. β [95%CI]=0.49 [0.25 to 0.73]), but not with muscle strength (St. β [95%CI]=0.17 [-0.10 to 0.43]). During a median follow-up of 21.6 [8.6-36.6] months, 16 (27.1%) patients died. Higher protein intake was associated with lower mortality risk (hazard ratio [95%CI]=0.34 [0.16-0.73]). This association remained significant after adjustment for potential confounders. Protein intake is independently associated with muscle mass, physical functioning domain of HRQOL, and mortality. Clinicians and dietitians should closely monitor the protein intake of hemodialysis patients.

Associations of serum arginine acid with sarcopenia in Chinese eldely women

BackgroundThe prevalence of sarcopenia is increasing in worldwide with accelerated aging process. The high dietary protein intakes are associated with improved muscle mass and strength especially in Asian countries. However, there are few researches on amino acid levels or mechanism exploration. We conducted a case-control study to explore the amino acid metabolic characteristics and potential mechanism of elderly women with sarcopenia using targeted amino acid metabolomics approach combined with an analysis of dietary intake.MethodsFor our case-control study, we recruited women (65–75 y) from a Shanghai community with 50 patients with sarcopenia and 50 healthy controls. The consensus updated by the Asian Working Group on Sarcopenia in 2019 was used to screening for sarcopenia and control groups. We collected fasting blood samples and evaluated dietary intake. We used the amino acid-targeted metabolomics by ultra performance liquid chromatography tandem mass spectrometry to identify metabolic differentials between the case and control groups and significantly enriched metabolic pathways.ResultsThe case (sarcopenia) group had a lower intake of energy, protein, and high-quality protein (P < 0.05) compared to the control (healthy) group. We identified four differential amino acids: arginine (P < 0.001) and cystine (P = 0.003) were lower, and taurine (P = 0.001) were higher in the case group.ConclusionLow levels of arginine in elderly women are associated with a higher risk of sarcopenia.

Dietary habits in Italian children with inflammatory bowel disease: A case-control multicenter study.

Patients with inflammatory bowel disease (IBD) tend to self-modify their dietary habits according to disease activity and symptoms. This study aimed to assess the adequacy of the usual diet in Italian children with IBD in comparison to a control group and to the recommended dietary allowances (RDA). Dietary habits of IBD children and age- and gender-matched healthy controls were investigated using a validated Food Frequency Questionnaire in five Italian pediatric IBD centers. Adherence to the Mediterranean diet (MD) was assessed using the KID-MED test. Energy (EI), macro, and micronutrients intakes were compared between the two groups, to the RDA and the predicted total energy expenditure (EI/total energy expenditure [TEE]%). IBD subjects (n = 110) reported a lower EI, EI/RDA%, and EI/TEE% compared to controls (n = 110) (p = 0.012, p < 0.0002, and p = 0.014), lower total protein and fat intakes (p = 0.017, p < 0.0001) and lower minerals/RDA, vitamins/RDA and micronutrients/RDA ratio (%). Poor adherence to the MD was more frequent in IBD children compared to controls (p = 0.013). The total EI and carbohydrate intake were inversely correlated with higher disease activity. Italian children with IBD report an inadequate diet in terms of energy, macro, and micronutrients and have a low adherence to a high-quality MD pattern.

The Effect of Daily Avocado Intake on Food and Nutrient Displacement in a Free-Living Population with Abdominal Obesity

BackgroundAvocado intake has been associated with improvements in diet quality. Whether this response is because of avocado intake, per se, or combined with a food and/or nutrient displacement (D) has yet to be determined. ObjectivesThis secondary analysis, conducted using dietary data from the Habitual Diet and Avocado Trial, sought to assess the effect of consuming a large avocado (168 g, 281 kcal) daily in the avocado-supplemented diet (AD) group compared with the habitual diet (HD) group on food and nutrient D. MethodsUsing data from 3 unannounced telephone 24-h dietary recalls conducted during the 6-mo intervention period, food intake data were evaluated for 898 participants, aged 25–87 y, and a BMI range of 20.5–60.3 kg/m2. The food group distribution, energy, and nutrient intake of the AD group (n = 436) were calculated and compared with those of the HD group (n = 462). ResultsThe AD group had a higher daily intake of energy (159 ± 575 kcal) (P < 0.001), potassium (3193 ± 817 mg compared with 2419 ± 843 mg) (P < 0.005), fiber (30 ± 8 g compared with 19 ± 9 g) (P < 0.05), and a lower daily intake of animal protein (49 ± 33 g compared with 55 ± 24 g) (P = 0.02) compared with the HD group. Partial D with an avocado was observed for energy (43%), total fat (23%), and carbohydrate (87%), indicating a lower intake of these nutrients from non-avocado sources in the AD group. Food group analysis revealed a lower consumption of animal-derived protein from red meat, processed meats, poultry, and fish in the AD group, with no significant differences observed in dairy and egg intake between groups. ConclusionsIncorporating 1 avocado daily led to favorable modifications in the dietary composition of participants, including an increase in potassium and fiber intake, which can improve diet quality.This trial was registered at https://clinicaltrials.gov as NCT03528031.

The relationship between dietary habits and menstruation problems in women: a cross-sectional study

BackgroundNutrition is important to the management and relief of the symptoms in menstrual disorders. This study aims to investigate the relationship between menstrual disorders and specific foods and nutrient intake in women.MethodsFive-hundred-nine menstruating women participated in the study. The questionnaire form was created by the researchers via Google Forms and distributed in online applications (WhatsApp, Instagram etc.). The questionnaire consists of 5 sections, including demographic data, declared anthropometric measurements (height (m or cm), weight (g or kg)), questions about eating habits, menstruation status, and 24-hour food consumption. Statistical analysis was made with SPSS 23; nutrient analysis of food consumption was made using BeBiS 9.0.ResultsIt was found that the body mass index (BMI) of healthy participants was higher than women with menstrual disorders. Women with menstrual disorders have lower intake of protein, vitamin K, vitamin B3, vitamin B5 and sodium compared with healthy women. All participants have a higher intake of vitamin B3, sodium, phosphorus, and manganese, and have a lower intake of other nutrients compared with the national adequate intake.ConclusionOur findings showed that women with menstrual disorders consume more high-sugar food/beverages and have inadequate nutrients intake.