Plant Protein Intake Research Articles

#1205 Protein intake and mortality in older adults with chronic kidney disease: a multicohort study

Abstract Background and Aims Limiting protein intake in older adults with chronic kidney disease (CKD) may reduce the risk of its progression, but whether it can adversely impact nutritional status and overall health is not well known. We aimed to study the associations of total, animal, and plant protein intake with all-cause mortality in older adults with CKD and replicated the analyses in those without CKD for comparison. Method We used data from three cohorts (Seniors-ENRICA 1 and Seniors-ENRICA 2 in Spain and SNAC-K in Sweden) of community-dwelling adults ≥60 years (2 555 with CKD and 6014 without). According to estimated glomerular filtration rates, urine albumin excretion, and diagnoses from electronic health records, 98% of participants with CKD were in stages 2 and 3. Cumulative protein intake was estimated via validated dietary histories and food frequency questionnaires. Vital status was ascertained with national death registers. Associations were estimated with Cox proportional hazards regression models, adjusted for sociodemographic, lifestyle, morbidity, and dietary variables. Results After a median follow-up of 10 years, 1 901 deaths were recorded. Higher total protein intake was associated with lower mortality among participants with CKD [hazard ratio (95% confidence interval) for 1.15 and 1.35 g/kg/day versus 1.0 g/kg/day = 0.93 (0.88, 0.98) and 0.85 (0.76, 0.95), respectively]. Low total protein intake was more detrimental to the youngest old (<75 years) and high total protein was less beneficial. Plant protein showed a stronger protective association with mortality than animal protein [0.73 (0.59, 0.90) and 0.91 (0.85, 0.98) per 0.2 g/kg/day increment, respectively]. Among participants without CKD, most hazard ratios were lower, especially in the oldest old, but no significant interactions between protein intake, CKD, and mortality arose. Conclusion Higher protein intake might have a positive impact on mortality in older adults with mild or moderate CKD, particularly plant protein. Recommendations for these patients may not differ substantially from those without CKD.

Analysis of the Association between Protein Intake and Disability-Adjusted Life Year Rates for Alzheimer's Disease in Japanese Aged over 60.

With advancements in medical technology, the structure of disease is shifting from acute illnesses to chronic conditions, such as Alzheimer's disease (AD). Consequently, there is an escalating need for evaluations that discourse on the potential effects on healthy life years, as well as disease onset. We aimed to evaluate the associations with AD disability-adjusted life year (AD-DALY) rates and protein intake by sex and age group. For the analysis, we used representative values for males and females in their 60s and aged over 70, extracted from the public dataset of the Global Burden of Disease Study and the National Health and Nutrition Survey in Japan, covering the years 1990 to 2019. In order to evaluate the association between AD-DALY rates and protein intake, we analyzed correlations and stratified multiple regression models. Additionally, we simulated alterations in AD-DALY rates associated with changes in protein intake by utilizing stratified multiple regression models. AD-DALY rates and protein intake indicated significant negative correlations across all sex and age groups. In stratified multiple regression models, significant associations were found between higher protein intake and lower AD-DALY rates in females. In the simulation, when protein intake was increased to 1.5 g/kg/day, AD-DALY rates decreased by 5-9 percent compared with 2019. However, the association between intake of animal and plant protein and AD-DALY rates were found to vary based on sex and age group. The present study suggests the possibility to improve AD-DALY rates by increasing population average protein intake levels in a recommended range.

Impact of dietary habits on renal function in Saku, a rural Japanese town: a cohort study.

High protein intake leads to a decline in renal function in the advanced stages of chronic kidney disease (CKD). An effective diet for maintaining renal function in healthy individuals or patients in the early stages of CKD has not been established. This cohort study was conducted in Saku, Nagano Prefecture, Japan, to investigate the impact of dietary habits on renal function. In this cross-sectional cohort study, we used the Saku Control Obesity Program (UMIN000016892), including 4,446 participants who submitted a brief-type self-administered diet history questionnaire and underwent routine physical examination. The amount of food intake was divided into quartiles. After adjusting for age and sex, multivariate logistic regression analysis was used to calculate the odds ratio (OR) for the risk of developing CKD (estimated glomerular filtration rate [eGFR] < 60mL/min/1.73 m2). In total, 3,899 participants were analyzed. The overall prevalence of patients with eGFR < 60mL/min/1.73 m2 was 11% (n = 434, male; 7.1%, female; 4.1%). The groups with a high intake of chicken (approximately 63.4g/day, adjusted OR: 0.632, P = 0.003), natto (fermented bean; approximately 21.7g/day, adjusted OR: 0.679, P = 0.01), and plant protein (approximately 0.8g/ideal body weight/day, adjusted OR: 0.695, P = 0.042) showed a low risk of developing CKD compared to the group with the lowest intake. Our cross-sectional study showed that the intake of chicken meat, natto, and plant protein was associated with high eGFR levels. This information can be of value for preventing CKD incidence in healthy Japanese individuals.

High-protein diet scores, macronutrient substitution, and breast cancer risk: insights from substitution analysis

BackgroundEvidence from recent studies suggested that variation in the quantity and quality of macronutrients in the diet may potentially play a role in predicting the risk of breast cancer (BC). In the current study, we aimed to assess the association of different high-protein diet scores and replacing fats and carbohydrate (CHO) with protein in the diet with the BC risk among Iranian women.MethodsThe current hospital-based case-control study was conducted on 401 participants, aged ≥ 30 years old, including 134 women in the case group who had been diagnosed with histologically confirmed BC and 267 women in the control group. Dietary intake data was collected using a validated food frequency questionnaire, and high protein diet scores were determined. Logistic regression models were used to determine the odds ratios (OR) and 95% confidence interval (CI) of BC across tertiles of high protein diet scores. Also, we assessed how substituting protein with other macronutrients affected BC odds while adjusting for the various confounding variables.ResultsParticipants’ mean ± SD of age and body mass index were 47.9 ± 10.3 years and 29.4 ± 5.5 kg/m2, respectively. The scores of high-protein-low-CHO and fat diet, high-protein and CHO-low-fat diet, and high-protein and fat-low-CHO diet in participants were 16.5 ± 3.8, 16.5 ± 6.7, and 16.4 ± 5.9, respectively. In the multivariable model, individuals in the highest tertile of high-protein-low-CHO and fat diet score (OR:0.71;95%CI:0.56–0.90) and high-protein and CHO-low-fat diet (OR:0.76;95%CI:0.60–0.97) had lower odds of BC compared to those in the lowest tertile (P < 0.05). However, no significant association was found between high-protein and fat-low-CHO diet and BC risk. Our results showed that replacing fat by protein (ORdifferences:-0.40;95%CI:-0.73,-0.07) and also replacing refined-CHO by plant protein (ORdifferences:-0.66;95%CI:-1.26,-0.07) in the diet are associated inversely with risk of BC(P < 0.05).ConclusionsThe results of our study suggested that higher adherence to a high-protein-low-CHO and fat diet, characterized by a higher intake of plant proteins and a lower intake of refined grains and saturated fat can play a protective role against the odds of BC.

Association of dietary protein intake, inflammation with muscle mass, physical performance and incident sarcopenia in Chinese community-dwelling older adults

ObjectivesInflammation and impaired muscle synthesis are important factors of sarcopenia. Plant protein may reduce inflammation but may not be as efficient as animal protein in providing essential amino acids. We therefore examined the associations between dietary protein intake and changes in muscle mass and physical performance, incident sarcopenia, and the interaction effect of inflammation. DesignProspective cohort study. SettingThe Mr. OS and Ms. OS (Hong Kong) cohort. ParticipantsA total of 2,811 sarcopenia-free participants and 569 sarcopenia participants aged ≥65 years were recruited from communities. MeasurementsDietary protein intake was assessed using a validated food frequency questionnaire. Serum high-sensitivity C-reactive protein (hs-CRP) was measured. Linear regression examined the associations between dietary protein intake and 4-year changes in muscle mass and physical performance. Cox regression examined the association between dietary protein intake and incident sarcopenia. ResultsHigher plant protein intake, but not total and animal protein, was associated with less decline in muscle mass and gait speed among sarcopenia-free participants. Conversely, higher ratio of animal-to-plant protein was associated with reduced muscle mass loss among participants with sarcopenia. The highest tertile of plant protein intake was associated with lower incident sarcopenia risk (HR: 0.75, 95% CI: 0.57−0.98; P-trend = 0.034) compared to the lowest tertile. Notably, this association was observed among participants with higher serum hs-CRP levels (HR: 0.57, 95% CI: 0.34−0.95), but not in those with lower hs-CRP levels. ConclusionDietary animal and plant protein intake have differential associations with muscle mass and physical performance in older adults with and without sarcopenia. The role of plant protein in preventing sarcopenia involves modulation of inflammation.

Dietary protein sources, genetics, and cardiovascular disease incidence

BackgroundTo explore the potential correlation between the amount and source of dietary protein and cardiovascular disease (CVD), as well as the potential impact of genetic susceptibility on these connections. MethodsWe performed a prospective analysis of 98,224 participants from the UK. We measured dietary protein intake using two 24-hour dietary recall interviews. To analyze the data, we used multivariable-adjusted Cox regression models and restricted cubic spline models. Additionally, we calculated weighted genetic risk scores. ResultsA total of 8818 new cases of CVD were documented, which included 4076 cases of coronary artery disease (CAD) and 1126 cases of stroke. The study found a J-shaped association (p nonlinearity = 0.005) between CVD risk and the percentage of energy obtained from consuming plant protein. Higher intake of plant protein and whole protein was associated with a decreased risk of CVD. On the other hand, larger intakes of animal protein was linked to a higher occurrence of CAD. Additionally, increased intake of plant protein was also linked to a lower incidence of stroke. Replacing 5 % of animal protein-based energy intake with plant protein-based energy intake resulted in a 5 % decrease in CVD risk. LimitationsThere remains an effect of residual confounders. ConclusionThe consumption of larger amounts of plant protein, whole protein, and nut protein was found to be associated with a lower risk of CVD events. Conversely, higher intakes of animal protein was associated with an increased risk of CAD events. Furthermore, replacing 5 % of energy intake from animal protein with energy intake from plant protein was found to reduce the risk of CVD by 5 %.

Delivery of a telehealth supported home exercise program with dietary advice to increase plant-based protein intake in people with non-alcoholic fatty liver disease: a 12-week randomised controlled feasibility trial.

This study evaluated the feasibility and safety of a telehealth delivered exercise plus plant-based protein diet in adults with non-alcoholic fatty liver disease (NAFLD). This was a 12-week, randomised controlled feasibility trial including twenty-eight adults aged > 45 years with NAFLD randomised to a home muscle strengthening program (3 d/week) with increased protein intake (target ∼1·2-1·5 g/kg/d) from predominately plant-based sources and behavioural change support (3-4 text messages/week) (Pro-Ex n 14) or usual care (UC, n 14). Feasibility was assessed via retention (≤ 10 % attrition), adherence (exercise ≥ 66 %; recommended daily protein serves ≥ 80 %) and safety (adverse events). Secondary outcomes included macronutrient intake (3 × 24-h records), weight, moderate-to-vigorous physical activity (MVPA) and 30 s sit-to-stand (STS) performance. Study retention was 89 %. Mean exercise adherence (Pro-Ex) was 52 % with one adverse event from 241 sessions. In Pro-Ex, mean daily plant protein serves increased (0·9 to 1·4/d) and animal protein decreased (1·5 to 1·2/d) after 12-weeks, but overall adherence (serves/day) was 32[RD1] % (plant) and 42 % (animal). Relative to UC, Pro-Ex experienced a mean 2·7 (95 % CI: 0·9, 4·4) increase in 30 s STS number, 46-minute (95 % CI: -153, 245) increase in MVPA, 1·7 kg (95 % CI: -3·5, 0·2) decrease in weight, 35·2 g (95 % CI: 11·0, 59·3) increase in protein. In adults with NAFLD a telehealth home exercise and dietary intervention was safe and improved habitual plant and animal protein intake, but overall adherence was modest suggesting more intensive healthcare support may be required.

Animal and plant protein intake during infancy and childhood DNA methylation: a meta-analysis in the NutriPROGRAM consortium

ABSTRACT Background Higher early-life animal protein intake is associated with a higher childhood obesity risk compared to plant protein intake. Differential DNA methylation may represent an underlying mechanism. Methods We analysed associations of infant animal and plant protein intakes with DNA methylation in early (2−6 years, N = 579) and late (7̄−12 years, N = 604) childhood in two studies. Study-specific robust linear regression models adjusted for relevant confounders were run, and then meta-analysed using a fixed-effects model. We also performed sex-stratified meta-analyses. Follow-up analyses included pathway analysis and eQTM look-up. Results Infant animal protein intake was not associated with DNA methylation in early childhood, but was associated with late-childhood DNA methylation at cg21300373 (P = 4.27 × 10¯8, MARCHF1) and cg10633363 (P = 1.09 × 10¯7, HOXB9) after FDR correction. Infant plant protein intake was associated with early-childhood DNA methylation at cg25973293 (P = 2.26 × 10−7, C1orf159) and cg15407373 (P = 2.13 × 10−7, MBP) after FDR correction. There was no overlap between the findings from the animal and plant protein analyses. We did not find enriched functional pathways at either time point using CpGs associated with animal and plant protein. These CpGs were not previously associated with childhood gene expression. Sex-stratified meta-analyses showed sex-specific DNA methylation associations for both animal and plant protein intake. Conclusion Infant animal protein intake was associated with DNA methylation at two CpGs in late childhood. Infant plant protein intake was associated with DNA methylation in early childhood at two CpGs. A potential mediating role of DNA methylation at these CpGs between infant protein intake and health outcomes requires further investigation.

The relation of dietary protein intake before and during the pregnancy with gestational diabetes mellitus (GDM): A GRADE-assessed systematic review and dose–response meta-analysis of epidemiologic studies

Although previous studies investigated the relation of protein intake and gestational diabetes mellitus (GDM), their findings were controversial. Therefore, we aimed to summarize this association, through a comprehensive systematic review and dose-response meta-analysis. Electronic databases including MEDLINE (PubMed), ISI Web of Science, Scopus and motor engineering of Google Scholar were systematically searched up to April 2023. Observational studies which investigated odds of GDM in relation to protein intake were included. A total of 31,005 participants with 3451 cases of GDM from 13 eligible investigations were included in the systematic review and meta-analysis. Comparing the highest and lowest intakes of total, animal, and plant proteins revealed the summary RRs of 1.82 (95% CI: 1.42, 2.33), 1.79 (95% CI: 1.50, 2.14), and 0.98 (95% CI: 0.81, 1.20), respectively, indicating a significant positive association between total and animal protein intake and GDM. In the dose-response analyses, each 5% increment in energy intake from total protein during pregnancy was related to 20% increased odds of GDM (RR=1.20; 95% CI: 1.09, 1.33). In the non-linear dose-response analyses, we found a non-linear association for animal protein intake during pregnancy (P for non-linearity <0.001); so that, a risk increase was seen from zero to 10% of energy intake from animal proteins, however, a risk reduction was seen after 10% of energy intake. However, there was not any significant non-linear trend between plant protein intake during pregnancy and risk of GDM. Based on the GRADE assessment, the quality of evidence for total, animal and plant protein was rated as "moderate", "moderate" and "very low", respectively. We found a significant positive association between total protein intake and GDM; however, the associations of animal and plant protein intake with GDM were dose-dependent.

Association between dietary protein intake and risk of chronic kidney disease: a systematic review and meta-analysis.

There is suggestive data indicating a correlation among dietary protein intake and the progression of chronic kidney disease (CKD). Nonetheless, the exact associations between dietary protein intake and the incidence of CKD have remained uncertain. We performed the first meta-analysis to explore the correlation among total protein, plant protein, animal protein intake and CKD risk. The study conformed the PRISMA statement guidelines. We comprehensively searched PubMed, Web of Science, and Embase until to December 2023. The retrieved studies underwent rigorous evaluation for eligibility, and relevant data were meticulously extracted. The Newcastle-Ottawa Scale (NOS) tool was applied to evaluate the risk of bias. Subsequently, relevant data were extracted and pooled to evaluate the relations among dietary protein intake and CKD incidence. Totally, 6,191 articles were identified, six studies were eligible. A total of 148,051 participants with 8,746 CKD cases were included. All studies had a low overall risk of bias. Higher total, plant and animal protein intake were all correlated with decreased CKD incidence, pooled risk ratios (RRs) and 95% confidence intervals (CIs) were as follows: (RR = 0.82, 95% CI = 0.71-0.94, p = 0.005; I2 = 38%, p = 0.17); (RR = 0.77, 95% CI = 0.61-0.97, p = 0.03; I2 = 77%, p = 0.001); (RR = 0.86, 95% CI = 0.76-0.97, p = 0.02; I2 = 0%, p = 0.59), respectively. For fish and seafood within animal protein: RR = 0.84, 95% CI = 0.74-0.94. Subgroup analysis showed that geographical region, sample size, follow-up time, not assessing protein by food frequency questionnaire, using %energy as the measurement index, not adjusting for several covariates may be the sources of heterogeneity for plant protein. A significant non-linear relation among plant protein and incident CKD was observed by dose-response analysis. The data showed a lower CKD risk significantly associated higher-level dietary total, plant or animal protein (especially for fish and seafood) intake. Further prospective studies demonstrating the correlations of precise sources, intake and duration of dietary protein and incident CKD are warranted.

Animal protein intake is directly associated with serum level of pentraxin 3 in hemodialysis patients

Inflammation plays an important role in Cardiovascular disease (CVD) pathogenesis as the main cause of mortality in hemodialysis (HD) patients. Despite the relevance of nutrition and dietary intakes for inflammation status, the role of dietary protein sources remains unclear. The aim of this study was to evaluate the association between the different types of dietary protein and pentraxin 3 (PTX3) levels in HD patients. In this multi-center cross-sectional study, 227 adult patients undergoing HD for a minimum 90 days were recruited. A validated 168-item food frequency questionnaire was used to assess dietary intakes. Also, 5 ml blood samples were collected from each patient to measure the concentration of serum PTX3. Overall, 227 patients, including 63 women and 164 men, with a mean age of 58 years, participated in this study. There was a greater intake of animal protein per kilogram dry weight among patients with higher levels of PTX3 (0.46 vs. 0.54 g/kg; P = 0.035). In contrast, consumption of total protein and plant protein per kilogram dry weight was not different across PTX3 levels. Moreover, the chance of increased PTX3 concentration was directly associated with a one-unit increase in animal protein intake per kilogram dry weight, after adjusting for confounders. We did not observe any association between one-unit increases in plant protein intake per kilogram dry weight and chance of increased PTX3. In conclusion, animal protein intake was directly associated with circulating PTX3.

Dietary total, plant, and animal protein intake in relation to cardiovascular outcomes and inflammatory factors in elderly men: A cross-sectional study.

The source and amount of protein intake may influence cardiovascular and inflammatory risk, especially in elders who are often more vulnerable. However, findings on elders have been contradictory. Therefore, we examined the association between dietary total, plant, and animal protein intake in relation to cardiovascular outcomes and inflammatory factors in elderly men. The present cross-sectional study included 357 elderly men. A validated and reliable food frequency questionnaire (FFQ) was used to assess dietary intake. All biochemical factors including triglycerides (TG), fasting blood sugar (FBS), high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL6), and tumor necrosis factor-α (TNF-α) were measured. Waist circumference (WC) and blood pressure (BP) were also assessed. A significant inverse association was found between animal protein intake and systolic blood pressure (SBP; OR: 0.62; 95% CI: 0.42, 0.91; ptrend = .014). There were significant inverse associations between plant protein intake and WC (OR: 0.34; 95% CI: 0.17, 0.68; ptrend < .001), FBS (OR: 0.51; 95% CI: 0.29, 0.89; ptrend = .018) and Hs-CRP (OR: 0.39; 95% CI: 0.21, 0.70; ptrend = .002). Moreover, significant inverse associations were also found between total protein intake and SBP (OR: 0.54; 95% CI: 0.33, 0.86; ptrend = .010) and total protein and Hs-CRP (OR: 0.50; 95% CI: 0.28, 0.88; ptrend = .015). In elderly men, a high dietary intake of plant protein was associated with lower odds of having high WC, FBS, and Hs-CRP. In addition, high dietary intake of animal protein was associated with higher odds of having a high SBP level, which was explained by higher intake of dairy products.

The Nutritional Benefit of UV-Exposed Mushrooms for the Dutch Population: Modeling the Addition of UV-Exposed Mushrooms to the Diet

BackgroundMushrooms are rich in fiber and vitamins B and vitamin D when exposed to UV light and are sometimes used as a meat substitute. A modeling study showed that adding a mushroom portion (84 g/d) to the diet of an American population caused a significant improvement in the intake of several nutrients. ObjectiveTo study the association between habitual intake of mushrooms and nutrient intake and to assess the change in micronutrient intake with the modeled addition of 60 or 84 grams of UV-exposed mushrooms to the diet of the Dutch population, with a subanalysis on subjects with a low animal: plant protein ratio. MethodsA modeling study was conducted in 3121 Dutch persons aged 9-80 y, using cross-sectional data from the Dutch National Food Consumption Survey 2012-2016. Linear regression was used to explore the association between habitual intake of mushrooms and nutrients. Habitual intake and nutritional adequacy were calculated before and after the modeled addition of mushrooms. ResultsA small association was observed between the habitual intake of mushrooms and the intake of copper, niacin, and vitamin B2 (beta ranging from 0.002 to 0.039). The modeled addition of UV-exposed mushrooms increased the intakes of plant protein (by 5–7%), fiber (4–6%), niacin (10–20%), vitamin D (176–388%), folate (11–17%), potassium (6–10%), and copper (29–48%). Nutritional adequacy also improved significantly. For subjects with a low animal:plant protein ratio, the added mushrooms increased the intakes of niacin (11–22%), potassium (6–11%), and vitamin D (190–445%). ConclusionsConsumption of mushrooms contributes to higher intakes of copper, niacin, and vitamin B2. Addition of UV-exposed mushrooms to the diet of the Dutch further improves nutrient intakes and, most notably, vitamin D, especially for people with low animal food consumption.

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

Evidence regarding the efficacy of a low-protein diet for patients with CKD is inconsistent and recommending a low-protein diet for pediatric patients is controversial. There is also a lack of objective biomarkers of dietary intake. The purpose of this study was to identify plasma metabolites associated with dietary intake of protein and to assess whether protein-related metabolites are associated with CKD progression. Nontargeted metabolomics was conducted in plasma samples from 484 Chronic Kidney Disease in Children (CKiD) participants. Multivariable linear regression estimated the cross-sectional association between 949 known, nondrug metabolites and dietary intake of total protein, animal protein, plant protein, chicken, dairy, nuts and beans, red and processed meat, fish, and eggs, adjusting for demographic, clinical, and dietary covariates. Cox proportional hazards models assessed the prospective association between protein-related metabolites and CKD progression defined as the initiation of kidney replacement therapy or 50% eGFR reduction, adjusting for demographic and clinical covariates. One hundred and twenty-seven (26%) children experienced CKD progression during 5years of follow-up. Sixty metabolites were significantly associated with dietary protein intake. Among the 60 metabolites, 10 metabolites were significantly associated with CKD progression (animal protein: n=1, dairy: n=7, red and processed meat: n=2, nuts and beans: n=1), including one amino acid, one cofactor and vitamin, 4 lipids, 2 nucleotides, one peptide, and one xenobiotic. 1-(1-enyl-palmitoyl)-2-oleoyl-glycerophosphoethanolamine (GPE, P-16:0/18:1) was positively associated with dietary intake of red and processed meat, and a doubling of its abundance was associated with 88% higher risk of CKD progression. 3-ureidopropionate was inversely associated with dietary intake of red and processed meat, and a doubling of its abundance was associated with 48% lower risk of CKD progression. Untargeted plasma metabolomic profiling revealed metabolites associated with dietary intake of protein and CKD progression in a pediatric population.

Association of Plant-Based Protein Intake with Cognitive Function in Adults with CKD.

Patients with chronic kidney disease (CKD) have accelerated cardiovascular and cognitive aging when compared to the non-CKD population. This cognitive decline contributes to excessive rates of physical and functional decline, reduced quality of life, and mortality in the CKD population. Mediterranean diets, a plant-forward diet, have been associated with positive cognitive performance in the general non-CKD population and with some beneficial outcomes in CKD. However, it is still unclear whether plant-based diets are associated with cognitive decline in patients with CKD. Using the National Health and Nutrition Examination Survey (NHANES) 2011-2012 and 2013-14 data, we conducted a secondary analysis evaluating the relationship of plant-based and unprocessed plant protein with cognitive outcomes measures in eligible participants aged 60 years and older. All data was extracted from the available NHANES demographic, questionnaire, examination, and laboratory data. CKD was calculated and defined in participants as urine albumin to creatinine ratio ≥30mg/g and/or estimated glomerular filtration rate (eGFR) <60 mL/min). In incremental models, we adjusted for total energy intake, age, sex, race/ethnicity, body mass index (BMI), total energy intake, diabetes, hypertension, education, smoking, and alcohol. Higher plant-based protein above median dietary intakes were significantly associated with higher executive function scores in participants with CKD (p<0.05). For all subjects and in those with CKD, plant-based protein was significantly associated (p<0.05) with higher composite cognitive scores in nearly all statistical models. Higher unprocessed plant protein was significantly associated (p<0.05) with higher composite cognitive scores in all categorical models. Higher plant protein intake was a significant predictor of certain individual and composite cognitive score measures within the general and in the CKD population. Future interventional trials are needed to determine if increasing plant-based protein intake improves measures of cognition in patients with CKD.

Dietary protein intake and changes in muscle mass measurements in community-dwelling middle-aged and older adults: A prospective cohort study

Increasing dietary protein intake can be an efficient strategy to prevent sarcopenia. Nevertheless, due to the discrepancy in the population and their dietary pattern, evidence suggested the effects of dietary protein amount or source on sarcopenia prevention varies. This prospective cohort study investigated the correlation between dietary protein intakes or sources and changes in muscle mass measurements. Additionally, the study explored the link between dietary protein and the prevalence of sarcopenia. Participants aged 40 to 75 were from Guangzhou Nutrition and Health Study (GNHS) 2011-2013 and returned in 2014-2017. Validated 79-item food frequency questionnaires were applied to calculate the amount of total, animal, and plant protein intakes and animal-to-plant protein ratio (APR). The body composition was examined by dual-energy x-ray absorptiometry (DXA) to calculate the appendicular lean mass (ALM) and its index (ASMI). Sarcopenia was diagnosed based on the 2019 Asia Working Group of Sarcopenia's criteria. ANCOVA was utilized to compare the differences of Δ ALM and Δ ASMI across the quartiles of the dietary protein, and linear regression was employed to examine dose-response associations. Multilinear mixed-effect models were employed to evaluate whether protein intake relates to annual changes in ALM and ASMI. Multivariable logistic regressions were performed to analyze the associations between dietary protein and sarcopenia. In total, 2709 participants during the 3.2-year follow-up period were considered eligible for analysis. Higher dietary protein intakes (total, animal, plant) in both sexes could preserve more ALM and ASMI in a dose-response manner (all P-trend<0.05). The annual estimated preservations of ASMI were greater in the highest dietary protein intakes (total, animal, plant) quartile than the lowest (0.05-0.13kg/m2/y, all P<0.05). In women, the risk of sarcopenia was reduced by 35%-50% in the highest protein intake (total, animal, plant) quartile than the lowest. The APR did not display any significant associations. Higher dietary protein intake, regardless of animal or plant sources, is associated with less muscle loss and a lower prevalence of sarcopenia in middle-aged and older Chinese, particularly women. NCT03179657.

Plant Protein but Not Animal Protein Consumption Is Associated with Frailty through Plasma Metabolites.

There is evidence that the association of protein intake and frailty may depend on the source of dietary protein. The mechanism underlying this association is not clear. In this study, we explore circulating metabolites as mediators of the relationship between dietary protein and of frailty in participants of the Baltimore Longitudinal Study of Aging (BLSA). Cross-sectional analyses in 735 BLSA participants of associations between plant and animal protein intake and frailty. Usual protein intake from plant and animal sources were estimated with a Food Frequency Questionnaire (FFQ) and frailty was assessed with a 44-item Frailty Index (FI). Compared with the lowest quartile, higher quartiles of plant, but not animal, protein were associated with lower FI. Twenty-five plasma metabolites were associated with plant protein intake; of these, fifteen, including phosphatidylcholines, cholesterol esters, sphingomyelins, and indole metabolites, mediated the association between plant protein intake and FI. The protective association between plant protein consumption and FI is mediated by lower abundance of lipid metabolites and higher abundance of tryptophan-related metabolites.

Quality of dietary macronutrients is associated with glycemic outcomes in adults with cystic fibrosis.

Poor diet quality contributes to metabolic dysfunction. This study aimed to gain a greater understanding of the relationship between dietary macronutrient quality and glucose homeostasis in adults with cystic fibrosis (CF). This was a cross-sectional study of N = 27 adults with CF with glucose tolerance ranging from normal (n = 9) to prediabetes (n = 6) to being classified as having cystic fibrosis-related diabetes (CFRD, n = 12). Fasted blood was collected for analysis of glucose, insulin, and C-peptide. Insulin resistance was assessed by Homeostatic Model Assessment for Insulin Resistance (HOMA2-IR). Subjects without known CFRD also underwent a 2-h oral glucose tolerance test. Three-day food records were used to assess macronutrient sources. Dietary variables were adjusted for energy intake. Statistical analyses included ANOVA, Spearman correlations, and multiple linear regression. Individuals with CFRD consumed less total fat and monounsaturated fatty acids (MUFA) compared to those with normal glucose tolerance (p < 0.05). In Spearman correlation analyses, dietary glycemic load was inversely associated with C-peptide (rho = -0.28, p = 0.05). Total dietary fat, MUFA, and polyunsaturated fatty acids (PUFA) were positively associated with C-peptide (rho = 0.39-0.41, all p < 0.05). Plant protein intake was inversely related to HOMA2-IR (rho = -0.28, p = 0.048). Associations remained significant after adjustment for age and sex. Improvements in diet quality are needed in people with CF. This study suggests that higher unsaturated dietary fat, higher plant protein, and higher carbohydrate quality were associated with better glucose tolerance indicators in adults with CF. Larger, prospective studies in individuals with CF are needed to determine the impact of diet quality on the development of CFRD.

The association between plant and animal protein intake and quality of life in patients undergoing hemodialysis.

Hemodialysis (HD) patients often experience a significant reduction in quality of life (QOL). The source of dietary protein intake may influence the renal function and complications of HD patients. The present study assessed the relationship between plant and animal protein intake and QOL in HD patients. 264 adult patients under dialysis for at least three months were included in this cross-sectional study. Dietary intakes were collected using a valid and reliable 168-item semi-quantitative food frequency questionnaire (FFQ) over the past year. Total, animal, and plant proteins were calculated for each patient. To evaluate QOL, Kidney Disease Quality of Life Short Form (KDQOL-SF 1/3) was used. Anthropometric measures were assessed according to standard protocols. In this study, the average age of participants was 58.62 ± 15.26 years old; most (73.5%) were men. The mean of total, plant, and animal proteins intake were 66.40 ± 34.29 g/d, 34.60 ± 18.24 g/d, and 31.80 ± 22.21 g/d. Furthermore, the mean score of QOL was 59.29 ± 18.68. After adjustment for potential confounders, a significant positive association was found between total dietary protein intake and QOL (β = 0.12; p = 0.03). Moreover, there was a significant association between plant-based protein intake and QOL (β = 0.26; p < 0.001). However, the association between animal protein intake and QOL was insignificant (β = 0.03; p = 0.60). Higher total and plant proteins intake were associated with better QOL in HD patients. Further studies, particularly prospective ones, are needed to corroborate these associations.

Maternal Dietary Protein Patterns and Neonatal Anthropometrics: A Prospective Study with Insights from NMR Metabolomics in Amniotic Fluid.

This study aimed to characterize dietary protein patterns (DPPs) in a sample pool of 298 well-nourished pregnant women and explore potential associations between DPPs and neonatal anthropometrics. Maternal dietary data were collected using a validated food frequency questionnaire. Neonatal anthropometrics were abstracted from health booklets. A hierarchical cluster analysis identified three DPPs: "Dairy-focused", "Med-fusion", and "Traditional-inspired". The "Dairy-focused" DPP exhibited the highest protein intake (p < 0.001), predominantly animal protein (p < 0.001), while the "Traditional-inspired" DPP presented higher plant protein (p < 0.001) and fiber intakes (p < 0.001), and, therefore, a reduced carbohydrate-to-fiber quotient (p < 0.001). The "Med-fusion" DPP had the lowest protein-to-fat ratio (p < 0.001). Infants of women following the "Dairy-focused" DPP had the highest birth height centiles (p = 0.007) and the lowest ponderal index (p = 0.003). The NMR-metabolomics approach was implemented on a subset of women that provided amniotic fluid (AF) specimens (n = 62) to elucidate distinct metabolic signatures associated with DPPs. PCA and OPLS-DA models verified the adherence to three DPPs, revealing that the levels of several amino acids (AAs) were the highest in "Dairy-focused", reflecting its protein-rich nature. The "Traditional-inspired" DPP showed decreased AAs and glucose levels. This knowledge may contribute to optimizing maternal dietary recommendations. Further research is needed to validate these findings and better understand the relationships between maternal diet, AF metabolic signature, and neonatal anthropometrics.