Adequate Protein Research Articles

Analisis Perbedaan Konsumsi Protein pada Remaja Putri Yang Mengalami KEK Usia 15-19 Tahun di Daerah Pesisir dan Non Pesisir

One of the macronutrients for the prevention of Chronic Energy Deficiency (SEZ) is protein. Muscle mass is affected by the level of adequacy of energy and protein, the level of adequacy of energy and less protein can lead to a decrease in muscle mass in the subject. If protein intake is sufficient, then nutritional status will be good including the size of the upper arm circumference (LILA). Factors that are strongly suspected to influence the diet of protein sources are the type of region that is closely related to the potential of the region in providing natural food for its population. The availability of various foods is largely determined by geographical conditions (including topography) of the region because it will affect the amount and type of food that can be produced by the region. Objective: This study is to determine the difference in protein consumption of adolescent girls who experience SEZ aged 15-19 years in coastal and non-coastal areas. This type of research is an observational analytical design with a comparative study approach with a population of 213 respondents selected by cluster random sampling technique and obtained 138 respondents. Data on independent and dependent variables were collected through questionnaire interview techniques. The Independent Sample T Test is used to determine whether there is an average difference between two unpaired samples (p-value <0.05). Independent sample test results obtained Asymp sig values. (2-tailed) of 0.008 for differences in protein consumption, it was concluded that the difference in protein consumption in adolescent girls who experienced SEZs aged 15-19 years in coastal and non-coastal areas.

Protein intake affects erythrocyte glutathione synthesis in young healthy adults in a repeated-measures trial

BackgroundIn 2005, the Institute of Medicine advised using methods other than nitrogen balance (NB) for determining protein requirements. Since then, protein requirements using indicator amino acid oxidation (IAAO) have been published and are higher than NB. Glutathione (GSH), a tripeptide of cysteine, glutamate, and glycine, is a principal antioxidant that can be used as a functional indicator of protein adequacy. ObjectivesThe aim of this study was to measure changes in erythrocyte GSH kinetics [fractional synthesis rate (FSR) and absolute synthesis rate (ASR)] in healthy adults following a range of protein intakes at and above the current recommendations. MethodsSixteen healthy adults [8 males and 8 females, aged 25.6 ± 0.9 y (mean ± SEM)] were studied at 4 of 6 protein intakes ranging from 0.6 to 1.5 g⋅kg-1⋅d-1. Erythrocyte GSH kinetics were assessed during a 7-h infusion of [U-13C2–15N]glycine following 2 d of adaptation to each protein intake. Blood and urine tests were performed to measure oxidative stress markers, plasma homocysteine, triglycerides, plasma amino acid concentrations, 5-L-oxoproline (5-OP), and urinary sulfate. The protein intake that maximized GSH synthesis was determined using mixed-effect change-point regression in R. Primary and secondary outcomes were analyzed using linear mixed-effects and repeated-measures analysis of variance with Tukey’s post hoc test. ResultsThe protein intake that maximized GSH FSR at 78%⋅d-1 was 1.0 g⋅kg-1⋅d-1 (95% confidence interval: 0.63, 1.39). GSH ASR was significantly lower at 0.6 and 0.8 g⋅kg-1⋅d-1 than at 1.5 g⋅kg-1⋅d-1 (2.03 and 2.17, respectively, compared with 3.71 mmol⋅L-1⋅d-1). Increasing the protein intake led to increased urinary sulfate but did not affect erythrocyte GSH concentration, plasma oxidative stress markers, triglycerides, homocysteine, or 5-OP. ConclusionsA protein intake of 1.0 g⋅kg-1⋅d-1 maximized GSH synthesis, which is in agreement with earlier IAAO-derived protein requirements of 0.93 to 1.2 g⋅kg-1⋅d-1. These findings suggest that recommendations based on NB (0.66 g⋅kg-1⋅d-1) may underestimate protein needs for adequate health.This trial was registered at clinicaltrials.gov as NCT02971046.

Nutrition provision in Australian and New Zealand PICUs: A prospective observational cohort study (ePICUre)

ObjectivesThe main aim of this study was to describe nutrition provision in Australian and New Zealand (ANZ) pediatric intensive care units (PICUs), including mode of nutrition and adequacy of enteral nutrition (EN) to PICU day 28. Secondary aims were to determine the proportion of children undergoing dietetics assessment, the average time to this intervention, and the methods for estimation of energy and protein requirements. MethodsThis observational study was conducted in all ANZ tertiary-affiliated specialist PICUs. All children ≤18 y of age admitted to the PICU over a 2-wk period and remaining for ≥48 h were included. Data were collected on days 1 to 7, 14, 21, and 28 (unless discharged prior). Data points included oral intake, EN and parenteral nutrition support, estimated energy and protein adequacy, and dietetics assessment details. ResultsWe enrolled 141 children, of which 79 were boys (56%) and 84 were <2 y of age (60%). Thirty children (73%) received solely EN on day 7 with documented energy and protein targets for 22 (73%). Of these children, 14 (64%) received <75% of their estimated requirements. A dietetics assessment was provided to 80 children (57%), and was significantly higher in those remaining in the PICU beyond the median length of stay (41% in patients staying ≤4.6 d versus 72% in those staying >4.6 d; P < 0.001). ConclusionsThis prospective study of nutrition provision across ANZ PICUs identified important areas for improvement, particularly in EN adequacy and nutrition assessment. Further research to optimize nutrition provision in this setting is urgently needed.

The impacts of partial replacement of red and processed meat with legumes or cereals on protein and amino acid intakes: a modelling study in the Finnish adult population

Background A shift towards more plant-based diets is considered healthy and environmentally sustainable but may cause a concern regarding protein and amino acid intakes. This modelling study aimed to assess the impacts of partial replacement of red and processed meat with legumes or cereals on the protein and indispensable amino acid intakes in the Finnish adult population. Materials and methods We used the cross-sectional data of the National FinDiet 2017 Survey (two non-consecutive 24-h recalls, n = 1655, 47% men, aged 18–74 years). Six replacement scenarios were created in which the amount of red and processed meat exceeding 70 g/day (Finnish nutrition recommendation), or 30 g/day (EAT-Lancet recommendation) was replaced with the same amounts of legumes, cereals or their combination. Differences to the reference diet were evaluated based on non-overlapping 95% confidence intervals. Population shares (%) below estimated average requirements (EAR) were calculated using the usual intake modelling methodology (SPADE). Results The replacement scenarios decreased the protein and indispensable amino acid intakes depending on gender and age. At the 70-g level, decreases were observed only in men aged 18–64 years. At the 30-g level, decreases were observed in other gender and age groups except women aged 65–74 years. In the scenarios, the mean daily protein intake was 15–18% of total energy intake (E%) (reference 17–18 E%), and the proportions below the EAR were 7–10% in men and 8–10% in women aged 18–64 years (reference 5–7%) and 20–25% in men and 16–20% in women aged 65–74 years (reference 14–17%). For total indispensable amino acids, the proportions below the EAR were <5% in the reference diet and the scenarios. Conclusions The mean daily protein intake remained sufficient when red and processed meat was partially replaced with legumes or cereals in the Finnish adult population. However, protein adequacy in the elderly population warrants attention and more research.

Nutritional and clinical factors associated with acute kidney injury development in critically ill children.

Acute kidney injury (AKI) is common in the pediatric intensive care unit (ICU) and is associated with poorer clinical outcomes. There is scarce data to support an association between nutritional status and nutrient delivery in critically ill pediatric patients. Therefore, the present study aimed to identify the nutritional and clinical factors associated with the development of AKI during pediatric ICU stay. This prospective study included critically ill pediatric patients aged < 15years who were admitted to the medical and surgical pediatric ICU. Clinical, laboratory, nutritional status, nutritional therapy parameters, and AKI data were recorded. Adjusted logistic regression was applied and expressed as odds ratio (OR) and 95% confidence interval (95%CI). P-value < 0.05 was considered significant. We enrolled 108 patients with a median age of 9months (interquartile range/IQR 2.4-62.5), and 43.5% developed AKI. Sepsis/septic shock (OR 8.00; 95% CI 2.06-32.51, p = 0.003), higher severity of illness (OR 1.89; 95% CI 1.24-2.90, p = 0.003), hypoalbuminemia (OR 4.11; 95% CI 1.61-10.46, p = 0.006), edema (OR 3.42, 95% CI 1.10-10.67, p = 0.034), fluid overload (OR 3.52, 95% CI 1.56-7.96, p = 0.003), need for mechanical ventilation (OR 3.62, 95% CI 1.45-9.04, p = 0.006) and adequate protein intake (OR 0.79, 95% CI 0.63-1.00, p = 0.048) were associated with development of AKI. Hypoalbuminemia, need for mechanical ventilation, fluid overload, severity of illness, sepsis/septic shock, and edema were risk factors for AKI in pediatric ICU. Furthermore, adequate protein intake is associated with AKI during pediatric ICU stay, making it important to implement nutritional assessment and nutritional therapy protocols for critically ill pediatric patients.

What Technological and Economic Elements Must be Addressed to Support the Affordability, Accessibility, and Desirability of Alternative Proteins in Low- and Middle-Income Countries?

Populations in low- and middle-income countries (LMIC) typically consume less than the recommended daily amount of protein. Alternative protein (AP) sources could help combat malnutrition, but this requires careful consideration of elements needed to further establish AP products in LMIC. Key considerations include technological, nutritional, safety, social, and economic challenges. This perspective analyzes these considerations in achieving dietary diversity in LMIC, using a combination of traditional and novel protein sources with high nutritional value, namely, soy, mycoprotein, and cultivated meat. Technological approaches to modulate the technofunctionality and bitter off-tastes of plant-sourced proteins facilitate processing and ensure consumer acceptance. Economic considerations for inputs, infrastructure for production, and transportation represent key elements to scale up AP. Dietary diversification is indispensable and LMIC cannot rely on plant proteins alone to provide adequate protein intake sustainably. Investments in infrastructure and innovation are urgently needed to offer diverse sources of protein in LMIC.

Hubungan Kebiasaan Sarapan Pagi, Tingkat Kecukupan Protein dan Vitamin C dengan Kejadian Anemia di SMKN 12 Surabaya

Anemia is one of the nutritional issues that teenagers face. Anemia is a result of the predominance of nutritional intake that is subpar, which might result in a danger if nutritional issues exist. inadequate nutrient intake, which affects the body's ability to absorb nutrients or absorb them properly and contributes to hemoglobin production. Breakfast habits are another element that causes anemia. The value of breakfast in helping youngsters satisfy their daily nutritional and energy demands. The goal of this research was to examine the relationships between anemia at SMKN 12 Surabaya and breakfast practices, protein intake, and vitamin C intake. 100 young women from SMKN 12 Surabaya were the sample for the study, which employed cross sectional analysis. The study's independent factors were breakfast practices, protein intake, and vitamin C intake. The dependent variable was young women's anemia. The Chi-Square test is used in a bivariate study to examine the relationship between breakfast consumption, protein intake, and vitamin C intake, and the prevalence of anemia. 39% of respondents reported having anemia. The majority of respondents reported eating breakfast often with adequate amounts of protein (56%) and inadequate levels of vitamin C (93%). The frequency of anemia and the amount of protein adequacy are significantly correlated (p=0.005). Breakfast consumption had no discernible impact on the prevalence of anemia (p=0.522). The incidence of anemia and the amount of vitamin C adequacy did not significantly correlate (p=0.557). The prevalence of anemia in female teenagers is correlated with the amount of adequate protein in the diet.

Food provision in Australian aged care homes does not meet protein needs of residents: A call for reform.

Malnutrition is common in older adults in aged care homes, partly due to inadequate protein intake. Menu planning guidelines are available however, adherence to guidelines is unknown. This study aimed to determine; (i) what are the average serving sizes of menu items provided and do they meet recommended portion sizes? (ii) does consumption from a 'typical' menu provide sufficient protein? and (iii) can substituting a 'typical' menu with high-protein options enable residents to achieve protein adequacy? This study involved 572 residents (73% female; aged 86.4 ± 7.3 years) from 60 aged-care homes in Australia involved in a 2-year cluster-randomised trial. During the trial, food intake was recorded quarterly using visual estimation of plate-waste and 42 061 foods analysed. As part of a secondary analysis of these data, portion sizes of foods were compared to guidelines by calculating the mean (95% confidence interval). Items were deemed inadequate if the upper 95% confidence interval remained below recommended portion sizes. On average 47% of breakfast and 80% of lunch/dinner items were below recommended portion sizes. Relative protein intakes, from a typical menu (most consumed foods), was 0.9 g and 0.8 g/kg body weight/day for females and males; both below recommendations. Substituting regular items with higher protein equivalents increased protein intake to 1.3 g and 1.2 g/kg body weight/day, for females and males, respectively. Aged care homes in Australia are not meeting menu planning guidelines resulting in insufficient protein being provided. Reform to menu guidelines including provision of high-protein foods, will ensure protein adequacy in older adults in aged-care homes.

Performance of the Global Diet Quality Score (GDQS) App in Predicting Nutrient Adequacy and Metabolic Risk Factors among Thai Adults

BackgroundThe Global Diet Quality Score (GDQS) was developed for monitoring nutrient adequacy and diet-related noncommunicable disease risk in diverse populations. A software application (GDQS app) was recently developed for the standardized collection of GDQS data. The application involves a simplified 24-h dietary recall (24HR) where foods are matched to GDQS-food groups using an onboard database, portion sizes are estimated at the food group level using cubic models, and the GDQS is computed. ObjectivesThe study aimed to estimate associations between GDQS scores collected using the GDQS app and nutrient adequacy and metabolic risks. MethodsIn this cross-sectional study of 600 Thai males and nonpregnant/nonlactating females (40–60 y), we collected 2 d of GDQS app and paper-based 24HR, food-frequency questionnaires (FFQs), anthropometry, body composition, blood pressure, and biomarkers. Associations between application scores and outcomes were estimated using multiple regression, and application performance was compared with that of metrics scored using 24HR and FFQ data: GDQS, Minimum Dietary Diversity–Women, Alternative Healthy Eating Index–2010, and Global Dietary Recommendations score. ResultsIn covariate-adjusted models, application scores were significantly (P < 0.05) associated with higher energy-adjusted mean micronutrient adequacy computed using 24HR (range in estimated mean adequacy between score quintiles 1 and 5: 36.3%–44.5%) and FFQ (Q1–Q5: 40.6%–44.2%), and probability of protein adequacy from 24HR (Q1–Q5: 63%–72.5%). Application scores were inversely associated with BMI kg/m2 (Q1–Q5: 26.3–24.9), body fat percentage (Q1–Q5: 31.7%–29.1%), diastolic blood pressure (Q1–Q5: 84–81 mm Hg), and a locally-developed sodium intake score (Q1–Q5: 27.5–24.0 points out of 100); positively associated with high-density lipoprotein cholesterol (Q1–Q5: 49–53 mg/dL) and 24-h urinary potassium (Q1–Q5: 1385–1646 mg); and inversely associated with high midupper arm circumference (Q5/Q1 odds ratio: 0.52) and abdominal obesity (Q5/Q1 odds ratio: 0.51). Significant associations for the application outnumbered those for metrics computed using 24HR or FFQ. ConclusionsThe GDQS app effectively assesses nutrient adequacy and metabolic risk in population surveys.

Evaluation of the ultrafiltration method to obtain a high-value protein concentrate from the edible insect Tenebrio molitor

Abstract The fractionation of edible insects is one of the major topics related to using insects as food. Developing adequate protein recovery methods is essential to guarantee acceptable incorporation of insect protein fractions into functional food products, which in turn is essential to the development of insect-based products with higher consumer acceptance. This research aimed to produce high-purity protein concentrates from Tenebrio molitor larvae with favourable techno-functional properties, through membrane ultrafiltration with a 50 kDa cut-off, while also comparing with protein concentrates obtained through isoelectric point precipitation (IP). The protein fractions were evaluated for extraction efficiency (protein content, yield, and recovery rate), protein profile (size exclusion chromatography), and techno-functional properties (colour, foaming, and emulsifying properties, and water/oil absorption capacities). The &gt;50 kDa fraction had a protein content above 80% (although lower than the IP fraction), while the &lt;50 kDa fraction only had a protein content of 44.2%. Despite its high protein content, the &gt;50 kDa fraction only attained a protein recovery rate of 27.9%, comparable to the IP fraction recovery rate. The &gt;50 kDa fraction had higher (lightness) and (yellowness) colour than the IP, defatted fraction and powder samples (dried and ground T. molitor). However, all the obtained protein fractions presented a higher Browning Index than the defatted fraction. Additionally, the protein fractions presented better techno-functional properties than the powder or defatted samples, with the &gt;50 kDa fraction presenting better properties than commercial protein concentrates (whey or pea protein). The protein isolation method based on ultrafiltration led to a protein concentrate with high purity and acceptable techno-functional properties, presenting itself as an alternative to the more common method based on isoelectric point precipitation.

Pengaruh Protein Hewani Terhadap Penurunan Angka Stunting Pada Anak Di Kampung Tengah

Stunting is a problem that occurs in babies and toddlers which is characterized by the toddler's height and weight not being in accordance with general standards. Stunting can be caused by inappropriate parenting patterns, inadequate nutrition, and economic factors. The purpose of writing this article is to determine the role of animal protein in reducing stunting rates in children in Central Villages, which is done through providing additional food containing animal protein. The method used in making this article is the literature review method, where we look at several article sources that are related to the topic we are discussing, then we carry out this additional feeding activity by considering the use of animal protein in providing nutrients that are useful for growth and development. child flower. The results of this research are that the animal protein content in eggs, both chicken eggs and quail eggs, greatly influences the adequacy of animal protein in children.

SAT112 Ad Libitum Ketogenic Diet Reverts WD-pathological Effects In Liver, But Not In Skeletal Muscle In Mice

Abstract Disclosure: A. Antonioli: None. A. Provera: None. S. Reano: None. L. Gadipudi: None. S. Tini: None. I. Zaggia: None. T. Raiteri: None. A. Scircoli: None. A. Colasanto: None. D. Raineri: None. N. Filigheddu: None. S. Sutti: None. F. Prodam: None. Western diet (WD), rich in sugars and saturated fats, is a critical factor contributing to obesity and its comorbidities. Since its effects on insulin resistance and inflammation, WD has been associated with many diseases, such as type 2 diabetes mellitus (T2DM), metabolic fatty liver disease (MAFLD) and steatohepatitis (NASH), and metabolic syndrome (MetS) in both animal and humans. Ketogenic diets (KDs) are nutritional regimens characterized by very low carbohydrate intake, high-fat amounts, and adequate protein content, with or without caloric restriction. Energy is provided by ketone bodies from lipid oxidation and protein metabolism. Since growing evidence suggests that KDs are able to reduce inflammation, oxidative stress, and improving mitochondrial function, we hypothesized that it could be a promising strategy to treat obesity related diseases, including MAFLD and sarcobesity. To demonstrate these effects, after 16 weeks of WD diet, we switched mice to standard diet (SD), ad libitum cholesterol-free KD, or maintained in WD for further 2 and 4 weeks. We demonstrated that both KD and SD are able to revert detrimental effects induced by WD in mouse liver, improving the pathological features and lowering the hepatic inflammatory responses associated with NASH. KD resulted in ketosis and mimicked fasting conditions promoting body weight loss and glycaemic control. However, KD did not have positive effects on skeletal muscle strength, mass, and histologic morphology after WD-induced muscle atrophy. Despite the positive effect on WD-induced liver damage and increased body weight, ad libitum KD does not seem to have protective effects against WD-associated loss of muscle mass and functionality. However, we cannot rule out that muscle might need a longer recovery period than the liver. Presentation: Saturday, June 17, 2023

SAT128 Low Concentration Of Butyrate Reverts PA-induced Atrophic Condition On C2C12 Myotubes

Abstract Disclosure: S. Tini: None. A. Antonioli: None. S. Reano: None. T. Raiteri: None. A. Scircoli: None. V. Antoniotti: None. I. Zaggia: None. N. Filigheddu: None. F. Prodam: None. Sarcobesity is a well-defined medical condition characterized by the coexistence between skeletal muscle atrophy and increased fat mass representing, nowadays, a relevant public health issue among the world population. Sarcobesity is often associated with the development of metabolic syndrome (MetS), insulin-resistance (IR), dyslipidaemia, and other pathologies such as cardiovascular diseases (CVDs) and type 2 diabetes (T2DM). The global increment of this condition has been favoured by changes in lifestyle and dietary habits as largely demonstrated. Particularly, Western Diet (WD), rich in saturated fats and sugars and poor in fibers, vitamins, and minerals seems to be the main cause of sarcobesity in association with low levels of physical activity. In recent years, Ketogenic Diet (KD) has been proposed as a fighting obesity therapy and as a new possible therapeutic strategy to counteract the WD detrimental effects on different tissues, i.e skeletal muscle that plays a key role in whole-body metabolism, glucose homeostasis and lipid use. KD regimen consists in a very low carbohydrates intake, high fat and adequate protein contents that cause the so-called “nutritional ketosis” with the production of Ketone bodies (KBs). KBs, such as beta-hydroxybutyrate (BHB), acetoacetate and acetone are the final products of the partial beta-oxidation of free fatty acid. They are short chain fatty acid produced in liver with different role on metabolism and they are used as a source of energy instead of glucose by different tissues including skeletal muscle. Preliminary experiments in our laboratory demonstrated that palmitate (PA), which is a saturated fat highly present in WD regimen, induces myotubes atrophy in dose dependent manner (100, 250, 500uM). The aim of the present study is to investigate not only if KBs have a direct effect on C2C12 skeletal muscle cells, but also if they are able to contrast the PA-induced atrophy in myotubes. We demonstrated with a co-treatment that sodium butyrate (s-BU), which is the main KB produced during ketogenesis, is able to prevent PA negative effects in skeletal muscle cells when it is used at low concentration. In contrast, high doses of BU reduced C2C12 diameters suggesting that KBs could have opposite effects depending on their concentration. Currently, other short chain fatty acids and KBs, i.e pyruvate and acetoacetate are under investigation in our laboratory. Collectively, these data suggest that KD could represent a promising intervention to contrast WD damages on skeletal muscle in overweight/obese individuals. Presentation: Saturday, June 17, 2023

Nutrition Education and Assistance Based on Behavior Change in Adolescent Girls to Improve Nutritional Status and Hemoglobin Levels

Inappropriate nutritional behavior is a common cause of nutritional issues among adolescents, often leading to conditions like underweight and anemia. This study aimed to assess the impact of nutrition education and behavioral change-based support on the nutritional status and hemoglobin levels of adolescent girls. The study included 75 adolescent girls aged 16-18 years from Singosari Village, Gresik District, chosen through purposive sampling. Over a 30-day period, intensive nutrition education and assistance were provided, utilizing various methods such as lectures, discussions, role play, and practical exercises. The results revealed significant improvements in various aspects. Participants exhibited increased nutrition knowledge, energy and protein intake, body weight, nutritional status, and hemoglobin levels after the intervention (p &lt; 0.05). The rise in knowledge was linked to higher protein intake (p=0.009), while adequate protein intake was associated with weight gain (p=0.025). Weight gain, in turn, correlated significantly with improved nutritional status based on BMI/U (p = 0.041). Hemoglobin levels also significantly increased, shifting from 11.6 + 0.2 mg/dl (low) to 13.4 + 0.1 mg/dl (normal) after the intervention. This improvement in hemoglobin levels was linked to increased energy intake (p = 0.012) and a change in the practice of consuming iron supplementation, shifting from no usage to weekly consumption. In conclusion, nutrition education and behavioral change-based support can effectively enhance energy, protein, and iron intake, leading to improved nutritional status and hemoglobin levels among adolescent girls.

Safety and Feasibility of the Addition of a Radiosensitizing Methionine-Restricted Diet to Radiation Therapy

Methionine is an amino acid necessary for numerous processes critical for cell growth and survival. While normal cells can tolerate methionine deficiency, most cancer cells are methionine auxotrophs, requiring dietary intake since they cannot synthesize it. In vitro, methionine deficiency causes cancer cells to undergo cell cycle arrest and cell death, and in vivo a methionine restricted diet (MRD) enhances radiosensitization without significant adverse effects. Combining a MRD and radiation therapy (RT) to treat human malignancies has never been evaluated. The hypothesis of this Phase I study was that a MRD would be safe, and feasible to administer concurrently with curative-intent RT. Eligible patients included adults with any non-skin cancer malignancy undergoing standard radiation therapy without concurrent cytotoxic chemotherapy. The MRD consisted of low-protein cereals, grains, and breads; fruits; vegetables; margarines and oils; and simple carbohydrates. A clinical dietician developed a personalized meal plan with each subject to reduce methionine consumption to 5-10 mg/kg body weight/day, while maintaining adequate protein and caloric intake. An unlimited supply of a commercially available methionine-free protein supplement was provided to minimize hunger and weight loss. The MRD extended from 2 weeks before initiation of RT, through 2 weeks beyond completion of RT. The primary endpoint for safety was the rate of grade 3 or higher acute and late toxicities per CTCAE, over 12 months follow-up. Feasibility was assessed with a biweekly quantitative plasma amino acid panel during the MRD. The target accrual was 15 subjects. Over two years, 53 patients were offered enrollment, 9 subjects enrolled, 5 completed the MRD and RT, and 4 withdrew during the MRD. The table summarizes subjects' characteristics and outcomes. There was no grade 3 or higher adverse events attributable to the MRD. Methionine plasma levels varied over the course of treatment, and while no subject achieved the target of 13 μM, two nadired at 14 μM. The trial was closed early due to slow accrual and subjects' difficulty maintaining the diet. This study suggests a MRD is safe with thoracic or abdominopelvic RT, with toxicities comparable to those expected with RT alone. However, the diet was challenging, and unacceptable to most patients with cancer.

Soy peptides ameliorate the progression of chronic kidney disease in mice via inhibition of inflammation

For patients with chronic kidney disease (CKD), adequate protein intake is required to cope with proteinuria-induced protein loss, but excessive protein consumption may increase renal pressure and exacerbate kidney injury. In contrast to macromolecular proteins, peptides with high tissue permeability and biological activity can efficiently serve as protein sources without exerting glomerular pressure. To investigate the potential of peptides as nutritional intervention in CKD, we initially optimized CKD mouse model by treating with 75 mg/kg/day adenine for up to 21 days. Subsequently, we confirmed that peptides exhibited higher increase in survival rate of CKD mice compared to proteins, possibly due to their relatively high oligopeptide levels of 64.5%. Additionally, compared to positive control group, the soy peptides replacement feed significantly reduced serum urea nitrogen levels (15.4%, P < 0.05) and notably decreased the cross-sectional area of renal tubules (13.1%, P < 0.05) as observed through HE staining. The findings further indicated that soy peptides ameliorated kidney damage by inhibiting inflammatory factors TNF-α and IL-6 expression. Combined with peptides composition analysis, soy peptides were shown to aid in regulating the acid-base balance in mice with CKD. In summary, this study evidenced that soy peptides are viable protein source for nutritional intervention to ameliorate the progression of CKD.

Considerations for a protein-focused screening instrument in clinical nutrition assessment

Physiological stress during injury and surgery negatively impacts protein balance and muscle mass maintenance. Adequate perioperative protein intake may attenuate muscle atrophy to maintain and facilitate functional recovery, particularly in older adults; yet, screening tools routinely used in clinical settings do not specifically assess protein intake when assessing nutrition risk. Although assessing malnutrition is a priority, suboptimal protein intake in non-malnourished patients should also be identified given protein's critical role in muscle health. This opinion paper highlights the potential for using a clinically appropriate protein-focused screener for rapid and efficient characterization of protein intake.

Hubungan Asupan Makanan dan BBLR dengan Kejadian Malnutrisi pada Balita Usia 1-5 Tahun di Wilayah Puskesmas Darul Imarah Aceh Besar

Malnutrition is an imbalance between food intake and the body's needs to fulfill specific functions of the body. Intake of macronutrients is needed by toddlers in growth and development. The imbalance in the level of consumption of macronutrients against the body's needs can affect tissue and body mass which has an impact on malnutrition. Children born with LBW have a 3.34 times greater risk of experiencing poor nutritional status compared to children who are not LBW. Objective: To determine the relationship between food intake and LBW with the incidence of malnutrition in toddlers aged 1-5 years. This research is descriptive analytic with a case control design with a total sample consisting of 31 cases and 31 controls. The research variables were food intake and LBW. This research was conducted in October 2021 at the Darul Imarah Health Center. Data analysis used Chi square test with 95% confidence level. In the case group, toddlers had adequate energy intake, mostly 22 people (44.9%), adequate carbohydrate intake 23 people (51.1%), adequate protein intake 27 people (47.4%), and fat intake deficit 31 people. (56.4%). The incidence of malnutrition in the case group was mostly experienced by 17 LBW infants (53.1%). There was a relationship between fat intake and the incidence of malnutrition (p &lt; 0.05), while the intake of energy, carbohydrates, protein and low birth weight had no relationship with the incidence of malnutrition (p &gt; 0.05).

185 Outcomes from a nutrition and exercise group targeting sarcopenia in older adults attending an integrated care for older persons hub

Abstract Background Sarcopenia refers to the generalised loss of skeletal muscle mass, strength and function. It is closely related to physical frailty, and is a common contributor to the presentation of older adults to integrated care teams. Research has shown that resistance exercises combined with adequate dietary protein intake can reverse sarcopenia. Methods Screening for probable sarcopenia using handgrip strength was introduced as part of the routine comprehensive geriatric assessment. Suitable candidates meeting the inclusion criteria were offered an 8-week program, led by a physiotherapist and a dietitian, incorporating a home-based resistance exercise and nutrition intervention. Measures of strength (using handgrip), muscle mass (using BIA [bioelectrical impedance analysis]) and physical performance (using ‘Timed Up &amp; Go’ [TUG], and gait speed) were taken pre and post intervention. Results 10 participants (2 female, 8 male) completed the program. Following the 8 week intervention, changes were observed in measures of grip strength (median 1.5 kg, P = 0.04), and in physical performance using gait speed (median − 0.355 seconds, P value = 0.8). This was not seen when using TUG to measure physical performance (median + 0.02 seconds). Issues measuring muscle mass in routine clinical practice using BIA were encountered making analysis non uniform within the group. Frailty scores using the fried frailty scale were taken for 6 out of 10 participants in which the median change was −1 on the Fried scale (p = 0.025). Conclusion Participation in this self-directed nutrition and exercise program over an 8 week period was associated with improvements in measures of muscle strength, physical performance (to a lesser extent), and frailty scores. Future work will aim to explore the feasibility of a longer duration of intervention, and to examine whether this results in a greater treatment effect.

186 Experiences of implementing a group intervention targeting sarcopenia in an integrated care for older persons hub

Abstract Background Sarcopenia is associated with declining mobility, falls, frailty, and increased mortality. Research suggests resistance exercises and ensuring adequate protein intake can improve muscle mass, strength and function. Methods Screening for probable sarcopenia was introduced as part of the comprehensive geriatric assessment in the hub. Suitable candidates who screened as having probable sarcopenia were offered a group intervention facilitated by a physiotherapist and a dietitian, followed by an 8 week at home self-management programme. Alongside objective assessments of outcomes, the clinicians conducting the program also undertook a process of reflection on the experience, to provide a qualitative analysis that might inform future work. Results The main barrier identified to the group intervention was enrolment. The primary reason for this appeared to be the presence of other comorbidities that precluded participation. These included active medical conditions, complex social issues, advanced cognitive impairment, complex falls, or malnutrition requiring more specialist intervention. The main facilitator identified was an engaged multidisciplinary team (MDT), willing to upskill to screen for sarcopenia and proactive about discussing the intervention with potential participants. Another facilitator was the practice of contacting participants at the midpoint, to check on compliance and provide encouragement. Conclusion Several conclusions were achieved through a qualitative reflection on the experience. Engaging and upskilling team members and therapist support were seen as facilitators, whilst recruitment was the most significant barrier. During reflection it was suggested that excluding those that did not screen for probable sarcopenia (53% of all screened) may have been a missed opportunity for promotion and prevention. These learnings will be used to inform the design of future such interventions. Despite the challenges encountered, there was a consensus among the MDT that offering a group intervention is a practical way to begin to address sarcopenia within the limited resources of a community hub.