This study investigated the drivers of dietary protein intake among healthy Danish older adults ( n = 57; aged 65–74). The median estimated protein intake of the participants was 0.75 g/kg adjusted body weight/day, well below the recommended 1.0–1.2 g/kg/day for this age group. Participants were categorized into lower (<0.8 g/kg/day protein) and higher (≥0.8 g/kg/day protein) protein intake groups. Despite the generally low protein intake, all participants reported a low perceived need for dietary improvement. There were no significant differences between the low and high protein groups in either subjective or objective nutrition knowledge, nor in emotional experience during grocery shopping. In contrast, participants in the higher protein intake group showed significantly greater well-being, including greater life satisfaction ( p = 0.035). These findings suggest that emotional and psychological well-being may be more strongly associated with total dietary protein intake than subjective and objective knowledge. Although participants demonstrated some awareness that certain fermented dairy products are high in protein, these products remained underutilized, contributing only modestly to overall intake. We suggest that further research is needed about the effectiveness of healthy aging promotion, which may depend on personalized, emotionally resonant communication strategies, including messaging that emphasizes immediate quality of life. • Most healthy Danish older adults consumed less protein than recommended for their age. • Higher protein intake was associated with greater life satisfaction and well-being. • Subjective and objective nutrition knowledge did not differ between lower- and higher protein intake groups. • Emotional experience during grocery shopping was not related to protein intake. • Fermented dairy products were perceived as protein-rich but contributed modestly to intake.

Evidence on protein intake on lean body mass and function in community-dwelling adults aged 50 years and over living with multiple long-term conditions: Systematic review.

Obesity among children and adolescents aged 5 to 19 years has increased dramatically. This study aimed to investigate the association of animal protein intake (API) and plant protein intake (PPI) with obesity in adolescents aged 12 to 17 years. This cross-sectional study used data from 70,332 adolescents who participated in the Study of Cardiovascular Risk in Adolescents (ERICA). Dietary intake of animal and plant proteins was assessed using a 24-h dietary recall (24HR). Protein intake was stratified into quintiles based on the percentage of total energy derived from this nutrient. Associations between protein intake and obesity were estimated using logistic regression models, adjusted for age, type of school (used as a proxy for income), physical activity level, and total energy intake. All models were stratified by sex. Among boys, those in the fourth and fifth quintiles of API had 75% and 91% higher odds of obesity, respectively. Among girls, there was a trend toward increased odds of obesity, although it was not statistically significant. Higher odds of abdominal obesity were observed for both sexes in the two highest quintiles of API intake (girls: OR1.26, 95% CI 1.03-1.54; boys: OR1.78, 95% CI 1.29-2.46). As for PPI, lower odds of abdominal obesity were observed only among girls in the fourth quintile (OR0.80, 95% CI 0.65-0.98). Our findings suggest that despite the multifactorial nature of obesity, reducing API and increasing PPI may help decrease the odds of general and abdominal obesity among adolescents.

Prevalence of the risk of malnutrition and early monitoring of caloric-protein intake in patients hospitalized in an internal medicine unit.

A highly specific wearable sensor based on o-phenylenediamine molecular imprinting for sweat creatinine detection.

Emerging adult college students often experience poor diet quality (DQ) and rely heavily on ultra-processed foods (UPFs), such as sugary beverages, salty snacks, sweet snacks, and other calorie-dense, convenience foods. Meal kits, which provide pre-portioned ingredients and simple recipes, may offer a practical strategy to support healthier eating among emerging adults, yet their relevance and feasibility in college settings remain poorly understood. This study aims to assess the health behaviors, needs, and preferences of the target college student population to inform the development and feasibility of a pilot meal kit program. This exploratory, community-informed research used a multi-method approach implemented in two phases: (1) an electronic survey of undergraduate students assessing sociodemographics, eating patterns, and meal preparation habits, and (2) virtual focus groups exploring protein intake, cooking behaviors, and desired meal-kit features. Quantitative data were analyzed using descriptive statistics, Pearson correlations, and logistic regression models. Qualitative data were coded using inductive thematic analysis. Students (N = 501) demonstrated low DQ (sHEI = 47.7 ± 10.0/100), and 33.7% reported low or very low food security. Higher UPF intake (OR = 1.14, 95% CI [1.02, 1.25], p = 0.015), more frequent cooking (OR = 1.31, 95% CI [1.02, 1.70], p = 0.037), and greater food insecurity (OR = 1.08, 95% CI [1.003, 1.16], p = 0.042) significantly predicted interest in meal kits, although effect sizes were small (Nagelkerke R2 = 0.015-0.023). Qualitative findings identified key barriers to healthy meal preparation, including limited time, inadequate kitchen access and equipment, financial constraints, and dissatisfaction with campus dining protein options. Students perceived meal kits as convenient and customizable but expressed concerns about affordability. Emerging adult college students face numerous barriers to healthy eating. Many view meal kits as a practical way to access convenient, nutritious meals. Affordable, culturally and economically tailored programs may help improve DQ and reduce reliance on UPFs. Findings support pilot testing a campus-based meal-kit program.

In-vitro digestion assessment of DIAAR, protein digestibility, and ACE/COX inhibitory activity of solid-state fermented beans.

In the past, large observational cohort studies suggested that ahigher protein intake might slow the age-associated loss of muscle mass and muscle strength. This observation led to the conclusion that ahigher protein intake may contribute to apreservation of function and to the prevention of sarcopenia. Therefore, the German Nutrition Society increased their recommendation for daily protein intake in adults aged ≥ 65years from 0.8to 1.0 g/kg body weight (estimated value); however, current data indicate that ahigher protein intake has no beneficial effect on muscle mass or muscle strength in healthy older adults. Yet, in patients with sarcopenia abeneficial effect on muscle health can be assumed for an increase in protein intake when combined with resistance exercise, while the evidence for an increase in protein intake alone is less convincing. Current research gaps pertain to the effect of different types of protein on muscle mass and muscle strength as well as to the relevance of avegan diet for healthy aging.

ObjectiveTo investigate if post-discharge oral nutritional supplementation improves physical functional performance and other outcomes in older hip fracture patients at nutritional risk.SettingDepartment of Orthopaedic Surgery, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.ParticipantsHip fracture patients aged ≥65 years and identified as being at nutritional risk. Of 768 individuals screened, 123 were randomised and 109 (89%) completed the 12-week follow-up.InterventionParticipants were randomised to receive either two cans of high energy, high protein oral nutritional supplementation enriched with vitamin D and omega 3 fatty acids daily for 12 weeks after discharge or standard care.Main measuresThe primary outcome was physical functional performance assessed by the 30-s chair-stand test. Secondary outcomes included muscle mass, hand grip strength, activities of daily living, hydration status, inflammation, appetite, quality of life, energy and protein intake, and omega-3 fatty acid status.ResultsPhysical functional performance improved in both groups, with no significant between-group difference in the number of repetitions performed in the intention-to-treat analysis. Protein intake increased in the intervention group (p = 0.003), while no between-group differences were observed for other outcomes. In the per-protocol analysis, the intervention group showed greater improvement in physical functional performance compared with the control group (p = 0.040). Energy and protein intake were also higher in the intervention group (p = 0.003, p = <.001),ConclusionsPost-discharge oral nutritional supplementation increased protein intake but did not improve physical functional performance. Per-protocol findings suggest that high adherence may be necessary to achieve functional benefits.

Diet impacts the pathogenesis of gastrointestinal diseases including inflammatory bowel diseases (IBD) and colorectal cancer (CRC). Although dietary protein can influence physiologic health, its impact on these diseases has not been adequately investigated. Consequently, clinical guidelines on optimal protein intake (i.e. amount and source) to help prevent or treat these conditions are limited. Recent preclinical and clinical studies have examined how modifying dietary protein can impact the pathogenesis of intestinal inflammation. For example, work in mice reveals that higher protein intake worsens colitis and that different dietary protein sources can exert differential effects on colitis severity. Microbial populations and their metabolism were shown to play an important role in mediating these effects. Studies in humans have shown that high intake of red meat is associated with increased IBD incidence and decreased time to relapse in patients with ulcerative colitis; however, it is unclear which other protein sources may be more beneficial. Although a direct connection between dietary protein and CRC has not been established, multiple preclinical studies have shown that reducing dietary protein exerts anticancer effects, including improved response to therapy across multiple tumor types. These effects were shown to be predominantly mediated by restricting tumors of exogenous growth-promoting amino acids, resulting in tumor stress, and in certain cases, activation of antitumor immunity. As a result of multiple studies, we have gained important insights into the role of dietary protein in mediating colonic inflammation and cancer. This work motivates clinical studies to directly test whether modifying source or amount of protein intake in patients with IBD or CRC will be beneficial for reducing disease severity and improving response to therapy.

Cardiovascular diseases are the leading cause of mortality worldwide. Nutritional counseling is a key component of cardiac rehabilitation (CR) but often faces challenges in patients' adherence, particularly in low-resource settings. To evaluate the adherence to nutritional recommendations among patients enrolled in a CR program and to assess the impact of individualized nutritional counseling on dietary intake. Randomized controlled clinical trial. Outpatient CR clinic at the Hospital das clinicas of Universidade Federal de Minas Gerais. A total of 98 adults (mean age 60.4 ± 10.9 y; 57.1% male) with diagnosed cardiovascular conditions referred to CR randomly assigned to intervention (n = 46) or control (n = 52) groups. The intervention group received individualized dietary plans and monthly nutritional counseling over 4 mo, while the control group received standard care without nutritional guidance during the study period. The primary outcome was the adherence to nutritional recommendations based on analysis of 3-d dietary records (caloric intake, macronutrients, sodium, fiber). Adherence was defined as meeting or improving toward dietary recommendations. At baseline, sodium intake showed the highest adherence (89.8%), and fiber intake the lowest (8.2%). After 4 mo, the intervention group had a significant increase in protein intake (P < 0.05) and a 27.5% higher adherence to protein recommendations compared to the control group (P = 0.008). No significant differences were observed for other nutrients. Individualized nutritional counseling within CR programs improves adherence to dietary protein recommendations, emphasizing its importance in secondary prevention of cardiovascular disease. Integrating structured nutritional strategies into CR may enhance clinical outcomes and support comprehensive care.

Evaluation of a multimodal personalized prehabilitation program in colon cancer patients undergoing surgery, focussing on changes in nutritional status, physical fitness and exploring clinical outcomes.

Dietary apps are widely used for tracking food intake due to their convenience and accessibility. However, their accuracy, particularly compared to expert-driven dietary assessment tools, remains insufficiently examined. This study evaluated the accuracy of dietary intake estimations-focusing on energy, carbohydrates, protein, and fat-using NutriComp (NC), a professional dietary software, and Yazio (Y), a commercial mobile application, to assess their suitability for both clinical practice and research purposes. Twenty-two 3-d dietary records were analyzed, with identical food entries provided for both tools. NC utilizes a scientifically validated food database, while Y incorporates user-generated, domestic, and international food data. Mean differences in energy and macronutrient estimations were compared using paired t tests, and agreement was assessed via Bland-Altman analysis. Significant differences were found for energy (P < 0.001), carbohydrates (P < 0.001), protein (P < 0.001), and fat (P = 0.019). NC reported systematically higher values for energy, carbohydrate, and protein intake, whereas Y tended to overestimate fat consumption. Bland-Altman analysis demonstrated systematic biases in energy (115.4 ± 197.1 kcal) and protein (20.3 ± 11.4 g), while fat intake exhibited greater variability (4.2 ± 14.8 g) in Y. These discrepancies may be related to differences in database quality, food categorization, and user input variations. While Y is user-friendly, its dependence on non-validated databases results in notable inaccuracies, limiting its clinical and scientific applicability. In contrast, NC's validated database ensures more precise estimations, making it more suitable for professional dietary assessments. These findings underscore the need for continuous validation and refinement of dietary tracking applications to enhance their reliability and long-term practical utility in nutritional monitoring and research.

Previous research has revealed associations between diet and health-related quality of life (HRQoL), between diet and kynurenine pathway (KP) metabolites (kynurenines), and between kynurenines and HRQoL in colorectal cancer (CRC) survivors. We examined if kynurenines mediate longitudinal associations between diet and HRQoL in CRC survivors up to 12-months posttreatment. Repeated measurements were performed in 209 stage I-III CRC survivors. Diet was assessed by seven-day dietary records. Plasma kynurenines were analyzed using LC-MS/MS. HRQoL outcomes were assessed through the validated EORTC QLQ-C30. We used confounder-adjusted multilevel parallel-multiple mediator models with all kynurenines simultaneously and single mediator models with established KP ratios to estimate total (c:diet-HRQoL), direct (c':diet-HRQoL), metabolite-specific indirect (ab: diet-metabolite-HRQoL), and total indirect (ab:diet-metabolites-HRQoL) effects. Higher carbohydrate intake was associated with worse role functioning, while higher fiber, alcohol, and zinc intake, and better adherence to the Dutch Healthy Diet (DHD) recommendations were associated with better physical and role functioning (c-path). Associations of fiber and DHD with HRQoL remained statistically significant after controlling for all KP metabolites (c'-path). All kynurenines simultaneously only mediated associations of higher carbohydrate intake with worse role functioning, and of higher alcohol intake with better physical functioning (ab). The kynurenic acid-to-quinolinic acid (KA/QA) ratio and hydroxykynurenine ratio (HKr) significantly mediated associations of carbohydrate, protein, fat, alcohol, magnesium, and zinc intake, and adherence to DHD recommendations, with physical and role functioning (ab). In conclusion, while all kynurenines simultaneously did not mediate diet-HRQoL associations, the KA/QA ratio and HKr did mediate several associations within the first year after CRC treatment.

Dietary interventions are essential for managing phenylketonuria (PKU) and may influence metabolic regulation beyond phenylalanine control. We characterized the urinary metabolomic fingerprint of pediatric participants (n=82) recruited into clinical phenotypes: PKU, PKU with response to tetrahydrobiopterin (BH4), and hyperphenylalaninemia (HPA), as well as sex- and age-matched healthy children controls. Untargeted metabolomics (HPLC-Q-TOF-MS/MS) revealed 59 discriminant metabolites across multiple biochemical pathways, including phenylalanine, tryptophan, and caffeine metabolisms, as well as metabolites related to dietary exposure or gut microbial metabolism. Distinct urinary signatures were described across phenotypes. Phenylalanine-related pathways predominated in PKU, accompanied by increased excretion of vitamin derivatives, consistent with protein substitute supplementation. In contrast, reduced levels of non-phenylalanine amino acid derivatives, methylhistidines, creatine, and branched-chain amino acid-related metabolites were observed in PKU, suggesting alterations in muscle metabolism or natural protein intake. Microbiota-derived metabolites were also less represented in PKU, indicating potential effects of dietary restrictions on gut-host metabolic interactions. HPA individuals showed a urinary fingerprint closer to controls, whereas the BH4 subgroup exhibited the greatest metabolic heterogeneity, reflecting variability in dietary and pharmacological treatment responses. These findings reveal metabolic diversity within the pediatric PKU spectrum driven by clinical phenotype and nutritional management. Urinary metabolomics may support more precise monitoring of metabolic health status and guide precision nutrition strategies in PKU and HPA from early life.

GLP-1 receptor agonists and surgical care: implications for bariatric Procedures, perioperative Outcomes, and nutritional optimization.

There is interest in the potential impact of increased protein intake on muscle function in older adults. However, there is paucity of information on effects of different protein types. To determine the impact of protein sources (plant vs dairy) on the plasma metabolomic profile, and to explore associations between metabolites and handgrip strength. In this secondary analysis of a 12-week double-blinded RCT, 171 healthy adults (≥50 years) were assigned to high plant protein (23 g/d), high dairy protein (22 g/d) or low protein (2 g/d) supplement. Plasma samples were collected pre- and post-intervention and analysed using a targeted LC-MS platform. Main and interaction effects were estimated using ANOVA-simultaneous component analysis (ASCA). Spearman correlation analysis evaluated associations between metabolites and handgrip strength, with false discovery rate correction (q < 0.05). ASCA revealed no significant main effect of group (p = 0.23) or group × time interaction (p = 1.00), while time had a significant effect on the metabolomic profile (p < 0.05). After FDR correction, 26 metabolites were significantly correlated with baseline handgrip strength. The strongest positive correlations were observed for creatinine (r = 0.53), leucine (r = 0.38), proline (r = 0.35) and isoleucine (r = 0.33). Baseline levels of leucine, isoleucine, PCaeC322 and SMOHC222 were associated with positive changes in handgrip strength (p < 0.05). Metabolomic changes were not related to protein type. However, metabolite levels were correlated with handgrip strength outcomes, suggesting the necessity to evaluate the metabolic state of individuals prior to interventions. This study is registered on isrctn.com as ISRCTN16651067.

We examined associations of polygenic scores (PS) for macronutrient intake with food intake and cardiometabolic outcomes during childhood and adolescence and evaluated gene enrichment in hypothalamic cell types. We derived carbohydrate, fat, and protein intake PS from an adult genome-wide association study among 516 non-Hispanic White children from the Project Viva cohort. We estimated dietary intake and calculated BMI z scores from measured height and weight at ages ∼3, 8, 13, and 18 years. Waist circumference, truncal fat, fasting glucose, insulin, glycated hemoglobin, and blood lipids were measured at 18 years. We estimated associations of PS with sugar-sweetened beverages (SSB), fast food, and BMI z score using generalized estimating equations (longitudinal), and using regression models for cardiometabolic and secondary dietary outcomes (cross-sectional). We evaluated enrichment of macronutrient intake genetic signals in hypothalamic cell types in the Human HYPOMAP data set. A 1-SD increase in carbohydrate PS was associated with higher odds of consuming two or more servings per week of SSB (odds ratio [OR] 1.20; 95% CI 1.07, 1.33) and one or more times per week of fast food (OR 1.11; 95% CI 1.004, 1.23) from ages 3 to 18 years. Higher-protein PS was associated with lower odds of consuming SSB (OR 0.84; 95% CI 0.75, 0.93). We did not observe consistent associations between macronutrient intake PS and cardiometabolic outcomes. We observed hypothalamic regional and neurotransmitter-specific patterns of gene enrichment for carbohydrate or protein intake. Genetic susceptibility for carbohydrate intake is associated with SSB and fast-food consumption in youth. Underlying pathways relating to hypothalamic nutrient-specific appetite signaling may be involved.

Malnutrition in children with congenital heart defects (CHD) is significantly associated with increased mortality risk and adversely affects physical and neuropsychological development as well as cardiac surgical outcomes. The aim of this this review is to analyse current approaches to the organisation of nutritional support for neonates and young children with CHD. A literature search was conducted in the scientometric databases PubMed, MEDLINE, and Embase. Clinical practice guidelines and consensus documents issued by SCCM, ASPEN, ESPNIC, ESPGHAN, AEP, ESPEN, PCICS, and NPC-QIC were also reviewed. Malnutrition has been identified as a prevalent condition in children with CHD, particularly neonates and infants, and is observed irrespective of the presence or absence of cyanosis. The primary risk factors for impaired nutritional status comprise inadequate nutritional intake, increased energy requirements, hypoxia, impaired feeding tolerance, and malabsorption. Concurrently, excess body weight and obesity in children with CHD have demonstrated an increasing prevalence trend. The initial step in formulating an individualised nutritional programme for a child with CHD is nutritional status assessment, including determination of anthropometric indices expressed as z-scores. Recognition of the limitations of anthropometry in the early stages of malnutrition has informed recommendations for incorporating validated nutritional screening tools into the routine clinical monitoring of children with CHD. Regular screening with validated instruments (STRONGkids, STAMP, and others) at both outpatient follow-up visits and during hospitalisations, supplemented by application of the RACHS-2 surgical risk assessment scale, facilitates comprehensive planning of medical dietary therapy (MDT) in the perioperative period. Approaches to calculating energy and protein requirements are presented. Features of nutritional support in the preoperative, interstage, and postoperative periods are discussed. Three clinical phenotypes of children with CHD based on nutritional status, together with corresponding MDT recommendations, are also presented. The importance of strict total fluid volume monitoring to prevent volume overload is emphasised. The requirement to maintain adequate energy and protein intake alongside fluid volume restriction necessitates the addition of either fortifiers or iso- and hypercaloric clinical nutrition products (foods for special medical purposes, FSMPs) to standard feeds. Conclusion. Nutritional management in children with CHD represents an extraordinary clinical challenge, given the risk of developing numerous pathological conditions arising from immaturity, hypoxia, or defect-associated complications (cNEC, protein-losing enteropathy, chylothorax, renal dysfunction), particularly in children with unstable ductus-dependent systemic circulation. Monitoring of physical growth and continuous nutritional optimisation should form an integral part of the ongoing care of every child with a congenital heart defect, irrespective of the need for surgical intervention.

To determine the prevalence of malnutrition among older adults with chronic wounds. A prospective cohort study was conducted to assess the nutrition status of adults over the age of 65 with a chronic wound. Participants who met inclusion criteria were recruited at the Sheldon Chumir Wound Clinic in Calgary, Alberta, Canada, from April 1, 2022, to March 31, 2023. The primary outcome was the diagnosis of malnutrition. Secondary outcomes included other nutrition diagnoses and identified diet barriers. Patient demographic and characteristic information were also collected. A total of 78 patients were included in the study, with a mean age of 75.9±7.7 years. A clinical diagnosis of malnutrition was made in 24.4% of participants, with more than two-thirds of the participants diagnosed with inadequate protein intake (69.2%) and knowledge deficiency (67.9%). Common dietary barriers included loss of appetite (46.2%), eating meals alone (30.2%), and constipation (19.2%). Older age increased the odds of malnutrition (odds ratio, 1.20; P=.004). In contrast, being male was associated with a lower likelihood of malnutrition (odds ratio, 0.07; P=.030). Patients with a psychiatric diagnosis had markedly higher odds of malnutrition (odds ratio, 76.89; P=.006), as did those with hypothyroidism (odds ratio, 20.55; P=.046). Previously, 34.2% of community-dwelling older adults in Canada were estimated to be at risk of malnutrition. The present study clinically diagnosed malnutrition in 24.4% of older adults with chronic wounds. This finding reinforces the importance of malnutrition screening in multidisciplinary wound clinics and advocates for establishing nutrition assessments as standard of care for geriatric patients with chronic wounds.