Significant Difference In Protein Intake Research Articles

Effect analysis of information-guided enteral nutrition-associated diarrhea treatment process in patients with chronic obstructive pulmonary disease undergoing continuous non-invasive assisted ventilation: a mixed cohort study of pre- and post-control

To clarify the application effect of information-guided enteral nutrition-associated diarrhea (ENAD) management process in patients with chronic obstructive pulmonary disease (COPD) undergoing non-invasive assisted ventilation. A mixed cohort study of pre- and post-control was conducted. Thirty-nine patients with COPD who were admitted to the emergency intensive care unit (ICU) of Huzhou First People's Hospital from July 1, 2021 to July 31, 2022 were enrolled. Taking the completion of the software development of ENAD management software for critically ill patients on January 28, 2022 as the time node, 20 patients admitted from July 1, 2021 to January 28, 2022 were set as the control group, and 19 patients admitted from January 29 to July 31, 2022 were set as the observation group. The two groups of patients received the same enteral nutrition support treatment, and the control group implemented the conventional ENAD treatment process with enteral nutrition intolerance disposal process as the core. On the basis of the control group, the observation group implemented the information-guided ENAD treatment process, and the system software actively captured the information of ENAD patients and reminded the medical team to improve the patient's diarrhea-related examination and provide alternative treatment plans. The duration of antidiarrhea, feeding interruption rate, and energy and protein intake, blood biochemical indexes, incidence of abnormal blood electrolyte metabolism, daily continuous non-invasive assisted ventilation and endotracheal intubation after 7 days of targeted diarrhea intervention were compared between the two groups. Except for the basal pulse rate, there were no significant differences in gender distribution, age, and vital signs, basic nutritional status, arterial blood gas analysis and blood biochemistry at admission between the two groups, indicating comparability between the two groups. When ENAD occurred, the patients in the observation group obtained earlier cessation of diarrhea than those in the control group [days: 3.00 (2.00, 3.25) vs. 4.00 (3.00, 5.00), P < 0.01], and the feeding interruption rate was significantly lower than that in the control group [10.53% (2/19) vs. 65.00% (13/20), P < 0.01]. After 7 days of diarrhea intervention, the energy intake of the observation group was significantly higher than that of the control group [kJ×kg-1×d-1: 66.28 (43.34, 70.36) vs. 47.88 (34.60, 52.32), P < 0.01], the levels of hemoglobin (Hb), albumin (Alb) and serum prealbumin (PAB) were significantly higher than those in the control group [Hb (g/L): 119.79±10.04 vs. 110.20±7.75, Alb (g/L): 36.00 (33.75, 37.25) vs. 31.00 (30.00, 33.00), PAB (mg/L): 155.79±25.78 vs. 140.95±14.97, all P < 0.05], the daily continuous non-invasive assisted ventilation duration was significantly shorter than that of the control group [hours: 14 (12, 16) vs. 16 (14, 18), P < 0.01], and the arterial partial pressure of carbon dioxide (PaCO2) was significantly lower than that of the control group [mmHg (1 mmHg ≈ 0.133 kPa): 66.00 (62.00, 70.00) vs. 68.00 (67.50, 70.05), P < 0.05]. However, there were no significant differences in protein intake, incidence of abnormal electrolyte metabolism, and incidence of endotracheal intubation due to acute respiratory failure between the two groups. The information-guided ENAD treatment process can enable the COPD patients undergoing continuous non-invasive assisted ventilation who experience ENAD to receive earlier cessation of diarrhea, and improve the protein energy metabolism and respiratory function of the patients.

Early-Life Metabolic and Hormonal Markers in Blood and Growth until Age 2 Years: Results from a Randomized Controlled Trial in Healthy Infants Fed a Modified Low-Protein Infant Formula.

Background: High protein intake in early life is associated with an increased risk of childhood obesity. Dietary protein intake may be a key mechanistic modulator through alterations in endocrine and metabolic responses. Objective: We aimed to determine the impact of different protein intake of infants on blood metabolic and hormonal markers at the age of four months. We further aimed to investigate the association between these markers and anthropometric parameters and body composition until the age of two years. Design: Term infants received a modified low-protein formula (mLP) (1.7 g protein/100 kcal) or a specifically designed control formula (CTRL) (2.1 g protein/100 kcal) until 6 months of age in a double blinded RCT. The outcomes were compared with a breast-fed (BF) group. Glucose, insulin, leptin, IGF-1, IGF-BP1, -BP2, and -BP3 levels were measured at the age of 4 months. Anthropometric parameters and body composition were assessed until the age of 2 years. Groups were compared using linear regression analysis. Results: No significant differences were observed in any of the blood parameters between the formula groups (n = 53 mLP; n = 44 CTRL) despite a significant difference in protein intake. Insulin and HOMA-IR were higher in both formula groups compared to the BF group (n = 36) (p < 0.001). IGF-BP1 was lower in both formula groups compared to the BF group (p < 0.01). We found a lower IGF-BP2 level in the CTRL group compared to the BF group (p < 0.01) and a higher IGF-BP3 level in the mLP group compared to the BF group (p = 0.03). There were no significant differences in glucose, leptin, and IGF-1 between the three feeding groups. We found specific associations of all early-life metabolic and hormonal blood parameters with long-term growth and body composition except for IGF-1. Conclusions: Reducing protein intake by 20% did not result in a different metabolic profile in formula-fed infants at 4 months of age. Formula-fed infants had a lower insulin sensitivity compared to breast-fed infants. We found associations between all metabolic and hormonal markers (except for IGF-1) determined at age 4 months and growth and body composition up to two years of age.

Provision of ready-to-drink protein following bariatric surgery: An evaluation of tolerability, body composition, and metabolic rate

It is recommended that patients consume at least 60g of dietary protein per day to attenuate loss of fat-free mass (FFM) following bariatric surgery. To date, research on the effectiveness and tolerability of protein supplementation in bariatric patients is limited. The purpose of the current study was to determine if provision of 12-weeks of daily protein supplementation was an effective and tolerable method of facilitating higher protein intakes in bariatric surgery patients. A secondary aim was to evaluate the effects of protein supplementation on body composition, metabolic rate, and functional outcomes. An exploratory aim was to compare body composition estimates from bioelectrical impedance spectroscopy and dual-energy x-ray absorptiometry. Bariatric surgery patients (n=49; 88% female) (mean±standard deviation; Age: 43.7±10.7yrs; BMI: 51.2±13.7kgm-2) were provided with either a 12-week supply of ready-to-drink protein shakes (PRO; n=25) or instructed to follow standard-of-care recommendations (SOC; n=24) following surgery. Patients completed measures of body composition (fat mass [FM], percent body fat [%BF], FFM; bioelectrical impedance [BIS] and/or dual-energy x-ray absorptiometry [DXA]), resting metabolic rate (RMR; indirect calorimetry), a 30-s chair stand, and 3-day food logs prior to surgery (base), 3-weeks, 12-weeks, and 24-weeks post-surgery. About 80% of all patients achieved the recommended intake of 60g per day, with no significant differences in protein intake between groups (p<0.05). Patients in PRO were more likely to increase protein consumption over the course of the entire intervention compared to SOC. Both groups experienced significant decreases in weight, BMI, %BF, FM, FFM, and total body water (TBW) (p<0.05). The percentage of weight lost as FFM was significantly greater when measured by BIS (39.1%) compared to when measured by DXA (17.8%) (p<0.05). There was a significant decrease in RMR from base-3 weeks for both groups (p=0.002; 95% confidence interval [-370.6,-90.7]); there were no significant changes after 3 weeks (p>0.05). The number of sit-to-stand trials increased at each testing session after the first 3 weeks (p<0.05). Patients were able to achieve the recommended 60g of protein per day post-surgery, but the provision of ready-to-drink protein shakes may help bariatric patients achieve higher post-surgery protein intakes. Both groups experienced significant decreases in weight, BMI, and body composition; results varied depending on the method of body composition used. Changes in FFM measured by BIS may reflect greater changes in TBW as opposed to actual muscle mass. Registered at ClinicalTrials.gov, ID#NCT02951663.

Effectiveness of Mediterranean Diet's Adherence in children with Inflammatory Bowel Diseases.

Background: Nutritional support is very important in the treatment of Paediatric Inflammatory Bowel Disease (IBD). The role of the Mediterranean Diet (MD) has been understudied in children with IBD. The aims of this study were to assess the dietary intakes of IBD children in comparison with healthy controls (HCs), their adherence to MD; and the relationship between inflammation and dietary behaviors. Methods: Paediatric IBD patients in clinical remission and HCs were enrolled. The nutritional status and adherence to the Mediterranean Diet was evaluated through a 3-day food diary and the Mediterranean Diet Quality Index for Children and Adolescents (KIDMED). Results: The analysis of food diaries showed a significantly higher kilocalorie intake in IBD patients compared to HCs (p = 0.012), an increase in carbohydrates (p = 0.015) and in protein intake (p = 0.024). Both IBD and HCs have an intermediate adherence to MD. The comparison between Crohn’s disease (CD) and Ulcerative colitis (UC) patients showed significant difference in protein intake in CD patients (p = 0.047), as well as for vitamin D (p = 0.044) and iron intake (p = 0.023). Interestingly; in IBD patients we found a significant association between adherence to MD and a low level of fecal calprotectin (p = 0.027). Conclusion: Children with IBD in remission have a sub-optimal food intake compared to HCs. MD seems to correlate to decreased intestinal inflammation.

Dietary Intake and Nitrogen Balance in British Army Infantry Recruits Undergoing Basic Training.

We assessed dietary intake and nitrogen balance during 14 weeks of Basic Training (BT) in British Army Infantry recruits. Nineteen men (mean ± SD: age 19.9 ± 2.6 years, height: 175.7 ± 6.5 cm, body mass 80.3 ± 10.1 kg) at the Infantry Training Centre, Catterick (ITC(C)) volunteered. Nutrient intakes and 24-h urinary nitrogen balance were assessed in weeks 2, 6 and 11 of BT. Nutrient intake was assessed using researcher-led weighed food records and food diaries, and Nutritics professional dietary software. Data were compared between weeks using a repeated-measures analysis of variance (ANOVA) with statistical significance set at p ≤ 0.05. There was a significant difference in protein intake (g) between weeks 2 and 11 of BT (115 ± 18 vs. 91 ± 20 g, p = 0.02, ES = 1.26). There was no significant difference in mean absolute daily energy (p = 0.44), fat (p = 0.79) or carbohydrate (CHO) intake (p = 0.06) between weeks. Nitrogen balance was maintained in weeks 2, 6 and 11, but declined throughout BT (2: 4.6 ± 4.1 g, 6: 1.6 ± 4.5 g, 11: −0.2 ± 5.5 g, p = 0.07). A protein intake of 1.5 g·kg−1·d−1 may be sufficient in the early stages of BT, but higher intakes may be individually needed later on in BT.

Intake of Aspartate Is Negatively Associated with Overall Cognitive Functioning in College Students (P14-015-19)

ObjectivesCertain amino acids are precursors for neurotransmitters (such as tyrosine being a precursor for dopamine) or directly act on receptors in the brain (such as glutamate and aspartate), and ultimately influence brain function. This study examines the association between dietary amino acids important for neurotransmission and cognitive function in college students with and without Attention Deficit Hyperactivity Disorder (ADHD). MethodsUndergraduate students (ADHD n = 17; controls n = 38; age 18–22) were recruited from a mid-Atlantic university. All participants completed a 3-day food diary and dietary data was entered into the Nutrition Data Systems for Research. Average intake estimates were evaluated for total protein and for the amino acids important for neurotransmission: glutamate, glycine, cysteine, aspartate, tyrosine, and tryptophan. Computerized cognitive testing was administered using CNS Vital Signs® software. The resulting Neurocognitive Index (NCI) was the main outcome of interest as a marker of overall neurocognitive status. Data were analyzed in SPSS. Multivariable linear regression was used to estimate the association between the intake of total protein and amino acids with the NCI. Estimates were adjusted for ADHD status, sex, age, and GPA. The protein model was further adjusted for total energy intake (kcal) and amino acid models were further adjusted for total protein intake. ResultsThere were no significant differences in protein intake, amino acid intake, nor in cognitive function between the ADHD and control group, thus, these groups were combined for later analyses. The intake of total protein and of glutamate, glycine, cysteine, tyrosine or tryptophan were not significantly related to NCI. However, aspartate was found to be negatively related to NCI (β = −6.83 (SE = 2.18), P = 0.003). ConclusionsIn this college population, ADHD was not associated with significant deficiencies in cognitive function. However, intake of aspartate was negatively associated with overall cognitive function within the whole college population. Higher dietary intake of aspartate can be observed in individuals consuming the artificial sweetener aspartame or high amounts of gelatin. Future research is needed to further explore the implications of specific amino acids on cognitive function. Funding SourcesN/A.

PERBEDAAN ASUPAN ZAT GIZI PASIEN HEMODIALISA DI RSUD dr. DORIS SYLVANUS PALANGKA RAYA

ABSTRACT&#x0D; Background: Hemodialysis is a catabolic process (breakdown of complex compounds into simpler compounds) in which amino acid removal and protein synthesis depletion occurred.&#x0D; Objective: To investigate differences in nutritional intake of hemodialysis patients at RSUD dr. Doris Sylvanus Palangka Raya.&#x0D; Research Methodology: This research is an observational research with Pre-post design. Purposive sampling technique was employed on 13 PGK patients who undertake weekly hemodialysis at RSUD dr. Doris Sylvanus Palangka Raya. Data of protein, sodium, potassium and oral intakes were obtained by interview and 24-hour food recall for 2 consecutive days of pre and post hemodialysis. BM photo book was used during interview and food recall. Data were analyzed using paired t-test.&#x0D; Result of the study: Most of samples were female (92%), ranged at 46-67 years old, graduated from elementary school and not working. Bivariate test showed p value of protein, sodium, potassium and fluid intakes were 0.022, 0.382, 0.075 and 0.836, respectively. Hemodialysis aims to restrain uremia, excessive fluid and electrolyte imbalance that occur in end-stage renal failure patients. Hemodialysis may increase survival rate of patients as it is effectively removing fluids, electrolytes and metabolites.&#x0D; Conclusion: There was a significant difference in protein intake and insignificant differences in sodium, potassium and fluid intakes of pre and post hemodialysis patients at RSUD dr. Doris Sylvanus Palangka Raya.&#x0D;

Dietary behaviors and nutritional intake of patients with type 2 diabetes mellitus in Japan

BackgroundThe prevalence of type 2 diabetes mellitus (DM) is increasing worldwide, which lead to being global concern about the social and economic burden of DM and its complications. Dietary instruction to the patients for the prevention of exacerbation emphasized the calorie restriction. Aside from calorie intake, various nutritional factors are also involved in the progression of DM and its complications. We, therefore, investigated that the dietary behavior and nutritional intake of the subjects including patients with DM to understand the relationship between dietary behavior and actual nutritional intake of DM patient.MethodsData were obtained from the subjects who visited the healthcare center for the medical checkup during 2012 – 2016 in Kyushu island, Japan (n = 6,261). The mean age of the subjects was 56.5 (range: 22 – 88) years old and the male‐to‐female ratio was 7: 3. Laboratory data and the self‐completed questionnaire including dietary, exercise, and other lifestyle‐related behaviors were collected. Dietary intakes of nutritional factors were estimated from the food frequency questionnaire.ResultsAmong the study population, 8.3% of the subjects were diagnosed with DM. Of those, 56.9% of the patient with DM (4.7% of all subjects) were overlapped with physician‐diagnosed hypertension. Eating sweets or snack was significantly less frequent in the DM patients than in the non‐DM subjects in both genders. Sweet beverage consumption was less frequent in the male DM patients than that in the male non‐DM subjects. There were no significant differences among the female subjects in eating‐out behaviors such as dining out frequency, choice of menu, and consideration of calorie intake, while the male DM patients usually chose the healthier menu and considered calorie intake more than the male non‐DM subjects. Estimated energy intake was significantly lower only in the male DM patients than in the male non‐DM subjects. There was no significant difference in protein intake, and fat intake was lower in the patient group in both genders. In the male subjects, carbohydrate intake was significantly lower in the DM patients than that in the non‐DM subjects in contrast to the female subjects in which the DM patient tended to take in carbohydrates more than the non‐DM subjects. There were no significant differences in frequency of eating salted food between the DM and non‐DM subjects in both genders. The percentage of the subjects who usually drink broth of noodles such as ramen of which the soup contains a lot of salt was significantly lower in the male DM patients than that in the male non‐DM subjects but not in the female subjects. Estimated salt intake, however, was significantly higher in the male DM patients than that in the male non‐DM subjects. In the female subjects, salt intake also tended to be estimated higher in the DM patients than in the non‐DM subjects.ConclusionsThe dietary behaviors regarding calorie and sugar intake were generally consistent with estimated calorie, fat, and carbohydrate intake aside from a few exceptions. The DM patients consumed significantly more salt than the non‐DM subjects. This result, however, was inconsistent with the behavior regarding salt intake. In conclusion, these results suggest that the resolution of the gaps between perceived dietary behavior and actual nutritional intake are crucial for the success of dietary instruction for the prevention of exacerbation of DM.Support or Funding InformationThis study was supported in part by Grants‐in‐Aid for Young Scientist (B) 16K16300 from the Ministry of Education, Culture, Sports, Science and Technology, Japan in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

High protein consumption in trained women: bad to the bone?

BackgroundIt has been posited that the consumption of extra protein (> 0.8 g/kg/d) may be deleterious to bone mineral content. However, there is no direct evidence to show that consuming a high-protein diet results in a demineralization of the skeleton. Thus, the primary endpoint of this randomized controlled trial was to determine if a high-protein diet affected various parameters of whole body and lumbar bone mineral content in exercise-trained women.MethodsTwenty-four women volunteered for this 6-month investigation (n = 12 control, n = 12 high-protein). The control group was instructed to consume their habitual diet; however, the high-protein group was instructed to consume ≥2.2 g of protein per kilogram body weight daily (g/kg/d). Body composition was assessed via dual-energy x-ray absorptiometry (DXA). Subjects were instructed to keep a food diary via the mobile app MyFitnessPal®. Exercise or activity level was not controlled. Subjects were asked to maintain their current levels of exercise.ResultsDuring the 6-month treatment period, there was a significant difference in protein intake between the control and high-protein groups (mean±SD; control: 1.5±0.3, high-protein: 2.8±1.1 g/kg/d); however, there were no differences in the consumption total calories, carbohydrate or fat. Whole body bone mineral density did not change in the control (pre: 1.22±0.08, post: 1.22±0.09 g/cm2) or high-protein group (pre: 1.25±0.11, post: 1.24±0.10 g/cm2). Similarly, lumbar bone mineral density did not change in the control (pre: 1.08±0.16, post: 1.05±0.13 g/cm2) or high-protein group (pre: 1.07±0.11, post: 1.08±0.12 g/cm2). In addition, there were no changes in whole body or lumbar T-Scores in either group. Furthermore, there were no changes in fat mass or lean body mass.ConclusionDespite an 87% higher protein intake (high-protein versus control), 6 months of a high-protein diet had no effect on whole body bone mineral density, lumbar bone mineral density, T-scores, lean body mass or fat mass.

Effects of dietary lipid levels on growth, feed utilization, digestive tract enzyme activity and lipid deposition of juvenile Manchurian trout,Brachymystax lenok(Pallas)

Six isoproteic diets were designated to evaluate the effects of dietary lipid levels (from 70 to 270 g/kg) on the growth performance, feed utilization, digestive tract enzyme activity and lipid deposition of juvenile Brachymystax lenok (average initial weight 0.54 ± 0.04 g). Each diet was fed to triplicate tanks (30 fish per tank) in an indoor closed recirculating system for 9 weeks. Final body weight and weight gain were highest in fish fed 190 g/kg diet and lowest in fish fed the 70 g/kg diet. Specific growth rate of fish fed with 190 g/kg diet was significantly higher than those fed with 70 and 270 g/kg diets (p < .05). Protein efficiency ratio of fish fed with 70 g/kg diet was significantly lower than the 110–230 g/kg treatments and was not significantly different from the 270 g/kg treatment. Fish fed with 270 g/kg diet had significantly higher hepatosomatic index and viscerosomatic index than those fed with 70–190 g/kg diets (p < .05). Intraperitoneal fat ratio and the whole-body lipid content had a trend to increase with increase in dietary lipid level. Muscle crude lipid content increased up to 190 g/kg with increase in dietary lipid level. Lipid retention decreased with increase in dietary lipid level, while no significant differences in protein intake and retention levels were observed in fish among all treatments. Lipase activity of the mixture of pyloric caeca and foregut in fish fed 190 and 230 g/kg diets was significantly higher than those fed 70 and 110 g/kg diets. Midgut and hindgut lipase activities of fish were significantly higher than those fed the 190 and 230 g/kg diets. In conclusion, based on the second-order polynomial model of WG and FCR, this study suggested that 173.8–195.0 g/kg dietary lipid levels were appropriated for B. lenok.

Changes in dietary intake during Ramadan in north east of Iran population

Introduction: Ramadan is the holiest month in Islamic calendar and Muslims abstain from eating, drinking, and smoking from dawn to sunset, in which there are changes in quality of food and eating patterns. The purpose of this study was to know whether these changes provide nutritional needs, and supply all of necessary macronutrients for individuals in the month. Method: A prospective observational study was performed during Ramadan of 1429A.H (September, 2008) in Mashhad, Iran. Among 335 subjects enrolled for the study, 266 subjects met inclusion criteria. We used a semi-quantitative 302-item food frequency questionnaire (FFQ) that was self-administered and assessed the subject’s energy, macronutrient, and fiber intake over the previous three days. Dietary intake assessment was carried out one week before or after Ramadan and during the month. Results: Data showed that the amount of energy intake and macronutrients increased significantly in women and men less than 35 years during Ramadan, and also we found a significant difference in protein intake between males and females less than 35 years old out of Ramadan time. Conclusion: This study revealed that there was a significant increase in intake of energy and macronutrients in men and women less than 35 years that was mainly due to high consumption of carbohydrate during this month. In this study there was no change in energy intake of participants over 35 years old.

Relationship between protein intake and dynapenia in postmenopausal women.

The purpose of this study was to investigate the relationship between protein intake and dynapenia. A cross-sectional/observational study. Department of Kinanthropology at the University of Quebec at Montreal. Seventy-two non-frail postmenopausal women aged between 50 to 75 years were recruited. Body weight (BW), lean body mass (LBM; %) and skeletal muscle mass (bio-electrical impedancemetry analysis), maximum voluntary handgrip strength (using hand dynamometer), aerobic capacity (VO2peak) and dietary intake were measured. Women were divided according to dynapenia criteria. The strongest correlation between muscle strength and protein intake was observed when we express the amount of protein in g/d/BW. No differences for age, BMI, status of menopause, fat mass and VO2peak were observed between non-dynapenic, type I dynapenic and type II dynapenic women, independently of the criteria used. We observed significant differences in protein intake (g/d/BW) between non-dynapenic and type II dynapenic (p<0.01) as well as between type I dynapenic and type II dynapenic (p<0.01) when dynapenia was expressed in kg/BW and in kg/LBM, respectively. It should be noted that no differences in LBM between the three groups were observed when dynapenia was expressed in kg/BW and kg/LBM. Protein intake for all groups respected the RDA of 0.8 to 1.2 g/d/BW (non-dynapenic: 1.44/1.38; type I dynapenic: 1.30/1.33; type II dynapenic: 1.05/1.08 g/d/BW). Protein intake seems to play a role in the development of dynapenia particularly at the level of type II dynapenia. Therefore, an increase in the recommended daily allowance for protein intake may be warranted.

Changes in body fat percentage during body weight stable conditions of increased daily protein intake vs. control

The objective of this study was to examine if increased protein intake vs. control influences body fat percentage during stable body weight. Body composition was assessed before and after a 3-month isoenergetic dietary intervention of 2MJ/d supplements exchanged with 2MJ/d of habitual ad libitum energy intake. The parallel design consisted of protein-rich supplements in the protein group (n=12) and an isoenergetic combination of carbohydrate and fat supplements in the control group (n=12). Daily protein intake was calculated from a 24h urinary nitrogen. Body composition was measured by a combination of underwater-weighing technique, deuterium-dilution technique and whole-body dual-energy X-ray absorptiometry (DXA), a method that allows for estimation of 4-body compartments (fat and lean; water, bone and rest). Subjects were weight stable and did not change their habitual physical activity. Daily protein intake increased in the protein group during the intervention compared to baseline with +11±14g (P<0.05) vs. the control group that did not change their protein intake -1±15g. This resulted in a significant difference in protein intake during the intervention of 80±21g of the protein group vs. 59±11g of the control group (P<0.01). Change in body fat percentage showed a significant group×time interaction of decreased body fat percentage of -1.0±1.1% of the protein group vs. 0.1±0.6% of the control group (P<0.05). The group×time interaction of change in fat mass was significant (P<0.05), and change in fat-free mass was a trend (P=0.05). Fat-free mass of the protein group had increased with +0.9±0.6kg (P<0.01), and fat mass had decreased with -0.6±0.8kg (P<0.05), while the control group had not changed. During increased daily protein intake vs. control body fat percentage decreased with unchanged physical activity during 3months of stable body weight.

Randomized Controlled Trial of Nutritional Counseling on Body Composition and Dietary Intake in Severe CKD

Progressive loss of kidney function results in an increased risk of malnutrition. Despite this, there is little evidence informing the impact of nutrition intervention on predialysis patients with chronic kidney disease (CKD; stages 4 and 5). Randomized controlled trial. 56 outpatients (men, 62%; mean age, 70.7 +/- 14.0 [SD] years) with CKD were randomly allocated to intervention (n = 29) or control (n = 27) by using a concealed computer-generated sequence. The intervention group, provided with individualized dietary counseling with regular follow-up aimed at achieving an intake of 0.8 to 1.0 g/kg of protein and greater than 125 kJ/kg of energy, or control, receiving written material only. Change in body composition (body cell mass, measured by means of total-body potassium, in 40 of 56 participants), nutritional status (Subjective Global Assessment), and energy and protein intake (3-day food record). During the 12 weeks, the intervention group had 3.5% (95% confidence interval, -2.1 to 9.1) less decrease in body cell mass, 17.7-kJ/kg/d (95% confidence interval, 8.2 to 27.2) greater increase in energy intake, greater improvement in Subjective Global Assessment (P < 0.01), and no significant difference in protein intake compared with the control group (-0.04 g/kg/d; 95% confidence interval, -0.73 to 0.16). The intervention was associated with greater increases in energy and protein intake in women than men (interaction P < 0.001 for both). Power to detect change in body cell mass, potential bias in ascertainment of Subjective Global Assessment. In predialysis patients with CKD, structured nutrition intervention had a greater effect on energy and protein intake in women than men. Additional investigations are warranted to determine the impact on body composition.

Red Drum, Sciaenops ocellatus, Production Diets

The replacement of fish meal with soybean meal in fish diets has met with varying degrees of success. Quite often, poor responses to high soybean meal diets are due to a reduced palatability of the diet when fish meal is removed. Recent work has demonstrated that poultry by-product meal can be used as a substitute for fish meal in practical diets for juvenile red drum (Sciaenops ocellatus), indicating it may have favorable palatability characteristics for this species. The present research was designed to evaluate the replacement of menhaden fish meal with solvent-extracted soybean meal in practical diets containing 20% poultry by-product meal and formulated to contain 44% protein and 10% lipid. Test diets were adjusted for phosphorus and methionine content to ensure that minimal dietary requirements were maintained. The response of red drum (mean initial weight 179 g) to diets containing fish meal ranging from 40 to 5% of the diet, as well as the response to a low fish meal diet supplemented with krill hydrolysate, were evaluated over a 14-week growth period. Final weights (percent gain) ranged from 588 g (237.8%) to 651 g (258.5%), with feed conversion efficiencies ranging from 62.1% to 69.9% and protein conversion efficiencies ranging from 27.8% to 30%. No significant differences (P > 0.05) were observed for diet intake, feed conversion efficiency, protein conversion efficiency, intraperitoneal fat ratio, or weight gain. Significant differences in protein intake and the hepatosomatic index were observed. The present findings suggest that fish meal can be reduced to 5% of the diet by replacing it with solvent-extracted soybean meal as well as methionine and phosphorus supplements. Although diets without poultry by-product meal were not tested, it is presumed that the poultry meal enhanced the palatability of the diets, allowing the replacement of fish meal with soybean meal.

Insulin‐Like Growth Factors and Leucine Kinetics During Exercise Training in Children With Cystic Fibrosis

ABSTRACTBackgroundLittle is known about the metabolic effects of exercise training in children with cystic fibrosis. The hypothesis for the current study was that in patients with declining clinical status, exercise increases circulating insulin‐like growth factors (IGFs) and improves protein kinetics.MethodsThis was a prospective intervention study in 10 children with cystic fibrosis who participated in a structured isoenergetic exercise (cycling) training program for 3 months. Measurements of IGFs, protein kinetics (using intravenous [13C]‐1‐leucine tracer infusions) and nutritional balance studies were conducted at baseline and after 3 months.ResultsStandard deviation scores of plasma IGF‐I, IGF‐II, and IGF binding protein (BP)‐3 were all decreased at baseline (mean ± SE: −2.0 ± 0.2, −2.0 ± 0.2, −0.6 ± 0.2, respectively). IGF‐I and IGF‐II concentrations were significantly higher after exercise training (standard deviation scores −1.4 ± 0.3 and −1.3 ± 0.1, respectively; compared with baseline: one‐tailed t‐test P = 0.03 and 0.002). The standard deviation score of the IGF‐I/IGF BP‐3 ratio, an indicator of free IGF‐I in the circulation, normalized during exercise training (0.0 ± 0.6 vs. −1.3 ± 0.2 SD units at baseline, one‐tailed t‐test P = 0.04). There was no significant difference in protein intake and fasting protein breakdown, oxidation, and protein synthesis or in energy balance and fat absorption.ConclusionsThese results show that isoenergetic exercise training can be safely recommended to patients with cystic fibrosis. It provides a positive anabolic stimulus to IGF status but is not sufficient to adequately augment protein accretion in patients with diminished nutritional status.

Insulin-Like Growth Factors and Leucine Kinetics During Exercise Training in Children With Cystic Fibrosis

Little is known about the metabolic effects of exercise training in children with cystic fibrosis. The hypothesis for the current study was that in patients with declining clinical status, exercise increases circulating insulin-like growth factors (IGFs) and improves protein kinetics. This was a prospective intervention study in 10 children with cystic fibrosis who participated in a structured isoenergetic exercise (cycling) training program for 3 months. Measurements of IGFs, protein kinetics (using intravenous [13C]-1-leucine tracer infusions) and nutritional balance studies were conducted at baseline and after 3 months. Standard deviation scores of plasma IGF-I, IGF-II, and IGF binding protein (BP)-3 were all decreased at baseline (mean +/- SE: -2.0+/-0.2, -2.0+/-0.2. -0.6+/-0.2, respectively). IGF-I and IGF-II concentrations were significantly higher after exercise training (standard deviation scores -1.4+/-0.3 and -1.3 +/-0. 1, respectively; compared with baseline: one-tailed t-test P = 0.03 and 0.002). The standard deviation score of the IGF-I/IGF BP-3 ratio, an indicator of free IGF-I in the circulation, normalized during exercise training (0.0+/-0.6 vs. -1.3+/-0.2 SD units at baseline, one-tailed t-test P = 0.04). There was no significant difference in protein intake and fasting protein breakdown, oxidation, and protein synthesis or in energy balance and fat absorption. These results show that isoenergetic exercise training can be safely recommended to patients with cystic fibrosis. It provides a positive anabolic stimulus to IGF status but is not sufficient to adequately augment protein accretion in patients with diminished nutritional status.

The correction of acidosis does not increase dietary protein intake in chronic renal failure patients

In normal humans and in patients with chronic renal failure (CRF), acidosis increases whole-body protein degradation. Correction of acidosis reduces protein degradation. The mechanisms underlying these changes in protein metabolism are unclear. However, one possibility is that dietary protein intake is reduced in acidosis and that this causes increased protein degradation. This possibility has not been tested. In this study the effects of acidosis on protein intake in patients with CRF have been assessed using 7-day weighed dietary inventories in the acidotic state (venous bicarbonate 15.6 ± 1.0 mmol/L) and following treatment with oral sodium bicarbonate (venous bicarbonate 21.0 ± 1.4 mmol/L). Protein intake was also derived from urinary nitrogen excretion. There was no significant difference in protein intake calculated from dietary records (1.0 ± 0.09 g/kg/d v 1.06 ± 0.1 g/ kg/d) or calculated from urinary nitrogen (1.13 ± 0.07 g/kg/d v 1.06 ± 0.06 g/kg/d) between the untreated and bicarbonate-treated states in eight patients with CRF. We conclude that acidosis in CRF patients does not affect dietary protein intake and that dietary changes therefore do not contribute significantly to the changes in protein metabolism seen in acidosis.

Protein intake and glomerular hyperfiltration in insulin--treated diabetics without manifest nephropathy.

Protein intake in relation to glomerular filtration rate (GFR) and urinary albumin excretion (UAE) has been studied in 96 insulin-treated diabetic patients, 20-40 years of age and without nephropathy. They had diastolic blood pressure (DBP) not exceeding 90 mmHg and a GFR exceeding -2 SD of the age-related value. They were without medications except for insulin. There were no significant differences in protein intake between diabetic patients with and without hyperfiltration (1.18 +/- 0.26 g/kg/d vs 1.21 +/- 0.42 g/kg/d, p = 0.75) or between diabetic patients with or without increased UAE (1.16 +/- 0.41 g/kg/d vs 1.24 +/- 0.37 g/kg/d, p = 0.37). No relations were found between protein intake and GFR or UAE in the whole sample, but a positive relation was found between UAE and protein intake in patients with increased UAE. Protein intake correlated with UAE in hyperfiltrators who use tobacco (n = 8, r = 0.85, p = 0.01), but not in non-users (n = 11, r = 0.24, p = 0.48). In conclusion our findings give no support for a relation between high protein intake and glomerular hyperfiltration in insulin-treated-diabetic patients. However, in contrast to non-users of tobacco, a positive relation was found between UAE and protein intake in tobacco users with hyperfiltration.