Vegetable Protein Intake Research Articles

Association between empirically derived nutrient patterns and breast cancer: a case–control study in a Middle Eastern country

PurposeThe risk of breast cancer (BC) and related mortality have increased in Middle-East countries during recent decades. The relationship between several nutrient intakes and the risk of BC has been investigated in several studies. However, few studies have estimated the effects of patterns of different nutrient intake on the risk of BC in this region.MethodsA total of 453 patients who were recently diagnosed with breast cancer and 516 healthy women participated in the current case–control study. To evaluate the dietary intakes, we used a validated 168-item food frequency questionnaire (FFQ) during the last year. Nutrient Patterns (NPs) were extracted through factor analysis (FA) of energy-adjusted twenty-six nutrients. The relationship between nutrient patterns and the risk of breast cancer in pre and post-menopausal women was estimated by multivariable regression.ResultsFour major nutrient patterns were identified in the current study. The first nutrient pattern was rich in animal protein, retinol, riboflavin, pantothenic acid, cobalamin, and calcium. Higher saturated fatty acids (SFAs), mono-unsaturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs), and trans fatty acids (TFAs), and lower intakes of niacin were observed in nutrient pattern 2. The third nutrient pattern was rich in fiber, potassium, and vitamin C. Nutrient pattern 4, was associated with higher intakes of vegetable protein, alpha-tocopherol, and magnesium. A significant inverse relationship was observed between adherence to nutrient pattern 3 and the risk of BC in all participants [odds ratio (OR) = 0.70, 95% confidence interval (CI): 0.50, 0.97, P = 0.03) and pre-menopausal women (OR = 0.59 (0.39–0.89), P = 0.01).ConclusionDecreasing odds of breast cancer were observed by adherence to a nutrient pattern high in dietary fiber, vitamin C, and potassium. Future prospective investigations are recommended to confirm these findings.

Effect of Sustainably Sourced Protein Consumption on Nutrient Intake and Gut Health in Older Adults: A Systematic Review.

Diet is integral to the healthy ageing process and certain diets can mitigate prolonged and deleterious inflammation. This review aims to assess the impact of diets high in sustainably sourced proteins on nutrient intake, gut, and age-related health in older adults. A systematic search of the literature was conducted on 5 September 2023 across multiple databases and sources. Studies assessing sustainably sourced protein consumption in community dwelling older adults (≥65 years) were included. Risk of bias (RoB) was assessed using 'RoB 2.0' and 'ROBINS-E'. Narrative synthesis was performed due to heterogeneity of studies. Twelve studies involving 12,166 older adults were included. Nine studies (n = 10,391) assessed habitual dietary intake and had some RoB concerns, whilst three studies (n = 1812), two with low and one with high RoB, conducted plant-based dietary interventions. Increased adherence to sustainably sourced diets was associated with improved gut microbial factors (n = 4640), healthier food group intake (n = 2142), and increased fibre and vegetable protein intake (n = 1078). Sustainably sourced diets positively impacted on gut microbiota and healthier intake of food groups, although effects on inflammatory outcomes and health status were inconclusive. Future research should focus on dietary interventions combining sustainable proteins and fibre to evaluate gut barrier function and consider inflammatory and body composition outcomes in older adults.

Animal and vegetable protein intake and malnutrition in older adults: a multicohort study.

Malnutrition is a global concern in older adults, as it negatively affects morbidity and mortality. While higher animal protein intake may help prevent and treat malnutrition, it might also increase the risk of chronic diseases and death. Conversely, vegetable protein intake might have a lower anabolic effect and not be as effective to improve nutritional status. We studied whether animal and vegetable protein intake are associated with changes in nutritional status in older adults. We used pooled data from two Spanish cohorts: the Seniors-ENRICA 1 and Seniors-ENRICA 2. 2,965 community-dwelling adults aged 62-92 years. Protein intake was estimated at baseline via an electronic, validated diet history. Nutritional status was assessed at baseline and after 2.6 years with the GLIM (Global Leadership Initiative on Malnutrition) phenotypic criteria: weight loss, low body mass index, and reduced muscle mass. The odds of improvements in nutritional status were assessed with logistic regression models, extensively adjusted for potential confounders. Higher animal and vegetable protein intake were associated with improvements in nutritional status [odds ratios (95% confidence intervals) per 0.25 g/kg/day were 1.15 (1.00, 1.32) and 1.77 (1.35, 2.32), respectively]. Cereal protein intake drove most of the latter association [2.07 (1.44, 2.98)]. Replacing 0.25 g/kg/day of total animal protein, meat, or fish protein (but not dairy or egg protein) with vegetable protein was associated with improvements in nutritional status [1.54 (1.13, 2.09), 1.70 (1.20, 2.41), and 1.77 (1.18, 2.64), respectively]. Higher animal and, especially, vegetable protein intake were associated with improvements in nutritional status in older adults. Replacing total animal protein, meat, or fish protein with vegetable protein may help improve malnutrition.

The association between dietary habits and recurrence of kidney stones: A systematic review and meta-analysis

Link of Video Abstract: https://youtu.be/0RQPy46hlvY Background: Kidney stone disease is a significant global health issue that imposes a substantial burden on both patients and healthcare systems which affects 5-10% of the general population. There are several factors involved in its pathogenesis including insufficient dietary habits and fluid intake. Therefore, we conducted a systematic review and meta-analysis to compare between dietary intake across populations and recurrent urinary tract stones. This systematic review and meta-analysis aims to compare the associations between dietary intake across populations and recurrent kidney stones. Methods: Systematic search up to March 2023 were conducted through PubMed, Scopus, EMBASE. The systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Means and standard deviation of the nutrient intakes were extracted in patients with urinary stone disease group and control group. Results: Seven articles were further assessed with two articles were assessed through meta-analysis. Two studies showed that high sodium intake [SMD = 0.29 95% CI = -0.13, 0,71] was found in patient with urinary stone disease, while high water intake [SMD = -0.40 95% CI = -1.14, 0.34] was found in the control group. Conclusion: Animal protein, processed meat, sodium, and sugary beverages were associated with an increased risk of developing urinary stones, whereas vegetable protein and water intake were associated with a decreased risk.

Optimization and Characterization of Lupin Protein Isolate Obtained Using Alkaline Solubilization-Isoelectric Precipitation.

The trend in today's society is to increase the intake of vegetable protein instead of animal protein. Therefore, there is a concern to find new sources of alternative protein. In this sense, legumes are the main protein source of vegetable origin. Of all of them, lupins are the ones with higher protein content, although they are currently undervalued as an alternative for human consumption. In this sense, it is vital to characterize and obtain protein isolates from this legume, which satisfies the growing demand. Therefore, in the present work, the procedure for obtaining a lupin (Lupinus luteus) protein isolate (LPI), based on basic solubilization followed by isoelectric precipitation, has been optimized and validated. The optimized LPI, as well as the lupin flour, were subsequently characterized. The chemical composition, physicochemical, as well as the technofunctional properties of the LPI were analyzed. The results show that the proposed procedure had a high yield (23.19 g LPI/100 g flour) and allowed to obtain high-purity protein isolates (87.7 g protein/100 g LPI). The amino acid composition and the chemical scores show high proportions of essential amino acids, being protein deficient only in methionine and valine. Therefore, it can be affirmed that it is a high-quality protein that meets the requirements proposed by the FAO. Regarding the lipid fraction, it is mainly composed of unsaturated fatty acids (C18:1n-9 and C18:2n-6), which is also advisable in order to follow a healthy diet. Finally, LPI showed interesting technofunctional properties (foaming, gelling, emulsifying, water and oil absorption, and solubility), which makes it especially attractive for use in the food industry.

The Influences of Macronutrients on Bone Mineral Density, Bone Turnover Markers, and Fracture Risk in Elderly People: A Review of Human Studies.

Osteoporosis is a health condition that involves weak bone mass and a deteriorated microstructure, which consequently lead to an increased risk of bone fractures with age. In elderly people, a fracture attributable to osteoporosis elevates mortality. The objective of this review was to examine the effects of macronutrients on bone mineral density (BMD), bone turnover markers (BTMs), and bone fracture in elderly people based on human studies. A systematic search was conducted in the PubMed®/MEDLINE® database. We included human studies published up to April 2023 that investigated the association between macronutrient intake and bone health outcomes. A total of 11 meta-analyses and 127 individual human studies were included after screening the records. Carbohydrate consumption seemed to have neutral effects on bone fracture in limited studies, but human studies on carbohydrates' effects on BMD or/and BTMs are needed. The human studies analyzed herein did not clearly show whether the intake of animal, vegetable, soy, or milk basic proteins has beneficial effects on bone health due to inconsistent results. Moreover, several individual human studies indicated an association between eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and osteocalcin. Further studies are required to draw a clear association between macronutrients and bone health in elderly people.

Dietary protein intake and mortality among survivors of liver cirrhosis: a prospective cohort study

BackgroundLiver cirrhosis is a worldwide burden and is associated with poor clinical outcomes, including increased mortality. The beneficial effects of dietary modifications in reducing morbidity and mortality are inevitable.AimThe current study aimed to evaluate the potential association of dietary protein intake with the cirrhosis-related mortality.MethodsIn this cohort study, 121 ambulatory cirrhotic patients with at least 6 months of cirrhosis diagnosis were followed-up for 48 months. A 168-item validated food frequency questionnaire was used for dietary intake assessment. Total dietary protein was classified as dairy, vegetable and animal protein. We estimated crude and multivariable-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs), applying Cox proportional hazard analyses.ResultsAfter full adjustment for confounders, analyses showed that total (HR = 0.38, 95% CI = 0.2–1.1, p trend = 0.045) and dairy (HR = 0.38, 95% CI = 0.13–1.1, p trend = 0.046) protein intake was associated with a 62% lower risk of cirrhosis-related mortality. While a higher intake of animal protein was associated with a 3.8-fold increase in the risk of mortality in patients (HR = 3.8, 95% CI = 1.7–8.2, p trend = 0.035). Higher intake of vegetable protein was inversely but not significantly associated with mortality risk.ConclusionA comprehensive evaluation of the associations of dietary protein intake with cirrhosis-related mortality indicated that a higher intakes of total and dairy protein and a lower intakes of animal protein are associated with a reduced risk of mortality in cirrhotic patients.

A Cross-Sectional Study: Animal and Vegetable Protein Intake Among Preschool Children

Protein is one of the macronutrients needed in child growth, which can be obtained from animal and plant foodstuffs. Protein intake gets more attention because energy-protein malnutrition is more common in children under five. Protein nutrition for children must be fulfilled to prevent growth retardation in the next phase. This research aims to establish a profile of preschool children's animal and vegetable protein intake. This type of research is descriptive observational with a cross-sectional design. This research was conducted at Bina Anasprasa Nuris Jember Kindergarden in March 2023. The sample in this study was preschool children aged 3-5 years, totaling 53 people who were taken by purposive sampling. Food consumption data for children was obtained using the 1x24-hour food recall method. Processing and analysis of data using univariate analysis. Preschool girls have more than boys (67.9% and 32.1%). The majority of mothers are not working/housewives (62.3%), while the majority of fathers are self-employed (45.3%). Most families have income above the 2023 Jember UMK (62.3%). Nutritional status with indicators of weight/age, height/age, weight/height of all preschool children has normal, normal, and good nutritional status (100%). Total protein intake increased slightly for boys and families whose income was above the minimum wage. Meanwhile, the intake of vegetable and animal protein sources in preschool children is similar but slightly higher in vegetable protein. Animal protein food ingredients still have high biological value because they contain all essential amino acids compared to vegetable protein. Therefore, preschoolers need to increase their consumption of animal protein food ingredients in their daily diet.

Reproductive Endocrinology and Infertility

lowest quintile of animal protein intake was 1.39 (1.01 to 1.90; 0.03). The corresponding RR (95% CI; P for trend) for vegetable protein intake was 0.78 (0.54 to 1.12; 0.07). Furthermore, consuming 5% of total energy intake as vegetable protein rather than as animal protein was associated with a more than 50% lower risk of ovulatory infertility (P .007). CONCLUSION: Replacing animal sources of protein with vegetable sources of protein may reduce ovulatory infertility risk.

Higher Intake of Vegetable Protein and Lower Intake of Animal Fats Reduce the Incidence of Diabetes in Non-Drinking Males: A Prospective Epidemiological Analysis of the Shika Study

Although nutrient intake and alcohol consumption are both closely associated with the incidence of diabetes, their interrelationships remain unclear. Therefore, we herein have investigated the interrelationships among nutrient intake, alcohol consumption, and the incidence of diabetes using longitudinal data. This study included 969 residents ≥40 years living in Japan. In 2011 and 2012, a baseline study was conducted using questionnaires on basic demographics, diabetes, nutrient intake, and lifestyle habits. In 2018 and 2019, a follow-up study was performed using questionnaires and medical records on diabetes. Two-way analysis of covariance (two-way ANCOVA) was used to test the interactions of drinking habits and diabetes incidence on nutrients intake. The prospective relationship between nutrient intake at baseline and the incidence of diabetes in the follow-up stratified by drinkers and non-drinkers was evaluated using multiple logistic regression analysis. Interactions were observed for vegetable protein intake (p = 0.023) and animal fat intake (p = 0.016) in males. Vegetable protein intake negatively correlated with the incidence of diabetes in non-drinkers (odds ratio (OR): 0.208; 95% confidence interval (95% CI): 0.046-0.935; p = 0.041). Furthermore, animal fat intake positively correlated with the incidence of diabetes in non-drinkers (OR: 1.625; 95% CI: 1.020-2.589; p = 0.041). Therefore, vegetable protein and animal fat intakes in combination with drinking habits need to be considered for the prevention of diabetes.

PS-C23-12: DIETARY INTERVENTION WITH THE PROCESSED LOW PROTEIN GENMAI (BROWN RICE) AGAINST CHRONIC KIDNEY DISEASE.

Background: Although protein-restricted diets have shown to preserve the renal function, there are a couple of challenges such as (1) the intake of vegetable protein, which is useful for maintaining renal function, is insufficient due to potassium restriction, and (2) caloric intake tends to be inadequate. Therefore, we investigated the effects of diets that may solve these problems with maintaining the current dietary restrictions and may also be additional effects on renal protection. Another study also has shown that patients with CKD are under a chronic inflammatory state and those uremic toxins produced by the gut microbiota are the causes of increased inflammatory cytokine production. We sought to intervene in renal function via modulating this kidney-gut axis in CKD. We thus focused on the processed low protein genmai (brown rice) (PLPG), marketed since 2018 by Follica Foods, Inc. as a candidate food that retains the fiber and GABA characteristic of brown rice, reduces protein to less than 20% of conventional rice, and also limits potassium and phosphorus. Methods: The study was conducted in a before-and-after trial. Thirty patients with eGFR of 59 or less were recruited. PLPG was a retort pack of 150 g for one meal. The patients ate provided with about 10 servings of PLPG per week for 3 months. Results: One patient withdrew due to poor health after participation, and a final total of 29 patients were analyzed. The median age of the participants was 73 years, the mean eGFR was 35.41 ml/min/1.73 m2. The median in BMI decreased by -0.31 (P = 0.037). The median change in the Constipation scoring system score improved by -1.00 (P = 0.032). The change in eGFRcreat decreased with a mean value of -1.241 ml/min/1.73 m2. (P = 0.044), but the monthly eGFRcreat slope was not significantly different. Indoxyl sulfate did not differ significantly, but it showed a decreasing trend with a median change of -0.20 (P = 0.050). The median change in IL-6 was 0.300 pg/mL (P = 0.004). Among short-chain fatty acids, only acetic acid showed an increase with a median change of 7.401 μmol/g (P = 0.010). Conclusion: Participants’ protein intake did not decrease. Therefore, it was thought that the effects of PLPG itself was observed, independent of the effect of low protein. The increase in acetic acid may have contributed to this change. The decrease in e-GFR along with the decrease in urinary protein levels indicated an initial dip due to correction of glomerular hypertension. Long-term follow-up is plausible to establish the novel dietary treatment.

Total protein intake and subsequent risk of chronic kidney disease: the Circulatory Risk in Communities Study.

Whether dietary protein intake worsens renal function in the general population has been discussed but not yet determined. We aimed to examine the longitudinal association between dietary protein intake and risk of incident chronic kidney disease (CKD). We conducted a 12-year follow-up study with 3,277 Japanese adults (1,150 men and 2,127 women) aged 40-74 years, initially free from CKD, who participated in cardiovascular risk surveys from two Japanese communities under the Circulatory Risk in Communities Study. The development of CKD was defined by the estimated glomerular filtration rate (eGFR) during the follow-up period. Protein intake was measured at baseline by using the brief-type self-administered diet history questionnaire. We estimated sex-, age-, community- and multivariate-adjusted hazard ratios (HR) for incident CKD were calculated using the Cox proportional hazards regression models according to quartiles of percentage of energy (%energy) from protein intake. During 26,422 person-years of follow-up, 300 participants developed CKD (137 men and 163 women). The sex-, age-, and community-adjusted HR (95% confidence interval, CI) for the highest (≥16.9%energy) versus lowest (≤13.4%energy) quartiles of total protein intake was 0.66 (0.48-0.90), p for trend = 0.007. The multivariable HR (95%CI) was 0.72 (0.52-0.99), p for trend = 0.016 after further adjustment for body mass index, smoking status, alcohol drinking status, diastolic blood pressure, antihypertensive medication use, diabetes mellitus, serum total cholesterol levels, cholesterol-lowering medication use, total energy intake, and baseline eGFR. The association did not vary by sex, age, and baseline eGFR. When examining animal and vegetable protein intake separately, the respective multivariable HRs (95%CIs) were 0.77 (0.56-1.08), p for trend = 0.036, and 1.24 (0.89-1.75), p for trend = 0.270. Higher protein intake, more specifically animal protein intake was associated with a lower risk of CKD.

Associations between saturated fat intake and other dietary macronutrients and incident hypertension in a prospective study of French women.

Saturated fat has long been associated with cardiovascular disease in multiple prospective studies, and randomized controlled trials. Few studies have assessed the relative associations between saturated fat and other macronutrients with hypertension, a major risk factor for cardiovascular disease. The aim of this study was to assess the relative associations between saturated fat, othermacronutrients such as monounsaturated and polyunsaturated fat, proteins, and carbohydrates, and incident hypertension in a large prospective cohort of French women. This study used data from the E3N cohort study, including participants free of hypertension at baseline. A food frequency questionnaire was used to determine dietary intakes of saturated fat (SFA), monounsaturated fat (MUFA), polyunsaturated fat (PUFA), animal protein (AP), vegetable protein (VP), carbohydrates (CH) and various foods. Cases of hypertension were based on self-report, validated by drug reimbursement data. Covariates were based on self-report. Cox proportional hazard models were used to estimate the relative associations between different macronutrients and hypertension risk, using the 'substitution' framework. Bootstrapping was used to generate 95% confidence intervals. This study included 45,854 women free of hypertension at baseline. During 708,887 person-years of follow-up, 12,338 incident cases of hypertension were identified. Compared to saturated fat, higher consumption of all other macronutrients was associated with a lower risk of hypertension (HRMUFA = 0.74 [0.67: 0.81], HRPUFA = 0.84 [0.77: 0.92], HRCH = 0.83 [0.77: 0.88], HRAP = 0.91 [0.85: 0.97], HRVP = 0.93 [0.83: 1.03]). This study finds that relative to other macronutrients such as monounsaturated or polyunsaturated fat, higher intake of saturated fat is associated with a higher risk of hypertension among women.

Association of Dietary Protein Intake with Muscle Mass in Elderly Chinese: A Cross-Sectional Study.

Most data regarding the association between dietary protein intake and muscle mass come from developed Western countries. This cross-sectional study investigates the association between the amount and distribution of dietary protein intake and muscle mass in elderly Chinese adults. This analysis includes 4826 participants aged 60 years and above from the dataset of the China Health and Nutrition Survey (CHNS) 2018. Protein intake data were assessed using 3-day, 24 h dietary recalls. Appendicular skeletal muscle mass (ASM) was obtained using the bioelectrical impedance analysis (BIA). Two-thirds of dietary protein intake comes from plant sources in the elderly Chinese population. The median total dietary protein intake was 60.5 g/d in low muscle mass participants for males and 52.5 g/d for females, which was lower than for their respective counterparts. Compared to the lowest quartile of protein intake, the highest total protein intake group had increased muscle mass by 0.96 kg among men and by 0.48 kg among women (p < 0.0001), and the highest vegetable protein intake group had increased muscle mass by 0.76 kg among men and by 0.35 kg among women (p < 0.0001). The amount of dietary protein intake with each meal was less than 20 g. High total protein intake and high plant-based protein intake were positively associated with higher muscle mass. A U-shape was observed between total dietary protein intake and low muscle mass risk in elderly Chinese adults. It should be encouraged to increase total daily protein intake to maintain muscle health.

ISPAD Clinical Practice Consensus Guidelines 2022: Ramadan and other religious fasting by young people with diabetes.

ISPAD Clinical Practice Consensus Guidelines 2022: Ramadan and other religious fasting by young people with diabetes.

Abstract 13226: Low-Carbohydrate Diets and Risk of Type 2 Diabetes in U.S. Men and Women

Introduction: Evidence regarding associations between overall low-carbohydrate diets (LCDs) and the risk of developing type 2 diabetes (T2D) remains to be mixed. In the current analysis, we aimed to prospectively assess associations of various LCDs that emphasize different quality of protein, fat, and carbohydrate with T2D risk in U.S. men and women. Methods: A prospective cohort study was conducted in 203,541 men and women participating in the Nurses’ Health Study (NHS), NHSII, and Health Professionals Follow-Up Study who were free of T2D, cardiovascular disease, and cancer at baseline and were followed for up to &gt;30 years. Five LCD scores based on sources of protein, fat, and carbohydrate differentiated by their qualities were derived every four years based on dietary assessments by a validated food frequency questionnaire. Results: During 5,095,048 person-years of follow-up, 19,675 T2D cases were documented. In the multivariable model, a higher overall LCD score was associated with higher T2D risk in a dose-response manner: the hazard ratio (HR) comparing highest vs. lowest quintile was 1.28 (95% confidence interval: 1.22-1.34; P -trend &lt;0.001). A vegetable-based LCD score that emphasizes vegetable protein and fat intake was associated with 6% lower T2D risk (0.94 [0.90-0.98; P -trend =0.003]), and a healthy LCD score that further de-emphasizes refined carbohydrate intake was associated with 15% lower T2D risk (0.85 [0.81-0.89; P -trend &lt;0.001]). In contrast, LCD scores emphasizing high animal protein and fat intake were associated with higher T2D risk. The HRs (95% CIs) comparing extreme quintiles were 1.35 (1.29-1.42; P -trend &lt;0.001) for an overall animal-based LCD score and 1.39 (1.32-1.46; P -trend &lt;0.001) when such a score that further de-emphasizes whole grain intake. Conclusions: LCDs were not beneficial for the primary prevention of T2D unless they emphasize the quality of the macronutrient compositions.

Meat Intake Is Associated with a Higher Risk of Ulcerative Colitis in a Large European Prospective Cohort Studyø.

We aimed to investigate the association between protein intake and risk of inflammatory bowel disease [IBD] in the European Prospective Investigation into Cancer and Nutrition. A total of 413 593 participants from eight European countries were included. Dietary data were collected at baseline from validated food frequency questionnaires. Dietary data were calibrated to correct errors in measures related to each country-specific questionnaire. Associations between proteins [total, animal, and vegetable] or food sources of animal proteins, and IBD risk were estimated by Cox proportional hazard models. After a mean follow-up of 16 years, 177 patients with Crohn's disease [CD] and 418 with ulcerative colitis [UC], were identified. There was no association between total protein, animal protein, or vegetable protein intakes and CD or UC risks. Total meat and red meat intakes were associated with UC risk (hazard ratio [HR] for the 4th vs 1st quartile = 1.40, 95% confidence interval [CI] = 0.99-1.98, p-trend = 0.01; and 1.61, 95% CI = 1.10-2.36, p-trend = 0.007, respectively]. There was no association between other food sources of animal protein [processed meat, fish, shellfish, eggs, poultry] and UC. We found no association between food sources of animal proteins and CD risk. Meat and red meat consumptions are associated with higher risks of UC. These results support dietary counselling of low meat intake in people at high-risk of IBD.

The Association between Dietary Protein Intake and the Risk of Pancreatic Cancer: Evidence from 14 Publications

Many studies have been published to assess the association about dietary protein intake on the risk of pancreatic cancer, but with inconsistent result. This meta-analysis aimed to evaluate whether protein intake could affect the risk of pancreatic cancer. A systematic literature search was performed in PubMed, EMBASE and Web of Science up to October 1, 2019. Pooled relative risks (RR) and 95% confidence intervals (CI) were calculated using a random-effect model. A total of 14 studies (12 case-control studies and two cohort studies) were included. Overall, total protein intake had no significant association on the risk of pancreatic cancer (RR = 1.02, 95%CI= 0.85–1.22, I2=45.7%). Subgroup analyses showed such relationships were almost not influenced by study design and geographic location. Interestingly, when we performed the subgroup analysis by protein type, the opposite association was found in animal protein intake (RR = 1.37, 95%CI= 0.93–2.01) and vegetable protein intake (RR = 0.78, 95%CI= 0.54–1.14), although these two groups were not statistically significant. In conclusion, this meta-analysis indicated that dietary total protein intake may be not associated with the risk of pancreatic cancer. However, protein type may be affecting the result which was found from our research. Therefore, studies with detailed information, especially protein type, are warranted to further confirm these findings.

Evaluation of the Consumption of Fruits and Vegetables by Phenylketonurics in the Metabolic Control of Phenylalanine: An Integrative Review.

Phenylketonuria (PKU) is an autosomal recessive disease caused by variants in the gene that encodes phenylalanine hydroxylase (PAH), limiting the metabolism of phenylalanine (Phe). When PAH activity is absent or hindered, Phe is not converted to tyrosine, leading to an accumulation of Phe in the blood, which can cause serious neurological complications. Once PKU is diagnosed, treatment should be started immediately, and the basis for this is dietary restriction of foods with high levels of Phe, associated with the use of protein substitutes and intake of foods with low protein content. This restriction accompanies patients throughout their lives, making their diets unpalatable and monotonous, which represents a major challenge for health professionals and patients, considering that these factors favor food transgression. In this context, the objective of this work was to carry out an integrative review based on evidence regarding the intake of fruits and vegetables, by phenylketonurics, taking into account the greater or lesser tolerance to Phe. Since, some researchers have dedicated themselves to evaluating the biochemical effect of unrestricted consumption of fruits and vegetables at PKU, unifying the information in this regard. It was observed that the intake of vegetable protein by patients with PKU has shown to be promising since the studies indicate that the intake of these proteins does not present adverse effects to the metabolic control of the Phe.

Dietary Intakes and Food Habits of Wheelchair Basketball Athletes Compared to Gym Attendees and Individuals who do not Practice Sport Activity.

Mediterranean diet (Med-D) has been previously suggested for athletes, but Paralympics usually have a low intake of plant foods. Orthorexia nervosa (ON) can drive dietary intake of both athletes and gym attendees. We aimed to compare dietary intakes and food habits of elite wheelchair basketball athletes (WBA) and able-bodied individuals who practice or not sport activity and with different fat mass percentage (FM%). We recruited 15 WBA from the Italian National team and 3 control groups (15 each group): healthy individuals who do not practice any sports activity (NSA) and gym attendees with low (GAL, FM%<17) and high (GAH, FM%>18) FM%. Food consumption was monitored by a 3- d diary, while Med-D scores and ON score were evaluated through standardized questionnaires. In WBA we also assessed Neurogenic Bowel Dysfunction (NBD), GastroEsophageal Reflux Disease (GERD), allergy questionnaire for athletes (AQUA) and Starvation Symptoms Inventory (SSI). In WBA, ON correlated with GERD and SSI. WBA and GAH with eating behavior of ON had higher adherence to Med-D, whereas NSA had less adherence to Med-D. Sub-score, including fruits, vegetables and legumes, was higher in the GAL and GAH groups compared to the WBA and NSA groups. Med-D was inversely related to animal protein intake (PRO-AN) in NSA and GAL. FM% was inversely related to PRO-AN in WBA and GAH, and to ON only in GAH. In WBA, PRO-AN and vegetable protein intake correlated with both carbohydrate and energy intakes. In WBA, commitment to wellness (ON and Med-D adherence) could be a response to gastrointestinal and starvation symptoms. WBA should be involved in setting their own individualized dietary strategies.