Dietary protein and amino acids intake and its relationship with blood pressure in adolescents: the HELENA STUDY

Dietary total, plant and animal protein intake in relation to metabolic health status in overweight and obese adolescents

Few studies have investigated dietary total protein intake and its subtypes in relation to metabolic health status. We explored the relation between dietary total, plant and animal protein intake with metabolic health status in Iranian overweight/obese adolescents. Overweight/obese adolescents (n = 203) were selected for this cross-sectional study by multistage cluster random-sampling method. A validated food frequency questionnaire was used to evaluate dietary intakes. Total, plant and animal protein intake were considered as percentage of energy intake. Anthropometric indices, blood pressure, lipid and glycemic profiles were collected. Participants were classified as metabolically healthy obese (MHO) or unhealthy obese (MUO) based on International Diabetes Federation (IDF) and IDF/Homeostasis Model Assessment Insulin Resistance (HOMA-IR) definitions. Subjects had a mean age of 13.98 years, and 50.2% of them were girls. Based on IDF criteria, adolescents in the top tertile of total (OR = 0.32; 95% CI 0.13–0.77), plant (OR = 0.30; 95% CI 0.10–0.91), and animal (OR = 0.20; 95% CI 0.08–0.54) protein intake had lower odds of being MUO compared to the reference category. Considering IDF/HOMA-IR criteria, subjects in the highest tertile of total (OR = 0.31; 95% CI 0.12–0.79) and animal (OR = 0.17; 95% CI 0.06–0.49) protein intake were less likely to be MUO. However, no substantial association was observed with plant protein intake. Also, an inverse association was observed between each SD increase in total and animal protein with MUO odds. We found inverse association between total, plant and animal protein intake and chance of being MUO in adolescents. Further prospective studies are needed to confirm the findings.

The longitudinal relationship between nutritional status and anaemia among Malaysian adolescents

INTRODUCTION

The triple burden of malnutrition characterised by stunting and wasting, overweight/obesity, and anaemia experienced by Malaysians causes severe and long-lasting damage during the period of development and rapid growth, particularly in adolescence. This study aimed to demonstrate the trend of anaemia prevalence and to determine its longitudinal association with nutritional status and lifestyle among Malaysian adolescents.

METHOD

The study involved secondary data analysis from the Malaysian Health and Adolescents Longitudinal Research Team (MyHeART) study. A closed cohort secondary data analysis was performed from the dynamic cohort of 528 adolescents (male = 151; female = 377) aged 13 years attending secondary school who were followed up at 15 and 17 years. Anaemia status was determined by haemoglobin level < 12g/dL based on FBC, and iron deficiency anaemia (IDA) was determined when the Mentzer Index < 13. A generalised estimating equation (GEE) was constructed to investigate the longitudinal relationship between nutritional status and lifestyle on anaemia status over five years.

RESULTS

The trend of anaemia prevalence increased significantly across the age group (7•9%; 95% CI: 2•3-11•1, 13•9%; 95% CI: 10•8-15•7 and 15•8%; 95% CI: 3•8-23•1) at 13, 15 and 17 years, respectively, especially among females. The trend of anaemia prevalence among females, also increased significantly across the age group (11.1%;95% CI:6.7-17.8, 15.7%;95% CI:11.4-21.3, 23.1%;95% CI:16.8-31.0). A similar trend was noted for the prevalence of IDA among those who were anaemic (66•5%; 95% CI: 40•4-85•3, 72•2%;95% CI: 54•8-85•4, 76•3%; 95% CI: 59•2-87•7). A longitudinal analysis using GEE revealed that adolescents who did not meet the Recommended Nutrient Intake (RNI) for total iron intake per day were significantly associated with anaemia (RR=1•517;95% CI: 1•012-2•275; p=0•044) and IDA (RR=1•776;95% CI: 1•225-2•57; p= 0•002).

CONCLUSION

The overall trend of anaemia among adolescents is in increasing trend and anaemia is prevalent among female adolescents in this study. It is crucial to understand that the current fortification strategy may need to be revisited, and robust intervention programmes are necessary and should be sex specific.

The Effect of Nut Consumption on Diet Quality, Cardiometabolic and Gastrointestinal Health in Children: A Systematic Review of Randomized Controlled Trials

Tree nuts and ground nuts are nutrient-rich foods known to improve human health when consumed regularly in the diet. Past observational studies suggest that nuts improve adult and child health; however, limited randomized control trials (RCTs) have assessed the health effects of nuts in children. Using a systematic review approach, we examined the effect of nut intake on health outcomes in children aged 8–18 years. We searched PubMed, Scopus, Web of Science, EMBASE and Cochrane library to identify RCTs of interest. A total of 5783 articles were identified, 4821 were screened by title and abstract and 37 by full text resulting in four articles that met the inclusion criteria for the review. Nut consumption was between 15 and 30 g with durations of between 3 and 16 weeks. Nut consumption was shown to improve children’s diet quality (increase children’s intake of essential nutrients including fats (monounsaturated and polyunsaturated fats), protein and fiber), there were inconsistent effects on biomarkers of cardiometabolic health (improve lipid profiles, microvascular reactivity and inflammation) and gastrointestinal health (increase in the proportion of beneficial fecal bacteria). Further studies exploring the broad health benefits of nuts in children are needed with consideration given to higher doses and longer intervention periods.

Association Between Blood Pressure and Branched-Chain/Aromatic Amino Acid Excretion Rate in 24-Hour Urine Samples from Elderly Hypertension Patients

BACKGROUND

Recently, the association between lifestyle-related diseases and free amino acids in the blood plasma-especially branched-chain amino acids (BCAAs) and aromatic amino acids (AAAs)-has been highlighted. However, few studies have been carried out on 24-hour urine samples. Therefore, we aimed to explore the relationships between 24-hour urinary BCAAs and AAAs excretion rate and blood pressure (BP) in elderly patients with hypertension.

METHODS AND RESULTS

Each of the 322 elderly patients with hypertension completed an in-person questionnaire interview, underwent a physical examination, and provided a 24-hour urine specimen. We measured their BCAAs and AAAs excretion rate, and used multiple linear regression analysis with variable selection to construct models describing the relationships between their BCAAs and AAAs excretion rate and BP. After adjusted for age, gender, height, and weight, valine was inversely associated with both systolic blood pressure (SBP) (β: -0.232, 95% CI: -0.16, -0.006) and diastolic blood pressure (DBP) (β: -0.144, 95% CI: -0.089, -0.005). These findings were invariant even following adjustment for urine volume and drugs history, and Ile was positively associated with DBP (β: 0.170, 95% CI: 0.001, 0.066).

CONCLUSION

The data revealed that the excretion rate of 24-hour urinary BCAAs was closely related to BP in elderly hypertension patients, and these findings will provide new insights into the association between BACC metabolism and BP.

Tolerance to graded dosages of histidine supplementation in healthy human adults

BACKGROUND

Histidine is an essential amino acid with health benefits that may warrant histidine supplementation; however, the clinical safety of histidine intake above the average dietary intake (1.52-5.20 g/d) needs to be vetted.

OBJECTIVES

We aimed to determine the tolerance to graded dosages of histidine in a healthy adult population.

METHODS

Healthy adults aged 21-50 y completed graded dosages of histidine supplement (4, 8, and 12 g/d, Study 1) (n = 20 men and n = 20 women) and/or a 16-g/d dosage of histidine (Study 2, n = 21 men and n = 19 women); 27 participants (n = 12 men and n = 15 women) completed both studies. After study enrollment and baseline measures, participants consumed encapsulated histidine for 4 wk followed by a 3-wk recovery period. Primary outcomes included vitals, select biochemical analytes, anthropometry, serum zinc, and body composition (via DXA).

RESULTS

No changes in vitals or body composition occurred with histidine supplementation in either study. Plasma histidine (measured in subjects who completed all dosages for Studies 1 and 2) was elevated at the 12- and 16-g/d dosages (compared with 0-8 g/d, P < 0.05) and blood urea nitrogen increased with dosage (P = 0.013) and time (P < 0.001) in Study 1 and with time in Study 2 (P < 0.001). In Study 1, mean ferritin concentrations were lower in 12 g/d (46.0 ng/mL; 95% CI: 34.8, 60.9 ng/mL) than in 4 g/d (51.6 ng/mL; 95% CI: 39.0, 68.4 ng/mL; P = 0.038). In Study 2, 16 g/d increased mean aspartate aminotransferase from baseline (19 U/L; 95% CI: 17, 22 U/L) to week 4 (24 U/L; 95% CI: 21, 27 U/L; P < 0.001) and mean serum zinc decreased from baseline (0.75 μg/dL; 95% CI: 0.71, 0.80 μg/dL) to week 4 (0.70 μg/dL; 95% CI: 0.66, 0.74 μg/dL; P = 0.011).

CONCLUSIONS

Although values remained within the normal reference ranges for all analytes measured, in all dosages tested, the human no-observed adverse effect level was determined to be 8 g/d owing to changes in blood parameters at the 12-g/d dosage.This trial was registered at clinicaltrials.gov as NCT04142294.

Benefits and Adverse Effects of Histidine Supplementation

Histidine is a nutritionally essential amino acid with many recognized benefits to human health, while circulating concentrations of histidine decline in pathologic conditions [e.g., chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD)]. The purpose of this review is to examine the existing literature regarding the benefits of histidine intake, the adverse effects of excess histidine, and the upper tolerance level for histidine. Supplementation with doses of 4.0-4.5 g histidine/d and increased dietary histidine intake are associated with decreased BMI, adiposity, markers of glucose homeostasis (e.g., HOMA-IR, fasting blood glucose, 2-h postprandial blood glucose), proinflammatory cytokines, and oxidative stress. It is unclear from the limited number of studies in humans whether the improvements in glucoregulatory markers, inflammation, and oxidative stress are due to reduced BMI and adiposity, increased carnosine (a metabolic product of histidine with antioxidant effects), or both. Histidine intake also improves cognitive function (e.g., reduces appetite, anxiety, and stress responses and improves sleep) potentially through the metabolism of histidine to histamine; however, this relation is ambiguous in humans. At high intakes of histidine (>24 g/d), studies report adverse effects of histidine such as decreased serum zinc and cognitive impairment. There is limited research on the effects of histidine intake at doses between 4.5 and 24 g/d, and thus, a tolerable upper level has not been established. Determining tolerance to histidine supplementation has been limited by small sample sizes and, more important, a lack of a clear biomarker for histidine supplementation. The U-shaped curve of circulating zinc concentrations with histidine supplementation could be exploited as a relevant biomarker for supplemental histidine tolerance. Histidine is an important amino acid and may be necessary as a supplement in some populations; however, gaps in knowledge, which this review highlights, need to be addressed scientifically.

Gut microbiota and neuroinflammation in pathogenesis of hypertension: A potential role for hydrogen sulfide

Inflammation and gut dysbiosis are hallmarks of hypertension (HTN). Hydrogen sulfide (H2S) is an important freely diffusing molecule that modulates the function of neural, cardiovascular and immune systems, and circulating levels of H2S are reduced in animals and humans with HTN. While most research to date has focused on H₂S produced endogenously by the host, H2S is also produced by the gut bacteria and may affect the host homeostasis. Here, we review an association between neuroinflammation and gut dysbiosis in HTN, with special emphasis on a potential role of H2S in this interplay.

Various proline food sources and blood pressure: substitution analysis

The aim of this study was to investigate the association of total proline intake, proline of various food sources, and substitution analysis for proline of food sources with blood pressure (BP) and 3.1-year incidence of hypertension in the framework of the Tehran Lipid and Glucose Study. The cohort consisted of 4287 participants (41.9% male), aged ≥ 20-70 years. In fully-adjusted model, individuals in the highest tertile for proline intake had an increased risk of incident hypertension than those in the lowest one (OR: 1.45; 95%CI: 1.06-1.97; p for trend: .017). Replacing proline of cheese and legumes source with that of yogurt, poultry, milk, and red meat source was associated with significant negative β coefficient for BP. The present study indicated that high dietary intakes of proline may increase the risk of incident hypertension. Also, substituting proline intake of cheese and legumes by those of proline intake of meats and milk is associated with a lower risk of high BP.

Purification of novel angiotensin converting enzyme inhibitory peptides from beef myofibrillar proteins and analysis of their effect in spontaneously hypertensive rat model

This study was conducted to purify the angiotensin converting enzyme (ACE) inhibitory peptides from beef myofibrillar proteins by using inexpensive enzymes alkaline-AK and papain. Different molecular weight peptides (<3 and <10 kDa) were obtained using ultrafiltration. The <3 kDa peptides obtained by alkaline-AK (AK3K) digestion showed the highest ACE inhibitory activity (74.29%) as compared to other alkaline-AK peptides, and a strong antihypertensive effect of AK3K was observed in the spontaneously hypertensive rat (SHR) model. The AK3K treatment groups (400 and 800 mg/kg body weight) exhibited a decrease in systolic blood pressure (SBP) by 28 and 35 mmHg, respectively in the SHR model. The study demonstrated that the ACE inhibitory peptide obtained from beef myofibrillar proteins had the sequence Leu-Ile-Val-Gly-Ile-Ile-Arg-Cys-Val, and could be possibly used for lowering the SBP.

Are dietary amino acids prospectively predicts changes in serum lipid profile?

BACKGROUND

Besides of dietary fat and carbohydrate, amino acids(AAs), as constituent components of dietary protein have been related with serum lipid levels. This study aims to examine the association between dietary AAs and prospective changes in serum lipid profile in adults.

METHODS

Analyses were conducted on 3881 participants aged, 18-75 years of Tehran lipid and Glucose study, at baseline (2008-2011) and were followed for 3 years (2011-2014) to ascertain serum lipid profile changes. Dietary intakes of AAs were collected at baseline using food frequency questionnaire. Multiple linear regression adjusted for age, sex, body mass index, physical activity, smoking and daily intakes of energy, total fat, and fiber were used.

RESULTS

The median(IQR) changes in triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were 6.0(-19.0, -35.5), 9.0(7.0, -24.0), 1.0(-3.0, -6.0), and 5.2(-8.0, -18.6) mg/dl, respectively. Higher intakes of isoleucine, lysine, tyrosine, alanine, threonine, methionine, valine, histidine, aspartic acid, and branched chain, alkaline, and alcoholic AAs were positively associated with TGs-changes in the final adjusted model, whereas tryptophan, glutamic acid, and acidic AAs were negatively related to TG-changes. Alanine and tryptophan were associated with higher and lower LDL-C-changes, respectively. Lysine, alanine, methionine, aspartic acid, and alkaline AAs showed positive association with changes in TC, whereas tryptophan and glutamic acid had a negative association with TC-changes.

CONCLUSION

Our findings showed that some dietary amino acids have the potential to increase or decrease serum lipid profile.

Do dietary amino acid ratios predict risk of incident hypertension among adults?

In the current study, we investigated the association between dietary amino acid ratios and the 3-year incidence of hypertension, conducted in the framework of the Tehran Lipid and Glucose Study with 4287 adults(41.9% men), aged 20-70 y. Dietary intakes of amino acids were assessed using a valid and reliable food frequency questionnaire and reported as percentage of protein. Then amino acid ratios including Leu.Ser/Thr.Trp, Leu/Trp, Leu/Thr, and Ser/Thr were calculated. We identified 429(10%) cases of hypertension during 3.1 y of follow up. The adjusted OR of the highest quartile of dietary Leu.Ser/Thr.Trp intake was 1.48 (95%CI:1.04-2.09, P for trend:0.02) compared with the lowest one. Furthermore, the OR of hypertension in the highest, compared with the lowest quartile of the leu/Thr ratio(2.19 vs 2.02) was 1.46(1.01-2.12), P for trend = 0.07. Our findings suggest that high dietary intakes of Leu.Ser/Thr.Trp ratio were associated with higher risk of incident hypertension and BP levels.

Dietary amino acids and incidence of hypertension: A principle component analysis approach

The current study aimed to investigate the association between dietary amino acid patterns and incidence of hypertension, using principal components factor analyses. This study was conducted within the framework of Tehran Lipid and Glucose Study on 4288 adults, who were free of hypertension at baseline (2008–2011) and were followed for three years (2011–2014). Principal component factor analyses were conducted based on eight amino acid groups and three amino acid patterns were extracted. The first pattern was characterized by branched chain, aromatic, and alcoholic amino acids, and proline. Acidic amino acids and proline were highly loaded in the second pattern and the third was characterized by sulphuric and small amino acids. Adjusted odds ratio of the highest quartile of the first pattern was 1.83 (95%CI: 1.21–2.77, P for trend = 0.002) compared to the lowest one. The first pattern had high positive correlation with dietary intakes of animal protein and dairy, but was negatively correlated with plant protein, fruit, and vegetable. There was no significant association for the second and third patterns. Findings indicate that the dietary amino acid pattern, rich in branched chain, aromatic, and alcoholic amino acids, and proline could increase the risk of hypertension.

High dietary intake of aromatic amino acids increases risk of hypertension

Recent studies investigated the relation between amino acids and blood pressure. Our aim was to examine the association between intake of aromatic amino acids (AAAs) and risk of hypertension. A total of 4288 individuals, aged 20-70 years, participants of the Tehran Lipid and Glucose Study, who were free of hypertension at baseline (2008-2011), were followed for 3 years (2011-2014). Average intakes of AAAs including phenylalanine, tyrosine, and tryptophan were collected using a valid and reliable food frequency questionnaire at baseline. Adjusted logistic regression models were used to report odds ratio (OR) of hypertension across quartiles of AAAs. At the end of follow-up, 429 (10%) hypertension cases were ascertained. The adjusted OR of hypertension for percentage of AAAs from total protein intakes was 1.63 (95% confidence interval, 1.06-2.50; P for trend: .03) when comparing the highest quartile to the lowest. Furthermore, in the adjusted analyses, a statistically significant positive relationship was observed between the highest versus the lowest quartile intake of phenylalanine (OR = 1.66; 95% confidence interval, 1.14-2.47; P for trend: .03). However, there was no significant association of tyrosine and tryptophan intakes with hypertension risk. Our data suggest that AAAs may increase the risk of incident hypertension.

Evaluation of Dietary Intakes, Body Composition, and Cardiometabolic Parameters in Adolescent Team Sports Elite Athletes: A Cross-sectional Study

Background:

Nutritional intake is an important issue in adolescent athletes. Proper athletes’ performance is a multifactorial outcome of good training, body composition, and nutritional status. The aim of the present study was to assess nutritional status, body composition, and cardiometabolic factors in adolescent elite athlete's province of Isfahan, Iran.

Materials and Methods:

In this cross-sectional study, 100 adolescent elite athletes from volleyball, basketball, and soccer teams were selected for the study. Demographic, anthropometric, and cardiometabolic parameters were assessed. Nutritional intakes of participants were recorded using three 24-h recall questioners.

Results:

Thirty-four female athletes and 66 male athletes participated in this study. Body mass index had not significantly different between the sexes. Energy, protein, carbohydrate, iron, and fat intakes were significantly higher in male athletes (P = 0.02), but calcium and folic acid intakes were not significantly different between the sexes, and Vitamin D intake was significantly higher in females (P = 0.01). Systolic and diastolic blood pressure was significantly higher in males (P = 0.04) and heart rate had not significantly different between the sexes (P = 0.09). Heart murmurs and heart sounds in the majority of participants were normal.

Conclusion:

All the evaluated anthropometric and cardiometabolic parameters were in normal range in the majority of participants. The results showed that dietary intake in these athletes is approximately normal but micronutrients intake status in these athletes needs to be investigated further and longer.

Is the pattern of dietary amino acids intake associated with serum lipid profile and blood pressure among individuals with spinal cord injury?

OBJECTIVE

The probable effect of dietary amino acids intake pattern on serum lipid profile and blood pressure (BP) have not yet been described among individuals with spinal cord injury (SCI).

DESIGN

Cross-sectional.

SETTING

Tertiary rehabilitation center.

PARTICIPANTS

People with SCI referred to Brain and Spinal Cord Injury Research Center between 2011 and 2014.

OUTCOME MEASURES

Dietary intakes were assessed by recording consumed foods by 24-hour dietary recall interviews using Nutritionist IV 3.5.3 modified for Iranian foods. Partial correlation test with adjustment for age, weight, body mass index, total energy intake, total fat, cholesterol and carbohydrate intake, and injury-related variables was used.

RESULTS

Dietary intake of lysine was positively related to levels of fasting plasma glucose (FPG), triglyceride (TG), systolic blood pressure (SBP) and diastolic blood pressure (DBP) (P < 0.0001, 0.046, 0.002 and 0.009, respectively). There was a positive significant relationship between the intake of cysteine and levels of TG and SBP as well (P : 0.027 and 0.048, respectively). Higher intakes of threonine and leucine had a negative relationship with TG level (P : 0.001 and 0.026, respectively). Furthermore, tyrosine, threonine and leucine were inversely correlated to blood pressure. Total cholesterol level was only related to intake of threonine and leucine (P : 0.004 and 0.012, respectively). FPG was positively associated with intake of all amino acids except for cysteine, glutamic acid, threonine, leucine and histidine.

CONCLUSION

In the present study, the pattern of relationships between dietary intake of amino acids and serum lipid profile and BP has been described among people with SCI.

Relationships of Dietary Histidine and Obesity in Northern Chinese Adults, an Internet-Based Cross-Sectional Study

Our previous studies have demonstrated that histidine supplementation significantly ameliorates inflammation and oxidative stress in obese women and high-fat diet-induced obese rats. However, the effects of dietary histidine on general population are not known. The objective of this Internet-based cross-sectional study was to evaluate the associations between dietary histidine and prevalence of overweight/obesity and abdominal obesity in northern Chinese population. A total of 2376 participants were randomly recruited and asked to finish our Internet-based dietary questionnaire for the Chinese (IDQC). Afterwards, 88 overweight/obese participants were randomly selected to explore the possible mechanism. Compared with healthy controls, dietary histidine was significantly lower in overweight (p < 0.05) and obese (p < 0.01) participants of both sexes. Dietary histidine was inversely associated with body mass index (BMI), waist circumference (WC) and blood pressure in overall population and stronger associations were observed in women and overweight/obese participants. Higher dietary histidine was associated with lower prevalence of overweight/obesity and abdominal obesity, especially in women. Further studies indicated that higher dietary histidine was associated with lower fasting blood glucose (FBG), homeostasis model assessment of insulin resistance (HOMA-IR), 2-h postprandial glucose (2 h-PG), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), C-reactive protein (CRP), malonaldehyde (MDA) and vaspin and higher glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and adiponectin of overweight/obese individuals of both sexes. In conclusion, higher dietary histidine is inversely associated with energy intake, status of insulin resistance, inflammation and oxidative stress in overweight/obese participants and lower prevalence of overweight/obesity in northern Chinese adults.

Protein intake in early childhood and cardiometabolic health at school age: the Generation R Study

Purpose

High protein intake in infancy has been linked to obesity. We aimed to examine the associations of protein intake in early childhood with cardiovascular and metabolic outcomes at school age.

Methods

This study was performed in 2965 children participating in a population-based prospective cohort study. Protein intake at 1 year was assessed with a food frequency questionnaire and was adjusted for energy intake. At the children’s age of 6 years, we measured their body fat percentage (BF%), blood pressure (BP), and insulin, HDL cholesterol, and triglyceride serum levels. These measures were incorporated into a cardiometabolic risk factor score, using age- and sex-specific SD scores.

Results

In covariate-adjusted models, higher protein intake was associated with a higher BF%, lower diastolic BP, and lower triglyceride levels. We observed a significant interaction of protein intake with child sex on metabolic outcomes. Stratified analyses showed that protein intake was positively associated with BF% [0.07 SD (95 % CI 0.02; 0.13) per 10 g/day] and insulin levels in girls, but not in boys. In boys, but not in girls, higher protein intake was associated with lower triglyceride levels [−0.12 SD (95 % CI −0.20; −0.04) per 10 g/day] and a lower cardiometabolic risk factor score. Protein intake was not consistently associated with systolic BP or HDL cholesterol levels.

Conclusion

Protein intake in early childhood was associated with a higher BF% and higher insulin levels at 6 years in girls and with lower triglyceride levels in boys. Further studies are needed to explore these sex differences and to investigate whether the observed changes persist into adulthood.

Electronic supplementary material

The online version of this article (doi:10.1007/s00394-015-1026-7) contains supplementary material, which is available to authorized users.