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Honfo SH, Senior AM, Legault V, Presse N, Turcot V, Gaudreau P, Simpson SJ, Raubenheimer D, Cohen AA. Evidence for protein leverage on total energy intake, but not body mass index, in a large cohort of older adults. Int J Obes (Lond) 2024; 48:654-661. [PMID: 38145994 DOI: 10.1038/s41366-023-01455-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/11/2023] [Accepted: 12/15/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Protein leverage (PL) is the phenomenon of consuming food until absolute intake of protein approaches a 'target value', such that total energy intake (TEI) varies passively with the ratio of protein: non-protein energy (fat + carbohydrate) in the diet. The PL hypothesis (PLH) suggests that the dilution of protein in energy-dense foods, particularly those rich in carbohydrates and fats, combines with protein leverage to contribute to the global obesity epidemic. Evidence for PL has been reported in younger adults, children and adolescents. This study aimed to test for PL and the protein leverage hypothesis (PLH) in a cohort of older adults. METHODS We conducted a retrospective analysis of dietary intake in a cohort of 1699 community-dwelling older adults aged 67-84 years from the NuAge cohort. We computed TEI and the energy contribution (EC) from each macronutrient. The strength of leverage of macronutrients was assessed through power functions ( TEI = μ * EC L ). Body mass index (BMI) was calculated, and mixture models were fitted to predict TEI and BMI from macronutrients' ECs. RESULTS In this cohort of older adults, 53% of individuals had obesity and 1.5% had severe cases. The mean TEI was 7673 kJ and macronutrients' ECs were 50.4%, 33.2% and 16.4%, respectively for carbohydrates, fat, and protein. There was a strong negative association (L = -0.37; p < 0.001) between the protein EC and TEI. Each percent of energy intake from protein reduced TEI by 77 kJ on average, ceteris paribus. However, BMI was unassociated with TEI in this cohort. CONCLUSIONS Findings indicate clear evidence for PL on TEI, but not on BMI, likely because of aging, body composition, sarcopenia, or protein wasting.
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Affiliation(s)
- Sewanou H Honfo
- PRIMUS Research Group, Department of Family Medicine, Université de Sherbrooke, 3001 12e Ave N, Sherbrooke, QC, J1H 5N4, Canada
| | - Alistair M Senior
- University of Sydney, Charles Perkins Centre, Camperdown, NSW, 2006, Australia
- University of Sydney, School of Life and Environmental Science, Camperdown, NSW, 2006, Australia
- University of Sydney, Sydney Precision Data Science Centre, Camperdown, NSW, 2006, Australia
| | - Véronique Legault
- Research Center on Aging, CIUSSS-de-l'Estrie-CHUS, Sherbrooke, QC, Canada
| | - Nancy Presse
- Research Center on Aging, CIUSSS-de-l'Estrie-CHUS, Sherbrooke, QC, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
- Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Valérie Turcot
- Research Center on Aging, CIUSSS-de-l'Estrie-CHUS, Sherbrooke, QC, Canada
| | - Pierrette Gaudreau
- Department of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Stephen J Simpson
- University of Sydney, Charles Perkins Centre, Camperdown, NSW, 2006, Australia
- University of Sydney, School of Life and Environmental Science, Camperdown, NSW, 2006, Australia
| | - David Raubenheimer
- University of Sydney, Charles Perkins Centre, Camperdown, NSW, 2006, Australia
- University of Sydney, School of Life and Environmental Science, Camperdown, NSW, 2006, Australia
| | - Alan A Cohen
- PRIMUS Research Group, Department of Family Medicine, Université de Sherbrooke, 3001 12e Ave N, Sherbrooke, QC, J1H 5N4, Canada.
- Research Center on Aging, CIUSSS-de-l'Estrie-CHUS, Sherbrooke, QC, Canada.
- Department of Environmental Health Sciences, Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY, USA.
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Mitchell E, Comerford K, Knight M, McKinney K, Lawson Y. A review of dairy food intake for improving health among black geriatrics in the US. J Natl Med Assoc 2024; 116:274-291. [PMID: 38365561 DOI: 10.1016/j.jnma.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 02/18/2024]
Abstract
The transition to older adulthood is generally marked by progressive declines in body composition, metabolism, cognitive function, and immunity. For socially disadvantaged geriatric populations such as Black Americans, this life stage may also include additional stressors, including dealing with discrimination, poor access to healthcare, and food insecurity. These types of chronic stressors are linked to a higher allostatic load, which is associated with accelerated biological aging, higher rates of adverse health outcomes, and an overall lower quality of life. Of the numerous factors involved in healthy aging, a growing body of research indicates that consuming a higher quality diet that is rich in fruits, vegetables, whole grains, protein foods, and dairy foods, is one of the most potent factors for helping to protect against age-related disease progression. Among the food groups listed above that are recommended by the 2020-2025 Dietary Guidelines for Americans dairy foods are unique in their ability to provide several of the essential nutrients (e.g., high-quality protein, calcium, potassium, vitamin B12, and vitamin D in fortified products) that are most often inadequately consumed by older Black Americans. However, dairy is the most inadequately consumed food group in the US, with older Black adults consuming fewer than half of the 3 daily recommended servings. Therefore, this review examines the current body of evidence exploring the links between dairy intake and age-related disease risk, with a special focus on health and disparities among older Black Americans. Overall, the evidence from most systematic reviews and/or meta-analyses focused on dairy intake and musculoskeletal health suggest that higher dairy intake across the life span, and especially from fermented and fortified products, is associated with better bone and muscle health outcomes in older adults. The evidence on dairy intake and neurocognitive and immune outcomes among older adults holds significant promise for potential benefits, but most of these results are sourced from individual studies or narrative reviews and are not currently corroborated in systematic reviews or meta-analyses. Additionally, most of the research on dairy intake and age-related disease risk has been performed in White populations and can only be extrapolated to Black populations. Nonetheless, older Black populations who do not meet the DGA recommended 3 servings of dairy per day due to lactose intolerance, restrictive dietary patterns, or for other reasons, are likely falling short of several of the nutritional requirements necessary to support healthy aging.
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Affiliation(s)
- Edith Mitchell
- Sidney Kimmel Cancer at Jefferson, Philadelphia, PA, United States
| | - Kevin Comerford
- OMNI Nutrition Science; California Dairy Research Foundation, Davis, CA, United States.
| | - Michael Knight
- The George Washington University School of Medicine and Health Sciences, Washington D.C., United States
| | - Kevin McKinney
- Department of Internal Medicine, Division of Endocrinology, University of Texas Medical Branch, Galveston, TX, United States
| | - Yolanda Lawson
- Baylor University Medical Center, Dallas, TX, United States
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Cui J, Zhai Z, Wang S, Song X, Qiu T, Yu L, Zhai Q, Zhang H. The role and impact of abnormal vitamin levels in autism spectrum disorders. Food Funct 2024; 15:1099-1115. [PMID: 38221882 DOI: 10.1039/d3fo03735e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
The prevalence of autism spectrum disorder (ASD), a neurodevelopmental disorder with a predominance of social behavioral disorders, has increased dramatically in various countries in recent decades. The interplay between genetic and environmental factors is believed to underlie ASD pathogenesis. Recent analyses have shown that abnormal vitamin levels in early life are associated with an increased risk of autism. As essential substances for growth and development, vitamins have been shown to have significant benefits for the nervous and immune systems. However, it is unknown whether certain vitamin types influence the emergence or manifestation of ASD symptoms. Several studies have focused on vitamin levels in children with autism, and neurotypical children have provided different insights into the types of vitamins and their intake. Here, we review the mechanisms and significance of several vitamins (A, B, C, D, E, and K) that are closely associated with the development of ASD in order to prevent, mitigate, and treat ASD. Efforts have been made to discover and develop new indicators for nutritional assessment of children with ASD to play a greater role in the early detection of ASD and therapeutic remission after diagnosis.
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Affiliation(s)
- Jingjing Cui
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, 214002, China.
- Department of child health care, Wuxi Maternity and Child Health Care Hospital, Affiliated Women's Hositipal of Jiangnan University, Wuxi, Jiangsu, 214002, China.
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi, Jiangsu, 214122, China.
| | - Zidan Zhai
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, 214002, China.
- Department of child health care, Wuxi Maternity and Child Health Care Hospital, Affiliated Women's Hositipal of Jiangnan University, Wuxi, Jiangsu, 214002, China.
| | - Shumin Wang
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi, Jiangsu, 214122, China.
- School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, China.
| | - Xiaoyue Song
- Department of Toxicology, School of Public Health, Anhui Medical University/Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, Anhui, China.
| | - Ting Qiu
- Department of child health care, Wuxi Maternity and Child Health Care Hospital, Affiliated Women's Hositipal of Jiangnan University, Wuxi, Jiangsu, 214002, China.
| | - Leilei Yu
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi, Jiangsu, 214122, China.
| | - Qixiao Zhai
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi, Jiangsu, 214122, China.
| | - Heng Zhang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, 214002, China.
- Department of child health care, Wuxi Maternity and Child Health Care Hospital, Affiliated Women's Hositipal of Jiangnan University, Wuxi, Jiangsu, 214002, China.
- Department of Toxicology, School of Public Health, Anhui Medical University/Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei 230032, Anhui, China.
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Brassard D, Chevalier S. Relationship between Adherence to the 2019 Canada's Food Guide Recommendations on Healthy Food Choices and Nutrient Intakes in Older Adults. J Nutr 2023; 153:2699-2708. [PMID: 37460086 DOI: 10.1016/j.tjnut.2023.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/24/2023] [Accepted: 07/11/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Following Canada's food guide (CFG) recommendations should ensure adequate nutrient intakes. Older adults have increased needs for certain nutrients and nutrient density; the extent to which adherence to CFG recommendations can help reduce inadequate nutrient intakes is unknown. OBJECTIVES We aimed to assess the relationship between adherence to CFG recommendations on healthy food choices and intake of key nutrients in adults 65 y and older from the Canadian Community Health Survey 2015 - Nutrition. METHODS Secondary analysis of data from 4093 older adults of the Canadian Community Health Survey 2015 - Nutrition (mean age, 73.6 y, 54% females). Dietary intakes were measured using an interviewer-administered 24-h dietary recall, including 1 repeat in a subsample (42%). The National Cancer Institute multivariate method was used to estimate usual (i.e., long-term) dietary intakes. Adherence to CFG recommendations was measured using the Healthy Eating Food Index (HEFI)-2019 score. Simple linear and logistic regression models estimated the effect of increased HEFI-2019 score on usual nutrient intakes and the prevalence of inadequate nutrient intakes (i.e., below the estimated average requirements), respectively. RESULTS Compared with the prevalence of inadequate intakes at median HEFI-2019 score (46.4/80 points), a higher HEFI-2019 (+11 points) was associated with reductions in the prevalence of inadequate intakes of magnesium, vitamin B6 and protein [-19.8% (95% confidence interval (CI): -30.8, -8.9), -12.7% (95% CI: -22.5, -3.0), and -4.7% (95% CI: -9.4, -0.1), respectively]. In contrast, data for higher HEFI-2019 scores were compatible with increased prevalence of inadequate intakes of folate, vitamin D, and calcium [4.0% (95% CI: -8.4, 16.3), 2.6% (95% CI: 1.1, 4.0), and 2.3% (95% CI: -3.0, 7.5), respectively]. CONCLUSIONS Based on dietary intakes of Canadian older adults in 2015, increasing the degree of adherence to CFG recommendations on healthy food choices may reduce nutrient intake inadequacy for most key nutrients except folate, vitamin D, and calcium.
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Affiliation(s)
- Didier Brassard
- School of Human Nutrition, McGill University, Montréal, QC, Canada
| | - Stéphanie Chevalier
- School of Human Nutrition, McGill University, Montréal, QC, Canada; Research Institute of the McGill University Health Centre, Montréal, QC, Canada.
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Lawrence AS, Huang H, Johnson BJ, Wycherley TP. Impact of a Switch to Plant-Based Foods That Visually and Functionally Mimic Animal-Source Meat and Dairy Milk for the Australian Population-A Dietary Modelling Study. Nutrients 2023; 15:nu15081825. [PMID: 37111044 PMCID: PMC10147004 DOI: 10.3390/nu15081825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023] Open
Abstract
Sales of plant-based 'meat' and 'milk'-products that mimic the visual and functional characteristics of animal-source foods-have increased rapidly during the past decade and are predicted to continue to increase. As plant-based 'meat' and 'milk' are nutritionally dissimilar to the animal-source originals, this study aimed to estimate the nutritional implications for the Australian population of substituting 'Easily Swappable' animal-source meat and dairy milk with plant-based imitation products. Computer simulation modelling was undertaken using dietary intake data collected in 2011-12 from a nationally representative survey sample. Conservative and Accelerated dietary transition scenarios were modelled in which various amounts of dairy milk and animal-source meat were replaced with plant-based 'milk' and plant-based 'meat', for the entire population and for various sub-populations. The scenarios were based on sales reports and economic projections. Modelling revealed that the intake of nutrients already at risk of inadequate intake, such as iodine and vitamin B12 (particularly for females), zinc (particularly for males) and n-3 long-chain fatty acids (for adults), would likely be adversely impacted in an Accelerated scenario. In conclusion, widespread replacement of dairy milk and animal-source meat with plant-based 'milk' and 'meat' may increase the risk of nutritional inadequacies in the Australian population. Messages and policy actions promoting the transition to more environmentally sustainable diets should be designed to avoid such adverse nutritional impacts.
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Affiliation(s)
- Anita S Lawrence
- School of Agriculture and Food, University of Melbourne, Parkville, VIC 3010, Australia
| | - Huiying Huang
- School of Agriculture and Food, University of Melbourne, Parkville, VIC 3010, Australia
| | - Brittany J Johnson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia
| | - Thomas P Wycherley
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA 5001, Australia
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Lamers Y. Vitamin B-12 Requirements in Older Adults-Increasing Evidence Substantiates the Need To Re-Evaluate Recommended Amounts and Dietary Sources. J Nutr 2022; 152:2317-2318. [PMID: 36774098 DOI: 10.1093/jn/nxac179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Yvonne Lamers
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Canada, Vancouver, British Columbia, Canada; British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada.
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