Higher Protein Density Diets Are Associated With Greater Diet Quality and Micronutrient Intake in Healthy Young Adults

Relationship between emotional eating and nutritional intake in adult women with overweight and obesity: a cross-sectional study

BACKGROUND

Emotional eating (EE) is particularly prevalent in overweight or obese women, who may turn to food as a way to cope with stress, sadness, or anxiety. Limited research has been conducted on the association between EE and nutritional intake. Therefore, present study was designed to explore this association in adult women with overweight and obesity.

METHODS

In this cross-sectional study, the relationship between EE and nutritional intake in 303 overweight and obese women (aged 18-50 years) was examined. The researchers used the validated semi-quantitative Food Frequency Questionnaire (FFQ) to assess participants' nutritional intake and the Dutch Eating Behavior Questionnaire (DEBQ) to evaluate their eating behavior. To determine the association between EE and nutritional intake, we employed the multiple linear regression analysis.

RESULTS

The frequency of high intensity EE was 64.4% among the study participants and the mean total score of EE subscale of DBEQ was 2.32 ± 0.81. The total score of EE was positively associated with the energy intake (β = 0.396, P = 0.007), even after adjusting for age and BMI. In addition, a significant inverse association was found between the score of EE and the daily intake of calcium (β= -0.219, P = 0.026), riboflavin (β= -0.166, P = 0.043), and vitamin B12 (β= -0.271, P = 0.035), independent from energy and age. Also the results showed a significant positive association between the score of EE and the frequency of daily intake of cracker, muffin, cake, cream cake, pastry, candy, ice cream, pickles, melon, hydrogenated vegetable oil, peanut, salted and roasted seeds, and corn-cheese puff snack.

CONCLUSION

This study found that overweight or obese women with higher intensity of EE might have a higher intake of energy and a lower intake of dietary calcium, riboflavin and vitamin B12. Integrating a balanced diet with psychotherapy is suggested to help individuals with EE reducing the urge to eat in response to emotions.

Association between protein intake, diet quality, and obesity in Australian adults: a comparison of measurement units

Previous investigations on protein associations with diet quality and obesity still have inconclusive findings, possibly due to how protein intake was expressed. This study aimed to compare how different ways of expressing total protein intake may influence its relationships with diet quality and obesity. Usual protein intake was estimated from the 2011-12 Australian National Nutrition and Physical Activity Survey (n = 7637 adults, ≥19 years), expressed in grams (g/d), percent energy (%EI), and grams per actual kilogram body weight (g/kgBW/d). Diet quality was assessed using the 2013 Dietary Guidelines Index, and obesity measures included Body Mass Index (BMI) and waist circumference (WC). Sex-stratified multiple linear and logistic regressions were performed and adjusted for potential confounders. Total protein (g/d) was directly associated with diet quality (males, β = 0.15 (95% CI 0.12, 0.19); females, β = 0.25 (0.22, 0.29)), and this association was consistent across units. Protein intake (g/d) was directly associated with BMI (males, β = 0.07% (0.04%, 0.11%); females, β = 0.09% (0.04%, 0.15%)), and WC (males, β = 0.04 (0.01, 0.06); females, β = 0.05 (0.00, 0.09)). While in males, protein as %EI was associated with higher WC, no association was found in females. Adults with higher protein intake (g/d) had higher odds of overweight/obesity (males, OR = 1.01 (1.00, 1.01); females, OR = 1.01 (1.00, 1.01)), and central overweight/obesity (females, OR = 1.01 (1.00, 1.01)), but no significant association with females odds of overweight/obesity when protein was expressed in %EI. In conclusion, protein intake was positively associated with diet quality and obesity, yet these associations were stronger for women. The effect sizes also varied by measurement unit due to the different scales of those units.

Effect of Low-Fat Diet on Depression Score in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials

CONTEXT

Current evidence on the effect of a low-fat (LF) diet on depression scores has been inconsistent.

OBJECTIVE

To explore the effect of an LF diet on depression scores of adults by systematic review and meta-analysis of randomized controlled trials (RCTs).

DATA SOURCES

The PubMed, ISI Web of Science, Scopus, and CENTRAL databases were searched from inception to June 7, 2023, to identify trials investigating the effect of an LF diet (fat intake ≤30% of energy intake) on the depression score.

DATA EXTRACTION

Random-effects meta-analyses were used to estimate pooled summary effects of an LF diet on the depression score (as Hedges g).

DATA ANALYSIS

Finding from 10 trials with 50 846 participants indicated no significant change in depression score following LF diets in comparison with usual diet (Hedges g = -0.11; 95% CI, -0.25 to 0.03; P = 0.12; I2 = 70.7% [for I2, 95% CI, 44%, 85%]). However, a significant improvement was observed in both usual diet and LF diets when the content of protein was 15-20% of calorie intake (LF, normal protein diet: n = 5, Hedges g = -0.21, 95% CI, -0.24 to -0.01, P = 0.04, I2 = 0%; usual, normal protein diet: n = 3, Hedges g = -0.28, 95% CI, -0.51 to -0.05, P = 0.01, I2 = 0%). Sensitivity analysis also found the depression score improved following LF diet intervention in participants without baseline depression.

CONCLUSION

This study revealed that LF diet may have small beneficial effect on depression score in the studies enrolled mentally healthy participants. Moreover, achieving to adequate dietary protein is likely to be a better intervention than manipulating dietary fat to improve depression scores. However, it is not clear whether this effect will last in the long term. Conducting more studies may change the results due to the low-certainty of evidence.

SYSTEMATIC REVIEW REGISTRATION

CRD42023420978 (https://www.crd.york.ac.uk/PROSPERO).

Changes in Immune Function during Initial Military Training

PURPOSE

Initial military training (IMT) is a transitionary period wherein immune function may be suppressed and infection risk heightened due to physical and psychological stress, communal living, and sleep deprivation. This study characterized changes in biomarkers of innate and adaptive immune function, and potential modulators of those changes, in military recruits during IMT.

METHODS

Peripheral leukocyte distribution and mitogen-stimulated cytokine profiles were measured in fasted blood samples, Epstein-Barr (EBV), varicella zoster (VZV), and herpes simplex 1 (HSV1) DNA was measured in saliva by quantitative polymerase chain reaction as an indicator of latent herpesvirus reactivation, and diet quality was determined using the healthy eating index measured by food frequency questionnaire in 61 US Army recruits (97% male) at the beginning (PRE) and end (POST) of 22-wk IMT.

RESULTS

Lymphocytes and terminally differentiated cluster of differentiation (CD)4+ and CD8+ T cells increased PRE to POST, whereas granulocytes, monocytes, effector memory CD4+ and CD8+ T cells, and central memory CD8+ T cells decreased ( P ≤ 0.02). Cytokine responses to anti-CD3/CD28 stimulation were higher POST compared with PRE, whereas cytokine responses to lipopolysaccharide stimulation were generally blunted ( P < 0.05). Prevalence of EBV reactivation was higher at POST ( P = 0.04), but neither VZV nor HSV1 reactivation was observed. Diet quality improvements were correlated with CD8+ cell maturation and blunted proinflammatory cytokine responses to anti-CD3/CD28 stimulation.

CONCLUSIONS

Lymphocytosis, maturation of T-cell subsets, and increased T-cell reactivity were evident POST compared with PRE IMT. Although EBV reactivation was more prevalent at POST, no evidence of VZV or HSV1 reactivation, which are more common during severe stress, was observed. Findings suggest increases in the incidence of EBV reactivation were likely appropriately controlled by recruits and immune-competence was not compromised at the end of IMT.

Association between a new dietary protein quality index and micronutrient intake adequacy: a cross-sectional study in a young adult Spanish Mediterranean cohort

PURPOSE

There is no evidence of a dietary index that measures not only the quantity but also the quality of protein. The aim is to investigate the association between a new dietary protein quality index (PQI) and micronutrient intake adequacy in a Mediterranean cohort.

DESIGN

We assessed 17,535 participants' diet at baseline using a semi-quantitative FFQ. The PQI was calculated according to the ratio of protein (g/d) sources: [fish, seafood, lean meat, pulses, eggs, nuts, low-fat dairy, and whole grains]/[red and ultra-processed meats, whole-fat or semi-skimmed dairy, potatoes and refined grains]. Participants were classified into quintiles of PQI. We evaluated the intakes of Fe, Cr, I, K, Mg, Ca, P, Na, Se, Zn and vitamins A, B1, B2, B3, B6, B12, C, E and folic acid. Micronutrient adequacy was evaluated using DRIs. Logistic regression analysis was used to assess the micronutrient adequacy according to quintiles of PQI.

RESULTS

In this cross-sectional analysis, a total of 24.2% and 4.3% participants did not to meet DRIs in ≥ 4 and ≥ 8 micronutrients, respectively. The odds of failing to meet ≥ 4 and ≥ 8 DRI were lower in participants in the highest quintile of protein quality (OR = 0.22; IC 95% = 0.18, 0.26; P-trend < 0.001; and OR = 0.08; IC 95% = 0.05, 0.14; P-trend < 0.001, respectively) as compared to participants in the lowest quintile.

CONCLUSION

Higher PQI was found to be strongly associated with better micronutrient intake adequacy in this Mediterranean cohort. The promotion of high-quality protein intake may be helpful for a more adequate intake of micronutrients. The odds of failing to meet certain numbers of DRIs were lower rather than saying lower risk.

Levels of Trace Elements in the Lens, Aqueous Humour, and Plasma of Cataractous Patients-A Narrative Review

Cataracts are one of the most common causes of effective vision loss. Although most cases of cataracts are related to the ageing process, identifying modifiable risk factors can prevent their onset or progression. Many studies have suggested that micro and macroelement levels, not only in blood serum but also in the lens and aqueous humour, may affect the risk of the occurrence and severity of cataracts. This systematic review aims to summarise existing scientific reports concerning the importance of trace elements in cataractogenesis. Many authors have pointed out elevated or decreased levels of particular elements in distinct ocular compartments. However, it is not known if these alterations directly affect the increased risk of cataract occurrence. Further studies are needed to show whether changes in the levels of these elements are correlated with cataract severity and type. Such information would be useful for determining specific recommendations for micronutrient supplementation in preventing cataractogenesis.

Initial military training modulates serum fatty acid and amino acid metabolites

Initial military training (IMT) results in increased fat-free mass (FFM) and decreased fat mass (FM). The underlying metabolic adaptations facilitating changes in body composition during IMT are unknown. The objective of this study was to assess changes in body composition and the serum metabolome during 22-week US Army IMT. Fifty-four volunteers (mean ± SD; 22 ± 3 year; 24.6 ± 3.7 kg/m2 ) completed this longitudinal study. Body composition measurements (InBody 770) and blood samples were collected under fasting, rested conditions PRE and POST IMT. Global metabolite profiling was performed to identify metabolites involved in energy, carbohydrate, lipid, and protein metabolism (Metabolon, Inc.). There was no change in body mass (POST-PRE; 0.4 ± 5.1 kg, p = 0.59), while FM decreased (-1.7 ± 3.5 kg, p < 0.01), and FFM increased (2.1 ± 2.8 kg, p < 0.01) POST compared to PRE IMT. Of 677 identified metabolites, 340 differed at POST compared to PRE (p < 0.05, Q < 0.10). The majority of these metabolites were related to fatty acid (73%) and amino acid (26%) metabolism. Increases were detected in 41% of branched-chain amino acid metabolites, 53% of histidine metabolites, and 35% of urea cycle metabolites. Decreases were detected in 93% of long-chain fatty acid metabolites, while 58% of primary bile acid metabolites increased. Increases in amino acid metabolites suggest higher rates of protein turnover, while changes in fatty acid metabolites indicate increased fat oxidation, which likely contribute changes in body composition during IMT. Overall, changes in metabolomics profiles provide insight into metabolic adaptions underlying changes in body composition during IMT.

Evaluating type and amount of dietary protein in relation to metabolic syndrome among Iranian adults: cross-sectional analysis of Fasa Persian cohort study

BACKGROUND AND AIM

Metabolic syndrome is characterized by several conditions including abdominal obesity, dyslipidemia, impaired glucose levels, and hypertension; which all are directly associated with an increased risk of cardiovascular disease and type 2 diabetes mellitus. This study aimed to evaluate the association of the amount and source of dietary protein with the risk of metabolic syndrome and its components in adult men and women.

MATERIAL AND METHOD

This study was performed using Persian cohort data, Fasa branch, which included 3660 men and 5262 women. Individuals were divided into five groups for total dietary proteins, plant proteins, and animal proteins using the quintiles, and the odds of incidence for metabolic syndrome and each component was evaluated.

RESULTS

A higher intake of total protein was associated with lower odds of having metabolic syndrome (OR: 0.24 95% CI 0.18-0.33, P-trend < 0.001 in men, OR: 0.42 95% CI 0.34-0.51, P-trend < 0.001 in women) and all of its components. men (OR: 0.35 95% CI 0.25-0.48, P-trend < 0.001) and women (OR: 0.41 95% CI 0.33-0.52, P-trend < 0.001) in the highest quintile of plant protein intake had a reduced prevalence of metabolic syndrome and its components. An increased animal protein intake was associated with a lower prevalence of metabolic syndrome (P-trend < 0.001), a declined risk of having elevated triglycerides (P-trend = 0.016) in men, and a reduced risk of having abdominal obesity in men (P-trend < 0.001) and women (P-trend < 0.001).

CONCLUSION

A higher consumption of total protein and plant protein was associated with a lower prevalence of metabolic syndrome and its components. Increased consumption of animal protein seemed to be related to a lower prevalence abdominal obesity. Also, only in men, animal protein was associated with decreased risk of having metabolic syndrome.

Physiological Limitations of Protein Foods Ounce Equivalents and the Underappreciated Role of Essential Amino Acid Density in Healthy Dietary Patterns

Protein quality is an important component of protein intake to support growth, development, and maintenance of essential body tissues and functions. Therefore, protein quality should be emphasized as a key characteristic during protein food selection within the larger context of healthy dietary patterns, especially when considering the wide variance of protein quality across animal- and plant-based foods. However, the USDA Dietary Guidelines for Americans (DGA) do not address specific protein quality recommendations within their protein foods ounce equivalents guidance or as a component of Healthy U.S. Style, Healthy Vegetarian, and Healthy Mediterranean Style dietary patterns. In addition, the protein foods ounce equivalents within the DGA are not established on any obvious metabolic equivalency characteristic [i.e., energy, protein, or essential amino acid (EAA) content], which creates misleading messaging of equivalent functional and metabolic benefit across protein foods. EAA content is a key characteristic of protein quality and can be a practical focal point for protein intake recommendations and achieving healthy dietary patterns. This review discusses the importance of protein quality, the state of messaging within DGA recommendations, and proposes EAA density (i.e., EAA content relative to total energy) as one practical approach to improve current dietary recommendations. Two recent publications that evaluated the DGA protein foods ounce equivalents based on metabolic effect and their application within DGA recommended dietary patterns are discussed.

Vitamins and other immune-supportive elements as cofactors for passing the COVID-19 pandemic

BACKGROUND

Coronavirus disease 2019 (COVID-19) is a viral disease that causes a respiratory disorder, started in December of 2019 in China. Several vitamins and trace elements could help in enhancing host immunity producing antioxidant or anti-inflammatory action. This work aimed to identify the role of different nutrition, vitamins, and trace elements on the immunity status of the infected subject and the possibility of the beneficial role of these elements in the management of COVID-19.

MAIN BODY

After collecting (PubMed, scholar, OVID, Embase, Cochrane Library) and investigating published articles, testing the effect of these elements on viral infection, it was found that most of these elements have a significant role during viral infection through a different mechanism, like antioxidant, anti-inflammatory, and immunomodulation. Nutritional interventions in COVID-19 infections are very important currently, and it was reported that vitamin C and D reduce the risk of acute respiratory infections. In addition, low vitamin A diets compromise the effectiveness of inactivated bovine coronavirus vaccines. Administration of N-acetyl cysteine showed a beneficial inhibitory effect in viral infections and enhanced glutathione production. The deficiency of selenium on COVID-19 subjects has a significant impact on the clinical outcome of the subjects. In addition, supplementation with vitamins proved to enhance immune response during viral infection. Vitamins and trace elements not only showed a beneficial effect but also Omega 3 fatty acids showed an immunomodulating effect during infections.

SHORT CONCLUSIONS

Assessment of levels for these trace elements at the baseline and providing supplementation containing different vitamins and elements could result in better control and clinical outcomes in the case of COVID-19.

Healthy Eating Index and Nutrition Biomarkers among Army Soldiers and Civilian Control Group Indicate an Intervention Is Necessary to Raise Omega-3 Index and Vitamin D and Improve Diet Quality

Diet quality and nutrition status are important for optimal health and military performance. Few studies have simultaneously evaluated diet quality and biochemical markers of nutritional status of military service members. The Healthy Eating Index (HEI) can be used to assess dietary quality and adherence to federal nutrition guidelines. The aim of this study was to assess soldiers' diet quality and nutritional status and compare results to a civilian control group.

METHODS

A cross-sectional study was conducted with 531 soldiers. A food frequency questionnaire was used to calculate HEI scores. A blood sample was collected for analysis of select nutrition biochemical markers. Non-parametric analyses were conducted to compare the diet quality and nutritional status of soldiers and controls. Differences in non-normally distributed variables were determined by using the Wilcoxon signed-rank test.

RESULTS

Soldiers had an HEI score of 59.9 out of 100, marginally higher than the control group (55.4). Biochemical markers of interest were within normal reference values for soldiers, except for the omega-3 index and vitamin D.

CONCLUSIONS

This study identified dietary components that need improvement and deficits in biochemical markers among soldiers. Improving diet quality and nutritional status should lead to better health, performance, and readiness of the force.

Comparison of Energy and Nutrient Intake vs. Estimated Needs in Warfighters: an Update

Active members of the military must perform optimally under conditions of thermal stress and/or energy deficiency. Military dietary reference intakes (MDRIs) provide guidelines for energy and nutrient intakes but is based studies largely conducted in Army. Needs may vary by service branch and/or position. New protein recommendations have emerged, which are not reflected in MDRIs. PURPOSE OF REVIEW: Compare reported dietary intake in active duty members to MDRIs and 2016 American College of Sports Medicine (ACSM) sports nutrition guidelines. RECENT FINDINGS: Active duty members are not meeting their energy and carbohydrate needs with low-to-adequate protein intake and adequate-to-high fat intake. Other nutrients of concern are vitamin D, calcium, iron, B-vitamins, and fiber. Thermal stress increases energy needs and suppresses appetite and thus increase risk for energy and nutrition deficiencies. Energy and nutrients needs can vary by branch of armed service, job responsibility, and external stressors.

Evaluation of the current methods used for assessing dietary intake in military research settings: a scoping review

INTRODUCTION

It is important to collate the literature that has assessed dietary intake within military settings to establish which methods are commonly used and which are valid so that accurate nutrition recommendations can be made. This scoping review aims to identify which methods are typically used to assess dietary intake in military settings and which of these have been validated. This review also aims to provide a recommendation as to which method(s) should be used in military settings.

METHODS

This scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Searches were conducted in PubMed, Web of Science and SPORTDiscus with the most recent search executed on 12th June 2020. Eligible studies had to report original data, assess and quantify dietary intake and have been published in peer-reviewed academic journals. The reporting bias was calculated for each study where possible.

RESULTS

Twenty-eight studies used a single method to assess dietary intake and seven studies used a combination of methods. The most commonly used methods were the gold standard food intake/waste method, Food Frequency Questionnaire (FFQ) or a food diary (FD). The only method to date that has been validated in military settings is weighed food records (WFR).

CONCLUSIONS

The food intake/waste method or WFR should be used where feasible. Where this is not practical the FFQ or FD should be considered with control measures applied. There is currently not sufficient evidence to state that using multiple methods together improves validity.