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He W, Connolly ED, Cross HR, Wu G. Dietary protein and amino acid intakes for mitigating sarcopenia in humans. Crit Rev Food Sci Nutr 2024:1-24. [PMID: 38803274 DOI: 10.1080/10408398.2024.2348549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Adult humans generally experience a 0.5-1%/year loss in whole-body skeletal muscle mass and a reduction of muscle strength by 1.5-5%/year beginning at the age of 50 years. This results in sarcopenia (aging-related progressive losses of skeletal muscle mass and strength) that affects 10-16% of adults aged ≥ 60 years worldwide. Concentrations of some amino acids (AAs) such as branched-chain AAs, arginine, glutamine, glycine, and serine are reduced in the plasma of older than young adults likely due to insufficient protein intake, reduced protein digestibility, and increased AA catabolism by the portal-drained viscera. Acute, short-term, or long-term administration of some of these AAs or a mixture of proteinogenic AAs can enhance blood flow to skeletal muscle, activate the mechanistic target of rapamycin cell signaling pathway for the initiation of muscle protein synthesis, and modulate the metabolic activity of the muscle. In addition, some AA metabolites such as taurine, β-alanine, carnosine, and creatine have similar physiological effects on improving muscle mass and function in older adults. Long-term adequate intakes of protein and the AA metabolites can aid in mitigating sarcopenia in elderly adults. Appropriate combinations of animal- and plant-sourced foods are most desirable to maintain proper dietary AA balance.
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Affiliation(s)
- Wenliang He
- Department of Animal Science, Texas A&M University, College Station, TX, USA
| | - Erin D Connolly
- Department of Animal Science, Texas A&M University, College Station, TX, USA
| | - H Russell Cross
- Department of Animal Science, Texas A&M University, College Station, TX, USA
| | - Guoyao Wu
- Department of Animal Science, Texas A&M University, College Station, TX, USA
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2
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Hawley AL, Baum JI. Nutrition as the foundation for successful aging: a focus on dietary protein and omega-3 polyunsaturated fatty acids. Nutr Rev 2024; 82:389-406. [PMID: 37319363 DOI: 10.1093/nutrit/nuad061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
Skeletal muscle plays a critical role throughout the aging process. People living with sarcopenia, a progressive and generalized loss of skeletal muscle mass and function, often experience diminished quality of life, which can be attributed to a long period of decline and disability. Therefore, it is important to identify modifiable factors that preserve skeletal muscle and promote successful aging (SA). In this review, SA was defined as (1) low cardiometabolic risk, (2) preservation of physical function, and (3) positive state of wellbeing, with nutrition as an integral component. Several studies identify nutrition, specifically high-quality protein (eg, containing all essential amino acids), and long-chain omega-3 polyunsaturated fatty acids (n-3 PUFAs), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), as positive regulators of SA. Recently, an additive anabolic effect of protein and n-3 PUFAs has been identified in skeletal muscle of older adults. Evidence further suggests that the additive effect of protein and n-3 PUFAs may project beyond skeletal muscle anabolism and promote SA. The key mechanism(s) behind the enhanced effects of intake of protein and n-3 PUFAs needs to be defined. The first objective of this review is to evaluate skeletal muscle as a driver of cardiometabolic health, physical function, and wellbeing to promote SA. The second objective is to examine observational and interventional evidence of protein and n-3 PUFAs on skeletal muscle to promote SA. The final objective is to propose mechanisms by which combined optimal intake of high-quality protein and n-3 PUFAs likely play a key role in SA. Current evidence suggests that increased intake of protein above the Recommended Dietary Allowance and n-3 PUFAs above the Dietary Guidelines for Americans recommendations for late middle-aged and older adults is required to maintain skeletal muscle mass and to promote SA, potentially through the mechanistical target of rapamycin complex 1 (mTORC1).
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Affiliation(s)
- Aubree L Hawley
- School of Human and Environmental Sciences, University of Arkansas, Fayetteville, AR, USA
| | - Jamie I Baum
- Center for Human Nutrition, Department of Food Science, University of Arkansas System Division of Agriculture, Fayetteville, AR, USA
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3
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Huang J, Yu Y, Li H, Wei Y, Sun M. Effect of dietary protein intake on cognitive function in the elderly with chronic kidney disease: analysis of the National Health and Nutrition Examination Survey 2011-2014. Ren Fail 2023; 45:2294147. [PMID: 38097960 PMCID: PMC10732213 DOI: 10.1080/0886022x.2023.2294147] [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: 08/22/2023] [Accepted: 12/07/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Cognitive dysfunction is prevalent among the elderly diagnosed with chronic kidney disease (CKD). Low protein diets are used for retarding the progression of CKD in clinical practice. Nonetheless, the impact of dietary protein consumption on cognitive function in this population remains uncertain. METHODS We recruited 2306 participants (≥60 years) from 2011 to 2014 National Health and Nutrition Examination Survey (NHANES). 24-h dietary recall questionnaire was utilized to evaluate protein intake. Cognitive function was measured using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). Participants' characteristics were analyzed, and the interaction between protein consumption and CKD on cognitive impairment were analyzed using a logistic regression model. RESULTS We divided participants into three groups based on CKD stages: no CKD, CKD stage G1 to G2 (19%), and CKD stage G3 to G5 (18%). The average protein intake was 0.97 g/(kg·d). In the higher protein intake group, CKD stages G1 to G2 elevated the risk of immediate memory impairment (OR: 2.441, 95% Cl: 1.161-5.132 for protein consumption in 1.0-1.2g/(kg·d); OR: 2.225, 95% Cl: 1.015-4.876 for protein consumption in >1.2 g/(kg·d)). However, no similar resuts were observed in the lower protein intake group. In addition, the interaction between CKD status and protein intake on immediate memory was statistically significant (p = .041). CONCLUSION A higher probability of cognitive impairment in the elderly with early-stage CKD may be linked to higher protein intake. Low protein diets may be a potential strategy to release cognitive impairment in the elderly with early-stage CKD.
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Affiliation(s)
- Jingda Huang
- Department of Nephrology, First Hospital of Jilin University, Changchun, China
| | - Yang Yu
- The Fourth Clinical Medical College, Hebei Medical University, Shijiazhuang, China
| | - Huimin Li
- Department of Nephrology, First Hospital of Jilin University, Changchun, China
| | - Yihui Wei
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Mindan Sun
- Department of Nephrology, First Hospital of Jilin University, Changchun, China
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Myers M, Ruxton CHS. Eggs: Healthy or Risky? A Review of Evidence from High Quality Studies on Hen's Eggs. Nutrients 2023; 15:2657. [PMID: 37375561 DOI: 10.3390/nu15122657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/21/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Hen's eggs (from Gallus gallus domesticus) provide choline, folate, vitamin D, iodine, B vitamins and high-quality protein and are no longer viewed by national bodies as a risk factor for hypercholesterolaemia and cardiovascular disease (CVD). Yet, questions remain about the benefits and risks of eating eggs regularly. This review evaluates recent high-quality evidence from randomised controlled trials (RCT) and meta-analyses of observational studies and considers new areas of interest, such as weight management, protein metabolism, allergy risk and sustainability. In several RCT, eggs increased muscle protein synthesis and lowered fat mass, which could support optimal body composition. Eggs within a meal improved satiety, which could translate into lower energy intakes, although more RCT are needed. In observational studies, higher egg consumption was associated with a null effect or a modest reduced risk of CVD. For type 2 diabetes (T2D) incidence and risk of CVD in people with T2D, there were inconsistencies between observational and RCT data, with the former noting positive associations and the latter seeing no effect of higher egg intake on markers of T2D and CVD. Sustainability metrics suggest that eggs have the lowest planetary impact amongst animal proteins. To lower allergy risk, earlier introduction of eggs into weaning diets is warranted. In conclusion, the balance of evidence points to eggs being a nutritious food suggesting there are broad health benefits from including eggs in the diet at intakes higher than that currently consumed by European populations.
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Li X, Li Z, Zhang X, Zeng Q, Huang X, Sheng L, Ahn DU, Cai Z. Restoration of immunity by whole egg was superior to egg white or egg yolk in a cyclophosphamide-induced immunocompromised mouse model. FOOD BIOSCI 2022. [DOI: 10.1016/j.fbio.2022.102013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Effects of protein intake from an energy-restricted diet on the skeletal muscle composition of overweight and obese rats. Sci Rep 2022; 12:20396. [PMID: 36437293 PMCID: PMC9701787 DOI: 10.1038/s41598-022-24961-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 11/22/2022] [Indexed: 11/28/2022] Open
Abstract
Excess weight and obesity are often associated with ectopic adipose tissue accumulation in skeletal muscles. Intermuscular adipose tissue (IMAT) impairs muscle quality and reduces insulin-stimulated skeletal muscle glucose uptake. Although energy restriction and high protein intake can decrease IMAT, the effects and mechanisms of protein intake from an energy-restricted diet on protein and fat masses in skeletal muscle have received little attention. After establishing a diet-induced overweight and obese Sprague-Dawley rat model (half male and half female), rats were divided into five groups: normal control (NC; normal weight, general maintenance diet), model control (MC; overweight and obesity, high-fat diet), energy-restricted low protein (LP; overweight and obesity, 60% energy intake of NC, general maintenance diet), energy-restricted normal protein (NP; overweight and obesity, 60% energy intake of NC, high-protein diet 1), and energy-restricted high protein (HP; overweight and obesity, 60% energy intake of NC, high-protein diet 2). After 8 weeks, plasma and skeletal muscle (quadriceps femoris and gastrocnemius) samples were collected. Plasma levels of glucose, triglycerides, and hormones were analyzed, while contents of protein, fat, and factors associated with their synthesis and degradation were evaluated in skeletal muscles. Plasma concentrations of hormones contrasted protein and fat contents in skeletal muscles. Fat weights and contents of quadriceps femoris and gastrocnemius muscles in the NP group were significantly lower compared with LP and HP groups (P < 0.05). Moreover, concentrations of factors associated with the degradation of muscle fat were significantly higher in the NP group compared with LP and HP groups (P < 0.05). During energy restriction, protein intake equal to that of a normal protein diet increased lipolysis of quadriceps femoris and gastrocnemius muscles in rats of both sexes.
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Effects of Whey Protein or Its Hydrolysate Supplements Combined with an Energy-Restricted Diet on Weight Loss: A Randomized Controlled Trial in Older Women. Nutrients 2022; 14:nu14214540. [PMID: 36364801 PMCID: PMC9657015 DOI: 10.3390/nu14214540] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/03/2022] [Accepted: 10/25/2022] [Indexed: 12/03/2022] Open
Abstract
An energy-restricted weight-loss approach has limitations when it used in the elderly, especially because of muscle loss. We aimed to assess the effects of whey protein (WP) or WP hydrolysate (WPH) combined with an energy-restricted diet (ERD) on weight reduction and muscle preservation in older women with overweight and obesity. A total of 60 women were randomized to the control (ERD), WP (ERD + 20 g/d WP) or WPH (ERD + 20 g/d WPH) group, using a 1:1:1 allocation ratio. After an 8-week intervention, body composition, gut microbiota, and serum metabolomics changes were compared among the three groups. The reductions in body weight (−1.11 ± 1.11 vs. −2.34 ± 1.35, p < 0.05), BMI (−0.46 ± 0.45 vs. −0.97 ± 0.54, p < 0.05), and body fat (−0.70 ± 0.92 vs. −2.45 ± 1.65, p < 0.01) were higher in the WPH group than in the control group. Body fat (%) was significantly decreased in the two protein groups. Fat-free mass did not significantly change among the three groups. Serum metabolomics showed that the tricarboxylic acid cycle pathway was upregulated in the WPH group. No significant changes in microbiota were observed among the groups. In conclusion, WP or WPH supplementation combined with an energy-restricted diet benefits older women during weight loss. WPH was more effective, possibly due to increased energy metabolism.
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Ling CJ, Chen XF, Xu JY, Wang GP, Wang Y, Sun Y, Li YL, Wan ZX, Tong X, Hidayat K, Zhu WZ, Qin LQ, Yang J. Whey protein hydrolysates alleviated weight gain and improved muscle in middle-aged obese mice induced by a high-fat diet. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.105241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Puglisi MJ, Fernandez ML. The Health Benefits of Egg Protein. Nutrients 2022; 14:nu14142904. [PMID: 35889862 PMCID: PMC9316657 DOI: 10.3390/nu14142904] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 12/31/2022] Open
Abstract
Once the general public accepts that dietary cholesterol is not a concern for cardiovascular disease risk, foods that have been labeled as high-cholesterol sources, including eggs, may be appreciated for their various other dietary components. One of the nutrients in eggs that deserves further discussion is egg protein. Egg protein has been recognized to be highly digestible and an excellent source of essential amino acids, with the highest attainable protein digestibility-corrected amino acid score. Egg protein has been shown to decrease malnutrition in underdeveloped countries, possibly increase height in children, and protect against kwashiorkor. Egg protein has been demonstrated to be important to skeletal muscle health and protective against sarcopenia. Egg protein also can decrease appetite, resulting in a reduction in the caloric intake from the next meal and weight reduction. Other protective effects of egg protein addressed in this review include protection against infection as well as hypotensive and anti-cancer effects.
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Maierean S, Webb R, Banach M, Mazidi M. The role of inflammation and the possibilities of inflammation reduction to prevent cardiovascular events. EUROPEAN HEART JOURNAL OPEN 2022; 2:oeac039. [PMID: 35919577 PMCID: PMC9271640 DOI: 10.1093/ehjopen/oeac039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 05/27/2022] [Indexed: 11/16/2022]
Abstract
Chronic systemic inflammation is a risk factor for cardiovascular (CV) disease (CVD). Whether this relationship extends to subclinical inflammation, quantified by values of circulating markers associated with inflammation in the high range of the normal interval, remains debatable. This narrative review evaluates evidence exploring this relationship. A review of pharmacological and non-pharmacological interventions, including diet and lifestyle strategies, supplements, nutraceuticals, and other natural substances aimed at reducing inflammation was also conducted, since few reviews have synthesized this literature. PubMed and EMBASE were used to search the literature and several well-studied triggers of inflammation [oxidized LDL, Lp(a), as well as C-reactive protein (CRP)/high-sensitivity CRP (hs-CRP)] were included to increase sensitivity and address the lack of existing reviews summarizing their influence in the context of inflammation. All resulting references were assessed. Overall, there is good data supporting associations between circulating hs-CRP and CV outcomes. However, the same was not seen in studies evaluating triggers of inflammation, such as oxidized LDL or Lp(a). There is also insufficient evidence showing treatments to target inflammation and lead to reductions in hs-CRP result in improvements in CV outcomes, particularly in those with normal baseline levels of hs-CRP. Regarding pharmacological interventions, statins, bempedoic acid, and apabetalone significantly reduce circulating hs-CRP, unlike PCSK-9 inhibitors. A variety of natural substances and vitamins were also evaluated and none reduced hs-CRP. Regarding non-pharmacological interventions, weight loss was strongly associated with reductions in circulating hs-CRP, whereas various dietary interventions and exercise regimens were not, unless accompanied by weight loss.
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Affiliation(s)
- Serban Maierean
- Department of Medicine, University of Toronto , Toronto, ON , Canada
| | - Richard Webb
- Faculty of Science, Liverpool Hope University , Taggart Avenue, Liverpool , UK
| | - Maciej Banach
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz , Rzgowska 281/289, Lodz 93-338 , Poland
- Department of Cardiology and Adult Congenital Heart Diseases, Polish Mother’s Memorial Hospital Research Institute (PMMHRI) , Rzgowska 281/289, Lodz 93-338 , Poland
- Cardiovascular Research Centre, University of Zielona Gora , Zyty 28, 65-046 Zielona Gora , Poland
| | - Mohsen Mazidi
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health , University of Oxford, Oxford , UK
- Department of Twin Research & Genetic Epidemiology, King’s College London , South Wing St Thomas’, London , UK
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11
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González-Torres S, González-Silva N, Pérez-Reyes Á, Anaya-Esparza LM, Sánchez-Enríquez S, Vargas-Becerra PN, Villagrán Z, García-García MR. Food Consumption and Metabolic Risks in Young University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010449. [PMID: 35010709 PMCID: PMC8744619 DOI: 10.3390/ijerph19010449] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/26/2021] [Accepted: 12/30/2021] [Indexed: 12/23/2022]
Abstract
The purpose of this study was to analyze the association between components of the diet, metabolic risks, and the serum concentrations of adiponectin and interleukin-6 (IL-6). With prior informed consent, an analytical cross-sectional study was carried out with 72 students in their first year of university. The subjects had a mean age of 19.2 ± 1.0 years and body mass index of 23.38 ± 4.2, and they were mainly women (80.6%). Sociodemographic, anthropometric, and dietary data and metabolic risk factors were evaluated, and biochemical parameters and adipocytokines were also considered. The data were analyzed using means, ranges, and correlations, as well as principal components. In general, the protein, fat, and sodium intake were higher than the international dietary recommendations, and deficiencies in vitamins B5 and E, potassium, phosphorus, selenium, and zinc were observed. The most frequently observed metabolic risks were insulin resistance and hypoalphalipoproteinemia. IL-6 was positively correlated with lipid and protein intake. Adiponectin showed a positive correlation with high-density lipoprotein and a negative correlation with insulin, weight, and waist, while the adiponectin pattern was similar to that of vitamins E and A, which decreased with increasing intake of calories, macronutrients, and sodium. In general, a hypercaloric diet that was high in protein, fat, and sodium and deficient in vitamins, mainly fat-soluble, was associated with a lower concentration of adiponectin and a higher concentration of IL-6, which favor the presence of metabolic risks, including insulin resistance. Intervention studies are required to evaluate the dietary intake of metabolic markers in young people without comorbidities, which will lay the foundation for implementing prevention strategies.
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Affiliation(s)
- Sughey González-Torres
- Division de Ciencias Biomedicas, Centro Universitario de los Altos, Universidad de Guadalajara, Rafael Casillas Aceves 1200, Tepatitlan de Morelos 47620, Mexico; (S.G.-T.); (Á.P.-R.); (S.S.-E.); (P.N.V.-B.)
| | - Napoleón González-Silva
- Division de Ciencias Agropecuarias e Ingenierias, Centro Universitario de los Altos, Universidad de Guadalajara, Rafael Casillas Aceves 1200, Tepatitlan de Morelos 47620, Mexico; (N.G.-S.); (L.M.A.-E.)
| | - Ángel Pérez-Reyes
- Division de Ciencias Biomedicas, Centro Universitario de los Altos, Universidad de Guadalajara, Rafael Casillas Aceves 1200, Tepatitlan de Morelos 47620, Mexico; (S.G.-T.); (Á.P.-R.); (S.S.-E.); (P.N.V.-B.)
| | - Luis Miguel Anaya-Esparza
- Division de Ciencias Agropecuarias e Ingenierias, Centro Universitario de los Altos, Universidad de Guadalajara, Rafael Casillas Aceves 1200, Tepatitlan de Morelos 47620, Mexico; (N.G.-S.); (L.M.A.-E.)
| | - Sergio Sánchez-Enríquez
- Division de Ciencias Biomedicas, Centro Universitario de los Altos, Universidad de Guadalajara, Rafael Casillas Aceves 1200, Tepatitlan de Morelos 47620, Mexico; (S.G.-T.); (Á.P.-R.); (S.S.-E.); (P.N.V.-B.)
| | - Patricia N. Vargas-Becerra
- Division de Ciencias Biomedicas, Centro Universitario de los Altos, Universidad de Guadalajara, Rafael Casillas Aceves 1200, Tepatitlan de Morelos 47620, Mexico; (S.G.-T.); (Á.P.-R.); (S.S.-E.); (P.N.V.-B.)
| | - Zuamí Villagrán
- Division de Ciencias Biomedicas, Centro Universitario de los Altos, Universidad de Guadalajara, Rafael Casillas Aceves 1200, Tepatitlan de Morelos 47620, Mexico; (S.G.-T.); (Á.P.-R.); (S.S.-E.); (P.N.V.-B.)
- Correspondence: (Z.V.); (M.R.G.-G.)
| | - Maritza R. García-García
- Programa Internacional de Medicina, Unidad Academica de Ciencias de la Salud, Escuela de Medicina, Universidad Autónoma de Guadalajara, Lomas del Valle, Zapopan 45129, Mexico
- Correspondence: (Z.V.); (M.R.G.-G.)
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12
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Hengeveld LM, de Goede J, Afman LA, Bakker SJL, Beulens JWJ, Blaak EE, Boersma E, Geleijnse JM, van Goudoever J(HB, Hopman MTE, Iestra JA, Kremers SPJ, Mensink RP, de Roos NM, Stehouwer CDA, Verkaik-Kloosterman J, de Vet E, Visser M. Health Effects of Increasing Protein Intake Above the Current Population Reference Intake in Older Adults: A Systematic Review of the Health Council of the Netherlands. Adv Nutr 2021; 13:1083-1117. [PMID: 35016214 PMCID: PMC9340973 DOI: 10.1093/advances/nmab140] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/07/2021] [Accepted: 11/17/2021] [Indexed: 01/06/2023] Open
Abstract
Whether older adults need more protein than younger adults is debated. The population reference intake for adults set by the European Food Safety Authority is 0.83 g/kg body weight (BW)/d based primarily on nitrogen balance studies, but the underlying data on health outcomes are outdated. An expert committee of the Health Council of the Netherlands conducted a systematic review (SR) of randomized controlled trials (RCTs) examining the effect of increased protein intake on health outcomes in older adults from the general population with an average habitual protein intake ≥0.8 g/(kg BW · d). Exposures were the following: 1) extra protein compared with no protein and 2) extra protein and physical exercise compared with physical exercise. Outcomes included lean body mass, muscle strength, physical performance, bone health, blood pressure, serum glucose and insulin, serum lipids, kidney function, and cognition. Data of >1300 subjects from 18 RCTs were used. Risk of bias was judged as high (n = 9) or "some concerns" (n = 9). In 7 of 18 RCTs, increased protein intake beneficially affected ≥1 of the tested outcome measures of lean body mass. For muscle strength, this applied to 3 of 8 RCTs in the context of physical exercise and in 1 of 7 RCTs without physical exercise. For the other outcomes, <30% (0-29%) of RCTs showed a statistically significant effect. The committee concluded that increased protein intake has a possible beneficial effect on lean body mass and, when combined with physical exercise, muscle strength; likely no effect on muscle strength when not combined with physical exercise, or on physical performance and bone health; an ambiguous effect on serum lipids; and that too few RCTs were available to allow for conclusions on the other outcomes. This SR provides insufficiently convincing data that increasing protein in older adults with a protein intake ≥0.8 g/(kg BW · d) elicits health benefits.
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Affiliation(s)
| | | | - Lydia A Afman
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Stephan J L Bakker
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Joline W J Beulens
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands,Amsterdam Cardiovascular Sciences Research Institute, Amsterdam University Medical Center, location VUmc, Amsterdam, The Netherlands,Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Ellen E Blaak
- Department of Human Biology, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Eric Boersma
- Erasmus MC, University Medical Center, Department of Cardiology, Rotterdam, The Netherlands
| | - Johanna M Geleijnse
- Health Council of the Netherlands, The Hague, The Netherlands,Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Johannes (Hans) B van Goudoever
- Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children's Hospital, Department of Pediatrics, Amsterdam, The Netherlands
| | - Maria T E Hopman
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jolein A Iestra
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Stef P J Kremers
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Ronald P Mensink
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Nicole M de Roos
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Coen D A Stehouwer
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands,Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | | | - Emely de Vet
- Department of Social Sciences, Chair group Consumption and Healthy Lifestyles, Wageningen University and Research, Wageningen, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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13
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Chen CN, Hsu KJ, Chien KY, Chen JJ. Effects of Combined High-Protein Diet and Exercise Intervention on Cardiometabolic Health in Middle-Aged Obese Adults: A Randomized Controlled Trial. Front Cardiovasc Med 2021; 8:705282. [PMID: 34485407 PMCID: PMC8415300 DOI: 10.3389/fcvm.2021.705282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Obesity is the main risk factor of cardiovascular diseases (CVD) and metabolic diseases. The middle-aged population is the age group with the highest prevalence of obesity. Thus, improving cardiometabolic health is important to prevent CVD and metabolic diseases in middle-aged obese adults. The aim of this study was to examine the effects of exercise alone or in combination with a high-protein diet on markers of cardiometabolic health in middle-aged adults with obesity. Methods: Sixty-nine middle-aged adults with obesity were assigned randomly to the control group (C; n = 23), exercise group (E; n = 23), or exercise combined with high-protein diet group (EP; n = 23). Individuals in the E and EP groups received supervised exercise training and individuals in the EP group received high-protein diet intervention. Body composition (assessed by dual-energy X-ray absorptiometry), oral glucose tolerance test (OGTT), lipid profiles, and inflammatory markers were determined before and after 12 weeks of intervention. Insulin sensitivity index (ISI0,120) was calculated from values of fasting and 2-h insulin and glucose concentration of OGTT. Insulin-peak-time during the OGTT was recorded to reflect β-cell function. Analysis of covariance with baseline values as covariates was used to examine the effects of the intervention. The significant level was set at 0.05. Results: After 12 weeks of intervention, the E group had a greater percentage of individuals with early insulin-peak-time during the OGTT than that in the C and EP groups (p = 0.031). EP group had lower total cholesterol and triglycerides than that in the C group (p = 0.046 and 0.014, respectively). Within-group comparisons showed that the 2-h glucose of OGTT and C-reactive protein decreased in the EP group (p = 0.013 and 0.008, respectively) but not in the E and C groups; insulin sensitivity improved in the EP group (p = 0.016) and had a trend to improve in the E group (p = 0.052); and abdominal fat mass and total body fat mass decreased in both intervention groups (p < 0.05). Conclusion: Combined high-protein diet and exercise intervention significantly decreased fat mass and improved lipid profiles, insulin sensitivity, glucose tolerance, and inflammation in middle-aged adults with obesity. Clinical Trial Registration: Thai Clinical Trials Registry, TCTR20180913003, 13-09-2018.
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Affiliation(s)
- Chiao-Nan Chen
- Department of Physical Therapy and Assistive Technology, School of Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kuo-Jen Hsu
- Department of Physical Therapy and Assistive Technology, School of Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kuei-Yu Chien
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Jeu-Jung Chen
- Department of Physical Therapy and Assistive Technology, School of Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Rehabilitation, Taiwan Adventist Hospital, Taipei, Taiwan
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14
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Sanlier N, Üstün D. Egg consumption and health effects: A narrative review. J Food Sci 2021; 86:4250-4261. [PMID: 34472102 DOI: 10.1111/1750-3841.15892] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 07/13/2021] [Accepted: 08/02/2021] [Indexed: 11/26/2022]
Abstract
This study was planned and conducted to investigate the effects of egg consumption on metabolic syndrome components and potential mechanisms of action on humans. Egg, an important source of animal protein, is defined as a functional food containing various bioactive compounds that can affect the proinflammatory and anti-inflammatory pathways. As a matter of fact, the egg can show immunomodulatory, anti-inflammatory, antioxidant, anticancer, or antihypertensive effects with its bioactive components. It is claimed that egg consumption may protect individuals against metabolic syndrome by increasing HDL-C levels and reducing inflammation. The increase in egg consumption creates the perception that it may lead to cardiovascular diseases due to its cholesterol content. However, there is insufficient evidence as to whether dietary cholesterol-lowers LDL-C. The possible potential mechanisms of egg impact on human health, MEDLINE, Embase, the Cochrane Central, www.ClinicalTrials.gov, PubMed, Science Direct, Google Scholar, and selected websites including) and databases were examined in this regard. With a view to delving into the rather mysterious relationship between egg cholesterol and blood cholesterol, it is necessary to understand the absorption of cholesterol from the egg and to know the functioning of the intestinal microbiota. Studies conducted to date have generally yielded inconsistent results regarding egg consumption and risks of CVD, diabetes, and metabolic syndrome.
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Affiliation(s)
- Nevin Sanlier
- Department of Nutrition and Dietetics, School of Health Sciences, Ankara Medipol University, Ankara, Turkey
| | - Dilara Üstün
- Department of Nutrition and Dietetics, Institute of Health Sciences, Ankara Medipol University, Ankara, Turkey
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15
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McCarthy D, Berg A. Weight Loss Strategies and the Risk of Skeletal Muscle Mass Loss. Nutrients 2021; 13:2473. [PMID: 34371981 PMCID: PMC8308821 DOI: 10.3390/nu13072473] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 12/18/2022] Open
Abstract
With energy intake restriction and exercise remaining the key diet and lifestyle approaches to weight loss, this is not without potential negative implications for body composition, metabolic health, and quality and quantity of life. Ideally, weight loss should be derived almost exclusively from the fat mass compartment as this is the main driver of metabolic disease, however, several studies have shown that there is an accompanying loss of tissue from the fat-free compartment, especially skeletal muscle. Population groups including post-menopausal women, the elderly, those with metabolic disease and athletes may be particularly at risk of skeletal muscle loss when following a weight management programme. Research studies that have addressed this issue across a range of population groups are reviewed with a focus upon the contribution of resistance and endurance forms of exercise and a higher intake dietary protein above the current guideline of 0.8 g/kg body weight/day. While findings can be contradictory, overall, the consensus appears that fat-free and skeletal muscle masses can be preserved, albeit to varying degrees by including both forms of exercise (but especially resistance forms) in the weight management intervention. Equally, higher intakes of protein can protect loss of these body compartments, acting either separately or synergistically with exercise. Elderly individuals in particular may benefit most from this approach. Thus, the evidence supports the recommendations for intakes of protein above the current guidelines of 0.8 g/kg body weight/d for the healthy elderly population to also be incorporated into the dietary prescription for weight management in this age group.
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Affiliation(s)
- David McCarthy
- Public Health Nutrition Research Group, London Metropolitan University, London N7 8DB, UK
| | - Aloys Berg
- Faculty of Medicine, University of Freiburg, 79117 Freiburg, Germany;
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16
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Vogtschmidt YD, Raben A, Faber I, de Wilde C, Lovegrove JA, Givens DI, Pfeiffer AFH, Soedamah-Muthu SS. Is protein the forgotten ingredient: Effects of higher compared to lower protein diets on cardiometabolic risk factors. A systematic review and meta-analysis of randomised controlled trials. Atherosclerosis 2021; 328:124-135. [PMID: 34120735 DOI: 10.1016/j.atherosclerosis.2021.05.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/25/2021] [Accepted: 05/19/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Higher protein (HP) diets may lead to lower cardiometabolic risk, compared to lower protein (LP) diets. This systematic review and meta-analysis aims to investigate the effects of HP versus LP diets on cardiometabolic risk factors in adults, using the totality of the current evidence from randomised controlled trials (RCTs). METHODS Systematic searches were conducted in electronic databases, up to November 2020. Random effects meta-analyses were conducted to pool the standardised mean differences (SMD) and 95% confidence intervals (CI). The main outcomes were weight loss, body mass index (BMI), waist circumference, fat mass, systolic and diastolic BP, total cholesterol, HDL-and LDL-cholesterol, triacylglycerol, fasting glucose and insulin, and glycated haemoglobin. RESULTS Fifty-seven articles reporting on 54 RCTs were included, involving 4344 participants (65% female, mean age: 46 (SD 10) years, mean BMI: 33 (SD 3) kg/m2), with a mean study duration of 18 weeks (range: 4 to 156 weeks). Compared to LP diets (range protein (E%):10-23%), HP diets (range protein (E%): 20-45%) led to more weight loss (SMD -0.13, 95% CI: -0.23, -0.03), greater reductions in fat mass (SMD -0.14, 95% CI: -0.24, -0.04), systolic BP (SMD -0.12, 95% CI: -0.21, -0.02), total cholesterol (SMD -0.11, 95% CI: -0.19, -0.02), triacylglycerol (SMD -0.22, 95% CI: -0.30, -0.14) and insulin (SMD -0.12, 95% CI: -0.22, -0.03). No significant differences were observed for the other outcomes. CONCLUSIONS Higher protein diets showed small, but favourable effects on weight loss, fat mass loss, systolic blood pressure, some lipid outcomes and insulin, compared to lower protein diets.
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Affiliation(s)
- Yakima D Vogtschmidt
- KingdomHugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights Campus, Harry Nursten Building, Reading RG6 6DZ, United Kingdom; Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6DZ, United Kingdom; Institute for Food, Nutrition and Health, University of Reading, Reading RG6 6AR, United Kingdom.
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 30, 1958, Frederiksberg C, Denmark; Steno Diabetes Center Copenhagen (SDCC), Niels Steensens Vej 2, 2820, Gentofte, Denmark
| | - Ilona Faber
- Department of Food Science, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
| | - Claudia de Wilde
- Center of Research on Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, 5000, LE Tilburg, the Netherlands
| | - Julie A Lovegrove
- KingdomHugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights Campus, Harry Nursten Building, Reading RG6 6DZ, United Kingdom; Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6DZ, United Kingdom; Institute for Food, Nutrition and Health, University of Reading, Reading RG6 6AR, United Kingdom
| | - D Ian Givens
- Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6DZ, United Kingdom; Institute for Food, Nutrition and Health, University of Reading, Reading RG6 6AR, United Kingdom
| | - Andreas F H Pfeiffer
- German Center for Diabetes Research, Partner Potsdam, Berlin, Germany; Department of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Charité University of Medicine, 12200, Berlin, Germany
| | - Sabita S Soedamah-Muthu
- Institute for Food, Nutrition and Health, University of Reading, Reading RG6 6AR, United Kingdom; Center of Research on Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, 5000, LE Tilburg, the Netherlands
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17
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Cai J, Chen Z, Wu W, Lin Q, Liang Y. High animal protein diet and gut microbiota in human health. Crit Rev Food Sci Nutr 2021; 62:6225-6237. [PMID: 33724115 DOI: 10.1080/10408398.2021.1898336] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The role of the intestinal flora in health and disease has become a research hotspot. Compared with carbohydrates and fats, proteins are metabolized primarily by microbial fermentation in the intestine. The production of protein fermentation products and metabolites depends on the composition, diversity, and metabolism of the gut microbiota. Several protein fermentation products, including indoles, phenols, polyamines, hydrogen sulfide (H2S), amines, and carnitine, are toxic. This study analyzes the relationship between high-protein diets (HPDs), the intestinal microbiota, and human health and disease. Long-term HPDs increase the risk of intestinal diseases, type 2 diabetes (T2DM), obesity, central nervous system (CNS) diseases, and cardiovascular diseases (CVD) by producing toxic metabolites in the colon, including amines, H2S, and ammonia. Short-term HPDs have little effect on the metabolism of healthy individuals under 65 years old. However, meeting the protein requirements of individuals over 65 years old using HPDs is more challenging. The adverse effects of HPDs on athletes are minimal. Natural compounds (plant extracts, whose main constituents are polysaccharides and polyphenols), prebiotics, probiotics, and regular physical exercise improve gut dysbiosis and reduce disease risk.
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Affiliation(s)
- Jie Cai
- Molecular Nutrition Branch, National Engineering Laboratory for Rice and By-product Deep Processing, College of Food Science and Engineering, Central South University of Forestry and Technology, Changsha, Hunan, China
| | - Zhongxu Chen
- Molecular Nutrition Branch, National Engineering Laboratory for Rice and By-product Deep Processing, College of Food Science and Engineering, Central South University of Forestry and Technology, Changsha, Hunan, China
| | - Wei Wu
- Molecular Nutrition Branch, National Engineering Laboratory for Rice and By-product Deep Processing, College of Food Science and Engineering, Central South University of Forestry and Technology, Changsha, Hunan, China
| | - Qinlu Lin
- Molecular Nutrition Branch, National Engineering Laboratory for Rice and By-product Deep Processing, College of Food Science and Engineering, Central South University of Forestry and Technology, Changsha, Hunan, China
| | - Ying Liang
- Molecular Nutrition Branch, National Engineering Laboratory for Rice and By-product Deep Processing, College of Food Science and Engineering, Central South University of Forestry and Technology, Changsha, Hunan, China
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18
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Ren H, Liu TC, Lu Y, Zhang K, Xu Y, Zhou P, Tang X. A comparison study of the influence of milk protein versus whey protein in high-protein diets on adiposity in rats. Food Funct 2021; 12:1008-1019. [PMID: 33502407 DOI: 10.1039/d0fo01960g] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
High-protein diets are known to reduce weight and fat deposition. However, there have been only a few studies on the efficacy of different types of high-protein diets in preventing obesity. Therefore, the emphasis of this study lies in comparing the efficacy of two high-protein diets (milk protein and whey protein) in preventing obesity and exploring specific mechanisms. Eighty Sprague Dawley rats were divided into two groups and fed with milk protein concentrate (MPC) and whey protein concentrate (WPC) for 12 weeks. Each group was divided into four levels: two low-fat regimens with either low or high protein content (L-14%, L-40%) and two high-fat regimens with either low or high protein content (H-14%, H-40%). The studies we have performed showed that rats treated with MPC at the 40% protein level had significantly reduced body weight, fat weight and fat ratio gain induced by a high-fat diet, while the protein level in the WPC group had no effect on body weight or body fat in rats fed with a high-fat diet. What is more, rats fed with MPC at the H-40% energy level showed a significant decrease in plasma triglyceride, total cholesterol and low-density lipoprotein cholesterol levels and a significant increase in plasma high-density lipoprotein cholesterol levels compared with the H-14% energy level group. In contrast, in the WPC groups, increasing the protein content in high-fat diets had no significant influence on plasma lipid levels. The results of the amino acid composition of the two proteins and plasma showed that the MPC diet of 40% protein level increased the transsulfuration pathway in rats, thereby increasing the level of H2S. This research work has shown that not all types of high-protein diets can effectively prevent obesity induced by high-fat diets, as effectiveness depends on the amino acid composition of the protein.
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Affiliation(s)
- Haoyi Ren
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi 214122, Jiangsu, China.
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19
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Hruby A, Jacques PF. Protein Intake and Human Health: Implications of Units of Protein Intake. Adv Nutr 2021; 12:71-88. [PMID: 32879937 PMCID: PMC7850043 DOI: 10.1093/advances/nmaa097] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/14/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023] Open
Abstract
Understanding the health effects of protein intake is bedeviled by a number of factors, including protein quality and source. In addition, different units, including grams, grams per kilogram body weight (g/kg BW), and percent energy, may contribute to confusion about protein's effects on health, especially BW-based units in increasingly obese populations. We aimed to review the literature and to conduct a modeling demonstration of various units of protein intake in relation to markers of cardiometabolic health. Data from the Framingham Heart Study Offspring (n = 1847; 60.3 y; 62.5% women) and Third Generation (n = 2548; 46.2 y; 55.3% women) cohorts and the NHANES 2003-04 (n = 1625; 46.2 y; 49.7% women) and 2005-06 (n = 1347; 43.7 y; 49.5% women) cycles were used to model cross-sectional associations between 7 protein units (grams, percent energy, g/kg ideal BW, g/kg actual BW, BW-adjusted g/kg actual BW, g/kg lean BW, and g/kg fat-free BW) and 9 cardiometabolic outcomes (fasting glucose, systolic and diastolic blood pressure, total and HDL cholesterol, triglycerides, BMI, waist circumference, and estimated glomerular filtration rate). The literature review indicated the use of myriad units of protein intake, with differential results on cardiometabolic outcomes. The modeling demonstration showed units expressed in BW were confounded by BW, irrespective of outcome. Units expressed in grams, percent energy, and ideal BW showed similar results, with or without adjustment for body size. After adjusting for BW, results of units expressed in BW aligned with results of grams, percent energy, and ideal BW. In conclusion, protein intake in cardiometabolic health appears to depend on protein's unit of expression. Authors should be specific about the use of WHO (g/kg ideal BW) compared with US (g/kg actual BW) units, and ideally use gram or percent energy in observational studies. In populations where overweight/obesity are prevalent, intake based on actual BW should be reevaluated.
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Affiliation(s)
- Adela Hruby
- Tufts University Friedman School of Nutrition Science and Policy, Boston, MA, USA
- Tufts University School of Medicine, Department of Public Health and Community Medicine, Boston, MA, USA
| | - Paul F Jacques
- Tufts University Friedman School of Nutrition Science and Policy, Boston, MA, USA
- Nutritional Epidemiology, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
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20
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Zhubi-Bakija F, Bajraktari G, Bytyçi I, Mikhailidis DP, Henein MY, Latkovskis G, Rexhaj Z, Zhubi E, Banach M. The impact of type of dietary protein, animal versus vegetable, in modifying cardiometabolic risk factors: A position paper from the International Lipid Expert Panel (ILEP). Clin Nutr 2021; 40:255-276. [PMID: 32620446 DOI: 10.1016/j.clnu.2020.05.017] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/08/2020] [Accepted: 05/14/2020] [Indexed: 02/08/2023]
Abstract
Proteins play a crucial role in metabolism, in maintaining fluid and acid-base balance and antibody synthesis. Dietary proteins are important nutrients and are classified into: 1) animal proteins (meat, fish, poultry, eggs and dairy), and, 2) plant proteins (legumes, nuts and soy). Dietary modification is one of the most important lifestyle changes that has been shown to significantly decrease the risk of cardiovascular (CV) disease (CVD) by attenuating related risk factors. The CVD burden is reduced by optimum diet through replacement of unprocessed meat with low saturated fat, animal proteins and plant proteins. In view of the available evidence, it has become acceptable to emphasize the role of optimum nutrition to maintain arterial and CV health. Such healthy diets are thought to increase satiety, facilitate weight loss, and improve CV risk. Different studies have compared the benefits of omnivorous and vegetarian diets. Animal protein related risk has been suggested to be greater with red or processed meat over and above poultry, fish and nuts, which carry a lower risk for CVD. In contrast, others have shown no association of red meat intake with CVD. The aim of this expert opinion recommendation was to elucidate the different impact of animal vs vegetable protein on modifying cardiometabolic risk factors. Many observational and interventional studies confirmed that increasing protein intake, especially plant-based proteins and certain animal-based proteins (poultry, fish, unprocessed red meat low in saturated fats and low-fat dairy products) have a positive effect in modifying cardiometabolic risk factors. Red meat intake correlates with increased CVD risk, mainly because of its non-protein ingredients (saturated fats). However, the way red meat is cooked and preserved matters. Thus, it is recommended to substitute red meat with poultry or fish in order to lower CVD risk. Specific amino acids have favourable results in modifying major risk factors for CVD, such as hypertension. Apart from meat, other animal-source proteins, like those found in dairy products (especially whey protein) are inversely correlated to hypertension, obesity and insulin resistance.
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Affiliation(s)
- Fjolla Zhubi-Bakija
- Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo
| | - Gani Bajraktari
- Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo; University of Prishtina, Medical Faculty, Prishtina, Kosovo; Department of Public Health and Clinical Medicine, Umeå University and Heart Centre, Umeå, Sweden.
| | - Ibadete Bytyçi
- Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo; University of Prishtina, Medical Faculty, Prishtina, Kosovo
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, UK
| | - Michael Y Henein
- Department of Public Health and Clinical Medicine, Umeå University and Heart Centre, Umeå, Sweden; Molecular & Clinical Sciences Research Institute, St George University London, UK; Brunel University, Middlesex, UK
| | - Gustavs Latkovskis
- Institute of Cardiology and Regenerative Medicine, Faculty of Medicine, University of Latvia, Riga, Latvia; Pauls Stradins Clinical University Hospital, Riga, Latvia
| | - Zarife Rexhaj
- Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo
| | - Esra Zhubi
- University of Prishtina, Medical Faculty, Prishtina, Kosovo
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland; Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland.
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21
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Englert I, Bosy-Westphal A, Bischoff SC, Kohlenberg-Müller K. Impact of Protein Intake during Weight Loss on Preservation of Fat-Free Mass, Resting Energy Expenditure, and Physical Function in Overweight Postmenopausal Women: A Randomized Controlled Trial. Obes Facts 2021; 14:259-270. [PMID: 33975325 PMCID: PMC8255642 DOI: 10.1159/000514427] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/31/2020] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Weight loss in old age increases the risk of sarcopenia caused by the age-related reduction of fat-free mass (FFM). Due to the strong correlation between FFM and resting energy expenditure (REE), the maintenance of this must also be considered. Besides, the physical function (PF) must be maintained. OBJECTIVE The impact of protein intake on changes in FFM, REE, and PF during weight loss in overweight postmenopausal women was investigated. METHODS Fifty-four postmenopausal women (BMI 30.9 ± 3.4; age 59 ± 7 years) were randomized into 2 groups receiving energy-restricted diets with either 0.8 g (normal protein; NP) or 1.5 g protein/kg body weight (high protein; HP) for 12 weeks, followed by a 6-month follow-up phase with an ad libitum food intake. FFM, REE, and PF (strength, endurance, and balance) were measured at baseline, after weight loss, and after follow-up. RESULTS Forty-six women completed the weight loss intervention and 29 were followed up. The weight loss was -4.6 ± 3.6 kg (HP) and -5.2 ± 3.4 kg (NP; both p < 0.001) and the weight regain during follow-up was 1.3 ± 2.8 kg (HP; p = 0.03) and 0.4 ± 2.5 kg (NP; p = 0.39), with no differences between groups. Similar decreases in FFM (-0.9 ± 1.1 [HP] vs. -1.0 ± 1.3 kg [NP]) and REE (-862 ± 569 [HP] vs. -1,000 ± 561 kJ [NP]; both p < 0.001) were observed in both groups. During follow-up, no changes in FFM were detected in either group, whereas in the NP group the REE increased again (+138 ± 296; p = 0.02). The main determinants of FFM loss were the energy deficit and the speed of weight loss. In the NP group, the Short Physical Performance Battery score improved with weight loss (+0.6 ± 0.8; p < 0.001) and handgrip strength decreased (-1.7 ± 3.4 kg; p < 0.001), whereas no changes were observed in the HP group. CONCLUSIONS An HP weight-loss diet without exercise had no impact on preservation of FFM and REE but may help to maintain muscle strength in postmenopausal women.
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Affiliation(s)
- Isabell Englert
- Fulda University of Applied Sciences, Fulda, Germany
- *Isabell Englert,
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22
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Liu C, Xue Y, Wang Y, Zhang Y, Zhang D, Qiao D, Wang B, Shen F, Mao Z, Yu S, Wang C, Li W, Li X. Association between daily egg intake and lipid profiles in adults from the Henan rural cohort study. Nutr Metab Cardiovasc Dis 2020; 30:2171-2179. [PMID: 33097413 DOI: 10.1016/j.numecd.2020.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 04/08/2020] [Accepted: 07/01/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS The association between daily egg intake and dyslipidemia remains a contentious issue. Therefore, our study was aimed to explore the relation of daily egg intake to lipid profile; and whether the association was mediated by body mass index (BMI). METHODS AND RESULTS A total of 39,021 participants (18-79 years) were enrolled from the Henan Rural Cohort Study. Data on egg consumptions and blood lipid indices were collected with standardized processes. Logistic regression and restricted cubic splines were used to estimate the odds ratio (OR) and 95% confidence intervals (95% CI). Mediation analysis using bootstrap was performed to examine the contribution of BMI to daily egg intake and HDL-C. The participants were divided into 3 egg intake groups (<26.79 g/d, 26.79-62.50 g/d, >62.5 g/d). According to our results, comparing with the low daily egg consumption group, medium and high egg intake tertiles were related with increased high-TC (ORmedium = 1.546, 95%CI (1.417,1.688); ORhigh = 1.902,95%CI (1.703, 2.124)), high LDL-C (ORmedium = 1.224, 95%CI (1.121, 1.337); ORhigh = 1.368,95%CI (1.220, 1.534)) and non-HDL-C(ORmedium = 1.486,95%CI(1.358,1.625); ORhigh = 1.715,95%CI (1.499, 1.888)), as well as inversely associated with high-TG (ORmedium = 0.825, 95% CI(0.778, 0.875); ORhigh = 0.778,95%CI(0.718,0.844)) and low HDL-C (ORmedium = 0.914, 95%CI (0.858, 0.973); ORhigh = 0.756,95%CI(0.693,0.825)). Moreover, mediation analysis showed that both of BMI and WC partly mediated the relationship between daily egg intake and HDL-C. CONCLUSIONS Our results suggested that the daily egg intake may have a role in effect on lipid profiles, and the effect of daily egg intake on HDL-C may be partly mediated by BMI and WC.
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Affiliation(s)
- Chang Liu
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Yuan Xue
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Yan Wang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Yujing Zhang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Dongdong Zhang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Dou Qiao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Bingya Wang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Fang Shen
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Songcheng Yu
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Wenjie Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Xing Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China.
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Abstract
PURPOSE OF REVIEW High-protein intake is commonly recommended to help people manage body weight. However, high-protein intake could have adverse health consequences. Here we review the latest findings concerning the effect of high-protein intake on cardiometabolic health. RECENT FINDINGS Calorie-reduced, high-protein, low-carbohydrate diets lower plasma glucose in people with type 2 diabetes (T2D). However, when carbohydrate intake is not markedly reduced, high-protein intake often does not alter plasma glucose and increases insulin and glucagon concentrations, which are risk factors for T2D and ischemic heart disease. High-protein intake does not alter plasma triglyceride and cholesterol concentrations but promotes atherogenesis in animal models. The effect of high-protein intake on liver fat remains unclear. In population studies, high-protein intake is associated with increased risk for T2D, nonalcoholic fatty liver disease, and possibly cardiovascular diseases. SUMMARY The relationship between protein intake and cardiometabolic health is complex and influenced by concomitant changes in body weight and overall diet composition. Although a high-protein, low-carbohydrate, reduced-energy diet can have beneficial effects on body weight and plasma glucose, habitual high-protein intake, without marked carbohydrate and energy restriction, is associated with increased cardiometabolic disease risk, presumably mediated by the changes in the hormonal milieu after high-protein intake.
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Affiliation(s)
- Alan Fappi
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
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Nutrient-dense protein as a primary dietary strategy in healthy ageing: please sir, may we have more? Proc Nutr Soc 2020; 80:264-277. [PMID: 33050965 DOI: 10.1017/s0029665120007892] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A progressive decrement in muscle mass and muscle function, sarcopoenia, accompanies ageing. The loss of skeletal muscle mass and function is the main feature of sarcopoenia. Preventing the loss of muscle mass is relevant since sarcopoenia can have a significant impact on mobility and the quality of life of older people. Dietary protein and physical activity have an essential role in slowing muscle mass loss and helping to maintain muscle function. However, the current recommendations for daily protein ingestion for older persons appear to be too low and are in need of adjustment. In this review, we discuss the skeletal muscle response to protein ingestion, and review the data examining current dietary protein recommendations in the older subjects. Furthermore, we review the concept of protein quality and the important role that nutrient-dense protein (NDP) sources play in meeting overall nutrient requirements and improving dietary quality. Overall, the current evidence endorses an increase in the daily ingestion of protein with emphasis on the ingestion of NDP choices by older adults.
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Myoprotective Whole Foods, Muscle Health and Sarcopenia: A Systematic Review of Observational and Intervention Studies in Older Adults. Nutrients 2020; 12:nu12082257. [PMID: 32731580 PMCID: PMC7469021 DOI: 10.3390/nu12082257] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/24/2020] [Accepted: 07/25/2020] [Indexed: 12/17/2022] Open
Abstract
Decline in skeletal muscle strength and mass (sarcopenia) accelerates with age, leading to adverse health outcomes and poor quality of life. Diet plays a crucial role in muscle ageing being an important element of a healthy lifestyle. However, unlike single nutrients, such as dietary protein, or dietary patterns, such as the Mediterranean diet, the relationship between individual whole foods and muscle health has not been systematically evaluated. We aimed to investigate which whole foods (meat, fish, eggs, fruit and vegetables, and non-liquid dairy) may be beneficial (myoprotective) for ageing muscle and sarcopenia in adults aged ≥ 50 years. Nineteen observational and nine intervention studies were identified through systematic searches of the four electronic databases (last search: March 2020). The synthesis of findings showed strong and consistent evidence for a beneficial effect of lean red meat on muscle mass or lean tissue mass in both observational and intervention studies. Higher intake of fruit and vegetables was associated with better muscle function in observational studies, but the evidence from intervention studies was scarce. Non-liquid dairy foods were beneficial for muscle mass in both observational and intervention studies. There was moderate evidence for the role of these foods in muscle strength and sarcopenia, and limited or inconclusive evidence for the benefits of other whole foods (e.g., fish, eggs) for muscle health in older adults. Although current nutritional recommendations are often based on a single nutrient approach, further research about the role of protein-rich and other foods in muscle health will allow for the development of guidelines that are based on whole foods, also highlighting the potential importance of non-protein nutrients within these foods for myoprotection in older adults.
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Khalighi Sikaroudi M, Soltani S, Kolahdouz-Mohammadi R, Clayton ZS, Fernandez ML, Varse F, Shidfar F. The responses of different dosages of egg consumption on blood lipid profile: An updated systematic review and meta-analysis of randomized clinical trials. J Food Biochem 2020; 44:e13263. [PMID: 32524644 DOI: 10.1111/jfbc.13263] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/01/2020] [Accepted: 04/04/2020] [Indexed: 12/16/2022]
Abstract
Diverse notions exist regarding egg intake, which is one of the main sources of dietary cholesterol, and its effect on blood lipids. We conducted this study to update the previous meta-analysis for their flaw in calculated effect size. PubMed, Scopus, ISI, and Cochrane were searched up to April 2019, for relevant randomized controlled clinical trials. Mean changes in total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), triglyceride (TG), very low-density lipoprotein cholesterol (VLDL-C), LDL-C/HDL-C, TC/HDL-C, apolipoprotein (apo)A1, and apoB100 were assessed. Meta-analysis of 66 RCTs with 3,185 participants revealed that egg consumption can significantly increase TC, LDL-C, HDL-C, TC/HDL-C, apoA1/and B100, but there was no significant effect on other serum lipids. Dose-response analysis showed a linear effect for TC, HDL-C, ApoA1, ApoB100, and nonlinear for LDL-C, and TC/HDL-C. In conclusion, intake of more than one egg daily in less than 12 weeks may increase some blood lipids without any changes in the ratio of LDL-C/HDL-C. PRACTICAL APPLICATIONS: There are controversies reports for egg intake, which is one of the main sources of dietary cholesterol. This study provides comprehensive information about the effect of the number of eggs consumed per day (dietary cholesterol) on blood lipids for nutritionists, physicians, researchers, and the general population. In this regard, our results indicated that there is a linear correlation between consumption of greater than one egg per day in a short time (no long time) and increasing lipid profiles which may increase the risk of cardiovascular diseases. However, consumption of one egg daily can be safe and this can be a useful recommendation for prevention of cardiovascular disease and promotion of healthy life which indeed are the potential or actual uses of this research.
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Affiliation(s)
| | - Sepideh Soltani
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Roya Kolahdouz-Mohammadi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Maria Luz Fernandez
- Department of Nutirional Sciences, University of Connecticut, Storrs, CT, USA
| | - Fatemeh Varse
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Farzad Shidfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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27
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Wirth J, Hillesheim E, Brennan L. The Role of Protein Intake and its Timing on Body Composition and Muscle Function in Healthy Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Nutr 2020; 150:1443-1460. [PMID: 32232404 DOI: 10.1093/jn/nxaa049] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 01/16/2020] [Accepted: 02/12/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Increased protein intake has been suggested to improve gains in muscle mass and strength in adults. Furthermore, the timing of protein intake has been discussed as a margin of opportunity for improved prevention measures. OBJECTIVE This systematic review investigated the effect of protein supplementation on body composition and muscle function (strength and synthesis) in healthy adults, with an emphasis on the timing of protein intake. METHODS Randomized controlled trials were identified using PubMed, Web of Science, CINAHL, and Embase, up to March 2019. For meta-analyses, data on lean body mass (LBM), handgrip strength, and leg press strength were pooled by age group (mean age 18-55 or >55 y) and timing of protein intake. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations approach. RESULTS Data from 65 studies with 2907 participants (1514 men and 1380 women, 13 unknown sex) were included in the review. Twenty-six, 8, and 24 studies were used for meta-analysis on LBM, handgrip strength, and leg press strength, respectively. The protein supplementation was effective in improving (mean difference; 95% CI) LBM in adults (0.62 kg; 0.36, 0.88) and older adults (0.46 kg; 0.23, 0.70), but not handgrip strength (older adults: 0.26 kg; -0.51, 1.04) and leg press strength (adults: 5.80 kg; -0.33, 11.93; older adults: 1.97 kg; -2.78, 6.72). Sensitivity analyses removing studies without exercise training had no impact on the outcomes. Data regarding muscle synthesis were scarce and inconclusive. Subgroup analyses showed no beneficial effect of a specific timing of protein intake on LBM, handgrip strength, and leg press strength. CONCLUSION Overall, the results support the positive impact of protein supplementation on LBM of adults and older adults, independently of intake timing. Effects on muscle strength and synthesis are less clear and need further investigation. This systematic review was registered on PROSPERO as CRD42019126742.
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Affiliation(s)
- Janine Wirth
- Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, Ireland.,Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin, Ireland
| | - Elaine Hillesheim
- Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, Ireland.,Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin, Ireland
| | - Lorraine Brennan
- Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, Ireland.,Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin, Ireland
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28
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Hezaveh ZS, Sikaroudi MK, Vafa M, Clayton ZS, Soltani S. Effect of egg consumption on inflammatory markers: a systematic review and meta-analysis of randomized controlled clinical trials. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2019; 99:6663-6670. [PMID: 31259415 PMCID: PMC7189602 DOI: 10.1002/jsfa.9903] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 05/24/2019] [Accepted: 06/03/2019] [Indexed: 05/12/2023]
Abstract
There is little evidence about whether eggs affect inflammation. The aim of this meta-analysis was to explore the effects of egg consumption on inflammation. A systematic search of online databases (Institute for Scientific Information (ISI), Scopus, Ovid, PubMed, Cochrane) was used to gather clinical trials that assessed the effect of egg consumption on circulating inflammatory biomarkers. Using a random-effects model, pooled weighted mean differences (WMD) and corresponding standard deviations (SD) were calculated. Of the 21 eligible studies found, nine trials were eligible for analysis. Eight trials assessed high-sensitivity C-reactive protein (hs-CRP), four trials assessed interleukin-6 (IL-6), and five trials assessed tumor necrosis factor-alpha (TNF-α). Egg consumption did not affect hs-CRP (WMD 0.24 mg/L; 95% CI: -0.43, 0.90; I2 = 53.8; P = 0.48), IL-6 (WMD 0.20 pg/mL; 95% CI: -0.71, 1.11; I2 = 69.3; P = 0.50), and TNF-α (WMD: -0.38 pg/mL; 95% CI: -0.87, 0.10; I2 = 0.00; P = 0.12) relative to controls. Overall, this meta-analysis revealed that egg consumption had no significant effect on serum biomarkers of inflammation in adults. © 2019 Society of Chemical Industry.
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Affiliation(s)
- Zohreh Sajadi Hezaveh
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Mohammadreza Vafa
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Sepideh Soltani
- Department of Nutrition, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Correspondence to: S Soltani, Yazd Cardiovascular Research Center, Shahid Sadoughi University ofMedical Sciences, Yazd, Iran.
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Protein Intake at Twice the RDA in Older Men Increases Circulatory Concentrations of the Microbiome Metabolite Trimethylamine-N-Oxide (TMAO). Nutrients 2019; 11:nu11092207. [PMID: 31547446 PMCID: PMC6770800 DOI: 10.3390/nu11092207] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 12/26/2022] Open
Abstract
Higher dietary protein intake is increasingly recommended for the elderly; however, high protein diets have also been linked to increased cardiovascular disease (CVD) risk. Trimethylamine-N-oxide (TMAO) is a bacterial metabolite derived from choline and carnitine abundant from animal protein-rich foods. TMAO may be a novel biomarker for heightened CVD risk. The purpose of this study was to assess the impact of a high protein diet on TMAO. Healthy men (74.2 ± 3.6 years, n = 29) were randomised to consume the recommended dietary allowance of protein (RDA: 0.8 g protein/kg bodyweight/day) or twice the RDA (2RDA) as part of a supplied diet for 10 weeks. Fasting blood samples were collected pre- and post-intervention for measurement of TMAO, blood lipids, glucose tolerance, insulin sensitivity, and inflammatory biomarkers. An oral glucose tolerance test was also performed. In comparison with RDA, the 2RDA diet increased circulatory TMAO (p = 0.002) but unexpectedly decreased renal excretion of TMAO (p = 0.003). LDL cholesterol was increased in 2RDA compared to RDA (p = 0.049), but no differences in other biomarkers of CVD risk and insulin sensitivity were evident between groups. In conclusion, circulatory TMAO is responsive to changes in dietary protein intake in older healthy males.
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30
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Barclay RD, Burd NA, Tyler C, Tillin NA, Mackenzie RW. The Role of the IGF-1 Signaling Cascade in Muscle Protein Synthesis and Anabolic Resistance in Aging Skeletal Muscle. Front Nutr 2019; 6:146. [PMID: 31552262 PMCID: PMC6746962 DOI: 10.3389/fnut.2019.00146] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 08/23/2019] [Indexed: 12/14/2022] Open
Abstract
Sarcopenia is defined as the combined loss of skeletal muscle strength, function, and/or mass with aging. This degenerative loss of muscle mass is associated with poor quality of life and early mortality humans. The loss of muscle mass occurs due to acute changes in daily muscle net protein balance (NPB). It is generally believed a poor NPB occurs due to reduced muscle protein synthetic responses to exercise, dietary amino acid availability, or an insensitivity of insulin to suppress breakdown. Hence, aging muscles appear to be resistant to the anabolic action of exercise and protein (amino acids or hormonal) when compared to their younger counterparts. The mechanisms that underpin anabolic resistance to anabolic stimuli (protein and resistance exercise) are multifactorial and may be partly driven by poor lifestyle choices (increased sedentary time and reduced dietary protein intake) as well as an inherent dysregulated mechanism in old muscles irrespective of the environmental stimuli. The insulin like growth factor 1 (IGF-1), Akt /Protein Kinase B and mechanistic target of rapamycin (mTOR) pathway is the primary driver between mechanical contraction and protein synthesis and may be a site of dysregulation between old and younger people. Therefore, our review aims to describe and summarize the differences seen in older muscle in this pathway in response to resistance exercise (RE) and describe approaches that researchers have sought out to maximize the response in muscle. Furthermore, this review will present the hypothesis that inositol hexakisphosphate kinase 1 (IP6K1) may be implicated in IGF-1 signaling and thus sarcopenia, based on recent evidence that IGF-1 and insulin share some intracellular bound signaling events and that IP6K1 has been implicated in skeletal muscle insulin resistance.
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Affiliation(s)
- Richie D Barclay
- Department of Life Sciences, University of Roehampton, London, United Kingdom
| | - Nicholas A Burd
- Division of Nutritional Sciences, Department of Kinesiology and Community Health, University of Illinois, Urbana, IL, United States
| | - Christopher Tyler
- Department of Life Sciences, University of Roehampton, London, United Kingdom
| | - Neale A Tillin
- Department of Life Sciences, University of Roehampton, London, United Kingdom
| | - Richard W Mackenzie
- Department of Life Sciences, University of Roehampton, London, United Kingdom
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31
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Nie C, Xie F, Ma N, Bai Y, Zhang W, Ma X. Nutrients Mediate Bioavailability and Turnover of Proteins in Mammals. Curr Protein Pept Sci 2019; 20:661-665. [DOI: 10.2174/1389203720666190125111235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 12/30/2018] [Accepted: 01/10/2019] [Indexed: 12/31/2022]
Abstract
As a major component of biologically active compounds in the body, proteins contribute to the synthesis of body tissues for the renewal and growth of the body. The high level of dietary protein and the imbalance of amino acid (AA) composition in mammals result in metabolic disorders, inefficient utilization of protein resources and increased nitrogen excretion. Fortunately, nutritional interventions can be an effective way of attenuating the nitrogen excretion and increasing protein utilization, which include, but are not limited to, formulating the AA balance and protein-restricted diet supplementing with essential AAs, and adding probiotics in the diet. This review highlights recent advances in the turnover of dietary proteins and mammal’s metabolism for health, in order to improve protein bioavailability through nutritional approach.
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Affiliation(s)
- Cunxi Nie
- College of Animal Science and Technology, Shihezi University, Shihezi, China
| | - Fei Xie
- State key Lab of Animal Nutrition, Institute of Animal Science, Chinese Academy of Agricultural Science, Beijing 100193, China
| | - Ning Ma
- State Key Laboratory of Animal Nutrition, College of Animal Science and Technology, China Agricultural University, Beijing, China
| | - Yueyu Bai
- Henan Institute of Science and Technology, Xinxiang, Henan 453003, China
| | - Wenju Zhang
- College of Animal Science and Technology, Shihezi University, Shihezi, China
| | - Xi Ma
- College of Animal Science and Technology, Shihezi University, Shihezi, China
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Kirk B, Mooney K, Amirabdollahian F, Khaiyat O. Exercise and Dietary-Protein as a Countermeasure to Skeletal Muscle Weakness: Liverpool Hope University - Sarcopenia Aging Trial (LHU-SAT). Front Physiol 2019; 10:445. [PMID: 31133863 PMCID: PMC6524700 DOI: 10.3389/fphys.2019.00445] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 04/01/2019] [Indexed: 01/06/2023] Open
Abstract
Objective To investigate the effects of a 16-week concurrent exercise regimen [resistance exercise (RE) + functional exercise (FE)] in combination with, or without, a leucine-enriched whey protein isolate supplement on muscle strength, physical functioning, aerobic capacity, and cardiometabolic health in older adults (≥60 years). Physical activity levels were also evaluated 6 months post-cessation of the intervention. Methods Forty-six, community-dwelling, previously untrained males, and females [age: 68 ± 5 years (mean ± SD); BMI: 27.8 ± 6.2 kg/m2] who completed the trial were initially randomized to one of two independent arms [Exercise n = 24 (E); Exercise+Protein n = 22 (EP)]. Both arms completed 16 weeks of RE (performed to fatigue) (2 times/week) with FE (1 time/week) on non-consecutive days. Additionally, EP were administered a leucine-enriched whey protein supplement (3 times/day) for 16 weeks based on individual body-weight (1.5 g/kg/day). Results As a result of dietary supplementation, protein intake increased in EP (∼1.2 ± 0.4 to 1.5 ± 0.7 g/kg/day) during the intervention. Maximal strength (1RM) values for leg press (E: +39 ± 7 kg, p = 0.006; EP: +63 ± 7 kg, p < 0.001), chest press (E: +22 ± 4 kg, p < 0.001; EP: +21 ± 6 kg, p < 0.001), and bicep curl (E: +7 ± 0 kg, p = 0.002; EP: +6 ± 1 kg, p = 0.008) significantly increased in E and EP respectively, with no differences between arms (p > 0.05). Physical functioning in the obstacle course (E: -5.1 ± 6.8 s, p < 0.001; EP: -2.8 ± 0.8 s, p < 0.001) and short-physical performance battery scores (E: +0.5 ± 0.5, p = <0.001; EP: +0.4 ± 0.5, p = 0.038), and aerobic capacity in the 6-min walk test (E: +37 ± 24 m, p = 0.014; EP: +36 ± 3 m, p = 0.005) improved in E and EP respectively, with no differences between arms (p > 0.05). No significant change was observed for markers of cardiometabolic health (glycaemic control or blood pressure) (p > 0.05). At follow-up, 86% of older adults reported to performing physical activity ≥1 per week. Of those, 61% were still participating in strength- and cardiovascular- based exercise. Conclusion Concurrent exercise (RE + FE) offers a potent method to combat age-related muscle weakness, and our results suggest a high proportion of older adults may continue to exercise unsupervised. However, leucine-enriched whey protein isolate supplementation did not confer any additional benefit in those already consuming ample amounts of dietary protein at trial enrolment. Future trials should utilize a whole-foods approach and investigate the effects in frail and non-frail older adults habitually consuming the RDA of protein, to assess if a higher intake of protein is needed to delay the onset of muscle weakness. Trial Registration Clinicaltrials.gov Identifier: NCT02912130.
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Affiliation(s)
- Ben Kirk
- School of Health Sciences, Liverpool Hope University, Liverpool, United Kingdom
| | - Kate Mooney
- School of Health Sciences, Liverpool Hope University, Liverpool, United Kingdom
| | | | - Omid Khaiyat
- School of Health Sciences, Liverpool Hope University, Liverpool, United Kingdom
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33
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Yannakoulia M, Poulimeneas D, Mamalaki E, Anastasiou CA. Dietary modifications for weight loss and weight loss maintenance. Metabolism 2019; 92:153-162. [PMID: 30625301 DOI: 10.1016/j.metabol.2019.01.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 12/29/2018] [Accepted: 01/02/2019] [Indexed: 12/15/2022]
Abstract
Worldwide obesity rates remain at a rise, and to treat obesity is at the top of the global public health agenda. In 2013, the AHA/ACC/TOS obesity management guidelines were published, in essence suggesting that any dietary scheme seems to be effective for weight loss, as long as it can induce a sustainable energy deficit. In the present review, we update and critically discuss available information regarding dietary modifications for weight loss and weight loss maintenance, published after the 2013 guidelines. Regarding weight loss, we found no proof to support that a single dietary scheme, be it nutrient-, food group- or dietary pattern- based, is more efficacious of the other for achieving weight loss. For weight loss maintenance, published interventions point towards the same direction, although inconclusively. Most research explores the effect of weight loss regimes on weight loss maintenance and not the effect of the diet during weight loss maintenance, and this literature gap should be more thoroughly investigated.
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Affiliation(s)
- Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University of Athens, Greece.
| | | | - Eirini Mamalaki
- Department of Nutrition and Dietetics, Harokopio University of Athens, Greece
| | - Costas A Anastasiou
- Department of Nutrition and Dietetics, Harokopio University of Athens, Greece
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Abstract
PURPOSE OF REVIEW Together with age-related body composition changes, the increased prevalence of obesity observed in the past few decades in older individuals has led to a condition called sarcopenic obesity, characterized by a mismatch between muscle mass and fat mass. The operative definition of sarcopenic obesity is still under discussion and creates difficulties in clinical practice. Muscle weakness, rather than low muscle mass, was previously proposed as an alternative criterion and, more recently, the dynapenic abdominal obese phenotype is of increasing interest because of its unfavorable health consequences and usability in clinical practice. RECENT FINDINGS This review focuses on the most recent findings of pathogenic inter-relationships between adipose tissue and muscle. Recent studies on health consequences of sarcopenic obesity and dynapenic abdominal obesity are also examined. Despite the lack of consensus on a definition for sarcopenic obesity, progress has been made in the delineation of the treatment principles for this condition. SUMMARY Further research is needed to compare different definitions of sarcopenic/dynapenic obesity to clarify the relationship between obesity and the most important adverse outcomes in the elderly. The next step will be the definition of best possible therapeutic approaches for this condition.
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Affiliation(s)
- Mauro Zamboni
- Geriatric Division, Department of Medicine, University of Verona
- HealthyAging Center Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Sofia Rubele
- Geriatric Division, Department of Medicine, University of Verona
- HealthyAging Center Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Andrea P Rossi
- Geriatric Division, Department of Medicine, University of Verona
- HealthyAging Center Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
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