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Ortega RM, Arribas-López N, Salas-González MD, Aparicio A, González-Rodríguez LG, Bermejo LM, Lozano-Estevan MDC, Cuadrado-Soto E, López-Sobaler AM, Loria-Kohen V. High-Protein Processed Foods: Impact on Diet, Nutritional Status, and Possible Effects on Health. Nutrients 2024; 16:1697. [PMID: 38892630 PMCID: PMC11174509 DOI: 10.3390/nu16111697] [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: 05/06/2024] [Revised: 05/25/2024] [Accepted: 05/27/2024] [Indexed: 06/21/2024] Open
Abstract
Proteins are macronutrients with multiple health benefits, but excessive consumption can negatively affect health. This study aimed to evaluate the characteristics of a sample of high-protein processed foods (HPPFs), describe how their consumption affects dietary balance, and acquire knowledge of the consumption patterns of these products in a Spanish population. A sample of HPPFs available in supermarkets and on websites was collected. The contribution to recommended protein intakes was calculated using national and international references and considering the single consumption of the HPPFs and the product plus 150 g of meat. Furthermore, an online survey was conducted among a convenience sample. A total of 36 enriched protein products were evaluated. The percentage of proteins in these products ranges from 10 to 88%. The contribution of the protein recommended intake was within a range of 87.4-306.6% and 66.4-232.8% (women and men, respectively), only considering the additional proteins from 150 g of meat. One hundred thirty-nine participants completed the survey; 67.6% affirmed that they had consumed HPPFs, and half consumed them without following any consumption control. Since these products are accessible to everyone in supermarkets and protein intake is generally higher than the recommended limits, regulating the mass sale of HPPFs is essential to ensure they do not lead to protein overconsumption.
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Affiliation(s)
- Rosa M. Ortega
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (R.M.O.); (N.A.-L.); (M.D.S.-G.); (A.A.); (L.G.G.-R.); (L.M.B.); (M.D.C.L.-E.); (E.C.-S.); (A.M.L.-S.)
- VALORNUT Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
- San Carlos Health Research Institute (IdISSC), 28040 Madrid, Spain
| | - Nerea Arribas-López
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (R.M.O.); (N.A.-L.); (M.D.S.-G.); (A.A.); (L.G.G.-R.); (L.M.B.); (M.D.C.L.-E.); (E.C.-S.); (A.M.L.-S.)
| | - María Dolores Salas-González
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (R.M.O.); (N.A.-L.); (M.D.S.-G.); (A.A.); (L.G.G.-R.); (L.M.B.); (M.D.C.L.-E.); (E.C.-S.); (A.M.L.-S.)
- VALORNUT Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
| | - Aránzazu Aparicio
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (R.M.O.); (N.A.-L.); (M.D.S.-G.); (A.A.); (L.G.G.-R.); (L.M.B.); (M.D.C.L.-E.); (E.C.-S.); (A.M.L.-S.)
- VALORNUT Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
- San Carlos Health Research Institute (IdISSC), 28040 Madrid, Spain
| | - Liliana Guadalupe González-Rodríguez
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (R.M.O.); (N.A.-L.); (M.D.S.-G.); (A.A.); (L.G.G.-R.); (L.M.B.); (M.D.C.L.-E.); (E.C.-S.); (A.M.L.-S.)
- VALORNUT Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
| | - Laura M. Bermejo
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (R.M.O.); (N.A.-L.); (M.D.S.-G.); (A.A.); (L.G.G.-R.); (L.M.B.); (M.D.C.L.-E.); (E.C.-S.); (A.M.L.-S.)
- VALORNUT Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
- San Carlos Health Research Institute (IdISSC), 28040 Madrid, Spain
| | - María Del Carmen Lozano-Estevan
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (R.M.O.); (N.A.-L.); (M.D.S.-G.); (A.A.); (L.G.G.-R.); (L.M.B.); (M.D.C.L.-E.); (E.C.-S.); (A.M.L.-S.)
- VALORNUT Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
| | - Esther Cuadrado-Soto
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (R.M.O.); (N.A.-L.); (M.D.S.-G.); (A.A.); (L.G.G.-R.); (L.M.B.); (M.D.C.L.-E.); (E.C.-S.); (A.M.L.-S.)
- VALORNUT Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
| | - Ana M. López-Sobaler
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (R.M.O.); (N.A.-L.); (M.D.S.-G.); (A.A.); (L.G.G.-R.); (L.M.B.); (M.D.C.L.-E.); (E.C.-S.); (A.M.L.-S.)
- VALORNUT Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
- San Carlos Health Research Institute (IdISSC), 28040 Madrid, Spain
| | - Viviana Loria-Kohen
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (R.M.O.); (N.A.-L.); (M.D.S.-G.); (A.A.); (L.G.G.-R.); (L.M.B.); (M.D.C.L.-E.); (E.C.-S.); (A.M.L.-S.)
- VALORNUT Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
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Muscogiuri G, De Marco O, Di Lorenzo T, Amicone M, Capuano I, Riccio E, Iaccarino G, Bianco A, Di Risi T, Pisani A. Diet and Physical Activity in Fabry Disease: A Narrative Review. Nutrients 2024; 16:1061. [PMID: 38613094 PMCID: PMC11013480 DOI: 10.3390/nu16071061] [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: 02/26/2024] [Revised: 03/31/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Fabry disease (FD) is caused by mutations in the galactosidase alpha (GLA) gene which lead to the accumulation of globotriaosylceramide (Gb-3). Enzyme replacement therapy (ERT) and oral chaperone therapy are the current pharmacological treatments for this condition. However, in the literature, there is a growing emphasis on exploring non-pharmacological therapeutic strategies to improve the quality of life of patients with FD. In particular, the nutritional approach to FD has been marginally addressed in the scientific literature, although specific dietary interventions may be useful for the management of nephropathy and gastrointestinal complications, which are often present in patients with FD. Especially in cases of confirmed diagnosis of irritable bowel syndrome (IBS), a low-FODMAP diet can represent an effective approach to improving intestinal manifestations. Furthermore, it is known that some food components, such as polyphenols, may be able to modulate some pathogenetic mechanisms underlying the disease, such as inflammation and oxidative stress. Therefore, the use of healthy dietary patterns should be encouraged in this patient group. Sports practice can be useful for patients with multi-organ involvement, particularly in cardiovascular, renal, and neurological aspects. Therefore, the aim of this review is to summarize current knowledge on the role of nutrition and physical activity in FD patients.
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Affiliation(s)
- Giovanna Muscogiuri
- Unità di Endocrinologia, Dipartimento di Medicina Clinica e Chirurgia, Diabetologia ed Andrologia, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy;
- Endocrinology Unit, Centro Italiano per la Cura e il Benessere del Paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy;
| | - Oriana De Marco
- Chair of Nephrology “Federico II”, Department of Public Health, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy; (M.A.); (I.C.); (T.D.R.); or (A.P.)
| | - Tonia Di Lorenzo
- Endocrinology Unit, Centro Italiano per la Cura e il Benessere del Paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy;
| | - Maria Amicone
- Chair of Nephrology “Federico II”, Department of Public Health, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy; (M.A.); (I.C.); (T.D.R.); or (A.P.)
| | - Ivana Capuano
- Chair of Nephrology “Federico II”, Department of Public Health, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy; (M.A.); (I.C.); (T.D.R.); or (A.P.)
| | - Eleonora Riccio
- Institute for Biomedical Research and Innovation, National Research Council of Italy, 90146 Palermo, Italy;
| | - Guido Iaccarino
- Interdepartmental Research Center for Arterial Hypertension and Associated Pathologies (CIRIAPA)-Hypertension Research Center, University of Naples “Federico II”, 80131 Naples, Italy; (G.I.); (A.B.)
- Department of Clinical Medicine and Surgery, Univeristy of Naples Federico II, 80131 Naples, Italy
| | - Antonio Bianco
- Interdepartmental Research Center for Arterial Hypertension and Associated Pathologies (CIRIAPA)-Hypertension Research Center, University of Naples “Federico II”, 80131 Naples, Italy; (G.I.); (A.B.)
- DAI Endocrinologia, Diabetologia, Andrologia e Nutrizione Ambulatorio AFA “Attività Fisica Adattata”, University of Naples “Federico II”, 80131 Naples, Italy
| | - Teodolinda Di Risi
- Chair of Nephrology “Federico II”, Department of Public Health, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy; (M.A.); (I.C.); (T.D.R.); or (A.P.)
- CEINGE Biotecnologie Avanzate, Via Gaetano Salvatore 486, 80145 Naples, Italy
| | - Antonio Pisani
- Chair of Nephrology “Federico II”, Department of Public Health, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy; (M.A.); (I.C.); (T.D.R.); or (A.P.)
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Prepok FF, Schnabel KK, Sumánszki C, Barta AG, Tislér A, Reismann P. Long-Term Renal Function in Adult Patients with Phenylketonuria. Nephron Clin Pract 2023; 148:195-203. [PMID: 37757776 DOI: 10.1159/000531913] [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: 12/27/2022] [Accepted: 07/04/2023] [Indexed: 09/29/2023] Open
Abstract
INTRODUCTION In phenylketonuria (PKU), toxic phenylalanine (Phe) can harm other organs beyond the brain. Furthermore, the lifelong therapy of PKU consists of consumption of increased amounts of amino-acid mixture that provoke hyperfiltration in the glomeruli. Therefore, the adherence to therapy in PKU might influence the long-term kidney function in PKU patients. METHODS Data from 41 adult, early treated PKU patients were analyzed in this 10-year, retrospective, monocentric study. Two subgroups were created according to their therapy adherence: one with long-term blood Phe levels in the therapeutic range (<600 µmol/L), and one with suboptimal blood Phe levels. Renal function and metabolic parameters were collected over 10 years. Kidney function parameters were compared between the two groups and associations between blood Phe levels and kidney function were tested. RESULTS After 10 years, serum creatinine levels (p = 0.369) and estimated glomerular filtration rate (eGFR) (p = 0.723) did not change significantly from baseline in the good therapeutic group. The suboptimal therapeutic group's eGFR decreased in the same period (from 110.4 ± 14 mL/min/1.73 m2 to 94.2 ± 16 mL/min/1.73 m2, p = 0.017). At 10 years, the suboptimal therapeutic group had an increased serum creatinine level (81 ± 14.4 μmol/L vs. 71.5 ± 13 μmol/L, p = 0.038), and a decreased eGFR (94.2 ± 16 mL/min/1.73 m2 vs. 103.3 ± 13 mL/min/1.73 m2p = 0.031) compared to the good adhering group. Significant negative correlation between Phe levels and eGFR (r = -0.41, p = 0.008) was observed. CONCLUSION Long-term suboptimal therapy adherence in PKU patients with high blood Phe levels may lead to deterioration in kidney function.
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Affiliation(s)
| | | | - Csaba Sumánszki
- Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
| | - András Gellért Barta
- Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
| | - András Tislér
- Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
| | - Péter Reismann
- Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
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Moyama S, Yamada Y, Makabe N, Fujita H, Araki A, Suzuki A, Seino Y, Shide K, Kimura K, Murotani K, Honda H, Kobayashi M, Fujita S, Yasuda K, Kuroe A, Tsukiyama K, Seino Y, Yabe D. Efficacy and Safety of 6-Month High Dietary Protein Intake in Hospitalized Adults Aged 75 or Older at Nutritional Risk: An Exploratory, Randomized, Controlled Study. Nutrients 2023; 15:2024. [PMID: 37432141 DOI: 10.3390/nu15092024] [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: 02/28/2023] [Revised: 04/15/2023] [Accepted: 04/21/2023] [Indexed: 07/12/2023] Open
Abstract
The aim of this study was to investigate the effects of increased dietary protein in daily-life settings in Japan for 6 months on the activities of daily living (ADL) in adults aged 75 or older at nutritional risk. The study was an open-label, exploratory, randomized controlled trial conducted at seven hospitals in Japan. The study participants were adults aged 75 or older who were hospitalized for treatable cancer, pneumonia, fractures, and/or urinary-tract infection at nutritional risk. The primary outcome was change in grip strength, skeletal muscle, and ADL indices (Barthel index, Lawton score). One hundred sixty-nine patients were randomly assigned to the intensive care (IC) or standard care (SC) group; the protein intake goals (g/kgw/day) were 1.5 for IC and 1.0 for SC. There was a significant improvement in grip strength only in the IC group (1.1 kg: 95% CI 0.1 to 2.1) (p = 0.02). While the skeletal muscle index and ADL indices were not significantly improved in either group, the improvement ratio tended to be greater in the IC group. There was no decrease in renal function in either group. Thus, intervention of increased dietary protein in daily-life settings for 6 months in adults aged 75 or older with treatable cancer, pneumonia, fractures, and/or urinary-tract infection and at nutritional risk may be effective in ameliorating loss of muscle strength.
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Affiliation(s)
- Shota Moyama
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kyoto 604-8436, Japan
- Center for Metabolism and Clinical Nutrition, Kansai Electric Power Hospital, Osaka 553-0003, Japan
| | - Yuichiro Yamada
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kyoto 604-8436, Japan
- Center for Diabetes, Endocrinology and Metabolism, Kansai Electric Power Hospital, Osaka 553-0003, Japan
| | - Noboru Makabe
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kyoto 604-8436, Japan
- Center for Metabolism and Clinical Nutrition, Kansai Electric Power Hospital, Osaka 553-0003, Japan
- Department of Human Life Sciences, Mimasaka University, Tsuyama 708-8511, Japan
| | - Hiroki Fujita
- Department of Endocrinology and Diabetes and Geriatric Medicine, Akita University School of Medicine, Akita 010-0852, Japan
| | - Atsushi Araki
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital, Tokyo 173-0015, Japan
| | - Atsushi Suzuki
- Department of Endocrinology and Metabolism, Fujita Health University, Toyoake 470-1192, Japan
| | - Yusuke Seino
- Department of Endocrinology and Metabolism, Fujita Health University, Toyoake 470-1192, Japan
| | - Kenichiro Shide
- Department of Metabolism and Clinical Nutrition, Kyoto University Hospital, Kyoto 606-8397, Japan
| | - Kyoko Kimura
- Department of Nutritional Sciences, Morioka University, Takizawa 020-0605, Japan
| | - Kenta Murotani
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kyoto 604-8436, Japan
- Biostatistics Center, Graduate School of Medicine, Kurume University, Kurume 830-0011, Japan
| | - Hiroto Honda
- Department of Physical Therapy, Faculty of Health Sciences, Aino University, Ibaraki 567-0012, Japan
| | - Mariko Kobayashi
- Department of Health and Welfare, Settsu City Hall, Settsu 566-8555, Japan
| | - Satoshi Fujita
- College of Sport and Health Sciences, Ritsumeikan University, Kusatsu 525-8577, Japan
| | - Koichiro Yasuda
- Department of Diabetes and Endocrinology, Saiseikai-Noe Hospital, Osaka 536-0001, Japan
| | - Akira Kuroe
- Department of Diabetes and Metabolism, Hikone Municipal Hospital, Hikone 522-0057, Japan
| | - Katsushi Tsukiyama
- Center for Diabetes, Kobayashi Memorial Hospital, Hekinan 447-0863, Japan
| | - Yutaka Seino
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kyoto 604-8436, Japan
- Center for Diabetes, Endocrinology and Metabolism, Kansai Electric Power Hospital, Osaka 553-0003, Japan
| | - Daisuke Yabe
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kyoto 604-8436, Japan
- Department of Diabetes, Endocrinology and Metabolism, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan
- Department of Rheumatology and Clinical Immunology, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
- Center for One Medicine Innovative Translational Research, Gifu University, Gifu 501-1194, Japan
- Center for Preemptive Food Research, Gifu University Institute for Advanced Study, Gifu 501-1194, Japan
- Center for Research, Education and Life Design, Gifu University, Gifu 501-1194, Japan
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Protein Supplementation for Strength and Functionality in Older Adults: Is There Still Any Doubt? A Brief Update Review. J Aging Phys Act 2022; 31:311-318. [PMID: 35940583 DOI: 10.1123/japa.2022-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/17/2022] [Accepted: 06/21/2022] [Indexed: 11/18/2022]
Abstract
It is widely known that the aging process induces relevant impairments on both muscle morphology and function. In this sense, resistance training alongside proper protein intake are important strategies to mitigate the sarcopenia process in older individuals. However, adding protein supplementation (PS) to resistance training interventions for enhancing muscle strength and functional performance has shown mixed results in this population. Therefore, the present study aimed to review the most recent evidence regarding PS and its effects on muscle strength and functional parameters of older adults. In addition, the effect size of each individual study (post-pre intervention) was also calculated to provide further clinical relevance on the topic. The results of the studies included do not seem to support PS for healthy older adults with proper protein intake. However, further studies with other sample characteristics (very old, frail, obese, and inadequate protein consumption) must be carried out to better understand the effects of PS in an older population.
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Lares-Michel M, Housni FE, Aguilera Cervantes VG, Reyes-Castillo Z, Michel Nava RM, Llanes Cañedo C, López Larios MDJ. The water footprint and nutritional implications of diet change in Mexico: a principal component analysis. Eur J Nutr 2022; 61:3201-3226. [PMID: 35438358 DOI: 10.1007/s00394-022-02878-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 03/22/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Nutrition transition (NT) has modified the way that the Mexican population eats, while their body composition has also been modified. These changes have been linked with environmental impacts; however, little is known regarding water footprint (WF). The objective of this paper was to analyze the NT process in Mexico and evaluate its impact on WF using principal component analysis (PCA). METHODS A validated Food Consumption Frequency Questionnaire (FCFQ) was modified and applied to 400 adults from the Metropolitan Zone of Guadalajara, Mexico. The WF was calculated according to the WF Assessment Method. PCA and tertiles analysis was carried out to define dietary patterns WFs (DPWF). Questions covering sociodemographic and socioeconomic factors, as well as body composition data and physical activity levels were measured. RESULTS The average DPWF was 6619.58 ± 3182.62 L per person per day (L p-1d-1). We found three DPWF by PCA: Medium NT (55% from the total sample), Healthy plant-based (28%), and High in animal protein (17%). The highest energy consumption, western and Mexican foods intake, and dietary WF were found in Medium NT DPWF, as well as obesity prevalence. Fruits and vegetable consumption was higher in Healthy plant-based DPWF. Muscle mass percentage was higher in the High in animal protein DPWF. CONCLUSIONS Although most of the population is currently on Medium NT, new dietary patterns have emerged, where there was found a trend to plant-based diets but also diets high in animal food sources that can influence nutritional status.
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Affiliation(s)
- Mariana Lares-Michel
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), University Center of the South, University of Guadalajara, Av. Enrique Arreola Silva 883, Col. Centro, 49000, Ciudad Guzmán, Jalisco, México.,Institute of Nutrition and Food Technology "José Mataix Verdú", Biomedical Research Center, University of Granada, Avenida del Conocimiento S/N. Parque Tecnológico de la Salud. Armilla, 18071, Granada, Spain
| | - Fatima Ezzahra Housni
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), University Center of the South, University of Guadalajara, Av. Enrique Arreola Silva 883, Col. Centro, 49000, Ciudad Guzmán, Jalisco, México.
| | - Virginia Gabriela Aguilera Cervantes
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), University Center of the South, University of Guadalajara, Av. Enrique Arreola Silva 883, Col. Centro, 49000, Ciudad Guzmán, Jalisco, México
| | - Zyanya Reyes-Castillo
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), University Center of the South, University of Guadalajara, Av. Enrique Arreola Silva 883, Col. Centro, 49000, Ciudad Guzmán, Jalisco, México
| | - Rosa María Michel Nava
- Tecnológico Nacional de México, Campus Ciudad Guzmán, Avenida Tecnológico 100, Col. Centro, 49000, Ciudad Guzmán, México
| | - Claudia Llanes Cañedo
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), University Center of the South, University of Guadalajara, Av. Enrique Arreola Silva 883, Col. Centro, 49000, Ciudad Guzmán, Jalisco, México
| | - Madeline de Jesús López Larios
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), University Center of the South, University of Guadalajara, Av. Enrique Arreola Silva 883, Col. Centro, 49000, Ciudad Guzmán, Jalisco, México
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Abstract
PURPOSE OF REVIEW Chronic kidney disease (CKD) is highly prevalent in elderly patients. There is growing recognition of the importance of attention to dietary protein intake (DPI) in this population given their predisposition to age-related changes in kidney function and coexisting comorbidities (i.e., hypertension). We reviewed the impact of DPI on kidney health and survival and the role of dietary protein management in older CKD patients. RECENT FINDINGS While kidney function parameters including glomerular filtration rate (GFR) and renal plasma flow are slightly lower in elderly patients irrespective of CKD status, the kidneys' ability to compensate for increased DPI by augmentation of GFR is preserved until 80 years of age or less. However, long-term consumption of high DPI in individuals of older age and/or with CKD may contribute to kidney function deterioration over time. Prescription of a plant-dominant low-protein diet of 0.6-0.8 g/kg/day with more than 50% from plant sources or very low protein diets less than 0.45 g/kg/day supplemented with essential amino acids or their keto-analogues may be effective in preserving kidney function in older patients and their younger counterparts, while also monitoring for development of protein-energy wasting (PEW). SUMMARY Using tailored precision nutrition approaches in prescribing plant-dominant low DPI that also maintains adequate energy and nitrogen balance may ameliorate kidney function decline while also preventing development of PEW in elderly patients with CKD.
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Affiliation(s)
- Yoko Narasaki
- Division of Nephrology, Hypertension and Kidney Transplantation, Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California Irvine, Orange, California
| | - Connie M Rhee
- Division of Nephrology, Hypertension and Kidney Transplantation, Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California Irvine, Orange, California
| | - Holly Kramer
- Department of Public Health Sciences
- Department of Medicine, Loyola University Chicago Stritch School of Medicine, Maywood
- Hines VA Medical Center, Hines, Illinois, USA
| | - Kamyar Kalantar-Zadeh
- Division of Nephrology, Hypertension and Kidney Transplantation, Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California Irvine, Orange, California
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Dietary Habits, Vitamin and Mineral Supplements in Patients with Chronic Kidney Disease (CKD). Nutrients 2020; 12:nu12123817. [PMID: 33327372 PMCID: PMC7764889 DOI: 10.3390/nu12123817] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 12/04/2020] [Indexed: 12/14/2022] Open
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Hengeveld LM, Boer JMA, Gaudreau P, Heymans MW, Jagger C, Mendonça N, Ocké MC, Presse N, Sette S, Simonsick EM, Tapanainen H, Turrini A, Virtanen SM, Wijnhoven HAH, Visser M. Prevalence of protein intake below recommended in community-dwelling older adults: a meta-analysis across cohorts from the PROMISS consortium. J Cachexia Sarcopenia Muscle 2020; 11:1212-1222. [PMID: 32548960 PMCID: PMC7567142 DOI: 10.1002/jcsm.12580] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 03/22/2020] [Accepted: 04/07/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Lower protein intake in older adults is associated with loss of muscle mass and strength. The present study aimed to provide a pooled estimate of the overall prevalence of protein intake below recommended (according to different cut-off values) among community-dwelling older adults, both within the general older population and within specific subgroups. METHODS As part of the PRevention Of Malnutrition In Senior Subjects in the EU (PROMISS) project, a meta-analysis was performed using data from four cohorts (from the Netherlands, UK, Canada, and USA) and four national surveys [from the Netherlands, Finland (two), and Italy]. Within those studies, data on protein and energy intake of community-dwelling men and women aged ≥55 years were obtained by either a food frequency questionnaire, 24 h recalls administered on 2 or 3 days, or food diaries administered on 3 days. Protein intake below recommended was based on the recommended dietary allowance of 0.8 g/kg body weight (BW)/d, by using adjusted BW (aBW) instead of actual BW. Cut-off values of 1.0 and 1.2 were applied in additional analyses. Prevalences were also examined for subgroups according to sex, age, body mass index (BMI), education level, appetite, living status, and recent weight loss. RESULTS The study sample comprised 8107 older persons. Mean ± standard deviation protein intake ranged from 64.3 ± 22.3 (UK) to 80.6 ± 23.7 g/d [the Netherlands (cohort)] or from 0.94 ± 0.38 (USA) to 1.17z ± 0.30 g/kg aBW/d (Italy) when related to BW. The overall pooled prevalence of protein intake below recommended was 21.5% (95% confidence interval: 14.0-30.1), 46.7% (38.3-55.3), and 70.8% (65.1-76.3) using the 0.8, 1.0, and 1.2 cut-off value, respectively. A higher prevalence was observed among women, individuals with higher BMI, and individuals with poor appetite. The prevalence differed only marginally by age, education level, living status, and recent weight loss. CONCLUSIONS In community-dwelling older adults, the prevalence of protein intake below the current recommendation of 0.8 g/kg aBW/d is substantial (14-30%) and increases to 65-76% according to a cut-off value of 1.2 g/kg aBW/d. To what extent the protein intakes are below the requirements of these older people warrants further investigation.
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Affiliation(s)
- Linda M Hengeveld
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Jolanda M A Boer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Pierrette Gaudreau
- Department of Medicine, University of Montreal, Montreal, Quebec, Canada.,Research Centre, Hospital of the University of Montreal, Montreal, Quebec, Canada
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU Medical Center, Amsterdam, The Netherlands
| | - Carol Jagger
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Nuno Mendonça
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.,Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK.,EpiDoC Unit, CHRC, NOVA Medical School, Universidade Nova de Lisboa (NMS-UNL), Lisbon, Portugal
| | - Marga C Ocké
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Nancy Presse
- Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Sherbrooke, Quebec, Canada.,Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Stefania Sette
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Heli Tapanainen
- Unit of Health Promotion, Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Aida Turrini
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Suvi M Virtanen
- Unit of Health Promotion, Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland.,Faculty of Social Sciences, Tampere University, Tampere, Finland.,Centre for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.,Science Centre, Pirkanmaa Hospital District, Tampere, Finland
| | - Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit, Amsterdam, The Netherlands
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10
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Lee CL, Liu WJ, Wang JS. Effect of low-protein intake on all-cause mortality in subjects with an estimated glomerular filtration rate higher than 60 mL/min/1.73 m 2 with or without albuminuria. Int J Clin Pract 2020; 74:e13505. [PMID: 32239620 DOI: 10.1111/ijcp.13505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 03/26/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND We aimed to investigate the effect of a low-protein intake on all-cause mortality in subjects with an estimated glomerular filtration rate (eGFR) ≧60 mL/min/1.73 m2 with or without albuminuria using data from the National Health and Nutrition Examination Survey (NHANES). METHODS We analysed participants in the NHANES from 2003 to 2010. We excluded participants with an eGFR less than 60 mL/min/1.73 m2 from the analyses. Low-protein intake was defined as a protein intake of less than 0.8 g/kg/day. The Healthy Eating Index 2010 was used to assess diet quality. The vital status of all participants in the NHANES was determined by linking to the National Death Index through the end of 2011. The hazard ratios (HRs) for the association of low-protein intake and mortality were determined using weighted Cox proportional hazards regression models. RESULTS A total of 7730 participants were included in the analyses. After a median follow up of 4.7 years, 462 participants died. A low-protein intake was associated with a higher risk of mortality (HRs 1.394, 95% CI 1.121-1.734, P = .004) with adjustment for diet quality and relevant risk factors. The higher risk of mortality associated with a low-protein intake was consistent in subjects with or without albuminuria (P interaction .280). CONCLUSION A protein intake of less than 0.8 g/kg/day was associated with a higher risk of mortality in subjects with an eGFR ≧60 mL/min/1.73 m2 , irrespective of whether they had albuminuria.
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Affiliation(s)
- Chia-Lin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Wei-Ju Liu
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Jun-Sing Wang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Rong Hsing Research Center for Translational Medicine, Institute of Biomedical Science, College of Life Science, National Chung Hsing University, Taichung, Taiwan
- PhD Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
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11
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Phillips SM, Paddon-Jones D, Layman DK. Optimizing Adult Protein Intake During Catabolic Health Conditions. Adv Nutr 2020; 11:S1058-S1069. [PMID: 32666115 PMCID: PMC7360447 DOI: 10.1093/advances/nmaa047] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/12/2020] [Accepted: 03/25/2020] [Indexed: 12/29/2022] Open
Abstract
The DRIs define a range of acceptable dietary intakes for each nutrient. The range is defined from the minimum intake to avoid risk of inadequacy (i.e., the RDA) up to an upper limit (UL) based on a detectable risk of adverse effects. For most nutrients, the minimum RDA is based on alleviating a clear deficiency condition, whereas higher intakes are often recommended to optimize specific health outcomes. Evidence is accumulating that similar logic should be applied to dietary recommendations for protein. Although the RDA for protein of 0.8 g/kg body weight is adequate to avoid obvious inadequacies, multiple studies provide evidence that many adults may benefit from protein quantity, quality, and distribution beyond guidelines currently defined by the RDA. Further, the dietary requirement for protein is a surrogate for the constituent amino acids and, in particular, the 9 considered to be indispensable. Leucine provides an important example of an essential amino acid where the RDA of 42 mg/kg body weight is significantly less than the 100-110 mg/kg required to optimize metabolic regulation and skeletal muscle protein synthesis. This review will highlight the benefits of higher protein diets to optimize health during aging, inactivity, bed rest, or metabolic dysfunction such as type 2 diabetes.
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Affiliation(s)
| | - Douglas Paddon-Jones
- Department of Nutrition and Metabolism, The University of Texas Medical Branch, Galveston, TX, USA
| | - Donald K Layman
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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12
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Hernández-Reyes A, Cámara-Martos F, Vidal Á, Molina-Luque R, Moreno-Rojas R. Effects of Self-Weighing During Weight Loss Treatment: A 6-Month Randomized Controlled Trial. Front Psychol 2020; 11:397. [PMID: 32210897 PMCID: PMC7077514 DOI: 10.3389/fpsyg.2020.00397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 02/20/2020] [Indexed: 01/18/2023] Open
Abstract
Objective To examine the effectiveness of self-weighing for weight loss in men for 6 months. Methods In the present study, 54 men, mean age of 40.1 ± 11.1 years, with overweight or obesity, were recruited and randomly assigned into two groups: control group (CG), without weight self-monitoring and intervention group (IG), with weight self-monitoring. Both groups received the same nutritional and educational advice and the establishment of a weight target to reach in the weight loss program. Subjects of IG also had individualized motivating content to improve self-management for 24 weeks. Anthropometric indices were measured at baseline and weekly for 24 weeks. Results When the group assigned after randomization was introduced in the analysis, its influence was significant in weight loss (F1.52 = 19.465, ± 2 = 0.272, p < 0.001) and in the decrease in body fat percentage (F1.52 = 8,306, ± 2 = 0.132, p < 0.01). Conclusion Study results indicate that self-weighing can help patients to lose additional weight. Our findings have implications in the emerging area of the behavioral approach of patients undergoing weight-loss treatment, as well as clinical care processes. Clinical Trial Registration www.ClinicalTrials.gov, identifier NCT04032249.
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Affiliation(s)
| | | | - Ángela Vidal
- Department of Animal Medicine and Surgery, University of Córdoba, Córdoba, Spain
| | | | - Rafael Moreno-Rojas
- Department of Bromatology and Food Technology, University of Córdoba, Córdoba, Spain
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13
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Illiano P, Brambilla R, Parolini C. The mutual interplay of gut microbiota, diet and human disease. FEBS J 2020; 287:833-855. [DOI: 10.1111/febs.15217] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 12/21/2019] [Accepted: 01/16/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Placido Illiano
- The Miami Project to Cure Paralysis Department of Neurological Surgery University of Miami Miller School of Medicine FL USA
| | - Roberta Brambilla
- The Miami Project to Cure Paralysis Department of Neurological Surgery University of Miami Miller School of Medicine FL USA
- Department of Neurobiology Research Institute of Molecular Medicine University of Southern Denmark Odense Denmark
- Department of Clinical Research BRIDGE‐Brain Research‐Inter‐Disciplinary Guided Excellence University of Southern Denmark Odense C Denmark
| | - Cinzia Parolini
- Department of Pharmacological and Biomolecular Sciences Università degli Studi di Milano Italy
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14
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Effects of dietary protein intake on renal outcome and mortality in patients with advanced diabetic nephropathy. Clin Exp Nephrol 2019; 24:119-125. [PMID: 31587125 DOI: 10.1007/s10157-019-01796-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 09/24/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND The difficulty of adhering to a low-protein diet is a serious limitation of randomized controlled trials aimed at validating the efficacy of this therapy. In this observational study of patients with diabetic nephropathy, we examined the association of dietary protein intake (DPI) with renal outcome and mortality, taking into account the nutritional status. METHODS We conducted a single-center historical cohort study of 449 adult Japanese patients with type 2 diabetes and the urinary albumin-to-creatinine ratio of ≥ 300 mg/g or estimated glomerular filtration rate of < 30 mL/min/1.73 m2. DPI was estimated with a formula using nitrogen levels in spot urine and body mass index. Malnutrition was defined as the Geriatric Nutritional Risk Index of ≤ 98. The primary and secondary endpoints were renal replacement therapy (RRT) initiation and mortality before RRT initiation, respectively. The Fine and Gray subdistribution hazard model was used to determine the relative effects of DPI on the respective endpoint. RESULTS Decreased DPI was associated with lower incidence of RRT with an adjusted hazard ratio of 0.81 (95% confidence interval: 0.72-0.92, p < 0.001). The interaction between DPI and nutritional status with respect to mortality was significant (p interaction = 0.047). Decreased DPI was a risk factor for mortality in patients with malnutrition (p = 0.009) but not in those without malnutrition (p = 0.559). CONCLUSIONS In patients with type 2 diabetic nephropathy, lower DPI was associated with lower incidence of RRT initiation, suggesting beneficial effects of a low-protein diet on kidneys. Conversely, lower DPI might lead to increased mortality in patients with malnutrition.
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