The role of protein in weight loss and maintenance

Effects of a functional yogurt enriched with soluble dietary fiber or vegetable proteins on appetite profile. An acute randomized controlled clinical trial

Introduction

Introduction: designing functional foods to control appetite could be a useful strategy for managing overweight and obesity. Fiber and proteins could be interesting ingredients to consider. Objectives: to evaluate the appetite profile of two experimental yogurts (fiber-enriched [FEY] and protein-enriched [PEY]) versus a control yogurt (CY) in a group of overweight/obesity people. Material and methods: an acute, randomized, double-blind, crossover clinical trial was carried out in a group of twelve healthy overweight/obesity type I people; randomized to consume 3 yogurts in a different order for 3 acute study days. The appetite profile (1. hunger, 2. satiety, 3. fullness, 4. prospective food consumption, 5. desire to eat something fatty, salty, sweet or savoury) was assessed using a Visual Analog Scale (ranging from 0 ''not at all'' to 10 ''extremely") at 12 moments in each acute study. Additionally, total food consumption in an ad libitum lunch was assessed. Results: FEY produce a significantly lower desire to consume any food at 30 (1.50 ± 0.42) and 60 minutes (2.78 ± 0.42) after consumption compared to PEY (3.46 ± 0.53; 4.33 ± 0.54) and CY (3.27 ± 0.69; 4.0 ± 0.78) respectively (p < 0.016). Also, FEY consumption produced a higher satiety and fullness and a lower desire to ingest something fatty, salty or savory after 90 minutes consumption compared to the other products, but the difference was not significance. Conclusion: FEY might be a good functional food prototype to control appetite in overweight and obese people.

Characterization and potential health benefits of millet flour and banana peel mixtures on rats fed with a high-fat diet

Millet (M) and banana peel (Bp) possess significant nutritional qualities and have been shown to reduce obesity resulting from a high-fat diet (HFD). The present research assessed the effect of millet flour and banana peel mixtures on lipid profiles, liver and kidney functions, and characterized food products derived from these mixtures. Thirty-five male albino rats were allocated into five groups for a biochemical analysis. The control group (n = 7) received a basal diet, while the remaining 28 rats were fed a high-fat diet (HFD) for 8 weeks to induce obesity. These rats were then separated into four sub-groups (n = 7 each): sub-group 1 as the positive control (+ve) receiving only HFD, while sub-groups 2, 3, and 4 were administered HFD supplemented with millet flour and banana peel mixtures (M90+Bp10 %, M80+Bp20 %, and M70+Bp30 %), respectively for an additional 8 weeks. The chemical composition analysis showed that banana peel (Bp) has higher levels of fat, ash, fiber, magnesium, and potassium, while millet flour is richer in carbohydrates. Bp also had superior antioxidant activity and total phenol content (13.32 % and 10.54 mg/100g) compared to millet flour (3.75 % and 4.55 mg/100g). Biochemical tests on the HFD plus (M70+Bp30 %) group revealed improved lipid profiles, leptin, antioxidant enzymes, and kidney and liver functions. Glucose levels were higher in the HFD group (137.33 mg/dl) than in the control (85.70 mg/dl), but these levels were reduced with millet and banana peel treatment. The histology of liver tissues confirmed the biochemical results. Sensory evaluation of pancakes and toast from the (M70+Bp30 %) mixture by forty panelists showed high acceptability, aligning with the biochemical outcomes. This study suggests that a banana peel and millet flour mixture could help reduce obesity.

Protein source associated with risk of metabolic syndrome in adults with low and adequate protein intake: A prospective cohort study of middle-aged and older adults

OBJECTIVES

Metabolic syndrome is associated with an increased risk of diabetes, cardiovascular disease, and all-cause mortality. Some evidence suggests that the cardiometabolic health benefits of protein intake may vary by the source (animal or plant); however, the evidence is inconsistent. This study aimed to assess the risk of developing metabolic syndrome according to the protein source.

PARTICIPANTS

Among a total of 3,310 participants aged 40 years or older in the Ansan and Ansung population based prospective cohort, 1,543 incident cases of metabolic syndrome were identified between 2007 and 2018.

MEASUREMENTS

Dietary intake was assessed using a validated food frequency questionnaire. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) by quintile (Q), adjusting for demographics and health-related lifestyle factors.

RESULTS

Higher intake of animal protein (HRquintile5 (Q5) vs quintile1 (Q1) [95% CIs]: 0.76 [0.59-0.96], P-trend ≤ 0.0307) and a higher relative intake of animal protein (HRQ5 vs.Q1: 0.78 [0.64-0.95], P-trend ≤ 0.0017) were associated with a significantly decreased risk of developing metabolic syndrome. In subgroup analyses, associations between the risk of metabolic syndrome and the relative intake of animal and plant protein differed according to whether the total protein intake was within the recommended nutrient intake (RNI). Specifically, significant associations were observed only among those with a total protein consumption below the RNI (HRQ5vs Q1 [95% CIs]: 0.72 [0.56-0.93] for the relative intake of animal protein), but not among those consuming above the RNI. This association was more significant in women than in men.

CONCLUSION

A higher absolute and relative intake of animal protein were associated with a significantly decreased risk of metabolic syndrome, particularly among those who consumed less than the RNI of protein.

Fundamental Body Composition Principles Provide Context for Fat-Free and Skeletal Muscle Loss With GLP-1 RA Treatments

During weight loss, reductions in body mass are commonly described using molecular body components (eg, fat mass and fat-free mass [FFM]) or tissues and organs (eg, adipose tissue and skeletal muscle). While often conflated, distinctions between body components established by different levels of the 5-level model of body composition-which partitions body mass according to the atomic, molecular, cellular, tissue/organ, or whole-body level-are essential to recall when interpreting the composition of weight loss. A contemporary area of clinical and research interest that demonstrates the importance of these concepts is the discussion surrounding body composition changes with glucagon-like peptide-1 receptor agonists (GLP-1RA), particularly in regard to changes in FFM and skeletal muscle mass. The present article emphasizes the importance of fundamental principles when interpreting body composition changes experienced during weight loss, with a particular focus on GLP-1RA drug trials. The potential for obligatory loss of FFM due to reductions in adipose tissue mass and distribution of FFM loss from distinct body tissues are also discussed. Finally, selected countermeasures to combat loss of FFM and skeletal muscle, namely resistance exercise training and increased protein intake, are presented. Collectively, these considerations may allow for enhanced clarity when conceptualizing, discussing, and seeking to influence body composition changes experienced during weight loss.

Effect of a higher protein diet and lifestyle camp intervention on childhood obesity (The COPE study): results from a nonrandomized controlled trail with 52-weeks follow-up

PURPOSE

In adults, diets rich in protein seem beneficial in relation to satiety, weight loss, and weight management; however, studies investigating dietary protein and weight development in children are scarce and inconsistent. This nonrandomized controlled trial aimed to investigate the effect of a higher protein diet during lifestyle intervention on anthropometry and metabolic biomarkers in children with overweight and obesity.

METHODS

Children (n:208) were recruited from two multicomponent lifestyle camps. One camp was assigned as the intervention group. In the intervention group, carbohydrates-rich foods at breakfast and two in-between-meals were replaced with protein-containing foods to increase the amount of protein from ~ 10-15 energy percent (E%) per day to ~ 25E% per day. Other components were similar between groups. Anthropometry and biochemical measurements were collected at baseline, 10 weeks (after camp) and 52 weeks.

RESULTS

The intervention group had a non-significant improvement in BMI-SDS (- 0.07 SD (- 0.19; 0.05), p = 0.24) compared to the control group, but in general, there was no effect of a higher protein diet on anthropometry and metabolic biomarkers. Overall, 10 weeks at camp resulted in a more favorable body composition [- 6.50 kg (p < 0.00), - 0.58 BMI-SDS (p < 0.00), and - 5.92% body fat (p < 0.00)], and improved metabolic health, with most changes maintained at 52 weeks.

CONCLUSION

A higher protein diet had no significant effect on body composition and metabolic health; however, these lifestyle camps are an efficiatious treatment strategy for childhood obesity.

CLINICAL TRIAL REGISTRATION

clinicaltrials.gov with ID: NCT04522921. Preregistered August 21st 2020.

Dietary strategies for cardiovascular disease risk factors prevention

Nutrition can play a key role in cardiovascular disease risk reduction, and its risk factors modification. This paper aims to present, compare, and summarize the main dietary concepts for preventing the main cardiovascular disease risk factors - obesity, hypertension, and dyslipidemia. The dietary models and macronutrient intakes were compared between main cardiovascular risk factors prevention recommendations. Dietary recommendations related to selected cardiovascular risk factors share the points, that can be suggested as crucial for overall cardiovascular risk factors reduction. Recommendations suggest limiting saturated fatty acids intake to <10% of total caloric intake in obesity, and <7 % in hypercholesterolemia, along with an increased intake of mono- and polyunsaturated fatty acids. In addition, daily dietary fiber intake should reach a level of 25-40 g. The vegetables and fruits should be consumed at a daily minimum level of 200g (or 4-5 portions) each. Salt intake should not exceed 5g/day. Alcohol should be generally avoided, and moderate intake levels (sex-specific) should not be exceeded. It is also worth noting, that proteins are essential for tissue formation and regeneration. Carbohydrates are the main source of energy, but it is necessary to choose products with a low glycemic index. Dietary antioxidants help combat free radicals and prevent cell damage.

Opportunities to optimize lifestyle interventions in combination with glucagon-like peptide-1-based therapy

Obesity is a chronic multi-system disease and major driver of type 2 diabetes and cardiometabolic disease. Nutritional interventions form the cornerstone of obesity and type 2 diabetes management. Some interventions such as Mediterranean diet can reduce incident cardiovascular disease, probably independently of weight loss. Weight loss of 5% or greater can improve many adiposity-related comorbidities. Although this can be achieved with lifestyle intervention, it is often difficult to sustain in the longer term due to adaptive endocrine changes. In recent years glucagon-like-peptide-1 receptor agonists (GLP-1RAs) have emerged as effective treatments for both type 2 diabetes and obesity. Newer GLP-1RAs can achieve average weight loss of 15% or greater and improve cardiometabolic health. There is heterogeneity in the weight loss response to GLP-1RAs, with a substantial number of patients unable to achieve 5% or greater weight. Weight loss, on average, is lower in older adults, male patients and people with type 2 diabetes. Mechanistic studies are needed to understand the aetiology of this variable response. Gastrointestinal side effects leading to medication discontinuation are a concern with GLP-1RA treatment, based on real-world data. With weight loss of 20% or higher with newer GLP-1RAs, nutritional deficiency and sarcopenia are also potential concerns. Lifestyle interventions that may potentially mitigate the side effects of GLP-1RA treatment and enhance weight loss are discussed here. The efficacy of such interventions awaits confirmation with well-designed randomized controlled trials.

Weight Loss Programs: Why Do They Fail? A Multidimensional Approach for Obesity Management

PURPOSE OF REVIEW

Despite the prevalence of weight loss programs, their success rates remain discouraging, with around half of individuals regaining lost weight within two years. The primary objective of this review is to explore the factors contributing to the failure of weight loss programs and to provide insights into effective weight management strategies.

RECENT FINDINGS

Factors contributing to the failure of weight loss programs include the impracticality of restrictive diets, potential metabolic impacts, limited focus on lifestyle changes, genetic predispositions, psychological influences, socioeconomic status, and medical conditions. A holistic approach considering these factors is crucial for safe and sustainable weight loss. Key findings indicate the importance of holistic approaches to weight management, including lifestyle modifications, medical interventions, and behavioral and psychological strategies. Effective weight loss strategies emphasize low-calorie, nutrient-rich diets, regular physical activity, and interventions tailored to individual needs. Combining multiple approaches offers the best chance of successful weight management and improved health outcomes. This review provides insights into the complexities of obesity management and the factors contributing to the failure of weight loss programs. It highlights the necessity of adopting a holistic approach that addresses dietary habits, physical activity, genetic factors, psychological well-being, and socioeconomic influences. Recommendations include implementing lifestyle modifications, medical interventions when necessary, and integrating behavioral and psychological support to achieve sustainable weight loss and mitigate the global health challenge posed by obesity.

Impact of Simulated Caloric Reduction on Nutrient Adequacy Among U.S. Adults with Overweight or Obesity (National Health and Nutrition Examination Survey [NHANES] 2015-2018)

BACKGROUND

Current guidelines for the treatment of obesity recommend dietary restriction to create a caloric deficit, and caloric reductions of 16% to 68% have been achieved in adults with overweight or obesity engaging in intentional weight loss programs.

OBJECTIVES

This study models the impact of simulated caloric reduction on nutrient adequacy among U.S. adults ≥19 y with overweight or obesity using National Health and Nutrition Examination Survey data (2015-2018).

METHODS

Four levels of caloric reduction (20%, 30%, 40%, and 50%) were modeled by prorating daily calorie intake such that usual intakes of 14 nutrients were reduced proportional to caloric reduction. The percentages below the estimated average requirement (EAR) or above the adequate intake (AI) were estimated at each level of caloric reduction, with and without dietary supplement use. Differences across percentages of simulated caloric reductions were determined using nonoverlapping confidence intervals of the means (97.5th percentile confidence intervals were used to approximate P < 0.05).

RESULTS

There were significant differences (P < 0.05) in percentages below the EAR (above the AI) between sequential levels of simulated caloric reduction for most of the nutrients analyzed (protein, vitamins A, B-6, folate, and C, calcium, iron, magnesium, potassium, and zinc). For example, after a simulated 30% caloric reduction, 25%-40% of the population had intakes below the EAR for protein, vitamin B-6, and zinc, and 75%-91% of the population had intakes below the EAR for vitamin A, calcium, and magnesium (vs. 4%-18% and 45%-56%, respectively, without caloric reduction). With the inclusion of dietary supplements, percentages below the EAR for all nutrients (except protein) were lower than those for food alone.

CONCLUSIONS

Caloric reduction may exacerbate nutrient inadequacies among adults with overweight or obesity. Inclusion of nutrient-dense foods, fortified foods, specially formulated products, and/or dietary supplements should be considered for those on calorie-restricted diets for long-term weight loss.

The Modification of Dietary Protein with Ammonium Hydroxide Enhancement Improves Longevity and Metabolic Outcomes in a Sex-Dependent Manner

(1) Background: Dietary protein is a key component of all dietary patterns. It has been demonstrated that there are subtle differences in health implications associated with the source of dietary protein consumed. This study examined dietary protein sources (DPSs) in a long-term study of diet-induced obesity ± ammonium hydroxide enhancement (AHE) and its role in improving long-term health outcomes. (2) Methods: Over 18 months, 272 C3H/HeJ mice (136 male and 136 female) were monitored on high-fat diets with varying DPSs ± AHE. Mice were monitored for weekly change in total mass, as well as 6-month assessments of lean and fat mass. At each assessment, a cohort (~8 mice per diet per sex) was censored for a cross-sectional examination of organ function. (3) Results: Longevity was improved in females fed AHE diets, regardless of DPSs. Females' measures of fat and lean mass were markedly elevated with casein protein diets compared to beef protein diets regardless of AHE. Females fed a beef protein diet + AHE demonstrated reduced fat mass and increased lean mass with aging. In males, AHE beef protein diet-fed mice showed marked improvement to longevity and increased lean mass at 6 months. (4) Conclusions: This study demonstrates that dietary protein modification by AHE attenuates the negative impacts of HF diets in both males and females in a sex-dependent manner. Furthermore, the results from this study emphasize the importance of identifying the differences in the utilization of dietary proteins in both a sex- and age-related manner and demonstrate the potential of DPS modification by AHE as a dietary intervention.

Diet and physical exercise in elderly people with obesity: The state of the art

Obesity is a disease that is assuming pandemic proportions in recent decades. With the advancement of medicine and increased access to care, average survival has increased, resulting in a larger number of elderly people. As a result, the amount of elderly people living with obesity is increasing, and the morbidity and impact of obesity on ageing implies severe limitations for these people. The link between obesity and ageing is not only epidemiological, but also strictly pathophysiological. Obesity accelerates the ageing process and ageing is characterised by pathophysiological mechanisms shared by obesity itself. Some examples of alterations shared by ageing and obesity are metabolic changes, sarcopenia and reduced functional capacity related to both loss of muscle strength and reduced cardiorespiratory fitness, as well as a general reduction in the perception of quality of life. The specific ability to antagonize these mechanisms through non-pharmacological treatment based on nutrition and exercise has always been one of the focal points of the international literature. Therefore, this review provides the state of the art on scientific knowledge regarding the main effects of an adequate nutritional plan and an individualised exercise prescription on the general health of elderly with obesity. In particular, this paper addresses the effect of nutrition and physical exercise on pathophysiological changes peculiar of ageing and obesity, providing also the scientific rational for nutritional and exercise prescription in the population.

Impacts of dietary animal and plant protein on weight and glycemic control in health, obesity and type 2 diabetes: friend or foe?

It is well established that high-protein diets (i.e. ~25-30% of energy intake from protein) provide benefits for achieving weight loss, and subsequent weight maintenance, in individuals with obesity, and improve glycemic control in type 2 diabetes (T2D). These effects may be attributable to the superior satiating property of protein, at least in part, through stimulation of both gastrointestinal (GI) mechanisms by protein, involving GI hormone release and slowing of gastric emptying, as well as post-absorptive mechanisms facilitated by circulating amino acids. In contrast, there is evidence that the beneficial effects of greater protein intake on body weight and glycemia may only be sustained for 6-12 months. While both suboptimal dietary compliance and metabolic adaptation, as well as substantial limitations in the design of longer-term studies are all likely to contribute to this contradiction, the source of dietary protein (i.e. animal vs. plant) has received inappropriately little attention. This issue has been highlighted by outcomes of recent epidemiological studies indicating that long-term consumption of animal-based protein may have adverse effects in relation to the development of obesity and T2D, while plant-based protein showed either protective or neutral effects. This review examines information relating to the effects of dietary protein on appetite, energy intake and postprandial glycemia, and the relevant GI functions, as reported in acute, intermediate- and long-term studies in humans. We also evaluate knowledge relating to the relevance of the dietary protein source, specifically animal or plant, to the prevention, and management, of obesity and T2D.

Effect of a Low-Glycemic Index Nutritional Intervention on Body Weight and Selected Cardiometabolic Parameters in Children and Adolescents with Excess Body Weight and Dyslipidemia

Excess body weight in pediatric patients and the resulting dyslipidemia, if left untreated, are a serious risk factor for cardiovascular disease in young adults. Despite this, there is still no effective and validated nutritional strategy for the treatment of overweight/obesity and comorbid dyslipidemia in children and adolescents. A low-glycemic index (LGI) diet may be recommended, but evidence for its effectiveness in the pediatric population is limited. The aim of this study was to evaluate the effectiveness of nutritional intervention in children and adolescents with excess body weight and dyslipidemia. The study was conducted in patients aged 8-16 with overweight or obesity and lipid disorders (n = 64), of which 40 participants who completed the entire 8-week study were included in the analysis. Patients were randomly selected and allocated to one of the two dietary groups: the LGI diet or the standard therapy (ST) diet. Both diets were based on the principal recommendation of Cardiovascular Health Integrated Lifestyle Diet-2 (CHILD-2). This study showed that both LGI and ST diets were equally beneficial in reducing body weight, body fat, blood pressure, total cholesterol (TC), and triglyceride (TG) levels. The LGI diet, compared to the ST diet, was less effective in reducing blood TG levels but more effective in reducing diastolic blood pressure (DBP). Therefore, the choice of the type of diet in the treatment of children and adolescents with excess body weight and dyslipidemia may be individual. However, it should be based on the recommendation of CHILD-2. Further long-term, larger-scale studies are needed.

Milk protein concentrate supplementation improved appetite, metabolic parameters, adipocytokines, and body composition in dieting women with obesity: a randomized controlled trial

BACKGROUND

Dairy consumption is associated with many health benefits. However, to our knowledge, no clinical trials examined the effects of milk protein concentrate (MPC) on metabolic health in overweight and obese adults. This study investigated the effect of supplementation with MPC on glycaemic status, lipid profile, biomarkers of inflammation, and anthropometric measurements in women with obesity under a weight loss diet.

METHODS

This is a single-blind, open-labelled, parallel-group, randomized trial. Forty-four healthy women with obesity were randomized into a control (n = 22) or MPC (n = 22) group. Participants in the MPC group were supplemented with 30 g of MPC per day for 8 weeks. Both groups were on a calorie-restricted diet plan with 800 Kcal lower intakes than their needs. Blood samples, dietary intake, and body composition were assessed before and after the intervention.

RESULTS

MPC group had a significantly lower body mass index (P = 0.009), waist circumference (P = 0.013), fat mass (P = 0.021), appetite score (P = 0.002), fasting blood sugar (P < 0.001), insulin (P = 0.027), low-density lipoprotein cholesterol (P = 0.025), and leptin (P = 0.014) levels and higher high-density lipoprotein cholesterol (P = 0.001) and adiponectin (P = 0.032) compared to the control group after supplementation. Lean body mass, total cholesterol, and triglyceride did not differ significantly (P > 0.05).

CONCLUSION

Daily intake of 30 g of MPC for 8 weeks may improve several anthropometric and metabolic markers in women with obesity under a hypocaloric diet.

Examining the Direct and Indirect Effects of Postprandial Amino Acid Responses on Markers of Satiety following the Acute Consumption of Lean Beef-Rich Meals in Healthy Women with Overweight

The consumption of protein-rich foods stimulates satiety more than other macronutrient-rich foods; however, the underlying mechanisms-of-action are not well-characterized. The objective of this study was to identify the direct and indirect effects of postprandial amino acid (AA) responses on satiety. Seventeen women (mean ± SEM, age: 33 ± 1 year; BMI: 27.8 ± 0.1 kg/m2) consumed a eucaloric, plant-based diet containing two servings of lean beef/day (i.e., 7.5 oz (207 g)) for 7 days. During day 6, the participants completed a 12 h controlled-feeding, clinical testing day including repeated satiety questionnaires and blood sampling to assess pre- and postprandial plasma AAs, PYY, and GLP-1. Regression and mediation analyses were completed to assess AA predictors and hormonal mediators. Total plasma AAs explained 41.1% of the variance in perceived daily fullness (p < 0.001), 61.0% in PYY (p < 0.001), and 66.1% in GLP-1 (p < 0.001) concentrations, respectively. Several individual AAs significantly predicted fluctuations in daily fullness, PYY, and GLP-1. In completing mediation analyses, the effect of plasma leucine on daily fullness was fully mediated by circulating PYY concentrations (indirect effect = B: 0.09 [Boot 95% CI: 0.032, 0.17]) as no leucine-fullness direct effect was observed. No other mediators were identified. Although a number of circulating AAs predict satiety, leucine was found to do so through changes in PYY concentrations in middle-aged women.

Quantification and interpretation of postprandial whole-body protein metabolism using stable isotope methodology: a narrative review

Stable isotopes are routinely applied to determine the impact of factors such as aging, disease, exercise, and feeding on whole-body protein metabolism. The most common approaches to quantify whole-body protein synthesis, breakdown, and oxidation rates and net protein balance are based on the quantification of plasma amino acid kinetics. In the postabsorptive state, plasma amino acid kinetics can easily be assessed using a constant infusion of one or more stable isotope labeled amino acid tracers. In the postprandial state, there is an exogenous, dietary protein-derived amino acid flux that needs to be accounted for. To accurately quantify both endogenous as well as exogenous (protein-derived) amino acid release in the circulation, the continuous tracer infusion method should be accompanied by the ingestion of intrinsically labeled protein. However, the production of labeled protein is too expensive and labor intensive for use in more routine research studies. Alternative approaches have either assumed that 100% of exogenous amino acids are released in the circulation or applied an estimated percentage based on protein digestibility. However, such estimations can introduce large artifacts in the assessment of whole-body protein metabolism. The preferred estimation approach is based on the extrapolation of intrinsically labeled protein-derived plasma bioavailability data obtained in a similar experimental design setting. Here, we provide reference data on exogenous plasma amino acid release that can be applied to allow a more accurate routine assessment of postprandial protein metabolism. More work in this area is needed to provide a more extensive reference data set.

A dairy-based, protein-rich breakfast enhances satiety and cognitive concentration before lunch in overweight to obese young females: A randomized controlled crossover study

The purpose of this study was to investigate if consumption of a high-protein, low-carbohydrate breakfast (PRO) leads to a lower subsequent ad libitum energy intake at lunch and the rest of the day compared with ingestion of an isocaloric low-protein, high-carbohydrate breakfast (CHO) or no breakfast (CON). The study was designed as a randomized controlled 3-period crossover study. Thirty young (18-30 yr) females with overweight to obesity (body mass index >25 kg/m2) in random order completed 3 separate experimental days where they consumed either a PRO, CHO, or CON breakfast test meal followed by an ad libitum lunch meal 3 h after breakfast. Participants were allocated to a sequence group by their inclusion number. The PRO and CHO breakfasts were matched in dietary fiber and fat content. Energy intake at lunch was calculated and dietary records were obtained for the rest of the day to calculate the total daily energy intake and macronutrient intake. Ratings of appetite sensations between meals and palatability of the test meals were assessed using visual analog scale sheets in intervals ranging from 10 to 30 min. In addition, blood samples were obtained at multiple time points separated by 10 to 60 min intervals between breakfast and lunch and were analyzed for appetite-regulating gut hormones, insulin, and glucose. Finally, performance in a cognitive concentration test was tested 150 min after breakfast. Compared with CHO and CON, the area under the curves for satiety, fullness, and satisfaction in the 3 h after breakfast were significantly higher after PRO, whereas the areas under the curve for hunger, desire to eat, and prospective eating were significantly lower after PRO. The appetite-regulating gut hormones cholecystokinin, glucagon-like peptide-1, and ghrelin in the hours after breakfast, energy intake during the ad libitum lunch meal, and the total daily energy intake did not differ significantly between PRO, CHO, and CON. However, the cognitive concentration test score was 3.5 percentage points higher for PRO, but not CHO, versus CON. A dairy-based high-protein, low-carbohydrate breakfast increased satiety sensation in the hours after breakfast but did not reduce total daily energy intake compared with an isocaloric low-protein, high-carbohydrate breakfast or omitting breakfast. However, performance in a cognitive concentration test before lunch was enhanced after the high-protein, low-carbohydrate breakfast, but not the low-protein, high-carbohydrate breakfast, compared with omitting breakfast.

Dietary cysteine and methionine promote peroxisome elevation and fat loss by induction of CG33474 expression in Drosophila adipose tissue

The high-protein diet (HPD) has emerged as a potent dietary approach to curb obesity. Peroxisome, a highly malleable organelle, adapts to nutritional changes to maintain homeostasis by remodeling its structure, composition, and quantity. However, the impact of HPD on peroxisomes and the underlying mechanism remains elusive. Using Drosophila melanogaster as a model system, we discovered that HPD specifically increases peroxisome levels within the adipose tissues. This HPD-induced peroxisome elevation is attributed to cysteine and methionine by triggering the expression of CG33474, a fly homolog of mammalian PEX11G. Both the overexpression of Drosophila CG33474 and human PEX11G result in increased peroxisome size. In addition, cysteine and methionine diets both reduce lipid contents, a process that depends on the presence of CG33474. Furthermore, CG33474 stimulates the breakdown of neutral lipids in a cell-autonomous manner. Moreover, the expression of CG33474 triggered by cysteine and methionine requires TOR signaling. Finally, we found that CG33474 promotes inter-organelle contacts between peroxisomes and lipid droplets (LDs), which might be a potential mechanism for CG33474-induced fat loss. In summary, our findings demonstrate that CG33474/PEX11G may serve as an essential molecular bridge linking HPD to peroxisome dynamics and lipid metabolism.

Food Cravings and Obesity in Women with Polycystic Ovary Syndrome: Pathophysiological and Therapeutic Considerations

Polycystic ovary syndrome (PCOS), the most common endocrine disorder in women of reproductive age, constitutes a metabolic disorder frequently associated with obesity and insulin resistance (IR). Furthermore, women with PCOS often suffer from excessive anxiety and depression, elicited by low self-esteem due to obesity, acne, and hirsutism. These mood disorders are commonly associated with food cravings and binge eating. Hypothalamic signaling regulates appetite and satiety, deteriorating excessive food consumption. However, the hypothalamic function is incapable of compensating for surplus food in women with PCOS, leading to the aggravation of obesity and a vicious circle. Hyperandrogenism, IR, the reduced secretion of cholecystokinin postprandially, and leptin resistance defined by leptin receptors' knockout in the hypothalamus have been implicated in the pathogenesis of hypothalamic dysfunction and appetite dysregulation. Diet modifications, exercise, and psychological and medical interventions have been applied to alleviate food disorders, interrupting the vicious circle. Cognitive-behavioral intervention seems to be the mainstay of treatment, while the role of medical agents, such as GLP-1 analogs and naltrexone/bupropion, has emerged.

What could be the reasons for not losing weight even after following a weight loss program?

INTRODUCTION

Approximately four million people worldwide die annually because of obesity. Weight loss is commonly recommended as a first-line therapy in overweight and obese patients. Although many individuals attempt to lose weight, not everyone achieves optimal success. Few studies point out that weight loss eventually slows down, stagnates or reverses in 85% of the cases.

RESEARCH QUESTION

What could be the reasons for not losing weight even after following a weight loss program?

METHODS

A scoping review of the literature was performed using weight loss-related search terms such as 'Obesity,' 'Overweight,' 'Lifestyle,' 'weight loss,' 'Basal Metabolism,' 'physical activity,' 'adherence,' 'energy balance,' 'Sleep' and 'adaptations. The search involved reference tracking and database and web searches (PUBMED, Science Direct, Elsevier, Web of Science and Google Scholar). Original articles and review papers on weight loss involving human participants and adults aged > 18 years were selected. Approximately 231 articles were reviewed, and 185 were included based on the inclusion criteria.

DESIGN

Scoping review.

RESULTS

In this review, the factors associated with not losing weight have broadly been divided into five categories. Studies highlighting each subfactor were critically reviewed and discussed. A wide degree of interindividual variability in weight loss is common in studies even after controlling for variables such as adherence, sex, physical activity and baseline weight. In addition to these variables, variations in factors such as previous weight loss attempts, sleep habits, meal timings and medications can play a crucial role in upregulating or downregulating the association between energy deficit and weight loss results.

CONCLUSION

This review identifies and clarifies the role of several factors that may hinder weight loss after the exploration of existing evidence. Judging the effectiveness of respective lifestyle interventions by simply observing the 'general behavior of the groups' is not always applicable in clinical practice. Each individual must be monitored and advised as per their requirements and challenges.

Development of high-yielding white maize hybrids with better chapatti-making quality compared to traditionally used local landraces

Introduction

The present research focuses on the chapatti making quality of high-yielding white maize hybrids compared to available low-yielding local yellow and white landraces in India.

Materials and methods

In this study, the top nine superior hybrids were selected for testing the physical properties of the maize kernels, proximate composition of flours and chapattis, physical parameters of chapatti, textural properties, sensory evaluation of chapattis and pasting properties of maize flour.

Results and discussion

The results revealed the superiority of white maize hybrids (WMH), viz., WHM 1, WHM 2, and WHM 8 over the local yellow and white landraces for most of the parameters studied. In sensory analysis, though, the yellow landrace was considered superior by the panellists in terms of colour but the white maize hybrids outperformed in overall sensory analysis and were more acceptable than the yellow and white maize landraces. These high yielding white maize hybrids with good consumer acceptance may cater for the needs of rural and tribal populations in India who prefer white maize as a staple food.

Dietary proteins: from evolution to engineering

Because of the indispensable amino acids dietary proteins are the most important macronutrients. Proper growth and body maintenance depends on the quantity and quality of protein intake and proteins have thus been most crucial throughout evolution with hominins living in quite diverse food ecosystems. Developments in agriculture and food science have increased availability and diversity of food including protein for a rapidly growing world population while nutrient deficiencies resulting in stunting in children for example have been reduced. Nevertheless, the developing world and growing population needs more protein of high quality - with around 400 million tons per annum estimated for 2050. In contrary, protein consumption in all developed countries exceeds meanwhile the recommended intakes considerably with consequences for health and the environment. There is a growing interest in dietary proteins driven by the quest for more sustainable diets and the increasing food demand for a growing world population. This brings new and novel sources such as algae, yeast, insects or bacteria into play in delivering the biomass but also new technologies such as precision fermentation or in vitro meat/fish or dairy. What needs to be considered when such new protein sources are explored is that proteins need to provide not only the required amino acids but also functionality in the food produced thereof. This review considers human physiology and metabolism in the context of protein intake from an evolutionary perspective and prospects on future protein production.

Higher Imported Food Patterns Are Associated with Obesity and Severe Obesity in Tuvalu: A Latent Class Analysis

Background

Tuvalu is a Pacific Island country within the small island developing states that has observed a significant and alarming increase in obesity rates over the past 40 years, affecting ∼60 %-70 % of the current population.

Objectives

This study aimed to investigate the association between food patterns and the proportion of obesity in a Pacific Island country.

Methods

The 2022 COMmunity-based Behavior and Attitude survey in Tuvalu (COMBAT) included 985 adults with complete data on sociodemographic information and the frequency of consumption of 25 common foods. A latent class analysis determined 4 food patterns. Bayesian multilevel logistic and linear regression models estimated the association between food patterns and the proportion of obesity [body mass index (BMI) ≥30 kg/m2], severe obesity (BMI ≥40 kg/m2), and weight (kg), adjusting for potential confounders and accounting for clustering by region.

Results

The latent class analysis revealed 4 food patterns with an entropy of 0.94 and an average posterior probability of class assignment for each individual of 0.97, described as follows: 1) local: locally produced foods with moderate food diversity (proportion of individuals = 28 %); 2) diverse-local: local with greater food diversity (17 %); 3) restricted-imported: more imported with restricted diversity (29 %); and 4) imported: heavily imported with high diversity (26 %). Compared to those following the diverse-local pattern, the odds of having obesity were greater for those classified with the imported pattern [odds ratio (OR): 2.52; 95 % credible interval (CrI): 1.59, 3.99], restricted-imported pattern (OR: 1.89; 95 % CrI: 1.59, 3.99), and local pattern (OR: 1.54; 95 % CrI: 0.94, 2.50). Similar trends were observed for severe obesity while body weight was positively associated with both restricted-imported and imported food patterns.

Conclusions

The high consumption of imported foods, together with the low consumption of plant-based foods and protein-rich foods, could be a relevant modifiable lifestyle factor explaining the high levels of obesity and severe obesity in Tuvalu, a Pacific Island country.

A genomics perspective of personalized prevention and management of obesity

This review discusses the landscape of personalized prevention and management of obesity from a nutrigenetics perspective. Focusing on macronutrient tailoring, we discuss the impact of genetic variation on responses to carbohydrate, lipid, protein, and fiber consumption. Our bioinformatic analysis of genomic variants guiding macronutrient intake revealed enrichment of pathways associated with circadian rhythm, melatonin metabolism, cholesterol and lipoprotein remodeling and PPAR signaling as potential targets of macronutrients for the management of obesity in relevant genetic backgrounds. Notably, our data-based in silico predictions suggest the potential of repurposing the SYK inhibitor fostamatinib for obesity treatment in relevant genetic profiles. In addition to dietary considerations, we address genetic variations guiding lifestyle changes in weight management, including exercise and chrononutrition. Finally, we emphasize the need for a refined understanding and expanded research into the complex genetic landscape underlying obesity and its management.

High-protein diet with immediate post-exercise protein drink: Impact on appetite in middle-aged obesity

Successful management of obesity can be challenging if individuals constantly experience cravings. The present study investigated the effects of a high-protein diet, including a high-protein drink consumed immediately after high-intensity interval training (HIIT), on appetite and weight loss in obese middle-aged individuals. A total of 52 obese middle-aged individuals (58.2 ± 4.11 years old) were randomly assigned to one of three groups: the exercise group (E, n=19), exercise and high-protein diet group (ED, n=21), and a control group (n=12). The E and ED groups engaged in cycling HIIT (comprising 90 % of peak heart rate (HRpeak) for 3 min, followed by 70 % of HRpeak for 3 min, for a total of 5 cycles) three times a week for 3 months. The ED group consumed a high-protein drink immediately after HIIT and had a daily protein intake of 1.6g/kg. Body composition and eating behavior were assessed before and after the intervention. Additionally, appetite levels were measured before and after each exercise session, before dinner, and before bedtime during three phases of the intervention: the first phase (weeks 3-4), the second phase (weeks 5-8), and the third phase (weeks 9-12). Results showed that only the ED group experienced a decrease in body mass index (from 27.4 ± 4.28 to 26.8 ± 4.09 kg/m2, p=0.04). Appetite significantly increased after exercise in both E and ED groups (p values for the three phases ranged from 0.04 to 0.001 for the E group and from 0.042 to 0.003 for the ED group). The desire to eat significantly increased after exercise in the E group (phase 1: p = 0.026; phase 2: p = 0.011; phase 3: p = 0.003), but not in the ED group. Furthermore, the frequency of late-night snacking decreased in the ED group (the score changed from 2.4 ± 0.86 to 2.7 ± 0.80, p = 0.034). Notably, the E group tended to have a higher pre-dinner appetite score than the ED group in the third phase (p = 0.063). In summary, a high daily protein intake, combined with the consumption of high-protein drinks after exercise, resulted in reduced post-exercise appetite and a decrease in the frequency of late-night snacking.

Nutrition and dietary restrictions in cancer prevention

The composition and pattern of dietary intake have emerged as key factors influencing aging, regeneration, and consequently, healthspan and lifespan. Cancer is one of the major diseases more tightly linked with aging, and age-related mortality. Although the role of nutrition in cancer incidence is generally well established, we are far from a consensus on how diet influences tumour development in different tissues. In this review, we will discuss how diet and dietary restrictions affect cancer risk and the molecular mechanisms potentially responsible for their effects. We will cover calorie restriction, intermittent fasting, prolonged fasting, fasting-mimicking diet, time-restricted eating, ketogenic diet, high protein diet, Mediterranean diet, and the vegan and vegetarian diets.

Association of meal-specific protein intake and cardiometabolic risk factors: a cross-sectional study

We aimed to investigate the association of main meals' specific protein intake with cardiometabolic risk factors, including general and abdominal obesity, serum lipid profile, and blood pressure (BP). This cross-sectional study was conducted on 850 subjects aged 20-59 years. Dietary intakes were assessed by completing three 24-h recalls, and the protein intake of each meal was extracted. Anthropometric measures, lipid profile, fasting blood sugar and BP were measured. Multivariate logistic regression controlling for age, physical activity, sex, marital status, smoking status, BMI and energy intake was applied to obtain OR and CI. The mean age was 42 years, and the mean BMI of the participants was 27·2. The mean protein intake for breakfast, lunch and dinner was 12·5, 22·2 and 18·7 g/d, respectively. After adjustment for confounders, higher protein intake was not associated with any of the cardiometabolic risk factors, including LDL-cholesterol, HDL-cholesterol, total cholesterol (TC), TAG, body weight, BP and fasting plasma glucose, in any of the three main meals consumed within a day. Adherence to a higher protein intake at each meal was not associated with cardiometabolic risk factors in Iranian adults. Further prospective studies are needed to justify our findings.

Food deprivation among adults in India: an analysis of specific food categories, 2016-2021

Background

Adult undernourishment remains pervasive throughout India, and often results from food deprivation, which refers to the inadequate consumption of foods with caloric and nutrient significance. Therefore, understanding the extent to which food groups are missing from an individual's diet is essential to understanding the extent to which they are undernourished.

Methods

We used data from two National Family Health Surveys conducted in 2016 and 2021 for this cross-sectional analysis. The study population consisted of women and pregnant women between the ages of 15-49, and men between the ages of 15-54. We examined shifts in the percentage of people not consuming dairy, pulses/beans/legumes, dark leafy green vegetables, fruits, eggs, and fish and meat among women, pregnant women, and men between the two time points. We also examined these patterns by household wealth and education, two important markers of socioeconomic status.

Findings

Overall, we found that fewer women, pregnant women, and men were not eating each of the six food groups in 2021 than in 2016. Additionally, the gap in food group consumption between women, pregnant women, and men in the lowest and highest socioeconomic groups shrank between 2016 and 2021. Yet, food group deprivation remained most prevalent among those in the lowest socioeconomic groups. The two exceptions for this were for eggs and meat/fish. Nevertheless, the majority of India's poorest and least educated adults are not consuming high-quality protein sources, including dairy, the consumption of which is far more common among wealthier and more educated Indian adults.

Interpretation

Our results show that fewer adults were not consuming important food groups in 2021 than in 2016. However, many of India's poorest and least educated adults are still not consuming high-quality sources of protein or fruits, two food groups that are essential for good health. While adults might be getting protein and nutrients from pulses, legumes, beans, and other vegetables, efforts are needed to improve affordability of, and access to, high-quality sources of protein and fruits.

Funding

This work was supported by the Bill & Melinda Gates Foundation, INV- 002992.

Unveiling the influence of daily dietary patterns on brain cortical structure: insights from bidirectional Mendelian randomization

Cognitive impairment is a significant concern in aging populations. This study utilized Mendelian randomization analysis to explore the impact of dietary habits and macro-nutrients on cortical structure. A bidirectional Mendelian randomization approach was employed, incorporating large-scale genetic data on dietary habits and brain cortical structure. The results did not reveal significant causal relationships between dietary factors and overall cortical structure and thickness. However, specific dietary factors showed associations with cortical structure in certain regions. For instance, fat intake affected six cortical regions, while milk, protein, fruits, and water were associated with changes in specific regions. Reverse analysis suggested that cortical thickness influenced the consumption of alcohol, carbohydrates, coffee, and fish. These findings contribute to understanding the potential mechanisms underlying the role of dietary factors in cognitive function changes and provide evidence supporting the existence of the gut-brain axis.

A Review of Healthy Dietary Choices for Cardiovascular Disease: From Individual Nutrients and Foods to Dietary Patterns

Cardiovascular disease (CVD) remains the first cause of mortality globally. Diet plays a fundamental role in cardiovascular health and is closely linked to the development of CVD. Numerous human studies have provided evidence on the relationship between diet and CVD. By discussing the available findings on the dietary components that potentially influence CVD progression and prevention, this review attempted to provide the current state of evidence on healthy dietary choices for CVD. We focus on the effects of individual macronutrients, whole food products, and dietary patterns on the risks of CVD, and the data from population-based trials, observational studies, and meta-analyses are summarized. Unhealthy dietary habits, such as high intake of saturated fatty acids, sugar-sweetened beverages, red meat, and processed meat as well as high salt intake are associated with the increased risk of CVD. Conversely, increased consumption of plant-based components such as dietary fiber, nuts, fruits, and vegetables is shown to be effective in reducing CVD risk factors. The Mediterranean diet appears to be one of the most evidence-based dietary patterns beneficial for CVD prevention. However, there is still great debate regarding whether the supplementation of vitamins and minerals confers cardioprotective benefits. This review provides new insights into the role of dietary factors that are harmful or protective in CVD, which can be adopted for improved cardiovascular health.

Dose-Response of Myofibrillar Protein Synthesis To Ingested Whey Protein During Energy Restriction in Overweight Postmenopausal Women: A Randomized, Controlled Trial

BACKGROUND

Diet-induced weight loss is associated with a decline in lean body mass, as mediated by an impaired response of muscle protein synthesis (MPS). The dose-response of MPS to ingested protein, with or without resistance exercise, is well characterized during energy balance but limited data exist under conditions of energy restriction in clinical populations.

OBJECTIVE

To determine the dose-response of MPS to ingested whey protein following short-term diet-induced energy restriction in overweight, postmenopausal, women at rest and postexercise.

DESIGN

Forty middle-aged (58.6±0.4 y), overweight (BMI: 28.6±0.4), postmenopausal women were randomly assigned to 1 of 4 groups: Three groups underwent 5 d of energy restriction (∼800 kcal/d). On day 6, participants performed a unilateral leg resistance exercise bout before ingesting either a bolus of 15g (ERW15, n = 10), 35g (ERW35, n = 10) or 60g (ERW60, n = 10) of whey protein. The fourth group (n = 10) ingested a 35g whey protein bolus after 5 d of an energy balanced diet (EBW35, n = 10). Myofibrillar fractional synthetic rate (FSR) was calculated under basal, fed (FED) and postexercise (FED-EX) conditions by combining an L-[ring-13C6] phenylalanine tracer infusion with the collection of bilateral muscle biopsies.

RESULTS

Myofibrillar FSR was greater in ERW35 (0.043±0.003%/h, P = 0.013) and ERW60 (0.042±0.003%/h, P = 0.026) than ERW15 (0.032 ± 0.003%/h), with no differences between ERW35 and ERW60 (P = 1.000). Myofibrillar FSR was greater in FED (0.044 ± 0.003%/h, P < 0.001) and FED-EX (0.048 ± 0.003%/h, P < 0.001) than BASAL (0.027 ± 0.003%/h), but no differences were detected between FED and FED-EX (P = 0.732) conditions. No differences in myofibrillar FSR were observed between EBW35 (0.042 ± 0.003%/h) and ERW35 (0.043 ± 0.003%/h, P = 0.744).

CONCLUSION

A 35 g dose of whey protein, ingested with or without resistance exercise, is sufficient to stimulate a maximal acute response of MPS following short-term energy restriction in overweight, postmenopausal women, and thus may provide a per serving protein recommendation to mitigate muscle loss during a weight loss program.

TRIAL REGISTRY

clinicaltrials.gov (ID: NCT03326284).

Protein Intake, Source and Effect on Children's Weight Status: An Epidemiological Study in Greece

The development of overweight and obesity during late childhood and early adolescence is one of the most critical issues in public health. Additionally, over the past few years, the consumption of protein has tended to increase in both children and adults. The present study aimed to evaluate whether the protein type, either plant- or animal-sourced, as well as the quantity consumed, could potentially have a relationship with excess body weight in children. A total of 47 primary schools were selected, and 1728 students, aged 10-12 years, were enrolled for the purposes of this study, leading to our final sample of 712. Physical measurements, such as weight and height, were measured, and children were separated into two weight status categories according to their Body Mass Index, which was obtained through the International Obesity Task Force criteria. Students' diets were assessed through a questionnaire, and total, plant- and animal-derived protein intakes were calculated. Unadjusted analysis showed a statistically significant association between body weight and plant protein. After adjustment for overall energy intake, sex, age, and exercise, there was a statistically significant negative association between plant protein and excess body weight in children (OR: 0.964, 95% CI: 0.936; 0.992), but a lack of association for animal-sourced protein (OR: 1.002, 95% CI: 0.991; 1.013). Dietary plant-derived protein seems to have a positive effect on weight status in children, independently of total energy intake and physical activity; nevertheless, additional research is required in order to elucidate the underlying mechanisms.

Protein and lipid content estimation in soybeans using Raman hyperspectral imaging

Unlike standard chemical analysis methods involving time-consuming, labor-intensive, and invasive pretreatment procedures, Raman hyperspectral imaging (HSI) can rapidly and non-destructively detect components without professional supervision. Generally, the Kjeldahl methods and Soxhlet extraction are used to chemically determine the protein and lipid content of soybeans. This study is aimed at developing a high-performance model for estimating soybean protein and lipid content using a non-destructive Raman HSI. Partial least squares regression (PLSR) techniques were used to develop the model using a calibration model based on 70% spectral data, and the remaining 30% of the data were used for validation. The results indicate that the Raman HSI, combined with PLSR, resulted in a protein and lipid model Rp2 of 0.90 and 0.82 with Root Mean Squared Error Prediction (RMSEP) 1.27 and 0.79, respectively. Additionally, this study successfully used the Raman HSI approach to create a prediction image showing the distribution of the targeted components, and could predict protein and lipid based on a single seeds.

Associations of Meat and Fish/Seafood Intake with All-Cause and Cause-Specific Mortality from Three Prospective Cohort Studies in Korea

SCOPE

Animal protein intake among Koreans has recently increased. However, there is limited evidence on the association of meat and fish/seafood intake and mortality.

METHODS AND RESULTS

This study uses three representative prospective cohorts in Korea and 134,586 eligible participants are selected. Food intake is assessed using a food frequency questionnaire. Outcomes are classified as death from cardiovascular disease (CVD), cancer, and all-causes. Red meat intake shows a marginally negative association with all-cause mortality in the median intake group and a positive association in the highest intake group. Processed meat intake in the highest quintile group is positively associated with all-cause mortality compared to that of the lowest quintile group. Fish intake in the highest quintile group is negatively associated with CVD mortality in men, and all-cause mortality in women, compared to those in the lowest quintile group, while processed fish intake has unfavorable effects on mortality. In addition, substitution of one serving per week of red and processed meat, and processed fish with fish is negatively associated with all-cause and CVD mortality.

CONCLUSION

Reduction of red and processed meat, and processed fish consumption or replacement of these foods with fish may be beneficial for longevity in Korean adults.

High- and normal-protein diets improve body composition and glucose control in adults with type 2 diabetes: a randomized trial

OBJECTIVE

Weight loss of ≥10% improves glucose control and may remit type 2 diabetes (T2D). High-protein (HP) diets are commonly used for weight loss, but whether protein sources, especially red meat, impact weight loss-induced T2D management is unknown. This trial compared an HP diet including beef and a normal-protein (NP) diet without red meat for weight loss, body composition changes, and glucose control in individuals with T2D.

METHODS

A total of 106 adults (80 female) with T2D consumed an HP (40% protein) diet with ≥4 weekly servings of lean beef or an NP (21% protein) diet excluding red meat during a 52-week weight loss intervention. Body weight, body composition, and cardiometabolic parameters were measured before and after intervention.

RESULTS

Weight loss was not different between the HP (-10.2 ± 1.6 kg) and NP (-12.7 ± 4.8 kg, p = 0.336) groups. Both groups reduced fat mass and increased fat-free mass percent. Hemoglobin A1c, glucose, insulin, insulin resistance, blood pressure, and triglycerides improved, with no differences between groups.

CONCLUSIONS

The lack of observed effects of dietary protein and red meat consumption on weight loss and improved cardiometabolic health suggests that achieved weight loss, rather than diet composition, should be the principal target of dietary interventions for T2D management.

Plant Proteins: Methods of Quality Assessment and the Human Health Benefits of Pulses

As countries increase their standard of living and individual income levels rise, there is a concomitant increase in the demand for animal-based protein. However, there are alternative sources. One of the alternatives available is that of increased direct human consumption of plant proteins. The quality of a dietary protein is an important consideration when discussing the merits of one protein source over another. The three most commonly used methods to express protein quality are the protein efficiency ratio (PER), a weight gain measurement; protein digestibility-corrected amino acid score (PDCAAS); and the digestible indispensable amino acid score (DIAAS). The possibility that alterations in the quality and quantity of protein in the diet could generate specific health outcomes is one being actively researched. Plant-based proteins may have additional beneficial properties for human health when compared to animal protein sources, including reductions in risk factors for cardiovascular disease and contributions to increased satiety. In this paper, the methods for the determination of protein quality and the potential beneficial qualities of plant proteins to human health will be described.

Effects of hyperprotein diet on anxiety, haemodynamics and morphofunctional aspects of the heart of Wistar rats

NEW FINDINGS

What is the central question of this study? The consumption of a high-protein diet has been associated with an anxiogenic factor that can influence anxiety and possible cardiovascular changes: does the consumption of a high-protein diet interfere with anxiety, haemodynamics and morphofunctional aspects of the heart of Wistar rats? What is the main finding and its importance? Our study showed that the high-protein diet did not interfere with anxiety and haemodynamics. The animals in the hyperproteic group showed positive heart adaptations characterized by less work and lower heart rate without impairing ejection fraction and systemic blood pressure.

ABSTRACT

Anxiety is a mechanism preparatory to a response in situations of threat and danger, involving behavioural, affective and physiological factors. Protein-based foods have a high concentration of amino acids which perform multiple functions, including in the biosynthesis of excitatory transmitters for the central nervous system. In recent years, adherence to high-protein diets has been gaining ground in society, on the basis that it brings benefits to the musculoskeletal system and cardiovascular health. The aim of the present study was to investigate the effect of a high-protein diet in a state of anxiety and to investigate morphofunctional cardiovascular effects of a high-protein diet in Wistar rats. The experiment lasted 8 weeks and two groups of male rats were submitted to either a normoproteic or a hyperproteic diet. Anxiety was assessed using the plus maze test and cardiovascular morphofunctional aspects using transthoracic echocardiography and invasive measurements of femoral blood pressure. There was no statistically significant difference in the anxiety test, but the hyperproteic group was more agitated, with greater displacement during the test. Changes were found in systolic and end-diastolic volume, left ventricular diameter in systole and heart rate, which were significantly lower in the hyperproteic group, and there was an increase in the thickness of the interventricular septum in diastole. The results showed no influence of the higher protein diet on the animals' anxiety, body weight and haemodynamics.

Protein Source Influences Acute Appetite and Satiety but not Subsequent Food Intake in Healthy Adults

BACKGROUND

Although current recommendations encourage plant-based dietary patterns, data is limited as to whether the equivalent substitution of animal-based protein-rich foods with plant-based versions impacts ingestive behavior.

OBJECTIVE

To compare higher-protein preloads, varying in protein source, on appetite, satiety, and subsequent energy intake.

METHODS

Thirty-two adults (Age: 25±1y; Body Mass Index (BMI): 24.2±0.5kg/m) randomly consumed 250kcal, protein-preload beverages (24g protein), varying in protein source (whey, soy, pea protein isolates (WHEY, SOY, PEA) or micellar casein (CAS)) each morning for 3 acclimation days/preload. On day 4, participants completed a 4-h clinical testing day in which the respective preload was consumed followed by blood sampling and questionnaires every 30min for appetite and satiety. An ad libitum lunch was provided 4-h post-preload. On day 5, participants consumed the respective preload at home followed by an ad libitum breakfast 30min afterwards. For normally-distributed data, repeated-measures analysis of variance (ANOVA) or Friedman non-parametric test were utilized to compare main effects of protein source on study outcomes. Post-hoc pairwise comparisons using least significant differences (LSD) were then performed.

RESULTS

CAS (-3330±690mm*240min) and PEA (-2840±930mm*240min) reduced 4-h appetite vs. SOY (-1440±936mm*240min; both, P<0.05). WHEY was not different (-2290±930mm*240min). CAS (3520±84pg/ml*240min) and PEA (3860±864pg/ml*240min) increased 4-h PYY concentrations vs. SOY (2200±869pg/ml*240min; both, P<0.05). WHEY was not different (3870±932pg/ml*240 min). No differences in ad libitum energy intake were observed.

CONCLUSIONS

CAS and PEA, but not WHEY, elicited greater acute changes in appetite and satiety vs. SOY in healthy adults, supporting that not all protein sources are equivalent. This trial is registered at clinicaltrials.gov (NCT03154606).

Effects of different weight loss dietary interventions on body mass index and glucose and lipid metabolism in obese patients

To investigate the effects of different weight loss interventions on body mass index (BMI) and glucose and lipid metabolism in obese patients. Obese patients (n = 135) admitted to our hospital between December 2020 and August 2022 were divided into 3 groups, according to their diet patterns: calorie-restricted diet (CRD) group (n = 39), high-protein diet (HPD) group (n = 28), and 5 + 2 intermittent fasting (IF) group (n = 68). Body weight, body fat rate, BMI, hip circumference, and waist circumference were measured before and 60 days after implementation of the respective diet plan. Glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), 2h postprandial blood glucose (2hPG), triglyceride (TG), total cholesterol, low-density lipoprotein, high-density lipoprotein, and adverse events were evaluated. Following the dietary intervention, the weight (P = .005 for CRD, P < .001 for HPD, and P = .001 for IF), body fat rate (P = .027 for CRD, P = .002 for HPD, and P = .011 for IF group), BMI (P = .017 for CRD, P < .001 for HPD, and P = .002 for IF group), hip circumference (P < .001 for CRD, P = .013 for HPD, and P = .032 for IF group), waist circumference (P = .005 for CRD, P < .001 for HPD, and P = .028 for IF group), HbA1c (P = .014 for CRD, P = .002 for HPD, and P = .029 for IF group), FBG (P = .017 for CRD, P < .001 for HPD, and P = .033 for IF group), and 2hPG (P = .009 for CRD, P = .001 for HPD, and P = .012 for IF group), were significantly decreased. TG (P = .007 for CRD, P < .001 for HPD, and P = .018 for IF group), TC (P = .029 for CRD, P = .013 for HPD, and P = .041 for IF group), LDL-C (P = .033 for CRD, P = .021 for HPD, and P = .042 for IF group), and LDL-C (P = .011 for CRD, P < .001 for HPD, and P = .027 for IF group) improved significantly in the 3 groups, when compared to that before treatment. The HPD had the best effect on reducing blood lipids, followed by the CRD; the effect of IF was slightly lesser. Short-term HPD, CRD, and IF can reduce the weight and body fat of overweight/obese individuals and improve blood lipid and blood sugar levels. The effect of HPD on weight loss, body fat, and blood lipid levels was greater than that of CRD or IF.

Relationship between dietary macronutrient composition with weight loss after bariatric surgery: A systematic review

This systematic review evaluated the relationship between macronutrient intake and weight loss after bariatric surgery (BS). The MEDLINE/Pubmed, EMBASE, COCHRANE/CENTRAL, and SCOPUS databases were accessed in August 2021 to search for eligible articles: original publications with adults undergoing BS and indicating the relationship between macronutrients and weight loss. Titles that did not meet these criteria were excluded. The review was written according to the PRISMA guide, and the risk of bias was according to the Joanna Briggs manual. Data were extracted by one reviewer and checked by another. Eight articles with 2.378 subjects were included. The studies indicated a positive relationship between weight loss and protein intake after BS. Prioritization of protein followed by carbohydrates with a lower percentage of lipids favors weight loss and increases weight stability after BS. Among the results found, a 1% increase in protein intake raises the probability of obesity remission by 6%, and high-protein diet increase 50% weight loss success. Limitations are the methods of included studies and review process. It is concluded that high-protein intake >60 g a 90 g/day may favor weight loss and maintenance after BS, but it is relevant to balance the other macronutrients.

Benefits of Whey Proteins on Type 2 Diabetes Mellitus Parameters and Prevention of Cardiovascular Diseases

Type 2 diabetes mellitus (T2DM) is a major cause of morbidity and mortality, and it is a major risk factor for the early onset of cardiovascular diseases (CVDs). More than genetics, food, physical activity, walkability, and air pollution are lifestyle factors, which have the greatest impact on T2DM. Certain diets have been shown to be associated with lower T2DM and cardiovascular risk. Diminishing added sugar and processed fats and increasing antioxidant-rich vegetable and fruit intake has often been highlighted, as in the Mediterranean diet. However, less is known about the interest of proteins in low-fat dairy and whey in particular, which have great potential to improve T2DM and could be used safely as a part of a multi-target strategy. This review discusses all the biochemical and clinical aspects of the benefits of high-quality whey, which is now considered a functional food, for prevention and improvement of T2DM and CVDs by insulin- and non-insulin-dependent mechanisms.

Improvement in chrono-nutrition is associated with robust weight loss outcomes: An extension of the feasibility study

Previously we had demonstrated the development and feasibility of an integrated chrono-nutrition weight reduction program among non-shift workers with morning and evening chronotypes. In this current paper, we described the association between the changes in chrono-nutrition practice and weight loss outcomes upon completing the weight reduction program. A total of 91 overweight/obese non-shift workers participated in the 12-week integrated chrono-nutrition weight reduction program (Age: 39.6 ± 6.3 y; 74.7% women; BMI: 31.2 ± 4.5 kg/m²). All the assessments including anthropometry, dietary, sleep habits, physical activity, and process of change were measured during pre- and post-intervention. Participants who had lost ≥3% of their body weight were categorized as satisfactory weight loss outcome, and those who did not achieve 3% weight loss were categorized as unsatisfactory weight loss. The satisfactory weight loss had greater daily percent energy intake during earlier in the day from protein (Mean difference (MD): +3.2%, 95% CI: 1.6, 4.9, p < .001) and smaller intake from fat during later in the day (MD: -2.6%, 95% CI: -5.1, -0.1, p = .045), earlier last mealtime (MD: -49.5 min, 95% CI: -86.5, -12.6, p = .009) and midpoint of eating (MD: -27.3 min, 95% CI: -46.3, -8.2, p = .006), shorter eating window (-0.8 h, 95% CI: -1.4, -0.1, p = .031) and greater reduction in night eating syndrome score (MD: -2.4, 95% CI: -4.3, -0.5, p = .015) compared to unsatisfactory weight loss outcome. After accounting for potential confounders, the temporal pattern of energy, protein, and fat intake were associated with greater odds of achieving a satisfactory weight loss. The findings suggest a promising role of chrono-nutrition as one of the strategies in weight reduction intervention.

Assessment of the Clinical Condition and Way of Patients' Nutrition before and after Laparoscopic Sleeve Gastrectomy

One of the most commonly performed bariatric procedures is the laparoscopic sleeve gastrectomy (LSG). It is highly effective in reducing body weight, but it carries the risk of developing nutritional deficiencies and their consequences. The aim of the study was to determine the clinical condition of obese patients after LSG in terms of nutritional status, metabolic disorders, and way of nutrition. Thirty participants (15 women and 15 men) took part in the study. A statistically significant reduction in the total body fat mass (women by 37.5% p < 0.05, men by 37.06% p < 0.05) and total fat free mass (women by 10% p < 0,05, men by 12.5% p < 0.05) was demonstrated 6 months after LSG. Moreover, insufficient protein intake has been shown in over 73% of women and 40% of men. Before and 6 months after LSG, insufficient intake of calcium, magnesium, potassium, folate, vitamin D, and iron was observed. Six months after the LSG, significant decreases of fasting glucose (p < 0.05), insulin (p < 0.05), TG (p < 0.05), and AST (p < 0.05) concentrations, were observed in both groups. Optimization of nutrition in order to prevent nutritional deficiencies and their complications is a key element of the therapy of obese patients treated surgically.

Alternative dietary protein sources to support healthy and active skeletal muscle aging

To mitigate the age-related decline in skeletal muscle quantity and quality, and the associated negative health outcomes, it has been proposed that dietary protein recommendations for older adults should be increased alongside an active lifestyle and/or structured exercise training. Concomitantly, there are growing environmental concerns associated with the production of animal-based dietary protein sources. The question therefore arises as to where this dietary protein required for meeting the protein demands of the rapidly aging global population should (or could) be obtained. Various non-animal-derived protein sources possess favorable sustainability credentials, though much less is known (compared with animal-derived proteins) about their ability to influence muscle anabolism. It is also likely that the anabolic potential of various alternative protein sources varies markedly, with the majority of options remaining to be investigated. The purpose of this review was to thoroughly assess the current evidence base for the utility of alternative protein sources (plants, fungi, insects, algae, and lab-grown "meat") to support muscle anabolism in (active) older adults. The solid existing data portfolio requires considerable expansion to encompass the strategic evaluation of the various types of dietary protein sources. Such data will ultimately be necessary to support desirable alterations and refinements in nutritional guidelines to support healthy and active aging, while concomitantly securing a sustainable food future.

An Updated Approach to Antiobesity Pharmacotherapy: Moving Beyond the 5% Weight Loss Goal

Despite professional society guidelines recommending that obesity be treated as a chronic disease by emphasizing the use of lifestyle modification in conjunction with pharmacotherapy, antiobesity medications are uncommonly prescribed in most clinical practices. The recent Food and Drug Administration approval of semaglutide 2.4 mg weekly to treat obesity-as well as other forthcoming advancements in diabetes and antiobesity medications-highlights the potential of pharmacotherapy to significantly augment weight loss efforts. In this Expert Endocrine Consult, we review the evolving role of antiobesity pharmacotherapy in clinical practice and suggest a framework for the use of these medications.

Obesity and type 2 diabetes mellitus: connections in epidemiology, pathogenesis, and treatments

The prevalence of obesity and diabetes mellitus (DM) has been consistently increasing worldwide. Sharing powerful genetic and environmental features in their pathogenesis, obesity amplifies the impact of genetic susceptibility and environmental factors on DM. The ectopic expansion of adipose tissue and excessive accumulation of certain nutrients and metabolites sabotage the metabolic balance via insulin resistance, dysfunctional autophagy, and microbiome-gut-brain axis, further exacerbating the dysregulation of immunometabolism through low-grade systemic inflammation, leading to an accelerated loss of functional β-cells and gradual elevation of blood glucose. Given these intricate connections, most available treatments of obesity and type 2 DM (T2DM) have a mutual effect on each other. For example, anti-obesity drugs can be anti-diabetic to some extent, and some anti-diabetic medicines, in contrast, have been shown to increase body weight, such as insulin. Meanwhile, surgical procedures, especially bariatric surgery, are more effective for both obesity and T2DM. Besides guaranteeing the availability and accessibility of all the available diagnostic and therapeutic tools, more clinical and experimental investigations on the pathogenesis of these two diseases are warranted to improve the efficacy and safety of the available and newly developed treatments.

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

PURPOSE

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

DESIGN

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

RESULTS

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

CONCLUSION

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

Egg Introduction during Infancy is Associated with Lower Fat Mass Index in Females at Early Adolescence

BACKGROUND

Egg consumption may play an important role in early-life growth given their high-quality protein, essential fatty acids, and micronutrients.

OBJECTIVES

Study objectives were to examine the longitudinal associations of infant age at egg introduction with obesity outcomes in early childhood, middle childhood (mid-childhood), and early adolescence.

METHODS

We used existing data from 1089 mother-child dyads from Project Viva to estimate age at egg introduction through a questionnaire completed by mothers at ∼1 y postpartum (mean ± SD, 13.3 ± 1.2 mo). Outcome measures included height and weight (early childhood, mid-childhood, and early adolescence), body composition including total fat mass, trunk fat mass, and lean mass (mid-childhood and early adolescence), and plasma adiponectin and leptin (early and mid-childhood and early adolescence). We defined childhood obesity as sex- and age-specific BMI ≥ 95th percentile. We estimated the associations of infant age at egg introduction with risk of obesity using multivariable logistic regression and multivariable linear regression models for BMI-z-score, body composition measures, and adiposity hormones; adjusted for maternal prepregnancy BMI and sociodemographics.

RESULTS

Among females, those introduced to egg by the 1-y survey had a lower total fat mass index (confounder-adjusted mean difference, -1.23 kg/m2; 95% CI: -2.14, -0.31), and trunk fat mass index (confounder-adjusted mean difference, -0.57 kg/m2; 95% CI: -1.01, -0.12) in early adolescence compared to those not introduced (reference group). However, no associations between infant age at egg introduction and risk of obesity were observed among males (confounder-adjusted odd ratio [aOR], 1.97; 95% CI: 0.90, 4.30) or females (aOR, 0.68; 95% CI: 0.38, 1.24) across all ages. Egg introduction in infancy was associated with lower plasma adiponectin among females (confounder-adjusted mean difference, -1.93 μg/mL; 95% CI: -3.70, -0.16) in early childhood only.

CONCLUSIONS

Egg introduction during infancy among females is associated with lower total fat mass index in early adolescence and plasma adiponectin in early childhood. This trial was registered at clinicaltrials.gov as NCT02820402.

Coadministration of L-alanine and L-glutamine ameliorate blood glucose levels, biochemical indices and histological features in alloxan-induced diabetic rats

We evaluated the effects of supplementation of L-alanine and L-glutamine on blood glucose levels and biochemical parameters in alloxan-induced diabetic rat. Forty-nine animals were distributed into seven equal groups. Except for the non-diabetic control, diabetes was induced in all groups by intravenous alloxan injection followed by daily supplementation with amino acids for 14 days. Weight and blood glucose were monitored during supplementation, while biochemical parameters such as liver and renal functions, lipid profile, and antioxidant markers were evaluated post-intervention. A significant increase (p < .05) in weight and decrease in blood glucose were observed in the amino acid(s) treated groups. The supplementation with both amino acids restored important tissue antioxidants, liver and kidney functions and rescued islets cells degeneration. Histopathological examinations of important tissues showed the restoration of alloxan-induced physiopathological changes by the amino acids. Thus, these amino acids might serve as nutraceuticals for the management and treatment of diabetes. PRACTICAL APPLICATIONS: The discovery and production of antidiabetic bioactive compounds are often challenging, and the existing antidiabetic drugs are expensive. Amino acids are key regulators of glucose metabolism, insulin secretion, and insulin sensitivity; thus, they can play a crucial role in alleviating diabetes. Here, we present findings that strongly suggest the potential of pure amino acids (L-alanine and L-glutamine) for the management and treatment of diabetes. We show that these amino acids, when supplemented singly or coadministered can lower blood glucose levels and restore several other biochemical parameters implicated in diabetes. Hence, these cheap amino acids may be consumed as nutraceuticals or food supplements by diabetics for the treatment/management of diabetes. Foods rich in these amino acids may also be consumed as part of the diet of diabetic patients.

Understanding sarcopenic obesity in young adults in clinical practice: a review of three unsolved questions

INTRODUCTION

Our aim was to summarize the available literature on three yet unsolved questions, namely: 1) the dilemma surrounding definition of sarcopenic obesity (SO), especially in young adults; 2) the potential impact of this phenotype on weight-loss programme outcomes; and 3) the strategies for optimum management (prevention/treatment) of SO in clinical practice.

EVIDENCE ACQUISITION

A literature review using the PubMed/Medline database was conducted, and data were summarized based on a narrative approach.

EVIDENCE SYNTHESIS

Firstly, SO can be screened by the 30-sec sit-to-stand test; ≤25 and ≤21; and confirmed by the ratio of (appendicular lean mass/Body Mass Index) ≤0.789 and 0.512 in males and females, respectively. Secondly, SO is associated with impaired physical fitness, reduced resting energy expenditure and an inactive lifestyle, that seems to negatively impact on weight-management outcomes, namely increasing early dropout and difficulty in maintaining weight loss in the long term. Finally, prevention/treatment of SO in young adults must be realized through tailored lifestyle intervention (diet+exercise) to preserve and improve strength and muscle mass, even where weight loss is necessary.

CONCLUSIONS

Our findings have clinical implications since they may help in screening, managing and improving the weight-loss outcomes of patients with SO in clinical settings.