Dietary Protein and Energy Balance in Relation to Obesity and Co-morbidities

Strategies for minimizing muscle loss during use of incretin-mimetic drugs for treatment of obesity

The rapid and widespread clinical adoption of highly effective incretin-mimetic drugs (IMDs), particularly semaglutide and tirzepatide, for the treatment of obesity has outpaced the updating of clinical practice guidelines. Consequently, many patients may be at risk for adverse effects and uncertain long-term outcomes related to the use of these drugs. Of emerging concern is the loss of skeletal muscle mass and function that can accompany rapid substantial weight reduction; such losses can lead to reduced functional and metabolic health, weight cycling, compromised quality of life, and other adverse outcomes. Available evidence suggests that clinical trial participants receiving IMDs for the treatment of obesity lost 10% or more of their muscle mass during the 68- to 72-week interventions, approximately equivalent to 20 years of age-related muscle loss. The ability to maintain muscle mass during caloric restriction-induced weight reduction is influenced by two key factors: nutrition and physical exercise. Nutrition therapy should ensure adequate intake and absorption of high-quality protein and micronutrients, which may require the use of oral nutritional supplements. Additionally, concurrent physical activity, especially resistance training, has been shown to effectively minimize loss of muscle mass and function during weight reduction therapy. All patients receiving IMDs for obesity should participate in comprehensive treatment programs emphasizing adequate protein and micronutrient intakes, as well as resistance training, to preserve muscle mass and function, maximize the benefit of IMD therapy, and minimize potential risks.

Effects of Varying Protein Amounts and Types on Diet-Induced Thermogenesis: A Systematic Review and Meta-Analysis

Protein is the most thermogenic macronutrient, but it is unclear how different amounts and types of protein impact diet-induced thermogenesis (DIT). The purpose of this meta-analysis was to compare the impact of isocaloric meals/diets containing different amounts or types of protein on energy metabolism. Databases were searched in June 2024 for studies that compare DIT or total daily energy expenditure (TDEE) in response to isocaloric acute meals or longer-term diets containing different amounts or types of protein. After identifying 3894 records, 52 studies were included. Standardized mean difference (SMD) estimates and 95% confidence intervals (CIs) were calculated for each outcome. In acute studies, intake of higher compared with lower-protein meals resulted in greater DIT (SMD: 0.45; 95% CI: 0.26, 0.65; P < 0.001) and TDEE (SMD: 0.52; 95% CI: 0.30, 0.73; P < 0.001). Notably, the subgroup analysis indicated that this effect on DIT was statistically significant for studies involving participants with normal weight but not overweight/obesity, although it is not clear if this finding was a true effect or because of study design characteristics. In chronic studies (ranging from 4 d to 1 y), intake of higher compared with lower-protein diets resulted in greater TDEE (SMD: 0.29; 95% CI: 0.10, 0.48; P = 0.003) and resting energy expenditure (SMD: 0.18; 95% CI: 0.01, 0.35; P = 0.039), but no differences in DIT (SMD: 0.10; 95% CI: -0.08, 0.28; P = 0.27). There was no evidence that different types of protein impacted energy metabolism. Higher protein meals/diets increase components of energy expenditure. This trial was registered at the International Prospective Register of Systematic Reviews (https://www.crd.york.ac.uk/prospero; PROSPERO 2023) as CRD42023389642.

Effects of Marine-Derived Components on Cardiovascular Disease Risk Factors and Gut Microbiota Diversity

Cardiovascular diseases (CVDs), which comprise coronary heart disease, hypertension, and stroke, collectively represent the number one cause of death globally. Atherosclerosis is the dominant cause of CVDs, and its risk factors are elevated levels of low-density lipoprotein cholesterol and triglycerides, hypertension, cigarette smoking, obesity, and diabetes mellitus. In addition, diverse evidence highlights the role played by inflammation and clonal haematopoiesis, eventually leading to immunity involvement. The human microbiota project and subsequent studies using next-generation sequencing technology have indicated that thousands of different microbial species are present in the human gut. Disturbances in the gut microbiota (GM) composition, i.e., gut dysbiosis, have been associated with diseases ranging from localised gastrointestinal disorders to metabolic and cardiovascular illnesses. Of note, experimental studies suggested that GM, host immune cells, and marine-derived ingredients work together to ensure intestinal wall integrity. This review discusses current evidence concerning the links among GM, marine-derived ingredients, and human inflammatory disease. In detail, we summarise the impact of fish-derived proteins/peptides and algae components on CVD risk factors and gut microbiome. Furthermore, we describe the interplay among these dietary components, probiotics/prebiotics, and CVDs.

Intestinal gluconeogenesis: A translator of nutritional information needed for glycemic and emotional balance

At the interface between the outside world and the self, the intestine is the first organ receiving nutritional information. One intestinal function, gluconeogenesis, is activated by various nutrients, particularly diets enriched in fiber or protein, and thus results in glucose production in the portal vein in the post-absorptive period. The detection of portal glucose induces a nervous signal controlling the activity of the central nuclei involved in the regulation of metabolism and emotional behavior. Induction of intestinal gluconeogenesis is necessary for the beneficial effects of fiber or protein-enriched diets on metabolism and emotional behavior. Through its ability to translate nutritional information from the diet to the brain's regulatory centers, intestinal gluconeogenesis plays an essential role in maintaining physiological balance.

Deciphering the complex interplay of obesity, epithelial barrier dysfunction, and tight junction remodeling: Unraveling potential therapeutic avenues

Obesity stands as a formidable global health challenge, predisposing individuals to a plethora of chronic illnesses such as cardiovascular disease, diabetes, and cancer. A confluence of genetic polymorphisms, suboptimal dietary choices, and sedentary lifestyles significantly contribute to the elevated incidence of obesity. This multifaceted health issue profoundly disrupts homeostatic equilibrium at both organismal and cellular levels, with marked alterations in gut permeability as a salient consequence. The intricate mechanisms underlying these alterations have yet to be fully elucidated. Still, evidence suggests that heightened inflammatory cytokine levels and the remodeling of tight junction (TJ) proteins, particularly claudins, play a pivotal role in the manifestation of epithelial barrier dysfunction in obesity. Strategic targeting of proteins implicated in these pathways and metabolites such as short-chain fatty acids presents a promising intervention for restoring barrier functionality among individuals with obesity. Nonetheless, recognizing the heterogeneity among affected individuals is paramount; personalized medical interventions or dietary regimens tailored to specific genetic backgrounds and allergy profiles may prove indispensable. This comprehensive review delves into the nexus of obesity, tight junction remodeling, and barrier dysfunction, offering a critical appraisal of potential therapeutic interventions.

Absence of the Peptide Transporter 1 Induces a Prediabetic and Depressive-Like Phenotype in Mice

INTRODUCTION

Protein-enriched diets improve glycemic control in diabetes or emotional behavior in depressive patients. In mice, these benefits depend on intestinal gluconeogenesis activation by di-/tripeptides. Intestinal di-/tripeptides absorption is carried out by the peptide transporter 1, PEPT1. The lack of PEPT1 might thus alter glucose and emotional balance.

METHODS

To determine the effects of PEPT1 deficiency under standard dietary conditions or during a dietary challenge known to promote both metabolic and cognitive dysfunction, insulin sensitivity, anxiety, and depressive-like traits, hippocampal serotonin (5-HT) and insulin signaling pathway were measured in wild-type (WT) and Pept1-/- mice fed either a chow or a high-fat high-sucrose (HF-HS) diet.

RESULTS

Pept1-/- mice exhibited slight defects in insulin sensitivity and emotional behavior, which were aggravated by an HF-HS diet. Pept1-/- mice fed a chow diet had lower hippocampal 5-HT levels and exhibited cerebral insulin resistance under HF-HS diet. These defects were independent of intestinal gluconeogenesis but might be linked to increased plasma amino acids levels.

CONCLUSION

Pept1-/- mice develop prediabetic and depressive-like traits and could thus be used to develop strategies to prevent or cure both diseases.

Role of Eating Behavior and Stress in Maintenance of Dietary Changes During the PREVIEW Intervention

OBJECTIVE

To examine whether eating behavior and perceived stress predict the maintenance of self-reported dietary change and adherence to dietary instructions during an intervention.

DESIGN

A secondary analysis of the behavior maintenance stage (6-36 months) of the 3-year PREVIEW intervention (PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World).

PARTICIPANTS

Adults (n = 1,311) with overweight and prediabetes at preintervention baseline.

VARIABLES MEASURED

Eating behavior (Three-Factor Eating Questionnaire), stress (Perceived Stress Scale), and dietary intake (4-day food records on 4 occasions) were reported.

ANALYSIS

Associations between predictors and dietary outcomes were examined with linear mixed-effects models for repeated measurements.

RESULTS

Eating behaviors and stress at 6 months did not predict the subsequent change in dietary outcomes, but higher cognitive restraint predicted lower energy intake, and both higher disinhibition and hunger predicted higher energy intake during the following behavior maintenance stage. In addition, higher disinhibition predicted higher saturated fat intake and lower fiber intake, and higher hunger predicted lower fiber intake. Stress was not associated with energy intake or dietary quality. Eating behaviors and stress were not consistently associated with adherence to dietary instructions.

CONCLUSIONS AND IMPLICATIONS

Higher cognitive restraint predicted lower energy intake (food quantity), but disinhibition and hunger were also associated with dietary quality.

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.

The comparison of total energy and protein intake relative to estimated requirements in chronic spinal cord injury

In chronic spinal cord injury (SCI), individuals experience dietary inadequacies complicated by an understudied research area. Our objectives were to assess (1) the agreement between methods of estimating energy requirement (EER) and estimated energy intake (EEI) and (2) whether dietary protein intake met SCI-specific protein guidelines. Persons with chronic SCI (n = 43) completed 3-day food records to assess EEI and dietary protein intake. EER was determined with the Long and Institute of Medicine (IOM) methods and the SCI-specific Farkas method. Protein requirements were calculated as 0·8-1·0 g/kg of body weight (BW)/d. Reporting accuracy and bias were calculated and correlated to body composition. Compared with IOM and Long methods (P < 0·05), the SCI-specific method did not overestimate the EEI (P = 0·200). Reporting accuracy and bias were best for SCI-specific (98·9 %, -1·12 %) compared with Long (94·8 %, -5·24 %) and IOM (64·1 %, -35·4 %) methods. BW (r = -0·403), BMI (r = -0·323) and total fat mass (r = -0·346) correlated with the IOM reporting bias (all, P < 0·05). BW correlated with the SCI-specific and Long reporting bias (r = -0·313, P = 0·041). Seven (16 %) participants met BW-specific protein guidelines. The regression of dietary protein intake on BW demonstrated no association between the variables (β = 0·067, P = 0·730). In contrast, for every 1 kg increase in BW, the delta between total and required protein intake decreased by 0·833 g (P = 0·0001). The SCI-specific method for EER had the best agreement with the EEI. Protein intake decreased with increasing BW, contrary to protein requirements for chronic SCI.

Identification of a leucine-mediated threshold effect governing macrophage mTOR signalling and cardiovascular risk

High protein intake is common in western societies and is often promoted as part of a healthy lifestyle; however, amino-acid-mediated mammalian target of rapamycin (mTOR) signalling in macrophages has been implicated in the pathogenesis of ischaemic cardiovascular disease. In a series of clinical studies on male and female participants ( NCT03946774 and NCT03994367 ) that involved graded amounts of protein ingestion together with detailed plasma amino acid analysis and human monocyte/macrophage experiments, we identify leucine as the key activator of mTOR signalling in macrophages. We describe a threshold effect of high protein intake and circulating leucine on monocytes/macrophages wherein only protein in excess of ∼25 g per meal induces mTOR activation and functional effects. By designing specific diets modified in protein and leucine content representative of the intake in the general population, we confirm this threshold effect in mouse models and find ingestion of protein in excess of ∼22% of dietary energy requirements drives atherosclerosis in male mice. These data demonstrate a mechanistic basis for the adverse impact of excessive dietary protein on cardiovascular risk.

A High-Protein Diet Promotes Atrial Arrhythmogenesis via Absent-in-Melanoma 2 Inflammasome

High-protein diets (HPDs) offer health benefits, such as weight management and improved metabolic profiles. The effects of HPD on cardiac arrhythmogenesis remain unclear. Atrial fibrillation (AF), the most common arrhythmia, is associated with inflammasome activation. The role of the Absent-in-Melanoma 2 (AIM2) inflammasome in AF pathogenesis remains unexplored. In this study, we discovered that HPD increased susceptibility to AF. To demonstrate the involvement of AIM2 signaling in the pathogenesis of HPD-induced AF, wildtype (WT) and Aim2-/- mice were fed normal-chow (NC) and HPD, respectively. Four weeks later, inflammasome activity was upregulated in the atria of WT-HPD mice, but not in the Aim2-/--HPD mice. The increased AF vulnerability in WT-HPD mice was associated with abnormal sarcoplasmic reticulum (SR) Ca2+-release events in atrial myocytes. HPD increased the cytoplasmic double-strand (ds) DNA level, causing AIM2 activation. Genetic inhibition of AIM2 in Aim2-/- mice reduced susceptibility to AF, cytoplasmic dsDNA level, mitochondrial ROS production, and abnormal SR Ca2+-release in atrial myocytes. These data suggest that HPD creates a substrate conducive to AF development by activating the AIM2-inflammasome, which is associated with mitochondrial oxidative stress along with proarrhythmic SR Ca2+-release. Our data imply that targeting the AIM2 inflammasome might constitute a novel anti-AF strategy in certain patient subpopulations.

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.

Chronic Thermogenic Dietary Supplement Consumption: Effects on Body Composition, Anthropometrics, and Metabolism

Multi-ingredient thermogenic supplements can acutely increase resting energy expenditure (REE) and subjective energy. However, less is understood about the effects of chronic consumption on body composition, metabolism, and subjective variables such as mood, sleep quality, and eating behaviors. Fifty-two healthy, exercise-trained participants (50% female; mean ± SD age: 23.5 ± 3.0 years; body fat percentage: 27.3 ± 8.0%) were randomized 2:2:1 to take a whey protein supplement alone (PRO; n = 20), in combination with a thermogenic supplement (PRO + FB; n = 19), or no supplement at all (CON; n = 13) for four weeks. Body composition, anthropometric, metabolic, hemodynamic, and subjective outcomes were collected before and after the intervention. Greater changes in REE occurred in PRO + FB as compared to CON (111.2 kcal/d, 95% CI 2.4 to 219.9 kcal/d, p = 0.04), without significant differences between PRO and CON (42.7 kcal/d, 95% CI -65.0 to 150.3 kcal/d, p = 0.61) or between PRO + FB and PRO (68.5 kcal/d, 95% CI -28.3, 165.3, p = 0.21). No changes in hemodynamic outcomes (blood pressure and heart rate) were observed. In exercising adults, four weeks of supplementation with protein and a multi-ingredient thermogenic product maintained fasted REE as compared to no supplementation, for which a decrease in REE was observed, without differential effects on body composition, anthropometrics, or subjective variables.

Association between dietary protein intake, diet quality and diversity, and obesity among women of reproductive age in Kersa, Ethiopia

Introduction

In Ethiopia, there is limited evidence on the effect of dietary protein intake on women's body mass index. Therefore, this study investigated the association between dietary protein intake, diet quality, and overweight and obesity.

Methods

A cross-sectional study was conducted among 897 women of reproductive age. Food frequency questionnaires were used to assess 7-day dietary intake. It was converted into protein and other macro-nutrient intakes, Minimum Dietary Diversity for Women, and Global Dietary Quality Score. Body Mass Index (BMI) of overweight & obese women were defined as ≥25 kg/m2. An adjusted odds ratio with a 95% confidence interval (in a multivariate logistic regression model) was used to determine the strength of the association between BMI and dietary protein intake, adjusting for potential confounders.

Results

The median dietary protein intake was 41.3 (32.9, 52.6) grams/day or 0.8 (0.6, 1.0) grams/kilogram of body weight/day. The prevalence of overweight and obesity was 7.5% (n = 67). Only 220 (24.5%) women could meet the recommended minimum dietary diversity of five or more food groups out of 10 per day. Furthermore, only 255 (28.4%) women were found to have a low risk for nutrient adequacy. Interestingly, women who consumed moderate dietary protein had a significantly lower likelihood of being overweight or obese, with AOR of 0.21 (95% CI 0.10-0.48). Similarly, those who consumed a high amount of protein had even lower odds, with AOR of 0.03 (95% CI 0.01-0.14), compared to those who consumed a low amount of dietary protein. Age of 40-49 years (AOR = 3.33, 95% CI 1.24-8.95) compared to 18-29 years, non-farmers (AOR = 3.21, 95% CI 1.55-6.62), higher consumption of food from unhealthy groups (AOR = 1.30, 95% CI 1.05-1.61), and high fat intake (AOR = 1.06, 95% CI 1.04-1.09) were associated with overweight and obesity.

Conclusions and recommendations

The study indicated an inverse relationship between BMI and dietary protein intake. It also revealed that women who consumed foods from unhealthy or unhealthy when consumed in excessive amounts were more likely to be overweight or obese. Increasing dietary protein consumption can help reproductive-age women reduce the odds of obesity and overweight. Furthermore, community-based educational programs, policy changes, and healthcare services can support this effort.

Ghanaian clients' perception of fitness instructors' adherence to exercise delivery services codes of conduct: An exploratory study

Background and Aims

Patronage for fitness and wellness activities has increased in Ghana, but the perception of primary consumers regarding exercise delivery service codes of conduct (EDCC) remains undocumented. This study reported the perception of clients about fitness instructors' adherence to EDCC.

Methods

Three hundred and seventy-nine (mean age = 26.12 ± 8.83 years) clients registered with National Sports for ALL Association, Ghana (NASFAAG) were recruited. The participants were not living with any diagnosed disability, using psychiatric medication, and had consistently participated in fitness training, at least three times a week for a year, and not below the age of 18 years. The participants were recruited from fitness and wellness centers, gyms, and fitness clubs in three regions (Greater Accra-GA, Upper East-UE, and Ashanti-A) of Ghana. A closed-ended, self-structured and validated awareness and adherence exercise delivery codes of conduct questionnaires was administered. The questionnaire focused on data protection and responsibility, informed consent, competence, and professional and personal conduct adapted from the British Association of Sports and Exercise Science codes of conduct was administered. Statistical Package for Social Sciences (SPSS) version 23.0 was used to run factor analysis which determined factorial distribution of clients' perception of instructors on codes of conduct.

Results

In total, 50.99% (UE), 47.68% (A), and 46.02% (GA) clients indicated that identities were unprotected when trainers displayed information. In all, 31.05% (UE), 40.34% (A), and 36.48% (GA) showed they were introduced to substances without consent. In total, 38.89% (UE), 32.70% (A), and 53.55% (GA) clients participated in training to realize that the expertise expected was not provided. In all, 38.10% (UE) and 36.23% (A) agreed that instructors put safety at risk, while 23.02% (GA) exploited clients for personal gain.

Conclusion

Fitness instructors need enlightenment to adhere ethically to EDCC activities in Ghana. Activities related to wellness and fitness in Ghana require regulations.

Effects of Mealworm Fermentation Extract and Soy Protein Mix Ratio on Hepatic Glucose and Lipid Metabolism in Obese-Induced Mice

Previous studies found that mealworm fermentation extract (TMP) reduced alcoholic hepatic steatogenesis. This study examined how the ratio of TMP and soy protein (SP) mix affected glucose and lipid metabolism in obese mice given a high-fat diet (HFD). Mice were given HFD supplemented with 100% SP or the following three ratios of TMP and SP mix for 12 weeks: 20% (S4T1), 40% (S3T2), and 60% (S2T3) TMP. When compared to the SP group, the S2T3 group had considerably lower body weight gain and food consumption. When compared to the SP group, the S2T3 group had slightly lower blood insulin and leptin levels, as well as a lower homeostasis model assessment of insulin resistance score. The use of TMP instead of SP reduced the size of epididymal adipose tissue cells. An increase in the extent of substitution of SP with TMP inhibited the gene expression of hepatic fructolysis/gluconeogenesis (KHK, ALDOB, DLD, and FBP1), lipogenesis (FAS, SCD1, CD36, and DGAT2), and its transcriptional factors (PPARγ and ChREBP). Furthermore, the S2T3 group dramatically reduced the expression of hepatic genes implicated in endoplasmic reticulum stress (PDI) and antioxidant defense (SOD1). The 60% TMP mix, in particular, reduced the expression of hepatic glucose and lipid metabolismrelated genes in HFD-fed mice. The manufacturing of functional processed goods may be accomplished by combining SP and TMP in a 2:3 ratio.

Poultry Consumption and Human Cardiometabolic Health-Related Outcomes: A Narrative Review

Poultry meats, in particular chicken, have high rates of consumption globally. Poultry is the most consumed type of meat in the United States (US), with chicken being the most common type of poultry consumed. The amounts of chicken and total poultry consumed in the US have more than tripled over the last six decades. This narrative review describes nutritional profiles of commonly consumed chicken/poultry products, consumption trends, and dietary recommendations in the US. Overviews of the scientific literature pertaining to associations between, and effects of consuming chicken/poultry on, body weight and body composition, cardiovascular disease (CVD), and type II diabetes mellitus (T2DM) are provided. Limited evidence from randomized controlled trials indicates the consumption of lean unprocessed chicken as a primary dietary protein source has either beneficial or neutral effects on body weight and body composition and risk factors for CVD and T2DM. Apparently, zero randomized controlled feeding trials have specifically assessed the effects of consuming processed chicken/poultry on these health outcomes. Evidence from observational studies is less consistent, likely due to confounding factors such as a lack of a description of and distinctions among types of chicken/poultry products, amounts consumed, and cooking and preservation methods. New experimental and observational research on the impacts of consuming chicken/poultry, especially processed versions, on cardiometabolic health is sorely needed.

No strong evidence of the protein leverage hypothesis in pregnant women with obesity and their infants

OBJECTIVE

The goal of this study was to investigate the role of dietary protein on macronutrient and energy intake, maternal adiposity during pregnancy, and infant adiposity at birth.

METHODS

In 41 women with obesity, early-pregnancy (13-16 weeks) protein intake was assessed with food photography and expressed as a ratio of Estimated Average Requirements (EAR) in pregnancy for protein (0.88 g/kg/d), herein "protein balance." Energy intake was measured by the intake-balance method, gestational weight gain as grams per week, and fat mass by a three-compartment model. Spearman correlations and linear models were computed using R version 4.1.1 (p < 0.05 considered significant).

RESULTS

Women had a mean (SD) age of 27.5 (4.8) years and a pregravid BMI of 34.4 (2.9), kg/m2 , and the majority were non-White (n = 23, 56.1%). Protein balance in early pregnancy was not significantly associated with energy intake across mid and mid/late pregnancy (β = 328.7, p = 0.30 and β = 286.2, p = 0.26, respectively) or gestational weight gain (β = 117.0, p = 0.41). Protein balance was inversely associated with fat mass in early, mid, and late pregnancy (β = -10.6, p = 0.01, β = -10.4, p = 0.03, β = -10.3, p = 0.03, respectively). Protein balance did not predict infant adiposity at birth (p > 0.05).

CONCLUSIONS

Low protein intake may have been present before pregnancy, explaining early relationships with adiposity in this cohort. The protein leverage hypothesis is likely not implicated in the intergenerational transmission of obesity.

Lysine Deprivation Suppresses Adipogenesis in 3T3-L1 Cells: A Transcriptome Analysis

Growing evidence proves that amino acid restriction can reverse obesity by reducing adipose tissue mass. Amino acids are not only the building blocks of proteins but also serve as signaling molecules in multiple biological pathways. The study of adipocytes' response to amino acid level changes is crucial. It has been reported that a low concentration of lysine suppresses lipid accumulation and transcription of several adipogenic genes in 3T3-L1 preadipocytes. However, the detailed lysine-deprivation-induced cellular transcriptomic changes and the altered pathways have yet to be fully studied. Here, using 3T3-L1 cells, we performed RNA sequencing on undifferentiated and differentiated cells, and differentiated cells under a lysine-free environment, and the data were subjected to KEGG enrichment. We found that the differentiation process of 3T3-L1 cells to adipocytes required the large-scale upregulation of metabolic pathways, mainly on the mitochondrial TCA cycle, oxidative phosphorylation, and downregulation of the lysosomal pathway. Single amino acid lysine depletion suppressed differentiation dose dependently. It disrupted the metabolism of cellular amino acids, which could be partially reflected in the changes in amino acid levels in the culture medium. It inhibited the mitochondria respiratory chain and upregulated the lysosomal pathway, which are essential for adipocyte differentiation. We also noticed that cellular interleukin 6 (IL6) expression and medium IL6 level were dramatically increased, which was one of the targets for suppressing adipogenesis induced by lysine depletion. Moreover, we showed that the depletion of some essential amino acids such as methionine and cystine could induce similar phenomena. This suggests that individual amino acid deprivation may share some common pathways. This descriptive study dissects the pathways for adipogenesis and how the cellular transcriptome was altered under lysine depletion.

Mushroom-Legume-Based Minced Meat: Physico-Chemical and Sensory Properties

A growing number of health-conscious consumers are looking for animal protein alternatives with similar texture, appearance, and flavor. However, research and development still needs to find alternative non-meat materials. The aim of this study was to develop a mushroom-based minced meat substitute (MMMS) from edible Pleurotus sajor-caju (PSC) mushrooms and optimize the concentration of chickpea flour (CF), beetroot extract, and canola oil. CF was used to improve the textural properties of the MMMS by mixing it with PSC mushrooms in ratios of 0:50, 12.5:37.5, 25:25, 37.5:12.5, and 50:0. Textural and sensory attributes suggest that PSC mushrooms to CF in a ratio of 37.5:12.5 had better textural properties, showing hardness of 2610 N and higher consumer acceptability with protein content up to 47%. Sensory analysis suggests that 5% (w/w) canola oil showed the most acceptable consumer acceptability compared to other concentrations. Color parameters indicate that 0.2% beetroot extract shows higher whiteness, less redness, and higher yellowness for both fresh and cooked MMMS. This research suggests that MMMS containing PSC, CF, canola oil, and beetroot extract could be a suitable alternative and sustainable food product which may lead to higher consumer adoption as a meat substitute.

Developments of Plant-Based Emulsion-Type Sausage by Using Grey Oyster Mushrooms and Chickpeas

Plant-based (PB) meat alternatives are developing due to the consumer's demand, especially those who are mainly health-concerned. Soy proteins (SP) are commonly used as the main ingredients for PB meat analogues; however, SP may have adverse effects on the cognitive function and mood of humans. This study aimed to use grey oyster mushroom (GOM) and chickpea flour (CF) as an alternative source of SP to prepare emulsion-type sausages (ES). The effect of different hydrocolloids and oil on the quality of sausage was also investigated. The sausage was prepared using different concentrations of GOM and CF (20:20, 25:15, and 30:10 w/w). The GOM to CF ratio 25:15 was selected for the ES based on protein content, textural properties, and sensory attributes. The result indicated that sausage containing konjac powder (KP) and rice bran oil (RBO) provided a better texture and consumer acceptability. The final product showed higher protein (36%, dry basis), less cooking loss (4.08%), purge loss (3.45%), higher emulsion stability, and better consumer acceptability than the commercial sausage. The best recipe for mushroom-based ES is 25% GOM, 15% CF, 5% KP, and 5% RBO. In addition, GOM and CF could be an alternative option to replace SP in PB meat products.

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).

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.

Dietary protein and the glycemic index handle insulin resistance within a nutritional program for avoiding weight regain after energy-restricted induced weight loss

BACKGROUND AND AIM

The role of dietary protein and glycemic index on insulin resistance (based on TyG index) within a nutritional program for weight loss and weight maintenance was examined.

METHODS

This study analyzed 744 adults with overweight/obesity within the DIOGenes project. Patients who lost at least 8% of their initial weight (0-8 weeks) after a low-calorie diet (LCD) were randomly assigned to one of five ad libitum diets designed for weight maintenance (8-34 weeks): high/low protein (HP/LP) and high/low glycemic index (HGI/LGI), plus a control. The complete nutritional program (0-34 weeks) included both LCD plus the randomized diets intervention. The TyG index was tested as marker of body mass composition and insulin resistance.

RESULTS

In comparison with the LP/HGI diet, the HP/LGI diet induced a greater BMI loss (p < 0.05). ∆TyG was positively associated with resistance to BMI loss (β = 0.343, p = 0.042) during the weight maintenance stage. In patients who followed the HP/LGI diet, TyG (after LCD) correlated with greater BMI loss in the 8-34 weeks period (r = -0.256; p < 0.05) and during the 0-34 weeks intervention (r = -0.222, p < 0.05) periods. ΔTyG1 value was associated with ΔBMI2 (β = 0.932; p = 0.045) concerning the HP/LGI diet.

CONCLUSIONS

A HP/LGI diet is beneficial not only for weight maintenance after a LCD, but is also related to IR amelioration as assessed by TyG index changes. Registration Clinical Trials NCT00390637.

Greater protein quality of an egg breakfast may be inadequate to induce satiety during weight loss, compared with a cereal breakfast of equal protein quantity

We compared the effects of consuming egg-breakfast of superior protein quality to cereal-breakfast of similar energy density and protein quantity, but lower protein quality. Two, two-week randomised crossover clinical trials included 30 otherwise healthy women with overweight or obesity. Subjects received counselling to follow a reduced-calorie diet. Under supervision, participants consumed either breakfast for one-week then crossed over to the opposite breakfast. Experiment-1 outcome variables included post-breakfast appetite hormones, glucose and insulin, subjective markers of satiety and energy intake at lunch and dinner. In Experiment-2, an appealing food (brownies) was included in lunch. Following the breakfasts, Experiment-1 showed no significant differences in outcome variables. In Experiment-2, the egg-breakfast increased fullness (p = 0.038), but lunch-time energy intake was not different. If these findings apply to other breakfasts, it suggests that in comparing two breakfasts with similar protein quantity, the greater protein quality of a breakfast may not be adequate to induce satiety.

Insights into the constellating drivers of satiety impacting dietary patterns and lifestyle

Food intake and body weight regulation are of special interest for meeting today's lifestyle essential requirements. Since balanced energy intake and expenditure are crucial for healthy living, high levels of energy intake are associated with obesity. Hence, regulation of energy intake occurs through short- and long-term signals as complex central and peripheral physiological signals control food intake. This work aims to explore and compile the main factors influencing satiating efficiency of foods by updating recent knowledge to point out new perspectives on the potential drivers of satiety interfering with food intake regulation. Human internal factors such as genetics, gender, age, nutritional status, gastrointestinal satiety signals, gut enzymes, gastric emptying rate, gut microbiota, individual behavioral response to foods, sleep and circadian rhythms are likely to be important in determining satiety. Besides, the external factors (environmental and behavioral) impacting satiety efficiency are highlighted. Based on mechanisms related to food consumption and dietary patterns several physical, physiological, and psychological factors affect satiety or satiation. A complex network of endocrine and neuroendocrine mechanisms controls the satiety pathways. In response to food intake and other behavioral cues, gut signals enable endocrine systems to target the brain. Intestinal and gastric signals interact with neural pathways in the central nervous system to halt eating or induce satiety. Moreover, complex food composition and structures result in considerable variation in satiety responses for different food groups. A better understanding of foods and factors impacting the efficiency of satiety could be helpful in making smart food choices and dietary recommendations for a healthy lifestyle based on updated scientific evidence.

Diet, microbiota, and the mucus layer: The guardians of our health

The intestinal tract is an ecosystem in which the resident microbiota lives in symbiosis with its host. This symbiotic relationship is key to maintaining overall health, with dietary habits of the host representing one of the main external factors shaping the microbiome-host relationship. Diets high in fiber and low in fat and sugars, as opposed to Western and high-fat diets, have been shown to have a beneficial effect on intestinal health by promoting the growth of beneficial bacteria, improve mucus barrier function and immune tolerance, while inhibiting pro-inflammatory responses and their downstream effects. On the contrary, diets low in fiber and high in fat and sugars have been associated with alterations in microbiota composition/functionality and the subsequent development of chronic diseases such as food allergies, inflammatory bowel disease, and metabolic disease. In this review, we provided an updated overview of the current understanding of the connection between diet, microbiota, and health, with a special focus on the role of Western and high-fat diets in shaping intestinal homeostasis by modulating the gut microbiota.

The Data Behind Popular Diets for Weight Loss

Both scientific evidence and popular diet trends have sought to identify the ideal diet for weight loss with strategies focused on either restricting carbohydrates or fat. While there is a strong physiologic rationale for either carbohydrate restriction or fat restriction to achieve a calorie deficit needed for weight loss, evidence from randomized controlled trials suggest either type of diet is effective for weight loss. The level of adherence, rather than macronutrient content, is the driver of successful weight loss.

Assessing patterns of change in lifestyle behaviours by parity: a longitudinal cohort study

BACKGROUND

The time constraints and reprioritization of personal health associated with having children may lead women to adopt less healthy lifestyles. We assessed the patterns of change in weight and lifestyle behaviours associated with having children and whether these differ between primiparous and multiparous women.

METHODS

Data were from Surveys 3 and 5 of the 1973-1978 birth cohort of the Australian Longitudinal Study on Women's Health. In women who were nulliparous at Survey 3, we assessed changes in weight, energy intake, diet (diet quality, macronutrients and micronutrients), physical activity and sitting time by parity status at Survey 5 using one-way analysis of covariance.

RESULTS

Of 4927 eligible women, 2503 gave birth (1090 primiparous and 1413 multiparous) by Survey 5. Women who had given birth 6 years later increased weight (1.0 kg; 95% CI 0.5, 1.5), energy intake (833.9 kJ/day; 95% CI 706.7, 961.1) and diet quality (1.5 units; 95% CI 0.8, 2.1), but decreased physical activity [-405.0 Metabolic Equivalent of Task.min/week; 95% CI -464.2, -345.8] and sitting time (-1.8 h/day; 95% CI -1.9, -1.6) (adjusted mean differences) relative to those who remained nulliparous. In subgroup analysis involving further stratification by parity, the increase in diet quality was only seen in women who became primiparous and the decrease in sitting time was more marked in multiparous women.

CONCLUSION

Childbearing is associated with increased weight and energy intake, decreased physical activity, increased diet quality and decreased sitting time. More research targeting weight, energy intake and physical activity for improvement in women during the childbearing years is warranted.

Higher protein intake during caloric restriction improves diet quality and attenuates loss of lean body mass

OBJECTIVE

Higher protein intake during weight loss is associated with better health outcomes, but whether this is because of improved diet quality is not known. The purpose of this study was to examine how the change in self-selected protein intake during caloric restriction (CR) alters diet quality and lean body mass (LBM).

METHODS

In this analysis of pooled data from multiple weight loss trials, 207 adults with overweight or obesity were examined before and during 6 months of CR (approximately 10 food records/person). Body composition was measured by dual-energy x-ray absorptiometry. Diet quality was assessed using the Healthy Eating Index in 2 groups: lower (LP) and higher (HP) protein intake.

RESULTS

Participants (mean [SD], 54 [11] years; 29 [4] kg/m² ) lost 5.0% (5.4%) of weight. Protein intake was 79 (9) g/d (1.0 [0.2] g/kg/d) and 58 (6) g/d (0.8 [0.1] g/kg/d) in the HP and LP groups, respectively (p < 0.05), and there was an attenuated LBM (kilograms) loss in the HP (-0.6% [1.5%]) compared with the LP (-1.2% [1.4%]) group (p < 0.01). The increased Healthy Eating Index score in the HP compared with the LP group was attributed to greater total protein and green vegetable intake and reduced refined grain and added-sugar intake (p < 0.05).

CONCLUSIONS

Increasing dietary protein during CR improves diet quality and may be another reason for reduced LBM, but it requires further study.

Changes in 24-h energy expenditure, substrate oxidation, and body composition following resistance exercise and a high protein diet via whey protein supplementation in healthy older men

PURPOSE

To investigate changes in 24-h energy expenditure (EE), substrate oxidation, and body composition following resistance exercise (RE) and a high protein diet via whey protein supplementation (alone and combined) in healthy older men.

METHODS

In a pooled groups analysis, 33 healthy older men [(mean ± SE) age: 67 ± 1 years; BMI: 25.4 ± 0.4 kg/m2] were randomized to either RE (2×/week; n = 17) or non-exercise (n = 16) and either a high protein diet via whey protein supplementation (PRO, 2 × 25 g whey protein isolate/d; n = 17) or control (CON, 2 × 23.75 g maltodextrin/d; n = 16). An exploratory sub-analysis was also conducted between RE+CON (n = 8) and RE+PRO (n = 9). At baseline and 12 weeks, participants resided in respiration chambers for measurement of 24-h EE and substrate oxidation and wore an accelerometer for 7 days for estimation of free-living EE.

RESULTS

Resistance exercise resulted in greater increases in fat-free mass (1.0 ± 0.3 kg), resting metabolic rate [(RMR) 36 ± 14 kcal/d], sedentary EE (60 ± 33 kcal/d), and sleeping metabolic rate [(SMR) 45 ± 7 kcal/d] compared to non-exercise (p < 0.05); however, RE decreased activity energy expenditure in free-living (-90 ± 25 kcal/d; p = 0.049) and non-exercise activity inside the respiration chamber (-1.9 ± 1.1%; p = 0.049). PRO decreased fat mass [(FM) -0.5 ± 0.3 kg], increased overnight protein oxidation (30 ± 6 g/d), and decreased 24-h protein balance (-20 ± 4 g/d) greater than CON (p < 0.05). RE+PRO decreased FM (-1.0 ± 0.5 kg) greater than RE+CON (p = 0.04).

CONCLUSION

Resistance exercise significantly increased RMR, SMR, and sedentary EE in healthy older men, but not total EE. PRO alone and combined with RE decreased FM and aided body weight maintenance. This study was registered at clinicaltrials.gov as NCT03299972.

Do gluten peptides stimulate weight gain in humans?

Observations from animal and in vitro laboratory research, and anecdotal evidence, have led to the suggestion that gluten consumption stimulates weight gain by the presence of peptides expressing opioid activity. Another proposed mechanism is that gluten peptides decrease resting energy expenditure resulting in a positive energy balance. In order to induce such effects in vivo, intact food peptides must be absorbed in sufficient quantities, remain intact in the blood for sufficient time to have long-lasting biological activity and bind to receptors involved in appetite, satiety and energy regulation. However, although peptides from food may pass from the intestine into the blood in extremely low quantities, they are generally rapidly degraded by plasma and vasculum-bound aminopeptidases, resulting in very short half-lives and loss of bioactivity. At present, gluten peptide sequences that influence regulators of energy metabolism have not been identified. Furthermore, data on the quantitative absorption of gluten peptides in the blood stream, their stability and lasting bioactivity are also lacking. Therefore, there is no evidence for proposed effects on driving appetite by the brain, nor on energy expenditure and weight gain. Furthermore, the level of overweight observed in various countries appears to be independent of the level of wheat consumption, and abundant observational evidence in humans shows that the levels of gluten consumption are neither related to daily calorie intake nor to BMI. This narrative review therefore discusses the proposed effects of gluten on bodyweight (BW) and putative biological mechanisms in the light of the current evidence.

Impacts of essential amino acids on energy balance

BACKGROUND

Obesity develops due to an imbalance in energy homeostasis, wherein energy intake exceeds energy expenditure. Accumulating evidence shows that manipulations of dietary protein and their component amino acids affect the energy balance, resulting in changes in fat mass and body weight. Amino acids are not only the building blocks of proteins but also serve as signals regulating multiple biological pathways.

SCOPE OF REVIEW

We present the currently available evidence regarding the effects of dietary alterations of a single essential amino acid (EAA) on energy balance and relevant signaling mechanisms at both central and peripheral levels. We summarize the association between EAAs and obesity in humans and the clinical use of modifying the dietary EAA composition for therapeutic intervention in obesity. Finally, similar mechanisms underlying diets varying in protein levels and diets altered of a single EAA are described. The current review would expand our understanding of the contribution of protein and amino acids to energy balance control, thus helping discover novel therapeutic approaches for obesity and related diseases.

MAJOR CONCLUSIONS

Changes in circulating EAA levels, particularly increased branched-chain amino acids (BCAAs), have been reported in obese human and animal models. Alterations in dietary EAA intake result in improvements in fat and weight loss in rodents, and each has its distinct mechanism. For example, leucine deprivation increases energy expenditure, reduces food intake and fat mass, primarily through regulation of the general control nonderepressible 2 (GCN2) and mammalian target of rapamycin (mTOR) signaling. Methionine restriction by 80% decreases fat mass and body weight while developing hyperphagia, primarily through fibroblast growth factor 21 (FGF-21) signaling. Some effects of diets with different protein levels on energy homeostasis are mediated by similar mechanisms. However, reports on the effects and underlying mechanisms of dietary EAA imbalances on human body weight are few, and more investigations are needed in future.

The establishment of the gut microbiota in 1-year-aged infants: from birth to family food

Purpose

With the aim of characterizing the gastrointestinal (GI) microbiota and contextually determine how different prenatal, perinatal, and postnatal factors affected its composition in early childhood, infants were enrolled in a longitudinal-prospective study named “A.MA.MI.” (Alimentazione MAmma e bambino nei primi MIlle giorni; NCT04122612, October 2019).

Methods

Forty-five fecal samples were collected at 12 months of infants’ age, identified as the 3rd follow-up (T3). The evaluated variables were pre-gestational weight and weight gain during pregnancy, delivery mode, feeding, timing of weaning, and presence/absence of older siblings. Fecal alpha and beta-diversities were analyzed. Noteworthy, to determine the impact of the influencing factors, multivariate analyses were conducted.

Results

At T3, all prenatal and perinatal variables did not result to be significant whereas, among the postnatal variables, type of milk-feeding and weaning showed the greatest contribution in shaping the microbiota. Although aged 1 year, infants exclusively breastfed until 6 months were mainly colonized by Lactobacillaceae and Enterobacteriaceae. Differently, Bacteroidaceae characterized the microbiota of infants that were never breastfed in an exclusive way. Moreover, although an early introduction of solid foods determined higher values of Faith’s PD, high abundances of Ruminococcaceae and Faecalibacterium mainly associated with infants weaned after the 4th month of age.

Conclusion

The microbial colonization during the first year of life is likely affected by a simultaneous effect of multiple variables playing a significant role at different times. Therefore, these data contribute to add evidence concerning the complex multifactorial interaction between GI microbiota and various stimuli affecting infants during the early stages of life.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00394-022-02822-1.

Amaranth Seed Polyphenol, Fatty Acid and Amino Acid Profile

In this paper, the extraction of polyphenols from amaranth seed using a Box–Benhken design using four factors—ultra-turrax speed, solid-to-liquid ratio (RSL), methanol concentration and extraction time—were studied. There were two responses studied for the model: total phenolic content (TPC) and total flavonoid content (TFC). The factors which influenced the most the extraction of the TPC and TFC were the RSL, methanol concentration and ultra-turrax speed. Twelve phenolic acids (rosmarinic acid, p-coumaric acid, chlorogenic acid, vanillic acid, caffeic acid, p-hydroxybenzoic acid, protocatechuic acid and gallic acid) and flavonoids (kaempferol, quercetin, luteolin and myricetin) were studied, and the most abundant one was kaempferol followed by myricetin. The amaranth seed is a valuable source of fatty acids, and 16.54% of the total fatty acids determined were saturated fatty acids, while 83.45% of the fatty acids were unsaturated ones. Amaranth seed is a valuable source of amino acids, with 9 essential amino acids being reported: histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan and valine.

Influence of Moringa (Moringa oleifera) enriched ice creams on rats’ brain: Exploring the redox and cholinergic systems

The broad application of Moringa oleifera leaves in the treatment of numerous diseases is prevalent globally where it extends to the management of diabetes, hypertension, inflammation, hypercholesterolemia and neurodegenerative diseases. This study provides findings on the role of Moringa oleifera leaves (MO) [MO leaves] formulated ice creams on brain cholinergic enzymes [acetylcholinesterase (AChE) and butyrylcholinesterase (BChE)], antioxidant enzymes, glycemic index and blood lipid profile of rats. Thirty (30) adult male rats acclimatized for 2 weeks were divided into five groups: Group 1 rats received commercial ice cream, Group 2 rats were received plain ice-cream, Group 3, 4 and 5 received 0.5 g, 1.0 g and 2.0 g of MO-formulated ice creams. Rats were fed on normal pellets and exposed to ice creams produced from whipping cream, skimmed milk and Moringa oleifera leaves for 30 consecutive days. Following administration, results from this study revealed that rats that received Moringa formulated ice-creams had reduced brain butyrylcholinesterase (BChE) and acetylcholinesterase (AChE) enzymes activities, glycemic index (GI), total cholesterol (TC), triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) levels and significantly increased high-density lipoprotein-cholesterol (HDL-C) level in the plasma while revealing elevated brain antioxidant status (Superoxide dismutase (SOD) and Catalase (CAT)) when compared against rats consuming commercial ice creams. Therefore, results from this study attests to the intake of ice creams made from blends of Moringa leaves in the reduction of rats’ body weight, glycemic index and lipid profile (TC, TG, LDL-C), inhibition of brain cholinergic enzymes (AChE and BChE) while increasing brain antioxidant enzymes activities (SOD and CAT).

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Ice creams enriched with Moringa leaves reduces rats' body weight gain and GI.

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Also, rats' brain antioxidant and cholinergic enzymes activities was modulated.

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This study shows the influence of Moringa ice creams on brain enzymes activities.

Does a Higher Protein Diet Promote Satiety and Weight Loss Independent of Carbohydrate Content? An 8-Week Low-Energy Diet (LED) Intervention

Both higher protein (HP) and lower carbohydrate (LC) diets may promote satiety and enhance body weight (BW) loss. This study investigated whether HP can promote these outcomes independent of carbohydrate (CHO) content. 121 women with obesity (BW: 95.1 ± 13.0 kg, BMI: 35.4 ± 3.9 kg/m2) were randomised to either HP (1.2 g/kg BW) or normal protein (NP, 0.8 g/kg BW) diets, in combination with either LC (28 en%) or normal CHO (NC, 40 en%) diets. A low-energy diet partial diet replacement (LEDpdr) regime was used for 8 weeks, where participants consumed fixed-energy meal replacements plus one ad libitum meal daily. Four-day dietary records showed that daily energy intake (EI) was similar between groups (p = 0.744), but the difference in protein and CHO between groups was lower than expected. Following multiple imputation (completion rate 77%), decrease in mean BW, fat mass (FM) and fat-free mass (FFM) at Week 8 in all was 7.5 ± 0.7 kg (p < 0.001), 5.7 ± 0.5 kg (p < 0.001), and 1.4 ± 0.7 kg (p = 0.054) respectively, but with no significant difference between diet groups. LC (CHO×Week, p < 0.05), but not HP, significantly promoted postprandial satiety during a preload challenge. Improvements in blood biomarkers were unrelated to LEDpdr macronutrient composition. In conclusion, HP did not promote satiety and BW loss compared to NP LEDpdr, irrespective of CHO content.

An Exploratory Study of the Role of Dietary Proteins in the Regulation of Intestinal Glucose Absorption

Several studies have demonstrated that high protein diets improve glucose homeostasis. Nevertheless, the mechanisms underlying this effect remain elusive. This exploratory study aims to screen and compare the acute effects of dietary proteins from different sources on intestinal glucose absorption. Six dietary proteins from various sources were thus selected and digested thanks to the INFOGEST static gastrointestinal digestion protocol. The digested proteins were able to decrease intestinal glucose absorption in vitro and ex vivo. Moreover, acute ingestion of casein and fish gelatin led to improved glucose tolerance in Wistar rats without significant effect on insulin secretion. In parallel, GLUT2 mRNA expression in enterocytes was decreased following short-term incubation with some of the digested proteins. These results strengthen the evidence that digested protein-derived peptides and amino acids are key regulators of glucose homeostasis and highlight their role in intestinal glucose absorption.

A comparative study of the effect of two procedures of classic Roux-en-Y and omega bariatric surgery on the control and management of diabetes

Background:

Patient management after bariatric surgery is important in controlling patients’ diabetes and recurrence prevention. This study aimed to meet the medical managements of patients with diabetes 6 months after the bariatric surgery.

Materials and Methods:

This cross-sectional study was performed on 77 type 2 diabetes patients’ candidates for bariatric surgery (Roux-en-Y [RYGP] and Omega). Postoperative implementation protocol was one-third of insulin for patients taking long-term insulin and the discontinuation of medications for patients of oral antidiabetic agents. Blood glucose (BG) level was checked regularly by the patients at home and the necessary medical management was applied. The weight, BG and HbA1C levels, and use of oral antidiabetic agents and insulin were assessed and recorded before 1, 3, and 6 months after the surgery.

Results:

BG levels and HbA1C percentage in the 1^st, 3^rd, and 6^th months after the intervention in Omega group were significantly lower than RYGB group (P value < 0.05). At 1 and 3 months after surgery, the mean insulin dose received by the Omega and RYGB groups was reduced to <30 units/day and 10 units/day, respectively, following the management protocol in this study. Moreover, 23.1% and 7.7% of patients in RYGB group and 12.1% and 3% of patients in Omega group took oral antidiabetic agents 1and 3 months after surgery, respectively. Insulin and oral antidiabetic agents were completely discontinued 6 months after the surgery.

Conclusion:

The long-term management and support of the patients by the implementation of a standard protocol after surgery are of great significance in obtaining the optimal outcome after bariatric surgery.

A high-protein total diet replacement alters the regulation of food intake and energy homeostasis in healthy, normal-weight adults

PURPOSE

Dietary intake can affect energy homeostasis and influence body weight control. The aim of this study was to compare the impact of high-protein total diet replacement (HP-TDR) versus a control (CON) diet in the regulation of food intake and energy homeostasis in healthy, normal-weight adults.

METHODS

In this acute randomized controlled, cross-over study, participants completed two isocaloric arms: a) HP-TDR: 35% carbohydrate, 40% protein, and 25% fat; b) CON: 55% carbohydrate, 15% protein, and 30% fat. The diets were provided for 32 h while inside a whole-body calorimetry unit. Appetite sensations, appetite-related hormones, and energy metabolism were assessed.

RESULTS

Forty-three healthy, normal-weight adults (19 females) participated. Appetite sensations did not differ between diets (all p > 0.05). Compared to the CON diet, the change in fasting blood markers during the HP-TDR intervention was smaller for peptide tyrosine-tyrosine (PYY; - 18.9 ± 7.9 pg/mL, p = 0.02) and greater for leptin (1859 ± 652 pg/mL, p = 0.007). Moreover, postprandial levels of glucagon-like peptide 1 (1.62 ± 0.36 pM, p < 0.001) and PYY (31.37 ± 8.05 pg/mL, p < 0.001) were higher in the HP-TDR. Significant correlations were observed between energy balance and satiety (r = - 0.41, p = 0.007), and energy balance and PFC (r = 0.33, p = 0.033) in the HP-TDR.

CONCLUSION

Compared to the CON diet, the HP-TDR increased blood levels of anorexigenic hormones. Moreover, females and males responded differently to the intervention in terms of appetite sensations and appetite-related hormones.

TRIAL REGISTRATION

NCT02811276 (retrospectively registered on 16 June 2016) and NCT03565510 (retrospectively registered on 11 June 2018).

Nutrients and Dietary Approaches in Patients with Type 2 Diabetes Mellitus and Cardiovascular Disease: A Narrative Review

Cardiovascular disease (CVD) is the most common cause of morbidity and mortality in developed countries. The prevalence of CVD is much higher in patients with type 2 diabetes mellitus (T2DM), who may benefit from lifestyle changes, which include adapted diets. In this review, we provide the role of different groups of nutrients in patients with T2DM and CVD, as well as dietary approaches that have been associated with better and worse outcomes in those patients. Many different diets and supplements have proved to be beneficial in T2DM and CVD, but further studies, guidelines, and dietary recommendations are particularly required for patients with both diseases.

Nutritional, textural, and sensory quality of bars enriched with banana flour and pumpkin seed flour

Introduction. Nowadays, health-conscious consumers attend to nutritional, health, and easy-to-use products. Demand for healthy snacks is significantly increasing. Our study aimed to develop high protein nutrition bars by incorporating pumpkin seed flour and banana flour and assess their quality. Study objects and methods. We analyzed three bar samples for nutritional, textural, and sensory quality. The bars contained banana flour, pumpkin seed flour, and the mixed flour. Proximate analysis was performed following the AOAC method. The mineral content and antioxidant properties of the bars were determined by using emission spectrophotometry and the 2,2-Diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging modified method, respectively. Results and discussion. The mixed flour nutrition bar had significantly higher total phenolic content and antioxidant activity than the bar with banana flour and the bar with pumpkin seed flour. Textural analysis demonstrated that the mixed flour sample had significantly (P < 0.05) higher hardness and color parameters compared to the other bar samples. Nutritional analysis indicated that mixed flour bar contained significantly higher amounts of protein, fat, and calcium; while pumpkin seed flour bar had higher ash, iron, and magnesium contents. The mixed flour sample also had better sensory parameters. Conclusion. The mixed flour demonstrated good quality. Hence, both banana and pumpkin seed flour have a potential to be used in bar formulations.

Associations of changes in reported and estimated protein and energy intake with changes in insulin resistance, glycated hemoglobin, and BMI during the PREVIEW lifestyle intervention study

BACKGROUND

Observed associations of high-protein diets with changes in insulin resistance are inconclusive.

OBJECTIVES

We aimed to assess associations of changes in both reported and estimated protein (PRep; PEst) and energy intake (EIRep; EIEst) with changes in HOMA-IR, glycated hemoglobin (HbA1c), and BMI (in kg/m2), in 1822 decreasing to 833 adults (week 156) with overweight and prediabetes, during the 3-y PREVIEW (PREVention of diabetes through lifestyle intervention and population studies In Europe and around the World) study on weight-loss maintenance. Eating behavior and measurement errors (MEs) of dietary intake were assessed. Thus, observational post hoc analyses were applied.

METHODS

Associations of changes in EIEst, EIRep, PEst, and PRep with changes in HOMA-IR, HbA1c, and BMI were determined by linear mixed-model analysis in 2 arms [high-protein-low-glycemic-index (GI) diet and moderate-protein-moderate-GI diet] of the PREVIEW study. EIEst was derived from energy requirement: total energy expenditure = basal metabolic rate × physical activity level; PEst from urinary nitrogen, and urea. MEs were calculated as [(EIEst - EIRep)/EIEst] × 100% and [(PRep - PEst)/PEst] × 100%. Eating behavior was determined using the Three Factor Eating Questionnaire, examining cognitive dietary restraint, disinhibition, and hunger.

RESULTS

Increases in PEst and PRep and decreases in EIEst and EIRep were associated with decreases in BMI, but not independently with decreases in HOMA-IR. Increases in PEst and PRep were associated with decreases in HbA1c. PRep and EIRep showed larger changes and stronger associations than PEst and EIEst. Mean ± SD MEs of EIRep and PRep were 38% ± 9% and 14% ± 4%, respectively; ME changes in EIRep and En% PRep were positively associated with changes in BMI and cognitive dietary restraint and inversely with disinhibition and hunger.

CONCLUSIONS

During weight-loss maintenance in adults with prediabetes, increase in protein intake and decrease in energy intake were not associated with decrease in HOMA-IR beyond associations with decrease in BMI. Increases in PEst and PRep were associated with decrease in HbA1c.This trial was registered at clinicaltrials.gov as NCT01777893.

Effects of Quality and Quantity of Protein Intake for Type 2 Diabetes Mellitus Prevention and Metabolic Control

PURPOSE OF REVIEW

The aim of this review is to evaluate the ideal protein quality and quantity and the dietary composition for the prevention and metabolic control of type 2 diabetes mellitus (T2DM).

INTRODUCTION

Although some reviews demonstrate the advantages of a diet with a higher protein intake, other reviews have observed that a diet high in carbohydrates, with low-glycaemic index carbohydrates and good fibre intake, is equally effective in improving insulin sensitivity.

METHODS

Over 2831 articles were screened, and 24 from the last 5 years were analysed and summarised for this review, using the protein, diabetes and insulin glucose metabolic keywords in Pubmed in June 2019.

RESULTS

Eleven studies demonstrate that a higher consumption of proteins has a positive effect on insulin sensitivity. A higher intake of animal protein seems to be related to an increased risk of T2DM. Four studies show that consumption of meat has a deleterious effect. Higher intake of plant protein and dairy products is associated with a modestly reduced risk.

DISCUSSION

Based on the results obtained, for the prevention of T2DM and all disorders related to metabolic syndrome, no ideal dietary composition has yet been found. The advantage of plant protein sources may be related to the foods' low-glycaemic index due to the high fibre content. However, the right protein quality (animal and plant) and the quantity for T2DM prevention and metabolic control are unclear and need to be investigated with further long-term studies.

Interactions between dietary patterns with the age of onset of obesity and body composition among obese and overweight female: A cross -sectional study

BACKGROUND

Obesity is associated to dietary factors, mostly those related to nutrients and energy. The aim of the present study was to explore the interaction of dietary patterns and the age of onset of obesity on anthropometric indicators among Iranian women.

METHODS

A cross-sectional study was conducted on 266 obese and overweight Iranian females who were between 18 and 48 years old with BMI>25 (kg/m²).Dietary intake was assessed using a semi-quantitative Food Frequency Questionnaire (FFQ) was calculated for all participants. Three dietary patterns principle component analysis (PCA) was used as a factor score for each of the three dietary patterns. Anthropometric evaluation was performed for participants.

RESULTS

A significant inverse relationship (p < 0.05) was found between DASH score and the age of onset of obesity under 18 years old, fat-free mass, and weight in women. Conversely it was observed that higher weight and body mass index (BMI) were associated with the age of onset of obesity under 18 years old compared to participants more than 18 years old (p < 0.05). Moreover, it was observed that higher adherence to DASH dietary pattern has a positive correlation with lower BMI (P = 0.07), visceral fat (P = 0.03), and body fat mass (BFM) (P = 0.07). A significant interaction between DASH pattern and onset obesity under 18 years old on weight observed in women (P = 0.001).

CONCLUSIONS

This study suggested that DASH dietary pattern is a good choice for weight management and a healthier body in general and may decrease the development of obesity-related diseases. It was suggested that higher adherence to DASH pattern may reduce the obesity markers and decrease the development of obesity-related diseases.

Effects of Dietary Protein Intake on Cutaneous and Systemic Inflammation in Mice with Acute Experimental Psoriasis

Background: Psoriasis is a systemic inflammatory disorder, primarily characterized by skin plaques. It is linked to co-morbidities including cardiovascular disease and metabolic syndrome. Several studies demonstrate that dietary habits can influence psoriasis development and severity. However, the effect of different dietary protein levels on psoriasis development and severity is poorly understood. In this study, we examine the influence of dietary protein on psoriasis-like skin disease in mice. Methods: We fed male C57BL/6J mice with regular, low protein and high protein chow for 4 weeks. Afterwards, we induced psoriasis-like skin disease by topical imiquimod (IMQ)-treatment on ear and back skin. The local cutaneous and systemic inflammatory response was investigated using flow cytometry analysis, histology and quantitative rt-PCR. Results: After 5 days of IMQ-treatment, both diets reduced bodyweight in mice, whereas only the high protein diet slightly aggravated IMQ-induced skin inflammation. IMQ-treatment induced infiltration of myeloid cells, neutrophils, and monocytes/macrophages into skin and spleen independently of diet. After IMQ-treatment, circulating neutrophils and reactive oxygen species were increased in mice on low and high protein diets. Conclusion: Different dietary protein levels had no striking effect on IMQ-induced psoriasis but aggravated the systemic pro-inflammatory phenotype.

Effect of different protein diets on weight loss, inflammatory markers, and cardiometabolic risk factors in obese women

BACKGROUND

Reducing and maintaining body weight has become more important than ever as obesity is becoming increasingly common worldwide. This study was aimed to investigate the effects of diets with different protein contents administered to obese women on anthropometric measurements, inflammatory markers, and cardiometabolic risk factors.

MATERIALS AND METHODS

This randomized controlled trial was conducted with sixty volunteering obese women aged between 20 and 45 years. The subjects were divided into two groups in equal numbers. The high-protein (HP) group (n = 30) was administered an iso-caloric HP diet (25% protein, 30% fat, and 45% carbohydrate), and the control group (n = 30) an isocaloric low-protein diet (15% protein, 30% fat, and 55% carbohydrate), and both groups were followed up for 8 weeks. The subjects' descriptive data, anthropometric measurements, homeostatic model assessment-insulin resistance (HOMA-IR), lipid profiles, and high-sensitive C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) levels were analyzed.

RESULTS

There was no significant difference at baseline (except for low-density lipoprotein cholesterol [LDL-C]), and end-of-study (except for IL-6, systolic blood pressure [SBP], and diastolic blood pressure) values of parameters between the two groups; after adjusted for baseline measurements, a significant difference was observed between the groups for body weight, body mass index, waist circumference, HOMA-IR, LDL-C, hs-CRP, TNF-α, IL-6, and SBP (P = 0.004, P = 0.001, P = 0.003, P = 0.029, P = 0.004, P = 0.016, P = 0.004, P = 0.010, and P = 0.000, respectively) and were greater in the HP group than in the control group (P < 0.05).

CONCLUSION

The HP diet was effective on improvement in HOMA-IR, SBP, LDL-C, hs-CRP, TNF-α, IL-6, and resulted in body weight loss.