Dietary Protein and Changes in Biomarkers of Inflammation and Oxidative Stress in the Framingham Heart Study Offspring Cohort

Association of dietary protein intake, inflammation with muscle mass, physical performance and incident sarcopenia in Chinese community-dwelling older adults

OBJECTIVES

Inflammation and impaired muscle synthesis are important factors of sarcopenia. Plant protein may reduce inflammation but may not be as efficient as animal protein in providing essential amino acids. We therefore examined the associations between dietary protein intake and changes in muscle mass and physical performance, incident sarcopenia, and the interaction effect of inflammation.

DESIGN

Prospective cohort study.

SETTING

The Mr. OS and Ms. OS (Hong Kong) cohort.

PARTICIPANTS

A total of 2,811 sarcopenia-free participants and 569 sarcopenia participants aged ≥65 years were recruited from communities.

MEASUREMENTS

Dietary protein intake was assessed using a validated food frequency questionnaire. Serum high-sensitivity C-reactive protein (hs-CRP) was measured. Linear regression examined the associations between dietary protein intake and 4-year changes in muscle mass and physical performance. Cox regression examined the association between dietary protein intake and incident sarcopenia.

RESULTS

Higher plant protein intake, but not total and animal protein, was associated with less decline in muscle mass and gait speed among sarcopenia-free participants. Conversely, higher ratio of animal-to-plant protein was associated with reduced muscle mass loss among participants with sarcopenia. The highest tertile of plant protein intake was associated with lower incident sarcopenia risk (HR: 0.75, 95% CI: 0.57-0.98; P-trend = 0.034) compared to the lowest tertile. Notably, this association was observed among participants with higher serum hs-CRP levels (HR: 0.57, 95% CI: 0.34-0.95), but not in those with lower hs-CRP levels.

CONCLUSION

Dietary animal and plant protein intake have differential associations with muscle mass and physical performance in older adults with and without sarcopenia. The role of plant protein in preventing sarcopenia involves modulation of inflammation.

Protein intake affects erythrocyte glutathione synthesis in healthy adults aged ≥60 years in a repeated-measures trial

BACKGROUND

Protein recommendations for older adults are based on nitrogen balance data from young adults. Physiological studies using the indicator amino acid oxidation method suggest they need 30% to 50% more protein than current recommendations. We herein present glutathione (GSH) as a physiological estimate of protein adequacy in older adults.

OBJECTIVES

The objective was to measure GSH kinetics in response to varying protein intakes in a repeated-measures design in healthy adults aged ≥60 y using the precursor-product method.

METHODS

Sixteen healthy older adults (n = 8 male and n = 8 female; body mass index ≤30 kg/m2) were studied. Each received 4 of 6 protein intakes in random order (0.66, 0.8, 0.9, 1.1, 1.3 and 1.5 g⋅kg-1⋅d-1). At each intake level, participants underwent isotope infusion studies of 7 h duration following a 3-d adaptation to the test level of protein. On the fourth day, GSH fractional (FSR) and absolute synthesis (ASR) rates were quantified by measuring the incorporation of U-[13C2-15N]glycine into GSH at isotopic steady state. A mixed-effect change-point regression model was used to determine a breakpoint in FSR and ASR. Secondary outcomes included plasma concentrations of oxidative stress markers, homocysteine, 5-L-oxoproline (5-OP), and urinary sulfate. The effect of secondary outcomes on GSH kinetics was analyzed using a joint linear mixed-effect model and Tukey's post hoc test.

RESULTS

A protein intake of 1.08 g⋅kg-1⋅d-1 (95% confidence interval [CI]: 0.83, 1.32; Rm2 = 0.207; Rc2 = 0.671; P < 0.001) maximized GSH FSR. There was no effect of protein intake on concentrations of erythrocyte GSH, plasma homocysteine, oxidative stress markers, or 5-OP (P > 0.05). Protein intake had a positive effect on urinary sulfate excretion (P < 0.0001).

CONCLUSION

A protein intake of 1.08 g⋅kg-1⋅d-1 from a high-quality protein maximized GSH synthesis in adults ≥60 y. This lends support to data suggesting a requirement higher than the current recommendation. This study was registered at clinicaltrials.gov as NCT02971046.

Associations between healthy food groups and platelet-activating factor, lipoprotein-associated phospholipase A2 and C-reactive protein: a cross-sectional study

PURPOSE

To investigate the association between pro-inflammatory markers platelet-activating factor (PAF), lipoprotein-associated phospholipase A2 (Lp-PLA2), hsCRP, and intake of core food groups including fruit, cruciferous and other vegetables, grains, meat and poultry, fish and seafood, nuts and legumes, and dairy.

METHODS

A cross-sectional study was conducted. 100 adults (49 ± 13 years, 31% male) with variable cardiovascular disease risk were recruited. Data were collected in 2021 and 2022. Fasting PAF, Lp-PLA2 activity, hsCRP and usual dietary intake (via a validated food frequency questionnaire) were measured. Intake of foods were converted into serves and classified into food groups. Correlations and multiple regressions were performed with adjustment for confounders.

RESULTS

A one-serve increase in cruciferous vegetables per day was associated with 20-24% lower PAF levels. An increase of one serve per day of nuts and legumes was associated with 40% lower hsCRP levels. There were small correlations with PAF and Lp-PLA2 and cheese, however, these were not significant at the Bonferroni-adjusted P < 0.005 level.

CONCLUSION

The lack of associations between PAF and Lp-PLA2 and other healthy foods may be due to confounding by COVID-19 infection and vaccination programs which prevents any firm conclusion on the relationship between PAF, Lp-PLA2 and food groups. Future research should aim to examine the relationship with these novel markers and healthy food groups in a non-pandemic setting.

The Dietary Inflammatory Index is associated with diet quality and nutrient intake during the gestational period

In pregnant women, the Energy-adjusted Dietary Inflammatory Index (E-DII) is adopted to measure the inflammatory potential of the diet, but it does not predict the quality of the diet. Our hypothesis is that a more pro-inflammatory diet during pregnancy is also a poorer quality diet. Thus, the objective of this study is to verify the association of the E-DII with the Diet Quality Index Adapted for Pregnancy (DQI-P) and the nutrient intake from the diet in terms of the second and third gestational trimesters. This is a cross-sectional study that took place in Brazil (2018-2019), with eligible adult women up to 72 hours' postpartum and in good health. Socioeconomic, gestational, anthropometric, and food consumption data were collected, enabling the calculation of E-DII, DQI-P, and nutrient intake. The sample (n = 260) had a median E-DII of 0.04 (-1.30 to 1.90) and DQI-P of 68.82 (18.82-98.22). There was no relevant difference between E-DII tertiles by sociodemographic, gestational, and anthropometric characteristics. The E-DII and the DQI-P showed agreement (55.7%) and inverse correlation (r = -0.53; P < .001). Each 1-unit increase in DQI-P, iron, iodine, magnesium, pyridoxine, and vitamin E decreased the E-DII score (P < .05). An increase of 1 unit in protein, saturated fatty acids, and vitamin C increased the E-DII score (P < .05). Thus, the results suggest that the E-DII can predict diet quality during pregnancy, with the added benefit of measuring the inflammatory potential of the diet.

Effects of a Short-Term Vegan Challenge in Older Adults on Metabolic and Inflammatory Parameters-A Randomized Controlled Crossover Study

SCOPE

A long-term vegan diet carries the risk of insufficient protein and micronutrient intake for older adults. However, even a short-term (48 h) vegan diet exerts positive metabolic effects in younger adults. In this study, we investigate the feasibility and effects of a short-term vegan challenge on metabolic and inflammatory markers in older adults.

METHOD AND RESULTS

In this randomized controlled crossover-study, 30 healthy older adults (≥65 years) are assigned to either a 48 h ad libitum vegan or omnivorous diet. During the vegan diet, participants exhibit lower protein (p = 0.001) and fat intake as well as higher carbohydrate and dietary fiber intake, resulting in a lower caloric intake (all p < 0.001). Insulin concentrations (p = 0.042) and insulin resistance (p = 0.036) decline only after the vegan diet. The study observes reductions in serum glucose (p < 0.001), triglyceride (p = 0.005), and hsCRP (p = 0.044) concentrations and weight (p < 0.001), independent of the diet. Participants with low-grade inflammation exhibit notable metabolic improvements after the vegan diet.

CONCLUSION

Improvements in insulin homeostasis are observed after the vegan diet, but meeting protein requirements are not feasible during the short-term vegan challenge despite dietary counseling, which warrants concern.

Dietary total, plant, and animal protein intake in relation to cardiovascular outcomes and inflammatory factors in elderly men: A cross-sectional study

The source and amount of protein intake may influence cardiovascular and inflammatory risk, especially in elders who are often more vulnerable. However, findings on elders have been contradictory. Therefore, we examined the association between dietary total, plant, and animal protein intake in relation to cardiovascular outcomes and inflammatory factors in elderly men. The present cross-sectional study included 357 elderly men. A validated and reliable food frequency questionnaire (FFQ) was used to assess dietary intake. All biochemical factors including triglycerides (TG), fasting blood sugar (FBS), high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL6), and tumor necrosis factor-α (TNF-α) were measured. Waist circumference (WC) and blood pressure (BP) were also assessed. A significant inverse association was found between animal protein intake and systolic blood pressure (SBP; OR: 0.62; 95% CI: 0.42, 0.91; ptrend = .014). There were significant inverse associations between plant protein intake and WC (OR: 0.34; 95% CI: 0.17, 0.68; ptrend < .001), FBS (OR: 0.51; 95% CI: 0.29, 0.89; ptrend = .018) and Hs-CRP (OR: 0.39; 95% CI: 0.21, 0.70; ptrend = .002). Moreover, significant inverse associations were also found between total protein intake and SBP (OR: 0.54; 95% CI: 0.33, 0.86; ptrend = .010) and total protein and Hs-CRP (OR: 0.50; 95% CI: 0.28, 0.88; ptrend = .015). In elderly men, a high dietary intake of plant protein was associated with lower odds of having high WC, FBS, and Hs-CRP. In addition, high dietary intake of animal protein was associated with higher odds of having a high SBP level, which was explained by higher intake of dairy products.

Association of dietary inflammatory potential, dietary oxidative balance score and biological aging

BACKGROUND & AIMS

The interaction between diet, inflammation, and oxidative stress significantly influences aging, but the available evidence has been limited. We evaluated potential associations of dietary inflammatory index (DII), dietary oxidative balance score (DOBS), and measures of biological aging.

METHODS

This cross-sectional study was performed among 8839 individuals from NHANES 2003-2014. DII and DOBS were determined by aggregating data from 26 to 17 a priori selected dietary components. Biological aging metrics included homeostatic dysregulation (HD), Klemera-Doubal method (KDM), phenotypic age (PA), and allostatic load (AL). Binomial logistic regression models and multivariate linear regression models were conducted.

RESULTS

The associations of dietary inflammation and oxidative stress potential and biological aging metrics were significant among American adults nationwide. Consuming foods with higher DII was significantly associated with accelerated HD 1.26 (1.10, 1.44), KDM 1.24 (1.06, 1.45), and PA 1.54 (1.33, 1.78). Compared with the lowest DOBS, the hazard ratios of accelerated HD, KDM, PA, and AL were 0.74 (0.64, 0.86), 0.80 (0.70, 0.92), 0.61 (0.52, 0.72) and 0.78 (0.63, 0.97), respectively. The adverse effects of pro-inflammatory and pro-oxidative diets on accelerated HD, KDM, and PA were 1.39 (1.18, 1.62), 1.28 (1.08, 1.51), and 1.76 (1.47, 2.10). Serum AST/ALT ratio and globulin were implicated in and mediate the aging effects.

CONCLUSIONS

Higher DII and/or lower DOBS are associated with higher markers of biological aging. Our research elucidates that diets may mitigate biological aging resulting from inflammation and/or oxidative stress.

How Do Older Patients with End-Stage Osteoarthritis of the Hip Eat Prior to Hip Replacement? A Preliminary Snapshot That Highlights a Poor Diet

Diet quantity and quality in older adults is critical for the proper functioning of the musculoskeletal system. In view of hip surgery, old patients should consume 1.2-1.5 g of proteins and 27-30 kcal per kilo of body weight daily, and adhere to healthy eating habits. In this analytical study, we studied diet quantity and quality in relation to the clinical chemistry and functional status of 57 older adults undergoing elective hip replacement. Nine in ten patients did not meet suggested protein and energy intakes and only one in ten patients exhibited high adherence to the Mediterranean diet. Legume consumption adjusted for sex, age, body mass index, and health status successfully forecasted haemoglobin levels (p < 0.05), and patients regularly consuming olive oil reported minor hip disability compared to those using it less frequently (p < 0.05). Patients who reported daily ingestion of <1 serving of meat versus those consuming >1.5 servings had greater cumulative comorbidity (p < 0.05), with meat consumption independently predicting walking ability, mobility, and balance in the fully adjusted model (p < 0.01). In conclusion, our patients seem to eat poorly. There is room for improvement in pre-operative pathways to make older adults eat better, but there is a need to plan an interventional study to fully understand the cause-effect of a dietary pattern or specific food in enhancing recovery after surgery.

Advances in psoriasis and gut microorganisms with co-metabolites

This review summarizes the potential role of gut microbes and their metabolites as novel mediators of psoriasis, including their composition and function in disease pathogenesis, progression, and management. Gut microbiota network analysis, colony construction, and in vivo large-scale interaction experiments showed that different degrees of damage and repair in psoriasis, both in animals and humans, involve cross-border homeostasis of the microbial community. Which gut microbiota interactions are present in psoriasis and how they collaborate with immune cells and influence psoriasis development via the gut-skin axis remain incompletely elucidated. In this article, we review the latest information on the unique patterns of gut microbiota and co-metabolites involved in the pathogenesis of psoriasis and attempt to explore microbial-based therapeutic targets derived from mono-and polymicrobial probiotics, fecal microbiota transplantation, pharmacomicrobiomics, and dietary interventions as diagnostic or therapeutic approaches promising to provide new options and long-term management for psoriasis.

Dietary Protein Intake and Associated Risks for Atopic Dermatitis, Intrinsic Eczema, and Allergic Sensitization among Young Chinese Adults in Singapore/Malaysia: Key Findings from a Cross-sectional Study

Through an investigator-administered questionnaire that follows the standard protocol of the International Study of Allergy and Asthma in Childhood, data on symptomatic histories of eczema and dietary habits were collected from 11,494 young Chinese adults in Singapore/Malaysia. Allergic sensitization status was assessed through a skin prick test reactivity to common house dust mites. Using three dietary indices (dietary protein score, animal protein score, and plant protein score), the associations between atopic dermatitis, intrinsic eczema, allergic sensitization, and intake of various proteins were estimated. On average, most subjects frequently eat meat, vegetables, and rice in their diets. Through a multivariable logistic regression adjusted for age, sex, body mass index, and parental eczema, subjects with high dietary protein score (adjusted OR = 1.397; 95% confidence interval = 1.133-1.724; P < 0.003) and high animal protein score (adjusted OR = 1.353; 95% confidence interval = 1.106-1.682; P < 0.003) were associated with increased risk of atopic dermatitis. Interestingly, synergy factor analysis revealed that a higher intake of plant proteins than animal proteins in diets significantly reduced overall associated risks of atopic dermatitis and allergic sensitization but not those of intrinsic eczema. Most importantly, these associations are independent of dietary fat intake. Taken together, frequent adherence to diets rich in plant proteins reduced associated risks of atopic dermatitis in Singapore/Malaysia Chinese adults.

Coping with the COVID-19 pandemic by strengthening immunity as a nonpharmaceutical intervention: A major public health challenge

Background and Aims

The global Coronavirus-2 outbreak has emerged as a significant threat to majority of individuals around the world. The most effective solution for addressing this viral outbreak is through vaccination. Simultaneously, the virus's mutation capabilities pose a potential risk to the effectiveness of both vaccines and, in certain instances, newly developed drugs. Conversely, the human body's immune system exhibits a robust ability to combat viral outbreaks with substantial confidence, as evidenced by the ratio of fatalities to affected individuals worldwide. Hence, an alternative strategy to mitigate this pandemic could involve enhancing the immune system's resilience.

Methods

The research objective of the review is to acquire a comprehensive understanding of the role of inflammation and immunity in COVID-19. The pertinent literature concerning immune system functions, the impact of inflammation against viruses like SARS-CoV-2, and the connection between nutritional interventions, inflammation, and immunity was systematically explored.

Results

Enhancing immune function involves mitigating the impact of key factors that negatively influence the immune response. Strengthening the immune system against emerging diseases can be achieved through nonpharmaceutical measures such as maintaining a balanced nutrition, engaging in regular exercise, ensuring adequate sleep, and managing stress.

Conclusion

This review aims to convey the significance of and provide recommendations for immune-strengthening strategies amidst the ongoing COVID-19 pandemic.

Macronutrient intake as a prospective predictor of depressive symptom severity: An exploratory study with adolescent elite athletes

BACKGROUND

Appropriate availability of macro- and micronutrients has an important impact on cognitive performance, mood and mental health. Although the critical role of nutrition for elite athletes' performance was recognized early on, little is known about whether consumption of specific macronutrients (carbohydrates, proteins, fat) predict the development of future depressive symptoms in adolescent elite athletes.

METHODS

Participants were recruited from three Swiss Olympic Partner Schools (SOPS) in the Northwestern German speaking part of Switzerland. A total of 97 adolescent elite athletes (38% girls, Mage = 16.35 ± 1.19) participated in the study. Depressive symptoms (PHQ9) were assessed at baseline and after 10 months follow-up. A 3-day food recall was completed three months after the baseline assessment. Linear regression analyses were used to examine whether macronutrients predict depression symptom severity after controlling for covariates and baseline depressive symptoms.

RESULTS

Higher protein consumption in athletes was a prospective predictor of lower depressive symptom severity at follow-up (β = -35, p < .05). Several deviations from recommended nutritional standards were observed in elite athletes.

CONCLUSIONS

The findings of this exploratory study support the notion that dietary behaviour may be prospectively associated with athletes' mental health. However, more research is required with larger samples and more in-depth assessment techniques. Future research should also examine whether nutrition education and dietary modification can be used to prevent depressive symptoms among adolescent elite athletes.

The association between inflammatory and immune system biomarkers and the dietary inflammatory index in patients with COVID-19

Background

Inflammation and cytokine storm have been reported to be the main cause of acute symptoms of coronavirus disease (COVID-19). Diet-induced inflammation may affect the condition of patients with COVID-19. Therefore, this study aimed to investigate the relationship between disease severity, inflammatory and immune system biomarkers, and the dietary inflammatory index (DII) in patients with COVID-19.

Methods

This cross-sectional study was conducted on 500 adult patients with COVID-19. Patients were divided into mild, moderate, and severe conditions based on clinical and laboratory evidence. A validated food frequency questionnaire (FFQ) was used to determine DII and energy-adjusted DII (E-DII) scores. The serum C-reactive protein (CRP) level and blood cell count were measured for all patients. Multiple linear regression was used to explore the association between DII and E-DII and CRP, blood cell counts, and hospitalization in patients with COVID-19.

Results

Coronavirus disease (COVID-19) patients with higher DII had higher consumption of fat and carbohydrate and lower intakes of protein, anti-inflammatory nutrients, garlic, caffeine, tea, onion, and fiber (P &lt; 0.05). There was a positive association between DII and CRP (β = 1.024, P &lt; 0.001), hospitalization (β = 1.062, P &lt; 0.001), WBC count (β = 0.486, P &lt; 0.009), neutrophil count (β = 0.565, P &lt; 0.001), and neutrophil-to-lymphocyte ratio (β = 0.538, P &lt; 0.001) and a negative association between DII and the lymphocyte count (β = −0.569, P &lt; 0.001). There was a positive association between E-DII and hospitalization (β = 1.645, P &lt; 0.001), WBC count (β = 0.417, P &lt; 0.02), and neutrophil-to-lymphocyte ratio (β = 0.35, P &lt; 0.03).

Conclusion

There is a positive correlation between DII and inflammation, immune hyperactivation, and length of hospital stay in patients with COVID-19. Further longitudinal studies are necessary.

Nutrigenomic profiling of reduced specification diets and phytogenic inclusion effects on critical TLR signaling, MAPK-apoptosis and PI3K-Akt-mTOR gene components along the broiler gut

The effects of concurrent reduction of dietary metabolizable energy (ME) and crude protein (CP) levels combined or not with the dietary inclusion of a phytogenic feed additive (PFA) were studied using a nutrigenomics approach. In particular, the expression of 26 critical genes relevant for inflammation control (TLR pathway), cellular apoptosis (MAPK pathway) cell growth and nutrient metabolism (PI3K-Akt-mTOR pathway) was profiled along the broiler intestine. Two dietary types (L and H) differing in metabolizable energy and crude protein levels (L: 95% and H: 100% of optimal Cobb 500 recommendations for ME and CP requirements) supplemented or not with PFA (- or +) and their interactions (L-, L+, H-, H+) were evaluated. There were only 3 total interactions (mTOR, IL8, and HRAS P < 0.05) between diet type and PFA inclusion indicating limited concurrent effects. Diet type, L upregulated genes related with inflammation mainly in the jejunum, ileum, and cecum (P < 0.05) and MAPK pathway in the ileum and cecum (P < 0.05). Moreover, diet type L negatively affected the expression of genes related to PI3K-Akt-mTOR pathway mainly in duodenum and cecum (P < 0.05). On the other hand, PFA inclusion downregulated (P < 0.05) genes related with TLR signaling pathway (TLR2B, MyD88, TLR3, IL8, LITAF) along the intestine and MAPK pathway genes (APO1, FOS) in jejunum (P < 0.05). Finally, PFA supplementation regulated nutrient sensing and metabolism in the cecum in a manner perceived as beneficial for growth. In conclusion, the study results highlight that the reduced ME and CP specifications, especially in the absence of PFA, regulate inflammation, apoptosis and nutrient metabolism processes at homeostatic control levels that hinder maximizing the availability of dietary energy and nutrients for growth purposes. Inclusion of PFA helped to adjust the respective homeostatic responses and control to levels supporting broiler performance, especially at reduced specification diets.

The Role of Nutrition on Meta-inflammation: Insights and Potential Targets in Communicable and Chronic Disease Management

PURPOSE OF REVIEW

Chronic low-grade inflammation may contribute to the onset and progression of communicable and chronic diseases. This review examined the effects and eventual mediation roles of different nutritional factors on inflammation.

RECENT FINDINGS

Potential nutritional compounds influencing inflammation processes include macro and micronutrients, bioactive molecules (polyphenols), specific food components, and culinary ingredients as well as standardized dietary patterns, eating habits, and chrononutrition features. Therefore, research in this field is still required, taking into account critical aspects of heterogeneity including type of population, minimum and maximum intakes and adverse effects, cooking methods, physiopathological status, and times of intervention. Moreover, the integrative analysis of traditional variables (age, sex, metabolic profile, clinical history, body phenotype, habitual dietary intake, physical activity levels, and lifestyle) together with individualized issues (genetic background, epigenetic signatures, microbiota composition, gene expression profiles, and metabolomic fingerprints) may contribute to the knowledge and prescription of more personalized treatments aimed to improving the precision medical management of inflammation as well as the design of anti-inflammatory diets in chronic and communicable diseases.

Dietary protein interacts with polygenic risk scores and modulates serum concentrations of C-reactive protein in overweight and obese Malaysian adults

Dietary intake may interact with gene variants and modulate inflammatory status. This study aimed to investigate the combined effect of fat mass and obesity-associated rs9930501, rs9930506, and rs9932754 and beta-2 adrenergic receptor rs1042713 on C-reactive protein (CRP) concentrations using polygenic risk scores (PRS), and modulatory effect of dietary nutrients on these associations. We hypothesized that higher protein intake is associated with lower inflammatory status in individuals genetically predisposed to obesity. PRS was computed as the weighted sum of the risk alleles possessed and stratified into first (0-0.64), second (0.65-3.59), and third (3.60-8.18) tertiles. A total of 128 overweight and obese Malaysian adults were dichotomized into groups of low and elevated inflammatory status (CRP concentrations ≤3 and >3 mg/L, respectively). One-half of the study participants (51%) were found to have elevated inflammatory status. Second- and third-tertile PRS were significantly associated with increased odds of elevated inflammatory status, 7.56 (95% confidence interval [CI], 1.98-28.80; adjusted P = .003) and 3.87 (95% CI, 1.10-13.60; adjusted P = .035), respectively. Individuals in the third-tertile PRS had significantly lower CRP concentrations (4.61 ± 1.3 mg/L vs 9.60 ± 2.6 mg/L, P = .019) when consuming ≥14% energy from protein (with an average of 18.0% ± 2.4%, 43.0% ± 7.7%, and 39.0% ± 8.0% energy from protein, carbohydrate, and fat per day). In conclusion, third-tertile PRS was significantly associated with increased odds of elevated CRP; higher protein intake may alleviate inflammatory status and reduce CRP concentrations systemically in those individuals.

Effects of inulin supplementation on inflammatory biomarkers and clinical symptoms of women with obesity and depression on a calorie-restricted diet: a randomised controlled clinical trial

Major depressive disorder (MDD) is regarded as an inflammatory disorder. Gut microbiota dysbiosis, observed in both MDD and obesity, leads to endotoxemia and inflammatory status, eventually exacerbating depressive symptoms. Manipulation of gut microbiota by prebiotics might help alleviate depression. The present study aimed to investigate the effects of inulin supplementation on psychological outcomes and biomarkers of gut permeability, endotoxemia, inflammation, and brain-derived neurotrophic factor (BDNF) in women with obesity and depression on a calorie-restricted diet. In a double-blind randomised clinical trial, forty-five women with obesity and MDD were allocated to receive 10 g/d of either inulin or maltodextrin for 8 weeks; all the patients followed a healthy calorie restricted diet as well. Anthropometric measures, dietary intakes, depression, and serum levels of zonulin, lipopolysaccharide (LPS), inflammatory biomarkers (TNF-α, IL-10, monocyte chemoattractant protein-1, toll-like receptor-4 and high-sensitivity C-reactive protein), and BDNF were assessed at baseline and end of the study. Weight and Hamilton Depression Rating Scale (HDRS) scores decreased in both groups; between-group differences were non-significant by the end of study (P = 0·333 for body weight and P = 0·500 for HDRS). No between-group differences were observed for the other psychological outcomes and serum biomarkers (P > 0·05). In this short-term study, prebiotic supplementation had no significant beneficial effects on depressive symptoms, gut permeability, or inflammatory biomarkers in women with obesity and depression.

The adverse effect of heat stress and potential nutritional interventions

Heat stress can cause tissue damage and metabolic disturbances, including intestinal and liver dysfunction, acid-base imbalance, oxidative damage, inflammatory response, and immune suppression. Serious cases can lead to heatstroke, which can be life-threatening. The body often finds it challenging to counteract these adverse effects, and traditional cooling methods are limited by the inconvenience of tool portability and the difficulty of determining the cooling endpoint. Consequently, more research was conducted to prevent and mitigate the negative effect of heat stress via nutritional intervention. This article reviewed the pathological changes and altered metabolic mechanisms caused by heat stress and discussed the protein (amino acid), vitamin, trace element, and electrolyte action pathways and mechanisms to mitigate heat stress and prevent heat-related disease. The main food sources for these nutrients and the recommended micronutrient supplementation forms were summarized to provide scientific dietary protocols for special populations.

Protein and Sport: Alternative Sources and Strategies for Bioactive and Sustainable Sports Nutrition

Nutrition and sport play an important role in achieving a healthy lifestyle. In addition to the intake of nutrients derived from the normal diet, some sport disciplines require the consumption of supplements that contribute positively to improved athletic performance. Protein intake is important for many aspects related to health, and current evidence suggests that some athletes require increased amounts of this nutrient. On the other hand, society's demand for more environmentally friendly products, focus on the search for alternative food sources more sustainable. This review aims to summarize the latest research on novel strategies and sources for greener and functional supplementation in sport nutrition. Alternative protein sources such as insects, plants or mycoproteins have proven to be an interesting substrate due to their high added value in terms of bioactivity and sustainability. Protein hydrolysis has proven to be a very useful technology to revalue by-products, such as collagen, by producing bioactive peptides beneficial on athletes performance and sport-related complications. In addition, it has been observed that certain amino acids from plant sources, as citrulline or theanine, can have an ergogenic effect for this target population. Finally, the future perspectives of protein supplementation in sports nutrition are discussed. In summary, protein supplementation in sports nutrition is a very promising field of research, whose future perspective lies with the search for alternatives with greater bioactive potential and more sustainable than conventional sources.

Associations of Nutritional Behavior and Gut Microbiota with the Risk of COVID-19 in Healthy Young Adults in Poland

The numerous consequences of the coronavirus disease 2019 (COVID-19) pandemic in healthy young people and the lack of clarity as to the long-term disease outcomes have spurred the search for risk factors for SARS-CoV-2 infection. We aimed to evaluate the associations of nutritional behaviors, gut microbiota, and physical activity with the risk of COVID-19 in healthy young nonobese people. Data on body composition, anthropometric measurements, physical activity, dietary intake, and gut microbiota were obtained from 95 adults (mean age, 34.66 ± 5.76 years). A balanced diet rich in vegetables and fruit, including nuts, wholegrain cereal products, and legumes, covers the need for vitamins and minerals. Such a diet can be an effective measure to reduce the risk of COVID-19 in nonobese healthy physically active young people with normal immune function. People with balanced diet and an average daily consumption of >500 g of vegetables and fruit and >10 g of nuts had an 86% lower risk of COVID-19 compared with those whose diet was not balanced and who consumed lower amounts of these products. It is well documented that proper nutrition, physical activity, and maintenance of normal weight facilitate good health by ensuring optimal immune function. The beneficial effects of these interventions should be strongly emphasized during the COVID-19 pandemic.

The relationship between dietary sulfur amino acids intake and severity and frequency of pain in Iranian patients with musculoskeletal pains, 2020

OBJECTIVE

Musculoskeletal pain conditions (MPs) are a widespread public problem that can affect 13.5% to 47% of the total population. Dietary changes can have strong effects on person's health; for instance, Sulfur amino acids (SAAs) can act as a precursor of neurotransmitters, antioxidative metabolic intermediates, such as glutathione, impact inflammation, and play a role in severity and frequency of MPs. We evaluated the relationship between dietary SAAs intake with severity and frequency of pain in patients with MPs.

RESULTS

This cross-sectional study consisted of 175 men and woman. Anthropometric measurements and pain assessments were conducted via questionnaires. Dietary data were collected using 7 days 24-h recall. ANOVA and Spearman correlation coefficients were used to examine the relationship and correlation, respectively, between exposure and outcome variables. There was a significant correlation between age, weight, waist circumference (WC), waist circumference to height (WHtR), body mass index (BMI), and severity and frequency of MPs among women. There was a correlation between age and severity of pain in men. The present study highlights a positive association between the dietary SAAs and severity of pain, even after adjusting for confounding variables.

Effect of whey protein consumption on IL-6 and TNF-α: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND AND AIMS

Due to inconsistent data about WP supplementation on inflammatory markers, present systematic review and meta-analysis was done to summarize its effect on TNF-α and IL-6.

METHODS

Our search was done in Pubmed, Scopus, Embase, and Cochrane up to June 2021. Weighted mean difference (WMD) and 95% confidence intervals (CI) was used to indicate the effect sizes. Conceivable sources of heterogeneity were detected by subgroup analysis.

RESULTS

Overall, 11 eligible RCTs were included. The pooled results showed that WP supplementation had no significant effect on TNF-α and IL-6 status compare to those receiving carbohydrate and other types of proteins as placebo. Results from subgroup analysis based on health status, study duration, WP dosage and sex, expressed no favorable effect of WP on TNF-α and IL-6 levels.

CONCLUSION

It can be concluded that whey supplementation had no favorable effects on inflammatory biomarkers including TNF- α and IL-6.

Interaction effect of systemic inflammation and modifiable rheumatoid cachexia risk factors on resting energy expenditure in patients with rheumatoid arthritis

Background

In rheumatoid cachexia (RC), high resting energy expenditure (REE) is associated with loss of muscle mass driven by proinflammatory cytokines. The objectives of this study were to investigate parameters associated with RC, and the interaction between systemic inflammation and modifiable risk factors for RC on REE.

Methods

Thirty-five rheumatoid arthritis (RA) and nineteen non-RA controls comparable in age, sex, race and BMI underwent measures of REE by indirect calorimetry. Clinical, dietary, body composition and physical function data were collected. Homeostasis model assessment for insulin resistance (HOMA-IR) and serum interleukin-6 (IL-6) were used as parameters of IR and systemic inflammation, respectively. Regression models tested association between REE and dependent variables, including pre-specified interaction tests involving HOMA-IR and IL-6 and dietary intake of protein per weight (PPW) and IL-6.

Results

RA subjects were mostly women (94%) and had a median age of 54 years (50.5, 70) and BMI of 30.5 kg/m2 (26.1, 36.9). We observed a significant interaction effect between PPW and serum IL-6 on REE among RA subjects in the multiple regression model among RA. The upper tertile of PPW demonstrated a significant negative correlation between REE and IL-6 (β=-19.97, 95% CI [-35.41, -4.54], p=0.01). The lower tertile of PPW demonstrated a significant positive correlation between REE and IL-6 (β=42.24, 95% CI [4.25, 80.23], p=0.03).

Conclusions

While IR can lead to muscle catabolism, IR was not significantly associated with REE in RA individuals. Higher dietary protein intake could attenuate the effect of systemic inflammation on REE in RA patients.

Intake of Vitamin D in Patients with Multiple Sclerosis in the Valencian Region and Its Possible Relationship with the Pathogenesis of the Disease

(1) Background: Multiple sclerosis (MS) is a neurodegenerative disease characterized by pronounced inflammation. Interleukin 6 (IL-6) is an accurate marker for the state of inflammation, due to the high levels of this cytokine linked to the pathogenesis of the disease. These IL-6 levels could be lowered with an adequate dietary intake of vitamin D. The objective of the study was to determine the level of vitamin D ingested in a sample of patients with MS in the Valencian region (Spain), to establish the vitamin sources, and the possible link between the intake of vitamin D and the pathogenesis of the disease through a relationship with the level of IL-6. (2) Materials and Methods: A descriptive pilot study was carried out with 39 patients with MS in the Valencian region. The dietary-nutritional anamnesis was gained through the food frequency questionnaire (FFQ) and a food diary. Diet and eating habits were analyzed through the Easy Diet (version: 2.0.1)-Consultation Management Program® software, and IL-6 levels in blood by ELISA technique. (3) Results: The results show a low intake of vitamin D, which is significantly and negatively related to the intake of proteins of vegetable origin, which are consumed in less quantity than proteins of animal origin, and significantly and negatively related with the high blood levels of IL-6, possibly as a consequence of the high intake of fats, mainly unsaturated. (4) Conclusions: MS patients in the Valencian region ingest little vitamin D related to low intake of vegetable protein, which would explain the high levels of IL-6 linked to the high intake of mainly saturated fats.

Certain dietary patterns are associated with GLIM criteria among Chinese community-dwelling older adults: a cross-sectional analysis

Disease-related malnutrition is prevalent among older adults; therefore, identifying the modifiable risk factors in the diet is essential for the prevention and management of disease-related malnutrition. The present study examined the cross-sectional association between dietary patterns and malnutrition in Chinese community-dwelling older adults aged ≥65 years in Hong Kong. Dietary patterns, including Diet Quality Index International (DQI-I), Dietary Approaches to Stop Hypertension (DASH), the Mediterranean Diet Score, ‘vegetable–fruit’ pattern, ‘snack–drink–milk product’ pattern and ‘meat–fish’ pattern, were estimated and generated from a validated food frequency questionnaire. Malnutrition was classified according to the modified Global Leadership Initiative on Malnutrition (GLIM) criteria based on two phenotypic components (low body mass index and reduced muscle mass) and one aetiologic component (inflammation/disease burden). The association between the tertile or level of adherence of each dietary pattern and modified GLIM criteria was analysed using adjusted binary logistic regression models. Data of 3694 participants were available (49 % men). Malnutrition was present in 397 participants (10⋅7 %). In men, a higher DQI-I score, a higher ‘vegetable–fruit’ pattern score and a lower ‘meat–fish’ pattern score were associated with a lower risk of malnutrition. In women, higher adherence to the DASH diet was associated with a lower risk of malnutrition. After the Bonferroni correction, the association remained statistically significant only in men for the DQI-I score. To conclude, a higher DQI-I score was associated with a lower risk of malnutrition in Chinese older men. Nutritional strategies for the prevention and management of malnutrition could potentially be targeted on dietary quality.

Natural Supplements for COVID19-Background, Rationale, and Clinical Trials

Worldwide, the turmoil of the SARS-CoV-2 (COVID-19) pandemic has generated a burst of research efforts in search of effective prevention and treatment modalities. Current recommendations on natural supplements arise from mostly anecdotal evidence in other viral infections and expert opinion, and many clinical trials are ongoing. Here the authors review the evidence and rationale for the use of natural supplements for prevention and treatment of COVID-19, including those with potential benefit and those with potential harms. Specifically, the authors review probiotics, dietary patterns, micronutrients, antioxidants, polyphenols, melatonin, and cannabinoids. Authors critically evaluated and summarized the biomedical literature published in peer-reviewed journals, preprint servers, and current guidelines recommended by expert scientific governing bodies. Ongoing and future trials registered on clinicaltrials.gov were also recorded, appraised, and considered in conjunction with the literature findings. In light of the controversial issues surrounding the manufacturing and marketing of natural supplements and limited scientific evidence available, the authors assessed the available data and present this review to equip clinicians with the necessary information regarding the evidence for and potential harms of usage to promote open discussions with patients who are considering dietary supplements to prevent and treat COVID-19.

Impact of Dairy Intake on Plasma F2-IsoProstane Profiles in Overweight Subjects with Hyperinsulinemia: A Randomized Crossover Trial

F₂-IsoProstanes (F₂-IsoPs) are major biomarkers of oxidative stress and are associated with type 2 diabetes (T2D). Further, plasma levels of F₂-IsoPs may be modified by dairy products. The aim is to investigate the effect of high dairy product (HD) consumption compared to an adequate dairy product (AD) consumption on the level of F₂-IsoPs among hyperinsulinemic subjects. In this crossover study, participants were randomized in two groups: HD (≥4 servings/day), or AD (≤2 servings/day) for six weeks. Fasting blood glucose and insulin were measured. The homeostatic model assessment of insulin resistance (HOMA-IR) was calculated. Six isomers of F₂-IsoPs were quantified by HPLC-MS/MS. Twenty-seven subjects with hyperinsulinemia (mean age; 55 ± 13 years, BMI; 31.4 ± 3.3 kg/m2) were included. Fasting glucose, insulin and HOMA-IR were unchanged after HD or AD intervention. After HD intake, the total level of F₂-IsoPs (p = 0.03), 5-F_2t-IsoP (p = 0.002), and 8-F_2t-IsoP (p = 0.004) decreased compared to AD. The 15-F_2t-IsoP tended to be positively correlated with fasting blood glucose (r = 0.39, p = 0.08). Generally, F₂-IsoPs levels were higher among men compared to women regardless of the dairy intake. Overall, intake of HD decreased plasma levels of F₂-IsoPs compared to AD without modifying glycemic parameters.

Lipopolysaccharide binding protein is associated with CVD risk in older adults

BACKGROUND

Intestinal (i.e., "gut") permeability may be related to cardiovascular disease (CVD) risk, but biomarkers for gut permeability are limited and associations with CVD risk are unknown-particularly among older adults.

AIMS

This cross-sectional study aimed to determine if serum biomarkers related to gut permeability [intestinal fatty acid-binding protein (iFABP)] and bacterial toxin clearing [cluster of differentiation 14 (CD14), lipopolysaccharide binding protein (LBP)] are associated with CVD risk among older adults.

METHODS

Older adults (n = 74, 69.6 ± 6.5-years-old) were stratified by CVD risk category. One-way ANOVAs determined differences in each biomarker by risk category, and associations with risk score were evaluated with Pearson correlations.

RESULTS

LBP (p = 0.007), but not iFABP and CD14, was significantly different between CVD risk categories. Post-hoc tests indicated LBP was higher in moderate risk and high-moderate risk compared to the high risk category (p < 0.005). Evaluation of LBP and individual components in the risk score demonstrated a moderate, negative correlation of LBP with age and systolic blood pressure (r = - 0.335 and r = - 0.297) and a small positive correlation between LBP and total cholesterol and LDL cholesterol (r = 0.204 and r = 0.220).

DISCUSSION/CONCLUSION

Lower risk for CVD was associated with higher circulating concentrations of LBP, lower iFABP, and lower systemic inflammation in older adults. Further, there were small positive relationships between total and LDL cholesterol and circulating levels of LBP. These data suggest LBP may be a key component in reducing CVD risk in older adults.

Elevated C-Reactive Protein in Patients With Depression, Independent of Genetic, Health, and Psychosocial Factors: Results From the UK Biobank

OBJECTIVE

The authors investigated the pathways (genetic, environmental, lifestyle, medical) leading to inflammation in major depressive disorder using C-reactive protein (CRP), genetic, and phenotypic data from the UK Biobank.

METHODS

This was a case-control study of 26,894 participants with a lifetime diagnosis of major depressive disorder from the Composite International Diagnostic Interview and 59,001 control subjects who reported no mental disorder and had not reported taking any antidepressant medication. Linear regression models of log CRP level were fitted to regress out the effects of age, sex, body mass index (BMI), and smoking and to test whether the polygenic risk score (PRS) for major depression was associated with log CRP level and whether the association between log CRP level and major depression remained after adjusting for early-life trauma, socioeconomic status, and self-reported health status.

RESULTS

CRP levels were significantly higher in patients with depression relative to control subjects (2.4 mg/L compared with 2.1 mg/L, respectively), and more case than control subjects had CRP levels >3 mg/L (21.2% compared with 16.8%, respectively), indicating low-grade inflammation. The PRS for depression was positively and significantly associated with log CRP levels, but this association was no longer significant after adjustment for BMI and smoking. The association between depression and increased log CRP level was substantially reduced, but still remained significant, after adjustment for the aforementioned clinical and sociodemographic factors.

CONCLUSIONS

The data indicate that the "genetic" contribution to increased inflammation in depression is due to regulation of eating and smoking habits rather than an "autoimmune" genetic predisposition. Moreover, the association between depression and increased inflammation even after full adjustment indicates either the presence of yet unknown or unmeasured psychosocial and clinical confounding factors or that a core biological association between depression and increased inflammation exists independently from confounders.

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.

Influence of Plant and Animal Proteins on Inflammation Markers among Adults with Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Proteins, especially plant proteins, may reduce inflammation among adults with chronic kidney disease (CKD). This systematic review and meta-analysis were conducted to evaluate the effect protein types (animal or plant) have on inflammation markers (CRP, IL-6, TNF-α) among adults with varying stages of CKD. The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) was conducted to identify articles from inception until January 2021, utilizing six databases. Controlled trials that compared the effects of different protein types were analyzed using random-effects meta-analysis. Quality assessment and risk of bias of the included articles were assessed by using Cochrane risk of bias instrument and ROBINS-I. Out of the 10 studies that met the criteria, there was a decreasing trend in CRP levels when consuming plant proteins compared to animal proteins among non-dialysis participants. There was a statistically significant decrease when comparing animal proteins to unspecified proteins in CRP levels among dialysis participants [Hedges’ g = 2.11; 95% CI 1.12, 3.11; p ≤ 0.001], favoring unspecified proteins. Furthermore, animal proteins (eggs, red meat) showed increasing trends in CRP levels compared to whey protein isolate. Caution must be considered regarding these results as controlled, non-randomized, trials were included in the analysis, which may have contributed to high risk of bias. Future research should focus on protein types and the impact they have on kidney disease progression and inflammation markers.

Effect of Breeding Techniques and Prolonged Post Dry Aging Maturation Process on Biomolecule Levels in Raw Buffalo Meat

Recently, several concerns have been expressed on red meat quality and consumption. The aims of this study were to evaluate the influence of different breeding techniques and a prolonged post dry aging (PDA) maturation process on biomolecules level in raw buffalo meat. In the first experiment, two groups of animals were maintained with different space availability (15 vs. 10 m²/animal) for 90 days and biomolecules content was evaluated. In experiment 2, two diets (with or without ryegrass green forage) were used to assess the concentration of these biomolecules. Finally, in experiment 3, the meat of the animals that showed the highest content of biomolecules was chosen to assess the influence of the PDA maturation process. Buffaloes reared at 15 m² showed a significantly (p < 0.05) higher content of the considered biomolecules compared with their counterparts. Similarly, buffaloes fed green forage showed higher content of biomolecules (p < 0.05) compared with the control group. The meat of the animals bred at 15 m² and fed green forage showed a significant (p < 0.01) increase of biomolecules content during the PDA maturation process up to 60 days without influence microbiological profile in terms of total aerobic bacterial counts, yeasts, and molds. In conclusion, breeding techniques and PDA maturation system could enhance biomolecules levels in terms of quality, without affect health standards.

Relation between Inflammation, Oxidative Stress, and Macronutrient Intakes in Normal and Excessive Body Weight Adolescent Girls with Clinical Features of Polycystic Ovary Syndrome

The impact of diet on inflammation and oxidative stress (OS) in girls with polycystic ovary syndrome (PCOS) is unknown. Therefore, our study aimed to investigate, in PCOS girls, whether certain macronutrient intakes can be associated with these disturbances. For this purpose, 59 PCOS participants (aged 14-18 years) were recruited to this study and divided into two subgroups: overweight/obese-Ov/Ob group (n = 22) and normal weight-N group (n = 37). Nutrition was assessed using a 3-day food record. The studied markers were total antioxidant capacity (TAC), malondialdehyde (MDA), C-reactive protein (CRP), tumor necrosis factor α (TNF-α), and interleukins 1 and 6 (IL-1 and IL-6). We found plant protein intake inversely correlated with IL-6 (p = 0.007; r = -0.557), TNF-α (p = 0.006; r = -0.564), MDA (p = 0.01; r = -0.539) in the Ov/Ob group and with TAC (p = 0.021; r = -0.38) in the N group. Inverse correlations in the Ov/Ob group were observed between protein intake and IL-6 (p = 0.031; r = -0.461), TNF- α (p = 0.043; r = -0.435); carbohydrates and IL-6 (p = 0.037; r = -0.448), MDA (p = 0.045; r = -0.431); fiber and IL-6 (p = 0.025; r = -0.475). A positive relationship between cholesterol intake and CRP concentration (p = 0.038; r = 0.342) was also found in the N group. These findings revealed that inflammation and OS are increased in Ov/Ob girls with decreased plant protein intake and low carbohydrates in the diet. Moreover, inflammation may be increased by cholesterol intake in slim PCOS girls. On the other hand, decreased intake of fiber and total protein intake increased inflammation. ClinicalTrials.gov Identifier: NCT04738409.

Association between dietary inflammatory index and gestational diabetes mellitus risk in a prospective birth cohort study

OBJECTIVE

Information is limited regarding the possible relationship between diet-related inflammation and the risk of gestational diabetes mellitus (GDM). This study investigated the association between the inflammatory potential of the diet, measured by the dietary inflammatory index (DII), and GDM risk in pregnant Chinese women.

METHODS

This study included 2639 eligible women from the Tongji Maternal and Child Health Cohort. Dietary intake was assessed by a validated semiquantitative food frequency questionnaire and was used to calculate the DII score. The DII was then validated using C-reactive protein measurements in a subsample of 133 pregnant women. GDM diagnoses were collected from medical records based on the results of a 75 g oral glucose tolerance test at 24 to 28 wk gestation. Multivariable-adjusted logistic regression models were performed to estimate the odds ratios (ORs) for GDM risk by DII score, modeled continuously and in tertiles.

RESULTS

Of the 2639 participants, 13.1% were diagnosed with GDM. DII scores ranged from -4.45 to 3.15 and were positively associated with C-reactive protein (adjusted β : 1.28, 95% confidence interval [CI]: 0.16, 2.40; P trend = 0.023) when comparing DII tertile 3 (most pro-inflammatory) to tertile 1 (most anti-inflammatory). A significant and positive association was observed between DII scores and GDM risk (adjusted OR: 1.43; 95% CI: 1.05, 1.95; P trend = 0.022) comparing the highest versus lowest tertiles. The stratified analysis showed that this association was stronger in pregnant women who were overweight or obese before pregnancy (adjusted OR: 2.20; 95% CI: 1.03, 4.69).

CONCLUSIONS

These findings suggest that a higher DII score, corresponding to a more proinflammatory diet, is associated with a higher risk of GDM, particularly in pregnant women who were overweight or obese before pregnancy.

Milk proteins and their derived peptides on bone health: Biological functions, mechanisms, and prospects

Bone is a dynamic organ under constant metabolism (or remodeling), where a delicate balance between bone resorption and bone formation is maintained. Disruption of this coordinated bone remodeling results in bone diseases, such as osteoporosis, the most common bone disorder characterized by decreased bone mineral density and microarchitectural deterioration. Epidemiological and clinical evidence support that consumption of dairy products is beneficial for bone health; this benefit is often attributed to the presence of calcium, the physiological contributions of milk proteins on bone metabolism, however, are underestimated. Emerging evidence highlighted that not only milk proteins (including individual milk proteins) but also their derived peptides positively regulate bone remodeling and attenuate bone loss, via the regulation of cellular markers and signaling of osteoblasts and osteoclasts. This article aims to review current knowledge about the roles of milk proteins, with an emphasis on individual milk proteins, bioactive peptides derived from milk proteins, and effect of milk processing in particular fermentation, on bone metabolism, to highlight the potential uses of milk proteins in the prevention and treatment of osteoporosis, and, to discuss the knowledge gap and to recommend future research directions.

Effects of High and Low Protein Diets on Inflammatory Profiles in People with Morbid Obesity: A 3-Week Intervention Study

Nutritional interventions in morbidly obese individuals that effectively reverse a pro-inflammatory state and prevent obesity-associated medical complications are highly warranted. Our aim was to evaluate the effect of high (HP) or low (LP) protein diets on circulating immune-inflammatory biomarkers, including C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-a), interleukin-10 (IL-10), monocyte chemoattractant protein-1 (MCP-1), chemerin, omentin, leptin, total adiponectin, high molecular weight adiponectin, and fetuin-A. With this aim, 18 people with morbid obesity were matched into two hypocaloric groups: HP (30E% protein, n = 8) and LP (10E% protein, n = 10) for three weeks. Biomarkers were measured pre and post intervention and linear mixed-effects models were used to investigate differences. Consuming HP or LP diets resulted in reduced CRP (HP: −2.2 ± 1.0 mg/L, LP: −2.3 ± 0.9 mg/L) and chemerin (HP: −17.9 ± 8.6 ng/mL, LP: −20.0 ± 7.4 ng/mL), with no statistically significant differences by diet arm. Participants following the LP diet showed a more pronounced decrease in leptin (−19.2 ± 6.0 ng/mL) and IL-6 (−0.4 ± 0.1 pg/mL) and an increase in total adiponectin (1.6 ± 0.6 µg/mL). Changes were also observed for the remaining biomarkers to a smaller degree by the HP than the LP hypocaloric diet, suggesting that a LP hypocaloric diet modulates a wider range of immune inflammatory biomarkers in morbidly obese individuals.

A moderate-carbohydrate diet with plant protein is inversely associated with cardiovascular risk factors: the Korea National Health and Nutrition Examination Survey 2013-2017

Background

Because a moderate-carbohydrate diet reportedly has minimal risks, the substitution of carbohydrate for protein has been emphasized. Few studies have explored the effect of moderate-carbohydrate diets with higher protein intake in Asians, who typically consume a high-carbohydrate low-fat diet. Therefore, this study evaluated the associations of moderate- versus high- carbohydrate diets with cardiovascular risk factors among Korean adults by protein source.

Methods

This study included 7965 adults (3196 men, 4769 women) aged ≥ 19 years who participated in the 2013–2017 Korea National Health and Nutrition Examination Survey. Dietary intake was assessed by a 24-h recall method and four types of diet were defined: a moderate-carbohydrate diet with plant protein (MCP) or animal protein (MCA) and a high-carbohydrate diet with plant protein (HCP) or animal protein (HCA).

Results

Compared with the MCP group, men in the other three groups had significantly higher odds ratios (ORs) for elevated total cholesterol, reduced high-density lipoprotein (HDL)-cholesterol, and metabolic syndrome. Among women, only the HCP group had an increased OR for reduced HDL-cholesterol, compared with the MCP group. Similar associations were observed in younger adults (19–49 years). In addition, younger adults in the MCA group exhibited higher ORs for elevated triglycerides in men and elevated total cholesterol in women, compared with those in the MCP group.

Conclusions

A moderate-carbohydrate diet with a high intake of plant protein was inversely associated with cardiovascular risk factors, especially among younger Korean adults. Further intervention studies are required to confirm this relationship and develop the optimal diet for cardiovascular health in the Korean population.

Strengthening the Immune System and Reducing Inflammation and Oxidative Stress through Diet and Nutrition: Considerations during the COVID-19 Crisis. Nutrients. 2020;12. [PMID: 32471251 PMCID: PMC7352291 DOI: 10.3390/nu12061562]

The coronavirus-disease 2019 (COVID-19) was announced as a global pandemic by the World Health Organization. Challenges arise concerning how to optimally support the immune system in the general population, especially under self-confinement. An optimal immune response depends on an adequate diet and nutrition in order to keep infection at bay. For example, sufficient protein intake is crucial for optimal antibody production. Low micronutrient status, such as of vitamin A or zinc, has been associated with increased infection risk. Frequently, poor nutrient status is associated with inflammation and oxidative stress, which in turn can impact the immune system. Dietary constituents with especially high anti-inflammatory and antioxidant capacity include vitamin C, vitamin E, and phytochemicals such as carotenoids and polyphenols. Several of these can interact with transcription factors such as NF-kB and Nrf-2, related to anti-inflammatory and antioxidant effects, respectively. Vitamin D in particular may perturb viral cellular infection via interacting with cell entry receptors (angiotensin converting enzyme 2), ACE2. Dietary fiber, fermented by the gut microbiota into short-chain fatty acids, has also been shown to produce anti-inflammatory effects. In this review, we highlight the importance of an optimal status of relevant nutrients to effectively reduce inflammation and oxidative stress, thereby strengthening the immune system during the COVID-19 crisis.

Replacing Animal-Based Proteins with Plant-Based Proteins Changes the Composition of a Whole Nordic Diet-A Randomised Clinical Trial in Healthy Finnish Adults

Increased consumption of plant-based foods and decreased consumption of animal-based foods is recommended for healthy diets and sustainable food production. We investigated the effects of partial replacement of dietary animal proteins with plant-based ones on intake of energy-yielding nutrients, fibre, and plasma lipoproteins. This 12-week randomised clinical intervention comprised 107 women and 29 men (20–69 years) in three diet groups with different dietary protein compositions (“ANIMAL”: Animal 70%/plant 30%; “50/50”: Animal 50%/plant 50%; “PLANT”: Animal 30%/plant 70%; all: Protein intake 17 E%). Nutrient intakes were assessed by 4-day food records. Saturated fat intake (E%) was lower and polyunsaturated fatty acid intake (E%) higher in the PLANT and 50/50 groups compared to the ANIMAL group (p < 0.001 for all). Fibre intake was higher in the PLANT (p ˂ 0.001) and 50/50 (p = 0.012) groups. Total and LDL cholesterol were lower in the PLANT than in the ANIMAL group (p = 0.003 for both) but no differences in HDL cholesterol or triglycerides were observed (p > 0.05). Replacing animal protein with plant protein sources in the diet led to an increased fibre intake and improved dietary fat quality as well as blood lipoprotein profile. Flexitarian diets could provide healthy and more sustainable alternatives for the current, predominantly animal-based diets.

Association between Neutrophil-to-Lymphocyte Ratio with Abdominal Obesity and Healthy Eating Index in a Representative Older Spanish Population

Poor diet quality and obesity, especially abdominal obesity, have been associated with systemic inflammation. The neutrophil-to-lymphocyte Ratio (NLR) is an available and inexpensive inflammation biomarker. The aim of the present study was to determine the association of dietary patterns and obesity with an inflammatory state. A group of 1747 Spanish noninstitutionalized older adults individuals were included, and a food-frequency questionnaire was applied. The Global Food Score (GFS) and Healthy Eating Index for Spanish population (SHEI) were calculated. Weight, height and waist (WC) and hip circumferences were measured, and BMI, waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR) determined. In addition, body-fat percentage was measured by bioimpedance. NLR was calculated (NLR ≥ p80: 2.6; 2.8 and 2.4 as inflammatory status in the entire population, men and women, respectively). The men with inflammatory status presented significative higher values of WC, WHtR, WHR, and body-fat percentage (101.82 ± 10.34 cm, 0.61 ± 0.06, 0.98 ± 0.06, and 31.68 ± 5.94%, respectively) than those with better inflammatory status (100.18 ± 10.22 cm, 0.59 ± 0.06, 0.97 ± 0.07, and 30.31 ± 6.16%, respectively). Those males with worse inflammatory state had lower scores for protein foods (OR = 0.898 (0.812–0.993); p = 0.037). The women with NLR ≥ 2.4 had higher WHtR and WHR (0.62 ± 0.09 and 0.91 ± 0.09) than those with NLR < 2.4 (0.60 ± 0.08 and 0.90 ± 0.08). In multiple linear regression analysis, NLR was positively related with WHtR and negatively related with SHEI score (β = 0.224 ± 0.094; R² = 0.060; p < 0.05 and β = −0.218 ± 0.101; R² = 0.061; p < 0.05), adjusting by sex, age, marital status, education level, smoking, hours of sleeping and inflammatory diseases. In women, the higher the SHEI and GFS scores were and the better meeting the aims of cereal and vegetable servings, the less the odds of inflammatory status (OR = 0.970 (0.948–0.992); p = 0.008; OR = 0.963 (0.932–0.995); p = 0.024; OR = 0.818 (0.688–0.974); p = 0.024 and OR = 0.829 (0.730–0.942); p = 0.004, respectively). WHtR and quality of diet is related to the inflammation status in older adults regardless to the sex.

Evaluation of in vivo anti-inflammatory and anti-angiogenic attributes of methanolic extract of Launaea spinosa

Launaea spinosa is used as an anti-inflammatory agent traditionally. This study was conducted to evaluate anti-inflammatory and anti-angiogenic activities of methanol extract of Launaea spinosa. Extraction was performed by maceration and the resultant green coloured extract was labelled as Ls.Me. Solubility analysis showed that Ls.Me was miscible with distilled water, normal saline, ethanol and methanol. Metal analysis following acid digestion method exhibited the presence of copper, magnesium, manganese, iron, zinc and calcium. Phytochemical analysis confirmed the presence of different classes of secondary metabolites in Ls.Me. HPLC analysis showed the presence of quercetin, gallic acid, caffeic acid, benzoic acid and sinapic acid in Ls.Me. Data of in vitro antioxidant assays showed moderate antioxidant potential of Ls.Me which was also confirmed by data of in vivo enzymes (SOD, CAT, and TSP) assays. Antimicrobial assays data showed that Ls.Me was active against S.aureus and S.epidermidis (bacterial) as well as C.albicans and A.niger (fungal) strains. Data of acute physio-pathological studies showed no abnormalities in Albino rats up to the dose of 2000 mg/kg of Ls.Me. Acute and chronic inflammatory models were used to evaluate anti-inflammatory effects of Ls.Me. Data of acute studies showed that Ls.Me has the potential to arrest inflammation produced by different mediators in a dose-dependent manner. 200 mg/kg of Ls.Me was found to produce significantly (p < 0.05) better anti-inflammatory effects than 100 mg/kg of Ls.Me. Ls.Me also significantly (p < 0.05) inhibited ear edema induced by xylene. Ls.Me showed profound anti-inflammatory responses in paw edema induced by formalin and also inhibited granuloma development in cotton pellet-induced granuloma model. Histopathological and biochemical investigations showed marked reduction in the number of inflammatory cells. TNF-α and IL-6 ELSIA kits were used to study effects of Ls.Me treatment on serum levels of TNF-α and IL-6. Data obtained showed significant (p < 0.05) reduction in TNF-α and IL-6 levels in serum of animals treated with Ls.Me. Data of in vivo angiogenesis assay showed that 200 µg/ml of Ls.Me significantly halted vasculature development indicating its potent anti-angiogenic potential. On the basis of findings of the current study, it is concluded that multiple phytochemicals present in Ls.Me act synergistically to produce anti-inflammatory and anti-angiogenic effects. Further studies are required to standardize the plant extract and explore its safety profile.

Dietary Protein and Muscle Mass: Translating Science to Application and Health Benefit

Adequate consumption of dietary protein is critical for the maintenance of optimal health during normal growth and aging. The current Recommended Dietary Allowance (RDA) for protein is defined as the minimum amount required to prevent lean body mass loss, but is often misrepresented and misinterpreted as a recommended optimal intake. Over the past two decades, the potential muscle-related benefits achieved by consuming higher-protein diets have become increasingly clear. Despite greater awareness of how higher-protein diets might be advantageous for muscle mass, actual dietary patterns, particularly as they pertain to protein, have remained relatively unchanged in American adults. This lack of change may, in part, result from confusion over the purported detrimental effects of higher-protein diets. This manuscript will highlight common perceptions and benefits of dietary protein on muscle mass, address misperceptions related to higher-protein diets, and comment on the translation of academic advances to real-life application and health benefit. Given the vast research evidence supporting the positive effects of dietary protein intake on optimal health, we encourage critical evaluation of current protein intake recommendations and responsible representation and application of the RDA as a minimum protein requirement rather than one determined to optimally meet the needs of the population.