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Hussain BM, Ryan R, Deierlein AL, Lal S, Bihuniak JD, Parekh N. Food Insecurity and Health Behaviors Among a Sample of Undergraduate Students at an Urban University. Journal of Hunger & Environmental Nutrition 2022. [DOI: 10.1080/19320248.2022.2119119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Bridget Murphy Hussain
- Public Health Nutrition, School of Global Public Health, New York University, New York, NY, USA
- Department of Child and Adolescent Psychiatry, New York University Langone Health, New York, NY, USA
| | - Rachel Ryan
- Department of Nutrition and Food Studies, New York University Steinhardt, New York, NY, USA
| | - Andrea L. Deierlein
- Public Health Nutrition, School of Global Public Health, New York University, New York, NY, USA
- Department of Population Health at New York University Grossman School of Medicine, New York University Langone Health, New York, NY, USA
| | - Supriya Lal
- Public Health Nutrition, School of Global Public Health, New York University, New York, NY, USA
| | - Jessica D. Bihuniak
- Department of Nutrition and Food Studies, New York University Steinhardt, New York, NY, USA
| | - Niyati Parekh
- Public Health Nutrition, School of Global Public Health, New York University, New York, NY, USA
- Department of Population Health at New York University Grossman School of Medicine, New York University Langone Health, New York, NY, USA
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Ryan RA, Murphy B, Deierlein AL, Lal S, Parekh N, Bihuniak JD. Food Insecurity, Associated Health Behaviors, and Academic Performance Among Urban University Undergraduate Students. J Nutr Educ Behav 2022; 54:269-275. [PMID: 34758921 DOI: 10.1016/j.jneb.2021.08.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 08/12/2021] [Accepted: 08/15/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To explore associations between food insecurity, health behaviors, and academic performance among undergraduates at a private, urban US university. METHODS A cross-sectional web-based survey was conducted among a convenience sample of New York University undergraduates. Multivariable logistic regression estimated associations of food security (using the 6-item US Household Food Security Survey Module) and health behaviors (fruit/vegetable, beverage and alcohol intakes, and sleep), self-rated health, and academic performance. RESULTS Of the 257 students who completed the survey, 41% reported food insecurity. Food insecurity was associated with approximately 2-fold higher odds of sugar-sweetened beverage consumption (adjusted odds ratio, 1.97; 95% confidence interval, 1.14-3.41) and fair/poor health (adjusted odds ratio, 2.29; 95% confidence interval, 1.23-4.25). CONCLUSIONS AND IMPLICATIONS Increased awareness of food insecurity and associated health behaviors among students has implications for higher education's provision of on-campus food support programs.
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Affiliation(s)
- Rachel A Ryan
- Department of Nutrition and Food Studies, New York University Steinhardt, New York, NY.
| | - Bridget Murphy
- Public Health Nutrition, School of Global Public Health, New York University, New York, NY; Department of Child and Adolescent Psychiatry, New York University Langone Health, New York, NY
| | - Andrea L Deierlein
- Public Health Nutrition, School of Global Public Health, New York University, New York, NY; Department of Population Health at New York University Grossman School of Medicine, New York University Langone Health, New York, NY
| | - Supriya Lal
- Public Health Nutrition, School of Global Public Health, New York University, New York, NY
| | - Niyati Parekh
- Public Health Nutrition, School of Global Public Health, New York University, New York, NY; Department of Population Health at New York University Grossman School of Medicine, New York University Langone Health, New York, NY; New York University Rory Meyers School of Nursing, New York, NY
| | - Jessica D Bihuniak
- Department of Nutrition and Food Studies, New York University Steinhardt, New York, NY
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Bihuniak JD, Bryant T, Kleiman J, Rotondo M, Decoteau J, Haisley S, Monserrate D, Cunningham M, MacKenzie A, Dauz S, Ippolito R, Fernandes N, LaRose JG, Leahey TM. Behavioural weight loss treatment preferences of college students with overweight and obesity. Clin Obes 2020; 10:e12343. [PMID: 31613059 DOI: 10.1111/cob.12343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/04/2019] [Accepted: 09/11/2019] [Indexed: 01/08/2023]
Abstract
The college environment increases risk of weight gain in young adults with overweight/obesity. Behavioural weight loss interventions are proven effective, however, young adults' adherence to such programs is poor. The purpose of the study was to determine weight loss treatment preferences of 2- and 4-year college students for the development of population-specific interventions. Students with a BMI ≥25, between 18 and 24 years of age, and enrolled in one of four institutions were recruited. A questionnaire was developed to assess students' preferences and was administered via Qualtrics. BMI was calculated from objectively assessed height and weight measurements. Descriptive analyses, chi-square, Fisher's Exact Test, Mann-Whitney U test and Cramer's V were performed. Participants (n = 133, age = 20.2 ± 1.8) predominately identified as female (70%), non-Hispanic (68%) and Black/African American (32%) or White (32%). Fifty-five percent met criteria for obesity. Most students preferred session length of ≤1 hour (78%), for meetings to be held on a weekday (70%) and for both a peer and a professional to co-facilitate meetings (61%). Preferences for health outcomes and physical activity monitoring, type of physical activity, frequency of dietary monitoring, physical activity tracking method and interest in financial incentives to promote core treatment components differed between institutions. Heterogeneity in program preferences by college environment should be considered when designing weight loss interventions.
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Affiliation(s)
- Jessica D Bihuniak
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York
| | - Tiffany Bryant
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York
| | - Jennifer Kleiman
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York
| | - Megan Rotondo
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut
| | - Jessica Decoteau
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut
| | - Samantha Haisley
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York
- Health Sciences Department, LaGuardia Community College, Long Island City, New York
| | - David Monserrate
- Health and Exercise Science Program, Manchester Community College, Manchester, Connecticut
| | - Michael Cunningham
- Health and Exercise Science Program, Manchester Community College, Manchester, Connecticut
| | - Allison MacKenzie
- Health and Exercise Science Program, Manchester Community College, Manchester, Connecticut
| | - Steve Dauz
- Health Sciences Department, LaGuardia Community College, Long Island City, New York
| | - Rosann Ippolito
- Health Sciences Department, LaGuardia Community College, Long Island City, New York
| | - Nicolle Fernandes
- Health Sciences Department, LaGuardia Community College, Long Island City, New York
| | - Jessica G LaRose
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Tricia M Leahey
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut
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Stojkovic V, Simpson CA, Sullivan RR, Cusano AM, Kerstetter JE, Kenny AM, Insogna KL, Bihuniak JD. The Effect of Dietary Glycemic Properties on Markers of Inflammation, Insulin Resistance, and Body Composition in Postmenopausal American Women: An Ancillary Study from a Multicenter Protein Supplementation Trial. Nutrients 2017; 9:nu9050484. [PMID: 28492492 PMCID: PMC5452214 DOI: 10.3390/nu9050484] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 05/02/2017] [Accepted: 05/03/2017] [Indexed: 11/25/2022] Open
Abstract
Controversy exists as to whether high glycemic index/glycemic load (GI/GL) diets increase the risk of chronic inflammation, which has been postulated as a pathogenic intermediary between such diets and age-related alterations in body composition and insulin resistance. We conducted an ancillary study to a randomized, double-blind trial comparing the effects of a whey protein supplement (PRO, n = 38) and a maltodextrin supplement (CHO, n = 46) on bone density to evaluate the impact of a calibrated increase in GI/GL on inflammation, insulin resistance, and body composition in a healthy aging population. Markers of inflammation, HOMA, body composition, and GI/GL (estimated from 3-day food records) were assessed at baseline and 18 months. By 18 months, the GL in the CHO group increased by 34%, 88.4 ± 5.2 → 118.5 ± 4.9 and did not change in the PRO group, 86.5 ± 4.1 → 82.0 ± 3.6 (p < 0.0001). Despite this change there were no differences in serum CRP, IL-6, or HOMA at 18 months between the two groups, nor were there significant associations between GL and inflammatory markers. However, trunk lean mass (p = 0.0375) and total lean mass (p = 0.038) were higher in the PRO group compared to the CHO group at 18 months There were also significant associations for GL and change in total fat mass (r = 0.3, p = 0.01), change in BMI (r = 0.3, p = 0.005), and change in the lean-to-fat mass ratio (r = −0.3, p = 0.002). Our data suggest that as dietary GL increases within the moderate range, there is no detectable change in markers of inflammation or insulin resistance, despite which there is a negative effect on body composition.
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Affiliation(s)
- Violeta Stojkovic
- Clinical Chemistry, University of Liège, place du 20-Août, Liège 7 B-4000, Belgium.
- Department of Internal Medicine, Section of Endocrinology, Yale University, 300 Cedar Street, New Haven, CT 06510, USA.
| | - Christine A Simpson
- Department of Internal Medicine, Section of Endocrinology, Yale University, 300 Cedar Street, New Haven, CT 06510, USA.
| | - Rebecca R Sullivan
- Department of Internal Medicine, Section of Endocrinology, Yale University, 300 Cedar Street, New Haven, CT 06510, USA.
| | - Anna Maria Cusano
- Department of Internal Medicine, Section of Endocrinology, Yale University, 300 Cedar Street, New Haven, CT 06510, USA.
| | - Jane E Kerstetter
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT 06269-1101, USA.
| | - Anne M Kenny
- Center on Aging, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA.
| | - Karl L Insogna
- Department of Internal Medicine, Section of Endocrinology, Yale University, 300 Cedar Street, New Haven, CT 06510, USA.
| | - Jessica D Bihuniak
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, 411 Lafayette Street, 5th Floor, New York University, New York, NY 10003, USA.
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Bihuniak JD, Ramos A, Huedo-Medina T, Hutchins-Wiese H, Kerstetter JE, Kenny AM. Adherence to a Mediterranean-Style Diet and Its Influence on Cardiovascular Risk Factors in Postmenopausal Women. J Acad Nutr Diet 2016; 116:1767-1775. [PMID: 27568885 DOI: 10.1016/j.jand.2016.06.377] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 06/24/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND A Mediterranean-style diet (MedSD) is associated with positive health outcomes, particularly reduced risk of cardiovascular disease. It is of interest to assess the feasibility of adherence to a MedSD in a subset of older adults in the United States. OBJECTIVE To assess the efficacy of implementing a MedSD intervention in a subset of postmenopausal women living in the United States, and to detect the influence of this dietary pattern on blood lipid levels. DESIGN A partial feeding, nutrition counseling, pilot study with a one-group longitudinal design. PARTICIPANTS Sixteen healthy, postmenopausal, American women living in suburban communities in Farmington, CT, with a mean±standard deviation age of 77±6.8 years and a body mass index of 26.1±3.1. INTERVENTION Participants were counseled by a registered dietitian nutritionist on how to follow a MedSD, which included increased sources of n-3 polyunsaturated fatty acids, fruits, and vegetables, and decreased saturated fat, n-6 polyunsaturated fatty acids, and simple sugars for 12 weeks. To maintain isocaloric conditions, participants were asked to substitute sources of saturated fat and refined carbohydrates for extra virgin olive oil (3 T/day), walnuts (1.5 oz/day), and fatty fish (3 to 5 servings/wk), which were provided at 3-week intervals. MAIN OUTCOME MEASURES Dietary adherence measures included the Mediterranean Diet Score, 3-day diet records, and serum fatty acid and lipid profiles. STATISTICAL ANALYSES Mixed model longitudinal analyses were conducted to assess changes over time (Weeks 0, 12, and 24) in the outcome variables. RESULTS Mediterranean Diet Score increased by 8.9 points (P<0.001) after the MedSD phase. Dietary sugar decreased by 10.8 g (P<0.05), total dietary n-3 increased by 1.6 g (P<0.01), total dietary n-6 increased by 5.5 g (P<0.01), and dietary n-6:n3 ratio decreased by 3.6 units (P<0.01). In serum, 22:6 (n-3), 20:5 (n-3), and 18:3 (n-3) increased (P<0.001, P<0.01, and P<0.001, respectively), and 14:0, 16:0, 17:0, 20:4 (n-6), 22:4 (n-6) declined after the intervention (P<0.01, P<0.001, P<0.01, P<0.01, and P<0.001, respectively), which support a change in dietary intake toward a MedSD. Serum high-density lipoprotein cholesterol levels increased by 3.8 mg/dL (0.098 mmol/L) (P<0.05) and serum triglyceride levels decreased by 11.6 mg/dL (0.131 mmol/L) (P<0.10). CONCLUSIONS A pilot study of a 12-week MedSD intervention with counseling from a registered dietitian nutritionist can favorably influence the dietary pattern and lipid profile of postmenopausal women living in the United States.
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Garcia M, Bihuniak JD, Shook J, Kenny A, Kerstetter J, Huedo-Medina TB. The Effect of the Traditional Mediterranean-Style Diet on Metabolic Risk Factors: A Meta-Analysis. Nutrients 2016; 8:168. [PMID: 26999195 PMCID: PMC4808896 DOI: 10.3390/nu8030168] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 03/01/2016] [Accepted: 03/10/2016] [Indexed: 01/08/2023] Open
Abstract
The Mediterranean-style diet (MedSD) has gained attention for its positive effects on health outcomes, including metabolic risk factors. However, it is unknown as to which components of MedSD interventions are most beneficial in reducing risk. The objective of this meta-analysis was to obtain effect sizes for metabolic risk factors and explain the variability across the current literature based on study design, sample, and diet characteristics. Six electronic databases were searched from inception until 9 February 2016. Data from 29 studies (N = 4133) were included. There were significant effects in favor of the MedSD for waist circumference, triglycerides, blood glucose, systolic blood pressure, and diastolic blood pressure (d+ = -0.54; d+ = -0.46; d+ = -0.50; d+ = -0.72; d+ = -0.94, respectively). The MedSD was significantly beneficial when the intervention was longer in duration, was conducted in Europe, used a behavioral technique, and was conducted using small groups. The traditional MedSD had significant beneficial effects on five of the six metabolic risk factors. Results from this study provide support for population specific dietary guideline for metabolic risk reduction.
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Affiliation(s)
- Marissa Garcia
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA.
| | - Jessica D Bihuniak
- NYU Steinhardt, Department of Nutrition and Food Studies, New York University, New York, NY 10003, USA.
| | - Julia Shook
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA.
| | - Anne Kenny
- Center on Aging, University of Connecticut Health Center, Farmington, CT06030, USA.
| | - Jane Kerstetter
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA.
| | - Tania B Huedo-Medina
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA.
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Huedo-Medina TB, Garcia M, Bihuniak JD, Kenny A, Kerstetter J. Methodologic quality of meta-analyses and systematic reviews on the Mediterranean diet and cardiovascular disease outcomes: a review. Am J Clin Nutr 2016; 103:841-50. [PMID: 26864357 DOI: 10.3945/ajcn.115.112771] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 12/01/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Several systematic reviews/meta-analyses published within the past 10 y have examined the associations of Mediterranean-style diets (MedSDs) on cardiovascular disease (CVD) risk. However, these reviews have not been evaluated for satisfying contemporary methodologic quality standards. OBJECTIVE This study evaluated the quality of recent systematic reviews/meta-analyses on MedSD and CVD risk outcomes by using an established methodologic quality scale. The relation between review quality and impact per publication value of the journal in which the article had been published was also evaluated. DESIGN To assess compliance with current standards, we applied a modified version of the Assessment of Multiple Systematic Reviews (AMSTARMedSD) quality scale to systematic reviews/meta-analyses retrieved from electronic databases that had met our selection criteria: 1) used systematic or meta-analytic procedures to review the literature, 2) examined MedSD trials, and 3) had MedSD interventions independently or combined with other interventions. RESULTS Reviews completely satisfied from 8% to 75% of the AMSTARMedSD items (mean ± SD: 31.2% ± 19.4%), with those published in higher-impact journals having greater quality scores. At a minimum, 60% of the 24 reviews did not disclose full search details or apply appropriate statistical methods to combine study findings. Only 5 of the reviews included participant or study characteristics in their analyses, and none evaluated MedSD diet characteristics. CONCLUSIONS These data suggest that current meta-analyses/systematic reviews evaluating the effect of MedSD on CVD risk do not fully comply with contemporary methodologic quality standards. As a result, there are more research questions to answer to enhance our understanding of how MedSD affects CVD risk or how these effects may be modified by the participant or MedSD characteristics. To clarify the associations between MedSD and CVD risk, future meta-analyses and systematic reviews should not only follow methodologic quality standards but also include more statistical modeling results when data allow.
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Affiliation(s)
- Tania B Huedo-Medina
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, and
| | - Marissa Garcia
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, and
| | - Jessica D Bihuniak
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, and
| | - Anne Kenny
- Center on Aging, UConn Health, University of Connecticut, Storrs, CT
| | - Jane Kerstetter
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, and
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Abstract
Dietary protein is required for optimal skeletal growth and maturation. Although Recommended Dietary Allowances (RDAs) exist for global dietary protein intake, the level and sources of dietary protein that are optimal for skeletal health over the life continuum have not been established. This is partly due to the difficulty in quantifying the effects of variable levels of a nutrient's intake over a lifetime as well as the complex nature of the relationships between dietary protein and calcium economy. Areas of current uncertainty include the precise source and amount of dietary protein required for optimal skeletal accretion and maintenance of skeletal mass, as well as the site-specific effects of dietary protein. The cellular and molecular mechanisms that underpin the actions of dietary protein on mineral metabolism and skeletal homeostasis remain unclear. This review attempts to summarize recent data bearing on these questions.
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Affiliation(s)
- Jessica D Bihuniak
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, 06269-1101, USA; Department of Internal Medicine, Section of Endocrinology, Yale University, New Haven, CT, 06269-1101, USA.
| | - Karl L Insogna
- Department of Internal Medicine, Section of Endocrinology, Yale University, New Haven, CT, 06269-1101, USA
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Kerstetter JE, Bihuniak JD, Brindisi J, Sullivan RR, Mangano KM, Larocque S, Kotler BM, Simpson CA, Cusano AM, Gaffney-Stomberg E, Kleppinger A, Reynolds J, Dziura J, Kenny AM, Insogna KL. The Effect of a Whey Protein Supplement on Bone Mass in Older Caucasian Adults. J Clin Endocrinol Metab 2015; 100:2214-22. [PMID: 25844619 PMCID: PMC4454800 DOI: 10.1210/jc.2014-3792] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT It has been assumed that the increase in urine calcium (Ca) that accompanies an increase in dietary protein was due to increased bone resorption. However, studies using stable Ca isotopes have found that dietary protein increases Ca absorption without increasing bone resorption. OBJECTIVE The objective of the study was to investigate the impact of a moderately high protein diet on bone mineral density (BMD). DESIGN This was a randomized, double-blind, placebo-controlled trial of protein supplementation daily for 18 months. SETTING The study was conducted at two institutional research centers. PARTICIPANTS Two hundred eight older women and men with a body mass index between 19 and 32 kg/m(2) and a self-reported protein intake between 0.6 and 1.0 g/kg participated in the study. INTERVENTION Subjects were asked to incorporate either a 45-g whey protein or isocaloric maltodextrin supplement into their usual diet for 18 months. MAIN OUTCOME MEASURE BMD by dual-energy x-ray absorptiometry, body composition, and markers of skeletal and mineral metabolism were measured at baseline and at 9 and 18 months. RESULTS There were no significant differences between groups for changes in L-spine BMD (primary outcome) or the other skeletal sites of interest. Truncal lean mass was significantly higher in the protein group at 18 months (P = .048). C-terminal telopeptide (P = .0414), IGF-1 (P = .0054), and urinary urea (P < .001) were also higher in the protein group at the end of the study period. There was no difference in estimated glomerular filtration rate at 18 months. CONCLUSION Our data suggest that protein supplementation above the recommended dietary allowance (0.8 g/kg) may preserve fat-free mass without adversely affecting skeletal health or renal function in healthy older adults.
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Bihuniak JD, Sullivan RR, Simpson CA, Caseria DM, Huedo-Medina TB, O’Brien KO, Kerstetter JE, Insogna KL. Supplementing a low-protein diet with dibasic amino acids increases urinary calcium excretion in young women. J Nutr 2014; 144:282-8. [PMID: 24431325 PMCID: PMC3927545 DOI: 10.3945/jn.113.185009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 10/10/2013] [Accepted: 12/23/2013] [Indexed: 11/14/2022] Open
Abstract
Increasing dietary protein within a physiologic range stimulates intestinal calcium absorption, but it is not known if specific amino acids or dietary protein as a whole are responsible for this effect. Therefore, we selectively supplemented a low-protein (0.7 g/kg) diet with either the calcium-sensing receptor-activating amino acids (CaSR-AAAs) L-tryptophan, L-phenylalanine, and L-histidine, or the dibasic amino acids (DAAs) L-arginine and L-lysine, to achieve intakes comparable to the content of a high-protein diet (2.1 g/kg) and measured intestinal calcium absorption. Fourteen young women took part in a placebo-controlled, double-blind, crossover feeding trial in which each participant ingested a 6-d low-protein diet supplemented with CaSR-AAAs, DAAs, or methylcellulose capsules (control) after an 11-d adjustment period. All participants ingested all 3 diets in random order. Intestinal calcium absorption was measured between days 5 and 6 using dual-stable calcium isotopes ((42)Ca, (43)Ca, and (44)Ca). There was no difference in calcium absorption between the diet supplemented with CaSR-AAAs (22.9 ± 2.0%) and the control diet (22.3 ± 1.4%) (P = 0.64). However, calcium absorption tended to be greater during the DAA supplementation period (25.2 ± 1.4%) compared with the control diet period (22.3 ± 1.4%) (P < 0.10). Larger and longer clinical trials are needed to clarify the possible benefit of arginine and lysine on calcium absorption.
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Affiliation(s)
| | | | | | | | | | | | - Jane E. Kerstetter
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT
| | - Karl L. Insogna
- Department of Internal Medicine, Section of Endocrinology and
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Gregorio L, Brindisi J, Kleppinger A, Sullivan R, Mangano KM, Bihuniak JD, Kenny AM, Kerstetter JE, Insogna KL. Adequate dietary protein is associated with better physical performance among post-menopausal women 60-90 years. J Nutr Health Aging 2014; 18:155-60. [PMID: 24522467 PMCID: PMC4433492 DOI: 10.1007/s12603-013-0391-2] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Sarcopenia, the involuntary loss of skeletal muscle with age, affects up to one-quarter of older adults. Evidence indicates a positive association between dietary protein intake and lean muscle mass and strength among older persons, but information on dietary protein's effect on physical performance in older adults has received less attention. DESIGN Cross-sectional observational analysis of the relationship of dietary protein on body composition and physical performance. SETTING Clinical research center. PARTICIPANTS 387 healthy women aged 60 - 90 years (mean 72.7 ± 7.0 y). MEASUREMENTS Measures included body composition (fat-free mass, appendicular skeletal mass and fat mass) via dual x-ray absorptiometry (DXA), physical performance (Physical Performance Test [PPT] and Short Physical Performance Battery [SPPB]), handgrip strength, Physical Activity Scale in the Elderly (PASE), quality of life measure (SF-8), falls, fractures, nutrient and macromolecule intake (four-day food record). Independent samples t-tests determined mean differences between the above or below RDA protein groups. STATISTICAL ANALYSIS Analysis of covariance was used to control for body mass index (BMI) between groups when assessing physical performance, physical activity and health-related quality of life. RESULTS The subjects consumed an average of 72.2 g protein/day representing 1.1 g protein/kg body weight/day. Subjects were categorized as below the recommended daily allowance (RDA) for protein (defined as less than 0.8 g protein/kg) or at or above the RDA (equal to or higher than 0.8 g protein/kg). Ninety-seven subjects (25%) were in the low protein group, and 290 (75%) were in the higher protein group. Women in the higher protein group had lower body mass, including fat and lean mass, and fat-to-lean ratio than those in the lower-protein group (p <0.001). Composite scores of upper and lower extremity strength were impaired in the group with low protein intake; SPPB score was 9.9±1.9 compared to 10.6±1.6 in those with higher protein intake and PPT was 19.8± 2.9 compared to 20.9± 2.1 in the low and higher protein groups, respectively. The results were attenuated by correction for BMI, but remained significant. The physical component of the SF-8 was also lower in the low protein group but did not remain significant when controlling for BMI. No significant differences were found in hand grip strength or reported physical activity. CONCLUSION Healthy, older postmenopausal women consumed, on average, 1.1 g/kg/d protein, although 25% consumed less than the RDA. Those in the low protein group had higher body fat and fat-to-lean ratio than those who consumed the higher protein diet. Upper and lower extremity function was impaired in those who consumed a low protein diet compared to those with a higher protein intake. Protein intake should be considered when evaluating the multi-factorial loss of physical function in older women.
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Affiliation(s)
- L Gregorio
- Anne Kenny, MD, Center on Aging, MC-5215, University of Connecticut Health Center, Farmington, CT 06030-5215, , Phone: (860) 679-3956, Fax: (860) 679-1307
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Bihuniak JD, Simpson CA, Sullivan RR, Caseria DM, Kerstetter JE, Insogna KL. Dietary protein-induced increases in urinary calcium are accompanied by similar increases in urinary nitrogen and urinary urea: a controlled clinical trial. J Acad Nutr Diet 2013; 113:447-451. [PMID: 23438496 DOI: 10.1016/j.jand.2012.11.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 11/02/2012] [Indexed: 10/27/2022]
Abstract
To determine the usefulness of urinary urea as an index of dietary protein intake, 10 postmenopausal women were enrolled in and completed a randomized, double-blind, cross-over feeding trial from September 2008 to May 2010 that compared 10 days of a 45-g whey supplement with 10 days of a 45-g maltodextrin control. Urinary nitrogen, urinary calcium, urinary urea, and bone turnover markers were measured at days 0, 7, and 10. Paired sample t tests, Pearson's correlation statistic, and simple linear regression were used to assess differences between treatments and associations among urinary metabolites. Urinary nitrogen/urinary creatinine rose from 12.3±1.7 g/g (99.6±13.8 mmol/mmol) to 16.8±2.2 g/g (135.5±17.8 mmol/mmol) with whey supplementation, but did not change with maltodextrin. Whey supplementation caused urinary calcium to rise by 4.76±1.84 mg (1.19±0.46 mmol) without a change in bone turnover markers. Because our goal was to estimate protein intake from urinary nitrogen/urinary creatinine, we used our data to develop the following equation: protein intake (g/day)=71.221+1.719×(urinary nitrogen, g)/creatinine, g) (R=0.46, R(2)=0.21). As a more rapid and less costly alternative to urinary nitrogen/urinary creatinine, we next determined whether urinary urea could predict protein intake and found that protein intake (g/day)=63.844+1.11×(urinary urea, g/creatinine, g) (R=0.58, R(2)=0.34). These data indicate that urinary urea/urinary creatinine is at least as good a marker of dietary protein intake as urinary nitrogen and is easier to quantitate in nutrition intervention trials.
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Bihuniak JD, Sullivan RR, Simpson CA, Caseria DM, O'Brien KO, Kerstetter JE, Insogna KL. The effect of selective amino acid supplementation on calcium absorption during a low protein diet. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.lb283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | | | | | | | - Karl L Insogna
- Internal Medicine EndocrinologyYale UniversityNew HavenCT
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