Impact of dietary protein intake and obesity on lean mass in middle-aged individuals after a 12-year follow-up: the Korean Genome and Epidemiology Study (KoGES)

AbstractThe present study investigated the association between protein intake and lean mass according to obesity status over a 12-year period. Data on 4412 participants aged 40–69 years were obtained from the Korean Genome and Epidemiology Study. The usual dietary protein intake of these participants was assessed at baseline using a semi-quantitative FFQ. Body composition was measured using bioelectrical impedance analysis at baseline and after a 12-year follow-up. Linear mixed-effects models were used to examine the associations between lean mass after a 12-year follow-up and protein intake at baseline. After adjusting for covariates and lean mass at baseline, comparisons between the highest and lowest tertiles revealed that dietary protein intake was positively associated with lean mass in both men (β = 0·79, P = 0·001) and women (β = 0·28, P = 0·082) after the 12-year period; however, those differences were attenuated after additional adjustment for fat mass at baseline and were stronger in the normal-weight group (men, β = 0·85, P = 0·002; women, β = 0·97, P < 0·001) but were not detected in the obese group. In the obese group, age (men, β = 4·08, P < 0·001; women, β = 2·61, P < 0·001) and regular physical activity (men, β = 0·88, P = 0·054; women, β = 0·76, P < 0·001) were significantly associated with lean mass after 12 years of follow-up. The results of the present study showed that protein intake may contribute to the prevention of ageing-related lean mass loss; however, the impact of this intake may vary depending on obesity status. Therefore, the maintenance of a healthy body weight during ageing through enhanced protein intake is likely to confer health benefits.

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Association between lean mass and dietary protein intake in postmenopausal women

Bone Abstracts ◽

10.1530/boneabs.5.p279 ◽

2016 ◽

Author(s):

Vladyslav Povoroznyuk ◽

Nataliia Dzerovych ◽

Roksolana Povorooznyuk

Keyword(s):

Postmenopausal Women ◽

Lean Mass ◽

Dietary Protein ◽

Protein Intake ◽

Dietary Protein Intake

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P1455PRIORITIZATION BY MEDICAL DIRECTORS OF NUTRITIONAL PROTEIN VERSUS DIETARY PHOSPHORUS CONTROL IN HEMODIALYSIS PATIENTS: ASSOCIATION WITH MORTALITY IN THE DIALYSIS OUTCOMES AND PRACTICE PATTERNS STUDY (DOPPS)

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1455 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Suguru Yamamoto ◽

Brian Bieber ◽

Hirotaka Komaba ◽

Hiroki Kitabayashi ◽

Takanobu Nomura ◽

...

Keyword(s):

Nutritional Status ◽

Serum Albumin ◽

Dietary Protein ◽

Protein Intake ◽

Case Mix ◽

Dietary Protein Intake ◽

All Cause Mortality ◽

Exposure Variable ◽

Medical Directors

Abstract Background and Aims Patients undergoing dialysis for end-stage kidney disease (ESKD) have poorer nutritional status than the general population, and worse nutritional status is associated with poor clinical outcomes. Hyperphosphatemia is common in dialysis patients owing to abnormal mineral and bone metabolism. Nephrologists manage hyperphosphatemia by prescribing phosphate binders and/or recommending restriction of dietary protein intake; the latter may, however, adversely affect nutritional status. In this analysis, we address the hypothesis that, even in the presence of hyperphosphatemia, liberalizing dietary protein leads to better patient outcomes. Method The analysis includes 11,628 hemodialysis (HD) patients in 12 countries in DOPPS phase 4 (2009-2011), from 254 facilities where the medical director completed a survey reporting facility practices. Demographic data, comorbid conditions, laboratory values, and medications were abstracted from patient records. Mortality was assessed during study follow-up. The primary exposure variable was response to the following question: “For patients with serum albumin 3.0 g/dL and phosphate 6.0 mg/dL, do you typically recommend to (A) increase or (B) not change or decrease dietary protein intake?” The primary outcome was all-cause mortality, analyzed by Cox regression, stratified by country, accounting for facility clustering using robust sandwich covariance estimators, and adjusted for case-mix and laboratory values. Linear regression was used to model the associations between the exposure variable and intermediate nutritional markers including serum albumin, creatinine, and phosphorus. We used multiple imputation to replace missing values for model covariates. Results Median follow-up was 1.4 years. In the case scenario, 91% of medical directors in North America recommended to increase protein intake compared to 58% in Europe (range=36-83% across 7 countries) and 56% in Japan (Figure). Advice to increase dietary protein intake was associated with 0.33 mg/dL higher serum creatinine levels (95% CI: 0.08-0.57) after adjustment for case mix, while clinically meaningful associations were not observed for serum albumin and phosphorus. Advice to increase dietary protein intake was weakly associated with lower mortality [HR (95% CI): 0.89 (0.77-1.03)]. The association with survival was stronger in patients with age 70+ years [HR (95% CI): 0.81(0.68-0.96), P=0.08 for interaction] and for those without diabetes [HR (95% CI): 0.81(0.66-0.98), P=0.20 for interaction] Conclusion In this large international cohort study, the medical director’s stated preference to recommend an increase in dietary protein intake for HD patients with low albumin and high phosphorus levels was most common in North America and was associated with higher patient serum creatinine levels and potentially lower all-cause mortality. Additional research into the possible benefits of protein intake liberalization for HD patients, even in the presence of hyperphosphatemia, is warranted. This abstract was directly supported by Kyowa Kirin Co.,Ltd..

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Protein Intake at Twice the RDA in Older Men Increases Circulatory Concentrations of the Microbiome Metabolite Trimethylamine-N-Oxide (TMAO)

Nutrients ◽

10.3390/nu11092207 ◽

2019 ◽

Vol 11 (9) ◽

pp. 2207 ◽

Cited By ~ 5

Author(s):

Mitchell ◽

Milan ◽

Mitchell ◽

Gillies ◽

D’Souza ◽

...

Keyword(s):

Insulin Sensitivity ◽

Glucose Tolerance ◽

Dietary Protein ◽

Protein Intake ◽

High Protein ◽

Oral Glucose ◽

Dietary Protein Intake ◽

Cvd Risk ◽

Post Intervention ◽

The Impact

Higher dietary protein intake is increasingly recommended for the elderly; however, high protein diets have also been linked to increased cardiovascular disease (CVD) risk. Trimethylamine-N-oxide (TMAO) is a bacterial metabolite derived from choline and carnitine abundant from animal protein-rich foods. TMAO may be a novel biomarker for heightened CVD risk. The purpose of this study was to assess the impact of a high protein diet on TMAO. Healthy men (74.2 ± 3.6 years, n = 29) were randomised to consume the recommended dietary allowance of protein (RDA: 0.8 g protein/kg bodyweight/day) or twice the RDA (2RDA) as part of a supplied diet for 10 weeks. Fasting blood samples were collected pre- and post-intervention for measurement of TMAO, blood lipids, glucose tolerance, insulin sensitivity, and inflammatory biomarkers. An oral glucose tolerance test was also performed. In comparison with RDA, the 2RDA diet increased circulatory TMAO (p = 0.002) but unexpectedly decreased renal excretion of TMAO (p = 0.003). LDL cholesterol was increased in 2RDA compared to RDA (p = 0.049), but no differences in other biomarkers of CVD risk and insulin sensitivity were evident between groups. In conclusion, circulatory TMAO is responsive to changes in dietary protein intake in older healthy males.

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Serum Amino Acids Patterns and 4-Year Sarcopenia Risk in Community-Dwelling Chinese Older Adults

Gerontology ◽

10.1159/000518412 ◽

2021 ◽

pp. 1-10

Author(s):

Suey S.Y. Yeung ◽

Zoe L.Y. Zhu ◽

Timothy Kwok ◽

Jean Woo

Keyword(s):

Older Adults ◽

Dietary Protein ◽

Protein Intake ◽

Principal Component ◽

Community Dwelling ◽

Dietary Protein Intake ◽

Chinese Older Adults ◽

Serum Amino Acids ◽

Composite Scores

Introduction: Dietary protein intake and serum amino acids (AAs) are factors controlling the rate of muscle protein synthesis and catabolism. This study examined the association between serum AAs patterns and incident sarcopenia in community-dwelling older adults. Methods: Chinese older adults in Hong Kong aged ≥65 years attended a health check at baseline and 4-year follow-up. At baseline, fasting blood was collected to measure 17 serum AAs. Serum AAs patterns were identified using principal component analysis. Dietary protein intake was assessed using a validated food frequency questionnaire. A composite score was computed by summing the principal component score and sex-standardized protein intake. Six composite scores representing each AAs pattern were available for each participant. Sarcopenia was defined using the updated version of the Asian Working Group for Sarcopenia. Crude and adjusted multiple logistic regressions were performed to examine the associations between each of the 6 composite scores and sarcopenia over 4 years. Results are presented as odds ratio (OR) and 95% confidence interval (CI). To address multiple testing, a Bonferroni correction was applied using a corrected significance level of p < 0.008 (α 0.05/6 patterns). Results: Data of 2,610 participants (mean age 71.6 years, 45.4% men) were available. In men, serum AAs patterns characterized by high branched-chain AAs (BCAAs) (OR 0.77, 95% CI 0.69–0.87, p < 0.001) and tyrosine, tryptophan, and phenylalanine (OR 0.79, 95% CI 0.71–0.89, p < 0.001) were significantly associated with a lower risk of sarcopenia over 4-year follow-up. After adjusting for confounders, the associations were no longer significant. In women, serum AAs patterns characterized by glutamine, glutamic acid, and methionine (OR 1.28, 95% CI 1.11–1.47, p = 0.001) and arginine, taurine, and serine (OR 1.20, 95% CI 1.06–1.35, p = 0.003) were associated with a higher risk of sarcopenia. After adjusting for confounders, serum AAs pattern characterized by high BCAAs (adjusted OR 1.52, 95% CI 1.25–1.86, p < 0.001) and arginine, taurine, and serine (adjusted OR 1.30, 95% CI 1.09–1.56, p = 0.004) were significantly associated with a higher risk of sarcopenia. No association between other AAs patterns with incident sarcopenia was found. Conclusions: In community-dwelling Chinese older adults, serum AAs patterns characterized by high BCAAs and nonessential AAs (arginine, taurine, and serine) were associated with a higher risk of sarcopenia in women. Findings may allow identifying new targets for interventions.

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Effectiveness of a Per-Meal Protein Prescription and Nutrition Education with versus without Diet Coaching on Dietary Protein Intake and Muscle Health in Middle-Aged Women

Nutrients ◽

10.3390/nu14020375 ◽

2022 ◽

Vol 14 (2) ◽

pp. 375

Author(s):

Kelley L. Jackson ◽

Sareen S. Gropper ◽

Dennis Hunt ◽

Deborah D’Avolio ◽

David Newman

Keyword(s):

Nutrition Education ◽

Dietary Protein ◽

Protein Intake ◽

Dietary Protein Intake ◽

Speed Test ◽

Significant Difference ◽

Meal Protein ◽

Muscle Health ◽

Chair Rise ◽

The Impact

Sufficient dietary protein intake is vital to maintaining muscle health with aging. Yet protein intake among adults is often inadequate. This study’s main objective was to examine the impact of nutrition education (NE) and a per-meal protein prescription (PRx) with versus without diet coaching on protein intake. A secondary objective examined its effects on muscle health. Participants included 53 women, age 45–64 years. All participants received NE and PRx; those randomized to coached-group received 10-weeks of diet coaching. Assessments included: protein intake at baseline, weeks 4 and 12 and muscle health (muscle mass, grip strength, five-chair rise test, 4 mgait speed test). The Chi-square test examined percentages of participants meeting PRx between groups. Repeated measures analysis of variance assessed within group and intervention effects on protein intake and muscle health parameters. Protein intake (g/kg body weight) increased (p < 0.001): not-coached (n = 28) 0.8 ± 0.2 to 1.2 ± 0.3 and coached (n = 25) 1.0 ± 0.2 to 1.4 ± 0.3 with no significant difference between groups. A greater percentage of coached-group participants met (p = 0.04) breakfast (72%) and met (p < 0.001) three-meal (76%) PRx versus not-coached participants (25% and 53%, respectively). Participants in both groups exhibited significantly (p < 0.001) improved times for the five-chair rise test and 4 mgait speed test. Diet coaching in conjunction with a PRx and NE should be considered to assist individuals in improving protein intake through self-selection of protein-rich foods.

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Dietary protein intake, energy deficit, and nitrogen balance in normal‐weight adults: a randomized controlled trial

The FASEB Journal ◽

10.1096/fasebj.27.1_supplement.1075.11 ◽

2013 ◽

Vol 27 (S1) ◽

Author(s):

Lee M Margolis ◽

Jay J Cao ◽

Leah D Whigham ◽

James P McClung ◽

Gerald F Combs ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Nitrogen Balance ◽

Dietary Protein ◽

Protein Intake ◽

Controlled Trial ◽

Normal Weight ◽

Energy Deficit ◽

Dietary Protein Intake ◽

Randomized Controlled

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Dietary Protein Intake Level Modulates Mucosal Healing and Mucosa-Adherent Microbiota in Mouse Model of Colitis

Nutrients ◽

10.3390/nu11030514 ◽

2019 ◽

Vol 11 (3) ◽

pp. 514 ◽

Cited By ~ 8

Author(s):

Sandra Vidal-Lletjós ◽

Mireille Andriamihaja ◽

Anne Blais ◽

Marta Grauso ◽

Patricia Lepage ◽

...

Keyword(s):

Dietary Protein ◽

Protein Intake ◽

High Protein Diet ◽

Repair Process ◽

Mucosal Healing ◽

High Protein ◽

Protein Diet ◽

Dietary Protein Intake ◽

Epithelial Repair ◽

The Impact

Mucosal healing after an inflammatory flare is associated with lasting clinical remission. The aim of the present work was to evaluate the impact of the amount of dietary protein on epithelial repair after an acute inflammatory episode. C57BL/6 DSS-treated mice received isocaloric diets with different levels of dietary protein: 14% (P14), 30% (P30) and 53% (P53) for 3 (day 10), 6 (day 13) and 21 (day 28) days after the time of colitis maximal intensity. While the P53 diet worsened the DSS- induced inflammation both in intensity and duration, the P30 diet, when compared to the P14 diet, showed a beneficial effect during the epithelial repair process by accelerating inflammation resolution, reducing colonic permeability and increasing epithelial repair together with epithelial hyperproliferation. Dietary protein intake also impacted mucosa-adherent microbiota composition after inflammation since P30 fed mice showed increased colonization of butyrate-producing genera throughout the resolution phase. This study revealed that in our colitis model, the amount of protein in the diet modulated mucosal healing, with beneficial effects of a moderately high-protein diet, while very high-protein diet displayed deleterious effects on this process.

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