scholarly journals The Impact of Dietary Protein in Complementary Foods on Infant Growth and Body Composition in a Population Facing the Double Burden of Malnutrition: Protocol for a Multicenter, Prospective Cohort Study (Preprint)

2020 ◽  
Author(s):  
Kulnipa Kittisakmontri ◽  
Julie Lanigan ◽  
Jonathan C K Wells ◽  
Mary Fewtrell
Keyword(s):  
Amino Acids ◽  
Growth Hormone ◽  
Body Composition ◽  
Protein Intake ◽  
Complementary Feeding ◽  
Iron Status ◽  
Plasma Amino Acids ◽  
Double Burden ◽  
Protein Sources ◽  
Double Burden Of Malnutrition

BACKGROUND Protein is an essential macronutrient with an important role during complementary feeding. Low protein intake contributes to undernutrition while high intake, especially from animal sources, may increase obesity risk. However, the influences of different protein sources (dairy, meat, and plants) on growth, and underlying mechanisms for these effects, are poorly understood. Animal-sourced foods provide both high-quality protein and iron and are recommended to improve iron status. However, it is unclear whether current dietary recommendations are adequate to support healthy growth and optimize iron status. These issues are of particular concern in countries facing the double burden of malnutrition, the coexistence of all forms of malnutrition. More evidence is needed to develop appropriate recommendations for these countries. OBJECTIVE This study will investigate associations between protein intake during complementary feeding and growth, body composition, and iron status of infants in Thailand, a country facing the double burden of malnutrition. The study will also explore how different protein sources influence growth via the growth hormone—insulin-like growth factor I (IGF-1) axis and plasma amino acids. METHODS A multicenter cohort study will be conducted in Chiang Mai, Thailand, in 150 healthy term infants aged 4-6 months with birth weight ≥2500 g. Demographic data, dietary intake, and anthropometry will be collected at 6, 9, and 12 months. Dietary intake will be assessed using 24-hour dietary recalls, 3-day food records, and food frequency questionnaires. Blood samples for iron status, growth hormone, IGF-1, insulin-like growth factor-binding protein III (IGFBP-3), and plasma amino acids and urine samples for body composition analysis using stable isotope dilution will be obtained at 12 months. RESULTS The recruitment of study participants and data collection was undertaken from June 2018 to May 2019. Data and laboratory analyses are ongoing and are expected to be completed by December 2020. A total of 150 participants were enrolled, and 146 completed the study. We hypothesized that protein intake from animal-sourced foods in recommended quantities could support normal weight and length gain and lower the risk of undernutrition associated with similar amounts of plant-based protein. However, higher protein intake, especially from milk protein, may be linked to increased body fat via plasma amino acids and the growth hormone-IGF axis. CONCLUSIONS The results of this study will provide data on current complementary feeding practices, focusing on protein and iron intake in Thai infants. This information, combined with data on associations with infant growth and iron status, will help inform complementary feeding recommendations for this population and may be found relevant to other settings experiencing the double burden of malnutrition. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/18112

scholarly journals The Impact of Dietary Protein in Complementary Foods on Infant Growth and Body Composition in a Population Facing the Double Burden of Malnutrition: Protocol for a Multicenter, Prospective Cohort Study

10.2196/18112 ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. e18112
Author(s):  
Kulnipa Kittisakmontri ◽  
Julie Lanigan ◽  
Jonathan C K Wells ◽  
Mary Fewtrell
Keyword(s):  
Amino Acids ◽  
Growth Hormone ◽  
Body Composition ◽  
Protein Intake ◽  
Complementary Feeding ◽  
Iron Status ◽  
Plasma Amino Acids ◽  
Double Burden ◽  
Protein Sources ◽  
Double Burden Of Malnutrition

Background Protein is an essential macronutrient with an important role during complementary feeding. Low protein intake contributes to undernutrition while high intake, especially from animal sources, may increase obesity risk. However, the influences of different protein sources (dairy, meat, and plants) on growth, and underlying mechanisms for these effects, are poorly understood. Animal-sourced foods provide both high-quality protein and iron and are recommended to improve iron status. However, it is unclear whether current dietary recommendations are adequate to support healthy growth and optimize iron status. These issues are of particular concern in countries facing the double burden of malnutrition, the coexistence of all forms of malnutrition. More evidence is needed to develop appropriate recommendations for these countries. Objective This study will investigate associations between protein intake during complementary feeding and growth, body composition, and iron status of infants in Thailand, a country facing the double burden of malnutrition. The study will also explore how different protein sources influence growth via the growth hormone—insulin-like growth factor I (IGF-1) axis and plasma amino acids. Methods A multicenter cohort study will be conducted in Chiang Mai, Thailand, in 150 healthy term infants aged 4-6 months with birth weight ≥2500 g. Demographic data, dietary intake, and anthropometry will be collected at 6, 9, and 12 months. Dietary intake will be assessed using 24-hour dietary recalls, 3-day food records, and food frequency questionnaires. Blood samples for iron status, growth hormone, IGF-1, insulin-like growth factor-binding protein III (IGFBP-3), and plasma amino acids and urine samples for body composition analysis using stable isotope dilution will be obtained at 12 months. Results The recruitment of study participants and data collection was undertaken from June 2018 to May 2019. Data and laboratory analyses are ongoing and are expected to be completed by December 2020. A total of 150 participants were enrolled, and 146 completed the study. We hypothesized that protein intake from animal-sourced foods in recommended quantities could support normal weight and length gain and lower the risk of undernutrition associated with similar amounts of plant-based protein. However, higher protein intake, especially from milk protein, may be linked to increased body fat via plasma amino acids and the growth hormone-IGF axis. Conclusions The results of this study will provide data on current complementary feeding practices, focusing on protein and iron intake in Thai infants. This information, combined with data on associations with infant growth and iron status, will help inform complementary feeding recommendations for this population and may be found relevant to other settings experiencing the double burden of malnutrition. International Registered Report Identifier (IRRID) DERR1-10.2196/18112

scholarly journals Using Body Composition Assessment to Evaluate the Double Burden of Malnutrition

2019 ◽  
Vol 75 (2) ◽  
pp. 103-108 ◽  
Author(s):  
Jonathan C.K. Wells
Keyword(s):  
Body Composition ◽  
Early Life ◽  
Noncommunicable Disease ◽  
Body Composition Assessment ◽  
Double Burden ◽  
Poor Growth ◽  
Middle Income ◽  
Child Undernutrition ◽  
Double Burden Of Malnutrition ◽  
The Individual

Background: Populations in low- and middle-income countries are increasingly experiencing a double burden of malnutrition (DBM), incorporating both persistent levels of child undernutrition and rising prevalence of overweight/obesity at later ages. A growing number of individuals experience both components of the DBM through the life-course, thereby accumulating high susceptibility to noncommunicable disease (NCD). Summary: Measurements of body composition may prove valuable for assessing NCD risk at the level of the individual. The capacity-load model provides a simple conceptual framework for integrating data on different components of body composition to predict NCD risk. Poor growth in early life, indexed by becoming wasted or stunted, constrains the development of lean mass components such as muscle and organ mass, each of which contribute to the metabolic capacity for homeostasis. Catch-up weight gain in early life, or the development of excess weight from childhood onwards, is associated with elevated adiposity, especially abdominal adiposity, which challenges cardio-metabolic homeostasis and elevates NCD risk. Key Messages: A variety of techniques are now available for the measurement of body composition, helping research the association of the DBM with NCD risk. Reference charts allow raw data to be converted to age- and sex-specific z-scores, aiding interpretation.

scholarly journals The Role of the Anabolic Properties of Plant- versus Animal-Based Protein Sources in Supporting Muscle Mass Maintenance: A Critical Review

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1825 ◽  
Author(s):  
Insaf Berrazaga ◽  
Valérie Micard ◽  
Marine Gueugneau ◽  
Stéphane Walrand
Keyword(s):  
Amino Acids ◽  
Protein Synthesis ◽  
Amino Acid ◽  
Amino Acid Composition ◽  
Protein Intake ◽  
Muscle Protein ◽  
Muscle Protein Synthesis ◽  
Essential Amino Acids ◽  
Protein Sources ◽  
Nutritional Strategies

Plant-sourced proteins offer environmental and health benefits, and research increasingly includes them in study formulas. However, plant-based proteins have less of an anabolic effect than animal proteins due to their lower digestibility, lower essential amino acid content (especially leucine), and deficiency in other essential amino acids, such as sulfur amino acids or lysine. Thus, plant amino acids are directed toward oxidation rather than used for muscle protein synthesis. In this review, we evaluate the ability of plant- versus animal-based proteins to help maintain skeletal muscle mass in healthy and especially older people and examine different nutritional strategies for improving the anabolic properties of plant-based proteins. Among these strategies, increasing protein intake has led to a positive acute postprandial muscle protein synthesis response and even positive long-term improvement in lean mass. Increasing the quality of protein intake by improving amino acid composition could also compensate for the lower anabolic potential of plant-based proteins. We evaluated and discussed four nutritional strategies for improving the amino acid composition of plant-based proteins: fortifying plant-based proteins with specific essential amino acids, selective breeding, blending several plant protein sources, and blending plant with animal-based protein sources. These nutritional approaches need to be profoundly examined in older individuals in order to optimize protein intake for this population who require a high-quality food protein intake to mitigate age-related muscle loss.

Amino acid imbalance protein intake, and changes in rat brain and plasma amino acids

1972 ◽  
Vol 223 (6) ◽  
pp. 1497-1497
Author(s):  
Y. Peng ◽  
J. K. Tews ◽  
A. E. Harper
Keyword(s):  
Amino Acids ◽  
Amino Acid ◽  
Rat Brain ◽  
Protein Intake ◽  
Plasma Amino Acids ◽  
Amino Acid Imbalance

Page 314: Y. Peng, J. K. Tews, and A. E. Harper. "Amino acid imbalance protein intake, and changes in rat brain and plasma amino acids." Page 317, Fig. 5: the top section should carry the heading "HISTIDINE IMBALANCE (liver)."

scholarly journals Strengthened Data Systems to Mitigate the Double Burden of Malnutrition: The Role of Stable Isotope Technique-Derived Nutrition Indicators

2019 ◽  
Vol 75 (2) ◽  
pp. 119-122
Author(s):  
Victor O. Owino ◽  
Theodora Mouratidou
Keyword(s):  
Body Composition ◽  
Stable Isotope ◽  
Metabolic Response ◽  
Data Availability ◽  
Noncommunicable Diseases ◽  
Surveillance Systems ◽  
Data Systems ◽  
Population Surveys ◽  
Double Burden ◽  
Double Burden Of Malnutrition

Indicators reflecting the double burden of malnutrition are rarely measured in nutrition surveys and are needed to strengthen national data systems. Indicators such as body composition reflect both metabolic response to undernutrition and obesity risk and nutrition-related noncommunicable diseases. Stable isotope techniques (SITs) provide accurate data on body composition, exclusive breastfeeding and vitamin A status that are otherwise problematic with routine methods. Integration of SIT-derived nutrition indicators in data systems could improve the design and evaluation of programmes focused on obesity prevention, food fortification and infant and young child feeding practices. The Working Group at the symposium considered “how SIT-derived nutrition indicators may be integrated into surveillance systems to strengthen data availability and capacity at national and regional levels”. Practical considerations for the use of SITs include cost, sample size, rigorous training and logistics. It was concluded that SITs are best suited, at present, for use in sub-samples of population surveys and for validating tools that can be scaled-up more easily in population surveys. In the long term, SITs could be applied to larger surveys following potential innovations in more affordable, hand-held devices for analysis of stable isotope enrichment in the field and simpler specimen collection protocols.

Plasma Amino Acids in Adolescents and Adults with Phenylketonuria on Three Different Levels of Protein Intake

1991 ◽  
Vol 80 (5) ◽  
pp. 577-580 ◽  
Author(s):  
P. C. Clemens ◽  
M. Heddrich-Ellerbrok ◽  
U. Wachtel ◽  
R. M. Link
Keyword(s):  
Amino Acids ◽  
Protein Intake ◽  
Plasma Amino Acids ◽  
Adolescents And Adults ◽  
Different Levels
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