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3.
J Sports Sci ; 42(4): 313-322, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38478743

RESUMO

In contrast to male football players, research on the nutritional requirements of female football players is limited. This study aimed to assess total daily energy expenditure (TDEE) in professional female football players, along with body composition, physical activity and dietary intake. This observational study included 15 professional football players playing in the highest Dutch Women's League. TDEE was assessed by doubly labelled water over 14 days, along with resting metabolic rate (RMR; ventilated hood), fat-free mass (FFM; dual-energy x-ray absorptiometry), and dietary intake (24-h recalls). Physical activity energy expenditure (PAEE) was derived from subtracting RMR and estimated diet-induced thermogenesis (10%) from TDEE. TDEE was 2882 ± 278 kcal/day (58 ± 5 kcal/kg FFM) and significantly (p < 0.05) correlated with FFM (r = 0.62). PAEE was 1207 ± 213 kcal/d. Weighted energy intake was 2344 kcal [2023-2589]. Carbohydrate intakes were 3.2 ± 0.7, 4.4 ± 1.1 and 5.3 ± 1.9 g/kg body mass for rest, training and match days, respectively, while weighted mean protein intake was 1.9 ± 0.4 g/kg body mass. In conclusion, the energy requirements of professional female football players are moderate to high and can be explained by the substantial PAEE. To fuel these requirements, sports nutritionists should consider shifting the players' focus towards prioritizing adequate carbohydrate intakes, rather than emphasizing high protein consumption.


Assuntos
Metabolismo Basal , Composição Corporal , Proteínas na Dieta , Ingestão de Energia , Metabolismo Energético , Futebol , Humanos , Feminino , Metabolismo Energético/fisiologia , Ingestão de Energia/fisiologia , Futebol/fisiologia , Adulto Jovem , Adulto , Proteínas na Dieta/administração & dosagem , Metabolismo Basal/fisiologia , Países Baixos , Carboidratos da Dieta/administração & dosagem , Necessidades Nutricionais , Fenômenos Fisiológicos da Nutrição Esportiva , Exercício Físico/fisiologia , Termogênese/fisiologia , Dieta
4.
Clin Exp Nephrol ; 28(5): 447-453, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38324198

RESUMO

INTRODUCTION: Patients with chronic kidney disease (CKD) are susceptible to frailty because of a range of nutrition-related factors. While protein restriction is commonly advised to preserve kidney function in patients with CKD, insufficient protein intake could potentially exacerbate frailty risk. This study aimed to elucidate the relationship between frailty and protein intake in patients with CKD. METHODS: This cross-sectional study enrolled patients with CKD stage 3-5. Frailty and prefrailty were assessed using the Japanese version of the Cardiovascular Health Study (J-CHS) criteria. To estimate dietary protein intake, Maroni's formula based on 24-h urine collection was used. The potential association between frailty/pre-frailty and protein intake was investigated using a logistic regression analysis. RESULTS: Ninety-seven individuals with CKD were included in the study, with a median age of 73.0 years (interquartile range: 67.0, 82.0). Among them, 34 were women (35.1%), and the estimated glomerular filtration rate (eGFR) was 36.3 mL/min/1.73 m2 (interquartile range: 26.9, 44.1). Frailty and pre-frailty were identified in 13.4% and 55.7% of participants, respectively. Comparing the groups, protein intake in the frailty/pre-frailty group (0.83 g/kgBW/day [0.72, 0.93]) was lower than that in the robust group (0.89 g/kgBW/day [0.84, 1.19], p = 0.002). Upon logistic regression analysis, protein intake exhibited an independent association with frailty/pre-frailty (odds ratio: 0.72, 95% confidence interval: 0.59-0.89, p = 0.003). CONCLUSION: Reduced protein intake in patients with CKD is associated with frailty and pre-frailty. It is advisable to ensure that patients with CKD who are at risk of frailty consume an adequate amount of protein.


Assuntos
Proteínas na Dieta , Fragilidade , Taxa de Filtração Glomerular , Insuficiência Renal Crônica , Humanos , Feminino , Masculino , Idoso , Insuficiência Renal Crônica/fisiopatologia , Insuficiência Renal Crônica/complicações , Fragilidade/fisiopatologia , Estudos Transversais , Proteínas na Dieta/administração & dosagem , Idoso de 80 Anos ou mais , Idoso Fragilizado , Fatores de Risco , Modelos Logísticos , Estado Nutricional , Rim/fisiopatologia , Japão/epidemiologia
5.
Br J Nutr ; 131(9): 1540-1553, 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38220222

RESUMO

Whole-body tissue protein turnover is regulated, in part, by the postprandial rise in plasma amino acid concentrations, although minimal data exist on the amino acid response following non-animal-derived protein consumption. We hypothesised that the ingestion of novel plant- and algae-derived dietary protein sources would elicit divergent plasma amino acid responses when compared with vegan- and animal-derived control proteins. Twelve healthy young (male (m)/female (f): 6/6; age: 22 ± 1 years) and 10 healthy older (m/f: 5/5; age: 69 ± 2 years) adults participated in a randomised, double-blind, cross-over trial. During each visit, volunteers consumed 30 g of protein from milk, mycoprotein, pea, lupin, spirulina or chlorella. Repeated arterialised venous blood samples were collected at baseline and over a 5-h postprandial period to assess circulating amino acid, glucose and insulin concentrations. Protein ingestion increased plasma total and essential amino acid concentrations (P < 0·001), to differing degrees between sources (P < 0·001), and the increase was further modulated by age (P < 0·001). Postprandial maximal plasma total and essential amino acid concentrations were highest for pea (2828 ± 106 and 1480 ± 51 µmol·l-1) and spirulina (2809 ± 99 and 1455 ± 49 µmol·l-1) and lowest for chlorella (2053 ± 83 and 983 ± 35 µmol·l-1) (P < 0·001), but were not affected by age (P > 0·05). Postprandial total and essential amino acid availabilities were highest for pea, spirulina and mycoprotein and lowest for chlorella (all P < 0·05), but no effect of age was observed (P > 0·05). The ingestion of a variety of novel non-animal-derived dietary protein sources elicits divergent plasma amino acid responses, which are further modulated by age.


Assuntos
Aminoácidos , Estudos Cross-Over , Proteínas na Dieta , Insulina , Período Pós-Prandial , Spirulina , Humanos , Masculino , Feminino , Idoso , Adulto Jovem , Aminoácidos/sangue , Proteínas na Dieta/administração & dosagem , Método Duplo-Cego , Insulina/sangue , Aminoácidos Essenciais/sangue , Aminoácidos Essenciais/administração & dosagem , Chlorella , Glicemia/metabolismo , Glicemia/análise , Adulto , Animais , Proteínas de Vegetais Comestíveis/administração & dosagem , Ervilhas/química , Proteínas de Ervilha/sangue , Leite/química , Proteínas do Leite/administração & dosagem , Fatores Etários
6.
J Diabetes Investig ; 14(10): 1172-1174, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37480216

RESUMO

Few studies in Asian populations have analyzed how glucagon secretion is affected by ingested glucose, proteins or lipids, individually. To investigate the fluctuations of glucagon secretion after the intake of each of these nutrients, 10 healthy volunteers underwent oral loading tests using each of glucose, proteins and lipids, and blood levels of glucose, insulin and glucagon were measured every 30 min for 120 min. Whereas glucagon secretion was suppressed and minimally affected by oral glucose intake and lipid intake, respectively, oral protein intake robustly increased glucagon secretion, as well as insulin secretion. Further studies are needed to elucidate the mechanism by which protein loading increases glucagon secretion.


Assuntos
Proteínas na Dieta , Glucagon , Humanos , Diabetes Mellitus , População do Leste Asiático , Glucagon/metabolismo , Glucose/administração & dosagem , Lipídeos/administração & dosagem , Proteínas na Dieta/administração & dosagem
7.
Nutrients ; 15(5)2023 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-36904253

RESUMO

BACKGROUND: The present study was conducted to explore the association between protein intake across the main meals and hypertension (HTN)-related parameters in community-dwelling Brazilian older adults. METHODS: Brazilian community-dwelling older adults were recruited in a senior center. Dietary habits were assessed through 24 h recall. Protein intake was classified as high and low according to median and recommended dietary allowance values. Absolute and body weight (BW)-adjusted protein consumption levels were quantified and analyzed according to ingestion across the main meals. Systolic (SBP) and diastolic blood pressure (DBP) were measured using an oscilometric monitor. Participants were categorized as hypertensive according to physician diagnosis or the detection of high SBP and/or DBP values. RESULTS: One hundred ninety-seven older adults were enrolled in the present study. Protein intake at lunch was independently and negatively associated with SBP. Furthermore, a lower prevalence of HTN (diagnosed by a physician) was observed in participants with higher intakes of protein. These results remained significant after adjustment for many covariates. However, significance was lost when kilocalories and micronutrients were included in the model. CONCLUSIONS: Findings of the present study indicate that protein intake at lunch was independently and negatively associated with systolic BP in community-dwelling older adults.


Assuntos
Pressão Sanguínea , Proteínas na Dieta , Hipertensão , Almoço , Idoso , Humanos , Estudos Transversais , Comportamento Alimentar , Hipertensão/epidemiologia , Proteínas na Dieta/administração & dosagem
8.
Nutrients ; 15(4)2023 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-36839233

RESUMO

High protein intake has been associated with kidney hypertrophy, which is usually reversible; however, when it occurs early in life, it could lead to cell programming with a long-lasting effect. This study aimed to assess whether higher protein ingestion early in life has a persistent effect on kidney volume at 11 years of age, as well as its influence on blood pressure. This is a secondary analysis of a randomized control trial that compared the growth of infants fed with a higher-protein formula versus those fed with a lower-protein formula, with a control group of breastfed infants. Renal ultrasound and anthropometric measurements were assessed at 6 months and 11 years of age. At 11 years, urinary protein, albumin and creatinine, and blood pressure were measured in 232 children. Feeding with a higher-protein formula was associated with a larger kidney volume (ß = 8.71, 95%CI 0.09-17.33, p = 0.048) and higher systolic blood pressure (ß = 3.43, 95%CI 0.78-6.08, p = 0.011) at 11 years of age. Microalbuminuria was detected in 7% of the patients, with no differences among groups (p = 0.56). The effect of increased protein ingestion early in life may condition kidney volume and blood pressure in later childhood.


Assuntos
Pressão Sanguínea , Proteínas na Dieta , Fenômenos Fisiológicos da Nutrição do Lactente , Rim , Criança , Feminino , Humanos , Lactente , Aleitamento Materno , Fórmulas Infantis , Rim/anatomia & histologia , Tamanho do Órgão , Proteínas na Dieta/administração & dosagem
9.
Braz. j. biol ; 83: 1-12, 2023. tab, graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1468976

RESUMO

Galaxias maculatus aquaculture objectives is to produce millions of eggs. Wild females are small (2 g), have quick sexual maturity and low mean fecundity (500 eggs/female), requiring larger fishes with higher fecundity. This study aim is to evaluate experimentally the effect of the levels of protein, lipid and dietary energy on weight increases in adults. Five independent experiments were performed at different sequential time periods at the UCT hatchery, Chile. Specimens were obtained from a) Crystalline sea return specimen catches in the Tolten estuary (4 -6 cm, 0.3-0.4 g.). b) Hatchery cultured fish. Fish were fed by hand ad libitum. In experiments 1 to 4, pelleted diets were prepared with 3 to 5 levels of protein (treatments 27 up to 57%), crumble size, three 100 L fibre ponds replicates. In experiment 5 the effect of two lipid levels (8 and 21%) was evaluated with commercial extruded Salmon Nutra Starter isoproteic crumble 1 diet at 63%, replicated in 4 ponds. The results show: A tendency to increased weight in all sizes with an increased protein level in the pelleted diet.A maximal adult growth is obtained with a diet containing a minimum of 37% crude protein, with 40% the optimal value. A higher % protein in the diet or growth in weight lower feed conversion ratio. The feed conversion ratio in the extruded diet reaches up to 0.5 and in the pelleted vary from 0.7 to 1.5. Fish 0.6 g fed with 63% protein, extruded commercial diet with two different lipid levels (8 and 21%, 20.40 and 23.84 MJ kg-1, PE/TE 0.62 and 0.71) increased weight the first month 67 and 105% each. It has been established that high-energy diets with optimal levels of protein and lipid are a good short-term solution to obtain G. maculatus of higher weight.


O objetivo da aquicultura de Galaxias maculatus é produzir milhões de ovos. As fêmeas selvagens são pequenas (2 g) e têm maturidade sexual rápida e fecundidade média baixa (500 ovos/fêmea), necessitando de peixes maiores e com fecundidade superior. O objetivo deste estudo é avaliar experimentalmente o efeito dos níveis de proteínas, lipídios e energia da dieta sobre o aumento de peso em adultos. Cinco experimentos independentes foram realizados em diferentes períodos sequenciais de tempo no incubatório UCT, Chile. Os espécimes foram obtidos a partir de: a) capturas de espécimes de retorno do mar cristalino no estuário de Tolten (4-6 cm, 0,3-0,4 g); b) peixes de cultura em incubatório. Os peixes foram alimentados à mão ad libitum. Nos experimentos de 1 a 4, dietas peletizadas foram preparadas com três a cinco níveis de proteína (tratamentos 27 a 57%), tamanho do crumble, três repetições de tanques de fibra de 100 L. No experimento 5, o efeito de dois níveis de lipídios (8 e 21%) foi avaliado com dieta comercial isoproteica crumble 1 de Salmon Nutra Starter extrusada a 63%, replicada em quatro tanques. Os resultados mostram: uma tendência ao aumento de peso em todos os tamanhos, com um aumento do nível de proteína na dieta peletizada; um crescimento adulto máximo com uma dieta contendo um mínimo de 37% de proteína bruta, com 40% do valor ideal; uma porcentagem maior de proteína na dieta ou crescimento em peso com menor taxa de conversão alimentar. A taxa de conversão alimentar na dieta extrusada chega a 0,5, e na peletizada varia de 0,7 a 1,5. Peixes de 0,6 g alimentados com 63% de proteína e dieta comercial extrusada com dois níveis lipídicos diferentes (8 e 21%; 20,40 e 23,84 MJ kg-1; PE / TE 0,62 e 0,71) aumentaram de peso no primeiro mês em 67 e 105% cada, respectivamente. Foi estabelecido que dietas de alta energia com níveis ótimos de proteínas e lipídios são uma boa solução de curto prazo para obter G. maculatus de peso mais alto.


Assuntos
Animais , Dieta Rica em Proteínas , Gorduras na Dieta/efeitos adversos , Osmeriformes/crescimento & desenvolvimento , Proteínas na Dieta/administração & dosagem
10.
Nutrients ; 14(19)2022 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-36235718

RESUMO

Growth differentiation factor 15 (GDF15) is a stress signal that can be induced by protein restriction and is associated with reduced food intake. Anorexia of aging, insufficient protein intake as well as high GDF15 concentrations often occur in older age, but it is unknown whether GDF15 concentrations change acutely after meal ingestion and affect appetite in older individuals. After an overnight fast, appetite was assessed in older (n = 20; 73.7 ± 6.30 years) and younger (n = 20; 25.7 ± 4.39 years) women with visual analogue scales, and concentrations of circulating GDF15 and glucagon-like peptide-1 (GLP-1) were quantified before and at 1, 2 and 4 h after ingestion of either dextrose (182 kcal) or a mixed protein-rich meal (450 kcal). In response to dextrose ingestion, appetite increased in both older and younger women, whereas GDF15 concentrations increased only in the older group. In older women, appetite response was negatively correlated with the GDF15 response (rho = -0.802, p = 0.005). Following high-protein ingestion, appetite increased in younger women, but remained low in the old, while GDF15 concentrations did not change significantly in either age group. GLP-1 concentrations did not differ between age groups or test meals. In summary, acute GDF15 response differed between older and younger women. Associations of postprandial appetite and GDF15 following dextrose ingestion in older women suggest a reduced appetite response when the GDF15 response is high, thus supporting the proposed anorectic effects of high GDF15 concentrations.


Assuntos
Apetite , Proteínas na Dieta , Glucose , Fator 15 de Diferenciação de Crescimento , Adulto , Idoso , Estudos Cross-Over , Proteínas na Dieta/administração & dosagem , Ingestão de Alimentos , Ingestão de Energia , Feminino , Peptídeo 1 Semelhante ao Glucagon/sangue , Glucose/administração & dosagem , Fator 15 de Diferenciação de Crescimento/sangue , Humanos , Período Pós-Prandial , Adulto Jovem
11.
Am J Clin Nutr ; 116(4): 887-896, 2022 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-35759368

RESUMO

BACKGROUND: Pregnancy induces bone mineral mobilization, which may be further compromised if diet and physical activity are suboptimal. OBJECTIVES: We aimed to determine the effects of a Nutrition + Exercise intervention during pregnancy on maternal calciotropic and bone biomarker profiles throughout pregnancy and the postpartum. METHODS: In the Be Healthy in Pregnancy (BHIP) randomized controlled trial, 203 of 225 participants who consented to the bone health substudy were, randomly assigned at 12-17 weeks gestation to receive either usual care (control) or a structured and monitored Nutrition + Exercise plan (intervention) providing an individualized high dairy protein diet and a walking program throughout pregnancy. Maternal serum total procollagen type 1 N-terminal propeptide (P1NP; bone formation), C-terminal telopeptide of type I collagen (CTX; bone resorption), and insulin-like growth factor-1 (IGF-1) were measured by ELISA, and vitamin D metabolites by ultra-performance LC tandem MS at early and late pregnancy, 6 mo postpartum, and in cord blood. RESULTS: In 187 participants completing all measures, significantly higher intakes were observed in the intervention than in the control group for total protein (P < 0.0001), protein intake from dairy foods (P < 0.0001), and calcium (P < 0.0001), whereas vitamin D intake was similar between treatment groups in both the second and third trimesters. The intervention group had significantly lower serum CTX at end of pregnancy (mean ± SD: 0.78 ± 0.31 ng/mL; n = 91 compared with 0.89 ± 0.33 ng/mL; n = 96, P = 0.034) and in cord serum (0.58 ± 0.13 ng/mL; n = 31 compared with 0.69 ± 0.18 ng/mL; n = 22, P < 0.025). Serum concentrations of P1NP rose significantly (P < 0.02) from early pregnancy to 6 mo postpartum for the intervention group only. Serum 25-hydroxyvitamin D status was >50 nmol/L for 97% of all participants. CONCLUSIONS: Higher maternal dietary protein and calcium intakes than usual care in concert with normal vitamin D status minimized bone resorption and maintained bone formation and may protect bone health during pregnancy.This trial was registered at clinicaltrials.gov as NCT01689961.


Assuntos
Densidade Óssea , Laticínios , Proteínas na Dieta , Caminhada , Biomarcadores , Reabsorção Óssea , Cálcio , Proteínas na Dieta/administração & dosagem , Feminino , Humanos , Fator de Crescimento Insulin-Like I , Gravidez , Pró-Colágeno , Vitamina D
12.
Lancet Child Adolesc Health ; 6(3): 171-184, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35123664

RESUMO

BACKGROUND: Oral immunotherapy is effective at inducing desensitisation to allergens and induces sustained unresponsiveness (ie, clinical remission) in a subset of patients, but causes frequent reactions. We aimed to investigate whether addition of a probiotic adjuvant improved the efficacy or safety of peanut oral immunotherapy. METHODS: PPOIT-003, a multicentre, randomised, phase 2b trial, was conducted in three tertiary hospitals in Australia (Adelaide [SA], Melbourne [VIC], and Perth [WA]) in children aged 1-10 years, weighing more than 7 kg, with peanut allergy confirmed by a double-blind placebo-controlled food challenge (cumulative 4950 mg dose of peanut protein) and positive peanut skin prick test (≥3 mm) or peanut-specific IgE (≥0·35 kU/L). Children were randomly assigned (2:2:1) to receive probiotic and peanut oral immunotherapy (PPOIT), placebo probiotic and peanut oral immunotherapy (OIT), or placebo probiotic and placebo OIT (placebo) for 18 months, and were followed up until 12 months after completion of treatment. Oral immunotherapy consisted of increasing doses of peanut protein (commercially available food-grade 12% defatted peanut flour [50% peanut protein]) until a 2000 mg daily maintenance dose was reached. The probiotic adjuvant was a daily dose of 2 × 1010 colony-forming units of the probiotic Lactobacillus rhamnosus ATCC 53103. Placebo immunotherapy comprised maltodextrin, brown food colouring, and peanut essence, and placebo probiotic was maltodextrin. Dual primary outcomes were 8-week sustained unresponsiveness, defined as no reaction to a cumulative dose of 4950 mg peanut protein at treatment completion and 8 weeks after treatment completion, in the PPOIT versus placebo groups and the PPOIT versus OIT groups, analysed by intention to treat. Safety endpoints were adverse events during the treatment phase, and peanut ingestion and reactions in the 12-month post-treatment period. This study is registered with the Australian New Zealand Clinical Trials Registry, 12616000322437. FINDINGS: Between July 4, 2016, and Sept 21, 2020, 201 participants were enrolled and included in the intention-to-treat analysis. 36 (46%) of 79 children in the PPOIT group and 42 (51%) of 83 children in the OIT group achieved sustained unresponsiveness compared with two (5%) of 39 children in the placebo group (risk difference 40·44% [95% CI 27·46 to 53·42] for PPOIT vs placebo, p<0·0001), with no difference between PPOIT and OIT (-5·03% [-20·40 to 10·34], p=0·52). Treatment-related adverse events were reported in 72 (91%) of 79 children in the PPOIT group, 73 (88%) of 83 children in the OIT group, and 28 (72%) of 39 children in the placebo group. Exposure-adjusted incidence of adverse events was 10·58 in the PPOIT group, 11·36 in the OIT, and 2·09 in the placebo group (ratio 0·92 [95% CI 0·85 to 0·99] for PPOIT vs OIT, p=0·042; 4·98 [4·11-6·03] for PPOIT vs placebo, p<0·0001; 5·42 [4·48-6·56] for OIT vs placebo, p<0·0001), with differences seen primarily in gastrointestinal symptoms and in children aged 1-5 years. During the 12-month post-treatment period, 60 (85%) of 71 participants in the PPOIT group, 60 (86%) of 70 participants in the OIT group, and six (18%) of 34 participants in the placebo group were eating peanut; rescue epinephrine use was infrequent (two [3%] of 71 in the PPOIT group, four [6%] of 70 in the OIT group, and none in the placebo group). INTERPRETATION: Both PPOIT and OIT were effective at inducing sustained unresponsiveness. Addition of a probiotic did not improve efficacy of OIT, but might offer a safety benefit compared with OIT alone, particularly in preschool children. FUNDING: National Health and Medical Research Council Australia and Prota Therapeutics.


Assuntos
Alérgenos/administração & dosagem , Arachis/imunologia , Dessensibilização Imunológica/métodos , Fatores Imunológicos/administração & dosagem , Lacticaseibacillus rhamnosus/imunologia , Hipersensibilidade a Amendoim/terapia , Probióticos/administração & dosagem , Administração Oral , Austrália , Criança , Pré-Escolar , Proteínas na Dieta/administração & dosagem , Método Duplo-Cego , Feminino , Humanos , Lactente , Masculino , Qualidade de Vida , Centros de Atenção Terciária , Resultado do Tratamento
13.
PLoS Med ; 19(2): e1003902, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35192606

RESUMO

BACKGROUND: Malnutrition among women of childbearing age is especially prevalent in Asia and sub-Saharan Africa and can be harmful to the fetus during pregnancy. In the most recently available Demographic and Health Survey (DHS), approximately 10% to 20% of pregnant women in India, Pakistan, Mali, and Tanzania were undernourished (body mass index [BMI] <18.5 kg/m2), and according to the Global Burden of Disease (GBD) 2017 study, approximately 20% of babies were born with low birth weight (LBW; <2,500 g) in India, Pakistan, and Mali and 8% in Tanzania. Supplementing pregnant women with micro and macronutrients during the antenatal period can improve birth outcomes. Recently, the World Health Organization (WHO) recommended antenatal multiple micronutrient supplementation (MMS) that includes iron and folic acid (IFA) in the context of rigorous research. Additionally, WHO recommends balanced energy protein (BEP) for undernourished populations. However, few studies have compared the cost-effectiveness of different supplementation regimens. We compared the cost-effectiveness of MMS and BEP with IFA to quantify their benefits in 4 countries with considerable prevalence of maternal undernutrition. METHODS AND FINDINGS: Using nationally representative estimates from the 2017 GBD study, we conducted an individual-based dynamic microsimulation of population cohorts from birth to 2 years of age in India, Pakistan, Mali, and Tanzania. We modeled the effect of maternal nutritional supplementation on infant birth weight, stunting and wasting using effect sizes from Cochrane systematic reviews and published literature. We used a payer's perspective and obtained costs of supplementation per pregnancy from the published literature. We compared disability-adjusted life years (DALYs) and incremental cost-effectiveness ratios (ICERs) in a baseline scenario with existing antenatal IFA coverage with scenarios where 90% of antenatal care (ANC) attendees receive either universal MMS, universal BEP, or MMS + targeted BEP (women with prepregnancy BMI <18.5 kg/m2 receive BEP containing MMS while women with BMI ≥18.5 kg/m2 receive MMS). We obtained 95% uncertainty intervals (UIs) for all outputs to represent parameter and stochastic uncertainty across 100 iterations of model runs. ICERs for all scenarios were lowest in Pakistan and greatest in Tanzania, in line with the baseline trend in prevalence of and attributable burden to LBW. MMS + targeted BEP averts more DALYs than universal MMS alone while remaining cost-effective. ICERs for universal MMS compared to baseline IFA were $52 (95% UI: $28 to $78) for Pakistan, $72 (95% UI: $37 to $118) for Mali, $70 (95% UI: $43 to $104) for India, and $253 (95% UI: $112 to $481) for Tanzania. ICERs for MMS + targeted BEP compared to baseline IFA were $54 (95% UI: $32 to $77) for Pakistan, $73 (95% UI: $40 to $104) for Mali, $83 (95% UI: $58 to $111) for India, and $245 (95% UI: $127 to $405) for Tanzania. Study limitations include generalizing experimental findings from the literature to our populations of interest and using population-level input parameters that may not reflect the heterogeneity of subpopulations. Additionally, our microsimulation fuses multiple sources of data and may be limited by data quality and availability. CONCLUSIONS: In this study, we observed that MMS + targeted BEP averts more DALYs and remains cost-effective compared to universal MMS. As countries consider using MMS in alignment with recent WHO guidelines, offering targeted BEP is a cost-effective strategy that can be considered concurrently to maximize benefits and synergize program implementation.


Assuntos
Análise Custo-Benefício/tendências , Proteínas na Dieta/economia , Ácido Fólico/economia , Ferro/economia , Micronutrientes/economia , Cuidado Pré-Natal/economia , Adolescente , Adulto , Estudos de Coortes , Proteínas na Dieta/administração & dosagem , Suplementos Nutricionais/economia , Anos de Vida Ajustados pela Incapacidade/tendências , Ingestão de Energia , Feminino , Ácido Fólico/administração & dosagem , Humanos , Índia/epidemiologia , Recém-Nascido , Ferro/administração & dosagem , Masculino , Mali/epidemiologia , Micronutrientes/administração & dosagem , Pessoa de Meia-Idade , Paquistão/epidemiologia , Gravidez , Cuidado Pré-Natal/tendências , Tanzânia/epidemiologia , Adulto Jovem
14.
J Mol Model ; 28(2): 42, 2022 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-35076787

RESUMO

Diabetes is a disease found in every 1 out of 4 people in the world. The glucose molecule is one of the sources of energy in the body and the lack of the digestion of glucose causes diabetes type 1 and type 2. Arginine and cysteine are nonessential amino acids that contain sulfur and help maintain the metabolisms of humans. We explored the glucose-arginine (Glc-arg) and glucose-cysteine (Glc-cys) molecules by finding their structural properties, electronic properties, chemical reactivity, mechanical strength, and transport properties because these non-essential amino acid molecules inhibit glucose-stimulated insulin secretion. Density functional theory (DFT) has been implemented to study all the properties of Glc-arg and Glc-cys using SIESTA software. Glucose-arginine (Glc-arg) inhibits a large percentage of glucose secretion and shows high chemical reactivity.


Assuntos
Aminoácidos , Glicemia , Diabetes Mellitus/dietoterapia , Diabetes Mellitus/metabolismo , Proteínas na Dieta , Glucose/metabolismo , Aminoácidos/química , Biomarcadores , Cisteína/análogos & derivados , Cisteína/sangue , Cisteína/química , Teoria da Densidade Funcional , Diabetes Mellitus/sangue , Proteínas na Dieta/administração & dosagem , Proteínas na Dieta/química , Gerenciamento Clínico , Glucose/análogos & derivados , Glucose/química , Humanos , Modelos Moleculares , Conformação Molecular , Estrutura Molecular , Análise Espectral , Resultado do Tratamento
15.
Nutrients ; 14(2)2022 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-35057438

RESUMO

Adequate and balanced nutrition is essential to promote optimal child growth and a long and healthy life. After breastfeeding, the second step is the introduction of complementary feeding (CF), a process that typically covers the period from 6 to 24 months of age. This process is, however, still highly controversial, as it is heavily influenced by socio-cultural choices, as well as by the availability of specific local foods, by family traditions, and pediatrician beliefs. The Società Italiana di Pediatria Preventiva e Sociale (SIPPS) together with the Federazione Italiana Medici Pediatri (FIMP), the Società Italiana per lo Sviluppo e le Origine della Salute e delle Malattie (SIDOHaD), and the Società Italiana di Nutrizione Pediatrica (SINUPE) have developed evidence-based recommendations for CF, given the importance of nutrition in the first 1000 days of life in influencing even long-term health outcomes. This paper includes 38 recommendations, all of them strictly evidence-based and overall addressed to developed countries. The recommendations in question cover several topics such as the appropriate age for the introduction of CF, the most appropriate quantitative and qualitative modalities to be chosen, and the relationship between CF and the development of Non-Communicable Diseases (NCDs) later in life.


Assuntos
Fenômenos Fisiológicos da Nutrição do Lactente , Doenças não Transmissíveis/prevenção & controle , Sociedades Médicas , Aleitamento Materno , Técnica Delfos , Carboidratos da Dieta/administração & dosagem , Gorduras na Dieta/administração & dosagem , Proteínas na Dieta/administração & dosagem , Humanos , Lactente , Itália
16.
Nutrients ; 14(2)2022 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-35057456

RESUMO

Dietary fat and fat quality have been inconsistently associated with puberty timing. The aim of this study was to investigate the prospective associations of dietary fat, saturated fatty acid (SFA), polyunsaturated fatty acid (PUFA), and monounsaturated fatty acid (MUFA) with puberty timing. Using longitudinal data from China Health and Nutrition Survey (CHNS) and Southwest China Childhood Nutrition and Growth (SCCNG) Study, we analyzed dietary data, anthropometric measurements, and potential confounders. Dietary intakes were assessed by 3-day 24-h recalls. Age at Tanner stage 2 for breast/genital development (B2/G2) and age at menarche/voice break (M/VB) were used as puberty development markers. Cox proportional hazard regression models were used to estimate the relevance of dietary intake of total fat, SFA, PUFA, and MUFA on puberty timing. Among 3425 girls and 2495 boys, children with higher intakes of total fat and PUFA were more likely to reach their B2/G2 or M/VB at an earlier age. Associations were not attenuated on additional adjustment for childhood dietary protein intake. However, higher intakes of SFA or MUFA were not independently associated with puberty development. A higher intake of dietary fat and PUFA in prepuberty was associated with earlier puberty timing, which was independent of dietary protein intake.


Assuntos
Gorduras na Dieta/administração & dosagem , Proteínas na Dieta/administração & dosagem , Ácidos Graxos/administração & dosagem , Puberdade/fisiologia , Adolescente , Fatores Etários , Criança , China , Ingestão de Alimentos , Ácidos Graxos Monoinsaturados/administração & dosagem , Ácidos Graxos Insaturados/administração & dosagem , Feminino , Humanos , Estudos Longitudinais , Masculino , Menarca/fisiologia , Inquéritos Nutricionais , Modelos de Riscos Proporcionais , Estatísticas não Paramétricas
17.
Nutrients ; 14(2)2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-35057547

RESUMO

We examined how dietary and physical activity behaviors influence fluctuations in blood glucose levels over a seven-day period in people at high risk for diabetes. Twenty-eight participants underwent a mixed meal tolerance test to assess glucose homeostasis at baseline. Subsequently, they wore an accelerometer to assess movement behaviors, recorded their dietary intakes through a mobile phone application, and wore a flash glucose monitoring device that measured glucose levels every 15 min for seven days. Generalized estimating equation models were used to assess the associations of metabolic and lifestyle risk factors with glycemic variability. Higher BMI, amount of body fat, and selected markers of hyperglycemia and insulin resistance from the meal tolerance test were associated with higher mean glucose levels during the seven days. Moderate- to vigorous-intensity physical activity and polyunsaturated fat intake were independently associated with less variation in glucose levels (CV%). Higher protein and polyunsaturated fatty acid intakes were associated with more time-in-range. In contrast, higher carbohydrate intake was associated with less time-in-range. Our findings suggest that dietary composition (a higher intake of polyunsaturated fat and protein and lower intake of carbohydrates) and moderate-to-vigorous physical activity may reduce fluctuations in glucose levels in persons at high risk of diabetes.


Assuntos
Glicemia/análise , Diabetes Mellitus Tipo 2/epidemiologia , Dieta/métodos , Exercício Físico , Acelerometria/métodos , Adulto , Automonitorização da Glicemia/métodos , Diabetes Mellitus Tipo 2/sangue , Carboidratos da Dieta/administração & dosagem , Proteínas na Dieta/administração & dosagem , Ingestão de Energia , Ácidos Graxos Insaturados/administração & dosagem , Comportamento Alimentar , Feminino , Humanos , Resistência à Insulina , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Comportamento Sedentário , Adulto Jovem
18.
Nutrients ; 14(2)2022 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-35057556

RESUMO

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.


Assuntos
Proteínas na Dieta/administração & dosagem , Educação em Saúde/métodos , Tutoria , Músculo Esquelético/fisiologia , Terapia Nutricional , Envelhecimento/fisiologia , Análise de Variância , Feminino , Força da Mão/fisiologia , Humanos , Refeições , Pessoa de Meia-Idade , Músculo Esquelético/anatomia & histologia , Prescrições , Risco , Sarcopenia/classificação , Velocidade de Caminhada
19.
Am J Physiol Cell Physiol ; 322(1): C94-C110, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34852208

RESUMO

Following anabolic stimuli (mechanical loading and/or amino acid provision), the mechanistic target of rapamycin complex 1 (mTORC1), a master regulator of protein synthesis, translocates toward the cell periphery. However, it is unknown if mTORC1-mediated phosphorylation events occur in these peripheral regions or before translocation (i.e., in central regions). We therefore aimed to determine the cellular location of a mTORC1-mediated phosphorylation event, RPS6Ser240/244, in human skeletal muscle following anabolic stimuli. Fourteen young, healthy males either ingested a protein-carbohydrate beverage (0.25 g/kg protein and 0.75 g/kg carbohydrate) alone [n = 7; 23 ± 5 yr; 76.8 ± 3.6 kg; and 13.6 ± 3.8% body fat (BF), FED] or following a whole body resistance exercise bout (n = 7; 22 ± 2 yr; 78.1 ± 3.6 kg; and 12.2 ± 4.9%BF, EXFED). Vastus lateralis muscle biopsies were obtained at rest (PRE) and 120 and 300 min following anabolic stimuli. RPS6Ser240/244 phosphorylation measured by immunofluorescent staining or immunoblot was positively correlated (r = 0.76, P < 0.001). Peripheral staining intensity of p-RPS6Ser240/244 increased above PRE in both FED and EXFED at 120 min (∼54% and ∼138%, respectively, P < 0.05) but was greater in EXFED at both poststimuli time points (P < 0.05). The peripheral-to-central ratio of p-RPS6240/244 staining displayed a similar pattern, even when corrected for total RPS6 distribution, suggesting RPS6 phosphorylation occurs to a greater extent in the periphery of fibers. Moreover, p-RPS6Ser240/244 intensity within paxillin-positive regions, a marker of focal adhesion complexes, was elevated at 120 min irrespective of stimulus (P = 0.006) before returning to PRE at 300 min. These data confirm that RPS6Ser240/244 phosphorylation occurs in the region of human muscle fibers to which mTOR translocates following anabolic stimuli and identifies focal adhesion complexes as a potential site of mTORC1 regulation in vivo.


Assuntos
Carboidratos da Dieta/administração & dosagem , Proteínas na Dieta/administração & dosagem , Alvo Mecanístico do Complexo 1 de Rapamicina/metabolismo , Fibras Musculares Esqueléticas/metabolismo , Treinamento de Força/métodos , Proteína S6 Ribossômica/metabolismo , Adulto , Humanos , Masculino , Alvo Mecanístico do Complexo 1 de Rapamicina/análise , Fibras Musculares Esqueléticas/química , Fibras Musculares Esqueléticas/efeitos dos fármacos , Músculo Esquelético/química , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/metabolismo , Fosforilação/efeitos dos fármacos , Fosforilação/fisiologia , Proteína S6 Ribossômica/análise , Adulto Jovem
20.
J Clin Endocrinol Metab ; 107(1): e205-e213, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34410410

RESUMO

CONTEXT: Dietary fat and protein impact postprandial hyperglycemia in people with type 1 diabetes, but the underlying mechanisms are poorly understood. Glucoregulatory hormones are also known to modulate gastric emptying and may contribute to this effect. OBJECTIVE: Investigate the effects of fat and protein on glucagon-like peptide (GLP-1), glucagon-dependent insulinotropic polypeptide (GIP) and glucagon secretion. METHODS: 2 crossover euglycemic insulin clamp clinical trials at 2 Australian pediatric diabetes centers. Participants were 12-21 years (n = 21) with type 1 diabetes for ≥1 year. Participants consumed a low-protein (LP) or high-protein (HP) meal in Study 1, and low-protein/low-fat (LPLF) or high-protein/high-fat (HPHF) meal in Study 2, all containing 30 g of carbohydrate. An insulin clamp was used to maintain postprandial euglycemia and plasma glucoregulatory hormones were measured every 30 minutes for 5 hours. Data from both cohorts (n = 11, 10) were analyzed separately. The main outcome measure was area under the curve of GLP-1, GIP, and glucagon. RESULTS: Meals low in fat and protein had minimal effect on GLP-1, while there was sustained elevation after HP (80.3 ± 16.8 pmol/L) vs LP (56.9 ± 18.6), P = .016, and HPHF (103.0 ± 26.9) vs LPLF (69.5 ± 31.9) meals, P = .002. The prompt rise in GIP after all meals was greater after HP (190.2 ± 35.7 pmol/L) vs LP (152.3 ± 23.3), P = .003, and HPHF (258.6 ± 31.0) vs LPLF (151.7 ± 29.4), P < .001. A rise in glucagon was also seen in response to protein, and HP (292.5 ± 88.1 pg/mL) vs LP (182.8 ± 48.5), P = .010. CONCLUSION: The impact of fat and protein on postprandial glucose excursions may be mediated by the differential secretion of glucoregulatory hormones. Further studies to better understand these mechanisms may lead to improved personalized postprandial glucose management.


Assuntos
Biomarcadores/sangue , Glicemia/análise , Diabetes Mellitus Tipo 1/fisiopatologia , Gorduras na Dieta/administração & dosagem , Proteínas na Dieta/administração & dosagem , Hiperglicemia/epidemiologia , Refeições , Adulto , Austrália/epidemiologia , Peptídeo C/sangue , Estudos Cross-Over , Feminino , Seguimentos , Esvaziamento Gástrico , Polipeptídeo Inibidor Gástrico/sangue , Glucagon/sangue , Peptídeo 1 Semelhante ao Glucagon/sangue , Humanos , Hiperglicemia/sangue , Hiperglicemia/patologia , Hiperglicemia/prevenção & controle , Insulina/sangue , Masculino , Prognóstico
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