Evidence for protein leverage on total energy intake, but not body mass index, in a large cohort of older adults.

BACKGROUND: Protein leverage (PL) is the phenomenon of consuming food until absolute intake of protein approaches a 'target value', such that total energy intake (TEI) varies passively with the ratio of protein: non-protein energy (fat + carbohydrate) in the diet. The PL hypothesis (PLH) suggests that the dilution of protein in energy-dense foods, particularly those rich in carbohydrates and fats, combines with protein leverage to contribute to the global obesity epidemic. Evidence for PL has been reported in younger adults, children and adolescents. This study aimed to test for PL and the protein leverage hypothesis (PLH) in a cohort of older adults. METHODS: We conducted a retrospective analysis of dietary intake in a cohort of 1699 community-dwelling older adults aged 67-84 years from the NuAge cohort. We computed TEI and the energy contribution (EC) from each macronutrient. The strength of leverage of macronutrients was assessed through power functions ( TEI = µ * EC L ). Body mass index (BMI) was calculated, and mixture models were fitted to predict TEI and BMI from macronutrients' ECs. RESULTS: In this cohort of older adults, 53% of individuals had obesity and 1.5% had severe cases. The mean TEI was 7673 kJ and macronutrients' ECs were 50.4%, 33.2% and 16.4%, respectively for carbohydrates, fat, and protein. There was a strong negative association (L = -0.37; p < 0.001) between the protein EC and TEI. Each percent of energy intake from protein reduced TEI by 77 kJ on average, ceteris paribus. However, BMI was unassociated with TEI in this cohort. CONCLUSIONS: Findings indicate clear evidence for PL on TEI, but not on BMI, likely because of aging, body composition, sarcopenia, or protein wasting.

Modeling COVID-19 dynamics in the sixteen West African countries.

The COVID-19 pandemic is currently causing several damages to the world, especially in the public health sector. Due to identifiability problems in parameters' estimation of complex compartmental models, this study considered a simple deterministic susceptible-infectious-recovered (SIR)-type model to characterize the first wave and predict the future course of the pandemic in the West African countries. We estimated some specific characteristics of the disease's dynamics, such as its initial conditions, reproduction numbers, true peak and peak of the reported cases, with their corresponding times, final epidemic size and time-varying attack ratio. Our findings revealed a relatively low proportion of susceptible individuals in the region and the different countries ( 1.2 % across West Africa). The detection rate of the disease was also relatively low ( 0.9 % for West Africa as a whole) and < 2 % for most countries, except for Gambia (12.5 %), Cape-Verde ( 9.5 % ), Mauritania ( 5.9 % ) and Ghana ( 4.4 % ). The reproduction number varied between 1.15 (Burkina-Faso) and 4.45 (Niger), and most countries' peak time of the first wave of the pandemic was between June and July. Generally, the peak time of the reported cases came a week (7-8 days) after the true peak time. The model predicted for the first wave, 222,100 actual active cases in the region at the peak time, while the final epidemic size accounted for 0.6 % of the West African population (2,526,700 individuals). The results showed that COVID-19 has not severely affected West Africa as in other regions. However, current control measures and standard operating procedures should be maintained over time to accelerate a decline in the observed trends of the pandemic.