Nutritional therapy for the prevention of post-intensive care syndrome.

Post-intensive care syndrome (PICS) is a triad of physical, cognitive, and mental impairments that occur during or following the intensive care unit (ICU) stay, affecting the long-term prognosis of the patient and also the mental health of the patient's family. While the severity and duration of the systemic inflammation are associated with the occurrence of ICU-acquired weakness (ICU-AW), malnutrition and immobility during the treatment can exacerbate the symptoms. The goal of nutrition therapy in critically ill patients is to provide an adequate amount of energy and protein while addressing specific nutrient deficiencies to survive the inflammatory response and promote recovery from organ dysfunctions. Feeding strategy to prevent ICU-AW and PICS as nutrition therapy involves administering sufficient amounts of amino acids or proteins later in the acute phase after the hyperacute phase has passed, with specific attention to avoid energy overfeeding. Physiotherapy can also help mitigate muscle loss and subsequent physical impairment. However, many questions remain to be answered regarding the potential role and methods of nutrition therapy in association with ICU-AW and PICS, and further research is warranted.

Protein Nutrition: Understanding Structure, Digestibility, and Bioavailability for Optimal Health.

This review discusses different protein sources and their role in human nutrition, focusing on their structure, digestibility, and bioavailability. Plant-based proteins, such as those found in legumes, nuts, and seeds, may contain anti-nutritional factors that impact their bioavailability apart from structural and compositional differences from animal proteins. Animal proteins are generally highly digestible and nutritionally superior to plant proteins, with higher amino acid bioavailability. Alternative protein sources are also processed in different ways, which can alter their structure and nutritional value, which is also discussed.

The effects of whey, pea, and collagen protein supplementation beyond the recommended dietary allowance on integrated myofibrillar protein synthetic rates in older males: a randomized controlled trial.

BACKGROUND: Skeletal muscle mass is determined predominantly by feeding-induced and activity-induced fluctuations in muscle protein synthesis (MPS). Older individuals display a diminished MPS response to protein ingestion, referred to as age-related anabolic resistance, which contributes to the progression of age-related muscle loss known as sarcopenia. OBJECTIVES: We aimed to determine the impact of consuming higher-quality compared with lower-quality protein supplements above the recommended dietary allowance (RDA) on integrated MPS rates. We hypothesized that increasing total protein intake above the RDA, regardless of the source, would support higher integrated rates of myofibrillar protein synthesis. METHODS: Thirty-one healthy older males (72 ± 4 y) consumed a controlled diet with protein intake set at the RDA: control phase (days 1-7). In a double-blind, randomized controlled fashion, participants were assigned to consume an additional 50 g (2 × 25g) of whey (n = 10), pea (n = 11), or collagen (n = 10) protein each day (25 g at breakfast and lunch) during the supplemental phase (days 8-15). Deuterated water ingestion and muscle biopsies assessed integrated MPS and acute anabolic signaling. Postprandial blood samples were collected to determine feeding-induced aminoacidemia. RESULTS: Integrated MPS was increased during supplemental with whey (1.59 ± 0.11 %/d; P < 0.001) and pea (1.59 ± 0.14 %/d; P < 0.001) when compared with RDA (1.46 ± 0.09 %/d for the whey group; 1.46 ± 0.10 %/d for the pea group); however, it remained unchanged with collagen. Supplemental protein was sufficient to overcome anabolic signaling deficits (mTORC1 and rpS6), corroborating the greater postprandial aminoacidemia. CONCLUSIONS: Our findings demonstrate that supplemental protein provided at breakfast and lunch over the current RDA enhanced anabolic signaling and integrated MPS in older males; however, the source of additional protein may be an important consideration in overcoming age-related anabolic resistance. This trial was registered clinicaltrials.gov as NCT04026607.

Inclusion of reeling wastewater-derived sericin peptides in high-protein nutrition bars for antihardening and storage stability.

The utilization of agroindustrial wastes to enrich food protein resources and the exploration of their broader applications are crucial for addressing the food crisis and achieving sustainable development goals. In this study, reeling wastewater-derived sericin was hydrolyzed using papain and trypsin to prepare sericin peptide (SRP) and was used as an antihardening ingredient of high-protein nutrition bars (HPNBs). The mechanism of the antihardening effect of SRP was elucidated by investigating the content of advanced glycation end products and protein oxidation products (carbonyl and free sulfhydryl), and the molecular weight change of HPNBs during storage before and after the addition of SRP. Our results confirmed the fortification of HPNBs with SRP, which is beneficial for the promotion and expansion of sericin applications in the food industry, with positive implications for the rational utilization of protein resources and the enrichment of food protein sources.

Nutritional, Textural, and Sensory Attributes of Protein Bars Formulated with Mycoproteins.

Research accumulated over the past decades has shown that mycoprotein could serve as a healthy and safe alternative protein source, offering a viable substitute for animal- and plant-derived proteins. This study evaluated the impact of substituting whey protein with fungal-derived mycoprotein at different levels (10%, 20%, and 30%) on the quality of high-protein nutrition bars (HPNBs). It focused on nutritional content, textural changes over storage, and sensory properties. Initially, all bars displayed similar hardness, but storage time significantly affected textural properties. In the early storage period (0-5 days), hardness increased at a modest rate of 0.206 N/day to 0.403 N/day. This rate dramatically escalated from 1.13 N/day to 1.36 N/day after 5 days, indicating a substantial textural deterioration over time. Bars with lower mycoprotein levels (10%) exhibited slower hardening rates compared with those with higher substitution levels (20% and 30%), pointing to a correlation between mycoprotein content and increased bar hardness during storage. Protein digestibility was assessed through in vitro gastric and intestinal phases. Bars with no or low-to-medium levels of mycoprotein substitution (PB00, PB10, and PB20) showed significantly higher digestibility (40.3~43.8%) compared with those with the highest mycoprotein content (PB30, 32.9%). However, digestibility rates for all mycoprotein-enriched bars were lower than those observed for whey-protein-only bars (PB00, 84.5%), especially by the end of the intestinal digestion phase. The introduction of mycoprotein enriched the bars' dietary fiber content and improved their odor, attributing a fresh mushroom-like smell. These findings suggest that modest levels of mycoprotein can enhance nutritional value and maintain sensory quality, although higher substitution levels adversely affect texture and protein digestibility. This study underscores the potential of mycoprotein as a functional ingredient in HPNBs, balancing nutritional enhancement with sensory acceptability, while also highlighting the challenges of textural deterioration and reduced protein digestibility at higher substitution levels.

Postabsorptive and postprandial myofibrillar protein synthesis rates at rest and after resistance exercise in women with postmenopause.

Feeding and resistance exercise stimulate myofibrillar protein synthesis (MPS) rates in healthy adults. This anabolic characterization of "healthy adults" has been namely focused on males. Therefore, the purpose of this study was to examine the temporal responses of MPS and anabolic signaling to resistance exercise alone or combined with the ingestion of protein in postmenopausal females and compare postabsorptive rates with young females. Sixteen females [60 ± 7 yr; body mass index (BMI) = 26 ± 12 kg·m-2] completed an acute bout of unilateral resistance exercise before consuming either: a fortified whey protein supplement (WHEY) or water. Participants received primed continuous infusions of L-[ring-13C6]phenylalanine with bilateral muscle biopsies before and after treatment ingestion at 2 h and 4 h in nonexercised and exercised legs. Resistance exercise transiently increased MPS above baseline at 0-2 h in the water condition (P = 0.007). Feeding after resistance exercise resulted in a late phase (2-4 h) increase in MPS in the WHEY condition (P = 0.005). In both conditions, resistance exercise did not enhance the cumulative (0-4 h) MPS response. In the nonexercised leg, MPS did not differ at 0-2 h, 2-4 h, or 0-4 h of the measurement periods (all, P > 0.05). Likewise, there were no changes in the phosphorylation of p70S6K, AMPKα, or total and phosphorylated yes-associated protein on Ser127. Finally, postabsorptive MPS was lower in premenopausal versus postmenopausal females (P = 0.023). Our results demonstrate that resistance exercise-induced changes in MPS are temporally regulated, but do not result in greater cumulative (0-4 h) MPS in postmenopausal women.NEW & NOTEWORTHY An adequate quality and quantity of skeletal muscle is relevant to support physical performance and metabolic health. Muscle protein synthesis (MPS) is an established remodeling marker, which can be hypertrophic or nonhypertrophic. Importantly, protein ingestion and resistance exercise are two strategies that support healthy muscle by stimulating MPS. Our study shows postmenopause modulates baseline MPS that may diminish the MPS response to the fundamental anabolic stimuli of protein ingestion and resistance exercise in older females.

Administration of Free Amino Acids Improves Exogenous Amino Acid Availability when Compared with Intact Protein in Critically Ill Patients: A Randomized Controlled Study.

BACKGROUND: Protein digestion and amino acid absorption appear compromised in critical illness. The provision of enteral feeds with free amino acids rather than intact protein may improve postprandial amino acid availability. OBJECTIVE: Our objective was to quantify the uptake of diet-derived phenylalanine after the enteral administration of intact protein compared with an equivalent amount of free amino acids in critically ill patients. METHODS: Sixteen patients who were mechanically ventilated in intensive care unit (ICU) at risk of malabsorption received a primed continuous infusion of L-[ring-2H5]-phenylalanine and L-[ring-3,5-2H2]-tyrosine after an overnight fast. Patients were randomly allocated to receive 20 g intrinsically L-[1-13C]-phenylalanine-labeled milk protein or an equivalent amount of amino acids labeled with free L-[1-13C]-phenylalanine via a nasogastric tube over a 2-h period. Protein digestion and amino acid absorption kinetics and whole-body protein net balance were assessed throughout a 6-h period. RESULTS: After enteral nutrient infusion, both plasma phenylalanine and leucine concentrations increased (P-time < 0.001), with a more rapid and greater rise after free amino acid compared with intact protein administration (P-time × treatment = 0.003). Diet-derived phenylalanine released into the circulation was 25% greater after free amino acids compared with intact protein administration [68.7% (confidence interval {CI}: 62.3, 75.1%) compared with 43.8% (CI: 32.4, 55.2%), respectively; P < 0.001]. Whole-body protein net balance became positive after nutrient administration (P-time < 0.001) and tended to be more positive after free amino acid in provision (P-time × treatment = 0.07). CONCLUSIONS: The administration of free amino acids as opposed to intact protein further increases postprandial plasma amino acid availability in critically ill patients, allowing more diet-derived phenylalanine to become available to peripheral tissues. This trial was registered at clinicaltrials.gov as NCT04791774.

Determinación de la ganancia de peso, claidad proteica y digestibilidad de ocho dietas a base de dos leguminosas, maní (Arachis hypogaea L. ) y ajonjolí (Sesamum indicum L. ) en ratas Wistar / Determination of weight gain, protein quality and digestibility of eight diets based on two legumes, peanut (Arachis hypogaea L. ) and sesame (Sesamum indicum L. ) in Wistar rats

El maní y ajonjolí, son dos fuentes importantes de macronutrientes y micronutrientes. El objetivo del estudio fue evaluar la ganancia de peso, calidad proteica y digestibilidad en ocho dietas compuestas a base de dos leguminosas, en ratas Wistar durante cuatro semanas. Las dietas se clasificaron en dieta control; dieta A (leche descremada), dieta B (libre de nitrógeno), dietas C, D, E, F (conformadas por 100%, 75%, 50%, 25% de maní complementadas con leche descremada), y dietas G, H, I, J (conformadas por 100%, 75%, 50%, 25% de ajonjolí, complementadas con leche descremada). Se encontraron diferencias significativas en la ganancia de peso en relación a la dieta control, principalmente en los grupos de ratas que consumieron la dieta D, maní 75% con un valor medio después de las cuatros semanas de 226.00 g (SD=55.29)(p<.05), dieta H, ajonjolí 75%, con un valor medio de 218.16 g (SD=56.28)(p<.05), y dieta I, ajonjolí 50%, con un valor medio de 216.83 g (SD=45.86)(p<.05). Las dietas formuladas con leche y leguminosas fueron de alta digestibilidad (96% - 100%), con un índice de eficiencia proteica de 2.73, muy similar al encontrado en la dieta control. Estas formulaciones basadas en leguminosas podrían tener potencial uso en la nutrición humana.

Peanuts and sesame are two important sources of macronutrients and micronutrients. The objectives of this study were to evaluate the weight gain, protein quality and digestibility of eight legume-based diets in Wistar rats during a period of four weeks. The diets were classified as: control diet, diet A (skim milk), diet B (nitrogen free), diets C, D, E, F (with peanuts in a proportion that varied from 100%, 75%, 50% to 25%, mixed with skim milk), diets G, H, I, J (with sesame in a proportion that varied from 100%, 75, 50% to 25%, mixed with skim milk). The study showed significant differences in weight gain when comparing with the control diet, particularly with diet D (75% peanut) with 226 g (SD=55.29) (p<0.05), diet H (75% sesame) with 218.16 g (SD=56.28) (p<0.05), and diet I (50% sesame) with 216.83 g (SD=45.86) (p<0.05). The study showed that the diets with skim milk and legumes were highly digestible (96% - 100%), with protein efficiency ratio (PER) of 2.73, very similar to the control diet. These formulations are promising and have potential implications for human nutrition.

Adição de lisina digestível em rações experimentais para juvenis de tilápia-do-nilo / Addition of lysine in experimental diets for Nile tilapia juveniles

Objetivou-se por meio deste estudo determinar a necessidade nutricional de lisina digestível em rações para juvenis de tilápia-do-nilo (Oreochromis niloticus). Setecentos e vinte peixes masculinizados (7,30±0,11g) foram alimentados durante 30 dias com oito rações (26,81% de proteína digestível e 3090kcal/kg de energia digestível da ração) contendo teores crescentes de lisina digestível (1,24; 1,36; 1,48; 1,60; 1,72; 1,84; 1,96 e 2,08%). As tilápias foram distribuídas em delineamento inteiramente ao acaso, com oito tratamentos, seis repetições e 15 peixes por unidade experimental. Foram avaliadas variáveis de desempenho (ganho de peso, taxa de crescimento específico, taxa de sobrevivência, consumo de ração, consumo de lisina digestível, conversão alimentar aparente, eficiência proteica para ganho, eficiência de lisina para ganho e eficiência de retenção de nitrogênio) e de composição corporal (teores de umidade, gordura, proteína, matéria mineral corporal e as taxas de deposição diária de proteína e gordura corporais). A elevação do teor de lisina digestível na ração não influenciou (P>0,05) o consumo de ração, a taxa de sobrevivência e os teores de umidade e de matéria mineral corporal, mas melhorou de forma quadrática (P<0,05) os demais parâmetros avaliados, com exceção do consumo de lisina e da eficiência de lisina para ganho, que aumentou e reduziu, respectivamente, de forma linear (P<0,05). Recomenda-se que rações para juvenis de tilápia-do-nilo devam conter 1,84% de lisina digestível para máximo ganho de peso...

The aim of this study was to determine the nutritional need of lysine in diets for juvenile Nile tilapia (Oreochromis niloticus). Seven hundred and twenty masculinized fish (7.30±0.11g) were fed for 30 days with eight diets (26.81% of digestible protein and 3090 kcal/kg digestible energy of feed) containing increasing levels of lysine (1.24, 1.36, 1.48, 1.60, 1.72, 1.84, 1.96 and 2.08%). The tilapia were distributed in a completely randomized design with eight treatments and six replicates of 15 fish per experimental unit. We evaluated the performance variables (weight gain, specific growth rate, survival rate, feed intake, digestible lysine intake, feed conversion, protein efficiency for gain, efficiency of lysine for gain and efficiency of retention nitrogen) and body composition (moisture, fat, protein, ash body and deposition rates of daily protein and fat). The high levels of dietary lysine did not affect (P>0.05) feed intake, the survival rate and the moisture and ash body, but improved (P<0.05) other parameters, except for lysine intake and efficiency of lysine for gain, which increased and decreased, respectively, linearly (P<0.05). It is recommended that diets for juvenile Nile tilapia should contain 1.84% digestible lysine for maximum weight gain...

The effect of early higher protein nutrition support and growth hormone in patients with severe craniocerebral injury / 肠外与肠内营养

Objective: To explore the effects of early higher protein nutrition support and growth hormone in patients with severe craniocerebral injury. Methods: 60 patients with severe craniocerebral injury were randomized into observation group and control group.The observation group (30 cases) had received on higher protein nutrition support [2-2.5 g/(kg?d)] and growth hormone for one week. The control group(30 cases) had received lower [1.2-1.5 g/(kg?d) protein nutrition support] for one week. The levels of protein index were determined. The clinical effect and complication were compared between the two groups. Results: The serum prealbumin, albumin, transferrin and hemoglobin in the observation group were significantly higher than those in the control group.The staying time in ICU was significantly shorter and the progrosis was better in the observation group. There were no statistical differences about the index of liver function, renal function and the morbility between the two groups. Conclusion: Early higher protein nutrition support and growth hormone can improve the nutrition status and the prognosis of patients with severe craniocerebral injury.

THE EFFECT OF ZINC DEFICIENCY ON PROTEIN NUTRITIONAL STATUS OF PRESCHOOL CHILDREN / 营养学报

Serum prealbumin (PAB) and plasm free amino acids were determined in normal and zinc deficient preschool children. In zinc deficient children, the prealbumin level was much lower than normal;cystine and .proline were higher but most of other amino acids and essential amino acids, branched chain amino acids, essential amino acids/total amino acids, branched chain amino acids/nonbranched chain amino acids were signifcantly lower than those of normal children.