Nutrition assistance improves skeletal muscle function and performance in community-dwelling older women / Assistência nutricional melhora o desempenho muscular esquelético de mulheres idosas residentes na comunidade

To analyze the effects of nutritional assistance focusing on protein intake (in the individual's usual diet) in relation to muscle mass, and the muscle strength and functional performance of community-dwelling older women. Methods: This is a non-randomized controlled clinical trial. Forty-three community-dwelling older women, who were allocated to the Control Group (CG; n = 20) or the Nutrition Group (NG; n = 23). The NG received individualized nutrition assistance and participated in group activities that focused on dietary protein intake once a week for 12 weeks. Main outcome measures: protein and energy intake; handgrip strength (HGS); gait speed (GS); quadriceps cross-sectional area (CSA); and intramuscular non-contractile tissue (IMNCT). The Student's t-test for independent samples, the Mann-Whitney U test, and a mixed model ANOVA with two factors (group and time) were adopted, followed by a post hoc Bonferroni test. A Spearman's correlation test was performed on tests for HGS; GS; CSA; IMNCT; age; and protein intake adjusted for weight (g/kg) (p ≤ 0.050). Results: Participants in the NG showed higher CSA values than those in the CG (p < 0.001). NG participants also had higher HGS (p < 0.001) and GS (p = 0.037) when compared to pre-intervention. Correlations were observed between IMNCT and protein intake adjusted for weight (g/kg) (r = -0.517; p = 0.020); HGS, and CSA (r = 0.827; p = 0.000); and CSA and age (r = -0.520, p = 0.009).

Analisar os efeitos da assistência nutricional com foco na ingestão proteica (na dieta habitual do indivíduo) em relação a massa muscular, força muscular e desempenho funcional de idosas de uma comunidade. Métodos: Trata-se um ensaio clínico controlado não randomizado. Quarenta e três idosas da comunidade foram alocadas no Grupo Controle (GC; n = 20) ou no Grupo Nutrição (GN; n = 23). O GN recebeu atendimento nutricional individualizado e participou de atividades grupais com foco na ingestão proteica da dieta uma vez por semana, durante 12 semanas. Principais medidas de resultado: ingestão de proteína e energia; força de preensão palmar (FPP); teste de velocidade da marcha (TVM); área de secção transversa do quadríceps (ASTq); e tecido intramuscular não contrátil (TIMNC). Utilizou-se o teste t de Student para amostras independentes, o teste U de Mann-Whitney e um modelo misto de análise de variância (ANOVA) com dois fatores (grupo e tempo), seguido de teste post hoc de Bonferroni. Um teste de correlação de Spearman foi realizado para FPP; TVM; ASTq; TIMNC; idade; e ingestão proteica ajustada para peso (g/kg) (p ≤ 0,050). Resultados: Os participantes do GN apresentaram valores de ASTq superiores aos do GC (p < 0,001). Os participantes do GN também exibiram maior FPP (p < 0,001) e GS (p = 0,037) quando comparados à pré-intervenção. Foram observadas correlações entre TIMNC e ingestão proteica ajustada para peso (g/kg) (r = -0,517; p = 0,020); HGS e ASTq (r = 0,827; p = 0,000); e ASTq e idade (r = -0,520, p = 0,009).

Consumo de embutidos en mujeres costarricenses: efecto del nivel socioeconómico / Intake of processed meats by Costa Rican women: effect of socioeconomic status

Resumen Introducción: El consumo de embutidos se ha asociado con serios problemas de salud que son comunes entre la población femenina. En el 2015 la Agencia Internacional para la Investigación en Cáncer clasificó los embutidos, como carcinógenos para los seres humanos ya que su ingesta está relacionada con el cáncer colorrectal. El aumento en el consumo de embutidos, los cuales son un alimento fuente de proteína de bajo costo, es diferencial según nivel socioeconómico y puede tener un impacto en la incidencia de enfermedades crónicas en la población. Objetivo: Examinar la asociación entre el consumo de embutidos y (a) la ingesta total de proteína, (b) la ingesta inadecuada de proteína, según NSE. Métodos: Se seleccionó una muestra (N = 135) de mujeres de 25 a 45 años, con 1 a 4 hijos, pertenecientes a tres diferentes niveles socioeconómicos, residentes de dos cantones del Gran Área Metropolitana de San José, Costa Rica, entre junio 2014 y marzo 2015. Mediante el uso de fotografías se indagó la percepción de las mujeres en cuanto al costo y su preferencia de consumo de 12 distintos alimentos, entre los cuales se incluyó los embutidos. Por medio de recordatorios alimentarios de 24 horas recolectados en tres visitas diferentes, y el uso de la base de datos de composición de alimentos ValorNut, se midió el consumo de proteína total en gramos y se determinó la cantidad promedio de veces por día que las mujeres consumen embutidos. A partir del peso de cada participante se determinó su requerimiento de proteína. La ingesta inadecuada de proteína se estimó como la diferencia entre el requerimiento y la ingesta observada. Mediante un modelo de regresión lineal se determinó la asociación entre el consumo total de proteína medido en gramos y la cantidad de veces por día que se ingiere embutidos. Mediante un modelo de regresión logística se estimó la asociación entre la ingesta inadecuada de proteína y la cantidad de veces por día que se ingiere embutidos. Resultados: Los embutidos son percibidos como la fuente de proteína menos apetecible, sin embargo, fue la tercera fuente de proteína más consumida. El consumo de embutidos difiere según NSE (P < 0.01), en el alto NSE es donde se consumen con menor frecuencia. Los embutidos más comúnmente consumidos fueron mortadela (bajo NSE), salchichón (NSE medio), y jamón de pavo (alto NSE). El consumo de embutidos se asocia significativamente con un incremento en la ingesta de proteína. Se encontró una asociación inversa entre el NSE y la ingesta inadecuada de proteína. Conclusiones: El consumo de embutidos está asociado con el nivel socioeconómico. Es probable que las mujeres consuman embutidos porque los perciben como un alimento fuente de proteína de bajo costo. Se requiere establecer estrategias educativas que ayuden a las mujeres a identificar sus necesidades alimentarias de proteína y a conciliar estas necesidades con la adquisición de alimentos saludables a un costo aceptable.

Abstract Introduction: Intake of processed meats has been associated with serious health problems that are common among women. In 2015, the International Agency for Research on Cancer classified processed meats as human carcinogens, associated specifically with colon cancer. The increase in intake of processed meats, which are a low-cost source of dietary protein, varies by socioeconomic status (SES) and can impact chronic disease incidence. Objective: Examine the association between processed meats intake and (a) total protein intake, (b) inadequate protein intake, by SES. Methods: This study included a representative sample (N = 135) of women age 25 to 45 years, with one to four children, from three different socioeconomic groups who were residents of two counties from the Greater Metropolitan Area of San José, Costa Rica between June 2014 and March 2015. Using photographs, we examined women's perceptions of the cost and perceived desirability of 12 different foods, including processed meats. Using 24-hour dietary recalls collected on three different days, and the ValorNut food composition database, we estimated total protein intake, in grams, and determined the intake frequency (times/day) of processed meat. Each women's dietary protein requirement was estimated based on her bodyweight. Inadequate protein intake was calculated as the difference between protein requirement and actual intake. A linear regression model was used to determine the association between total protein intake in grams and intake frequency (times/day) of processed meat. A logistic regression model was used to estimate the association between low protein intake and intake frequency (times/day) of processed meat. Results: Processed meats were perceived as the least preferred protein source but were the third most commonly consumed protein source. Consumption of processed meats differed by SES and was lower in the higher SES group (P < 0.01). The most commonly consumed processed meats by SES were "mortadella" (low-SES), sausages (middle-SES), and sliced turkey/ham (high-SES). Processed meat intake was significantly associated with an increase in protein intake. There was an inverse association between SES and inadequate protein intake. Conclusions: Processed meat intake is associated with SES. Women may consume processed meats because they are perceived to be a low-cost protein source. Educational strategies are needed to help women identify their protein needs and meet those needs with healthier and affordable dietary alternatives.

Energy and protein intakes are associated with stunting among preschool children in Central Jakarta, Indonesia: a case-control study

@#Introduction: Stunting is a major nutritional problem in Indonesia. The prevalence of stunting in DKI Jakarta province was relatively high at 27.5% in 2013 and 17.7% in 2018. This study aims to describe nutrient intakes of children aged 25-30 months and to determine the proportional differences in nutrient intakes between stunting and normal children in Central Jakarta, Indonesia. Methods: A case-control study with a total sample of 121 children aged 25-30 months was conducted in Gambir and Sawah Besar sub-districts, Central Jakarta, where the prevalence of stunting was high. All children were exclusively breastfed for at least four months and had similar socio-economic levels. Data collected included height measurement, questionnairebased interview, and 24-hour food recall. T-test and chi-square test were used to investigate the differences between two groups and logistic regression was used in multivariate analysis. Results: Factors associated with stunting were energy intake (AOR=6.0; 95% CI=1.0-35.0) and protein intake (AOR=4.0; 95% CI=1.1-15.5) after controlling for fat, carbohydrate, vitamin C, iron, and zinc intakes. The percentage of children with energy intake below the recommendation was much higher in stunted children (86.1%) compared to normal children (43.5%). Similarly, the percentage of children with protein intake below the recommendation was very much higher among stunted children (30.6%) compared to 8.2% in normal children. Conclusion: Children who lacked energy and protein intakes were at a higher risk of stunting than children who had sufficient intakes. Macronutrient intakes are important and should be consumed in sufficient quantities every day to prevent stunting.

Metabolizable energy levels in diets with a fixed nutrient: calorie ratio for free-range broilers / Níveis de energia metabolizável com manutenção da relação nutriente: caloria em dietas para frangos de corte tipo caipira

The present study proposes to examine the effect of dietary levels of metabolizable energy, under a fixed nutrient:calorie ratio, on the production performance; body fat and protein deposition; and carcass characteristics of free-range broilers from 1 to 84 days of age. Nine hundred unsexed chicks were allocated to six treatments in a completely randomized design with six replicates of 25 birds each. Treatments consisted of diets with varying levels of metabolizable energy (2700, 2800, 2900, 3000, 3100 and 3200 Kcal ME/kg of diet) and a fixed proportion of nutrients relative to the energy level according to the nutritional requirements for each rearing phase. Body weight, weight gain, feed intake, feed conversion, production viability, metabolizable energy intake, protein intake, lysine intake, body fat deposition, body protein deposition and carcass characteristics were evaluated. Data were subjected to analysis of variance and, later, to regression analysis. Increasing levels of metabolizable energy, coupled with a fixed nutrient:calorie ratio, reduced feed intake, increased body weight and weight gain, improved feed conversion and did not affect carcass characteristics. In conclusion, adjusting the nutrient supply according to the dietary energy level improves production performance by improving feed conversion, ensuring adequate nutrient intake and preserving fat and protein deposition in the carcass when the metabolizable energy level is raised up to 3200 Kcal/kg in all rearing stages.(AU)

O objetivo do presente estudo foi avaliar os níveis de energia metabolizável, sob uma relação nutriente:caloria fixa, no desempenho produtivo; deposição de gordura e proteína corporal e características de carcaça de frangos de corte tipo caipiras. Foram utilizados novecentos pintainhos não sexados, distribuidos em seis tratamentos em delineamento inteiramente casualizado com seis repetições de 25 aves cada. Os tratamentos consistiram em dietas com diferentes níveis de energia metabolizável (2700, 2800, 2900, 3000, 3100 e 3200 Kcal EM / kg de dieta) e uma proporção fixa de nutrientes em relação ao nível de energia de acordo com as necessidades nutricionais de cada fase de criação. Foram avaliados o peso corporal, ganho de peso, consumo de ração, conversão alimentar, viabilidade criatória, consumo de energia metabolizável, consumo de proteína, consumo de lisina, deposição de gordura corporal, deposição de proteína corporal e características de carcaça. Os dados foram submetidos à análise de variância e posteriormente à análise de regressão. O aumento dos níveis de energia metabolizável juntamente com a manutenção da relação nutriente:caloria reduziu o consumo de ração, aumentou o peso corporal e o ganho de peso, melhorou a conversão alimentar e não afetou as características da carcaça. Em conclusão, o ajuste da oferta de nutrientes de acordo com o nível de energia da dieta melhora o desempenho da produção, melhorando a conversão alimentar, garantindo a ingestão adequada de nutrientes e preservando a deposição de gordura e proteína na carcaça quando o nível de energia metabolizável é elevado até 3200 Kcal/kg em todas as fases de criação.(AU)

Factors Associated With Adherence to Low Protein Diet Among Patients With Stage III-V of Chronic Kidney Disease in an Outpatient Clinic at Hospital Pakar Sultanah Fatimah

@#Introduction: Although the benefit of low protein diet (LPD) on chronic kidney disease (CKD) progression is well documented, patients’ adherence remains as the main challenge. Therefore, this study sought to identify adherence towards LPD among CKD patients and determine possible associating factors. Methods: This cross-sectional study was done at the Hospital Pakar Sultanah Fatimah in Muar, Johor, among stage III to V CKD patients. Three-day dietary recalls were used to quantify dietary energy (DEI) and protein intake (DPI). Factors investigated include socio-demographic characteristics, medical history, anthropometry and body composition measurements, dietary knowledge, appetite level, handgrip strength, perceived stress, and health locus of control. Associating variables were analysed with logistic regression analysis. Results: The final analysis included 113 patients (54% male) with a mean estimated glomerular filtration rate of 17.5±11.2mL/min/1.73m2 and the average age of 56.3±12.8 years. Mean DEI and DPI were 22.4±5.9kcal/kg/day and 0.83±0.28g/kg/day, respectively. Only 34.5% of patients adhere to the LPD diet with 59% exceeding the DPI recommendation. Poorer LPD adherence was associated with longer duration of hospitalization (OR 0.707, 95%CI 0.50-1.00, p=0.048), higher energy intake (OR 0.744, 95%CI 0.65-0.85, p<0.001), advance CKD stage (OR 0.318, 95%CI 0.13-0.77, p=0.012) and having better dietary knowledge (OR 0.380, 95%CI 0.170.85, p=0.018). Conclusion: LPD adherence of CKD patients in our institution is very poor signifying the need for engagement at the earlier stage of CKD to identify and stratify the patients for a targeted dietary intervention.

Energy, Protein Intake and Mid-Upper Arm Circumference in Pregnant Women in Boyolali Regency, Indonesia

@#Introduction: : Mid-Upper Arm Circumference (MUAC) of pregnant women is an indicator to assess the chronic energy deficiency (CED) in ensuring healthy outcomes in women and newborns. This research aims to analyze correlation between energy protein intake and MUAC of pregnant women. Methods: The design of this research was an observational cross-sectional study. The study population included a total of 164 pregnant women in second and third trimester in a Community Health Center in Indonesia. The samples were chosen by a simple random sampling technique. Energy and protein intakes were assessed by interviewing the subjects’ meal intake in the past three months using the semi-quantitative Food Frequency Questionnaire (SQ-FFQ) form. MUAC of pregnant women was assessed using a measuring tape by a trained researcher. Pearson product-moment tests were applied to analyze correlation between energy intake, protein intake and MUAC. Result: Majority of pregnant women experienced energy and protein intake deficiency, 97.6% and 73.2%, respectively. CED was found to be 17.1%. There were correlations between energy intake and MUAC (p=0.0215, r=0.181), and between protein intake and MUAC (p=0.001, r=0.319) in pregnant women. Conclusion: This study discovered that majority of pregnant women suffer from lack of energy and protein intake. Effective community nutritional program is still needed as the effort to reduce prevalence of inadequate energy and protein intake and prevent the CED among the pregnant women.

Factors associated with malnutrition among head and neck cancer in-patients before radiotherapy in National Cancer Institute, Putrajaya

@#Introduction: Head and neck cancer (HNC) patients are often malnourished during diagnosis and before treatment. This study determined the prevalence of malnutrition and factors associated with malnutrition among HNC patients. Methods: A crosssectional study among HNC in-patients before radiotherapy was conducted. Malnutrition status of the patients was determined using scored Patient GeneratedSubjective Global Assessment (PG-SGA). Nutritional parameters of muscle mass, fat mass, albumin, energy and protein intakes were collected. Nutrition impact symptoms (NIS) of the patients were assessed using a validated Head and Neck Symptoms Checklist© (HNSC©). Results: Fifty HNC patients were recruited in this study and the age range of patients was 21 to 78 years old, with gender distribution of 78% males and 22% females. More than half of the patients were malnourished, with 20% severely malnourished before radiotherapy. The lack of dietitian referral before treatment was found to significantly affect nutritional status (p=0.027). There was a significant negative relationship between energy intake (r=0.342, p=0.015) and protein intake (r=0.386, p=0.006) with PG-SGA, indicating lower energy and protein intakes related with poor nutritional status. The result showed a significant positive relationship between NIS score (r=0.731, p<0.001) and PG-SGA, indicating the lower the NIS, the better the nutritional status among HNC patients. More than half of the HNC patients had difficulty chewing. Conclusion: A strong association between nutritional status and NIS showed the importance of dietary management in HNC patients. Early identification of the nutritional status of HNC patients can ensure optimal nutritional status to improve treatment outcomes.

A Comparative Study of Plasma Protein and Hemoglobin in 18-21 Years Age Group Students of MGM Medical College, Jamshedpur, Jharkhand

Background: Anaemia is a global public health problem. InIndia, Jharkhand state is one of the state where under nutritionis highly prevalent. Most of the health problems like lowimmunity, Anaemia, hypoprotienemia arise due to low proteinintake. During erythropoiesis, Haemoglobin synthesis requiresprotein, Vitamin B12, Folic acid, Vitamin C as well as mineralslike Fe, Cu etc. Adequate nutrition is of prime importance andthis is reflected in plasma also.Objectives: To assess the level of Hb and plasma proteinamong study subjects with a co-relation of Hb with plasmaprotein.Materials and Methods: Present study was undertaken atMGM Medical College, Jamshedpur. 177 participants wereselected for the study and the data were obtained on differentvariables. Blood samples were also taken from the participants.Results: Most of the study subjects were anaemic. Anaemiawas more common among female subjects in comparison withmales. The present study found a positive co-relation betweenHb and Plasma protein.Conclusion: There is a strong co-relation observed betweenplasma protein, daily protein intake, and BMI withhaemoglobin.

Effect of early enough protein intake on outcomes of critically ill patients / 中华临床营养杂志

Objective To investigate the effects of protein intake in the early phase and later phase on the outcomes of critically ill patients.Methods A total of 326 critically ill patients admitted in intensive care unit of our hospital from September 2016 to March 2018 were enrolled in this prospective observational study.According to the 28-day prognosis of patients,they were divided into death group and survival group.Early protein target (EPT) was defined as the daily protein intake≥0.8 g/ (kg · d) on days 1-3,and late protein target (LPT) was defined as the daily protein intake≥0.8 g/ (k · d) on days 4-7.Results Daily protein intakes on day 1 and day 3 and cumulative protein intakes on days 1-3 were significantly higher in non-survivors than in the survivors (P＜0.05),but daily protein intakes on day 2,4,5,6 and 7 and cumulative protein intakes on days 4-7 and 1-7 showed no significant difference between two groups (P＞0.05).Hospital mortality was the lowest in the LPT group,the highest in the EPT,and in the middle in the EPT+LPT group and non-EPT+non-LPT group (P＜0.05).The survival curve analysis showed that the survival time of the EPT-only group was significantly lower than that of the LPT-only group (P＜0.05).Multivariate analysis showed that age,sex,cumulative protein and caloric intakes on days 1-7 were the independent risk factors for mortality.Conclusion Early low protein intake is benefit for the outcomes of critically ill patients,and combined with adequate intake of protein in the later stage may further improve the outcomes.

Protein intake and weight gain among low-income pregnant women from Mesquita County, Rio de Janeiro, Brazil / Consumo de proteína e ganho de peso entre gestantes de baixa renda do município de Mesquita, Rio de Janeiro, Brasil

ABSTRACT Objective To evaluate the effect of protein intake on body weight gain at pregnancy. Methods A cross-sectional study was carried out with 297 women who delivered a child at the maternity ward of Municipal Hospital Leonel de Moura Brizola in Mesquita city in the state of Rio de Janeiro. Sociodemographic and anthropometric data were collected through the use of a structured questionnaire at first week after delivery. Food intake was assessed by a food frequency questionnaire. Protein intake per kilogram of body weight (g/kg per day) during pregnancy was categorized as high or low protein intake according to overall median levels. Hierarchical multiple linear regression was fitted to estimate the effect of protein intake per kg during pregnancy on weight gain. Results Women presented an average weight gain of 12.8kg (SD=6.34) and 26.8kg/m2 (SD=4.78) of Body Mass Index. Those who consumed a diet with high levels of protein content significantly presented less weight at postpartum (p<0.01) lower Early-Pregnancy Body Mass Index (p<0.01). In the hierarchical linear regression, it was found a negative association of protein intake per kg and Weight gain (b=-4.3025; IC95%=-6.0215; -2.5836; p<0.01). In the final model, all others covariates (energy, schooling, family income and gestational age) were significantly associated with the outcome (p<0.05). The additional model showed a negatively association between Early-Pregnancy Body Mass Index and weight gain (b=-0.2951; IC95%= -0.4987; -0.0915; p<0.01). Conclusion Higher levels of protein intake per kg of body weight during pregnancy were associated with lower weight gain.

RESUMO Objetivo Este estudo teve como objetivo testar a associação entre a ingestão de proteína e o ganho de peso na gestação. Métodos Foi realizado um estudo transversal com 297 mulheres que deram à luz na maternidade do Hospital Municipal Leonel de Moura Brizola, na cidade de Mesquita, situada na baixada do estado do Rio de Janeiro. Os dados sociodemográficos e antropométricos foram coletados na primeira semana após o parto, com base em um questionário estruturado. Aplicou-se um questionário de frequência do consumo alimentar para avaliar a Ingestão de Proteína durante a gravidez, que foi classificada como alta ou baixa de acordo com os valores medianos observados. Adotou-se a regressão hierárquica linear múltipla para estimar o efeito da ingestão de proteína (ptn) por quilograma (kg) sobre o ganho de peso. Resultados As gestantes apresentaram, em média, um ganho de peso de 12,8kg (DP=6,34) e um Índice de Massa Corporal Pré-Gestacional de 26,8kg/m2 (DP=4,78). As gestantes com alta ingestão de proteína apresentaram valores significantemente menores em relação ao peso no pós-parto (p<0,01) e ao Índice de Massa Corporal pré-gestacional (p<0,001). No modelo final, todas as covariáveis (energia, escolaridade, renda familiar e idade gestacional) foram associadas ao desfecho (p<0,05), sendo verificada uma associação negativa entre a ingestão de ptn/kg e o ganho de peso (b=-4.3025; -6.0215; -2.5836 IC95%; p<0,01). No modelo adicional, observou--se uma associação negativa entre o Índice de Massa Corporal Pré-Gestacional e o ganho de peso (b=-4.3025; IC95%=-6.0215; -2.5836; p<0,01). Conclusão A pesquisa concluiu que teores elevados de proteína dietética foram associados com menores valores de ganho de peso na gestação.

A new approach to feed frequency studies and protein intake regulation in juvenile pirarucu

ABSTRACT This study aimed to investigate pirarucu's (Arapaima gigas) ability to trigger a self-feeding system to regulate protein intake between two standard diets that contained 39% and 49% of crude protein. The same system allowed the evaluation of daily feeding and locomotor activity rhythms. Eighteen fish (654.44±26.85g) were distributed into six 250 L tanks (3 fish/tank). Fish had free access to both diets (39% vs. 49% protein) by feeders (2 per tank), adapted to be activated by fish themselves. This system was connected to a computer system. After an adaptation period, fish learned to activate feeders and the mean food intake recorded was 2.14% of their body weight on a daily basis. Fish showed feeding (72.48%) and locomotor (72.49%) activity predominantly during the daytime, and daily variations of choice between diets, but fixed a protein intake feeding target at 44.53%. These results should be considered when discussing feeding behavior, feeding schedules and diet intake regulations.

Nutrientes y parámetros bioquímicos relacionados con la salud ósea en mujeres mayores de 65 años / Dietary intake and biochemical parameters related to bone health in women older than 65 years old / Nutrientes e parâmetros bioquimicos relacionados com a saúde óssea em mulheres maior do que 65 anos

Ingestas (I) bajas de energía (E), proteínas (Pr), calcio (Ca), y vitamina D (VD) afectan la salud ósea del adulto mayor. El objetivo del trabajo consistió en evaluar la I de E, Pr, Ca y VD en mujeres mayores de 65 años y su relación con parámetros bioquímicos (PB) del metabolismo óseo. La población estudiada estuvo formada por: Grupo total (GT): 151 mujeres ambulatorias de la Ciudad de Buenos Aires y alrededores, de (X±DE) 72±6 años [102 en verano (G V) y 49 en otoño-invierno (G O-I)]. Se realizaron cuestionarios de frecuencia de consumo de alimentos y de exposición solar. Se midió en suero 25-hidroxi vitamina D (25OHD), crosslaps (CTX), fosfatasa alcalina ósea (FAO), calcio (Ca) y fósforo (P), y en orina de 24 h: índice calciuria y creatininuria (cau/cru). Como resultado se evidenció una adecuada I.E, elevada de Pr, sin superar límites máximos; I bajas de VD (100%), y Ca (50%). Los niveles de 25OHD fueron deficientes (<20 ng/mL) en el 93% del G O-I y 37,2% del G V. Se observaron correlaciones positivas débiles entre 25OHD y Ca (r=0,212; p<0,013), P (r=0,267; p<0,003), Cau/Cru (r=0,227; p<0,02), exposición solar (r=0,267; p<0,014); I. Ca (r=0,26; p<0,003) en el GT y entre 25OHD e I. de VD sólo en G-OI (r=0,367, p<0,012). Se evidenció una I. insuficiente de Ca y de VD con elevada prevalencia de deficiencia de VD. Se requieren programas de suplementación de VD y promoción de ingesta de lácteos en adultos mayores.

An inadequate intake (I) of energy (E), protein (Pr), calcium (Ca) and vitamin D (VD) might affect elderly bone health. The objectives of the present work were to assess energy (E), protein (Pr), calcium (Ca), and VD I in women older than 65 years old(y) and to evaluate bone biochemical parameters (BP) and the relationship with dietary I The population under sudy was constituted by a total group (TG):151 [102 in summer (SG) and 49 in autumm-winter (A-WG)] ambulatory healthy women with 72±6 (X±SD). Food consumption frequency and sunlight exposure questionnaires were carried out. Serum 25 hydroxy vitamin D (25OHD), crosslaps (CTX), calcium (sCa), phosphate (sP), bone alkaline phosphatase and uCa/uCr ratio were measured in 24-hour urine samples. As a result, the TG showed an adequate EI, lower CaI (in 50%) and VD (in 100%) and higher PrI than dietary reference intake but not higher than the upper I level. A total of 93% of A-WG and 37.2% of SG had vitamin D deficiency (25OHD < 20 ng/mL). There were significative but weak correlations between 25OHD and sCa (r=0.212; p<0.013), sP (r=0.267; p<0.003), uCa/uCr (r=0.227; p<0.02), sunlight exposure (r=0.267; p<0.014), CaI (r=0.26; p<0.003) in TG; and between 25OHD and VD I only in the A-WG (r=0.367, p<0.012). An inadequate intake of Ca and VD and high prevalence of VD deficiency were evident. VD supplementation and promotion of a higher intake of dairy products in the elderly are suggested.

Ingestões (I) baixas de energia (E), proteínas (Pr), cálcio (Ca), e vitamina D (VD) afetam a saúde óssea do adulto maior. O objetivo do trabalho consistiu em avaliar a I de E, Pr, Ca e VD em mulheres mais do que 65 anos e sua relação com parâmetros bioquímicos (PB) do metabolismo ósseo. A população estudada esteve constituída por: Grupo total (GT): 151 mulheres ambulatórias da cidade de Buenos Aires e seus arredores, de (X±DE) 72±6 anos [102 no verão (G V) e 49 no outono-inverno (G O-I)]. Foram realizados questionários de frequência de consumo de alimentos e de exposição solar. Mensurou-se em soro 25-hidroxi vitamina D (25OHD), crosslaps (CTX), fosfatase alcalina óssea (FAO), cálcio (Ca) e fósforo (P), e em urina 24 h: índice calciúria e creatininúria (cau/cru). Como resultado, foi evidenciada uma adequada I E, elevada de Pr, sem superar limites máximos; I baixas de VD (100%), e Ca (50%). Os níveis de 25OHD foram deficientes (<20 ng/mL) em 93% do G O-I e 37.2% do G V. Observaram-se correlações positivas fracas entre 25OHD e Ca (r=0.212; p<0.013), P (r=0.267; p<0.003), Cau/Cru (r=0.227; p<0.02), exposição solar, (r=0.267; p<0.014,i. Ca (r=0.26; p<0.003) no GT e entre 25OHD e IVD só em GO-I (r=0.367, p<0.012). Foi evidenciada uma i insuficiente de Ca e VD com elevada prevalència de deficiência de VD. Requerem-se programas de suplementação VD e promoção de ingestão de lacticínios em adultos maiores.

Comparison of Muscle Mass Indexes According to Protein Intake in Obese Patients

BACKGROUND: Protein is the most important nutrient for the muscle synthesis and maintenance of muscle mass. However, there have been no studies comparing muscle mass indexes according to protein intake in obese patients. Thus, the present study investigated the hypothesis that high protein intake positively affected muscle mass indexes in obese patients. METHODS: Male (n=50) and female (n=30) obese patients were recruited. Each sex was divided into 2 groups according to their protein intake. Dietary intake, fat-free mass, appendicular skeletal muscle mass, appendicular skeletal muscle mass/height², skeletal muscle index, total bone area, bone mineral count, bone mineral density, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, interleukin-6, tumor necrosis factor α, smoking, alcohol, and exercise were assessed. RESULTS: Fat-free mass, appendicular skeletal muscle mass, and appendicular skeletal muscle mass/height² were significantly higher in obese men in the higher protein intake group, while serum triglyceride was significantly lower in the same group. However, bone indexes and inflammatory cytokines according to protein intake were not significantly different in obese men. Fat-free mass, bone indexes, muscle indexes, blood lipid profiles, and inflammatory cytokines were not significantly different according to protein intake in obese women. CONCLUSION: In this population, increasing protein intake may positively affect fat-free mass, appendicular skeletal muscle mass, appendicular skeletal muscle mass/height², and serum triglyceride in obese men. Therefore, additional studies may be necessary to identify the appropriate level of protein intake required to prevent a decrease in muscle mass, and increase muscle mass in obese patients.

Metabolic Syndrome Risk by Intake Ratio and Intake Pattern of Proteins in Middle-aged Men Based on the 2012-2013 Korean National Health and Nutrition Examination Survey Data / 대한지역사회영양학회지

OBJECTIVES: The purpose of the study was to compare intake of energy nutrients, physical characteristics, and the prevalence of metabolic syndrome according to protein intake group. METHODS: Subjects were 827 men aged 40-65 years. The results presented were based on data from the 2012-2013 National Health and Nutrition Examination Survey and analyzed using SPSS. The odds ratio (OR) of metabolic syndrome was assessed according to the protein intake group and intake pattern of protein-rich foods. RESULTS: The mean of protein intake was 73.96 ± 0.71 g. According to level of protein intake, four groups (deficient, normal, excess 1, excess 2) were created and their percentages were 8.3%, 39.6%, 37.1%, and 15.0% respectively. The mean of daily energy intake was 2,312.33 ± 24.08 kcal. It was higher in excess group 2 than in the deficiency group (p < 0.001). Moreover, the intake of all energy nutrients increased significantly with protein intake group (p < 0.001). The main contribution to daily protein included mixed grains (10.96 ± 0.32 g), milled rice (7.14 ± 0.30 g), chicken (3.50 ± 0.21 g), and grilled pork belly (3.04 ± 0.16 g). With regard to physical characteristics, and blood pressure and blood test results, only body mass index increased significantly according to protein intake groups (p < 0.05). The prevalence of metabolic syndrome in subjects was 38.5%, and there was no significant correlation with protein intake group. The OR of metabolic syndrome increased with protein intake, and was higher 4.452 times in excess group 2 than in the normal group (p < 0.05). Conversely, the OR of metabolic syndrome according to the frequency of protein-rich food intake did not show a significant correlation. CONCLUSIONS: The results of this study can be used as significant supporting data to establish guidelines for protein intake in middle-aged men.

Avaliação da ingestão proteica por meio do registro alimentar em pacientes com doença renal crônica / Evaluation of protein intake by food record in patients with chronic kidney disease

Introdução: A principal manipulação dietética utilizada na tentativa de reduzir a progressão da doença renal crônica (DRC) é o controle da ingestão proteica. Objetivo: analisar a utilização do registro alimentar (RA) para avaliação da ingestão proteica de pacientes com DRC em tratamento conservador, considerando o Equivalente Proteico do Aparecimento de Nitrogênio Ureico (PNA) como método de referência. Metodologia: avaliaram-se os prontuários de pacientes adultos em acompanhamento nutricional no Serviço de Nefrologia do Hospital das Clínicas da Universidade Federal de Minas Gerais, no período de janeiro de 2009 a dezembro de 2011. Foram coletados dados clínicos, epidemiológicos, bioquímicos e RA no prontuário e na ficha de anamnese do serviço. A ingestão proteica estimada por meio do RA foi comparada aos valores de PNA em dois momentos distintos, ambos referentes ao mesmo dia de avaliação. Resultados: foram incluídos no estudo 45 pacientes, sendo 23 (51,1%) do sexo masculino. A idade foi superior a 60 anos em 25 pacientes (55,6%) e a escolaridade média foi de 5,62 ± 3,73 anos de estudo. Não houve correlação entre a avaliação da ingestão proteica pelo RA e o PNA nos dois momentos de avaliação (teste de correlação de Pearson; r=0,06 e p=0,69 e r=0,15 e p=0,32, respectivamente). A ingestão calórica média nos dois momentos de avaliação por meio do RA foi abaixo da recomendação. Conclusão: na amostra estudada não houve correlação do RA com o método de referência PNA para avaliação da ingestão proteica em pacientes com DRC em tratamento conservador.

The Prevalence of Hypertension and Related Nutritional Risk Factors of Elderly Living in a Rural Area / 대한지역사회영양학회지

OBJECTIVES: The prevalence of hypertension in Korean rural elderly was significantly higher than that of the general population. Determining the potential risk factors of hypertension would be useful for managing and improving the treatment and prevention of hypertension in rural areas. METHODS: We studied 336 elderly individuals 110 males, 226 females) aged between 65 years and 95 years residing in the rural area, S-gun Jeonbuk. Health-related habits, frequency of intake of food groups, nutrient intakes, anthropometric and biochemical measurements were assessed. Subjects were defined as hypertensive if SBP was > or = 140 mmHg or if DBP was > or = 90 mmHg or take an antihypertensive drug. RESULTS: The rate of prevalence of hypertension in the study group was 51.8% (male 40.0%, female 57.5%). The risk of occurrence of hypertension was higher among females (OR, 1.98), 75 years old or older (OR, 1.62), BMI > or = 25 kg/m2 (OR, 2.84), acceptable range (upper end) of body fat (OR, 2.29) and unhealthy (too high) range of body fat (OR, 3.28), hypertriglyceridemia (OR, 2.17) and hypercholesterolemia (OR, 5.42), low protein intakes (OR, 1.78). However, health related habits, frequencies of intake of food groups and most nutrient intakes except for protein did not show any significant relationship with the occurrence of hypertension. CONCLUSIONS: To reduce the risk of occurrence of hypertension among elderly individuals in rural areas, it is needed to avoid increase of body fat, 25 or higher BMI (kg/m2) and hyperlipidemia and low intake of proteins.

Influence of Protein Intake from Haem and Non-haem Animals and Plant Origin on Inflammatory Biomarkers among Apparently-healthy Adults in Greece.

Intake of different types of protein may be associated with differences in biomarkers among various populations. This work investigated the influence of protein intake from haem and non-haem animals as well as protein from plants on haematological and biochemical parameters in inflammation among apparentlyhealthy adults living in Greece, a Mediterranean country. Four hundred and ninety apparently-healthy subjects (46±16 years, 40% men), who consecutively visited Polykliniki General Hospital for routine examinations, voluntarily agreed to participate in the study (participation rate 85%). Demographic, anthropometric and lifestyle characteristics were recorded. Participants completed a valid, semi-quantitative food frequency questionnaire. Protein intake was classified into three sources: protein from haem animals, protein from non-haem animals, and protein from plant origin. Fasting blood samples were taken from all participants; uric acid, creatinine, lipids, cystatin C, haptoglobin, haemoglobin, haematocrit, iron, ferritin, white blood cells, monocytes, platelets, and C-reactive protein were measured. Protein intake from only haem animals was associated with increased haemoglobin and haematocrit levels (p<0.05) whereas intake of protein from non-haem animals and plant origin was not associated with the investigated haematological and biochemical markers of low-grade chronic inflammation when lifestyle factors and overall dietary habits were taken into account. Intake of protein from only haem animals seems to be consistently associated with haematological markers. The confounding role of dietary habits and lifestyle variables on the tested parameters deserves further attention in future research.

Milk and Protein Intake by Pregnant Women Affects Growth of Foetus.

The study assessed the effects of the daily intake of milk and protein by pregnant women on foetal growth and determined the growth pattern and velocity of growth. A total of 504 ultrasound observations from 156 respondents were collected following a cross-sectional design in the last trimester of pregnancy; majority of them were in the last month of pregnancy. De facto and purposive sampling was done, and direct interviews of affluent pregnant women were conducted. Kruskal-Wallis test shows that majority of the respondents had tendency to consume 155.65 to 465.17 mL of milk per day, resulting in better and higher foetal growth. Most respondents consumed about 50-70 g of protein per day, and the foetal growth measurements, such as abdomen-circumference, femur length, biparietal diameter, and head-circumference, on an average, were higher in the same group. Quadratic regression model exhibited that all the traits of growth pattern in Model 1 (low milk and protein intake) appeared to have more mode of decline, in contrast to Model 2 (more milk and protein intake), which shows better growth. In addition, velocity of growth pattern was obtained through the first derivative of quadratic regression of growth pattern. Moreover, 95% confidence interval calculated for regression line slope of Model 1 and Model 2 showed that the estimation point (2 B2) of Model 1 does not lay into 95% CI of Model 2; so, statistical significance assorted and also the same trend conversely hold for Model 2. The rate of growth was highly influenced by maternal milk and protein intake. These findings suggest that contribution of common nutrients or other nutritional factors present in milk and protein promote the growth of foetus.

Valores de referencia de proteínas para la población venezolana

Se presenta la revisión de los valores de referencia de proteínas. Se determinó el consumo de la población venezolana según las Encuestas de Seguimiento al Consumo de Alimentos (ESCA) 2010- 2012. La dieta aportó proteínas de buena calidad, combinando alimentos de origen animal y vegetal en relación aproximada de 1:1. Los valores de referencia se calcularon en base a la ingesta proteica segura indicada por WHO/ FAO/ONU 2007, y ajustando el aporte de proteínas según edad, peso y contribución a la fórmula calórica de proteínas para una actividad física ligera. Los valores de referencia de proteínas recomendados como ingesta segura en g/kg/día son: para niñas y niños, menores de 1 año 1,14 a 1,80; de 1 a 3 años 0,90 a 1,14; de 4 a 6 años 0,86 a 0,89; y de 7 a 10 años 0,91 a 0,92. En adolescentes de 12 a 19 años, el promedio es de 0,88 y 1,07 para el sexo masculino y femenino respectivamente. En adultos de 20 a 59 años, se recomienda 0,83 y en adultos mayores de 60 años 1,00 para hombres y mujeres. En embarazadas se recomiendan consumos adicionales de proteínas según el trimestre de gestación. Las embarazadas adolescentes deben consumir 1,2 a 1,7 g/ kg/día adicional al requerimiento normal. En mujeres lactantes, los valores difieren entre los primeros seis meses post-parto y después de seis meses lactando. En esta actualización de 2012 los valores de referencia de proteínas resultaron en general menor a los recomendados en la revisión del año 2000.

Reference values of proteins for the Venezuelan population. This study presents the reference values for protein requirements. The consumption of the Venezuelan population was obtained according to the Food Consumption Monitoring Survey (ESCA) 2010-2012. The diet provided good quality proteins, combining animal and vegetable foods in an approximate ratio of 1:1.The reference values were calculated based on the safe levels of protein intake recommended by WHO/FAO/UN 2007, with an adjustment for protein supply depending on age, weight, and contribution to the caloric formula of proteins for light physical activity. The reference values for protein requirements recommended as safe levels of intake in g/kg/day are 1.14 to 1.80 for males and females less than one-year-old, from 1 to 3 years, 0.90 to 1.14; from 4 to 6 years old, 0.86 to 0.89; and from 7 to 10 years old, 0.91 to 0.92. For adolescents, the average is 0.88 and 1.07 for males and females, respectively. In adults from 20 to 59 years old, 0.83 for men and women is recommended, and for older adults, 1.00 for men and women. In pregnant women, additional consumptions are recommended according to gestation time. Adolescent pregnant women must consume additional 1.2 to 1.7 g/kg/day to normal requirement. In breastfeeding women, the values differ between the first six months postnatal period and after six months of breastfeeding. The reference values for protein in this update were lower than the values of the 2000 version.

Comparative study of serum levels of albumin and hs-CRP in hemodialysis patients according to protein intake levels / 한국영양학회지

Protein-energy malnutrition, PEM, and increased hs-CRP level are considered to be associated with increased risk of cardiovascular disease (CVD) in hemodialysis (HD) patients. This is commonly referred to as the vicious circle of malnutrition-inflammation-atherosclerosis cardiovascular disease (MIA syndrome) in chronic kidney disease (CKD). Low protein intake can decrease the serum level of albumin and increase inflammational markers; further, both low serum albumin and high hs-CRP are independent risk factors for all-cause mortality in HD patients. The aim of this study is comparing the serum levels of albumin and hs-CRP in HD patients according to the protein intake levels. The total number of subjects was 60 hemodialysis patients; they were grouped by dietary protein intake: low protein intake group (LPI, protein intake or = 1.0 g/kg IBW, 12 men and 18 women). Blood biochemical parameters, nutrient intake, and dietary behaviors were compared between the LPI and API groups. The LPI group showed a significantly lower serum level of albumin and higher serum level of hs-CRP than the API group (p < 0.05). The LPI group showed a significantly lower intake of most nutrients than the API group (p < 0.05). Index of Nutritional Quality of most nutrients of the LPI and API groups were lower than 1.0. Dietary protein intake was positively correlated with the serum level of albumin (r = 0.306, p < 0.05) and negatively correlated with the serum level of hs-CRP (r = -0.435, p < 0.01). The serum level of hs-CRP was negatively correlated with that of albumin (r = -0.393, p < 0.01). According to these result, serum albumin and hs-CRP in HD patients were influenced by the protein intake levels. To prevent MIA syndrome, it is necessary to improve nutritional status, especially in protein and energy.