Whey Protein Supplementation and Type 2 Diabetes Mellitus Risk Factors: An Umbrella Systematic Review of Randomized Controlled Trials.

Emerging research suggests whey protein (WP) supplementation may modify type 2 diabetes mellitus (T2DM) risk factors, including glucose control. As systematic reviews and/or meta-analyses of randomized controlled trials (RCTs) gain importance in nutrition literature, we conducted an umbrella systematic review to chronicle published systematic reviews and/or meta-analyses of RCTs pertinent to WP supplementation and T2DM modifiable risk factors. This review was conducted in accordance with Preferred Reporting Items for Overviews of Reviews standards. Potentially eligible articles were identified via a systematic search of 5 electronic health research databases (PubMed, Cochrane Library, CINAHL [EBSCO], Scopus, and SPORTDiscus [EBSCO]). Included articles were assessed for quality using the "A MeaSurement Tool to Assess systematic Reviews 2" critical appraisal tool. Thirteen articles, representing 109 unique RCTs, of the 2205 identified articles met the inclusion criteria. Nine articles (69%) were deemed high quality, 2 (15%) moderate quality, and 2 (15%) low quality. Findings from this umbrella review of 13 systematic reviews, including 12 meta-analyses, suggest WP may lower hemoglobin A1c, homeostasis model assessment of insulin resistance, and fasting insulin in groups classified as overweight/obese or at risk for or with metabolic syndrome; blood triglycerides in groups classified as overweight/obese or at risk for or with metabolic syndrome; and blood pressure in groups classified as overweight/obese. WP did not differentially affect C-reactive protein, body weight, body mass index, or waist circumference, nor did it adversely affect any T2DM risk factors. Insufficient evidence precluded assessing the influence of WP on glucose control-related outcomes in groups classified at lower risk for T2DM. Information regarding WP dose, duration, or types was insufficient to draw conclusions. Collectively, evidence suggests WP supplementation may improve multiple clinical indicators of glucose control, along with triglycerides and blood pressure, in groups of adults at increased risk of developing T2DM.

Poultry Consumption and Human Cardiometabolic Health-Related Outcomes: A Narrative Review.

Poultry meats, in particular chicken, have high rates of consumption globally. Poultry is the most consumed type of meat in the United States (US), with chicken being the most common type of poultry consumed. The amounts of chicken and total poultry consumed in the US have more than tripled over the last six decades. This narrative review describes nutritional profiles of commonly consumed chicken/poultry products, consumption trends, and dietary recommendations in the US. Overviews of the scientific literature pertaining to associations between, and effects of consuming chicken/poultry on, body weight and body composition, cardiovascular disease (CVD), and type II diabetes mellitus (T2DM) are provided. Limited evidence from randomized controlled trials indicates the consumption of lean unprocessed chicken as a primary dietary protein source has either beneficial or neutral effects on body weight and body composition and risk factors for CVD and T2DM. Apparently, zero randomized controlled feeding trials have specifically assessed the effects of consuming processed chicken/poultry on these health outcomes. Evidence from observational studies is less consistent, likely due to confounding factors such as a lack of a description of and distinctions among types of chicken/poultry products, amounts consumed, and cooking and preservation methods. New experimental and observational research on the impacts of consuming chicken/poultry, especially processed versions, on cardiometabolic health is sorely needed.

Effects of Consuming Ounce-Equivalent Portions of Animal- vs. Plant-Based Protein Foods, as Defined by the Dietary Guidelines for Americans on Essential Amino Acids Bioavailability in Young and Older Adults: Two Cross-Over Randomized Controlled Trials.

BACKGROUND: The Dietary Guidelines for Americans (DGA) recommends consuming a variety of "Protein Foods" based on "ounce-equivalent" (oz-eq) portions. No study has assessed the same oz-eq portions of animal- vs. plant-based protein foods on essential amino acid (EAA) bioavailability for protein anabolism in young and older adults. OBJECTIVES: We assessed the effects of consuming two oz-eq portions of pork, eggs, black beans, and almonds on postprandial EAA bioavailability in young and older adults. METHODS: We conducted two investigator-blinded, randomized crossover trials in young (n = 30; mean age ± SD: 26.0 ± 4.9 y) and older adults (n = 25; mean age ± SD: 64.2 ± 6.6 y). Participants completed four testing sessions where they consumed a standardized meal with two oz-eq of either unprocessed lean pork, whole eggs, black beans, or sliced almonds. Blood samples were taken at baseline and 30, 60, 120, 180, 240, and 300 min postprandially. Plasma EAA bioavailability was based on postprandial integrated positive areas under the curve. RESULTS: Participant age did not affect EAA bioavailability among the four protein foods tested. Two oz-eq portions of pork (7.36 g EAA) and eggs (5.38 g EAA) resulted in greater EAA bioavailability than black beans (3.02 g EAA) and almonds (1.85 g EAA) in young and older adults, separately or combined (p < 0.0001 for all). Pork resulted in greater EAA bioavailability than eggs in young adults (p < 0.0001), older adults (p = 0.0007), and combined (p < 0.0001). There were no differences in EAA bioavailability between black beans and almonds. CONCLUSIONS: The same "oz-eq" portions of animal- and plant-based protein foods do not provide equivalent EAA content and postprandial bioavailability for protein anabolism in young and older adults.

Poultry Consumption and Human Health: How Much Is Really Known? A Systematically Searched Scoping Review and Research Perspective.

This scoping review was conducted to systematically search and chronicle scientific literature pertinent to poultry intake and human health. The protocol (uploaded to Open Science Framework, https://osf.io/2k7bj/) was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines. Articles with observational and experimental research, narrative and systematic reviews, and meta-analyses were included. Among 13,141 articles identified, 525 met inclusion criteria. Among these 525 articles, 212 focused on cancer morbidity and mortality; 41 on cardiovascular disease (CVD) morbidity and mortality; 52 on CVD risk factors; 32 on type 2 diabetes mellitus (T2DM) morbidity and mortality; 33 on T2DM risk factors; and 42 on body weight and body composition. An "Other" category (181 articles) included nutrient status, psychological well-being/mental health, cognition, microbiome, chronic kidney disease, nonalcoholic fatty liver disease, skin disorders, and fertility, among others. Among the 525 included articles, 366 were observational, 64 were experimental, and 76 were reviews and meta-analyses. Eighty-three percent of articles focused on adults or older adults. A paucity of research exists to support poultry as health-promoting foods, with most research only indirectly assessing poultry intake compared with other foods of interest (e.g., red meats or plant-based protein foods). No randomized controlled trials and only 1% of OBS assessed the influence of processed poultry intake on human health. In the future, the relative health effects of consuming poultry will be compared with a widening array of traditional and new protein-rich food products, necessitating the need for research to assess poultry as foods of choice. Science and health professionals, the poultry industry, and the public will benefit from new observational and experimental research to address cutting-edge scientific, public policy, and consumer topics pertinent to poultry intake and human health.

Comparison of Wrist- and Hip-Worn Activity Monitors When Meeting Step Guidelines.

INTRODUCTION: Physical activity (PA) guidelines aimed at accumulating 10,000 steps per day have become increasingly common with the advent of wristband PA monitors. However, accumulated steps measured with wristband PA monitors may not be equal to steps measured with validated, hip-worn pedometers. Consequently, evaluating and developing guidelines for step counts using wristband PA monitors for the general population is needed. We compared step counts accumulated with hip-worn pedometers with those accumulated with wrist-worn activity monitors during 1) treadmill exercise, 2) treadmill walking, and 3) activities of daily living (ADL) to determine their accuracy in meeting step count guidelines (ie, 10,000 steps/d). METHODS: Eighty-six adults (aged 18-65 y; body mass index, 19-45 kg/m2) completed 30 minutes of treadmill exercise while simultaneously using a hip-worn pedometer and wrist-worn PA monitor. Remaining steps needed to reach 10,000 steps (ie, 10,000 steps minus the number of pedometer steps recorded from treadmill exercise = remainder) were completed via treadmill walking or ADL. Steps were recorded for both devices after treadmill exercise, treadmill walking, and ADL for both devices. RESULTS: Fewer steps were accumulated via wrist-worn PA monitors than via hip-worn pedometers during treadmill exercise (3,552 [SD, 63] steps vs 3,790 [SD, 55] steps, P < .01) and treadmill walking (5,877 [SD, 83] steps vs 6,243 [SD, 49] steps, P < .01). More steps were accumulated via wrist-worn PA monitors than hip-worn pedometers during ADL (7,695 [SD, 207] steps vs 6,309 [SD, 57] steps, P < .01). Consequently, total steps were significantly higher for wristband PA monitors than hip-worn pedometers (11,247 [SD, 210] steps vs 10,099 [SD, 39] steps; P < .01). CONCLUSION: The widely used 10,000-step recommendation may not be accurate for all users of all activity monitors, given the discrepancy in daily step count among wrist-worn and hip-worn devices. Having a more accurate indication of number of steps taken per day based on the device used could have positive effects on health.

Medically managed prosthetic valve endocarditis caused by Salmonella enteritidis.

Infective endocarditis is associated with morbidity and mortality even when appropriately treated. It can be more complicated to treat when prosthetic material is present, often necessitating surgical revision as well as antimicrobial therapy. Endocarditis caused by gram-negative bacilli is a rare occurrence, with some literature and expert opinion suggesting superior outcomes with combined surgery and antibiotics when a prosthetic valve is involved. In cases where the prosthetic valve is well-functioning and undamaged, or cardiothoracic surgery represents a significant operative risk, it can be unclear how best to proceed. This report documents a case of Salmonella enterica subspecies enterica serovar enteritidis endocarditis of a mechanical mitral valve. The patient was managed with 6 weeks of intravenous antibiotics followed by suppressive oral antibiotic therapy. They remain in good health at 24 months.

Vitamin D status and supplementation impacts on skeletal muscle function: comparisons between young athletes and older adults.

PURPOSE OF REVIEW: The present narrative review analyzes emerging research implicating vitamin D status and supplementation with skeletal muscle homeostasis and functions in two distinct segments of the adult population: young athletes and older adults. RECENT FINDINGS: Vitamin D deficiency compromises multiple indices of muscle function in young athletes and older adults. A variety of vitamin D3 (cholecalciferol) supplementation regimens may transition young athletes and older adults from deficient or inadequate to adequate vitamin D status. Vitamin D supplementation, used to treat a vitamin D deficiency, but not necessarily an inadequacy, promotes muscle anabolism in older adults. For both young athletes and older adults, vitamin D supplementation, which transitions them from inadequate to adequate vitamin D status, may not beneficially affect measures of muscle strength and power, or physical performance. Also, when vitamin D status is adequate, vitamin D supplementation to further increase serum 25(OH)D concentrations does not seem to confer additional benefits to muscle strength and power and physical performance. SUMMARY: The impacts of vitamin D status and supplementation on skeletal muscle homeostasis and functions seem comparable in young athletes who strive to maximize physical performance and older adults who seek to attenuate muscle mass and physical performance declines.

A Single Bout of Foam Rolling Increases Flexibility of the Hip Adductor Muscles without Compromising Strength.

Foam rolling (FR) is a method of self-myofascial release (SMR) implemented to reduce tension in underlying soft tissue, leading to increased range of motion (ROM). The hip adductor muscles of the groin are commonly less flexible and often a site for soft tissue injuries. Limited research has been done to determine the most effective flexibility exercises to increase ROM in the groin muscles prior to exercise without comprising strength. The purpose was to determine the effect of an acute bout of FR on passive groin flexibility and strength. Randomized crossover study with 3 × 2 (Condition × Time) repeated measures ANOVA statistical design. 40 volunteers (n = 20 males; n = 20 females) with limited flexibility in groin ROM participated. Following warm-up, maximal voluntary isometric contraction (MVC) and static ROM were measured pre and postintervention. Conditions included 60 seconds of FR, SS, and CON. The Condition × Time interaction was not significant for MVC or ROM. A main effect of time showed a significant increase in ROM from pre to post for FR (1.2°, p < 0.001), SS (1.0°, p < 0.001), and CON (0.5°, p = 0.039). No significant changes in MVC were observed for FR from pre to post (p > 0.05), whereas SS and CON both increased (p < 0.05). An increase in passive groin ROM after acute bouts of SMR or SS without compromising MVC was observed. This suggests that 60 seconds of FR may be employed before exercise to improve flexibility without strength decrement.

Comparison of Two Static Stretching Procedures on Hip Adductor Flexibility and Strength.

It has been shown that acute static stretching (SS) may increase flexibility, improve performance and reduce the risk of muscle strains, but may also result in decreased maximal force output. Literature review revealed little research had specifically been done on the most effective ways to stretch the hip adductor muscles. The purpose was to determine the effects that an acute bout of SS (active vs passive) has on hip adductor flexibility and maintenance of strength. Randomized cross-over study using a 3 × 2 (Condition X Time) repeated measures ANOVA statistical design. Forty healthy and physically active subjects (20 male and 20 female) that screened positive for limited flexibility in hip adductor range of motion (ROM) participated. Following a warm-up, baseline maximal voluntary isometric contraction (MVC) and peak static ROM tests were administered. On separate days subjects randomly performed either 60 seconds of passive SS, active SS, or a time-matched control protocol before post measures were recorded for MVC and ROM. There was a significant time effect (p<0.001) that revealed both types of SS and control resulted in increased ROM pre-to-post (passive = 1.0; active = 1.1; control = 0.6 degrees) with no between condition differences (p=0.171). Neither type of SS resulted in reduced strength. Both methods minimally increased hip adductor flexibility without a decrease in force output. This suggests that individuals do not need to avoid SS for the hip adductors prior to engaging in physical activity for fear of a strength decrement.