Amount Rather than Animal vs Plant Protein Intake Is Associated with Skeletal Muscle Mass in Community-Dwelling Middle-Aged and Older Chinese Adults: Results from the Guangzhou Nutrition and Health Study

BackgroundCurrent literature does not indicate if the amount and animal vs plant protein are equally important in the prevention of muscle loss in middle-aged and older Chinese adults.ObjectiveThe aim of the study was to examine the associations between amount or animal vs plant protein and skeletal muscle mass in Chinese adults aged 40 to 80 years.DesignA cross-sectional analysis of a prospective, community-based cohort was performed.Participants/settingParticipants included 1,044 men and 2,169 women aged 40 to 80 years from the Guangzhou Nutrition and Health Study 2011-2013 with body composition measurements by dual-energy x-ray absorptiometry.Main outcome measureThe skeletal muscle index (SMI) was defined as appendicular skeletal muscle mass divided by body weight. Participants in the lowest quartile of the sex-specific SMI were considered to have low muscle mass (LMM).Statistical analysisAnalyses of covariance were performed to estimate the SMI across quintiles of relative dietary intake of total, animal, and plant protein and the ratio of animal-to-plant protein. Logistic regression models were applied to assess the associations between quintiles of protein intake and LMM.ResultsThe SMI increased significantly across quintiles of relative dietary intake of total, animal, and plant protein (all P trends<0.001). Odds ratios (95% CIs) for LMM among participants in the highest (vs lowest) quintile were 0.3 (0.2, 0.4) for total protein, 0.3 (0.2, 0.5) for animal protein, and 0.4 (0.3, 0.7) for plant protein, respectively (all P trends<0.001). However, the ratio of animal-to-plant protein was not associated with either the SMI or the presence of LMM.ConclusionHigher dietary intakes of total, animal, and plant protein, regardless of the ratio of animal-to-plant protein, are associated with greater skeletal muscle mass in community-dwelling middle-aged and older Chinese adults with a mean protein intake above the current recommendation for protein of 0.8 g/kg per day.     

Higher Branched-Chain Amino Acid Intake Is Associated with Handgrip Strength among Korean Older Adults

Sarcopenia is a disease of old age characterized by decreased muscle mass and strength. Branched-chain amino acids (BCAAs) promote muscle mass synthesis and increase muscle strength. We aimed to develop a dietary amino acid database and to examine the association between BCAA intake and handgrip strength in Korean older adults. Data from the Korea National Health and Nutrition Examination Survey 2014–2018 were used. Overall, 4852 participants aged ≥65 years were included in the study. Demographic, lifestyle, and health data were obtained through interviews and questionnaires. The 24-h recall method was used to assess dietary intake. An amino acid database was established using the 9th revision of the Korean Standard Food Composition Table. The mean handgrip strength was estimated from triplicate measurements obtained using the dominant hand. Multivariable linear regression analysis was performed to assess the association between BCAA intake and handgrip strength. Grains greatly contributed to amino acid intake; however, a significant negative association was observed between handgrip strength and increased BCAA intake through grains. In the fully adjusted model, leucine intake and handgrip strength showed a positive association. Thus, consuming BCAAs (especially leucine) via a variety of food sources can help maintain muscle health in older people.     

Vitamin Intake and Loss of Muscle Mass in Older People with Type 2 Diabetes: A Prospective Study of the KAMOGAWA-DM Cohort

The aim of this prospective cohort study was to examine the relationships between the intakes of various vitamins and the loss of muscle mass in older people with type 2 diabetes (T2DM). The change in skeletal muscle mass index (SMI, kg/m²) (kg/m²/year) was defined as follows: (SMI at baseline (kg/m²) − SMI at follow-up (kg/m²))/follow-up period (year). The rate of SMI reduction (%) was calculated as follows (the change in SMI (kg/m²/year)/SMI at baseline (kg/m²)) × 100. The rate of SMI reduction ≥ 1.2% was considered as the loss of muscle mass. Among 197 people with T2DM, 47.2% of them experienced the loss of muscle mass at the 13.7 ± 5.2 month follow-up. Vitamin B1 (0.8 ± 0.3 vs. 0.8 ± 0.3 mg/day, p = 0.031), vitamin B12 (11.2 ± 8.3 vs. 13.4 ± 7.5 μg/day, p = 0.049), and vitamin D (16.5 ± 12.2 vs. 21.6 ± 13.0 μg/day, p = 0.004) intakes in people with the loss of muscle mass were significantly lower than those without. Vitamin D intake was related to the loss of muscle mass after adjusting for sex, age, exercise, alcohol, smoking, body mass index, SMI, glucagon-like peptide-1 agonist, sodium glucose cotransporter-2 inhibitor, insulin, HbA1c, creatinine, energy intake, and protein intake (adjusted odds ratio 0.93, 95% confidence interval: 0.88–0.97, p = 0.003). This study showed that vitamin D intake was related to the loss of muscle mass in older people with T2DM. Vitamin B12 intake tended to be related to the loss of muscle mass, although vitamin A, vitamin B2, vitamin B6, vitamin C, and vitamin E intake were not related.     

Association between Branched-Chain Amino Acid Intake and Physical Function among Chinese Community-Dwelling Elderly Residents

This study aimed to evaluate the potential associations of dietary BCAAs (isoleucine, leucine, and valine) with physical function in the elderly Chinese population. A validated semiquantitative food frequency questionnaire and anthropometric and physical function measurements were used to collect data. We modeled trends in physical function indicators for BCAA quartiles using multivariate linear regression models. Among 4336 (43.97% men) participants aged 72.73 ± 5.48 years, a higher dietary intake of BCAAs was positively associated with increased handgrip strength (all p trends < 0.001), shorter times for 4-m fast walking (all p trends < 0.001) and repeated chair rises (all p trends < 0.001). No linear association was found between subtypes of amino acids and any physical functions (all p trends > 0.05). Individuals in the highest quartiles of BCAA intake had a reduced risk of developing low muscle strength, and the multiadjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for women and men were 0.50 (0.38–0.65) and 0.67 (0.50–0.91), respectively. Similarly, higher BCAA consumption was associated with a lower risk of developing low physical performance (4-m walking speed: OR = 0.68 [0.50–0.93]; repeated chair rises: OR = 0.66 [0.54–0.81]). Higher dietary BCAA intake might be beneficial for physical function in the elderly population.     

Dietary Protein Requirement Threshold and Micronutrients Profile in Healthy Older Women Based on Relative Skeletal Muscle Mass

Although multiple nutrients have shown protective effects with regard to preserving muscle function, the recommended amount of dietary protein and other nutrients profile on older adults for maintenance of high muscle mass is still debatable. The aims of this paper were to: (1) identify dietary differences between older women with low and high relative skeletal muscle mass, and (2) identify the minimal dietary protein intake associated with high relative skeletal muscle mass and test the threshold ability to determine an association with skeletal muscle phenotypes. Older women (n = 281; 70 ± 7 years, 65 ± 14 kg), with both low and high relative skeletal muscle mass groups, completed a food questionnaire. Skeletal muscle mass, fat-free mass (FFM), biceps brachii thickness, vastus lateralis anatomical cross-sectional area (VL_ACSA), handgrip strength (HGS), maximum elbow flexion torque (MVC_EF), maximum knee extension torque (MVC_KE), muscle quality (HGS/Body mass), and fat mass were measured. Older women with low relative skeletal muscle mass had a lower daily intake of protein, iodine, polyunsaturated fatty acid (PUFA), Vit E, manganese, milk, fish, nuts and seeds (p < 0.05) compared to women with high relative skeletal muscle mass. The minimum required dietary protein intake for high relative skeletal muscle mass was 1.17 g/kg body mass/day (g/kg/d) (sensitivity: 0.68; specificity: 0.62). Women consuming ≥1.17 g/kg/d had a lower BMI (B = −3.9, p < 0.001) and fat mass (B = −7.8, p < 0.001), and a higher muscle quality (B = 0.06, p < 0.001). The data indicate that to maintain muscle mass and function, older women should consume ≥1.17 g/kg/d dietary protein, through a varied diet including milk, fish and nuts that also contain polyunsaturated fatty acid (PUFA) and micronutrients such as iodine, Vit E and manganese.     

Association of waist circumference with muscle and fat mass in adults with a normal body mass index

BACKGROUND/OBJECTIVESWe aimed to investigate the association of waist circumference (WC) with body composition among individuals with a normal body mass index (BMI) to distinguish muscle and fat mass, as both affect health differently.SUBJECTS/METHODSWe analyzed dual-energy X-ray absorptiometry data (derived from the Korean National Health and Nutrition Survey, which includes information on fat and lean mass) of 7,493 adults with a normal BMI. Subjects were categorized into four groups of increasing WC. The fourth group was defined as being centrally obese. Each number of subjects are as follows: 1,870, 695, 231, and 39 among men and 3,054, 1,100, 406, and 98 among women. We conducted a sex-stratified linear regression analysis of body composition according to WC group after adjustments for covariates.RESULTSWe observed a positive association of body fat with increasing WC in both men and women (all P for trend: < 0.001). The adjusted mean values for percent body fat with 95% confidence intervals (CIs) according to the four WC groups in ascending order were 17.8 (17.5–18.3), 21.0 (20.6–21.5), 22.1 (21.5–22.8), and 25.1 (24.2–26.1) in men and 29.7 (29.4–30.0), 32.0 (31.6–32.3), 32.9 (32.4–33.4), and 34.7 (33.2–36.1) in women. However, there was an inverted J-shaped association between muscle mass and WC. The fourth group had a higher percent body fat and lower muscle mass than other groups. The adjusted mean values for appendicular skeletal muscle mass index (kg/m²) with 95% CIs according to the four WC groups in ascending order were 7.55 (7.51–7.59), 7.62 (7.56–7.68), 7.65 (7.56–7.74), and 7.22 (7.04–7.41) in men and 5.83 (5.80–5.85), 5.96 (5.92–6.00), 6.03 (5.96–6.10), and 5.88 (5.73–6.03).CONCLUSIONSThere was a positive association between body fat and WC among individuals with normal BMI; conversely there was an inverted J-shaped association between lean body mass and WC. Our findings support the WC measurement should be included in obesity evaluations for adults with a normal BMI.     

CT-Determined Sarcopenia in GLIM-Defined Malnutrition and Prediction of 6-Month Mortality in Cancer Inpatients

Our objective was to evaluate the clinical application of third lumbar vertebra (L3)-computer tomography (CT)-determined sarcopenia as a marker of muscle mass in cancer inpatients diagnosed with malnutrition according to the Global Leadership Initiative on Malnutrition (GLIM) criteria and to establish its association with 6-month mortality. Methods: This was an observational, prospective study in patients from an inpatient oncology unit. We performed a nutritional assessment according to GLIM criteria, including muscle cross-sectional area at L3 by CT and skeletal muscle index (SMI). Six-month mortality was evaluated. Results: A total of 208 patients were included. The skeletal muscle cross-sectional area at L3 was 136.2 ± 32.5 cm² in men and 98.1 ± 21.2 cm² in women. The SMI was 47.4 ± 12.3 cm²/m² in men and 38.7 ± 8.3 cm²/m² in women. Sarcopenia (low SMI) was detected in 59.6% of the subjects. Using SMI as a marker of low muscle mass in application of GLIM criteria, we found 183 (87.9%) malnourished patients. There were 104 deaths (50%) at 6 months. The deceased patients had a lower skeletal muscle cross-sectional area (112.9 ± 27.9 vs. 126.1 ± 37.8 cm²; p = 0.003) and a lower SMI (41.3 ± 9.5 vs. 45.7 ± 12.9 cm²/m²; p = 0.006). An increased risk of 6-month mortality was found in malnourished patients according to GLIM criteria using SMI (HR 2.47; 95% confidence interval 1.07–5.68; p = 0.033). Conclusions: Low muscle mass, assessed by L3-CT, was observed to affect more than half of cancer inpatients. The deceased patients at 6 months had a lower skeletal muscle cross-sectional area and SMI. Malnutrition according to GLIM criteria using CT-determined sarcopenia was shown to adequately predict 6-month mortality.     

Western dietary pattern is associated with higher risk of lower lean muscle mass in Korean postmenopausal women: data from the Korea National Health and Nutrition Examination Survey 2008–2011

BACKGROUND/OBJECTIVESIn a healthy person, from 35 years of age, there is an annual loss of muscle mass at the rate of 1–2% and is associated with a decline in the quality of life. This study aimed to identify the particular dietary patterns associated with the risk of lower lean muscle mass in Korean postmenopausal women.SUBJECTS/METHODSThe Korea National Health and Nutrition Examination Survey (KNHANES) is a population-based, continuous cross-sectional annual survey. The participants of the KNHANES IV (2008–2009) and V (2010–2011) were considered for this study. The study sample consisted of 1548 postmenopausal women, aged 45–86 years. Lower lean muscle mass was defined as having appendicular skeletal muscle mass corrected for body weight less than 1 standard deviation of the young reference group aged 20 to 39 years in KNHANES IV and V. To identify the dietary pattern using factor analysis, 24-h recall data was used.RESULTSThe prevalence of lower lean muscle mass was 31.3% in this study population. Four dietary patterns were identified by factor analysis; ‘Diverse’, ‘Western’, ‘Traditional’, and ‘Snacks and beverages’. The ‘Western’ pattern, highest factor loadings for flour and bread, potatoes, red meat, processed meat, eggs, and cheese, was significantly associated with a high (60%) risk of lower lean muscle mass (odds ratio [95% confidence interval] = 1.60 [1.07–2.39], P for trend = 0.01) after adjustments for potential covariates. The other 3 dietary patterns were not associated with lower lean muscle mass.CONCLUSIONSThe study findings suggest that the ‘Western’ dietary pattern that includes flour and bread, potatoes, red meat, processed meat, eggs, and cheese, may be associated with a higher risk of lower lean muscle mass in Korean postmenopausal women.     

Association of Dietary Protein Intake with Muscle Mass in Elderly Chinese: A Cross-Sectional Study

Most data regarding the association between dietary protein intake and muscle mass come from developed Western countries. This cross-sectional study investigates the association between the amount and distribution of dietary protein intake and muscle mass in elderly Chinese adults. This analysis includes 4826 participants aged 60 years and above from the dataset of the China Health and Nutrition Survey (CHNS) 2018. Protein intake data were assessed using 3-day, 24 h dietary recalls. Appendicular skeletal muscle mass (ASM) was obtained using the bioelectrical impedance analysis (BIA). Two-thirds of dietary protein intake comes from plant sources in the elderly Chinese population. The median total dietary protein intake was 60.5 g/d in low muscle mass participants for males and 52.5 g/d for females, which was lower than for their respective counterparts. Compared to the lowest quartile of protein intake, the highest total protein intake group had increased muscle mass by 0.96 kg among men and by 0.48 kg among women (p < 0.0001), and the highest vegetable protein intake group had increased muscle mass by 0.76 kg among men and by 0.35 kg among women (p < 0.0001). The amount of dietary protein intake with each meal was less than 20 g. High total protein intake and high plant-based protein intake were positively associated with higher muscle mass. A U-shape was observed between total dietary protein intake and low muscle mass risk in elderly Chinese adults. It should be encouraged to increase total daily protein intake to maintain muscle health.     

Longitudinal Association of Dietary Energy Density with Abdominal Obesity among Chinese Adults from CHNS 1993–2018

Few studies have explored the longitudinal association between dietary energy density and waist circumference and abdominal obesity in adults in China. This study aimed to analyze the relationship between dietary energy density and waist circumference and abdominal obesity in Chinese residents aged 18–64. Using data from the CHNS from 1993 to 2018, 25,817 adult residents aged 18 to 64 were selected for the study. Three consecutive 24-h dietary recalls and home-weighed seasonings were used to assess food intake. A multilevel model was used to analyze the relationship between dietary energy density and waist circumference and abdominal obesity. The results showed that compared with the lowest dietary energy density group, females had an increased risk of abdominal obesity (OR = 1.16, 95% CI: 1.05, 1.29), and females’ waist circumference increased significantly by 0.24 cm (95% CI: 0.39–1.09) in the highest dietary energy density group. No association between dietary energy density and waist circumference and abdominal obesity was observed in males. This study shows that higher dietary energy density is significantly associated with females’ waist circumference and abdominal obesity. Further research on high dietary energy density and abdominal obesity will provide scientific basis for the effective control of abdominal obesity.     

Dietary Pattern Classifications and the Association with General Obesity and Abdominal Obesity in Korean Women

ObjectivesThis study was done to identify dietary patterns and determine relationships between obesity and dietary patterns in Korean women.Subjects/methodsUsing 3,742 cases of baseline data from the Korean Health and Genome Study, dietary patterns were identified using factor analysis of data from a validated food frequency questionnaire. Relationships between dietary patterns and obesity were analyzed.ResultsFour dietary patterns were identified: (a) “animal food” (greater intake of meats and fish), (b) “rice-vegetable” (greater intake of steamed rice, tofu, Kimchi, vegetables, dried anchovy, and seaweeds), (c) “bread-dairy” (greater intake of bread, eggs, milk, and dairy products), and (d) “noodle” (greater intake of ramyun, noodles, and Chajangmyeon). The “animal food,” “bread-dairy,” and “noodle” dietary patterns were preferred by younger people with higher education levels (P<0.01), but the “rice-vegetable” dietary pattern was preferred by older people with lower incomes and education levels (P<0.01). In Korean women, dietary patterns were related to abdominal obesity but not obesity. The “rice-vegetable” and “noodle” dietary patterns were associated with an increased risk of abdominal obesity. However, the “bread-dairy” dietary pattern had an inverse relationship with abdominal obesity.ConclusionIn this study we identified four unique dietary patterns in Korean women that were independently associated with abdominal obesity. Abdominal obesity was positively related to the “rice-vegetable” and “noodle” dietary patterns. These finding may be useful in the development of dietary guidelines and the prevention of abdominal obesity in Korean women.     

Association Between Nutrient Patterns and Fatty Liver Index: Baseline Survey of the Japan Multi-Institutional Collaborative Cohort Study in Tokushima,Japan

BackgroundsThe fatty liver index (FLI) is a good non-invasive approach for fatty liver disease diagnosis. The objective of this study was to examine the associations of nutrient patterns with non-alcoholic fatty liver disease (NAFLD) in a Japanese population.MethodsA total of 1,588 subjects (789 men and 799 women) aged 35–69 years were recruited in the baseline survey of the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study in Tokushima Prefecture. Factor analysis was applied to energy-adjusted intake of 21 nutrients, and nutrient patterns were extracted. Multiple logistic regression analysis was used to analyze the relationships between nutrient patterns and the high FLI category (≥60).ResultsFour nutrient patterns were extracted: Factor 1, vitamins, dietary fiber, iron and potassium pattern; Factor 2, fats and fat-soluble vitamins pattern; Factor 3, saturated fat, calcium, vitamin B₂ and low carbohydrate pattern; and Factor 4, sodium, protein and vitamin D pattern. After adjustment for sex, age, and other potential confounding variables, higher Factor 1 scores were significantly associated with lower odds ratios of NAFLD (P for trend <0.05). Analysis of each component of FLI showed that there were significant inverse associations between Factor 1 scores and high body mass index and large waist circumference.ConclusionThe present findings suggest that a nutrient pattern rich in vitamins, fiber, iron, and potassium was associated with lower prevalence of NAFLD in a Japanese population. Obesity and abdominal obesity may be intermediate variables for the association between this nutrient pattern and NAFLD.Key words: fatty liver index, nutrient patterns, cross-sectional study, factor analysis     

Fighting Sarcopenia in Ageing European Adults: The Importance of the Amount and Source of Dietary Proteins

While an adequate protein intake is important for the maintenance of muscle mass during ageing, the amount and source of protein necessary for optimal prevention of sarcopenia remains to be determined. The present study aimed to investigate the influence of the amount and source of dietary proteins on sarcopenia risk in a cohort of 65–79-year-old European adults within the frame of the NU-AGE study. A total of 986 participants were included in the analysis. Skeletal muscle index (SMI), assessed by dual-energy X-ray absorptiometry (DXA), and handgrip strength (HG) were employed to create a continuous sex-specific sarcopenia risk score (SRS). Total amount together with animal- and plant-derived sources of proteins were obtained from a 7-day food record. Differences in SRS were analysed across groups of total protein intake (<0.8 g/body weight (BW); 0.8–<1.0 g/BW; 1.0–<1.2 g/BW; and ≥1.2 g/BW). The association between SRS and the different sources of protein was assessed using isocaloric substitution models adjusted by demographic, medical, and lifestyle factors. A significant linear dose-response relationship was observed, with a lower SRS linked to higher protein intakes. Based on the isocaloric substitution modelling, a reduced SRS was observed when increasing plant protein to the detriment of animal protein, while holding total protein intake constant. Further, this result remained significant after stratifying the analysis by adherence to different levels of protein intake. Our findings suggest that older adults may benefit from increasing protein intakes above current recommendations. Besides total amount, protein source should be considered when promoting health dietary habits in older adults for the prevention of sarcopenia.     

Using Dietary Macronutrient Patterns to Predict Sarcopenic Obesity in Older Adults: A Representative Korean Nationwide Population-Based Study

Older adults with sarcopenic obesity (SO) are at increased risk of adverse health outcomes. It has not been identified which pattern of macronutrient intake is appropriate in relation to SO. We aimed to compare the patterns of macronutrient intake for predicting SO in older adults. Data from a total of 3828 older adults who participated in the 2008–2011 Korea National Health and Nutrition Examination Survey were analyzed. The one-day 24 h dietary recall method was used to assess macronutrient intake. SO was defined by a combination of body mass index (BMI) ≥ 25 kg/m² and BMI adjusted-appendicular skeletal muscle mass <0.789 for men and <0.512 for women. Weighted logistic regression analysis revealed the odds ratio (95% confidence interval) for SO of total calorie intake per 100 increments and carbohydrate (CHO) intake (g/kg/day) per 1 increment to be 0.95 (0.91–0.99) and 0.83 (0.74–0.94), respectively, after adjusting for confounding variables in women. The predictive power for SO of CHO intake (g/kg/day) was higher compared with the other patterns of macronutrient intake both in men and women. In conclusion, total calorie intake and CHO intake (g/kg/day) are inversely related to SO in women. CHO intake (g/kg/day) could be the best index for determining SO.     

Dietary Patterns of Infants and Toddlers Are Associated with Nutrient Intakes

Dietary patterns are a useful summary measure of diet. Few studies have examined the nutrient profiles underpinning the dietary patterns of young children. The study aim is to determine whether dietary patterns at 6 and 15 months of age are associated with nutrient intakes at 8 and 18 months, respectively. Participants were children from the Avon Longitudinal Study of Parents and Children who had complete dietary pattern and nutrient intake data (n = 725 at 6–8 months, n = 535 at 15–18 months). The association between tertiles of dietary pattern scores and nutrient intake was examined using a non-parametric test for trend. Scores on the home-made traditional pattern (6–8 months) were positively associated with median energy intake. Each dietary pattern had different associations with energy-adjusted intakes of macro- and micro-nutrients. At both times, the discretionary pattern was positively and the ready-prepared baby foods pattern was negatively associated with sodium intake. At 6–8 months, calcium and iron intakes decreased across scores on the home-made traditional and breastfeeding patterns, but increased across the ready-prepared baby food patterns. These findings highlight that dietary patterns in infants and toddlers vary in their underlying energy and nutrient composition.     

A Novel Dietary Intervention Reduces Circulatory Branched-Chain Amino Acids by 50%: A Pilot Study of Relevance for Obesity and Diabetes

Elevated circulating branched-chain amino acids (BCAAs; isoleucine, leucine, and valine) are associated with obesity and type 2 diabetes (T2D). Reducing circulatory BCAAs by dietary restriction was suggested to mitigate these risks in rodent models, but this is a challenging paradigm to deliver in humans. We aimed to design and assess the feasibility of a diet aimed at reducing circulating BCAA concentrations in humans, while maintaining energy balance and overall energy/protein intake. Twelve healthy individuals were assigned to either a 7-day BCAA-restricted diet or a 7-day control diet. Diets were iso-nitrogenous and iso-caloric, with only BCAA levels differing between the two. The BCAA-restricted diet significantly reduced circulating BCAA concentrations by ~50% i.e., baseline 437 ± 60 to 217 ± 40 µmol/L (p < 0.005). Individually, both valine (245 ± 33 to 105 ± 23 µmol/L; p < 0.0001), and leucine (130 ± 20 to 75 ± 13 µmol/L; p < 0.05), decreased significantly in response to the BCAA-restricted diet. The BCAA-restricted diet marginally lowered Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) levels: baseline 1.5 ± 0.2 to 1.0 ± 0.1; (p = 0.096). We successfully lowered circulating BCAAs by 50% while maintaining iso-nitrogenous, iso-caloric dietary intakes, and while meeting the recommended daily allowances (RDA) for protein requirements. The present pilot study represents a novel dietary means by which to reduce BCAA, and as such, provides a blueprint for a potential dietary therapeutic in obesity/diabetes.     

Association of Dietary Sugars and Sugar-Sweetened Beverage Intake with Obesity in Korean Children and Adolescents

Few studies have examined the association between dietary sugar intake and obesity in Asian children and adolescents. We evaluated the association of dietary sugar intake and its food source with obesity in Korean children and adolescents. In this cross-sectional analysis, data were obtained from five studies conducted between 2002 and 2011. The study included 2599 children and adolescents who had completed more than three days of dietary records and had anthropometric data. Total sugar intake was higher in girls than in boys (54.3 g for girls and 46.6 g for boys, p < 0.0001). Sugar intake from milk and fruits was inversely associated with overweight or obesity in girls only (OR for overweight, 0.52; 95% CI, 0.32–0.84; p for trend = 0.0246 and OR for obesity, 0.42; 95% CI, 0.23–0.79; p for trend = 0.0113). Sugar-sweetened beverage (SSB) consumption was not associated with obesity in girls, while boys had lower odds ratios for obesity (OR for obesity, 0.52; 95% CI, 0.26–1.05; p for trend = 0.0310). These results suggest that total sugars and SSB intake in Asian children and adolescents remains relatively low and sugar intake from milk and fruits is associated with a decreased risk of overweight or obesity, especially in girls.     

Trends in sodium intake and major contributing food groups and dishes in Korea: the Korea National Health and Nutrition Examination Survey 2013–2017

BACKGROUND/OBJECTIVESExcess intake of dietary sodium, either directly or indirectly, increases the risk of several diseases, including cardio-cerebral vascular diseases such as stroke and hypertension. Excessive sodium intake and increased prevalence of hypertension have emerged as major issues worldwide. Therefore, the present study evaluated the recent trends in dietary sodium intake and the food sources of sodium intake in the Korean population using the Korea National Health and Nutrition Examination Survey (KNHANES, 2013–2017) data.SUBJECTS/METHODSThis study used the one-day 24-h recall dietary intake survey data from the 2013–2017 KNHANES to determine the average daily sodium intake by sex and age and the main dishes and food groups contributing to the dietary sodium intake.RESULTSThe mean sodium intake range was 3,477.2–3,889.6 mg/day during 2013–2017. The major food groups contributing to sodium intake were seasonings (1,597.5–1,870.5 mg/day), vegetables (680.4–756.7 mg/day), and cereal and grains (573.2–609.4 mg/day). Noodles and dumplings (536.7–573.2 mg/day), kimchi (487.3–539.6 mg/day), and soups (367.6–428.9 mg/day) were the top three dish groups that contributed to the sodium intake. In these dishes, the major sources of sodium intake were ramyeon (age groups 10–18 and 19–29 yrs), baechukimchi (age groups 40–49 and 50–59 yrs) and doenjang-kuk (age groups 60–69 and ≥ 70 yrs), respectively.CONCLUSIONSIn summary, reducing the consumption of soups and kimchi is an effective way to reduce sodium intake. Personalized nutrition education on dietary sodium intake management is required because of the different food sources contributing to the sodium intake according to the subjects'' age.     

Relationship Between Calcium Intake and Impaired Activities of Daily Living in a Japanese Population: NIPPON DATA90

BackgroundMajor reasons for long-term care insurance certification in Japan are stroke, dementia, and fracture. These diseases are reported to be associated with calcium intake. This study examined the association between calcium intake and impaired activities of daily living (ADL) using the data from NIPPON DATA90, consisting of representative sample of the Japanese population.MethodsA population-based nested case-control study was performed. A baseline survey was conducted in 1990, followed by ADL surveys of individuals ≥65 years old in 2000. Individuals with impaired ADL and selected age- and sex-matched controls were then identified. We obtained 132 pairs. Calcium intake was energy-adjusted using the residual method. The association between calcium intake and impaired ADL was examined using conditional logistic regression models. To assess the accuracy of the estimates, we conducted bootstrap analyses.ResultsThe adjusted odds ratios (ORs) for impaired ADL compared with the group with a calcium intake of <476 mg/day were 0.72 (95% confidence interval [CI], 0.37–1.40) for the 476–606 mg/day group and 0.44 (95% CI, 0.21–0.94) for the ≥607 mg/day group in 2000 (P for linear trend = 0.03). After the bootstrap analyses, the inverse relationship unchanged (median OR per 100-mg rise in calcium intake, 0.87 [1,000 resamplings]; 95% CI, 0.76–0.97).ConclusionsAfter bootstrap analyses, calcium intake was inversely associated with impaired ADL 10 years after the baseline survey.Key words: bootstrap analyses, calcium intake, impaired activities of daily living, nested case-control study, NIPPON DATA90     

Dietary Calcium Intake and Fat Mass in Spanish Young Adults: The Role of Muscle Strength

Obesity is declared as a chronic multifaceted health problem, and young adults may be particularly vulnerable to weight gain. This study aims to identify the role of dietary calcium intake and the muscle strength index in handling excess of fat mass in young adults and to examine if the relationship between dietary calcium intake and fat mass percentage is mediated by muscle strength. A cross-sectional study including 355 Spanish college students (aged 21.05 ± 3.11) was performed during the 2017–2018 academic year. Pearson correlation coefficients were estimated to determine the relationship between dietary calcium intake, fat mass percentage, body mass index, muscle strength components, and total energy intake. ANCOVA models were used to analyze the differences in the muscle strength index by total dietary calcium intake categories, as well as the differences in % fat mass by total dietary calcium intake and muscle strength index categories, controlling for different sets of confounders. A mediator analysis was conducted to test if the relationship between dietary calcium intake and fat mass percentage was explained by muscle strength. Data on the fat mass percentage, dietary calcium intake, and muscle strength index as the sum of the standardized z-score of the standing long jump and z-score of handgrip/weight were collected. The muscle strength index was significantly better in young adults with higher dietary calcium intake. Moreover, the fat mass percentage was significantly lower in those with a higher dietary calcium intake and a better muscle strength index. Finally, the relationship between dietary calcium intake and fat mass percentage was fully mediated by muscle strength (z = −1.90; p < 0.05), explaining 33.33% of this relationship. This study suggests that both a major dietary calcium intake and muscle strength are associated with fat mass percentage. Moreover, muscle strength mediates the link between dietary calcium intake and fat mass percentage. Therefore, both high dietary calcium intake and exercise activities aimed at improving muscle strength levels may help to prevent the cardiometabolic risk associated with an excess of fat mass in young people.