This study examined meal patterns and protein-rich food utilization in the foodservice practices of public and private geriatric long-term care hospitals in South Korea. Over a period of 6 months, a total of 612 daily menus (306 from each hospital type, breakfast, lunch, and dinner) were collected from four hospitals (two public, two private). Each menu was categorized by meal composition, included staple food, soup, main dish, side dishes, and kimchi. The most common meal pattern consisted of a staple food, soup, main dish, two side dishes, and kimchi. Compared with private hospitals, public hospitals offered a greater variety in meal composition, staple foods, soups, and main dishes. However, no significant differences were observed in protein foods of main dishes. Overall, meat accounted for about half, whereas fish accounted for one-third. Approximately 30% of protein foods in main dishes were processed. In side dish 1, the proportion of protein-rich foods was lower in public than in private hospitals, whereas the proportion of processed foods exceeded two-thirds in both hospital, but was significantly higher in public hospitals. Soup was the second most important protein source after the main dish, with fish as the most often used; however, processed protein foods were also common. These findings indicate that the main dish and soup are the principal protein sources, and the relatively high inclusion of fish reflects a favorable pattern. However, to ensure intake of high-quality proteins by older adults, the high reliance on processed protein foods highlights the need to reconsider foodservice practices.
Protein intake has been identified as a key modifiable factor in preventing and managing sarcopenia, a common age-related condition characterized by the loss of muscle mass, strength, and function. This scoping review aimed to summarize the available literature on the association between protein intake and sarcopenia-related outcomes among Korean older adults and identify current research trends and gaps in this field. The review followed the 5-step methodological framework developed by Arksey and O’Malley for scoping reviews and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist to ensure a comprehensive search strategy. Protein intake was assessed using various methods, including grams per day, grams per kilogram of body weight per day, and intake quartiles. Sarcopenia-related outcomes were categorized into 3 domains as follows: muscle mass, strength, and physical performance. Although most intervention studies demonstrated improvements in muscle mass following protein supplementation, findings on muscle strength and physical function were inconsistent. Cross-sectional studies generally reported better sarcopenia-related outcomes with higher protein intake, particularly when the intake was expressed relative to body weight or analyzed according to quartiles. However, heterogeneity in protein intake assessments and variations in sarcopenia definitions could have contributed to the inconsistent findings across studies. This review highlights the need for applying standardized approaches for protein intake measurement and sarcopenia diagnosis. Future studies should consider the quantity, quality, and timing of protein intake while also focusing on the implementation of integrated, multidisciplinary intervention strategies to promote healthy aging among Korean older adults.
Exercise, especially when prolonged or highly intense, can temporarily increase inflammation in both trained and untrained individuals. C-reactive protein (CRP) is an established biomarker of inflammation. However, clinical trials assessing the impact of fish oil supplementation on CRP levels in trained individuals have yielded inconsistent and often contradictory results. The main
objective
of this study was to conduct a systematic review of clinical trials exploring the effects of fish oil supplementation on CRP levels among trained individuals. We performed structured searches on the PubMed, Scopus, and ISI Web of Science databases for articles published from the earliest available date until September 2023. Of the 385 articles found and screened, three clinical trials met our criteria for inclusion in this review. The results suggested that fish oil supplementation may help prevent spikes in CRP levels after exercise. However, only one of the three studies produced statistically significant findings. The differences in statistical significance among these studies could be due to variations in the study design, sample populations, dosages, and duration of supplementation. In summary, this systematic review provides evidence that fish oil supplementation can reduce circulating CRP levels in trained individuals. Additional studies with long-term follow-up and larger sample sizes are needed to investigate this effect further.
This systematic review and meta-analysis aimed to evaluate the effectiveness of almond consumption on serum C-reactive protein (CRP) and malondialdehyde (MDA) levels in individuals at risk of cardiovascular disease (CVD). An electronic database search was performed on PubMed, Web of Science, Scopus, and the Cochrane Library from inception through October 2024. Summary effect size measurements were calculated using random effects model estimation and were reported as weighted mean differences (WMDs) along with 95% confidence intervals (CIs). A total of 258 articles were identified, and 13 randomized controlled trials (RCTs) were included in the systematic review and meta-analysis. The meta-analysis of eleven RCTs, which involved a total of 544 participants, indicated that almonds significantly reduced levels of CRP (WMD, −0.28 mg/L; 95% CI, −0.52, −0.04; p = 0.02). However, we found no significant benefit of almond consumption in improving serum MDA levels, and due to the limited number of studies, the examination of MDA was conducted only qualitatively. This study supports the conclusion that almond consumption has favorable effects on CRP levels in individuals with CVD risk factors. More high-quality trials are needed to confirm these findings.
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The purpose of this study was to evaluate the nutritional adequacy of senior-friendly foods sold in Korea, focusing on protein and sodium. This study examined the nutritional content of 170 products with nutritional labels that were sold in online stores in Korea and categorized the products into 93 staple foods (cooked rice, porridge, and mousse) and 77 side-dish and snack foods (braized·steam·roast products, broth, sauces, and snacks). Then, the adequacy of the nutritional content of these foods, focusing on protein and sodium, was evaluated according to product type. The 93 staple products and 77 side-dish products had average serving sizes of 163.27 g and 127.92 g, prices of $3.25 and $2.72, and energy contents of 295.25 kcal and 141.95 kcal, respectively. For staple foods, the energy content was significantly greater in cooked rice, but the protein content and index of nutrition quality (INQ) were significantly greater in mousse. There were no significant differences in sodium content or contribution to adequate intake (AI) by product type, but the sodium INQ was significantly greater in the mousse and porridge. For side-dish foods and snack products, the protein content, contribution to the recommended intake, and INQ were all significantly greater for the braized·steam·roast products. Sauces and braized·steam·roast products were significantly higher in sodium content and contribution to the AI, while broth was significantly higher in sodium INQ. These findings can be used to guide proper product selection and nutritional management that considers the health characteristics of health-vulnerable and elderly people.
Numerous studies have indicated that low levels of serum adiponectin are linked with the development of various chronic diseases. While some recent research has suggested that soy has a positive impact on serum adiponectin levels, the results are inconsistent. Therefore, we aim to conduct a thorough systematic review and meta-analysis of randomized controlled trials (RCTs) that investigate the effects of soy on serum adiponectin levels in adults. The search was conducted until March 2024 on PubMed, Scopus, Web of Science, and Cochrane Library databases to identify RCTs that studied the effects of soy supplementation on serum adiponectin levels. A random-effects model was used to pool the weighted mean differences (WMDs). Ten and nine RCTs were selected for the systematic review and meta-analysis, respectively. After analyzing data from 9 eligible RCTs, it was found that soy supplementation did not significantly impact the concentrations of adiponectin (WMD = −0.24 μg/mL; 95% confidence interval, −1.56 to 1.09; p = 0.72). However, there was significant heterogeneity between the studies (I2 = 89.8%, p < 0.001). Sensitivity analysis showed that overall estimates were not affected by the elimination of any study. We did not observe any evidence regarding publication bias. In conclusion, soy supplementation did not have a significant effect on adiponectin levels in adults. However, further RCTs are needed with longer intervention duration, higher doses, and studies conducted in different countries.
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A randomized, double-blind, placebo-controlled trial was conducted to confirm whether collagen peptide supplementation for 12 week has a beneficial effect on body fat control in older adults at a daily physical activity level. Participants were assigned to either the collagen group (15 g/day of collagen peptide) or the placebo group (placebo drink). Body composition was measured by bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DEXA). In total, 74 participants (collagen group, n = 37; placebo group, n = 37) were included in the final analysis. The collagen group showed a significant reduction in total body fat mass compared with the placebo group, as evidenced by both BIA (p = 0.021) and DEXA (p = 0.041) measurements. Body fat mass and percent body fat of the whole body and trunk reduced at 12 weeks compared with baseline only in the collagen group (whole body: body fat mass, p = 0.002; percent body fat, p = 0.002; trunk: body fat mass, p = 0.001; percent body fat, p = 0.000). Total fat mass change (%) (collagen group, −0.49 ± 3.39; placebo group, 2.23 ± 4.20) showed a significant difference between the two groups (p = 0.041). Physical activity, dietary intake, and biochemical parameters showed no significant difference between the groups. The results confirmed that collagen peptide supplementation had a beneficial effect on body fat reduction in older adults aged ≥ 50 years with daily physical activity level. Thus, collagen peptide supplementation has a positive effect on age-related changes.
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Early prevention of sarcopenia can be an important strategy for muscle maintenance, but most studies target subjects at slightly pre-sarcopenic state. Our previous paper describes the effect of protein supplements rich in leucine and vitamin D on muscle condition, and in this paper, we performed a sub-analysis to evaluate who benefitted the most in terms of improvement in muscle health. A 12-week randomized clinical trial of 120 healthy adults (aged 50 to 80) assigned to an intervention group (n = 60) or control group (n = 60) were analyzed. Subjects in the intervention group received, twice per day, a protein supplement containing (per serving) 800 IU of vitamin D, 20 g of protein (3 g of total leucine), 300 mg of calcium, 1.1 g of fat, and 2.5 g of carbohydrate. The subjects were classified into ‘insufficient’ and ‘sufficient’ groups at 25-hydroxyvitamin D (25[OH]D) value of 30 ng/mL. The skeletal muscle mass index normalized to the square of the skeletal muscle mass (SMM) height (kg/m2) increased significantly in the ‘insufficient group’ difference value of change between weeks 0 and 12 (Δ1.07 ± 2.20; p = 0.037). The SMM normalized by body weight (kg/kg, %) was higher, but not significantly, in the insufficient group (Δ0.38 ± 0.69; p = 0.050). For people with insufficient (serum 25[OH]D), supplemental intake of protein and vitamin D, calcium, and leucine and adequate energy intake increases muscle mass in middle-aged and older adults and would be likely to exert a beneficial effect on muscle health.
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Previous studies have frequently reviewed how different macronutrients affect liver health. Still, no study centered around protein intake and the non-alcoholic fatty liver disease (NAFLD) risk relationship. This study aimed to examine the association between the consumption of total and different sources of protein and NAFLD risk. We allocated 243 eligible subjects to the case and control groups, including 121 incidence cases of NAFLD, and 122 healthy controls. Two groups were matched in age, body mass index, and sex. We evaluated the usual food intake of participants using FFQ. Binary logistic regression was conducted to estimate the risk of NAFLD in relation to different sources of protein intake. The age of participants was 42.7 years on average, and 53.1% were male. We found Higher intake of protein in total (odds ratio [OR], 0.24; 95% confidence interval [CI], 0.11–0.52) was significantly associated with a lower risk of NAFLD, despite adjusting for multiple confounders. in detail, higher tendency to the vegetables (OR, 0.28; 95% CI, 0.13–0.59), grains (OR, 0.24; 95% CI, 0.11–0.52), and nuts (OR, 0.25; 95% CI, 0.12–0.52) as the main sources of protein, were remarkably correlated with lower NAFLD risk. In contrary, increased intake of meat protein (OR, 3.15; 95% CI, 1.46–6.81) was positively associated with a higher risk. Totally, more calorie intake from proteins was inversely associated with lower NAFLD risk. This was more likely when the protein sources were selected less from meats and more from plants. Accordingly, increasing the consumption of proteins, particularly from plants, may be a good recommendation to manage and prevent NAFLD.
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Through a survey on dietary intake of children and adolescents with brain lesions, the present study aimed to analyze the current status of nutrient intake and examine the effect of high-protein nutrient drink on their nutritional and muscle statuses. The study participants were 90 juvenile participants aged 8–19 years, with brain lesions. The participants were provided with a protein nutrient drink for 12 weeks and a questionnaire survey on dietary intake was performed to analyze the level of nutrient intake before and after ingestion. The physical measurements were taken to determine the improvements in nutrient and muscle statuses. The results showed that, before the intake of protein nutrient drink as a supplement, the participants exhibited lower height, weight, and body mass index than those of the standard levels of healthy individuals, and the level of nutrient intake through diet was lower than those of the required and recommended levels of nutrient intake for Koreans. Conversely, after the intake of protein nutrient drink for 12 weeks, the level of nutrient intake and physical statuses such as weight showed significant improvements. In addition, the muscle status had undergone approximately 10% of change during the intervention with no significant difference. Thus, to ensure an adequate level of nutrient supply to children and adolescents with brain lesions, there is an urgent need to develop a guideline of nutrient intake. The findings in this study are expected to serve as the basic data for such guidelines.
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Adequate nutritional support in critically ill patients is important, however, sometimes it has been neglected in perioperative period of patients at surgical intensive care units (SICU). The aim of this study was to investigate whether approaching target calorie intake of surgical patients influences on their clinical outcomes. A total of 279 patients who admitted at SICU in perioperative period from August 2014 to July 2016 at our hospital were analyzed. Demographics, supplied calorie amount and its method, lengths of SICU and hospital stay, and mortality of study population were collected. Among 279 patients, 103 patietns (36.9%) approached target calorie intake during SICU stay. Patients who approached target calorie intake had significantly decreased length of stay in SICU (10.78 ± 11.5 vs. 15.3 ± 9.9, p = 0.001) and hospital (54.52 ± 40.6 vs. 77.72±62.2, p < 0.001), than those did not, however there was no significant difference of mortality (9.7% vs. 8.5%, p = 0.829). Enteral feeding was a significant factor for target calorie achievement (odd ratio [OR], 2.029; 95% confidence interval [CI], 1.096–3.758; p = 0.024) and especially in patients with ≤ 7 days of SICU stay (OR, 4.13; 95% CI, 1.505–11.328; p = 0.006). Target calorie achievement in surgical patients improves clinical outcomes and enteral feeding, especially in early postoperative period would be an effective route of nutrition.
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Selenium (Se) supplementation may decrease the severity of ulcerative colitis (UC) through the activation of genes responsible for immune modulation. The present research was aimed to assess the effect of Se supplementation on the expression of silent information regulator 1 (SIRT1) and peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) in UC patients. In a double-blind randomized parallel clinical trial, 100 patients with mild-to-moderate active UC met inclusion criteria and divided into 2 groups of treatment (50 patients received selenomethionine [200 µg daily]) and placebo (50 patients received placebo [1 capsule daily]) for 10 weeks. The expression rates of SIRT1 and PGC-1α were examined in the peripheral blood mononuclear cell (PBMC) using the real-time polymerase chain reaction. There was no considerable difference in the mean of baseline demographic and clinical characteristics between groups. Also, there were no significant differences in total energy intake, macronutrients, and micronutrients between groups. The SIRT1 gene expression in the Se group was significantly increased compared to the placebo (p < 0.001). An increase in the expression of the PGC-1α gene in the Se group was not statistically significant. It seems that Se supplementation caused a significant decrease in the inflammatory response of the colon by a significant increase in the expression of the SIRT1 gene.
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The purpose of this study was to investigate the relationship between serum tumor markers and dietary intakes in healthy adults to address a nutrition guide for cancer prevention. We analyzed tumor-related markers, carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), prostate-specific antigen (PSA), and cancer antigen 125 (CA125) in serum and daily food and nutrient intakes using a 24-hour recall method in 23 healthy men and 32 healthy women. The average age was 50.7 years for men and 48.9 years for women. There were no significant differences in biochemical tumor markers and food intake between the men and women except energy intake. A significantly positive correlation was found between serum AFP, a biochemical marker of liver cancer, and serum glutamic oxaloacetic transaminase (GOT) and/or glutamic pyruvate transaminase (GPT) in both men and women. CEA had a significant and negative correlation with energy intake for men and food intake in women. PSA, a biomarker of prostate cancer, was significantly and positively correlated with the intake of animal iron and cholesterol in men. CA125, a biomarker of gynecologic cancers, was significantly and positively correlated with meat intake in women. As this study revealed the significant relationship between biochemical tumor markers and dietary factors, further studies are needed to elucidate the underlying mechanism of this relationship.
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Pycnogenol is a standardized extract from the bark of the French maritime pine. The aim of the present systematic review and meta-analysis was to clarify the effect of Pycnogenol supplementation on C-reactive protein (CRP) concentration. To identify eligible studies in order to find clinical trials which examined the effect of Pycnogenol supplementation on the level of CRP in adult participants, PubMed, Scopus, and Google Scholar were systematically searched until December 2017. Mean of CRP was collected to estimate the effect size of the supplementation. Potential sources of heterogeneity were explored by subgroup analysis. Five trials including 324 participants were included in this meta-analysis. Pooled effect size showed significant effect of Pycnogenol supplementation on CRP (−1.22 mg/dL, 95% confidence interval, −2.43, −0.003; I2 = 99%, pheterogeneity < 0.001). When the meta-analysis was subgrouped by dose of Pycnogenol, heterogeneity was attenuated in > 150 mg/d category (I2 = 0.0%, p = 0.42). There was significant difference between-subgroup heterogeneity (p < 0.001). Furthermore, no evidence of publication bias for CRP (p = 0.27, Begg's test and p = 0.62, Egger's test) was seen. Present systematic review and meta-analysis suggested Pycnogenol consumption can decrease the level of CRP and have anti-inflammatory effect. So, Pycnogenol as an anti-inflammatory agent might be a priority in interventions. Further studies with large-scale and better design are needed to confirm this result.
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Chronic inflammation is a major etiology of cancer. Accumulating epidemiological and experimental evidences suggest that intake of high protein diet (HPD) is associated with colitis-associated colon cancer, however, most of the studies were confined in colon. Systemic influence of HPD on inflammation indices in different tissues of an organism has never been studied. We therefore investigated the effect of HPD on mouse skin and colonic inflammation using the well characterized inflammation induction protocol in both tissues (12-
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