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Background: A meal rich in saturated fatty acids induces a postprandial metabolic challenge. The type of dietary protein may modulate postprandial metabolism.Objective: We studied the effect of dietary protein type on postprandial changes in the metabolome after a high-fat meal.Methods: In a 3-period, crossover, postprandial study, 10 healthy overweight men with an elevated waist circumference (>94 cm) ingested high-fat meals made up of cream fat (70% of energy), sucrose (15% energy), and protein (15% energy) from either casein (CAS), whey protein (WHE), or α-lactalbumin-enriched whey protein (LAC). Urine collected immediately before and 2, 4, and 6 h after the meal was analyzed for metabolomics, a secondary outcome of the clinical study. We used mixed-effect models, partial least-square regression, and pathway enrichment analysis.Results: At 4 and 6 h after the meal, the postprandial metabolome was found to be fully discriminated according to protein type. We identified 17 metabolites that significantly explained the effect of protein type on postprandial metabolomic changes (protein-time interaction). Among this signature, acylcarnitines and other acylated metabolites related to fatty acid or amino acid oxidation were the main discriminant features. The difference in metabolic profiles was mainly explained by urinary acylcarnitines and some other acylated products (protein type, Ps < 0.0001), with a dramatically greater increase (100- to 1000-fold) after WHE, and to a lesser extent after LAC, as compared with CAS. Pathway enrichment analysis confirmed that the type of protein had modified fatty acid oxidation (P < 0.05).Conclusion: Taken together, our results indicate that, in healthy overweight men, the type of protein in a high-fat meal interplays with fatty acid oxidation with a differential accumulation of incomplete oxidation products. A high-fat meal containing WHE, but not CAS, resulted in this outpacing of the tricarboxylic acid cycle. This study was registered at clinicaltrials.gov as NCT00931151. [ABSTRACT FROM AUTHOR]

Background: Fructose feeding in the context of high energy intake is recognized as being responsible for metabolic dysregulation. However, its consumption in the postabsorptive state might contribute to reducing the use of amino acids (AAs) as energy substrates and thus spare nitrogen resources, which could be beneficial during catabolic states.Objective: We hypothesized that fructose feeding during a catabolic situation corresponding to protein-energy restriction (PER) in older rats would reduce AA utilization for energy purposes, thus slowing down the loss of body weight (BW) and improving body composition.Methods: For 45 d, 22-mo-old male Wistar rats (average weight: 716 g) were fed a control ration (13% protein) either at normal (20 g/d), restricted (PER: 10 g/d), or at PER levels supplemented with glucose (3 g/d) or fructose (3 g/d) and then studied in the postabsorptive state. We measured BW, body composition, and enzyme activities and metabolite concentrations related to glucose, fructose, and AA metabolism.Results: Both glucose and fructose feeding reduced PER-induced loss of BW and lean mass (-27% compared with PER), but only fructose reduced the loss of fat mass (-28% compared with PER). Fructose feeding prevented the PER-induced loss of muscle and intestinal mass. Fructose feeding also reduced circulating branched-chain AA concentrations by 50% (compared with PER) and increased those of alanine (+65% compared with PER). A reduction in hepatic enzymes related to AA catabolism was also observed during fructose feeding (compared with PER), whereas glycogen concentrations were enhanced in both intestine (+300%) and muscle (+21%).Conclusions: We showed that in PER older rats, fructose feeding improved body composition and the weight of several organs by reducing AA catabolism and utilization for energy production and liver autophagy potential. This could be advantageous in sparing body proteins, particularly during catabolic states, such as those related to malnutrition during aging. [ABSTRACT FROM AUTHOR]

Background: Meat cooking conditions in in vitro and in vivo models have been shown to influence the rate of protein digestion, which is known to affect postprandial protein metabolism in the elderly. Objective: The present study was conducted to demonstrate the effect of cooking conditions on meat protein assimilation in the elderly. We used a single-meal protocol to assess the meat protein absorption rate and estimate postprandial meat protein utilization in elderly subjects. Design: The study recruited 10 elderly volunteers aged 70-82 y. Each received, on 2 separate occasions, a test meal exclusively composed of intrinsically 15N-labeled bovine meat (30 g protein), cooked at 55°C for 5 min [rare meat (RM)] or at 90°C for 30 min [fully cooked meat (FCM)], and minced. Whole-body fluxes of leucine, before and after the meal, were determined with the use of a [1-13C]leucine intravenous infusion. Meat protein absorption was recorded with the use of 15N enrichment of amino acids. Results: Postprandial time course observations showed a lower concentration in the plasma of indispensable amino acids (P < 0.01), a lower entry rate of meat leucine in the plasma (P < 0.01), and a lower contribution of meat nitrogen to plasma amino acid nitrogen (P < 0.001), evidencing lower peripheral bioavailability of meat amino acids with RM than with FCM. This was associated with decreased postprandial whole-body protein synthesis with RM than with FCM (40% compared with 56% of leucine intake, respectively; P < 0.01). Conclusions: Whereas meat cooking conditions have little effect on postprandial protein utilization in young adults, the present work showed that the bioavailability and assimilation of meat amino acids in the elderly is lower when meat is poorly cooked. In view to preventing sarcopenia, elderly subjects should be advised to favor the consumption of well-cooked meat. This trial was registered at clinicaltrials.gov as NCT02157805. [ABSTRACT FROM AUTHOR]

Background: Today, high chronic intake of added sugars is frequent, which leads to inflammation, oxidative stress, and insulin resistance. These 3 factors could reduce meal-induced stimulation of muscle protein synthesis and thus aggravate the age-related loss of muscle mass (sarcopenia). Objectives: Our aims were to determine if added sugars could accelerate sarcopenia and to assess the capacity of antioxidants and anti-inflammatory agents to prevent this. Methods: For 5 mo, 16-mo-old male rats were starch fed (13% sucrose and 49% wheat starch diet) or sucrose fed (62% sucrose and 0% wheat starch diet) with or without rutin (5 g/kg diet), vitamin E (4 times), vitamin A (2 times), vitamin D (5 times), selenium (10 times), and zinc (+44%) (R) supplementation. We measured the evolution of body composition and inflammation, plasma insulin-like growth factor 1 (IGF-I) concentration and total antioxidant status, insulin sensitivity (oral-glucose-tolerance test), muscle weight, superoxide dismutase activity, glutathione concentration, and in vivo protein synthesis rates. Results: Sucrose-fed rats lost significantly more lean body mass (28.1 % vs. 25.4%, respectively) and retained more fat mass (+0.2% vs. 233%, respectively) than starch-fed rats. Final muscle mass was 11 % higher in starch-fed rats than in sucrose-fed rats. Sucrose had little effect on inflammation, oxidative stress, and plasma IGF-I concentration but reduced the insulin sensitivity index (divided by 2). Meal-induced stimulation of muscle protein synthesis was significantly lower in sucrose-fed rats (+7.3%) than in starch-fed rats (+22%). R supplementation slightly but significantly reduced oxidative stress and increased muscle protein concentration (+4%) but did not restore postprandial stimulation of muscle protein synthesis. Conclusions: High chronic sucrose intake accelerates sarcopenia in older male rats through an alteration of postprandial stimulation of muscle protein synthesis. This effect could be explained by a decrease of insulin sensitivity rather than by changes in plasma IGF-I, inflammation, and/or oxidative stress. [ABSTRACT FROM AUTHOR]

The high requirement of the gut for threonine has often been ascribed to the synthesis of mucins, secreted threonine-rich glycoproteins protecting the intestinal epithelium from injury. This requirement could be even greater during intestinal inflammation, when mucin synthesis is enhanced. In this study, we used an animal model to investigate the effects of an acute ileitis on threonine splanchnic fluxes. Eight adult multi-catheterized minipigs were fed with an enteral solution. Four of them were subjected to experimental ileitis involving direct administration of trinitrobenzene sulfonic acid (TNBS) into the ileum (TNBS-treated group) and the other 4 were not treated (control group). Threonine fluxes across the portal-drained viscera (PDV) were quantified with the use of simultaneous i.g. L-[15Nithreonine and iv. L-[U-13C]threonine infusions. Ileal mucosa was sampled for mucin fractional synthesis rate measurement, which was greater in the TNBS-treated group (114 ± 15%/d) than in the control group (61 ± 8%/d) (P= 0.021). The first-pass extraction of dietary threonine by the PDV and liver did not differ between groups and accounted for ∼27 and 10% of the intragastric delivery, respectively. PDV uptake of arterial threonine increased from 25 ± 14 μmol·kg-1· h-1 in the control group to 171 ± 35 μmoI·kg-1· h-1 in the TNBS-treated group (P < 0.001). In conclusion, ileitis increased intestinal mucin synthesis and PDV utilization of threonine from arterial but not luminal supply. This leads to the mobilization of endogenous proteins to meet the increased threonine demand associated with acute intestinal inflammation. [ABSTRACT FROM AUTHOR]

Aging is characterized by a progressive loss of muscle mass that could be partly explained by a defect in the anabolic effect of food intake. We previously reported that this defect resulted from a decrease in the protein synthesis response to leucine in muscles from old rats. Because aging is associated with changes in oxidative status, we hypothesized that reactive oxygen species-induced oxidative damage may be involved in the impairment of the anabolic effect of leucine with age. The present study assessed the effect of antioxidant supplementation on leucine-regulated protein metabolism in muscles from adult and old rats. Four groups of 8-and 20-mo-old male rats were supplemented or not for 7 wk with an antioxidant mixture containing rutin, vitamin E, vitamin A, zinc, and selenium. At the end of supplementation, muscle protein metabolism was examined in vitro using epitrochlearis muscles incubated with increasing leucine concentrations. In old rats, the ability of leucine to stimulate muscle protein synthesis was significantly decreased compared with adults. This defect was reversed when old rats were supplemented with antioxidants. It was not related to increased oxidative damage to 70-kDa ribosomal protein S6 kinase that is involved in amino acid signaling. These effects could be mediated through a reduction in the inflammatory state, which decreased with antioxidant supplementation. Antioxidant supplementation could benefit muscle protein metabolism during aging, but further studies are needed to determine the mechanism involved and to establish if it could be a useful nutritional tool to slow down sarcopenia with longer supplementation. [ABSTRACT FROM AUTHOR]

Abstract: We examined the role of vagus nerves in the transmission of the portal glucose signal in conscious dogs. At time 0, somatostatin infusion was started along with intraportal insulin and glucagon at 4-fold basal and basal rates, respectively. Glucose was infused via a peripheral vein to create hyperglycemia (≃2 fold basal). At t = 90, hollow coils around the vagus nerves were perfused with −10°C or 37°C solution in the vagally cooled (COOL) and sham-cooled (SHAM) groups, respectively (n = 6 per group). Effectiveness of vagal blockade was demonstrated by increase in heart rate during perfusion in the COOL vs SHAM groups (183 ± 3 vs 102 ± 5 beats per minute, respectively) and by prolapse of the third eyelid in the COOL group. Arterial plasma insulin (22 ± 2 and 24 ± 3 μU/mL) and glucagon (37 ± 5 and 40 ± 4 pg/mL) concentrations did not change significantly between the first experimental period and the coil perfusion period in either the SHAM or COOL group, respectively. The hepatic glucose load throughout the entire experiment was 46 ± 1 and 50 ± 2 mg · kg−1 · min−1 in the SHAM and COOL groups, respectively. Net hepatic glucose uptake (NHGU) did not differ in the SHAM and COOL groups before (2.2 ± 0.5 and 2.9 ± 0.8 mg · kg−1 · min−1, respectively) or during the cooling period (3.0 ± 0.5 and 3.4 ± 0.6 mg · kg−1 · min−1, respectively). Likewise, net hepatic glucose fractional extraction and nonhepatic glucose uptake and clearance were not different between groups during coil perfusion. Interruption of vagal signaling in the presence of hyperinsulinemia and hyperglycemia resulting from peripheral glucose infusion did not affect NHGU, further supporting our previous suggestion that vagal input to the liver is not a primary determinant of NHGU. [Copyright &y& Elsevier]

Acute leucine supplementation of the diet has been shown to blunt defects in postprandial muscle protein metabolism in old rats. This study was undertaken to determine whether the effect of leucine persists in a 10-d experiment. For this purpose, adult (9 mo) and old (21 mo) rats were fed a semiliquid 18.2 g/100 g protein standard diet during the 8-h dark period for 1 mo. Then, each group was given either a leucine-supplemented meal or an alanine-supplemented meal (as the control meal) for 1 h and the standard diet the rest of the feeding period. On d 10, rats were fed either no food (postabsorptive group) or the supplemented meal for 1 h. Muscle protein synthesis was assessed in vivo 90-120 min after meal distribution using the flooding dose method (1-(13)C phenylalanine). Leucinemia was similar in rats of both ages in the postabsorptive state. Postprandial plasma leucine concentrations were one- to twofold greater after the leucine meal than after the control meal. In the postabsorptive state, leucine supplementation did not modify the muscle protein synthesis rate in old rats but enhanced it to the postprandial rate in adult rats. As expected, muscle protein synthesis was stimulated by the control meal in adult rats but not in old rats. The leucine meal restored this stimulation in old rats but did not further stimulate muscle protein synthesis in adult rats. In conclusion, the beneficial effect of leucine supplementation on postprandial muscle protein anabolism persists for at least 10 d. The long-term utilization of leucine-rich diets may therefore limit muscle protein wasting during aging. [ABSTRACT FROM AUTHOR]

Aging induces a dysregulation of immune and inflammation functions that may affect protein synthesis rates in lymphoid tissue and plasma proteins. We quantified in vivo synthesis rates of thymus, spleen and plasma proteins, including albumin and acute phase proteins, in adult (8 mo old) and old (22 mo old) rats using the flooding dose method [L-(1-(13)C) phenylalanine]. Immunosenescence was reflected by thymus atrophy and spleen hypertrophy in old rats but not in adult rats. A low albumin plasma level associated with high concentrations of fibrinogen, alpha(2)-macroglobulin, alpha(1)-acid glycoprotein and proteins other than albumin revealed a low grade inflammation in old rats. Protein fractional synthesis rates (FSR) and protein synthesis efficiencies of thymus were 29 and 26% lower in old than in adult rats, respectively; these variables did not differ in spleen. Protein absolute synthesis rates (ASR) of the thymus and spleen were 76% lower and 67% greater in old than adult rats, respectively. The FSR and ASR of albumin and other plasma proteins were greater in old than in adult rats. Protein synthesis measurement is a valuable nonimmunological tool to assess, in vivo, immune and inflammatory variables. Alterations in secondary lymphoid organs and plasma protein synthesis may contribute to the significant repartitioning of amino acids in old compared with adult rats and may be involved in sarcopenia. [ABSTRACT FROM AUTHOR]

Muscle loss during aging could be related to a lower sensitivity of muscle protein synthesis to feeding. To overcome this decrease without increasing protein intake, we proposed to modulate the daily protein feeding pattern. We showed that consuming 80% of dietary proteins at noon (pulse pattern) improved nitrogen balance in elderly women. The present study was undertaken in rats to determine which tissues are the targets of the pulse pattern and what mechanisms are involved. Male Sprague-Dawley 11- and 23-mo-old rats (n = 32 per age) were fed 4 isoproteic (18% protein) meals/d for 10 d. Then half of the rats at each age were switched to a 11/66/11/11% repartition of daily proteins (pulse pattern) for 21 d. On d 21, rats were injected with a flooding dose of L-(13)C-valine (50 atom% excess, 150 micromol/100 g body) and protein synthesis rates were measured in liver, small intestine and gastrocnemius muscle in either the postabsorptive or the fed state. Epitrochlearis muscle degradation rates and plasma amino acid concentrations were measured at the same times. The pulse pattern had the following effects: 1) it significantly increased liver protein synthesis response to feeding and postprandial plasma amino acid concentrations at both ages; 2) it restored a significant response to feeding of gastrocnemius muscle protein synthesis in old rats; and 3) it had no effect in small intestine or on muscle breakdown. Thus, using a pulse pattern could be useful in preventing the age-related loss of muscle by increasing feeding-induced stimulation of muscle protein synthesis. [ABSTRACT FROM AUTHOR]

Aging is characterized by a progressive loss of muscle mass. A decrease of muscle protein synthesis stimulation has been detected in the postprandial state and correlated to a decrease of muscle protein synthesis sensitivity to leucine in vitro. This study was undertaken to examine the effect of a leucine-supplemented meal on postprandial (PP) muscle protein synthesis during aging. Adult (8 mo old) and old (22 mo old) rats were fed a semiliquid 18.2% protein control diet for 1 mo. The day of the experiment, rats received no food (postabsorptive group) or either an alanine or leucine-supplemented meal for 1 h (postprandial groups: PP and PP + Leu groups, respectively). Muscle protein synthesis was assessed in vivo 90-120 min after the meal distribution using the flooding dose method (1-(13)C phenylalanine). Plasma leucine concentrations were significantly greater in the PP + Leu group compared with the PP group at both ages. Muscle protein synthesis was significantly greater in the adult PP group, whereas it was not stimulated in the old PP group. When supplemented with leucine, muscle protein synthesis in old rats was stimulated and similar to that observed in adults. We conclude that acute meal supplementation with leucine is sufficient to restore postprandial stimulation of muscle protein synthesis in old rats. Whether chronic leucine meal supplementation may limit muscle protein wasting during aging remains to be verified. [ABSTRACT FROM AUTHOR]

Aging is characterized by a decrease of muscle mass associated with a decrease in postprandial anabolism. This study was performed to gain a better understanding of the intracellular mechanisms involved in the stimulation of muscle protein synthesis by amino acids and their role in the decrease of muscle sensitivity to food intake during aging. The effects of amino acids or leucine alone were assessed in vitro on epitrochlearis muscle from young, adult and old rats. Protein synthesis was assessed by incorporation of radiolabeled phenylalanine into protein and p70 S6 kinase activity by incorporation of (32)P into a synthetic substrate. Amino acids, at physiologic concentrations, stimulated muscle protein synthesis (P < 0.05) and leucine reproduced this effect. The intracellular targets of amino acids were phosphatidylinositol 3' kinase and the rapamycin-sensitive pathways mammalian target of rapamycin (mTOR)/p70 S6 kinase. In old rats, the sensitivity of muscle protein synthesis to leucine was lower than in adults (P < 0.05) and this paralleled the lesser ability of leucine to stimulate the rapamycin-sensitive pathways (P < 0.05). We demonstrated that amino acids and leucine stimulate muscle protein synthesis and that aging is associated with a decrease in this effect. However, because aged rats are still able to respond normally to high leucine concentrations, we hypothesize that a nutritional manipulation increasing the availability of this amino acid to muscle could be beneficial in maintaining the postprandial stimulation of protein synthesis. [ABSTRACT FROM AUTHOR]

Whereas reactive oxygen species (ROS) can have opposite impacts on insulin signaling, they have mainly been associated with mitochondrial dysfunction in skeletal muscle. We analyzed the relationship between these three features in skeletal muscle of senescence accelerated mice (SAM) prone (P8), which are characterized by enhanced oxidative stress compared to SAM resistant (R1). Oxidative stress, ROS production, antioxidant system, mitochondrial content and functioning, as well as in vitro and in vivo insulin signaling were investigated in gastrocnemius and quadriceps muscles. In SAMP8 compared to SAMR1, muscle content in carbonylated proteins was two-fold (p < 0.01) and ROS production by xanthine oxidase 70% (p < 0.05) higher. Furthermore, insulin-induced Akt phosphorylation measured in vivo and ex vivo as well as muscle glucose uptake measured ex vivo were significantly higher (p < 0.05). Mitochondrial respiration evidenced uncoupling and higher respiration rates with substrates of complexes II and IV, in agreement with higher maximal activity of complexes II and IV (+ 18% and 62%, respectively, p < 0.05). By contrast, maximal activity of complex I was 22% lower (p < 0.05). All strain differences were corrected after 6 months of N-acetylcysteine (NAC) treatment, thus supporting the involvement of high ROS production in these differences. In conclusion in muscle of SAMP8 compared to SAMR1, high ROS production is associated to higher insulin sensitivity and glucose uptake but to lower mitochondrial complex I activity. These conflicting adaptations, with regards to the resulting imbalance between NADH production and use, were associated with intrinsic adjustments in the mitochondrial respiration chain (mitochondrial uncoupling, enhanced complexes II and IV activity). We propose that these bioenergetics adaptations may help at preserving muscle metabolic flexibility of SAMP8. [ABSTRACT FROM AUTHOR]

Abstract: Insulin resistance (IR) constitutes the most important feature of the metabolic syndrome, whose prevalence is highly associated to the consumption of Western diets. Resistant starch (RS) consumption has been shown to have beneficial metabolic effects, including improved insulin sensitivity, and glucose and lipid homeostasis. However, the mechanisms (especially at the molecular level) by which this takes place are still not completely known. In the present study, we aimed to evaluate the role of the liver in the ameliorated high-fat (HF)-induced IR status by RS. Thus, three groups of rats were fed either a control diet, or an HF diet containing or not RS. After 9 weeks of feeding, we evaluated the whole-body insulin sensitivity, and the hepatic glucose and lipid metabolism at the biochemical and molecular levels and the metabolome of the cecum content. We demonstrated for the first time that at least part of the beneficial effects of RS consumption in the context of an HF feeding can be driven by changes elicited at the hepatic level. The ability of the RS to correct the HF-induced dyslipidemia and the associated IR resulted from the return to the basal expression levels of transcription factors involved in lipogenesis (SREBP-1c), cholesterol metabolism (SREBP-2, LXRs) and fatty acid oxidation (PPARα). Moreover, the RS feeding was able to correct the HF-induced reduction in hepatic glucose phosphorylation and muscle glucose transport, improving glucose tolerance. Finally, as a whole, the improved hepatic metabolism seemed to be the result of an ameliorated inflammatory status. [Copyright &y& Elsevier]

Abstract: One of the most important effects of aging is sarcopenia, which is associated with impaired locomotion and general weakness. In addition, there is increased susceptibility to illness in aging, which often results in muscle wasting episodes. In such instances, the mobilization of muscle proteins provides free amino acids that are used for energetic purpose, the synthesis of acute phase proteins, and the immune response. However, since muscle protein mass is already depleted, the ability of the aged organism to recover from stress is impaired. Therefore, elucidating the mechanisms that result in sarcopenia is of obvious importance. Age-related changes in protein synthesis and proteolysis are rather small and our current methodology does not enable one to establish unequivocally whether sarcopenia results from depressed protein synthesis, increased proteolysis or both. By contrast, in anabolic and catabolic periods, a number of dysregulations in muscle protein turnover became clearly apparent. The aim of this review is to provide an overview of such altered responses to nutrients and catabolic treatments, which may ultimately contribute to explain sarcopenia. This includes impaired recovery in catabolic states, impaired anabolic effects of nutrients, in particular leucine, and a lack of regulation of the ubiquitin-proteasome proteolytic system. These alterations are discussed with respect to modifications in the insulin/IGF-1 axis and glucocorticoid related effects. [Copyright &y& Elsevier]

Obesity induced by overfeeding ultimately can lead to nonalcoholic fatty liver disease, whereas dietary fiber consumption is known to have a beneficial effect. We aimed to determine if a supplementation of a mix of fibers (inulin, resistant starch and pectin) could limit or alleviate overfeeding-induced metabolic perturbations. Twenty female minipigs were fed with a control diet (C) or an enriched fat/sucrose diet supplemented (O + F) or not (O) with fibers. Between 0 and 56 days of overfeeding, insulin (+88%), HOMA (+102%), cholesterol (+45%) and lactate (+63%) were increased, without any beneficial effect of fibers supplementation. However, fibers supplementation limited body weight gain (vs. O, -15% at D56) and the accumulation of hepatic lipids droplets induced by overfeeding. This could be explained by a decreased lipids transport potential (-50% FABP1 mRNA, O + F vs. O) inducing a down-regulation of regulatory elements of lipids metabolism / lipogenesis (-36% SREBP1c mRNA, O + F vs. O) but not to an increased oxidation (O + F not different from O and C for proteins and mRNA measured). Glucose metabolism was also differentially regulated by fibers supplementation, with an increased net hepatic release of glucose in the fasted state (diet × time effect, P<.05 at D56) that can be explained partially by a possible increased glycogen synthesis in the fed state (+82% GYS2 protein, O + F vs. O, P=.09). The direct role of short chain fatty acids on gluconeogenesis stimulation is questioned, with probably a short-term impact (D14) but no effect on a long-term (D56) basis. [ABSTRACT FROM AUTHOR]

Highlights • We made a systematic review of non-pharmacological interventions in malnourished older people. • Relevant nutritional and clinical outcomes were agreed by a wide panel of experts in nutrition and geriatrics. • We included 19 studies from 17 systematic reviews after reviewing 7984 references. • Our findings were negative: we did not find high quality evidence on interventions to treat malnutrition in older people. • High quality research studies are urgently needed in this area. Abstract Introduction We aimed to perform a review of SRs of non-pharmacological interventions in older patients with well-defined malnutrition using relevant outcomes agreed by a broad panel of experts. Methods PubMed, Cochrane, EMBASE, and CINHAL databases were searched for SRs. Primary studies from those SRs were included. Quality assessment was undertaken using Cochrane and GRADE criteria. Results Eighteen primary studies from seventeen SRs were included. Eleven RCTs compared oral nutritional supplementation (ONS) with usual care. No beneficial effects of ONS treatment, after performing two meta-analysis in body weight changes (six studies), mean difference: 0.59 (95%CI -0.08, 1.96) kg, and in body mass index changes (two studies), mean difference: 0.31 (95%CI -0.17, 0.79) kg/m2 were found. Neither in MNA scores, muscle strength, activities of daily living, timed Up&Go, quality of life and mortality. Results of other intervention studies (dietary counselling and ONS, ONS combined with exercise, nutrition delivery systems) were inconsistent. The overall quality of the evidence was very low due to risk of bias and small sample size. Conclusions This review has highlighted the lack of high quality evidence to indicate which interventions are effective in treating malnutrition in older people. High quality research studies are urgently needed in this area. [ABSTRACT FROM AUTHOR]

[Display omitted] • Texturized wheat proteins with protein digestibility equivalent to meat were developed. • Chickpea and/or free lysine addition during processing improves nutritional quality. • The nutritional quality of the wheat-based product reaches that of texturized soybean. • Accompaniment of the product with quinoa allows a balanced supply in amino acids. The development of plant-based protein foods may facilitate the decrease in animal product consumption in western countries. Wheat proteins, as a starch coproduct, are available in large amounts and are good candidates for this development. We investigated the effect of a new texturing process on wheat protein digestibility and implemented strategies aimed at enhancing the lysine content of the product developed. Protein true ileal digestibility (TID) was determined in minipigs. In a preliminary experiment, the TID of wheat protein (WP), texturized wheat protein (TWP), TWP enriched with free lysine (TWP-L), or with chickpea flour (TWP-CP) was measured and compared to beef meat proteins. In the main experiment, minipigs (n = 6) were fed a dish (blanquette type) containing 40 g of protein in the form of TWP-CP, TWP-CP enriched with free lysine TWP-CP+L, chicken filet, or texturized soy, together with quinoa (18.5 g of protein) in order to improve meal supply of lysine. Wheat protein texturing did not affect total amino acid TID (96.8 % for TWP vs 95.3 % for WP), which was not different from that of beef meat (95.8 %). Chickpea addition did not affect protein TID (96.5 % for TWP-CP vs 96.8 % for TWP). The Digestible Indispensable Amino Acid Score for adults of the dish combining TWP-CP+L with quinoa was 91, whereas it was 110 and 111 for the dishes containing chicken filet or texturized soy. The above results show that, by optimizing lysine content through the formulation of the product, wheat protein texturization can enable the development of protein-rich products of nutritional quality compatible with quality protein intake in the context of a complete meal. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Energy restriction decreases fat mass and fat-free mass. Our aim was to prevent the latter using type and timing of protein nutrition as tools. Methods: Young male Wistar rats were given a high-energy diet for 5 wk and then energy restricted and fed a high-protein diet containing caseins, milk-soluble proteins (MSP), or a casein–MSP mixture (n = 9 per group) as the only source of protein for 3 wk. Food intake was spread over 12 h, whereas in a previous experiment rats consumed their daily ration within 2 to 3 h. Weight and food intake were recorded. The body composition was measured by dual-energy x-ray absorptiometry before and after energy restriction. After 3 wk, the hind-limb muscles, the kidney, intestine, liver, and spleen weights, metabolic plasma parameters, and the liver and extensor digitorum longus muscle protein synthesis rates were measured in the postprandial state. Results: The food intake was similar in all groups. Energy restriction induced a significant decrease in body weight and fat mass (P < 0.001) and stopped the slow growth of lean body mass, with no differences between groups. Among all tissues, a significant effect was detected only for the intestine (P = 0.0012), with a higher weight in the casein group. Postprandial liver and muscle protein synthesis rates were not different between groups. Conclusion: When using a high-protein diet spread over 12 h, the nature of the protein intake has no influence on the sparing of lean body mass during energy restriction in young overweight rats. [Copyright &y& Elsevier]

Abstract: Objective: We aimed to evaluate the effects of resistance exercise (RE) and leucine (LEU) supplementation on dexamethasone (DEXA)-induced muscle atrophy and insulin resistance. Methods: Male Wistar rats were randomly divided into DEXA (DEX), DEXA + RE (DEX-RE), DEXA + LEU (DEX-LEU), and DEXA + RE + LEU (DEX-RE-LEU) groups. Each group received DEXA 5 mg · kg−1 · d−1 for 7 d from drinking water and were pair-fed to the DEX group; LEU-supplemented groups received 0.135 g · kg−1 · d−1 through gavage for 7 d; the RE protocol was based on three sessions of squat-type exercise composed by three sets of 10 repetitions at 70% of maximal voluntary strength capacity. Results: The plantaris mass was significantly greater in both trained groups compared with the non-trained groups. Muscle cross-sectional area and fiber areas did not differ between groups. Both trained groups displayed significant increases in the number of intermediated fibers (IIa/IIx), a decreased number of fast-twitch fibers (IIb), an increased ratio of the proteins phosphoSer2448/total mammalian target of rapamycin and phosphoThr389/total 70-kDa ribosomal protein S6 kinase, and a decreased ratio of phosphoSer253/total Forkhead box protein-3a. Plasma glucose was significantly increased in the DEX-LEU group compared with the DEX group and RE significantly decreased hyperglycemia. The DEX-LEU group displayed decreased glucose transporter-4 translocation compared with the DEX group and RE restored this response. LEU supplementation worsened insulin sensitivity and did not attenuate muscle wasting in rats treated with DEXA. Conversely, RE modulated glucose homeostasis and fiber type transition in the plantaris muscle. Conclusion: Resistance exercise but not LEU supplementation promoted fiber type transition and improved glucose homeostasis in DEXA-treated rats. [Copyright &y& Elsevier]

Abstract: Immobilization is characterized by activation of the ubiquitin (Ub)–proteasome-dependent proteolytic system (UPS) and of the mitochondrial apoptotic pathway. Increased oxidative stress and inflammatory response occur in immobilized skeletal muscles. Curcumin exhibits antioxidant and anti-inflammatory properties, blocked proteasome activation in intact animals, and may favor skeletal muscle regeneration. We therefore measured the effects of curcumin on immobilization-induced muscle atrophy and subsequent recovery. Rats were subjected to hindlimb immobilization for 8 days (I8) and allowed to recover for 10 days (R10). Fifty percent of the rats were injected daily with either curcumin or vehicle. Proteolytic and apoptotic pathways were studied in gastrocnemius muscles. Curcumin treatment prevented the enhanced proteasome chymotrypsin-like activity and the trend toward increased caspase-9-associated apoptosome activity at I8 in immobilized muscles. By contrast, the increase of these two activities was blunted by curcumin at R10. Curcumin did not reduce muscle atrophy at I8 but improved muscle recovery at R10 and the cross-sectional area of muscle fibers of immobilized muscles. Curcumin reduced the increased protein levels of Smac/DIABLO induced by immobilization and enhanced the elevation of X-linked inhibitory apoptotic protein levels at R10. Ub-conjugate levels and caspase-3 activity increased at I8 and were normalized at R10 without being affected by curcumin treatment. Altogether, the data show that curcumin treatment improved recovery during reloading. The effect of curcumin during the atrophic phase on proteasome activities may facilitate the initiation of muscle recovery after reloading. These data also suggest that this compound may favor the initial steps of muscle regeneration. [Copyright &y& Elsevier]

Abstract: Although activation of the mammalian target of rapamycin complex/p70 S6 kinase (S6K1) pathway by leucine is efficient to stimulate muscle protein synthesis, it can also exert inhibition on the early steps of insulin signaling leading to insulin resistance. We investigated the impact of 5-week leucine supplementation on insulin signaling and sensitivity in 4-month old rats fed a 15% protein diet supplemented (LEU) or not (C) with 4.5% leucine. An oral glucose tolerance test was performed in each rat at the end of the supplementation and glucose transport was measured in vitro using isolated epitrochlearis muscles incubated with 2-deoxy-d-[3H]-glucose under increasing insulin concentrations. Insulin signaling was assessed on gastrocnemius at the postabsorptive state or 30 and 60 min after gavage with a nutrient bolus. Tyrosine phosphorylation of IRβ, IRS1 and PI3 kinase activity were reduced in LEU group 30 min after feeding (−36%, −36% and −38% respectively, P<.05) whereas S6K1, S6rp and 4EBP1 phosphorylations were similar. Overall glucose tolerance was reduced in leucine-supplemented rats and was associated with accumulation of perirenal adipose tissue (+27%, P<.05). Conversely, in vitro insulin-response of muscle glucose transport tended to be improved in leucine-supplemented rats. In conclusion, dietary leucine supplementation in adult rats induced a delay in the postprandial stimulation in the early steps of muscle insulin signaling without muscle resistance on insulin-induced glucose uptake. However, it resulted in overall glucose intolerance linked to increased local adiposity. Further investigations are necessary to clearly define the beneficial and/or deleterious effects of chronic dietary leucine supplementation in healthy subjects. [Copyright &y& Elsevier]

Objective: Aged muscle is characterized by a defect in the ability of leucine to stimulate protein synthesis. We showed previously that antioxidant supplementation improved the anabolic response to leucine of old muscle and reduced inflammation. The aim of the present study was to determine if the positive effects observed in muscle could be related to an improvement of local muscle oxidative status. Methods: Two groups of 20-mo-old male Wistar rats were supplemented or not with rutin, vitamin E, vitamin A, zinc, and selenium during 7 wk. We measured body weight, food intake, oxidative status in muscle and other tissues, gastrocnemius muscle proteolytic activities, and liver glutathione metabolism. Results: Antioxidant supplementation had no effect on muscle antioxidant capacity, superoxide dismutase activities, and myofibrillar protein carbonyl content and induced an increase in muscle cathepsin activities. In other tissues, antioxidant supplementation increased liver glutathione (reduced plus oxidized glutathione) content, reduced oxidative damage in the liver and spleen (as measured by γ-keto-aldehyde content), and reduced heart thiobarbituric acid-reactive substances. Conclusion: Our results showed that the positive effects of antioxidant supplementation observed previously on the anabolic response to leucine of old muscle were not directly related to an improvement of in situ muscle oxidative status. It could result from reduced systemic inflammation/oxidative stress. The dialog between muscle and other organs should be studied more thoroughly, especially during aging. [Copyright &y& Elsevier]

Abstract: Aging is characterized by a decline in muscle mass that could be explained by a defect in the regulation of postprandial muscle protein metabolism. This study was undertaken to examine a possible link between the development of low-grade inflammation (LGI) in elderly and the resistance of muscle protein synthesis and degradation pathways to food intake. Fifty-five 20-month-old-rats were studied for 5 months; blood was withdrawn once a month to assess plasma fibrinogen and α2-macroglobulin. Animals were then separated into two groups at 25 months old according to their inflammation status: a control non-inflamed (NI, n=24) and a low-grade inflamed group (LGI, n=23). The day of the experiment, rats received no food or a meal. Muscle protein synthesis was assessed in vivo using the flooding dose method ([1-13C]phenylalanine) and muscle phosphorylation of protein S6 kinase, and protein S6 was measured in gastrocnemius muscle. Muscle proteolysis was assessed in vitro using the epitrochlearis muscle. Postabsorptive muscle protein synthesis and proteolysis were similar in NI and LGI. After food intake, muscle protein synthesis was significantly stimulated in NI but remained unresponsive in LGI. Muscle proteolysis was similar in both groups whatever the inflammation and/or the nutritional status. In conclusion, we showed that development of LGI during aging may be responsible, at least in part, for the defect in muscle protein synthesis stimulation induced by food intake in rats. Our results suggested that the control of LGI development in elderly improve meal effect on muscle protein synthesis and consequently slow down sarcopenia. [Copyright &y& Elsevier]

Abstract: Objective: We previously found that aging was characterized by a decreased sensitivity of muscle protein synthesis to leucine and that a free leucine-supplemented diet corrected this defect in old rats and elderly humans. The present experiment was undertaken to evaluate the efficiency of selected leucine-rich proteins to stimulate postprandial muscle protein synthesis in old rats to optimize nutritional protein support in the elderly. Methods: Sixty rats (22 mo old) received an experimental meal for the first hour of feeding and a standard diet for the rest of the day for 30 d. Experimental meals contained milk proteins that differed in leucine content: β-lactoglobulin (14.5% leucine), Prolacta (13.4%), α-lactalbumin (10.9%), and casein (10%). As a control, a fifth group was added that received herring flour protein (7.3% leucine). Muscle protein synthesis was determined in vivo in the postprandial state at the end of the 30-d nutritional period using the flooding dose method (1-13C phenylalanine). Results: Leucine intake and plasma leucine concentrations were significantly increased in rats fed meals containing the leucine-rich proteins (i.e., β-lactoglobulin and Prolacta). As previously observed with free leucine-supplemented meals, postprandial muscle protein synthesis was significantly improved in rats fed the meals containing the leucine-rich proteins. Interestingly, the beneficial effect was maintained after the 30-d supplementation. Conclusion: The results indicated that leucine-rich proteins were efficient in improving muscle protein synthesis in old rats. Thus, nutritional supplements containing such proteins may be efficient in preventing sarcopenia in the elderly and would represent a safe and optimized nutritional strategy. However, further experiments are necessary to determine the duration of such nutritional support to obtain a significant protein gain in muscle. [Copyright &y& Elsevier]

Abstract: Objective: This study examined the effect of a specific acute postprandial leucine deficiency on skeletal muscle protein synthesis in growing and adult rats. Because the anabolic action of dietary leucine supplementation is controversial, except during aging, we hypothesized that the maximum leucine effect might be already achieved for a normal postprandial rise of leucine. Preventing this rise during the 1- to 3-h period after feeding may reveal the leucine regulation. Methods: On the day of the experiment, rats were fasted (postabsorptive, PA group) or fed for 1 h a control meal (postprandial, control, PP group) or a leucine-poor meal (postprandial, PP-Leu group). Muscle protein synthesis was assessed in vivo, over the 1- to 3-h period after meal distribution, using the flooding dose method (L-1-13C phenylalanine). Results: As expected, the postprandial increase in plasma free leucine was specifically abolished after feeding the leucine-poor meal, whereas all the other plasma free amino acids were roughly at normal postprandial levels. Plasma insulin increased after feeding in young rats but was constant in adult rats. Plasma insulin was similar whatever dietary leucine levels. Rates of muscle protein synthesis were stimulated by feeding in gastrocnemius and soleus muscles from young rats but only in gastrocnemius muscles from adult rats. The PP-Leu group did not differ from the control PP group regarding muscle protein synthesis. Conclusion: The rise in plasma free leucine is not required for the stimulation of muscle protein synthesis during the 1- to 3-h period after feeding young and adult rats, as previously observed in old rats. [Copyright &y& Elsevier]

This experiment was undertaken to examine leucine responsiveness of muscle protein synthesis during dexamethasone treatment and the subsequent recovery in young (4–5 weeks), adult (10–11 months) and old rats (21–22 months). Rats received dexamethasone in their drinking water. The dose and length of the treatment was adapted in order to generate the same muscle atrophy. Protein synthesis was assessed in vitro by incorporation of radiolabelled phenylalanine into proteins at the end of the treatment and after 3 or 7-day recovery. Results showed that dexamethasone did not alter muscle protein synthesis stimulation by leucine in young rats. In contrast, muscles from adult and old rats became totally resistant to leucine. Furthermore, the recovery of leucine responsiveness after dexamethasone withdrawal was slowed down in old rats when compared to younger rats. We concluded that glucocorticoids exert their catabolic action in adult and old rats partly through antagonising the stimulatory effect of leucine and may contribute to sarcopenia in old rats. [Copyright &y& Elsevier]

Leucine has a major anabolic impact on muscle protein synthesis in young as in old animals. However, myosin heavy chain (MHC), sarcoplasmic and mitochondrial proteins may differently respond to anabolic factors, especially during aging. To test this hypothesis, fractional synthesis rates (FSR) of the three muscle protein fractions were measured using a flooding dose of [1-13C] phenylalanine, in gastrocnemius muscle of adult (8 months) and old (22 months) rats, either in postabsorptive state (PA), or 90–120 min after ingestion of a alanine-supplemented meal (PP+A) or a leucine-supplemented meal (PP+L). In adult and old rats, in comparison with PA, leucine stimulated mitochondrial (adult: 0.260±0.011 vs 0.238±0.012% h-1; old: 0.289±0.010 vs 0.250±0.010% h-1; PP+L vs PA, P<0.05) and sarcoplasmic (adult: 0.182±0.011 vs 0.143±0.006% h-1; old: 0.195±0.010 vs 0.149±0.008% h-1; PP+L vs PA, P<0.05) protein FSR, but not MHC synthesis in old rats (0.101±0.009 vs 0.137±0.018% h-1; PP+L vs PA, P=NS).In conclusion, synthesis of specific muscle protein is activated by leucine supplementation, but MHC may be less sensitive to anabolic factors with aging. [Copyright &y& Elsevier]