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Research has shown that vegetarian diets have a low environmental impact, but few studies have examined the environmental impacts and nutritional adequacy of these diets together, even though vegetarian diets can lead to nutritional issues.Our objective was to optimize and compare 6 types of diets with varying degrees of plant foods (lacto-, ovolacto-, and pescovegetarian diets and diets with low, medium, and high meat content) under nutritional constraints.Consumption data in 30,000 participants were derived from the French NutriNet-Santé cohort using an FFQ. Diets were optimized by a nonlinear algorithm minimizing the diet deviation while meeting multiple constraints at both the individual and population levels: nonincrease of the cost and environmental impacts (as partial ReCiPe accounting for greenhouse gas emissions, cumulative energy demand, and land occupation, distinguishing production methods: organic and conventional), under epidemiologic, nutritional (based on nutrient reference values), and acceptability (according to the diet type) constraints.Optimized diets were successfully identified for each diet type, except that it was impossible to meet the EPA (20:5n-3) + DHA (22:6n-3) requirements in lacto- and ovolactovegetarians. In all cases, meat consumption was redistributed or reduced and the consumption of legumes (including soy-based products), whole grains, and vegetables were increased, whereas some food groups, such as potatoes, fruit juices, and alcoholic beverages, were entirely removed from the diets. The lower environmental impacts (as well as individual indicators) observed for vegetarians could be attained even when nutritional references were reached except for long-chain n-3 (omega-3) fatty acids.A low-meat diet could be considered as a target for the general population in the context of sustainable transitions, although all diets tested can be overall nutritionally adequate (except for n-3 fatty acids) when planned appropriately.This trial was registered at clinicaltrials.gov as NCT03335644.

Water use (WU) and greenhouse gas emissions (GHGe) are two main issues facing food systems. Still, they have rarely been studied together even though they are potentially conflicting because their levers for improvement are not necessarily the same. Data on food-related environmental pressures suggest that GHGe and WU can be improved jointly, but their potential conflicts and trade-offs have not been explored. This is what we studied here by a compromise programming approach, using multi-criteria non-linear optimization under a set of nutritional and epidemiological constraints. We used food consumption data of adults aged 18-64 years (n=1,456) from the French representative study INCA 3 (2014-2015) coupled with food environmental impact data from the Agribalyse ® database. A full range of scenarios was identified by prioritizing the two objectives differently, giving weight from 0% to 100%, by 5-% steps, to GHGe improvement over WU improvement.Overall, we showed that it is possible to achieve significant joint reductions in WU and GHGe relative to their observed values: across the prioritization scenarios, WU reduction ranged from -36% to -14% as its prioritization decreased, while GHGe reduction varied less, from -44 to -52% as its prioritization increased. These joint important reductions in GHGe and WU required the removal of meat consumption (beef, pork, poultry and processed meat), while the consumptions of offal and dairy products remained moderate in order to meet nutrient reference values. However, the consumption of some foods varied according to the priority given to WU over GHGe reductions (namely, vegetables, fruit juice, dairy products, eggs, refined cereal, substitutes, offal and potatoes). Fish, whole grains, and fruit remained more constant due to the epidemiological constraints used. Whatever the scenario, the modeled diets were more plant-based than the observed diet from which they differed significantly (only 23-31% of common food consumptions), and were therefore healthier (63-76% reduction in distance to theoretical minimum risk of chronic disease).To conclude, while focusing solely on WU reduction induces a joint GHGe reduction that is near-maximal, the reverse is not true, showing that there is good alignment but also some divergence between these objectives. This suggests that food systems WU should be better considered in dietary guidelines for healthy and sustainable diet.

International audience; Purpose. While consumer demand for meat substitutes is growing, their varied composition raises questions regarding their nutritional value. We aimed to identify and characterize the optimal composition of a meat substitute that would best improve diet quality after complete meat replacement.Methods. From an average individual representing the dietary intake of French adults (INCA3, n=1125), meat was replaced with an equivalent amount of a mostly pulse-based substitute, whose composition was based on a list of 159 possible plant ingredients and optimized non-linearly to maximize diet quality assessed with the PANDiet score (considering adequacy for 32 nutrients), while taking account of technological constraints and applying nutritional constraints to limit the risk of overt deficiency in 12 key nutrients.Results. The optimized meat substitute contained 13 minimally processed ingredients. When used to substitute meat, the PANDiet score increased by 5.7 points above its initial value before substitution (versus -3.1 to +1.5 points when using other substitutes on the market), mainly because of higher intakes of nutrients that are currently insufficiently consumed (e.g. alpha-linolenic acid, fiber, linoleic acid) and a lower SFA intake. The meat substitute also mostly compensated for the lower provision of some indispensable nutrients to which meat greatly contributed (e.g. vitamin B6, potassium, bioavailable iron), but it could not compensate for bioavailable zinc and vitamin B12. Conclusion. Choosing the correct ingredients can result in a nutritionally highly effective meat substitute that could compensate for reductions in many nutrients supplied by meat while providing key nutrients that are currently insufficiently consumed.

International audience; The dietary shift from animal protein (AP) to plant protein (PP) sources is encouraged for both environmental and health reasons. For instance, PPs are associated with lower cardiovascular and diabetes risks compared with APs, although the underlying mechanisms mostly remain unknown. Metabolomics is a valuable tool for globally and mechanistically characterizing the impact of AP and PP intake, given its unique ability to provide integrated signatures and specific biomarkers of metabolic effects through a comprehensive snapshot of metabolic status. This scoping review is aimed at gathering and analyzing the available metabolomics data associated with PP- and AP-rich diets, and discusses the metabolic effects underlying these metabolomics signatures and their potential implication for cardiometabolic health. We selected 24 human studies comparing the urine, plasma, or serum metabolomes associated with diets with contrasted AP and PP intakes. Among the 439 metabolites reported in those studies as able to discriminate AP- and PP-rich diets, 46 were considered to provide a robust level of evidence, according to a scoring system, especially amino acids (AAs) and AA-related products. Branched-chain amino acids, aromatic amino acids (AAAs), glutamate, short-chain acylcarnitines, and trimethylamine-N-oxide, which are known to be related to an increased cardiometabolic risk, were associated with AP-rich diets, whereas glycine (rather related to a reduced risk) was associated with PP-rich diets. Tricarboxylic acid (TCA) cycle intermediates and products from gut microbiota AAA degradation were also often reported, but the direction of their associations differed across studies. Overall, AP- and PP-rich diets result in different metabolomics signatures, with several metabolites being plausible candidates to explain some of their differential associations with cardiometabolic risk. Additional studies specifically focusing on protein type, with rigorous intake control, are needed to better characterize the associated metabolic phenotypes and understand how they could mediate differential AP and PP effects on cardiometabolic risk.

Background Plant-based substitutes are designed to have the same use as animal-based foods in the diet and could therefore assist the transition toward more plant-based diets. However, their nutritional impact has not been characterized. Objectives We assessed and compared the effects of plant-based substitutes on the nutritional quality of the diet. Methods We simulated separately the substitution of meat, milk, and dairy desserts with 96 plant-based substitutes in the diets of 2121 adults (18-79 y old) from the cross-sectional French Third Individual and National Study on Food Consumption Survey (INCA3; 2014-2015). The quality of initial individual diets and the 203,616 substituted diets was evaluated using the Probability of Adequate Nutrient Intake (PANDiet) scoring system, which assesses the probability of adequate (sufficient and not excessive) nutrient intake; also, nutrient security was evaluated using the SecDiet scoring system, which assesses the risk of overt deficiency. Results Impacts on PANDiet depended on both the food substituted and the types of substitutes. Soy-based substitutes provided a slight improvement in diet quality (0.8% increase of the PANDiet score when substituting meat), whereas cereal-based substitutes resulted in a 1.1% decrease. Globally, substitutions led to better adequacies for fiber, linoleic acid, α-linolenic acid, vitamin E, folate, and SFAs, but lower adequacies regarding vitamin B-12 and riboflavin, as well as bioavailable zinc and iron when substituting meat, and calcium and iodine when substituting milk/dairy desserts. When they substituted dairy products, calcium-fortified substitutes allowed maintenance of calcium adequacy but there was a higher risk of iodine deficiency when substituting dairy, which may warrant iodine fortification. Substitutions modified the energy share of ultra-processed foods from 29% to 27%-40%, depending on the food substituted and the substitute used. Conclusions Plant-based substitutes had a small effect on overall diet quality and heterogeneous impacts on nutrient adequacy and security. Plant-based substitutes that include legumes appear more nutritionally adequate to substitute animal products than do other substitutes.

BackgroundScientific literature about environmental pressures associated with dietary patterns has been considerably growing over the last decade. However, few studies have analyzed the environmental impacts associated with the consumption of ultra-processed food (UPF) and which steps of the food system that contribute most to environmental pressures. The objective of this study was to investigate, in a representative sample of the adult French population, the environmental pressures of diets according to UPF consumption.MethodsThe study was conducted in 2,121 adults of the French nationally representative survey INCA 3. Food intakes were analyzed to define the %UPF (in weight) in the diet according to NOVA classification. Using detailed environmental data of foods of Agribalyse, we could assess the contribution of UPF to 14 indicators of environmental pressure and details those related to the stage of the food consumed: production, processing, storage, packaging, transport and retailing at the food level. The data was described according to quintiles of % of UPF in the diet and analyzed using crude and energy-adjusted models.ResultsCompared to low consumers of UPF (Q1, median UPF= 7%), high consumers (Q5, median UPF= 35%) had a higher energy intake (+22%) which came along with different environmental pressures (e.g. +15% greenhouse gas emissions (GHGe), +17% land use, -7% water use and +8% cumulative energy demand). Higher pressures could be ascribed to higher energy. However, the processing and packaging stages were significant contributor to energy demand. In Q5, contributions of the UPF category to total pressure were 35%, 39%, 28% and 42% for GHGe, water use land use, and energy demand, respectively, while ranging from 11 to 15% in Q1.ConclusionsDiets rich in UPF, compared to low, were overall associated with intensification in GHGe, land use, and energy demand and with higher contribution of post-farm stages, in particular processing regarding energy demand.HighlightsOverall, higher UPF consumption was associated with higher environmental impact, in particular GHGE and land useLow UPF consumers had overall higher water footprint (due to their high fruit and vegetable intake)A large part of the higher pressures observed among participants with higher UPF consumption was explained by their higher dietary energy intake since the associations did not remain or were even reversed after energy adjustmentRegardless of the % UPF in the diet, GHGe, land use and water use pressures mostly occurred at the stage of agricultural production, in contrast, packaging and processing stages were also important contributors to energy demandContribution of the UPF category to total impact/pressure varied across indicators, with a high contribution of the UPF category to energy demand, due to the packaging and processing stages, but a low contribution to GHGe and land use, because higher consumers of UPF are lower consumers of animal products

Although micronutrient deficiencies affect 2 billion people worldwide, no index focuses on measuring the risk of overt nutrient deficiency. We aimed to develop an index that could capture the nutrient dimension of nutritional security, a nutrient security index (named SecDiet), and evaluate its apparent validity. The SecDiet (range: 0–1) is based on the square-weighted average of the probabilities that the intake of twelve critical nutrients exceeds the threshold value associated with a risk of overt deficiency. Using adult populations from a French representative survey (INCA3, n 1774) and a large cohort (NutriNet-Santé, n 104 382), the content and construct validity of the SecDiet was evaluated by estimating associations of the SecDiet with its components and with relevant socio-demographic characteristics. The SecDiet was high in the overall population (0·93 (SD 0·09) in INCA3) and markedly skewed towards 1 (i.e. lower risk of insufficient intake). It correlated positively with its twelve components (r 0·17–0·78, all P < 0·001). The SecDiet was associated with monthly income (P = 0·002), perception of financial situation, professional situation, food insufficiency and security statuses (all P < 0·001) in the INCA3 population and with monthly income, professional situation and level of education (all P < 0·001) in the NutriNet-Santé population. Unlike a broader nutrient-based quality index taken as comparison, the SecDiet mean decreased and the tail of its distribution notably extended downwards in at-risk sub-populations, thus revealing its specific sensitivity. The SecDiet could be used to screen sub-groups or study the determinants of nutrient insecurity in large population surveys.

International audience; Reducing meat consumption is a current trend and a strong prospect for the future in Western countries, but its dietary modalities and nutrient challenges remain poorly documented. Using diet optimization under a broad set of constraints, we tried to identify a sequential meat reduction transition and analyze its nutrient issues and dietary levers. Based on the consumption of French adults (INCA3, n=1 125, 18-64 years old), we modeled a transition towards a nutritionally adequate healthy dietary pattern under the constraint of a gradual reduction in meat consumption in successive 10% steps. Using a multi-criteria optimization procedure, the diet modeled at each meat reduction step was to be healthier but close to the previous diet. The most significant changes occurred early in the modeled transition process, with drastic reductions in processed and red meats in favor of poultry, which rapidly became the predominant meat before gradually decreasing from 50% to 100% meat reduction. At the same time, whole grain products, fruits and vegetables consumption increased rapidly to reach a plateau from 50% meat reduction onwards. Some nutrients were limiting, in particular bioavailable iron and zinc, and vitamin A, but sufficient intakes were achieved by restructuring diets based on food groups other than meat. Other nutrients mainly supplied by meat such as vitamin B6 and B12, protein and indispensable amino acids, were never limiting. Healthy and nutritionally adequate food patterns can be identified throughout a transition to complete meat reduction. After a 50% reduction in meat consumption, poultry is almost the only meat remaining and its further reduction makes the diet only marginally healthier.

International audience; This review focuses on the added value provided by a research strategy applying metabolomics analyses to assess phenotypic flexibility in response to different nutritional challenge tests in the framework of metabolic clinical studies. We discuss findings related to the Oral Glucose Tolerance Test (OGTT) and to mixed meals with varying fat contents and food matrix complexities. Overall, the use of challenge tests combined with metabolomics revealed subtle metabolic dysregulations exacerbated during the postprandial period when comparing healthy and at cardiometabolic risk subjects. In healthy subjects, consistent postprandial metabolic shifts driven by insulin action were reported (e.g., a switch from lipid to glucose oxidation for energy fueling) with similarities between OGTT and mixed meals, especially during the first hours following meal ingestion while differences appeared in a wider timeframe. In populations with expected reduced phenotypic flexibility, often associated with increased cardiometabolic risk, a blunted response on most key postprandial pathways was reported. We also discuss the most suitable statistical tools to analyze the dynamic alterations of the postprandial metabolome while accounting for complexity in study designs and data structure. Overall, the in-depth characterization of the postprandial metabolism and associated phenotypic flexibility appears highly promising for a better understanding of the onset of cardiometabolic diseases.

BackgroundAnimal and plant protein sources have contrasting relationships with nutrient adequacy and long-term health, and their adequate ratio is highly debated.ObjectiveWe aimed to explore how the percentage of plant protein in the diet (%PP) relates to nutrient adequacy and long-term health but also to environmental pressures, to determine the adequate and potentially optimal %PP values.MethodsObserved diets were extracted from the dietary intakes of French adults (INCA3, n=1 125). Using reference values for nutrients and disease burden risks for foods, we modeled diets with graded %PP values that simultaneously ensure nutrient adequacy, minimize long-term health risks and preserve at best dietary habits. This multi-criteria diet optimization was conducted in a hierarchical manner, giving priority to long-term health over diet proximity, under the constraints of ensuring nutrient adequacy and food cultural acceptability. We explored the tensions between objectives and identified the most critical nutrients and influential constraints by sensitivity analysis. Finally, environmental pressures related to the modeled diets were estimated using the AGRIBALYSE database.ResultsWe find that nutrient-adequate diets must fall within the ∼15%-80% %PP range, a slightly wider range being nevertheless identifiable by waiving the food acceptability constraints. Fully healthy diets, also achieving the minimum-risk exposure levels for both unhealthy and healthy foods, must fall within the 25%-70% %PP range. All of these healthy diets were very distant from current typical diet. Those with higher %PP had lower environmental impacts, notably on climate change and land use, while being as far from current diet.ConclusionsThere is no single optimal %PP value when considering only nutrition and health, but high %PP diets are more sustainable. For %PP>80%, nutrient fortification/supplementation and/or new foods are required.

International audience; Background: Plant proteins (PP) have been associated with better cardiovascular health than animal proteins (AP) in epidemiological studies. However, the underlying metabolic mechanisms remain mostly unknown. Objective: Using a combination of cutting-edge isotopic methods, we aimed at better characterizing the differences in protein and energy metabolisms induced by dietary protein sources (PP vs AP), in a prudent or western dietary context.Methods: Male Wistar rats (n=44, 8 weeks old) were fed for 4.5 months with isoproteic diets differing in their protein isolate sources, either AP (100% milk) or PP (50%:50% pea: wheat), and being normal (NSF) or high (HFS) in sucrose (6 or 15%kcal, respectively) and saturated fat (7 or 20%kcal, respectively). We measured body weight and composition, hepatic enzyme activities and lipid content, and plasma metabolites. In the intestine, liver, adipose tissues and skeletal muscles, we concomitantly assessed the extent of amino acid (AA) trafficking using a 15N natural abundance method, the rates of macronutrient routing to dispensable AA using a 13C natural abundance method, and the metabolic fluxes of protein synthesis (PS) and de novo lipogenesis (DNL) using a 2H labelling method. Data were analyzed using ANOVA and mixed models.Results: At the whole-body level, PP limited HFS-induced insulin resistance (-27% in HOMA-IR between HFS groups, P

International audience

Visioconférence; International audience; Objectives: A dietary shift in favor of plant protein (PP) sources over animal protein (AP) sources has been advocated for both sustainability and health reasons, this dietary transition being noticeably associated to decreased cardiovascular and diabetes risks. The differences in amino acid composition between PP and AP may have several effects on the metabolic pathways, and in turn health impacts, which are still poorly characterized. This project aims at characterizing, with a combination of “omics” approaches, the metabolic reorientations induced by a dietary shift from AP to PP sources and understanding their health effects in a population at cardiometabolic risk. Methods: We will conduct a cross-over randomized feeding trial (NCT04236518) in 20 healthy overweight males (BMI 25–35), aged 25–55, with an enlarged waist circumference (> 94cm) and high plasma triglycerides (>1.5g/L). Participants will be assigned for 1 month each to 2 diets containing predominantly either AP (65% AP:35% PP) or PP (35% AP:65% PP) in a randomized order, separated by a 2-week wash-out period. Lunch and diner will be directly provided while dietary guidelines will be given for breakfast and snacks. Blood, urine and stool samples will be collected at the fasted state every 2 weeks. At the end of each dietary intervention, blood and urine will be collected following a high fat meal, which challenges metabolism and vascular homeostasis. Plasma and urine non-targeted metabolomics analyses (LC-MS) will be combined with Peripheral Blood Mononuclear Cell (PBMC) transcriptomics and fluxomics analyses (D2O tracer) to get a comprehensive overview of the metabolic phenotype associated with AP or PP intake. Flow-Mediated Dilatation (FMD) and Flow Laser Doppler (FLD) will be used to measure respectively macrovascular endothelial function and microvascular skin blood flow at the fasted state and after the high-fat meal. We will also measure anthropometric parameters and analyze biochemistry and inflammatory markers. Results: Not applicable (protocols abstract). Conclusions: We expect the multi-omics fingerprinting to reveal subtle metabolic differences associated to AP or PP intake, with a positive effect of PP intake. Improved inflammatory status and endothelial function are also expected to be associated to PP intake. Funding Sources INRAE and Roquette Frères.

International audience; Abstract Objectives While consumers’ demand is growing, meat substitutes have much varied composition, raising questions about their nutritional interest. We aimed to identify the composition of a meat substitute that would best improve diet quality, and analyze the impact on nutrient adequacy. Methods We aimed at maximizing the overall diet quality of an average individual representing the nutrient intake of the French adult population (INCA3, n = 1125) by modeling the composition of a meat substitute intended to replace meat, using non-linear optimization (using SAS, proc optmodel). The diet quality was assessed using the PANDiet scoring system, which assesses the probability of adequate nutrient intake. Nutritional constraints were applied in order to not increase the risk of overt deficiency for 12 nutrients. A list of 159 ingredients was used to compose the meat replacer and technological constraints were defined so as to take into account the feasibility of the formulation. The impacts on diet quality of the modelled meat substitute were analyzed and compared with those of 43 meat substitutes on the market. Results The optimized meat substitute was composed of 13 ingredients (such as coco bean, yellow sweet pepper, rapeseed oil, dried shiitake mushroom, wheat bran and thyme) and this formulation proved to be relatively robust to variations in the model constraints, as shown by a sensitivity analysis. Meat substitution with this optimized meat substitute largely increased the PANDiet, by 5.5 points above its initial value before substitution (73.7/100). In particular, it led to better adequacies for nutrients that are currently insufficiently consumed (e.g., alpha-linolenic acid, fiber, linoleic acid). It also allowed to compensate for loss of some nutrients partly provided by meat (e.g., vitamin B6, potassium and, to a certain extent, bioavailable iron), but was not sufficient to compensate for bioavailable zinc and vitamin B12. The optimized meat substitute proved to be dramatically more nutritionally efficient than the available meat substitutes, whose individual impact on the PANDiet ranged from −3.1 to +1.5 points. Conclusions We proved that it is possible to select appropriate ingredients resulting in a meat substitute that could be a fairly good nutritional lever when substituting meat. Funding Sources Partly funded by a PhD fellowship from Terres Univia.

International audience; Abstract Objectives We aimed to characterize the effects of a low dose of a sustained-release L-arginine (L-ARG) supplementation on plasma metabolome in healthy overweight adults with cardiometabolic risk factors, and study if its effect could improve the capacity to handle a high fat-high sugar meal, that deeply and acutely challenge metabolic capacities. Methods In a randomized, double-blind, controlled trial, 33 healthy overweight adults (BMI > 25kg/m²) with cardiometabolic risk (plasma triglycerides > 150 mg/dL; waist circumference > 94 cm (men) or > 80 cm (women)) were treated with 1.5 g L-ARG 3 times/d (4.5 g/d) or placebo for 4 weeks. On the last day of treatment, the volunteers consumed a high fat, high sugar meal challenge (900 kcal). Plasma was collected at fasting and 2, 4 and 6 h after the meal. Metabolites were analyzed by high-resolution mass spectrometry hyphenated to liquid chromatography, using reversed and normal phase columns, and operated in both positive and negative ionization modes. Annotation was performed using an in-house database referencing more than 1300 metabolites. Metabolic profiles were analyzed using Linear Mixed Models-PCA (LiMM-PCA), which enables to analyze repeated multivariate data. LiMM-PCA combines linear mixed models and PCA to assess the effects of both fixed factors (Treatment, Time before and after meal, interaction Treatment x Time, Order of treatment administration and Period of the study) and random factors (Individual). Results 521 metabolic features were identified in the plasma. Time accounted for most part of the variance in dataset (30.0%, P 0.10). The analysis of the metabolites contributing the most to these effects is under progress. Conclusions L-ARG supplementation has a significant effect on the metabolome in a situation where the metabolome is heavily impacted by a large allostatic load, and these two effects are independent of each other. Funding Sources Supported by a grant from Pierre Fabre Research Institute.

International audience; Objectives We aimed to study if, and to what extent, the current nutrient reference values for bioavailable iron and zinc limit the identification of healthier dietary patterns. Methods Using observed diets from a representative French survey (INCA3) and multi-criteria optimization, we identified diets that comply with all nutrient reference values and maximize a health criteria based on food-based dietary guidelines while minimally departing from the observed diet. Nutrient reference values included absorbed iron and zinc. This non-linear diet optimization problem was solved in men and women with higher (Fe−) and lower (Fe+) iron requirements separately, either strictly (Non Flexible model, NF) or by allowing some tolerance on absorbed iron and zinc using goal programming to minimize their decreases below reference values (Flexible Model, F). Using a comparative risk assessment framework and a probabilistic approach, we estimated changes in risks of cardiovascular diseases, diabetes and colorectal cancer, and changes in estimates of the prevalence of iron-deficiency anemia for the diets optimized using each model. Results With the NF model, the reference values for absorbed iron and zinc were the most binding constraints (over 34 constraints). Compared to the observed diets, the NF-optimized diets showed large redistributions within cereals and meats, with total meat consumption remaining similar in men and Fe- women and doubling in Fe + women. In contrast, the F-optimized diets had higher value for the health criteria objective, being systematically lower in meat, especially red meat, and higher in whole grain products. We estimated that the reduction in mortality risk would be 17.7% wih the NF-optimized diets and 21.5% with the F-optimized diets. However, the later diets would increase the prevalence of iron-deficiency anemia from 2.1% currently to 5.6%. Conclusions We evidenced that the reference values for iron and zinc with regard to their bioavailability are critical factors when modelling healthy eating patterns. Considering lower references for iron and zinc leads to identify diets with an apparent higher benefit for the population health with regards long-term health. Funding Sources None.

BACKGROUND AND OBJECTIVES: Use of mid–upper arm circumference (MUAC) as a single screening tool for severe acute malnutrition (SAM) assumes that children with a low weight-for-height z score (WHZ) and normal MUAC have lower risks of morbidity and mortality. However, the pathophysiology and functional severity associated with different anthropometric phenotypes of SAM have never been well characterized. We compared clinical characteristics, biochemical features, and health and nutrition histories of nonedematous children with SAM who had (1) low WHZ only, (2) both low WHZ and low MUAC, or (3) low MUAC only. METHODS: In Bangladesh, Burkina Faso, and Liberia, we conducted a multicentric cohort study in uncomplicated, nonedematous children with SAM and low MUAC only (n = 161), low WHZ only (n = 138), or a combination of low MUAC and low WHZ (n = 152). Alongside routine anthropometric measurements, we collected a wide range of critical indicators of clinical and nutritional status and viability; these included serum leptin, an adipocytokine negatively associated with mortality risk in SAM. RESULTS: Median leptin levels at diagnosis were lower in children with low WHZ only (215.8 pg/mL; P < .001) and in those with combined WHZ and MUAC deficits (180.1 pg/mL; P < .001) than in children with low MUAC only (331.50 pg/mL). The same pattern emerged on a wide range of clinical indicators, including signs of severe wasting, dehydration, serum ferritin levels, and caretaker-reported health deterioration, and was replicated across study sites. CONCLUSIONS: Illustrative of the likely heterogeneous functional severity of the different anthropometric phenotypes of SAM, our results confirm the need to retain low WHZ as an independent diagnostic criterion.

Background Diet-related greenhouse gas emissions (GHGe) mainly comes from animal-sourced foods. As progressive changes are more acceptable for a sustainable food transition, we aimed to identify nutritionally adequate and culturally acceptable optimized diets ensuring a gradual reduction in GHGe, using observed diet from a large sample of French adults, while considering the mode of food production (organic vs conventional farming) and the co-production link between milk and beef. Material and method Based on the consumption of 257 organic and conventional foods among 29,413 participants (75% women, age: 53.5 ± 14.0y) of the NutriNet-Sante study, we modelled optimal diets according to GHGe reduction scenarios in 5% steps, from 0 to 50% with nutritional, acceptability, and coproduct constraints, for men, premenopausal and menopausal women separately. Results Gradual GHGe decrease under these constraints led to optimal diets with an overall decrease in animal foods, with marked reductions in dairy products (up to −83%), together with a stable but largely redistributed meat consumption in favor of poultry (up to +182%) and pork (up to +46%) and at the expense of ruminant meat (down to −92%). Amounts of legumes increases dramatically (up to +238%). The greater the reduction in diet-related GHGe, the lower the cumulative energy demand (about −25%) and land use (about −43%). The proportion of organic food increased from ~30% in the observed diets to ~70% in the optimized diets. Conclusion Our results suggest that meeting both nutrient reference value and environmental objectives of up to 50% GHGe reduction requires the reduction of animal foods together with important substitutions between animal food groups, which result in drastic reductions in beef and dairy products. Further research is required to explore alignment with long-term health value and conflict with acceptability, in particular for even greater GHGe reductions.

Improving the sustainability of diets requires the identification of diets that meet the nutritional requirements of populations, promote health, are within planetary boundaries, are affordable and are acceptable. Here we explore the extent to which dimensions of sustainability could be optimally aligned and identify more sustainable dietary solutions, from the most conservative to the most disruptive, among 12,166 participants of the NutriNet-Sante cohort. We aim to concomitantly lower environmental impacts (including greenhouse gas emissions, cumulative energy demand and land occupation), increase organic food consumption and study departure from observed diets (considered as a proxy for acceptability). From the most conservative to the most disruptive scenario, optimized diets were gradually richer in fruits, vegetables and soya-based products and markedly poorer in animal-based foods and fatty and sweet foods. The contribution of animal protein to total protein intake gradually decreased by 12% to 70% of the observed value. The greenhouse gas emissions from food production for the diets gradually decreased across scenarios (as a percentage of observed values) by 36–86%, land occupation for food production by 32–78% and energy demand by 28–72%. Our results offer a benchmark of scenarios of graded dietary changes against graded sustainability improvements. Conservative to disruptive changes in dietary patterns of French adults from the NutriNet-Sante cohort are considered for reducing environmental impacts, increasing organic food consumption, providing adequate nutrition and being economically acceptable. A progressive substitution of animal products by plant products across dietary scenarios more closely aligned dimensions of sustainability.

International audience

International audience; The EAT-Lancet Commission has recently proposed a “universal” healthy reference diet. However, no study has specifically investigated its possible environmental benefits at the individual level based on observed data. Our objective was therefore to characterize the environmental pressures and impacts related to the level of adherence to the EAT-Lancet diet among French adults. Dietary data from a 264-item FFQ in 29,210 NutriNet-Santé participants (75% women, mean age = 53.5y (SD = 14.0)), were used to estimate (i) the level of adherence to the EAT-Lancet diet through the EAT-Lancet diet index (ELD-I), (ii) the food production-related environmental impacts using 3 individual environmental indicators (greenhouse gas emissions, cumulative energy demand and land occupation) and (iii) the overall environmental impact using a validated aggregated partial score (pReCiPe). For clarity purpose, results are presented by quintile (Q) of ELD-I. High ELD-I (Q5), compared to low (Q1), was associated with lower greenhouse gas emissions (−56%), cumulative energy demand (−31%) and land occupation, (−54%). The pRECIPE was 62% lower in high ELD-I than in low ELD-I but the range of pReCiPe in Q1 was large. In this large scale-study of French adults, adherence to the EAT-Lancet recommendations led to lower environmental impacts. Nonetheless, some low-EAT diets (reflecting unhealthy diets), may exhibit low environmental impacts.

International audience; Background: Healthier dietary patterns involve more plant-based foods than current Western diets rich in animal products containing high levels of bioavailable iron and zinc. Little consideration is given to the bioavailability of iron and zinc when studying healthy eating patterns.Objectives Our aim was to determine whether currently estimated requirements for bioavailable iron and zinc limit the identification of healthier dietary patterns.Methods Using dietary data from a representative French survey and multi-criteria non-linear optimization, we identified diets that maximize health criteria based on Food-Based Dietary Guidelines and concomitantly depart only minimally from the observed diet, while complying with all nutrient reference values either strictly (non-flexible optimization) or by allowing bioavailable iron and zinc below the current reference values, but to a limited extent (flexible optimization). Using a comparative risk assessment model, we estimated the resulting impact on cardiometabolic and colorectal cancer mortality/morbidity, and changes to iron-deficiency anemia.Results Under non-flexible optimization, reference values for bioavailable iron and zinc were the most binding of the 35 nutrient constraints and modeled diets displayed considerable redistributions within grains and meat. With flexible optimization, modeled diets were healthier as they contained less red meat and more whole-grain products, but would increase iron-deficiency anemia to 5.0% (95% CI: 3.9%, 6.4%). Globally, in terms of Disability Adjusted Life Years (DALYs), as the loss due to anemia would represent

Natural abundances of stable nitrogen and carbon isotopes (δ15N and δ13C) can vary with both dietary intake and metabolic (specifically catabolic) state. In low-income countries, weaning is a period of dietary transition from milk to plant-based foods and a high-risk period for malnutrition. We explored how diet and malnutrition impact hair δ15N and δ13C in young children by an observational, cross-sectional study in Cox’s Bazar District, Bangladesh [255 children, 6–59 months with 19.6% wasted (7.1% severely) and 36% stunted (9.8% severely)]. Hair δ15N and δ13C exhibited exponential decreases with age, with the loss of one trophic level (3.3‰ and 0.8‰, respectively) from 6 to 48 months, which we associate with the shift from exclusive breastfeeding to complete weaning. After adjustment for age and breastfeeding status, hair isotopic values were unaffected by wasting but lower in severe stunting (−0.45‰ to −0.6‰, P 15N and δ13C values in severely stunted children that likely indicate chronic exposure to diets low in animal products.

Little is known about the effects of the development of metabolic syndrome (MS) on protein and amino acid (AA) metabolism. During this study, we took advantage of the variability in interindividual susceptibility to high fat diet-induced MS to study the relationships between MS, protein synthesis, and AA catabolism in multiple tissues in rats. After 4 mo of high-fat feeding, an MS score (ZMS) was calculated as the average of the z-scores for individual MS components [weight, adiposities, homeostasis model for the assessment of insulin resistance (HOMA-IR), and triglycerides]. In the small intestine, liver, plasma, kidneys, heart, and muscles, tissue protein synthesis was measured by 2H2O labeling, and we evaluated the proportion of tissue AA catabolism (relative to protein synthesis) and nutrient routing to nonindispensable AAs in tissue proteins using natural nitrogen and carbon isotopic distances between tissue proteins and nutrients (Δ15N and Δ13C), respectively. In the liver, protein mass and synthesis increased, whereas the proportion of AA catabolism decreased with ZMS. By contrast, in muscles, we found no association between ZMS and protein mass, protein synthesis (except for a weak positive association in the gastrocnemius muscle only), and proportion of AA catabolism. The development of MS was also associated with altered metabolic flexibility and fatty acid oxidation, as shown by less routing of dietary lipids to nonindispensable AA synthesis in liver and muscle. In conclusion, MS development is associated with a greater gain of both fat and protein masses, with higher protein anabolism that mainly occurs in the liver, whereas muscles probably develop anabolic resistance due to insulin resistance.

Introduction et but de l’etude Pour diagnostiquer la malnutrition aigue severe (MAS) chez l’enfant, l’OMS recommande d’utiliser deux criteres anthropometriques independants : l’indice poids-taille (IPT Materiel et methodes L’etude a pris appui sur une etude longitudinale multicentrique (Bangladesh, Burkina Faso et Liberia) chez les enfants identifies comme souffrant de MAS, sans complications medicales, sur la base d’un faible PB seulement (PB-seul, n = 164), d’un faible IPT seulement (IPT-seul, n = 138), ou des deux deficits anthropometriques concomitamment (PB&IPT, n = 153). En plus des mesures anthropometriques de routine, nous avons mesure une gamme d’indicateurs de l’etat clinique et nutritionnel, dont la leptine serique. En effet, l’hypoleptinemie a recemment ete reconnue comme un facteur majeur de risque de mortalite a court-terme chez les enfants atteints de MAS. Resultats et analyse statistique A l’admission pour la rehabilitation nutritionnelle, la leptinemie (valeur moyenne [IC 95 %]) des enfants PB-seul (331 [159–560] pg/mL) etait significativement (p Conclusion Plutot que de limiter les criteres d’admission a la mesure du PB seul, nos resultats confirment la necessite de conserver l’IPT en tant que critere diagnostic independant de la MAS et de renforcer les systemes de sante en consequence, conformement aux dernieres recommandations de l’OMS.

Introduction et but de l’etude Face aux enjeux de durabilite, il est primordial d’identifier des regimes alimentaires qui satisfassent les besoins nutritionnels, soient acceptables et reduisent les impacts de leur production sur la sante et l’environnement. L’objectif de ce travail etait de caracteriser, par une methode originale d’optimisation multicritere, les leviers d’amelioration de la durabilite des regimes alimentaires. Materiel et methodes L’optimisation a ete realisee sur les regimes de 12 166 participants de la cohorte NutriNet-Sante, sur trois criteres et de maniere hierarchique. Pour chaque individu, nous avons d’abord evalue l’amelioration potentielle maximale de l’impact environnemental (pReCIPE, incluant emissions de gaz a effet de serre, demande en energie et occupation des terres), puis l’amelioration potentielle de la contribution des aliments biologiques (%Bio) sous contrainte d’une amelioration du pReCIPE d’au moins p% de son amelioration maximale. Nous avons alors optimise chaque regime pour qu’il soit le plus proche du regime observe (minimisation des ecarts de consommation), sous contrainte que pReCIPE et %Bio soient ameliores d’au moins p% de leurs ameliorations potentielles precedemment estimees. Nous avons conduit 5 scenarios de rupture croissante, ou p% etait fixe a 25 %, 50 %, 70 %, 80 % et 90 %, tout en incluant des contraintes sur les quantites maximales d’items, les apports energetiques et nutritionnels et le prix. Les resultats sont presentes par tertile de score provegetarien initial. Resultats et analyse statistique Dans les regimes optimises, les contributions des fruits, legumes, feculents et soja augmentaient au detriment de celles des aliments d’origine animale et des aliments gras et sucres ou sales. Ces changements s’accentuaient progressivement des scenarios conservateurs vers ceux de rupture, avec par exemple la consommation de viande qui passait de 58,4 a 2,7 g/j. Les contributions des noix et legumineuses augmentaient dans les scenarios les plus conservateurs, mais diminuaient au profit de celle du soja dans les scenarios de rupture. Le niveau de vegetalisation initial du regime affectait uniquement l’amplitude mais pas la nature des modifications de composition de regime. Des scenarios conservateurs jusqu’a ceux de rupture, les emissions de gaz a effet de serre des regimes allaient de 1,04 a 0,20 tonnes d’equivalents carbone par an et par personne, la reduction des surfaces occupees pour la production alimentaire variait de 41 % a 80 %, et celle de la demande en energie de 47 % a 75 %. Conclusion Le regime moyen du scenario le plus conservateur (25 % d’amelioration) apparait insuffisant pour repondre aux objectifs climatiques. Les scenarios plus en rupture permettraient de mieux repondre aux enjeux environnementaux tout en restant economiquement accessibles et en couvrant les besoins nutritionnels. Les differents scenarios restent a departager en fonction des objectifs de durabilite et des efforts a operer par l’alimentation. De plus, ces regimes theoriques devront etre confrontes aux realites agronomiques.

Online; Background. Our diets are undergoing a transition towards a lower consumption of animal protein, in line with the sustainability of diets. Given the differences in nutritional profile between protein sources, changes in consumption, even marginal, raise the question of the nutritional quality of diets. Objectives. Our objective was to identify the consequences, on sustainability parameters, of rearrangements of protein intake aiming at improving nutritional adequacy, depending on whether or not we constrained an increase of the proportion of vegetable proteins.Methods. Based on the consumption data from the INCA2 study (2006-2007), we simulated, for each individual, all possible substitutions of a portion of a protein food for a portion of another protein food, and selected the substitution that increased nutritional adequacy the most (estimated with probabilistic PANDiet score). This step was iterated 20 times for each individual under two different scenarios: by constraining (P) or not (N) an increase in the percentage of plant protein at each iteration. The sustainability parameters studied were diet costs, greenhouse gas emissions (GHGE), exposure to food contaminants and premature deaths avoided (estimated with the PRIME model).Results. The percentage of plant protein (31.1%) decreased slightly in N (30.0%) and increased in P (37.7%). The food groups whose contribution to protein intake increased the most were legumes (+225%), fatty fish (+151%) and lean chicken (+82%) in N and legumes (+502%), pizzas and quiches (+190%) and fatty fish (+102%) in P. The PANDiet increased slightly more in N (+7.5) than in P (+6.2) due to higher probabilities of adequacy in EPA + DHA, iron, iodine, potassium, zinc, riboflavin, vitamin B-6 and B-12 despite lower probabilities of adequacy in fiber and folates. GHGE increased in N and decreased in P. The diet cost increased more in N than in P. Risks related to exposure to inorganic arsenic, dioxins and furans and nickel increased in N and P. The modifications identified could lead to 1,700 and 2,200 premature deaths avoided / year in N and P, respectively.Conclusion. We identified simple modifications of the protein intake that significantly increased the nutritional adequacy of diets. By forcing these changes to systematically increase the proportion of vegetable protein, nutritional adequacy increased less, but the price increased less, the GHGE decreased and deaths avoided increased.; Contexte. Nos régimes alimentaires comportent moins de protéines animales aujourd'hui, en ligne avec la durabilité des régimes alimentaires. Compte tenu des différences de profil nutritionnel entre les sources de protéines, l'évolution de la consommation, même marginale, pose la question de la qualité nutritionnelle des régimes.Objectifs. Notre objectif était d'identifier les conséquences, sur les paramètres de durabilité, des réarrangements de l'apport en protéines visant à améliorer l'adéquation nutritionnelle, selon que nous ayons ou non limité l'augmentation de la proportion de protéines végétales.Méthodes. Sur la base des données de consommation de l’étude INCA2 (2006-2007), nous avons simulé, pour chaque individu, toutes les substitutions possibles d’une portion d’un aliment protéiné par une portion d’un autre aliment protéique, et avons sélectionné la substitution qui augmentait le plus le score PANDiet probabiliste. Cette étape a été itérée 20 fois pour chaque individu selon deux scénarios différents: en contraignant (P) ou non (N) une augmentation du pourcentage de protéines végétales à chaque itération. Les paramètres de durabilité étudiés étaient les coûts de l'alimentation, les émissions de gaz à effet de serre (GES), l'exposition aux contaminants de l'alimentation et les décès prématurés évités (estimés avec le modèle PRIME).Résultats. Le pourcentage de protéines végétales (31,1%) a légèrement diminué en N (30,0%) et augmenté en P (37,7%). Les légumineuses (+ 225%), les poissons gras (+ 151%) et le poulet maigre (+ 82%) en azote et les légumineuses (+ 502%), les pizzas et les quiches (+190 %) et les poissons gras (+ 102%) dans P. Le PANDiet a augmenté légèrement plus dans N (+7,5) que dans P (+6,2) en raison de probabilités plus élevées d’adéquation en EPA + DHA, fer, iode, potassium, zinc, riboflavine, vitamines B-6 et B-12 malgré des probabilités plus faibles d’adéquation des fibres et des folates. Les GES ont augmenté dans N et diminué dans P. Le coût de l'alimentation a augmenté davantage dans N que dans P. Risques liés à l'exposition à l'arsenic inorganique, les dioxines et les furannes et nickel a augmenté dans N et P. Les modifications identifiées pourraient entraîner 1 700 et 2 200 décès prématurés évités / année en N et P, respectivement.Conclusion. Nous avons identifié de simples modifications de l'apport en protéines qui ont considérablement augmentées l'adéquation nutritionnelle des régimes. L'augmentation systématiquement de la proportion de protéines végétales a légèrement augmenté l'adéquation nutritionnelle et le prix, a diminué les émissions de GES et a augmenté le nombre de décès évités.

International audience; Meat consumption in Western countries is declining and, while the proportion of strict vegetarians remains low, intermediate diets such as flexitarianism have been developing in recent years. Our objectives were to identify the different levels of transition towards low-meat diets, characterize how these diets differ in terms of food intake, and identify whether attitudes and beliefs can explain these degrees of transition. In a representative survey of the French adult population conducted in 2018 (n = 2055), participants declared whether they followed a particular diet and completed a food frequency questionnaire on 29 food sources of protein and a questionnaire on their attitudes and beliefs regarding protein sources. We identified four dietary types based on these declarative data: vegetarians, flexitarians, pro-flexitarians and omnivores. The theory of planned behavior was used to predict meat intake and intentions to reduce meat intake. The sample contained 2.5% vegetarians, 6.3% flexitarians, 18.2% pro-flexitarians and 72.9% omnivores. The diet groups displayed specific dietary profiles and attitudinal scores. Compared with omnivores, pro-flexitarians consumed less red meat, more vegetables and legumes and were much more in agreement about the environmental impacts of meat. Compared with pro-flexitarians, flexitarians consumed less red meat and processed meat, and agreed much more about the health impacts of meat. Finally, versus flexitarians, vegetarians consumed almost no meat but far more legumes, nuts and seeds, and were much more sensitive to animal welfare issues. Attitudes, social norms and perceived behavioral control (PBC) predicted intentions to reduce meat consumption but attitude was the most important predictor. Intentions and PBC were both predictive of meat consumption. The dietary type related to the level of meat intake could be predicted by self-declared attitudes and beliefs regarding protein sources.

Background There is a current trend in Western countries toward increasing the intake of plant protein. A higher plant-protein intake has been associated with nutritional and health benefits, but these may depend on the pattern of plant-protein sources. Objective We hypothesized that the diversity of plant foods could be important to nutrient adequacy when increasing plant-protein intake in the diet. Methods Using data on 1341 adults (aged 18–64 y) from a representative French national dietary survey conducted in 2014–2015 (the third Individual and National Study on Food Consumption Survey—INCA3), we studied the links between plant-protein intake, dietary diversity (using various dimensions), and nutrient adequacy [assessed using the PANDiet (Probability of Adequate Nutrient Intake) scoring system, comprising adequacy (AS) and moderation (MS) subscores]. We simulated substituting plant-protein foods for animal-protein foods using different models of plant-protein diversity. Results We found that overall diet quality was weakly associated with total and protein diversity and more strongly with plant-protein diversity. Plant-protein intake was inversely associated with animal-protein intake, and positively with the PANDiet and MS, but not with the AS. Plant-protein intake displayed little diversity, mostly taking the form of grains (61% of plant-protein intake), and this diversity was even less marked under a higher plant-protein intake. Finally, modeled substitutions showed that reducing animal-protein intake increased the MS (by 32%) in a similar manner whichever plant protein was used for substitution, whereas it decreased the AS (by 20%) unless using a highly diversified plant-protein mix. These simulated improvements in overall adequacy included marked decreases in adequacy regarding certain nutrients that are typically of animal origin. Conclusions We conclude that in French adults the current pattern of plant-protein intake is hindering the nutritional benefits of a transition toward more plant protein, indicating that the consumption of plant-protein-based foods other than refined grains should be encouraged.

International audience; Promoting a more balanced animal/plant dietary protein ratio by changing portion sizes or introducing new foods is a promising means to improve diet quality, but little is known about the willingness of individuals to adopt such changes. Our objective was to assess the willingness to adopt dietary changes by these means. In a French cross-sectional study in 2018 (n = 2055), we analyzed the association between the willingness to eat smaller or larger portions or to introduce non-consumed protein foods and the current dietary patterns of individuals and their socio-demographic characteristics. These modifications had previously been identified as improving the nutrient adequacy of diets. Participants were more willing to eat smaller portion sizes than to introduce new foods and to eat larger portion sizes. The willingness for any modification varied depending on the food groups concerned. Participants were also more willing to eat larger portions and less willing to eat smaller portions when they were the most frequent consumers of the foods concerned. Participants were more willing to eat a new food if it was consumed in large quantities by individuals with a similar dietary pattern. This study underlines the importance of accounting for individual food habits when issuing nutritional recommendations.

Visio conférence; International audience; Objectives: The dietary shift from animal protein (AP) sources to plant protein (PP) sources is promoted for both environmental and health reasons. Indeed, PP are associated to lower cardiovascular and diabetes risks compared to AP, but the underlying mechanisms remain mostly unknown. Metabolomics, which has a unique ability to provide an integrative snapshot of the metabolic status of an individual, is a valuable tool to investigate the different metabolic pathways activated by AP or PP intake and to provide biomarkers of their metabolic effects. This scoping review aimed at gathering and analyzing the available data on the metabolomics signatures associated to PP or AP intake, for discussing the metabolic effects underlying these signatures and their potential implication for cardiometabolic health. Methods: We selected a total of 23 human studies comparing the urine, plasma or serum metabolomes associated to diets with contrasted AP and PP intakes, such as vegetarian and omnivore diets, and collected all discriminant metabolites across diets. Results: Out of the 447 discriminant metabolites, 44 were repeatedly reported across studies, amino acids (AA) and AA-related products accounting for a high proportion. Branch-chained amino acids (BCAA), aromatic amino acids (AAA), glutamate, short-chained acylcarnitines and Trimethylamine-N-Oxide (TMAO) were associated to AP while glycine was associated to PP intake. TCA cycle intermediates and products from AAA gut microbiota degradation were also often reported, but the direction of their associations with AP or PP remained unclear. As regard to their implication for cardiometabolic health, BCAA, AAA, glutamate, short-chained acylcarnitines and TMAO are known to be associated to increased risk while glycine is rather associated with a decreased risk.Conclusions: AP or PP intakes result in different metabolomics signatures, several metabolites being plausible candidates to at least partially explain their differential associations with cardiometabolic risk. Additional studies with a specific focus on protein type, deep dietary data and tight intake control are needed to better characterize the associated metabolic phenotype and understand how it could mediate AP or PP effects on cardiometabolic risk. Funding Sources INRAE

Background: Oral L-arginine supplements can have a beneficial effect on nitric oxide (NO)-related functions when subjects have cardiovascular disease risk factors. Objective: The study was designed to determine the utilization for NO synthesis of oral L-arginine as a function of the cardiometabolic risk and the speed of absorption by comparing immediate-release arginine (IR-Arg), as in supplements, and sustained-release arginine (SR-Arg), which mimics the slow release of dietary arginine. Methods: In a randomized, single-blind, 2-period crossover, controlled trial (1 wk of treatment, >2 wk of washout), using[N-15-(15)-N(guanidino)]-arginine for the first morning dose, we compared the bioavailability (secondary outcome) and utilization for NO synthesis (primary outcome) of 1.5 g IR- and SR-Arg 3 times/d in 12 healthy overweight [body mass index (BMI; in kg/m(2)): 25-30] adults with the hypertriglyceridemic waist phenotype [HTW; plasma triglycerides (TGs): >150 mg/dL; waist circumference: >94 cm (men) or >80 cm (women)] and 15 healthy control adults (CON; BMI: 18.5-25; no elevated TGs and waist circumference). Results: Plasma oral arginine areas under the curve were lower after supplementation with SR-Arg than with IR-Arg (112 +/- 52.3 and 142 +/- 50.8 mu mol . h/L; P < 0.01). The utilization of oral arginine for NO synthesis was 58% higher in HTW subjects than in CON subjects and higher with SR-Arg than with IR-Arg (P < 0.05 both), particularly in HTW subjects (group-by-treatment interaction, P < 0.05). In HTW subjects administered the SR form, utilization for NO synthesis was 32% higher than with the IR form and 87% higher than in CON subjects who were administered the SR form. Conclusion: In overweight adults with the HTW phenotype, a slow- compared with a fast-release form of oral arginine markedly favors the utilization of arginine for NO synthesis. The utilization of low-dose, slow-release arginine for NO synthesis is higher in overweight adults with the HTW phenotype than in healthy controls, suggesting that the sensitivity of NO synthesis to the dietary arginine supply increases with cardiometabolic risk. The trial was registered at clinicaltrials.gov as NCT02352740.

Protein turnover is an energy-consuming process essential for ensuring the maintenance of living organisms. Gold standard methods for protein turnover measurement are based on intravenous infusions of stable isotopes. Although accurate they have inherent drawbacks precluding their generalization for large farm animals and during long time periods. We proposed here a non-invasive proxy of the whole-body fractional protein degradation (WBFPDR; protein turnover for a growing animal) in the long term and in a large number of beef cattle. The proxy is based on the rate at which urine-N and plasma proteins are progressively depleted in 15N after a slight decrease in the isotopic N composition of diet (i.e. diet-switch). We aimed to test the ability of this proxy to adequately discriminate the WBFPDR of 36 growing-fattening young bulls assigned to different dietary treatments known to impact the protein turnover rate: the protein content and amino acid profile. To achieve this objective, the experimental diets were enriched with 15N labeled-urea during 35 days while the animals were adapted to diets. After stopping the 15N labeled-urea administration the animals were thereafter sampled for spot urines (n = 13) and blood (n = 10) over 5 months and analyzed for their 15N enrichments in total N and plasma proteins, respectively. Adequately fitting the 15N kinetics in plasma proteins and urines required mono- and bi-exponential models, respectively, and the model parameters were compared across dietary conditions using a non-linear mixed effect model. The single 15N depletion rate found in plasma proteins represented their fractional synthesis rate, whereas the slowest depletion rate found in urines was interpreted as a proxy of the WBFPDR. The proxy here tested in urines suggested different WBFPDR values between Normal vs High protein diets but not between balanced vs unbalanced methionine diets. In contrast, the proxy tested in plasma indicated that both dietary conditions affected the fractional synthesis rate of plasma proteins. We consider that the rate at which urines are progressively 15N-depleted following an isotopic diet-switch could be proposed as a non-invasive proxy of the long-term whole-body fractional protein degradation rate for large farm animals.

International audience; Background : Patterns of protein food intake are undergoing a transition in Western countries, but little is known about how dietary changes to protein intake affect nutrient adequacy of the diet.Objectives : Our objective was to identify simple modifications to protein food intake that can gradually increase overall nutrient adequacy.Methods : We identified patterns of dietary protein intake in 1678 adults from a representative French national dietary survey. For each individual, we identified the increase in portion size of 1 protein food paired with a decrease in the portion size of another protein food that would best increase nutrient adequacy (using PANDiet probabilistic scoring). Then, such an optimum simple dual change was iterated 20 times for each individual according to 2 scenarios, either by manipulating the intake of foods already consumed [scenario 1 (S1)] or by enabling the introduction of foods consumed by >10% of individuals with the same protein pattern [scenario 2 (S2)]. Results : The optimum stepwise changes to protein intake primarily consisted of reducing portions of deli meats (both scenarios), sandwiches, and cheese (S2), while increasing portions of fatty fish and lean poultry (both scenarios) and legumes (S2). However, these changes differed depending on the initial dietary protein pattern of the individual. For example, in S2, legume intake increased among “poultry” and “fish” eaters only and low-fat meat among “take-away eaters” and “milk drinkers” only. The improvements in overall nutrient adequacy were similar among the different initial dietary patterns, but this was the result of changes to the adequacy of different specific nutrients. Conclusion : Beyond generic changes to protein intake in the entire French adult population, the initial dietary protein pattern is key to identifying the food groups most likely to improve overall nutrient adequacy and the profile of nutrients whose adequacy can easily be increased.

Protein turnover is an energy-consuming process that is essential for ensuring the maintenance of living organisms. Gold standard methods for whole-body protein turnover (WBPT) measurement have inherent drawbacks precluding their generalization for large farm animals and use during long periods. Here, we proposed a non-invasive proxy for the WBPT over a long period of time and in a large number of beef cattle. The proxy is based on the rate at which urine-N and plasma proteins are progressively depleted in terms of15N after a slight decrease in the isotopic N composition of the diet (i.e. diet switch). We aimed to test the ability of this proxy to adequately discriminate the WBPT of 36 growing-fattening young bulls assigned to different dietary treatments known to impact the WBPT rate, with different protein contents (normalv.high) and amino acid profiles (balancedv.unbalanced in methionine). The15N depletion rate found in plasma proteins represented their fractional synthesis rate, whereas the slow depletion rate found in urine was interpreted as a proxy of the WBPT. The proxy tested in urine suggested different WBPT values between the normal- and high-protein diets but not between the balanced and unbalanced methionine diets. In contrast, the proxy tested in plasma indicated that both dietary conditions affected the fractional synthesis rate of plasma proteins. We considered that the rate at which urine is progressively15N-depleted following an isotopic diet switch could be proposed as a non-invasive proxy of the WBPT rate in large farm animals.

A growing body of evidence supports a role for tissue-to-diet 15N and 13C discrimination factors (&Delta, 15N and &Delta, 13C), as biomarkers of metabolic adaptations to nutritional stress, but the underlying mechanisms remain poorly understood. In obese rats fed ad libitum or subjected to gradual caloric restriction (CR), under a maintained protein intake, we measured &Delta, 13C levels in tissue proteins and their constitutive amino acids (AA) and the expression of enzymes involved in the AA metabolism. CR was found to lower protein mass in the intestine, liver, heart and, to a lesser extent, some skeletal muscles. This was accompanied by &Delta, 15N increases in urine and the protein of the liver and plasma, but &Delta, 15N decreases in the proteins of the heart and the skeletal muscles, alongside &Delta, 13C decreases in all tissue proteins. In Lys, &Delta, 15N levels rose in the plasma, intestine, and some muscles, but fell in the heart, while in Ala, and to a lesser extent Glx and Asx, &Delta, 13C levels fell in all these tissues. In the liver, CR was associated with an increase in the expression of genes involved in AA oxidation. During CR, the parallel rises of &Delta, 15N in urine, liver, and plasma proteins reflected an increased AA catabolism occurring at the level of the liver metabolic branch point, while &Delta, 15N decreases in cardiac and skeletal muscle proteins indicated increased protein and AA catabolism in these tissues. Thus, an increased protein and AA catabolism results in opposite &Delta, 15N effects in splanchnic and muscular tissues. In addition, the &Delta, 13C decrease in all tissue proteins, reflects a reduction in carbohydrate (CHO) oxidation and routing towards non-indispensable AA, to achieve fuel economy.

Discipline Epidemiologie. Introduction et but de l’etude Comme l’abondance naturelle en 15N (δ15N) dans l’organisme depend de l’exposition alimentaire et du statut nutritionnel, les variations de δ15N le long de la tige capillaire pourraient servir a retracer leurs historiques. Cette etude visait a en apporter la preuve de concept dans le contexte de la prise en charge nutritionnelle de la malnutrition aigue severe (MAS) chez le jeune enfant. Materiel et methodes L’etude a pris appui sur une etude longitudinale menee par Action Contre la Faim (ACF) a Cox's Bazar, au Bangladesh, sur un echantillon de 144 jeunes enfants souffrant de MAS sans complications medicales. La MAS a ete diagnostiquee selon les 2 indicateurs anthropometriques de l’OMS : le perimetre medio-brachial (PMB, Resultats et analyse statistique Chez les 68 enfants analyses jusqu’ici (56 % de sexe feminin, âge de 19 ± 14 mois, poids de 6,7 ± 2,1 kg, taille de 72,6 ± 12,2 cm et PMB de 114 ± 8,6 mm a l’admission), au cours de la prise en charge nutritionnelle, le δ15N des cheveux baissait moderement lors de la 1e quinzaine (–0,12 ± 0,34 ‰, p Conclusion Apres la denutrition qui avait probablement induit une augmentation du δ15N du fait de la fonte proteique subie, la renutrition entraine une baisse (renormalisation) du δ15N qui est bien proportionnelle a l’augmentation (renormalisation) de certains indicateurs anthropometriques. Les correlations etaient plus marquees avec les indicateurs lies au poids qu’avec ceux lies a la masse musculaire comme le PMB. Ces resultats partiels, issus de l’analyse de ∼50 % des enfants, seront completes pour augmenter la puissance de l’etude.

Discipline Epidemiologie. Introduction et but de l’etude Une transition dietetique vers une restructuration de la consommation de sources de proteines a debute dans les annees 2000 dans les pays occidentaux du fait, notamment, de l’emergence de critiques sur les consequences potentielles des niveaux de consommation actuels de produits carnes sur le bien-etre animal, l’environnement et la sante. Plus recemment, cette transition s’est manifestee par une progression des comportements de vegetarisme et de flexitarisme. L’objectif de cette etude etait de caracteriser les differents stades de cette transition dietetique, en termes de consommation d’aliments proteiques et d’attitudes vis-a-vis des proteines animales. Materiel et methodes Un questionnaire auto-administre en ligne a ete rempli entre avril et mai 2018 par un echantillon representatif de la population francaise (n = 2692). Les individus ont precise leur regime alimentaire et rempli un frequentiel concernant leur consommation alimentaire. Ils ont repondu a des questions sur leurs attitudes et croyances vis-a-vis des proteines animales sur la sante, l’environnement et le bien-etre animal (sous forme de scores, un score eleve correspondant a une vision deletere des produits carnes). Nous avons identifie 4 profils de consommateurs en fonction de leur stade dans la transition dietetique : les individus se declarant vegetariens ; ceux se declarant flexitariens ; ceux ayant declare envisager de ne consommer de la viande qu’une seule fois par semaine (pro-flexitariens) ; et ceux sans regime particulier (omnivores). Resultats et analyse statistique Dans la population, 2,0 % des individus se sont declares vegetariens, 6,5 % flexitariens et 18,7 % pro-flexitariens. La consommation de viande totale diminue en fonction du stade de transition dietetique declare : 97 ± 8 g/j pour les omnivores, 53 ± 10 g/j pour les pro-flexitariens, 27 ± 7 g/j pour les flexitariens et 8 ± 2 g/j pour les vegetariens. Cette gradation est similaire pour tous les types de viande (porc, bœuf et volaille), sauf la charcuterie dont la consommation est similaire entre omnivores et pro-flexitariens et entre flexitariens et vegetariens. La consommation d’œufs, de plats prepares, de sandwiches et de fast foods est similaire entre les profils. Les omnivores consomment moins de legumes et legumineuses et plus de pain que les autres profils. Enfin, les flexitariens consomment plus de noix et graines, et moins de pâtes, de lait et de fromage que les autres profils. Les scores lies aux attitudes vis-a-vis des produits carnes sur la sante, l’environnement et le bien-etre animal suivent la meme tendance que la consommation de viande, avec les scores les plus faibles chez les omnivores puis des scores de plus en plus eleves chez les pro-flexitariens, flexitariens, et vegetariens. Conclusion La population francaise presente differents profils de consommation proteique avec, depuis les omnivores jusqu’aux vegetariens, une baisse de la consommation de produits carnes et une augmentation de la consommation de legumes et legumineuses. Les attitudes envers la viande en lien avec la sante, l’environnement et le bien-etre animal sont associees aux profils de consommation et donc pourraient expliquer le stade des individus au sein de la transition dietetique.

Animal tissues are naturally 15N enriched relative to their diet and the extent of this difference (Δ15Nanimal-diet) has been correlated to the efficiency of N assimilation in different species. The rationale is that transamination and deamination enzymes, involved in amino acid metabolism are likely to preferentially convert amino groups containing 14N over 15N. However, in ruminants the contribution of rumen bacterial metabolism relative to animal tissues metabolism to naturally enrich animal proteins in terms of 15N has been not assessed yet. The objective of this study was to assess the impact of rumen and digestion processes on the relationship between Δ15Nanimal-diet and efficiency of N utilization for milk protein yield (milk N efficiency (MNE); milk N yield/N intake) as well as the relationship between the 15N natural abundance of rumen bacteria and the efficiency of N use at the rumen level. Solid- and liquid-associated rumen bacteria, duodenal digesta, feces and plasma proteins were obtained (n=16) from four lactating Holstein cows fed four different diets formulated at two metabolizable protein supplies (80% v. 110% of protein requirements) crossed by two different dietary energy source (diets rich in starch v. fiber). We measured the isotopic N fractionation between animal and diet (Δ15Nanimal-diet) in these different body pools. The Δ15Nanimal-diet was negatively correlated with MNE when measured in solid-associated rumen bacteria, duodenal digesta, feces and plasma proteins, with the strongest correlation found for the latter. However, our results showed a very weak 15N enrichment of duodenal digesta (Δ15Nduodenal digesta-diet mean value=0.42) compared with that observed in plasma proteins (Δ15Nplasma protein-diet mean value=2.41). These data support the idea that most of the isotopic N fractionation observed in ruminant proteins (Δ15Nplasma protein-diet) has a metabolic origin with very little direct impact of the overall digestion process on the existing relationship between Δ15Nplasma protein-diet and MNE. The 15N natural abundance of rumen bacteria was not related to either rumen N efficiency (microbial N/available N) or digestive N efficiency (metabolizable protein supply/CP intake), but showing a modest positive correlation with rumen ammonia concentration. When using diets not exceeding recommended protein levels, the contribution of rumen bacteria and digestion to the isotopic N fractionation between animal proteins and diet is low. In our conditions, most of the isotopic N fractionation (Δ15Nplasma protein-diet) could have a metabolic origin, but more studies are warranted to confirm this point with different diets and approaches.

International audience; Animal proteins are naturally 15N enriched relative to the diet and the extent of this difference (Δ15Nanimal-diet or N isotopic fractionation) has been correlated to N use efficiency (NUE; N gain or milk N yield/N intake) in some recent ruminant studies. The present study used meta-analysis to investigate whether Δ15Nanimal-diet can be used as a predictor of NUE across a range of dietary conditions, particularly at the level of between-animal variation. An additional objective was to identify variables related to N partitioning explaining the link between NUE and Δ15Nanimal-diet. Individual values from eight publications reporting both NUE and Δ15Nanimal-diet for domestic ruminants were used to create a database comprising 11 experimental studies, 41 treatments and individual animal values for NUE (n=226) and Δ15Nanimal-diet (n=291). Data were analyzed by mixed-effect regression analysis taking into account experimental factors as random effects on both the intercept and slope of the model. Diets were characterized according to the INRA feeding system in terms of N utilization at the rumen, digestive and metabolic levels. These variables were used in a partial least squares regression analysis to predict separately NUE and Δ15Nanimal-diet variation, with the objective of identifying common variables linking NUE and Δ15Nanimal-diet. For individuals reared under similar conditions (within-study) and at the same time (within-period), the variance of NUE and Δ15Nanimal-diet not explained by dietary treatments (i.e. between-animal variation plus experimental error) was 35% and 55%, respectively. Mixed-effect regression analysis conducted with treatment means showed that Δ15Nanimal-diet was significantly and negatively correlated to NUE variation across diets (NUE=0.415 -0.055×Δ15Nanimal-diet). When using individual values and taking into account the random effects of study, period and diet, the relationship was also significant (NUE=0.358 -0.035×Δ15Nanimal-diet). However, there may be a biased prediction for animals close to zero, or in negative, N balance. When using a novel statistical approach, attempting to regress between-animal variation in NUE on between-animal variation in Δ15Nanimal-diet (without the influence of experimental factors), the negative relationship was still significant, highlighting the ability of Δ15Nanimal-diet to capture individual variability. Among the studied variables related to N utilization, those concerning N efficiency use at the metabolic level contributed most to predict both Δ15Nanimal-diet and NUE variation, with rumen fermentation and digestion contributing to a lesser extent. This study confirmed that on average Δ15Nanimal-diet can predict NUE variation across diets and across individuals reared under similar conditions.