Dataset Information

Protein Adequacy Is Primarily a Matter of Protein Quantity, Not Quality: Modeling an Increase in Plant:Animal Protein Ratio in French Adults.

ABSTRACT: A downward trend in animal protein (AP) intake has been observed in western countries over the last decade and the effects of such a transition on protein adequacy remain debatable. Using the probability approach and diet modeling with data on 1678 adults from a representative French national dietary survey, we studied the sensitivity of the adequacy of protein and amino acid intakes to changes in animal:plant protein. We simulated the gradual substitution of AP with different mixtures of plant protein (PP), containing various proportions of PP already consumed and legumes, nuts and seeds (LNS). We found that protein and amino acid intakes met dietary requirements in virtually the entire population studied. Up to 50% of PP in diets, protein and amino acid intakes were adequate in all models. From 50%, protein inadequacy was primary due to protein quantity, and from 70%, to protein quality (as lysine inadequacy). The introduction of LNS in the mixture substituting AP led to adequate protein intakes for higher percentages of PP. An increase in PP based on the current pattern of plant protein sources, low in protein:energy, could lead to inadequate protein intake, but the contribution of LNS ensures the safety of a further transition.

SUBMITTER: de Gavelle E

PROVIDER: S-EPMC5748783 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Protein Adequacy Is Primarily a Matter of Protein Quantity, Not Quality: Modeling an Increase in Plant:Animal Protein Ratio in French Adults.

de Gavelle Erwan E Huneau Jean-François JF Bianchi Clélia M CM Verger Eric O EO Mariotti François F

Nutrients 20171208 12

A downward trend in animal protein (AP) intake has been observed in western countries over the last decade and the effects of such a transition on protein adequacy remain debatable. Using the probability approach and diet modeling with data on 1678 adults from a representative French national dietary survey, we studied the sensitivity of the adequacy of protein and amino acid intakes to changes in animal:plant protein. We simulated the gradual substitution of AP with different mixtures of plant ...[more]

PMID: 29292749

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Project description:Plant-based low protein diets (LPDs) have gained popularity for managing chronic kidney disease (CKD) patients. The nutritional adequacy of these and other LPDs prescribed for CKD patients have not been carefully examined. This study assessed the nutrient composition of such LPDs and moderately high protein diets (MHPDs) that might be prescribed for patients in the Asia Pacific region with CKD who are not dialyzed or undergoing maintenance dialysis. Conventional diets containing at least 50% animal-based proteins and plant-based diets were also planned with protein prescriptions of 0.5 to 0.8 g/kg/day and MHPDs with protein prescriptions of 1.0 to 1.2 g/kg/day. Plant-based, lacto-, ovo-, and lacto-ovo-vegetarian and vegan LPDs and MHPDs were planned by replacing some or all of the animal proteins from the conventional diet. With 0.5 g protein/kg/day, all diets were below the Recommended Dietary Allowances (RDA) for at least one essential amino acid (EAA). At a protein prescription of 0.6 g/kg/day, only the conventional LPD met the RDA for all EAAs. This deficiency with the plant-based LPDs persisted even with several plant food substitutions. With a protein prescription ≥0.7 g/kg/day, all the plant-based and vegetarian LPDs provided the RDA for all EAA. The plant-based and vegetarian diets also contained relatively greater potassium, phosphorus, and calcium content but lower long-chain n-3 polyunsaturated fatty acids and vitamin B-12 than the conventional diet. Other essential micronutrients were commonly below the RDA even at higher protein intakes. The low contents of some essential micronutrients were found in both animal-based and plant-based diets. Prescription of all LPDs for CKD patients, especially plant-based and vegetarian LPDs, requires careful planning to ensure the adequacy of all nutrients, particularly essential amino acids. Consideration should be given to supplementing all animal-based and plant-based LPDs and MHPDs with multivitamins and certain trace elements.

Project description:Kidney biopsy is part of the diagnostic workup of many children with renal disease. Traditionally, a perpendicular approach to the biopsy has been used, but more recently, some proceduralists have favoured a tangential approach. It is not clear if one technique is superior with regards to tissue adequacy or complication rates. In our centre, interventional radiologists (IR) use general anaesthetic and a tangential approach, whereas paediatric nephrologists (PN) use sedation and a perpendicular approach. We examined consecutive native kidney biopsies performed between January 2008 and December 2017 for adequacy (sufficient tissue for light and electron microscopy and immunofluorescence) and examined the electronic medical records for data regarding technique and complications. IR performed 72 (29%) of the 245 native kidney biopsies, obtaining more total glomeruli (median 39 vs 16, p < 0.001) and more glomeruli per tissue core (median 13 vs 8, p < 0.001) than PN. No differences in specimen adequacy were observed between the two groups (79% IR vs 81% PN, p = 0.75) and a diagnosis could be made in 99% and 94% respectively (p = 0.1). A statistically lower rate of peri-nephric haematoma (28% vs 42%, p = 0.04) was detected in the IR group, but there were no significant differences in other complications. One patient required a blood transfusion (PN) and another required surgical intervention for a perinephric haematoma (IR).ConclusionIR obtained larger samples and number of glomeruli, but the overall adequacy for native kidney biopsies was good using both perpendicular and tangential techniques, with low rates of significant complications.What is known• Kidney biopsy is integral to the diagnostic work-up of many children with kidney disease. • Kidney biopsy is a safe procedure with well-established complications in a minority of children.What is new• Interventional radiologists had higher biopsy yield than paediatric nephrologists, possibly due to the tangential approach. • Biopsy adequacy rates are high using both techniques and provided a diagnosis in over 95% of cases.

Dataset Information

Protein Adequacy Is Primarily a Matter of Protein Quantity, Not Quality: Modeling an Increase in Plant:Animal Protein Ratio in French Adults.

Publications

Protein Adequacy Is Primarily a Matter of Protein Quantity, Not Quality: Modeling an Increase in Plant:Animal Protein Ratio in French Adults.

Similar Datasets

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