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Nutrition and Metabolic Factors
Published in Michael H. Stone, Timothy J. Suchomel, W. Guy Hornsby, John P. Wagle, Aaron J. Cunanan, Strength and Conditioning in Sports, 2023
Michael H. Stone, Timothy J. Suchomel, W. Guy Hornsby, John P. Wagle, Aaron J. Cunanan
The biological value (BV) of a protein is a measure of the absorption and utilization of a protein. If the BV of a protein is higher, more nitrogen is absorbed, used, and retained, making proteins with higher BV those that can better promote greater levels of tissue remodeling and muscle gains. Protein synthesis (anabolism) in humans requires approximately 22 distinct amino acids, nine of which are classified as essential amino acids (EAA) in adults. Essential amino acids are defined as those that cannot be synthesized within the human body and must instead be consumed within an individual’s diet (Table 4.3). In contrast, nonessential amino acids can be synthesized from other substances, such as carbohydrate, assuming an adequate nitrogen source (such as other amino acids) has been made available. Regarding various food sources that supply EAA, some dietary proteins have been classified as either complete or incomplete proteins. Complete proteins are those that contain all the EAA needed for the synthesis of human tissue and have a high BV. Many of these proteins are typically found in animal sources and products such as red meat, dairy products, eggs, fish, and fowl. In contrast, incomplete proteins are those that contain very low amounts of one or more EAA. These proteins generally originate from plant sources and include nuts, grains, legumes, and seeds. However, it should be noted that the quantity of protein available in some plant sources (e.g., beans) is relatively high and may partially offset the lower BV that is typical of incomplete proteins.
Parenteral Nutrition Components, Admixture and Administration
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
In nature, protein sources vary in terms of their amino acid content. The digestibility of a protein and its amino acid content can be given a numeric score called the biological value (BV). For example, soy protein has a BV of 74 whereas whey protein has a BV of 96 (Srikantia 1981). MAAs in PN have a high BV because they contain ~50% EAAs.
Inborn Errors of Metabolism
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Surekha Pendyal, Areeg Hassan El-Gharbawy
Dietary management of PKU requires utilization of medical food (metabolic formula) devoid of PHE to meet protein and energy needs, provide micronutrients missing from diet, and in the implementation of a low-protein diet to restrict the intake of PHE. Prescription of medical food and dietary PHE allowance is based on individual PHE tolerance. An individual with classical PKU may derive as much as 80% of protein needs from the medical food and only 20% natural protein from foods due to limited ability to metabolize PHE. An individual with mild PKU on the other hand is likely to have a bigger allowance of dietary protein and hence need less of the medical food. The protein in medical foods is present as free amino acids which are rapidly digested and absorbed and result in lower nitrogen retention than intact proteins of higher biological value. Hence, the protein requirement in patients with PKU is 20%–50% above the RDA. The amount of medical food prescribed is based on the difference between the total protein recommendation and the intact protein allowance. For best utilization, consumption of medical food should be divided in multiple doses daily.
Dietary intake of HIV-seropositive clients attending Longisa County Hospital Comprehensive Care Clinic, Bomet County, Kenya
Published in South African Journal of Clinical Nutrition, 2020
Kenneth Kipngeno Tonui, Eunice Njogu, Agatha Christine Onyango
According to the WHO,1 HIV-seropositive adults require approximately 50% to 100% more proteins than non-HIV-infected adults. Irregular consumption of legumes, meats, eggs and fish by the HIV-seropositive respondents in the current study meant that the protein needs were rarely met. As such, the respondents were more predisposed to protein energy malnutrition. The most frequently consumed source of protein was milk. While it is true that milk is a high biological value protein (animal-based protein), there is always the need to complement plant and animal proteins to enhance the nutritional status of an individual. The most probable reason for reduced consumption of proteins by the respondents is the reduced production of such foods in the study area. The commonly consumed staple food crop in the study location (Bomet County) is maize,8 which is milled into flour and consumed as porridge. In addition, beans are grown in this area. On another note, irregular consumption of certain protein types such as fish by the respondents is a result of cultural norms, whereby fish is not considered as a food by the Kalenjin and Maasai cultures whose members are the major residents in the areas surrounding the study setting.9,10
Phenylketonuria in the adult patient
Published in Expert Opinion on Orphan Drugs, 2019
Leticia Ceberio, Álvaro Hermida, Eva Venegas, Francisco Arrieta, Montserrat Morales, Maria Forga, Montserrat Gonzalo
Dietary treatment is the basis of PKU management. It consists of eating low-protein foods in order to restrict the Phe intake. Foods rich in high biological value (HBV) proteins (meat, fish, eggs, dairy products, legumes, and nuts) are completely restricted. The limitations for foods rich in medium biological value (MBV) proteins (cereals) are variable while foods containing low biological value (LBV) proteins (fruits, vegetables, sugars, fats and oils) can be freely consumed. This severe restriction of natural protein intake should be supplemented with a suitable Phe-free protein substitute that supplies much of the essential amino acid needs. Protein substitutes typically provide 52% to 80% of the total protein intake [41]. The recommended daily intake of protein through the supplements varies between 1.7–2g/kg as the individual tolerance [19]. Besides proteins, this restricted diet may lack other important nutrients including omega-3 essential fatty acids, vitamins, minerals and trace elements. Their supplementation is essential, thus they are included in many Phe-free L-amino acid formulas for different age patients. In Spain, these formulas are fully financed by the Spanish National Health Service (SNHS). Although there is not sufficient data to establish an appropriate dosage and frequency of the protein substitute for adults [41], the European guidelines advise to divide the intake of Phe-free L-amino acids mixture into at least 3 equal portions throughout the day to minimize fluctuations in blood Phe concentrations and losses of L-amino acids [4].
Development of a Natural Product Rich in Bioavailable Omega-3 DHA from Locally Available Ingredients for Prevention of Nutrition Related Mental Illnesses
Published in Journal of the American College of Nutrition, 2020
Christina N. Charles, Hulda Swai, Titus Msagati, Musa Chacha
Apart from omega-3 fatty acids, single serving of the optimized formulation contains 15 mg and 95 mcg of iron and vitamin A, respectively, which are reported as one of the most limiting nutrients among children in the developing world. This amount can achieve about 100% and 50% of recommended daily intake (RDI) for iron and vitamin A, respectively, for a 1 to 3-year-old child. This amount can also achieve about 60% RDI for iron and approximately 30% RDI for vitamin A, for an adolescent girl (42). Likewise, one serving of the optimized formulation can achieve 100% RDI for vitamin B3, 100% RDI for vitamin B6, 70% RDI for vitamin C, 60% RDI for vitamin E, 100% RDI for zinc and more than 100% RDI for magnesium for the child aged 12-36 months (42). All these nutrients are cofactors for the conversion of omega-3 ALA into omega-3 DHA in the human body. Therefore, the proposed optimized formulation is in a position to offer adequate amount of precursors which when absorbed can help consumers get more DHA from ALA conversion in the body (10). The formulation can also provide more than 100% RDI for lysine, threonine, methionine, tryptophan (limiting essential amino acids), respectively, for children aged between 1 and 2 years (43). In fact, the optimized formulation meets the recommended protein content of 10–12 percent of kcal and have a PDCAAS of 1.0 as per international standards (44). This makes the present formulation to have the protein with high biological value as that of meat and fish. The energy content (520 kcal) of the present formulation (Table 1) meets the international standards for ready to use therapeutic foods which ranges between 520 and 550 kilocalories (kcal) per 100 grams. The contribution of fatty acids to this energy is 0.3% for total omega-3 fatty acids, and 3% for total omega-6 fatty acids, all of which are within the international specifications for ready-to-use foods (44). Likewise, the present formulation does not contain artificial antioxidants and artificial flavorings as per recommended standards for ready to use therapeutic foods. The present formulation is also free from table sugar, instead it contains dried fruits for sweet taste, making it a future candidate for the management of diabetic conditions among vulnerable individuals in low income countries like Tanzania. The texture of the present formulation is a fine paste that can be squeezed easily into the mouth by a child or by his/her caregiver as per international standards (44). Furthermore, peanut (despite its availability) was not included in the formulation because of safety concerns associated with reported mycotoxin (aflatoxin) contamination in groundnuts (45).