From athletes to older adults: food-focused approaches for maximising the health effects of protein
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Dr Caoileann Murphy, RD
Marie Sklodowska Curie Fellow, Teagasc, Trinity College Dublin and Australian Catholic University
Bio
Caoileann is a registered dietitian currently working as a Marie Sklodowska Curie Fellow between Teagasc, Dublin and Australian Catholic University, Melbourne. Caoileann has an MSc in Sport and Exercise Nutrition from Loughborough University, UK and a PhD in Nutrition, Exercise and Health from McMaster University, Canada. Caoileann’s research is mainly focused on nutrition and exercise strategies to maintain muscle mass and strength in ageing, with a focus on personalized approaches. Caoileann was awarded the Irish Nutrition and Dietetic Institute Research Dietitian of the Year 2018 and the British Nutrition Foundation Drummond Early Career Scientist Award 2018.
Summary
Practical aspects of optimizing food-focused protein nutrition
Accumulating evidence suggests that higher protein intakes (i.e. above the recommended daily allowance of 0.8 g/kg/d) can enhance adaptations to exercise training and slow the loss of muscle mass and function with age. A food-first approach to achieving protein requirements has numerous advantages including the co-consumption of other essential nutrients, food matrix effects, and enhanced palatability, affordability, acceptability, accessibility and social aspects. For example, increasing dairy foods was recently shown to be a practical, acceptable and low cost intervention for increasing protein (and calcium) intakes and reducing falls and fractures among older adults living in residential care.
In addition to the total daily protein intake, per-meal protein intake and characteristics of the protein source (protein quality, protein density, energy content, volume, texture, convenience) are important considerations. There is a saturable dose-response relationship between the quantity of protein consumed in a single meal and the postprandial rate of muscle protein synthesis. This suggests that the consumption of an even pattern of protein intake, with an optimally stimulatory amount of protein at each of the daily meals, would effectively stimulate rates of muscle protein synthesis throughout the day. However, in practice, older adults and athletes tend to skew protein intake, consuming the majority of daily protein (~40% – 50%) at the evening meal and smaller, suboptimal amounts at the other meals. Protein intakes are typically particularly low at breakfast and therefore this represents a good target to improve intake via increased consumption of protein-dense, culturally acceptable foods (e.g. eggs, dairy, smoked fish).
Different sources of protein vary in their capacity to stimulate muscle protein synthesis due to differences in their essential amino acid content and digestibility. Some, but not all, studies report that isolated plant-based proteins like soy and wheat are less effective for stimulating muscle protein synthesis than animal proteins like whey. Nonetheless, it appears that the lesser anabolic properties of plant-derived proteins can be overcome with the ingestion of a larger protein dose and/or by combining different sources of protein within the meal. From a practical perspective, many whole food sources of plant protein are lower in protein density, meaning that a large amounts (volume and energy content) must be consumed to derive an equivalent amount of protein. As such, the most appropriate whole food sources of protein to achieve the per-meal protein target will vary between individuals depending on factors such as age, appetite, energy requirement, activity levels, and personal preferences.
Dr Nicholas A Burd
Associate Professor, Department of Kinesiology and Community Health, University of Illinois, USA
Bio
Nicholas is Associate Professor in the Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, USA. His research interest is nutrition and exercise metabolism. Nicholas has a Kinesiology PhD from McMaster University, Canada followed by a postdoctoral research fellowship at Maastricht University in the Netherlands. Nicholas’s work aims to understand how exercise, nutrition, or disease may regulate skeletal muscle mass (e.g., protein synthesis). The knowledge gained from this research is used to define nutritional and exercise strategies to improve muscle health and performance. His publications include over 100 papers in peer-reviewed journals and book chapters.
Summary
Food matrix effects – implications for the impact of protein on muscle
An adequate quantity and quality of skeletal muscle is important to optimize health and physical performance across the lifespan. Dietary protein intake is essential for stimulating skeletal muscle protein synthesis and remodeling, which ultimately contributes to the maintenance of skeletal muscle mass and health throughout adult life.
Muscle-centric protein recommendations generally recognize the value of protein quality to robustly stimulate postprandial muscle protein accretion. However, there is increasing evidence that food matrix effects are likely have an important role in the regulation of skeletal muscle mass.
The food matrix is a term used to describe the nutrient and non-nutrient components of whole foods, including how various food components are structured and their molecular interactions. Food matrix manipulations can be accomplished by heat treatment, changing food texture, as well as various food fortification techniques (i.e., leucine, omega-3, vitamin D fortifications, etc).
This presentation will outline the potential of food matrix effects to modulate the anabolic properties of protein foods and the value of nutrient and protein dense foods as the basis of a more optimal dietary allowance for protein to support skeletal muscle mass for athletes and aging.
Prof. Amandine Everard
Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Walloon Excellence in Life Sciences and BIOtechnology (WELBIO), UCLouvain, Université catholique de Louvain, Brussels, Belgium
Bio
Amandine Everard is a researcher associate from the FNRS (Fonds National de la Recherche Scientifique) at UCLouvain in Brussels, Belgium. She is professor and leading a researcher group studying the roles of gut microbes in the regulation of host metabolism and food intake at the Louvain Drug Research Institute.
She is author of more than 50 research publications in that field and her work is internationally recognized as she is part of the Highly Cited Researcher over the world.
Summary
Gut microbes: a promising therapeutic target for obesity and type-2 diabetes?
The gut microbiota is a key player involved in health and diseases. Gut microbes have been identified as important regulators of host metabolism. Therefore, different tools targeting the gut microbiota such as probiotics, are studied to reduce obesity and metabolic disorders. Probiotics have a long history of use even if a clear definition only emerged at the end the twentieth century. The more commonly exploited species are lactobacilli and bifidobacteria. Over these last years, other genus were also proposed as potential beneficial microbes and are referred as next-generation beneficial bacteria candidates. Among the potential next-generation beneficial bacteria that are under investigation in the context of obesity, Akkermansia muciniphila seems to be a promising candidate. Akkermansia muciniphila is inversely associated with obesity, diabetes, cardiometabolic diseases and low-grade inflammation. We demonstrated that this bacterium was able to counteract diet-induced obesity and metabolic disorders in mice. Nowadays, a large body of evidence also demonstrates the causal beneficial effects of Akkermansia muciniphila in several preclinical models. In order to translate these preclinical data into human applications, we administered this bacterium in volunteers suffering from overweight and metabolic syndrome. This study demonstrates that pasteurized Akkermansia muciniphila was safe and well tolerated in humans. Moreover, this first exploratory study reveals that Pasteurized Akkermansia muciniphila has also protectives effects on the deleterious progression of the metabolic syndrome over time in humans. In conclusion, these results support the interest of targeting gut microbes to counteract metabolic disorders.
Prof. Konstantinos Gerasimidis
Professor of Clinical Nutrition, University of Glasgow
Bio
Professor Konstantinos Gerasimidis is Professor of Clinical Nutrition. He has graduated in Nutrition and Dietetics and completed his postgraduate studies in Clinical Nutrition. During his doctoral research at the University of Glasgow, he explored the effect of exclusive enteral nutrition on the gut microbiota and nutritional status of children with Crohn’s disease; Professor Gerasimidis also leads a laboratory team which explores the role of gut microbiota and its interaction with diet in the onset, propagation, and management of acute and chronic conditions. He has a strong interest in exploring the effect of habitual diet, elimination diets and artificial nutritional support on the gut microbiota of children and adults with inflammatory bowel disease.
Summary
In the human gut resides a complex microbial community whose size is at least equal to that of the human body eucaryotic cells, but with a functional capacity which outnumbers that of the host by a number of 100. Recent evidence suggests that this microbial community, often named as the gut microbiome, is important not only for the onset of infectious disease but also for the development of non-communicable conditions, including conditions of the digestive tract. Diet is a major regulator of the human gut microbiome composition and function. However, the role of diet in the causal pathway between the gut microbiome and gastrointestinal disease can be complex. For example, in patients with coeliac disease, it is unclear if the gut microbiome plays a role in the underlying disease pathogenesis, or any changes observed are the effects of treatment with gluten free diet. Likewise, beneficial members of gut microbiome, like Bifidobacteria, have been implicated in the aetiology of irritable bowel syndrome (IBS), but treatment of active IBS symptoms with a low FODMAP diet further decreases the concentration of these species, and interventions with probiotics have had modest only effects. An exciting area of future research is whether we can use microbial signatures as prognostic markers of adverse disease outcomes in conditions, like intestinal failure, and also if dietary manipulation of the gut microbiome can control disease activity outcomes in patients with Crohn’s disease and ulcerative colitis.
Dr Siv Kjølsrud Bøhn
Associate professor, Norwegian University of Life Sciences
Bio
Siv Kjølsrud Bøhn (PhD) is Associate professor at Norwegian University of Life Sciences. Her current scientific focus on improving health via impacting the gut microbiota. Bøhn participates in various clinical trials across different patient populations, mainly taking the responsibility of trial- design and implementation and outcomes ranging from the microbiota-effects, molecular biomarkers, to method validations and measures of fatigue and health-related quality of life. Bøhn has teaching and supervision expertise within nutrition, public health, cell biology, biotechnology, and immunology.
Bøhn has a solid background molecular effects of diet interventions in different patient populations with hands-on experience from clinical trial design, trial implementation and biobanking, biomarker profiling of inflammation and gene expression analysis as well as statistics and bioinformatics.
Summary
Introducing the gut microbiota – why do we have bacteria in our guts and why are they important for health?
On all bodily surfaces that are exposed to the environment we find a complex and diverse ecosystem of microorganisms (bacteria, viruses, fungi, and protozoa), collectively termed the microbiota. During the last decades it has become clear that the microbes in the gut (‘the gut microbiota’), are serving many beneficial roles for our health and that disturbances in the gut microbiota are associated with the development of many different diseases. During evolution we have adapted to co-exist with the microbes using efficient strategies to keep the microbes in check in the mucosal linings. At the same time, the microbes help us to digest ‘left-over’ food components that are otherwise indigestible to us. The products of bacterial metabolism in the gut not only provide energy, but also serve other roles such as regulating the immune responses. However, we are only at the beginning of understanding how the gut microbiota and their metabolic products affect our health.
The lecture will introduce the microbiota and broadly explain why we have bacteria in our guts, what they are doing there, how we control them, how they are affected by the food that we eat and why disturbances in the microbiota may lead to diseases of various kinds.
Pauline Douglas
Ulster University, EFAD Honorary Treasurer
Pauline has over 25 years of clinical and academic experience in dietetics. Her main teaching disciplines in the Nutrition Innovation Centre for Food and Health at Ulster University are in Professional Practice for dietetic students and dietetic practice educators and Nutrition Education of healthcare professionals. She has been the Key Contact for Ulster University in the European funded “Dietitians Improving the Education and Training Standards (DIETS) project” and was a member of the Exploitation work package.
Pauline is a previous Honorary Chairman of the British Dietetic Association (BDA). She was elected to Fellowship of the BDA for her professional achievements in 2010. She is her Professional Body’s European and International representative. She is a partner with the Health and Care Professions Council, the statutory regulator for Allied Health Professions in the UK.
Pauline works closely with Ray et al across the domains of NNEdPro Global Centre for Nutrition and Health and she is an elected Visiting Scholar/College Research Associate at Wolfson College, University of Cambridge.
She is a member of the Executive Committee of the European Federation of the Associations of Dietitians (EFAD). She has led and been an integral part of the European Healthy Hydration Awareness Campaign on behalf of EFAD over the past 7 years.