Low protein

About: Low protein is a research topic. Over the lifetime, 8139 publications have been published within this topic receiving 213225 citations.

“Dietaly”: practical issues for the nutritional management of CKD patients in Italy

Abstract: Evidence exists that nutritional therapy induces favorable metabolic changes, prevents signs and symptoms of renal insufficiency, and is able to delay the need of dialysis. Currently, the main concern of the renal diets has turned from the efficacy to the feasibility in the daily clinical practice. Herewith we describe some different dietary approaches, developed in Italy in the last decades and applied in the actual clinical practice for the nutritional management of CKD patients. A step-wise approach or simplified dietary regimens are usually prescribed while taking into account not only the residual renal function and progression rate but also socio-economic, psychological and functional aspects. The application of the principles of the Mediterranean diet that covers the recommended daily allowances for nutrients and protein (0.8 g/Kg/day) exert a favorable effect at least in the early stages of CKD. Low protein (0.6 g/kg/day) regimens that include vegan diet and very low-protein (0.3-0.4 g/Kg/day) diet supplemented with essential amino acids and ketoacids, represent more opportunities that should be tailored on the single patient’s needs. Rather than a structured dietary plan, a list of basic recommendations to improve compliance with a low-sodium diet in CKD may allow patients to reach the desired salt target in the daily eating. Another approach consists of low protein diets as part of an integrated menu, in which patients can choose the “diet” that best suits their preferences and clinical needs. Lastly, in order to allow efficacy and safety, the importance of monitoring and follow up of a proper nutritional treatment in CKD patients is emphasized.

Topiramate: a new antiepileptic drug

Abstract: The pharmacology, pharmacokinetics, clinical efficacy, adverse effects, drug interactions, and dosage of topiramate are reviewed. Topiramate is indicated for use in the adjunctive treatment of adult partial-onset epilepsy. A sulfamate-substituted monosaccharide, it is structurally distinct from other antiepileptic agents. Topiramate acts by blocking the spread of seizures. Oral topiramate has high bioavailability and low protein binding, and as monotherapy its half-life permits once- or twice-daily administration. The drug is excreted largely unchanged in the urine. Clinical trials have shown that topiramate is effective as adjunctive therapy in treating adult partial-onset epilepsy with or without secondarily generalized seizures. In adults with refractory partial epilepsy, topiramate has shown efficacy when carbamazepine or phenytoin has failed. Topiramate may also be effective against partial-onset epilepsy and Lennox-Gastaut syndrome in children, but more pediatric studies are needed. CNS adverse effects are the most common; weight loss and nephrolithiasis have also been reported. The drug does not appear to interact significantly with other antiepileptic agents, but enzyme inducers like phenytoin and carbamazepine can decrease serum topiramate levels by 50%. The initial dosage is 50 mg nightly for seven nights, followed by an increase weekly to 400 mg/day in two divided doses. Topiramate is more costly than other anticonvulsants; however, drug therapy accounts for less than 10% of the total direct cost of epilepsy treatment. Topiramate offers an effective, well-tolerated option in patients with adult partial-onset seizures.

Composition and nutritional quality of pea (Pisum sativum L.), faba bean (Vicia faba L. spp. minor) and lentil (Lens culinaris Medik) meals, protein concentrates and isolates

Abstract: Pea (Pisum sativum L.), faba bean (Vicia faba L. spp. minor), and lentil (Lens culinaris Medik.) meals, protein concentrates and isolates were analyzed for proximate composition, oligosaccharides, and amino acid composition. Protein quality was evaluated using a mouse bio-assay. The concentrates contained 59.2 to 70.6% and the isolates 86.7 to 90.8% protein (N × 6.25) on moisture-free basis. Glucose, sucrose, raffinose, stachyose and verbascose were present in the highest concentrations in the protein concentrates (7.1 to 11.1%), the pea protein concentrate contained 8.7% sugars and faba bean and lentil protein concentrates 7.1% and 6.6% respectively. The protein isolates were almost free (containing less than 0.79%) of the sugars. Amino acid composition of the meals, concentrates and isolates showed, as expected, sulfur-amino acid deficiency (about two thirds of the rat requirement), which was probably largely responsible for the low protein efficiency ratios (0.75 to 1.18), and net protein ratios (0.25 to 0.73) of the three products, compared to values of 2.56 and 2.18 respectively obtained for casein. The protein digestibilities of the meals, concentrates and isolates (81 to 90%) were similar to that of casein (87%). The poor growth-promoting abilities of the meals, concentrates and isolates were possibly also due to growth-depressing factors such as tannins, trypsin inhibitors and hemagglutinins present, particularly in faba bean and lentil.

Amino Acid Supplementation of Low-Protein Broiler Diets: 1. Glutamic Acid and Indispensable Amino Acid Supplementation

Abstract: To maintain optimal growth and carcass development, nutritionists commonly fortify diets low in crude protein (CP) with crystalline amino acids. This experiment sought to apply the ideal amino acid concept and the need of dispensable amino acid nitrogen in poultry by evaluating the effects of lower levels of CP along with amino acid supplementation on broiler performance and carcass development. Lowering dietary CP without amino acid supplementation reduced body weight (BW) gain and increased feed:gain ratio. Supplementation of glutamic acid (Glu) had no effect on feed conversion, but appeared to decrease feed intake and BW gain. Supplementation of indispensable amino acids (IDAA) in addition to Glu to the reduced CP diets improved BW gain and feed:gain ratio, but failed to improve performance to a level achieved by birds fed the positive control diet. Lowering dietary CP, without or with Glu, resulted in reduced carcass yield, increased percentage abdominal fat, and reduced breast meat yield. Birds fed diets supplemented with IDAA + Glu had carcass yields, percentage abdominal fat, and breast meat yields similar to those of birds fed the positive control. This research demonstrates the importance of IDAA in low-CP broilers diets, but failed to show an advantage to Glu supplementation as a dispensable amino acid nitrogen source.

Sepsis modifies the contribution of different organs to whole-body protein synthesis in rats.

Abstract: 1. Protein synthesis rate was measured in the liver, muscle, intestine and whole body of septic rats and pair-fed controls by administration of a large dose of L-[U14C]valine. Sepsis was induced by intravenous injection of live bacteria, and protein synthesis measurements were carried out 48 h later. 2. Septic rats exhibited a reduction in food intake to between 10 and 50% of the normal level on the 2 days after infection. Animals lost body weight and the relative organ weight was increased in liver, unchanged in intestine and decreased in skeletal muscle. 3. The fractional protein synthesis rate of the whole body excluding liver was increased by 19% in septic rats in comparison with pair-fed controls, but the absolute protein synthesis rate was similar in the two groups because of the low protein content of the infected group. 4. The fractional protein synthesis was increased in whole intestine and liver but was decreased in skeletal muscle. In muscle and liver, the difference between infected and pair-fed animals was more pronounced for the absolute than for the fractional protein synthesis rate. In intestine, the fractional protein synthesis rate was similarly increased in whole intestine and the muscular layer of ileum. This suggests different regulation of protein synthesis in skeletal and smooth muscles. 5. The present investigation shows a complete redistribution of protein synthesis in sepsis. Liver represents about a third of the whole-body protein synthesis instead of 15% and becomes predominant over synthesis of muscle.