Osteoporosis, a major public health problem, likely has its origins in childhood. During periods of rapid skeletal growth, diet may influence accrual of bone mineral density (BMD) and adult bone health. This study used novel approaches in bone imaging to further characterize optimal skeletal development and enhance our understanding of key dietary components that influence attainment of peak bone mass (PBM) and contribute to determinants of peak bone strength in peri-pubertal females. The use of a validated food-frequency questionnaire (FFQ) enabled the influence of usual dietary intake on bone parameters to be examined.This study examined the relationship of dietary intake of micronutrients and bone macro-architectural structure in peri-pubertal girls. This study suggested that vitamin C and zinc intake are associated with objective measures of bone status in 4th, but not 6th grade girls. This indicates potential differences in micronutrient and bone associations at various age-associated stages of bone maturation.The impact of dietary fat on peri-pubertal skeletal growth is not well characterized. This study examined relationships of select dietary fatty acid (FA) intakes and measures of bone status in peri-pubertal girls. This study suggested that MUFA, total PUFA, n-6 and linoleic acid (LA) are inversely associated with bone status prior to menarche, but composition of dietary fat may be more important during the early-pubertal years. Decreased intakes of n-6 PUFA may benefit bone health in young girls.The impact of a dietary protein on volumetric bone mineral density (vBMD), bone mineral content (BMC) and bone strength throughout maturation remains controversial. Given evidence of both anabolic and catabolic affects of protein on bone health, this study examined relations of dietary protein from different sources with bone parameters in peri-pubertal girls. This study showed that dietary protein intake is related to higher trabecular but not cortical vBMD, BMC and BSI, and accounts for 2-4% of their variability in peri-pubertal girls. The relationship seems to vary by the source of dietary protein and calcium intake. However, a negative impact of animal protein on bone health is not supported. Large scale observational and intervention studies are needed to establish causality.

As dificuldades associadas à coleta de urina de 24h e à baixa credibilidade do uso do biomarcador na prática clínica para estimar a ingestão de proteína de pacientes com doença renal crônica (DRC) na fase não-dialítica sinalizam para busca de alternativas acuradas e de ampla acessibilidade para a descrição do consumo de proteína nessa população. Avaliar a acurácia de métodos de inquérito dietético para estimar o consumo de proteína em pacientes de DRC na fase não dialítica e, a concordância desses com o biomarcador de ingestão protéica. Também foi avaliado a concordâncias entre o registro alimentar (RA) e recordatório alimentar de 24 horas (Rec24h). Cento e vinte e dois pacientes com DRC na fase não dialítica, que atenderam aos critérios de elegibilidade, foram submetidos à avaliação antropométrica, laboratorial e, tiveram a ingestão de proteína estimada por três métodos de avaliação do consumo alimentar, sendo estes dois métodos de inquérito dietético e um método de biomarcador. Os métodos de inquéritos alimentares compreenderam 4 dias de RA e 2 dias de Rec24h. Para o biomarcador foi avaliado a excreção de nitrogênio uréico em uma amostra de urina de 24 horas, o qual foi utilizado em equação do equivalente protéico do aparecimento do de nitrogênio uréico (PNA). Na análise estatística dos métodos de inquérito dietético, utilizou-se o PC-Side para estimar a variabilidade da ingestão de proteína, equações para estimar o número de dias necessários para estimativas acuradas da ingestão de proteína em avaliações no nível individual e coletivo. Para avaliar a concordância entre os três métodos de avaliação do consumo de proteína, utilizou-se o Concordance correlation coefficient (CCC) e o gráfico de Bland & Altman. Resultados: Os 4 dias de RA e 2 Rec24h descreveram com acurácia elevada a ingestão de proteína no nível coletivo, sendo respectivamente de 0,85 e 0,73. Para o nível individual, com erro tolerado intermediário de 20% (acurácia de 0,8), foram necessários 6 dias de RA e 5 de Rec24h para avaliação do consumo de proteína. Ao avaliar a concordância entre o PNA com o RA e Rec24h, observou-se CCC reduzido (< 0,3). Da mesma forma, ao avaliar a dispersão individual das diferenças obtidas entre o PNA e RA e Rec24h pelo gráfico de Bland & Altman, notou-se valores amplos de limite de concordância. Por outro lado, valores mais elevados de CCC (>0,4) foram encontrados entre o RA e o Rec24h. O gráfico de Bland & Altman desses dois métodos mostrou menor dispersão. Contudo, essa melhor concordância pode ser decorrente de superestimação da correspondência entre os métodos. Além disso, a concordância reduzida observada entre o PNA e o RA e Rec24h não permitiram afirmar que os métodos de inquéritos dietéticos ofereçam medidas irreais da ingestão de proteína, nem tampouco foi possível afirmar que a medida real é aquela sugerida pelo PNA. Em pacientes com DRC na fase não dialítica, orientada a seguir dieta hipoprotéica, o RA e Rec24h podem ser usados em substituição ao uso PNA como alternativas de baixo custo e de ampla acessibilidade à prática clínica para descrever a ingestão de proteína, desde que sejam definidos o nível da avaliação, o número ideal de dias e a acurácia desejada. / It has been well described in the literature the errors inherent to the 24 hours urine collection in free-living individuals. Therefore, the assessment of protein intake in nondialyzed chronic kidney disease (CKD) patients by the urinary urea excretion in the 24 hour urine sample, may lead to important errors related to the method itself. In this regard, assessing surrogate methods is of high relevance. To evaluate the accuracy of the dietary methods to estimate the protein consumption in nondialyzed CKD patients and also to assess the agreement between a biomarker of protein intake and dietary methods. In addition, it was also evaluated the agreement between two dietary methods. One hundred and twenty-two nondialyzed CKD patients, who met the eligibility criteria, were included. All participants underwent to antropometric and laboratory assessments, and had the protein intake estimated by three methods: two methods of dietary intake and one dietary biomarker. The dietary intake comprised 4 days of food records (FRec) and 2 days of 24-hour food recall (24hFRecall). For the biomarker, it was evaluated the urinary urea nitrogen excretion in a 24 hours urine sample, which was used in the equation of the protein equivalent of nitrogen appearance (PNA). The software PC-Side was used to estimate the variability of the protein intake in the FRec and 24hFRecall. In addition, specific equations were used to assess the number of days needed to estimate the protein intake with high accuracy in the individual and collective level. In order to evaluate the agreement between the 3 methods, it was used the concordance correlation coefficient (CCC) and the Bland & Altman plot analysis (1986). In the collective level, 4 days FRec and the 2 days of 24hFRecall described the protein intake with an accuracy close the highest acceptable level, being of respectively 0.85 and 0.73. For the individual level, by accepting an intermediate tolerated error of 20% (accuracy 0.8), 6 days of FR and 5 days of 24hFR were needed for the assessment of protein intake. When assessing the agreement between the PNA and the FRec and 24hFRecall, it was observed reduced CCC (< 0.3). Likewise, when evaluating the individual differences obtained between the PNA and the FRec and 24hFRecall by the Bland & Altman plot analysis, it was observed a wide concordance limit, which is consistent with the low concordance observed between the methods. Moreover, higher values of CCC (> 0.4) were found between the FRec and 24hFRecall. The Bland & Altman plot analysis of these two methods showed more narrows differences, which is consistent with the higher CCC observed. However, this best agreement may be due to an overestimation between the methods. Furthermore, the reduced concordance observed between the PNA and the FRec and 24hFRecall does not mean that the dietary intake methods give biased or unrepresentative measurements of protein intake, nor was that the PNA gave unbiased measurements of protein intake. FRec and 24hFRecall can be used as surrogate methods for the PNA, as an alternative low cost and high applicability method in the clinical routine practice to describe the protein intake.

As dificuldades associadas à coleta de urina de 24h e à baixa credibilidade do uso do biomarcador na prática clínica para estimar a ingestão de proteína de pacientes com doença renal crônica (DRC) na fase não-dialítica sinalizam para busca de alternativas acuradas e de ampla acessibilidade para a descrição do consumo de proteína nessa população. Avaliar a acurácia de métodos de inquérito dietético para estimar o consumo de proteína em pacientes de DRC na fase não dialítica e, a concordância desses com o biomarcador de ingestão protéica. Também foi avaliado a concordâncias entre o registro alimentar (RA) e recordatório alimentar de 24 horas (Rec24h). Cento e vinte e dois pacientes com DRC na fase não dialítica, que atenderam aos critérios de elegibilidade, foram submetidos à avaliação antropométrica, laboratorial e, tiveram a ingestão de proteína estimada por três métodos de avaliação do consumo alimentar, sendo estes dois métodos de inquérito dietético e um método de biomarcador. Os métodos de inquéritos alimentares compreenderam 4 dias de RA e 2 dias de Rec24h. Para o biomarcador foi avaliado a excreção de nitrogênio uréico em uma amostra de urina de 24 horas, o qual foi utilizado em equação do equivalente protéico do aparecimento do de nitrogênio uréico (PNA). Na análise estatística dos métodos de inquérito dietético, utilizou-se o PC-Side para estimar a variabilidade da ingestão de proteína, equações para estimar o número de dias necessários para estimativas acuradas da ingestão de proteína em avaliações no nível individual e coletivo. Para avaliar a concordância entre os três métodos de avaliação do consumo de proteína, utilizou-se o Concordance correlation coefficient (CCC) e o gráfico de Bland & Altman. Resultados: Os 4 dias de RA e 2 Rec24h descreveram com acurácia elevada a ingestão de proteína no nível coletivo, sendo respectivamente de 0,85 e 0,73. Para o nível individual, com erro tolerado intermediário de 20% (acurácia de 0,8), foram necessários 6 dias de RA e 5 de Rec24h para avaliação do consumo de proteína. Ao avaliar a concordância entre o PNA com o RA e Rec24h, observou-se CCC reduzido (< 0,3). Da mesma forma, ao avaliar a dispersão individual das diferenças obtidas entre o PNA e RA e Rec24h pelo gráfico de Bland & Altman, notou-se valores amplos de limite de concordância. Por outro lado, valores mais elevados de CCC (>0,4) foram encontrados entre o RA e o Rec24h. O gráfico de Bland & Altman desses dois métodos mostrou menor dispersão. Contudo, essa melhor concordância pode ser decorrente de superestimação da correspondência entre os métodos. Além disso, a concordância reduzida observada entre o PNA e o RA e Rec24h não permitiram afirmar que os métodos de inquéritos dietéticos ofereçam medidas irreais da ingestão de proteína, nem tampouco foi possível afirmar que a medida real é aquela sugerida pelo PNA. Em pacientes com DRC na fase não dialítica, orientada a seguir dieta hipoprotéica, o RA e Rec24h podem ser usados em substituição ao uso PNA como alternativas de baixo custo e de ampla acessibilidade à prática clínica para descrever a ingestão de proteína, desde que sejam definidos o nível da avaliação, o número ideal de dias e a acurácia desejada. / It has been well described in the literature the errors inherent to the 24 hours urine collection in free-living individuals. Therefore, the assessment of protein intake in nondialyzed chronic kidney disease (CKD) patients by the urinary urea excretion in the 24 hour urine sample, may lead to important errors related to the method itself. In this regard, assessing surrogate methods is of high relevance. To evaluate the accuracy of the dietary methods to estimate the protein consumption in nondialyzed CKD patients and also to assess the agreement between a biomarker of protein intake and dietary methods. In addition, it was also evaluated the agreement between two dietary methods. One hundred and twenty-two nondialyzed CKD patients, who met the eligibility criteria, were included. All participants underwent to antropometric and laboratory assessments, and had the protein intake estimated by three methods: two methods of dietary intake and one dietary biomarker. The dietary intake comprised 4 days of food records (FRec) and 2 days of 24-hour food recall (24hFRecall). For the biomarker, it was evaluated the urinary urea nitrogen excretion in a 24 hours urine sample, which was used in the equation of the protein equivalent of nitrogen appearance (PNA). The software PC-Side was used to estimate the variability of the protein intake in the FRec and 24hFRecall. In addition, specific equations were used to assess the number of days needed to estimate the protein intake with high accuracy in the individual and collective level. In order to evaluate the agreement between the 3 methods, it was used the concordance correlation coefficient (CCC) and the Bland & Altman plot analysis (1986). In the collective level, 4 days FRec and the 2 days of 24hFRecall described the protein intake with an accuracy close the highest acceptable level, being of respectively 0.85 and 0.73. For the individual level, by accepting an intermediate tolerated error of 20% (accuracy 0.8), 6 days of FR and 5 days of 24hFR were needed for the assessment of protein intake. When assessing the agreement between the PNA and the FRec and 24hFRecall, it was observed reduced CCC (< 0.3). Likewise, when evaluating the individual differences obtained between the PNA and the FRec and 24hFRecall by the Bland & Altman plot analysis, it was observed a wide concordance limit, which is consistent with the low concordance observed between the methods. Moreover, higher values of CCC (> 0.4) were found between the FRec and 24hFRecall. The Bland & Altman plot analysis of these two methods showed more narrows differences, which is consistent with the higher CCC observed. However, this best agreement may be due to an overestimation between the methods. Furthermore, the reduced concordance observed between the PNA and the FRec and 24hFRecall does not mean that the dietary intake methods give biased or unrepresentative measurements of protein intake, nor was that the PNA gave unbiased measurements of protein intake. FRec and 24hFRecall can be used as surrogate methods for the PNA, as an alternative low cost and high applicability method in the clinical routine practice to describe the protein intake.

No description available.

La cicatrisation complète de la muqueuse, définie comme l'absence de lésions visibles par endoscopie, est considérée comme un objectif thérapeutique dans la prévention des complications associées aux Maladies Inflammatoires Chroniques de l’Intestin (MICI).Dans ce contexte, le rôle de l’apport protéique alimentaire et les besoins protéiques nécessaires à la cicatrisation ont été peu étudiés. L’objectif de cette thèse était d’évaluer l’effet du niveau d’apport protéique alimentaire sur la réparation épithéliale après un épisode inflammatoire intestinal dans un modèle murin de colite chimio-induite. Dans un premier temps, l’analyse de la progression de certains modulateurs impliqués dans le processus cicatriciel a mis en évidence que la réparation colique s’initiait et se consolidait avant que l’inflammation ne soit résolue et cela, dans un contexte où la composition du microbiote adhérent à la muqueuse était altérée de manière persistante. Les effets de trois régimes alimentaires ayant un niveau d'apport protéique différent (moyen, modérément élevé et élevé) ont ensuite été évalués sur la réparation de la muqueuse colique, ce qui a permis de montrer qu’au-delà d’un certain seuil, le niveau d’apport protéique aggravait et perpétuait l’inflammation colique. En revanche, un apport modérément élevé en protéines était bénéfique par rapport à un apport moyen, de par ses effets sur la perméabilité colique, l'hyper-prolifération cryptique, l’expression de plusieurs gènes codant pour des facteurs de réparation et sur la modulation de la composition du microbiote adhérent. Enfin, ces travaux ont montré que l’inflammation et le niveau d’apport en protéines affectaient le métabolisme protéique dans des organes non-cibles de l’inflammation colique en association avec une endotoxémie persistante.Ce travail a ainsi permis de mieux comprendre les événements locaux et périphériques impliqués dans la cicatrisation de la muqueuse colique et leur modulation par un apport majoré en protéines suite à un épisode inflammatoire aigu. / Advanced mucosal healing, defined by endoscopy as the absence of visible lesions, is considered as a therapeutic goal in the prevention of complications associated with IBD.In this context, the role of dietary protein intake and the protein requirements for mucosal healing have been poorly studied. The aim of this thesis was to evaluate the effect of dietary protein intake level on epithelial repair after an acute intestinal inflammatory episode in a murine model of colitis. Firstly, the progression analysis of several modulators involved in the repairing process showed that colonic repair can be initiated and consolidated in the context of inflamed mucosa, associated with persistent alterations of the colonic luminal environment. The effect of three diets with different levels of protein intake (average, moderately high and high) on colon mucosa repair were evaluated in the same model. This study showed that, beyond a threshold, the level of protein intake aggravated and perpetuated colitis. However, a moderately high protein intake was beneficial due to its effect on colonic permeability, cryptic hyper-proliferation, expression of multiple genes encoding repair factors, and composition modulation of the mucosal-adherent microbiota. Finally, both inflammation and dietary protein intake levels altered protein metabolism of other organs at the periphery of the inflammation in association with persistent endotoxemia.This work deepened the understanding of the events involved in the epithelial repair process and their modulation by an increase in the dietary protein intake after an acute episode of colitis.

Introduction: The main topic of this diploma thesis was the nutrition of athletes compared to people with a sedentary lifestyle. Aim: The main goal of the thesis was the nutrition of athletes compared to people with a sedentary lifestyle using analyzing dietary regimen. Material and methods: We evaluated the dietary regimen of 40 women at the age of 20- 30 years old. Women were divided into the groups of non-athletes ("sedentary people") and women who exercise fitness sports ("fitness people"). Their average age was in the range of 25,3-26 years. Respondents filled out the form with their dietary regimen for three days using a 24-hod recall. Records where evaluated with using an extensive food database which was created at the Institute of Physical Education, First of Medicine, Charles University. Student's two-tailed unpaired mean t-test was used to compare the groups. We used the F-test to analysing a equation scattering before using t-test. Results: Group of fitness athletes consumed average 335 kcal less total energy (p = 0.008), 15.17 g more plant-based proteins (p = 0.031), 15.24 g less fats (p = 0.025) and 13.23 g less animal fat (p = 0.044). The results for other nutrients weren't statistically significant, but from a nutritional point of view they provided an interesting overview of eating...

Background: Higher protein diets, especially from animal sources, have seen a rise in popularity due to potential metabolic. This may have consequences for kidney function particularly in rising middle class populations who are allocating more income towards meat. The objective of this systematic review and meta-analysis was to evaluate the effects of higher versus lower protein intake on glomerular filtration rate (GFR) in adult populations without renal impairment. Methods: Search strategies were developed and electronic databases searched: MEDLINE and EMBASE. Data were extracted up until June 3, 2015. The main outcome measure was GFR and a random effect model (Cochrane’s Review Manager Version 5.3) was used to pool mean differences in GFR values. Results: Database searches yielded 25 trials from 1914 articles that were eligible for analysis based on inclusion/exclusion criteria. 12 studies were randomized controlled trials and 11 studies were crossover trials. As a result of data presented, 2 crossover studies were treated as 4 trials to result in 25 total trials. A total of 810 subjects from 25 trials were included in this systematic review and meta-analyses. The age of participants was 24-62 years and their BMI was 21-36 kg/m2. Higher protein compared to lower protein-containing diets were associated with increased GFR values [mean difference (MD): 8.33 ml/min (95% CI 4.87 to 11.79), P < 0.00001] but this was less pronounced when assessing change from baseline GFR values [MD: 4.71 ml/min (95% CI 0.06 to 9.36), P = 0.05]. Moreover, significant heterogeneity was present and funnel plot asymmetry indicated potential publication bias in both meta-analyses. Conclusion: Higher protein diets were associated with increased GFR, however, these results were inconclusive due to significant heterogeneity and overestimation by random effect analyses. There is still no clear evidence that high protein diets negatively impact renal function in healthy populations. / Thesis / Master of Science (MSc) / Globally, the leading causes of mortality in industrialized countries are cardiovascular disease (CVD), stroke, and type 2 diabetes (T2D). Deaths from these chronic diseases now outpace deaths due to malnutrition. Being overweight and obese increases the risk of both morbidity and mortality from CVD, stroke, and T2D. Global rates of overweight and obesity have now reached ‘epidemic’ proportions and the World Health Organization has stated that, “… [a] global epidemic of overweight and obesity – ‘globesity’ – is taking over many parts of the world. If immediate action is not taken, millions will suffer from an array of serious health disorders.” Over the past 20-30 years, the popularity of higher protein energy restricted diets have grown due to the potential benefits regarding weight loss, appetite regulation, and maintenance of lean (muscle) mass. Additionally, the expansion of the global ‘middle-class’ has resulted in families allocating more income towards meat products as a primary protein source in their diet. A health concern is that higher protein intake may have an adverse effect on kidney function. In individuals with chronic kidney disease, higher protein diets have been shown to result in further renal impairment. However, the effects of increased protein intake in healthy populations are unclear. The aim of this systematic review and meta-analysis was to compare higher versus lower protein diets on kidney function in healthy populations based on the literature to date. This was accomplished by looking at changes in glomerular filtration rate (the rate at which kidneys filter blood), which is the ‘gold standard’ marker of kidney function.