Search Results (2,235)

Chronic kidney disease (CKD) affects more than 10% of the world’s population, increasing the risk of cardiovascular disease and mortality. Background: Nephroprotective interventions can reduce the risk of end-stage renal disease, delay the time to dialysis, and prolong life. However, there is ongoing debate about the effectiveness of combining amino acid ketoanalogues (KAA) with a low-protein diet (LPD) to slow CKD progression. This study aimed to retrospectively analyze kidney function outcomes after a 6-month KAA+LPD regimen in patients with CKD. Methods: The analysis included results from 38 non-dialyzed patients (12 F, 26 M; age 64.0 ± 13.6 years) with stable CKD in stages G4 to G5, who followed LPD with KAA (Ketosteril, Fresenius Kabi) treatment as part of the Polish National Health Fund Ketosteril Drug Program. Results: No significant change in estimated glomerular filtration rate (eGFR) was observed during 6 months of KAA+LPD therapy. However, eGFR increased or decreased in half of the patients (p < 0.001), and this change was associated only with initial protein intake and urinary phosphate excretion. Initial high phosphate excretion was independently associated with an increase in eGFR, and initial phosphaturia > 0.5 g/24 h identified eGFR improvement (sensitivity 84.2%; specificity 57.9%; AUC 0.712; p = 0.018) in CKD patients who started KAA+LPD treatment. Conclusions: Six-month treatment with KAA+LPD may be associated with stabilization of kidney function in patients with CKD stages G4-G5. The individual effect of KAA+LPD on renal function may be related to the initial protein intake level and urinary phosphate excretion. Further studies are needed to validate these findings across larger patient populations with a broader spectrum of symptoms. Full article

Background: Pyrroloquinoline quinone (PQQ), a naturally occurring redox cofactor with potent antioxidant and anti-inflammatory properties, has been shown to protect against cardiac injury. However, its therapeutic potential in diabetic cardiomyopathy (DCM) induced by Type 2 diabetes mellitus (T2DM) and the underlying mechanisms remain poorly understood. Methods: A T2DM mouse model was established via a high-fat diet and low-dose STZ. We investigated the cardioprotective effects of 12-week oral PQQ administration, assessing fasting blood glucose, oral glucose tolerance, cardiac function, myocardial histopathology, blood biochemistry, mitophagy, and NLRP3 inflammasome activation. In vitro experiments using AC16 cardiomyocytes exposed to palmitic acid and high glucose were also conducted. Results: Results showed PQQ significantly improved cardiac function, attenuated remodeling, and reduced proinflammatory cytokines in mice with T2DM, regulated key mitophagy-related proteins (Parkin, Beclin-1, LC3B-II, p62), and downregulated NLRP3 inflammasome pathway components (Caspase-1, NLRP3, IL-1β, IL-18). In vitro experiments demonstrated that PQQ reduced reactive oxygen species (ROS) production, improved mitochondrial membrane potential, promoted mitophagy, and inhibited NLRP3 inflammasome-mediated pyroptosis. Conclusions: PQQ alleviates DCM in mice with T2DM by improving mitochondrial quality control, promoting mitophagy, and subsequently inhibiting NLRP3 inflammasome-mediated pyroptosis, highlighting its potential as a promising therapeutic agent for T2DM-associated cardiomyopathy. Full article

Nickel (Ni) is a ubiquitous trace metal, yet its physiological dynamics and dose-dependent roles in skeletal biology remain unclear. Here we combined elemental mapping, cellular assays, multi-omics and mouse models to define how Ni availability modulates osteogenesis. Ni, together with Manganese (Mn), chromium (Cr) and copper (Cu), was readily detectable in serum from both mice and humans. In situ LA–ICP–MS further showed that Ni levels in embryonic calvaria rose significantly across stages and CaO exhibited a consistent upward trend, suggesting coordinated accumulation of Ni with cranial mineralization. In vitro, Ni exerted biphasic effects on bone marrow mesenchymal stromal cells (BMSCs): high-dose Ni (100 μM) suppressed proliferation, elevated ROS, and induced time-dependent upregulation of Hmox1 and Nos2, consistent with escalating oxidative/nitrosative stress. By contrast, low-dose Ni (0.1 μM) enhanced matrix mineralization, whereas this pro-mineralization effect was attenuated at higher concentrations. In vivo, both Ni deprivation and Ni overload impaired bone formation: a Ni-free diet caused trabecular rarefaction and reduced mineral apposition, while high Ni hindered bone development of mice, especially in the early-stage intake. Mechanistically, RNA-seq and Ni-NTA proteomics identified Ni-driven osteogenic transcriptional remodeling and increased Ni-binding proteins, prioritizing integrin-linked kinase (ILK) as a Ni-inducible binder. ILK was required for osteogenic differentiation, and low-dose Ni activated AKT–mTOR signaling in an ILK-dependent manner. Finally, low-dose Ni-pretreated collagen scaffolds enhanced calvarial defect repair. Together, these findings define a narrow physiological window in which Ni supports osteogenesis via ILK–AKT–mTOR, whereas both deficiency and excess disrupt skeletal accrual. Full article

Largemouth bass (Micropterus salmoides) represents an important freshwater aquaculture species. Dietary protein strategies significantly influence growth performance, immune markers, and intestinal microbiota homeostasis. This study evaluated the physiological effects of five phased protein regimens on juvenile largemouth bass (9.77 ± 0.03 g) over 60 days. A constant 46% protein diet (CON) served as the control, compared with four dynamic regimens (LLH, LMH, LHH, HML) comprising low (L, 43%), medium (M, 46%), or high (H, 50%) protein levels across three 20-day phases. Seven hundred fish were randomly allocated into five groups (four replicates each). Daily feed intake was recorded, body weight was measured at the start and end, and survival rates were monitored. Post-trial assessments included body composition, serum biomarkers, intestinal morphology, and intestinal microbiota. Results showed that the LHH regimen significantly increased immunoglobulin M, complement C3 and C4, lysozyme activity, catalase, glutathione peroxidase, and total antioxidant capacity compared to the CON group. The LHH group also exhibited a reduced relative abundance of Stenotrophomonas_A. Functional predictions indicated downregulation of limonene/pinene degradation and the renin–angiotensin system. The LHH feeding regimen synergistically enhances immune-antioxidant function and optimizes intestinal microbiota in juvenile largemouth bass. Full article

Background/Objectives: Dietary adherence to the Dietary Approaches to Stop Hypertension (DASH) pattern is associated with lower blood pressure; however, most prior studies have relied on office-based measurements and non-specific dietary assessment tools. This study examined the association between DASH diet quality, assessed by the validated DASH-Q questionnaire, and 24-h ambulatory blood pressure in treatment-naive adults referred for diagnostic ambulatory blood pressure monitoring (ABPM). Materials and Methods: This cross-sectional study enrolled 227 consecutive treatment-naive adults referred for diagnostic 24-h ABPM at a cardiology outpatient clinic. DASH diet quality was assessed using the validated Turkish version of the DASH-Q questionnaire and categorized as low (<36), moderate (36–49), or high (≥50). Hypertension was defined by ABPM-based thresholds. Multivariable linear regression was performed to identify independent predictors of 24-h mean systolic and diastolic blood pressure, and binary logistic regression was used to evaluate independent predictors of ABPM-defined hypertension, with both models adjusted for age, sex, BMI, smoking, physical activity, and self-reported discretionary salt-adding behavior. Results: DASH-Q total score was the sole statistically significant independent predictor of both 24-h mean systolic blood pressure (B = −1.068, 95% CI: −1.270 to −0.866; β = −0.589; p < 0.001) and diastolic blood pressure (B = −0.560, 95% CI: −0.706 to −0.414; β = −0.470; p < 0.001) in the adjusted models. Each one-unit higher DASH-Q score was also associated with 14.6% lower odds of ABPM-defined hypertension (OR = 0.854, 95% CI: 0.820–0.890; p < 0.001). Higher DASH-Q scores were further associated with a more favorable metabolic profile, including lower LDL cholesterol, triglycerides, glucose, and C-reactive protein levels. Conclusions: DASH diet quality was independently and inversely associated with 24-h ambulatory blood pressure and the odds of ABPM-defined hypertension in this treatment-naive population. Given the cross-sectional design and the possibility of reverse causality, these results should be interpreted as hypothesis-generating and require confirmation in prospective studies. Full article

For optimal growth and development, black soldier fly larvae require a balanced diet. This study focused on how nutrients other than protein, specifically fat, starch, fibre, and ash, affect larval growth, body composition, and the quality of the leftover material called frass. To isolate the effects of these nutrients, five types of organic byproducts: fast food (FF) waste, solid pig manure (PS), mushroom stems (MS), slaughter waste (SW) and poultry meal (PM), were used to create six different diets, all with similar protein levels (about 22% DM). The results showed that diets rich in fat and starch, such as those based on FF waste, produced the heaviest larvae (155.9 mg), which also had high fat (30.31% DM) and protein contents (52.74% DM). In contrast, diets based on PM, which were low in fat and starch but high in fibre and ash, resulted in lower larval weight, which had lower fat content but variable protein content depending on other diet ingredients. Similar dietary protein levels yielded different larval protein contents, indicating that other nutrients may have influenced how protein was stored. However, other components of the diet, especially fat and ash, were consistently reflected in both the larvae and the frass. Overall, the study shows that nutrients other than protein play important roles in larval development and should be considered when designing black soldier fly diets. Full article

Yaks (Bos grunniens) on the Qinghai–Tibetan Plateau face severe nutritional limitations during the dry season due to dependence on highly lignified, low-quality roughage. Identifying safe and effective rumen regulators capable of enhancing fiber utilization in this species is therefore of great practical importance. This study employed a two-pronged approach integrating in vitro mechanistic investigation and in vivo validation to evaluate the effects of the amphoteric surfactant cocamidopropyl betaine (CAPB) on rumen fermentation, the micro-spatial distribution of digestive enzymes, apparent total tract digestibility, and the macroscopic growth performance of yaks. In the in vitro fermentation trial (Experiment 1), a randomized block design was employed where a straw-based high-forage diet was used as the substrate and supplemented with 0, 0.5, 1.0, 1.5, 2.0, 2.5, and 3.0% CAPB (based on substrate dry matter, DM) for a 48 h batch culture. The results showed that as the CAPB supplementation level increased, cumulative gas production, the degradation rates of DM and neutral detergent fiber (NDF), and the yields of total volatile fatty acids and microbial protein all exhibited significant quadratic responses (p < 0.05), peaking at the 0.5–1.0% supplementation levels. Concurrently, CAPB significantly promoted the transfer and release of carboxymethyl cellulase and xylanase into the free liquid phase (p < 0.01). In the in vivo validation trial (Experiment 2), 24 healthy growing male yaks (initial body weight 131.2 ± 8.4 kg) were allocated in a completely randomized design to four groups and fed a basal diet supplemented with 0, 0.5, 1.0, or 2.0% CAPB for 44 days. The results indicated that, while maintaining a stable DM intake, the addition of 0.5% CAPB significantly increased the average daily gain (ADG) of yaks (p < 0.05), improved the feed-to-gain ratio, and significantly enhanced the apparent total tract digestibility of NDF and ether extract (p < 0.05). However, when the supplementation dose exceeded the safety threshold (≥2.5% in vitro and ≥2.0% in vivo), both fermentation parameters and growth advantages declined. In conclusion, under the present experimental conditions, 0.5% CAPB improved roughage fermentation efficiency, putatively through an ‘enzyme elution’ mechanism, and was associated with macroscopic improvements in NDF and EE apparent digestibility and ADG in growing yaks. These findings identify 0.5% CAPB as a promising candidate rumen regulator for improving roughage utilization in growing yaks; broader generalization will require larger-scale and longer-duration trials. Full article

Background: In chronic kidney disease (CKD) treatment, a holistic approach, which involves not only nephrologists but also nutritionists, sports physicians, and kinesiologists, is becoming increasingly important, characterized as including not only pharmacological therapy but also integrative treatments, i.e., nutritional therapies (like low protein diet-LPD) and adapted physical exercise (APE) programs. The aim of this study was to evaluate the potential adjuvant therapeutic role of an integrated APE + LPD program on CKD comorbidities, comparing its additional beneficial effects with those induced by the LPD alone. Methods: This clinical study is a randomized controlled trial, where 40 CKD patients (stage G3b-G5) were enrolled and divided into two homogeneous groups: an APE + LPD group, which performed an online APE protocol combined with LPD; and an LPD group, which received only LPD. All enrolled patients were evaluated at baseline (T₀) and after 12 weeks (T₁) for clinical and body composition parameters and for functional assessment and health-related quality of life (HRQoL). Results: Both groups showed a significant reduction in lipid and glucose metabolism parameters. Good adherence to the prescribed LPD led to significantly better control of systolic blood pressure and electrolytes, along with an increase in venous bicarbonate levels. Improvements in body composition and physical performance were also observed. In the APE + LPD group only we observed a significant increase in neutrophil count, serum iron levels, muscle strength, and patients’ HRQoL. Conclusions: Our results suggest that the integrated approach, rather than the LPD alone, is more effective for muscle-related outcomes, HRQoL, and in the positive modulation of the immune system. Full article

Background: Sapropterin allows dietary liberalisation in responsive individuals with phenylketonuria (PKU), increasing natural protein intake and reducing dependence on protein substitutes (PSs). As PSs provide essential micronutrients, dietary liberalisation may increase the risk of nutritional insufficiency. Evidence describing detailed micronutrient intake in sapropterin-treated children remains limited. Methods: This secondary analysis evaluated dietary protein and micronutrient intake after 24 months of sapropterin treatment in 21 responsive children from a prospective longitudinal study. Caregiver-completed three-day food records were analysed for protein, calcium, iron, zinc, vitamin D, and vitamin B₁₂, with micronutrient intakes compared with UK dietary reference values (DRVs). Results: Mean total protein intake was 75 ± 14 g/day, comprising 30 ± 16 g/day natural protein and 45 ± 21 g/day protein equivalent from PSs; natural protein tolerance ranged from 8 to 66 g/day. PSs contributed most micronutrients: calcium 80%, iron 84%, zinc 87%, vitamin D 96%, and vitamin B₁₂ 78%. Median micronutrient intakes exceeded DRVs for most children; however, four had intakes below DRVs, almost exclusively when PSs were reduced or omitted. One child consuming >40 g/day natural protein without PSs had low iron (51%), zinc (90%), and vitamin D (4%) intakes. A non-adherent adolescent had low intakes of calcium (46%), iron (64%), zinc (41%), and vitamin D (60%). Another child receiving 60 g/day protein equivalent from PSs had marginally low vitamin D intake (85%) due to lower fortification. Children maintaining regular PS use met micronutrient requirements. Conclusions: After two years of sapropterin treatment, dietary liberalisation increased natural protein intake but did not consistently ensure adequate micronutrient intake. Micronutrient shortfalls were associated with reduced PS use, emphasising the need for careful dietitian-guided adjustment as diets become more flexible. Full article

Objectives: This study’s main objective was to examine the association between dietary greenhouse gas emissions (GHGEs) and diet quality among U.S. primary and secondary schoolchildren. Our secondary objectives were to identify demographic characteristics associated with higher-GHGE diets and to assess the relationship between school meal consumption and dietary GHGE. Methods: We conducted a cross-sectional secondary analysis of dietary intake data from 2165 primary and secondary students participating in the nationally representative 2014–2015 US School Nutrition and Meal Cost Study (SNMCS). Dietary GHGEs (kg CO₂-equivalents per 1000 kcal) were estimated by linking reported foods to an environmental impact database. Diet quality was assessed using the Healthy Eating Index-2010 (HEI). Students were categorized into GHGE groups, and differences in total HEI and component scores were examined using appropriate statistical tests. Statistical significance was set at p < 0.05. Results: The average dietary GHGE of the sample was 3.64 kg CO₂-equivalent per person per day. Overall, HEI scores did not differ between the GHGE groups (p = 0.22). However, compared to the high-GHGE group, the low-GHGE group scored significantly higher on some HEI-2010 components, such as fatty acid ratios (p < 0.0001) and sodium (p < 0.0001), and significantly lower on others, such as dairy (p < 0.0001), total protein foods (p < 0.0001), and refined grains (p < 0.0001). Male students and students who ate school meals on the day of recall had higher odds of being in the high-GHGE group compared with their respective reference groups. Conclusions: Lower dietary carbon footprints are achievable without sacrificing overall diet quality, but tradeoffs in specific dietary components indicate the need for additional research and care in recommending diet changes or setting school policies. Full article

Chronic kidney disease (CKD) is characterized by persistent exposure to uremic toxins (UTs), many of which originate from gut microbial metabolism and contribute to renal, cardiovascular, and metabolic complications. Current evidence indicates that CKD is associated with dysbiosis and the enrichment of microbial taxa carrying genes involved in UT precursor production. Diet is a major modulator of the gut microbiota and therefore represents a promising lever to reduce UT generation in synergy with current nephroprotective therapies. Beyond simple protein restriction, more specific dietary approaches, particularly plant-based low-protein diets, appear especially relevant. Additional factors, including amino acid composition, lipid quality, food processing, constipation, transit time, meal timing, and circadian rhythms, may also influence microbial metabolism and UT production. This review examines the role of nutrition in shaping the gut microbiota–UT–kidney axis and discusses how dietary modulation may support precision nutrition in the context of CKD. It also highlights future directions based on multidimensional phenotyping and robust biomarkers to capture interindividual variability, guide personalized interventions, and ultimately improve renal and cardiovascular outcomes in CKD. Full article

Selenium-enriched donkey milk (Se-DM) is characterized by low fat levels, low casein levels, high antioxidant activity, and high selenium content. To date, the regulatory role of Se-DM in the context of a high-fat diet (HFD) is unclear, prompting this present study to elucidate the potential mechanisms by which it affects the gut microbiota and hepatic lipid metabolism in rats fed a high-fat diet. The effects of Se-DM on fat accumulation and lipid peroxidation in HFD rats were investigated through non-targeted fecal metabolomics, short-chain fatty acid (SCFA) quantification, 16S microbial analysis, and pathological assessments. The results showed that Se-DM enhanced SCFA production by promoting Akkermansia muciniphila (A. muciniphila) proliferation, thereby regulating the AMP-activated protein kinase pathway and ferroptosis. Immunoblotting of hepatic tissues and qPCR analyses confirmed the engagement of the AMP-activated protein kinase cascade, suppression of ferroptosis, and reduction in fatty acid synthesis-related proteins (FASN, CD36, SCD1). Our findings revealed that Se-enriched donkey milk (Se-DM) ameliorated lipid metabolism in rats, providing theoretical support for developing functional foods to treat hyperlipidemia. Full article

Background: The very-low-calorie ketogenic diet (VLCKD) is increasingly used before bariatric surgery (BS), but its effects on surgical and long-term outcomes remain unclear. Objective: The aim of this study was to compare the impact of a 4-week VLCKD with a 4-week low-calorie diet (LCD) on preoperative, perioperative and postoperative outcomes for up 12 months in patients undergoing BS. Methods: In this prospective study, 72 (n = 36: VLCKD; n = 36: LCD) patients (mean age 43.2 ± 10.6 years; BMI 45.6 ± 6.4 kg/m²; 87.5% female) submitted to sleeve gastrectomy were enrolled at a tertiary care center from 2022 to 2024. Results: No adverse events were detected with both diets. The VLCKD was associated with a greater preoperative median weight loss percentage (−5.5 vs. −2.6 kg, p < 0.001), BMI reduction (−2.6 vs. −1.2 kg/m², p < 0.001), shorter hospital stay (3.0 ± 0.2 vs. 3.4 ± 0.9 days, p = 0.017), higher day-1 postoperative hemoglobin (12.7 ± 1.3 vs. 12.0 ± 1.2 g/dL, p = 0.024), and lower day-1 postoperative median C-reactive protein levels (9.7 vs. 13.4 mg/L, p = 0.042). These associations were confirmed in a multiple regression model, after adjustments for BMI at enrolment, age and sex. After 6 months, the VLCKD was associated with greater reductions in mean weight loss percentage (−24.9 ± 7.8 vs. −19.6 ± 9.4 kg, p = 0.012), BMI reduction (−11.7 ± 4.4 vs. −8.7 ± 3.9 kg/m², p = 0.003), neck circumference (−4.9 vs. −3.6 cm, p = 0.027) and lower aminotransferase levels. At 12 months, VLCKD patients maintained significant advantages over the same variables, except for neck circumference. Conclusions: A short preoperative VLCKD was safe and was associated with greater short-term weight reduction compared with the LCD, with potential benefits extending to early postoperative recovery and 1-year outcomes. Full article

Background/Objectives: Leptin, an adipocyte-derived hormone, suppresses appetite and regulates adiposity. Its soluble receptor (sOb-R), generated from the extracellular domain of the leptin receptor (Ob-R), circulates as a leptin-binding protein. We previously demonstrated that dietary protein restriction increased hepatic Ob-R mRNA expression and plasma sOb-R levels in C57BL/6J mice. However, the mechanism underlying this increase and its physiological relevance remain unclear. This study aimed to determine whether leptin is required for the protein-restriction-induced rise in circulating sOb-R and to evaluate whether elevated sOb-R modifies leptin responsiveness. Methods: C57BL/6J and ob/ob mice were fed a low-protein diet to assess the effects on hepatic Ob-R expression and plasma sOb-R levels. To examine whether increased sOb-R affects leptin action, exogenous leptin was administered to both strains under control and protein-restricted conditions, and appetite responses were evaluated. Results: Protein restriction increased hepatic Ob-R mRNA expression in both strains. Plasma sOb-R levels were elevated in C57BL/6J mice but not in ob/ob mice, indicating that endogenous leptin is essential for the protein-restriction-induced increase in circulating sOb-R. The anorexigenic effect of exogenous leptin was not altered by protein restriction in either strain. Conclusions: Protein restriction elevates circulating sOb-R through a leptin-dependent mechanism; however, this increase does not modify leptin-induced appetite suppression. These findings provide insight into the regulation of sOb-R under protein-restricted conditions. Full article

Ecdysterone is a natural compound proposed as an alternative to anabolic-androgenic steroids (AAS) due to its comparable ergogenic potential and more favorable safety profile. This narrative review summarizes current evidence using a standardized search protocol. Although many plants synthesize ecdysteroids, only a few cultivated species—emphasizing quinoa and spinach—contribute meaningfully to dietary intake, while wild species such as those from the Ajuga genus contain substantially higher concentrations. Experimental studies indicate that ecdysterone enhances protein synthesis and physical performance through estrogen receptor-beta activation, avoiding the adverse effects typically associated with AAS. Additional pharmacological effects, including potential roles in breast cancer therapy and Alzheimer’s disease, have also been described. Ecdysteroids are generally considered non-toxic in humans; however, analysis of commercial supplements frequently reveals poor quality control and discrepancies between labeled and actual ecdysterone content. Although prevalence of use among athletes appears low, establishing urinary reference ranges to differentiate dietary exposure from supplement-derived intake is essential. Ecdysterone and its metabolites, 14-deoxy-ecdisterone and 14-deoxy-poststerone, are detectable in urine for more than two days depending on dosage. Given its ergogenic potential and detectability, ecdysterone may pose risks for unethical use and should be considered for inclusion in initial anti-doping testing procedures. Further research on ecdysteroids is required to elucidate their mechanisms of action, confirm the absence of adverse effects, and establish reference urinary concentration ranges that allow differentiation between diet-related metabolites and those derived from drug use. Full article