Association of Urinary and Plasma Levels of Trimethylamine N-Oxide (TMAO) with Foods

Introduction: Trimethylamine N-oxide (TMAO) may play a key mediator role in the relationship between the diet, gut microbiota and cardiovascular diseases, particularly in people with kidney failure. The aim of this review is to evaluate which foods have a greater influence on blood or urinary trimethylamine N-oxide (TMAO) levels. Methods: 391 language articles were screened, and 27 were analysed and summarized for this review, using the keywords "TMAO" AND "egg" OR "meat" OR "fish" OR "dairy" OR "vegetables" OR "fruit" OR "food" in December 2020. Results: A strong correlation between TMAO and fish consumption, mainly saltwater fish and shellfish, but not freshwater fish, has been demonstrated. Associations of the consumption of eggs, dairy and meat with TMAO are less clear and may depend on other factors such as microbiota or cooking methods. Plant-based foods do not seem to influence TMAO but have been less investigated. Discussion: Consumption of saltwater fish, dark meat fish and shellfish seems to be associated with an increase in urine or plasma TMAO values. Further studies are needed to understand the relationship between increased risk of cardiovascular disease and plasma levels of TMAO due to fish consumption. Interventions coupled with long-term dietary patterns targeting the gut microbiota seem promising

An oveview and update on sarcopenic obesity

Sarcopenic obesity (OS) is a multifactorial condition characterized by the simultaneous presences of sarcopenia and obesity. It represents a natural phenomenon related to aging that can significantly increase the risk of osteoporosis, frailty, mobility, disability and mortality. It is estimated that approximately 45% of the elderly American population—about 18 million people—are affected by sarcopenia and that the risk of disability is 1.5–4.6 fold greater in elderly people suffering from sarcopenia than older people with unaffected muscle mass. The prevalence of OS is increasing in adults over 65 years of age; people with OS present greater health risks than people who are only sarcopenic or obese. Therefore, the study of OS and the search for effective treatment are important due to the constant increase of the elderly population. OS is a relatively new concept in the panorama of age-related diseases. There is currently no single definition of the pathology; however, the evidence suggests a close correlation to the onset of cardiovascular disease and mortality. Although many questions remain unresolved today, it is important to note that OS can be prevented and treated by adopting a healthy lifestyle. The ideal approach is based on the targeted intervention to both slow down the course of sarcopenia and promote a decrease in adipose mass.The beneficial potential of physical activity, expressed through strength and resistance exercises, on OS is widely documented. The benefits obtained from aerobic exercises and strength exercises are shown at the level of muscle mass, muscle strength, muscular capacity and mitochondrial activity. However, the best results were obtained by coupling adequate nutritional treatment with regular physical activity. The adequate intake of proteins high in essential amino acids promotes protein synthesis and muscle health, effectively counteracting the onset of sarcopenia. In case of malnutrition a supplementation with BCAA-based supplements, leucine, vitamin D and β-HMB might help to improve and reduce the effects of sarcopenia. The deficiency of muscle mass in obese elderly subjects will be one of the health challenges of the future to reduce the risk of chronic diseases

Diet Rich in Plant Protein May Prevent Type 2 Diabetes

Purpose : The aim is to show the ideal protein quality and quantity and the dietary composition for the prevention and metabolic control of type 2 diabetes mellitus (T2DM). Introduction Although some reviews demonstrate the advantages of a diet with a higher protein intake, other reviews have observed that a diet high in carbohydrates, with low-glycaemic index carbohydrates and good fibre intake, is equally effective in improving insulin sensitivity. Methods Over 2831 articles were screened, and 24 from the last 5 years were analysed and summarised for this review, using the protein, diabetes and insulin glucose metabolic keywords in Pubmed in June 2019. Results Eleven studies demonstrate that a higher consumption of proteins has a positive effect on insulin sensitivity. A higher intake of animal protein seems to be related to an increased risk of T2DM. Four studies show that consumption of meat has a deleterious effect. Higher intake of plant protein and dairy products is associated with a modestly reduced risk. Discussion Based on the results obtained, for the prevention of T2DM and all disorders related to metabolic syndrome, no ideal dietary composition has yet been found. The advantage of plant protein sources may be related to the foods' low-glycaemic index due to the high fibre content. However, the right protein quality (animal and plant) and the quantity for T2DM prevention and metabolic control are unclear and need to be investigated with further long-term studies

Effects of quality and quantity of protein intake for type 2 Diabetes Mellitus prevention and metabolic control

The aim of this review is to evaluate the ideal protein quality and quantity and the dietary composition for the prevention and metabolic control of type 2 diabetes mellitus (T2DM)

The different daily distribution of proteins does not influence the variations in body composition in a sample of subjects undergoing a low-calorie mediterranean-type diet

Controversy exists regarding whether the different daily balances of proteins between meals and snacks in a low-calorie diet may influence the effects on body composition (BC) results. Aim of this study is to evaluate BC changes made by a lifestyle intervention in a randomised homogeneous sample of two groups with equal daily caloric reduction but different protein distributions between meals

Diet high in protein-rich foods with structured sport activity may be useless to lose fat mass and maintain fat-free mass

This study aimed to demonstrate that a normal protein diet along with minimal sports activity can be enough to lose fat mass and maintain muscle mass

Microsatellite instability in medullary carcinoma of the colon

Medullary carcinoma (MC) of the large intestine is a relatively new histological type of adenocarcinoma characterized by poor glandular differentiation and an intraepithelial lymphocytic infiltrate. MC can be associated to a defective mechanism for DNA mismatch repair, caused by the so-called microsatellite instability (MSI). We present the case of a 44 years old Caucasian woman, who referred to the Emergency Room with symptoms mimicking an acute appendicitis. Computed tomography and colonoscopy demonstrated an ulcerated and stenotic lesion of the caecum without signs of metastasis and peritoneal carcinosis. Patient underwent a laparoscopic right colectomy. The final pathologic findings provided the diagnosis of medullary carcinoma with MSI. Patient then underwent adjuvant chemotherapy according to the FOLFOX- 4 protocol (association of 5-Fluorouracil, Leucovorin, and Oxaliplatin) for twelve cycles. At two-years follow-up, patient is disease free. MC in association with MSI is a non-frequent tumor of the colon characterized by a better prognosis compared to other types of poorly differentiated adenocarcinoma. In the observed case, 24 months after the surgical operation, the patient is in good health and there is no evidence of metastasis or relapse