Limitations of the Digestible Indispensable Amino Acid Score (DIAAS) and Choice of Statistical Reporting. Comment on "A Comparison of Dietary Protein Digestibility, Based on DIAAS Scoring, in Vegetarian and Non-Vegetarian Athletes. Nutrients 2019, 11, 3106".
Limitations of the Digestible Indispensable Amino Acid Score (DIAAS) and Choice of Statistical Reporting. Comment on "A Comparison of Dietary Protein Digestibility, Based on DIAAS Scoring, in Vegetarian and Non-Vegetarian Athletes. <i>Nutrients</i> 2019, <i>11</i>, 3106".
Project description:BackgroundThe Checklist for the Reporting of Updated Guidelines (CheckUp) was recently developed. However, so far, no systematic assessment of the reporting of updated clinical guidelines (CGs) exists. We aimed to examine (1) the completeness of reporting the updating process in CGs and (2) the inter-observer reliability of CheckUp.MethodsWe conducted a systematic assessment of the reporting of the updating process in a sample of updated CGs using CheckUp. We performed a systematic search to identify updated CGs published in 2015, developed by a professional society, reporting a systematic review of the evidence, and containing at least one recommendation. Three reviewers independently assessed the CGs with CheckUp (16 items). We calculated the median score per item, per domain, and overall, converting scores to a 10-point scale. Multiple linear regression analyses were used to identify differences according to country, type of organisation, scope, and health topic of updated CGs. We calculated the intraclass coefficient (ICC) and 95% confidence interval (95% CI) for domains and overall score.ResultsWe included in total 60 updated CGs. The median domain score on a 10-point scale for presentation was 5.8 (range 1.7 to 10), for editorial independence 8.3 (range 3.3 to 10), and for methodology 5.7 (range 0 to 10). The median overall score on a 10-point scale was 6.3 (range 3.1 to 10). Presentation and justification items at recommendation level (respectively reported by 27 and 38% of the CGs) and the methods used for the external review and implementing changes in practice were particularly poorly reported (both reported by 38% of the CGs). CGs developed by a European or international institution obtained a statistically significant higher overall score compared to North American or Asian institutions (p = 0.014). Finally, the agreement among the reviewers on the overall score was excellent (ICC 0.88, 95% CI 0.75 to 0.95).ConclusionsThe reporting of updated CGs varies considerably with significant room for improvement. We recommend using CheckUp to assess the updating process in updated CGs and as a blueprint to inform methods and reporting strategies in updating.
Project description:Indispensable amino acid (IAA) composition and standardized ileal digestibility (SID) of five animal- and 12 plant-based proteins were used to calculate their respective Digestible Indispensable Amino Score (DIAAS) according to the three age categories defined by the Food and Agriculture Organization (FAO). Mean IAA content and mean SID obtained from each protein dataset were subsequently used to simulate optimal nutritional quality of protein mixtures. Datasets revealed considerable variation in DIAAS within the same protein source and among different protein sources. Among the selected protein sources, and based on the 0.5- to 3-year-old reference pattern, pork meat, casein, egg, and potato proteins are classified as excellent quality proteins with an average DIAAS above 100. Whey and soy proteins are classified as high-quality protein with an average DIAAS ≥75. Gelatin, rapeseed, lupin, canola, corn, hemp, fava bean, oat, pea, and rice proteins are classified in the no quality claim category (DIAAS <75). Potato, soy, and pea proteins can complement a broad range of plant proteins, leading to higher DIAAS when supplied in the form of protein mixtures and at specific ratios. Such complementarity highlights the potential to achieve an optimal nutritional efficiency with plant proteins alone.
Project description:The objective of this study was to evaluate the digestible energy (DE), metabolizable energy (ME) content, apparent total tract digestibility (ATTD) of nutrients in chili meal (CM), and to determine the effects of CM on the performance of growing pigs. In Exp. 1, 12 barrows (Duroc x Landrace x Yorkshire) with an initial body weight (BW) of 50.9 ± 1.8 kg were allocated to one of two treatments, corn-soybean meal basal diet or diet containing 194.2 g/kg CM, which replaced corn and soybean meal in the basal diet. Pigs were placed in metabolism crates for a 7-d adaptation period followed by a 5-d total collection of feces and urine to detect DE, ME and ATTD of nutrients in CM. Exp. 2 was conducted for 4 wk. to evaluate the effect of CM on performance of growing pigs. 150 growing pigs (58.4 ± 1.2 kg BW) were allocated to 1 of 5 treatments. Treatment 1 was a corn-soybean meal basal diet met the DE requirement for growing pigs recommended by NRC (2012). Treatment 2 or 3 were diets containing 50 g/kg or 100 g/kg CM respectively.4 or 5 were based on treatment 2 or 3, while soybean oil (SBO) was added to improve the DE content to that in treatment 1. In Exp. 1, the DE and ME content of CM were 9.08 and 8.48 MJ/kg. The ATTD of dry matter (DM), gross energy (GE), organic matter (OM) and neutral detergent fiber (NDF) were 0.60, 0.54, 0.66 and 0.38, respectively. In Exp. 2, addition of CM linearly decreased (P < 0.05) average daily gain (ADG) and the ATTD of DM, GE and OM while ATTD of crude protein (CP) had a quadratic (P < 0.05) change. When SBO was supplemented in diets containing CM, greater values (P < 0.05) of ATTD of most nutrients were observed. With the dietary inclusion of CM, the albumin/globulin ratio in serum had a quadratic change (P < 0.05), and the level of low-density cholesterol linearly (P < 0.05) increased. In treatments with 50 g/kg CM, a significant reduction (P < 0.05) of total antioxidant capacity was found in diet formulated with SBO. In treatments with 100 g/kg CM, the level of total cholesterol was lower (P < 0.05) in the diet with SBO. In conclusion, CM had moderate energy density and nutrients digestibility in pig diets. 50 g/kg CM with SBO in diets could be fed to growing pigs with no significant negative effects.
Project description:The present study was aimed at understanding a shift in rumen microbiome of buffaloes fed various levels of total digestible nutrients. To understand the process, the metagenomics of rumen microbes, in vivo and in vitro rumen fermentation studies were carried out. Three rumen fistulated adult male Murrah buffaloes were fed three isonitrogenous diets varying in total digestible nutrients (70, 85 and 100% of TDN requirement) in 3X3 switch over design. On dry matter basis, wheat straw/ roughage content were 81, 63 and 51% and that of maize grain was 8, 16 and 21% in three diets respectively. After 20 d of feeding, rumen liquor and rumen contents were sampled just before (0h) and 4h post feeding. Ruminococcus flavefaciens and R. albus (estimated with real time PCR) were higher in high roughage diets. The predominant phyla in all the three groups were Bacteroidetes, Firmicutes followed by Proteobacteria, Actinobacteria and Fibrobacteres. A core group of more than fifty rumen bacteria was present in all the animals with very little variations due to level of TDN. The most predominant bacterial genera reported in order of decreasing abundance were: Prevotella, Bacteroides, Clostridium, Ruminococcus, Eubacterium, Parabacteroides, Fibrobacter, Butyrivibrio etc. The higher diversity of the enyzmes families GH 23, GH 28, GH 39, GH 97, GH 106, and GH 127 (the enzymes active in fibre and starch degradation) were significantly higher on 100%TDN diet while CE 14 (required for the hydrolysis of bond between carbohydrate and lignin) was higher on low TDN (70%) diet, indicating ester bond cleavage was better in animals fed high roughage (wheat straw) diet.
Project description:This study was conducted to investigate the effect of the total digestible nutrients (TDN) level of commercial concentrates on growth performance, carcass characteristics, and meat composition of late fattening Hanwoo steers. A total of 28 steers were randomly assigned to one of four dietary groups; T1 (73.30% TDN), T2 (74.50% TDN), T3 (76.40% TDN), and T4 (77.10% TDN). Average daily gain (ADG) was slightly but not significantly higher in the T2 than in the other treatments. Dry matter intake (DMI) and feed conversion ratio (FCR) were higher in the T2 than in the other treatments; however, the differences were not statistically significant. Carcass back fat thickness was thicker in the T4 and marbling score was higher in the T2 than in the other treatments; however, the differences were not statistically significant. The TDN level of concentrates had no effect on the physicochemical characteristics and fatty acid composition of the longissimus muscle. The finding of this study indicate that less than 74% or greater than 75% TDN in the commercial concentrate did not contribute to improve ADG, FCR, marbling score; therefore, in the present study, the recommendable TDN level in the commercial concentrate for late fattening period was 74% to 75% in terms of growth performance and marbling score of Hanwoo steer.
Project description:BackgroundAn athlete's lack of concussion knowledge could lead to significant underreporting and injury mismanagement. To provide more effective management strategies of concussions in adolescent athletes, further examination of reporting behaviors is of critical importance.HypothesisThe hypotheses for this study were as follows: (1) Girls are more likely to report concussion, (2) girls are more likely to report future concussions after an educational intervention, and (3) a difference in rationale for not reporting concussion will be found between sexes.Study designCross-sectional, cohort design.Level of evidenceLevel 3.MethodsSurvey answers were collected on 454 high school athletes (212 girls, 242 boys; mean age, 15.7 ± 1.15 years). Individual team meetings lasting approximately 30 minutes were held to collect data and provide an educational lecture. Participants were randomly provided an iClicker to submit a response to questions asked.ResultsGirls were more likely to report a concussion (?(2) = 8.32, df = 3, N = 454, P = 0.040) and more likely to report future concussions after educational intervention (?(2) = 8.54, df = 2, N = 454, P = 0.014). There were no differences between sexes regarding rationale for not reporting a concussion (?(2) = 6.42, df = 4, N = 454, P = 0.170).ConclusionThere is concern these athletes still fail to understand the severity and potential sequelae of concussion injury. Both sexes cited that concussion is not a serious enough injury to warrant reporting to a medical professional.Clinical relevanceHigh school athletes recover more slowly from concussions compared with college athletes; therefore, educating this population and promoting the importance of being knowledgeable regarding concussion recognition may increase reporting prevalence.
Project description:BackgroundTea, a commonly consumed beverage, contains high amounts of polyphenols that can impair protein digestibility, as demonstrated in vitro. There are no human studies examining the inhibitory influence of tea polyphenols (TPP) on high-quality protein digestibility.ObjectiveThe aim of this study was to determine the effect of black tea on the true indispensable amino acid (IAA) digestibility of whole boiled egg protein, in healthy adult humans, through use of a dual isotope tracer approach.MethodsThe effect of black TPP (4.6 mg/mL, ingested as a beverage with the meal) on 2H-labeled whole boiled egg protein, administered with ghee rice and tomato curry, was measured with reference to 13C-spirulina protein in healthy Indian adults aged 20-27 y of both sexes with BMI of 22.0 ± 2.8 kg/m2. The results were then compared to previously determined whole egg mean IAA digestibility measured by the same method, without black tea, in the same subjects (n = 5). To correct for any independent effect of TPP on spirulina protein (used as a standard protein), the true IAA digestibility of 13C-spirulina protein was independently measured with reference to a 2H-amino acid mixture, with and without co-ingestion of black tea, in 3 of the same subjects.ResultsThe true IAA digestibility of whole boiled egg protein significantly decreased by 17% when co-ingested with black tea. However, there was no significant reduction in the true IAA digestibility of spirulina protein when co-ingested with black tea.ConclusionsTPP protein interactions reduced whole egg digestibility in healthy Indian adults but had minimal effect on spirulina protein digestibility. In populations who are at risk of dietary quality protein inadequacy, the consumption of tea during or after a meal can further increase the risk of inadequacy. This trial was registered at Clinical Trials Registry of India (http://ctri.nic.in) as CTRI/2018/03/012265.
Project description:ContextAlthough it has been suggested that developmental and sociological factors play a role in concussion reporting, the empirical evidence related to this is limited.ObjectiveTo examine the influences of sex, school level, school location, concussion-reporting history, and socioeconomic status on concussion-related knowledge, attitudes, and reporting intentions among middle school and high school athletes.DesignCross-sectional study.SettingMaster students and High School athletes attending pre-participation examinations (PPEs) were asked to complete paper-based surveys.Patients or other participantsOverall, 541 athletes representing 18 sports returned fully completed surveys.Main outcome measure(s)Outcomes were concussion-related knowledge, perceived seriousness, positive feelings about reporting, and self-reporting intentions. We examined group differences in these outcomes across levels of the explanatory variables of sex, school level (middle school versus high school), school location (urban versus rural), concussion self-reporting history (yes or no), and socioeconomic status (free or reduced-price lunch versus no free or reduced-price lunch) using Wilcoxon rank sum tests. Then we used multivariable ordinal logistic regression models to identify predictors of higher score levels for each outcome. Odds ratio (OR) estimates with 95% confidence intervals (CIs) excluding 1.00 were deemed significant.ResultsOdds of higher levels of knowledge were higher in urban versus rural school student-athletes (ORAdjusted = 1.81; 95% CI = 1.03, 3.17), and lower in student-athletes on free or reduced-price lunch versus those not on free or reduced-price lunch (ORAdjusted = 0.52; 95% CI = 0.36, 0.77). Similarly, odds of higher levels of seriousness were lower in male versus female student-athletes (ORAdjusted = 0.48; 95% CI = 0.32, 0.72). Further, odds of higher levels of self-reporting intentions were lower among male versus female student-athletes (ORAdjusted = 0.53; 95% CI = 0.37, 0.75).ConclusionsDevelopmental and sociological factors were differentially associated with concussion-related knowledge, attitudes, and self-reporting intentions. These results can inform medical providers, parents, and coaches with regard to context-specific clinical assessments of concussion symptoms.