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The aim of the review was to evaluate which diets are associated with higher TMAO levels.Several studies have shown that plasma and urinary levels of trimethylamine N-oxide (TMAO) are a reliable indicator of cardiovascular disease risk. Diet certainly has a strong influence on TMAO levels, but there is still uncertainty about which diet is the most effective in reducing this risk factor. PubMed, Web of Science and Scopus were searched for studies that were published up until July 1, 2021 using specific keywords. In total, 447 studies were evaluated, of which papers on individual foods or supplements, or conducted in children, in vitro or in animal model studies were excluded. Twenty-five studies were included in this review. Three studies showed that caloric restriction and (visceral) weight loss improve TMAO levels. Six out of eight studies revealed beneficial effects of plant-based diets on plasma or urinary TMAO concentrations. Most of the studies demonstrated that a diet high in protein, particularly of animal origin, such as diets rich in fish or red meat, have negative effects on TMAO levels. Most studies that have evaluated the relationship between diet and plasma or urinary concentrations of TMAO seem to indicate that plant-based diets (Mediterranean, vegetarian and vegan) are effective in improving TMAO levels, while animal-based diets appear to have the opposite effect. Further long-term studies are needed to assess whether vegetarian or vegan diets are more effective than the Mediterranean diet in reducing TMAO levels.

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.

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.

BACKGROUND 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 randomized homogeneous sample of two groups with equal daily caloric reduction but different protein distributions between meals. METHODS Forty-seven men and women (mean age: 32±10 years; Body Mass Index: 28.4±2.4 kg/m2) consumed an energy-restricted diet (788 kcal/d below the requirement) for eight weeks in a free-living contest. Subjects consumed 90.1 g protein/d (1.10±0.16 g/kg/day) and were randomized in an EVEN (16.7% at breakfast, 32.8% at lunch, 31.3% at dinner, 19.2% at snacks; N.=23) or UNEVEN (15.4% at breakfast, 36.6% at lunch, 34.9% at dinner, 12.4% at snacks; N.=24) distribution pattern. The nutritional characteristics and caloric deficit of the two diets were similar. RESULTS The total sample had an overall improvement in both BMI (-0.9±0.6) and fat mass (FM: -2.3±1.5), while lean body mass was preserved (LBM: 0.0±0.7). There were no significant differences between the two groups in variations in BC. CONCLUSIONS In overweight and obese subjects undergoing a Mediterranean-type low-calorie diet, a different distribution of daily protein intake between meals and snacks does not result in significant differences in terms of FM loss and LBM maintenance. This is one of the first studies showing that nutritional dietary plans with different daily protein distribution show no particular differences in fat loss and lean mass maintenance.

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.

PurposeThis study aims to evaluate if soya consumption can compromise or positively influence the effects of the Mediterranean diet (MD).Design/methodology/approachA full literature review has been conducted as part of a proposal of a new point of view on the consumption of soya and its derivatives in areas where until a few decades ago this type of food did not exist at all.FindingsThere does not seem to be any contraindications for soy systematic use, therefore, excluding historical-geographical reasons, soya could be included in an MD without altering the benefits associated with it.Practical implicationsSoya is not advised as a typical food in the MD, but promoting its use could probably contribute to increase the variety of the diet and likely consolidates the positive health benefits characteristic of MD.Originality/valueTo the best of the authors’ knowledge, this review is one of the first to evaluate soybean consumption within the MD.

Objective: It is a common belief that menopausal women have greater difficulty losing weight. The aim of this study was to assess the efficacy of a Mediterranean diet (MD) to promote weight loss in postmenopausal women. All participants were prescribed a hypocaloric traditional MD, tailored to the individual. Subjects were asked not to begin any kind of physical activity. Body composition was measured at the beginning and after 8 weeks of treatment. In total, 89 women (age 52.8 &plusmn, 4.5 years, BMI 30.0 &plusmn, 5.2 kg/m2, fat mass 31.6 &plusmn, 10.5 kg) were divided into two groups: the first group consisted of fertile women over 45 years of age, the second group consisted of those diagnosed as menopausal. All women had an improvement in body composition (fat mass &minus, 2.3 &plusmn, 2.1 kg, p &lt, 0.001, protein &minus, 0.1 &plusmn, 0.7 kg, p = 0.190) and blood pressure values. No differences were found between the two groups except for a higher reduction of low-density lipoprotein in the menopausal group (p = 0.035). A positive significant correlation between plant to animal protein ratio and fat-free mass variation was found in the menopausal group. These data suggest that a high adherence to a traditional MD would enable menopausal women to lose fat mass and maintain muscle mass with no significant difference to younger women. Fat mass reduction provides menopausal women with improved cardiovascular and metabolic risk factors.

Purpose of Review: 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). 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 5years 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.

Background The aim of this study was to demonstrate that a normal protein diet along with minimal sports activity can be enough to lose fat mass and maintain muscle mass. Methods All participants were prescribed a hypocaloric nutritionally balanced Mediterranean-style diet tailored to the individual for 8 weeks. Body composition and energy expenditure were measured. Sedentary patients (G1) were only recommended to perform minimal aerobic training, while sport subjects (G2) were prescribed structured physical activity and higher calorie and protein contents in the diet. Results There were no significant differences between the two groups for any of the measured parameters. Conclusions The models of lifestyle changes that are currently circulating were for the most part ineffective. It does not appear to be necessary to increase the protein content of the diet above that recommended by guidelines in order to lose weight. Even prescribing specific physical activity is not necessary to maintain muscle mass.

Purpose The purpose of this paper is to examine gender differences in food habits and food choices, including decisions in healthy eating, to personalize diet therapies to be as effective possible for long-term weight loss. Design/methodology/approach In this cross-sectional study, eating behaviours were assessed using a questionnaire composed of 12 questions concerning food habits, 17 concerning food taste, and four about healthy eating. There were 2,021 (1,276 women) Caucasian adults enrolled in the study. Findings Statistically significant differences in women compared to men occurred for the following questionnaire entries reading eating habits: whole grain food (10.0 per cent higher in women; p p p < 0.001); eggs (5.0 per cent lower in women, p = 0.03); meat (9.3 per cent lower in women, p p Research limitations/implications The authors observed strong evidence of profound gender-specific differences between men and women in terms of dietary habits, the taste of food and in the relationship with meals. Practical implications The findings suggest a need for the creation of gender-specific programs for promoting a healthy lifestyle. Social implications A need for the creation of gender-related programs for promoting healthy lifestyle has been demonstrated. Originality/value Reasons for the different eating behaviours among men and women have been found. Western society’s perception of the ideal body weight is much lower for women than for men. In general, social perceptions influence nutritional behaviour to a great extent. Women’s greater nutritional knowledge and sex-specific taste preferences also account for the differences in eating behaviour.