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Alpha Summit | Idaho, USA | 4-5 August 2015 Dietary Protein Quality: Its importance in Nutrition and Health Paul Moughan Riddet Institute, Massey University, Palmerston North Dietary Protein Quality is of fundamental importance. 2 “World-wide 842 million people are undernourished. Protein/Energy Malnutrition is by far the most lethal form of malnutrition – Children are its most visible victims” WHO (2001) “Protein / Energy malnutrition affects every fourth child world-wide” WHO/NHD (2000) > Protein holds a central place in body metabolism. > Lifestyle diseases (diabetes, hypertension, cardiovascular disease etc) are all related to disturbances in body metabolism. > Amino acids are critical nutrients and dairy foods are an important source of amino acids. 5 Dietary Amino Acids: > Promote Lean Body Mass (LBM) and normal body weight. > Support optimal organ function (eg muscle mass and strength). > Amino acids have specific metabolic roles (eg leucine and muscle protein synthesis; glutamate and gut energy supply; tryptophan and serotonin synthesis; arginine and nitric oxide production). 6 So, Protein and amino acids are critical nutritionally But, not all proteins are of equal value nutritionally > Milk > Meat > Egg > Soya > Bean > Cereals etc 7 In particular vegetable-based proteins are of lower quality than dairy based proteins > fibre > anti-nutritional factors > different structures 8 How then should Protein Quality be determined? 9 > In the past PDCAAS (protein digestibility corrected amino acid score) has been the recommended scoring method (FAO 1989) > There are a number of shortcomings of PDCAAS. > New Recommendations (FAO, 2013) 10 1. Emphasis on individual digestible amino acid contents rather than a single score (ie treat each amino acid as an individual unit). This maximises the information on the nutritional (protein) value of food. > Amino acid digestibility is determined at the end of the small intestine (True ileal digestibility). > For processed foods ‘reactive lysine’ is determined in diet and ileal digesta rather than ‘total lysine’ to give lysine availability measures. 11 How should ileal amino acid/ “reactive lysine” digestibility be determined? 12 In humans: > Digesta can be collected using ileostomates > Digesta can be collected using a naso-ileal tube > Both methods have drawbacks and are not routine Need for an animal model. Terminal ileum Ref: Wrong OM, Edmonds CJ and Chadwick VS (1981) ComparaHve anatomy and physiology In: The Large IntesHne, p 5, MTP Press Ltd, England. 13 13 Growing pig (a meal-eating omnivore) is preferred model: Need to collect ileal digesta 14 True N digestibility in human (%) True ileal AA digestibility in the adult human and growing pig True N digestibility in pig (%) (Moughan, unpublished) 15 Processed Foods — Conventional lysine Digestibility Is Inaccurate: > Conventional determination of lysine and lysine digestibility are inaccurate for some processed foods. > Damaged lysine molecules revert to lysine with conventional procedures. > Need for a new approach. > Reaction of food and digesta with o-methylisourea (Moughan and Rutherfurd assay1) allows accurate determination of “available” lysine. 1Moughan and Rutherfurd (1996) Journal of Agricultural and Food Chemistry 44:2202-2209. 16 Differences can be great Digestible reactive1 (available) lysine versus digestible total lysine (gKg-1) Lysine Digestible Total Available Difference % Shredded Wheat Dried corn 1.8 2.6 1.6 1.9 11 27 Unleavened bread2 6.5 4.9 25 Puffed Rice 1.1 0.6 45 Rolled Oats 3.7 2.8 24 Wheat Bran 1.1 0.7 36 Corn 0.4 0.2 50 Evaporated milk 23.4 20.5 12 1Based on ο-methylisourea assay; 2P Pellett, N Scrimshaw and P Moughan (unpublished data). 17 But generally not in dairy: Ileal digestible total and “available” lysine contents (g/kg air-dry) for 12 dairy protein sources Lysine Whole milk protein Digestible 26.2 Availablea 24.0 Infant formula A 8.3 8.6 Infant formula B 9.1 9.2 Infant formula C 11.1 11.7 Whey protein concentrate 79.9 77.5 UHT milk 31.7 31.4 Evaporated milk 23.4 20.5 Weight-gain formula 24.4 24.1 Sports formula 20.4 19.1 Elderly formula 11.7 11.8 Hydrolysed lactose milk powder 27.2 25.1 High-protein supplement 14.3 14.3 aBioavailable lysine; minimal difference between total lysine and reactive lysine denotes minimal Maillard damage. Adapted from Rutherfurd & Moughan (2005), with permission of the publisher. 18 Dairy proteins such as whey and alpha-lactalbumin have high amino acid digestibilities and lysine availability/digestible reactive lysine 19 True ileal digestibility, Whey Protein Whey Protein Concentrate (n = 4) Whey Protein Isolate (n = 1) Whey Protein Hydrolysate (n = 1) Lysine1 98 100 94 Methionine 99 100 80 Cysteine 100 100 94 Leucine 99 100 96 Isoleucine 99 100 96 Valine 98 100 96 Tryptophan 100 100 - Histidine 93 100 90 Threonine 94 100 93 1Available lysine 20 True ileal digestibility, Alpha Lactalbumin α Lactalbumin 1 n=6 α Lactalbumin 2 n=6 α Lactalbumin 3 n=6 Lysine1 95 100 100 Methionine 99 96 97 Cysteine 96 98 97 Leucine 96 99 99 Isoleucine 95 98 99 Valine 96 96 99 - 100 100 Histidine 89 97 98 Threonine 95 97 98 Phenylalanine 97 97 98 Tyrosine 97 97 98 NEAA’s2 94 94 96 Tryptophan 1Available 2Dietary lysine non-essential amino acids. Sample 1 = laboratory rat. Samples 2&3 = growing pig. 21 The true ileal AA digestibility assay has been applied to infant formulas and human milk Bovine milk formula1 Soya isolate formula1 Human milk2 Lysine 96 96 98 Methionine + Cysteine 94 92 100 Tryptophan 94 91 100 Isoleucine 96 94 98 Leucine 97 94 99 Threonine 89 89 86 1Moughan 2Darragh et al., (1990) Journal of Paediatric Gastroenterology and Nutrition 10:385-394. and Moughan (1998) British Journal of Nutrition 80:25-34.. 22 The digestible pattern in human milk can be used to assess amino acid contents of formulas True ileal digestible amino acids (g 100g DM) Bovine milk formula Human milk Lysine 1.10 (100) 0.55 (100) Methionine + Cysteine 0.59 (53) 0.36 (65) Tryptophan 0.15 (14) - Isoleucine 0.82 (75) 0.45 (79) Leucine 1.40 (127) 0.82 (148) Threonine 0.69 (63) 0.43 (65) - Formula protein is reasonably well balanced (pattern) but supplies more AA’s per gram than breast milk. 23 α Lactalbumin is well-balanced compared to Human breast milk True ileal digestible AAs (g/100g DM) α Lactalbumin Human milk Lysine1 100 100 Methionine + Cysteine 60 65 Tryptophan 45 - Isoleucine 74 79 Leucine 127 148 Threonine 58 65 1Available lysine 24 When a single score of Protein Quality is needed DIAAS 2. replaces PDCAAS. With DIAAS (FAO, 2013): > Ileal AA digestibility replaces faecal CP digestibility > Reactive lysine replaces total lysine (conventional AA analysis) > Scores are not truncated (unless diet or sole-source food) > AA Reference Pattern (for regulatory purposes): Infants: AA composition human milk All others: AA requirement pattern for child (6 months – 3 years) 25 Non truncation is significant Milk Protein Concentrate Whey Protein Isolate Whey Protein Concentrate Non-truncated 1.31 1.25 1.10 1.10 Truncated 1.0 1.0 1.0 1.0 DIAAS Red meat 26 DIAAS and PDCAAS values1 are different. PDCAAS often overestimates particularly for lower quality proteins Milk Protein Concentrate Whey Protein Isolate Soya Protein Isolate Pea Protein Cooked Beans Cooked Rolled Oats Wheat Bran Roasted Peanuts Rice Protein Cooked Peas PDCAAS 1.00 1.00 1.00 0.89 0.65 0.67 0.53 0.51 0.42 0.60 DIAAS 1.10 0.97 0.82 0.58 0.54 0.41 0.43 0.37 0.58 1(Rutherfurd 1.18 and Moughan, unpublished data). 27 27 α Lactalbumin has a high DIAAS (>100) indicating that the amino acid profile exceeds the amino acid scoring pattern (requirement) for the six month – three year old child DIAAS Limiting AA α Lactalbumin 1 α Lactalbumin 2 α Lactalbumin 3 107 115 113 Histidine Valine Valine 28 But single scores omit much useful information: (eg leucine supply for optimal muscle function versus body protein maintenance). Threonine Met + Cys Valine Isoleucine Leucine Tyr + Phe Histidine Tryptophan Lysine Whey Protein Isolate 1.80 2.29 1.21 2.22 2.57 1.71 1.09 3.35 2.51 Whey Protein Concentrate 2.53 1.71 1.29 2.35 1.93 1.43 0.97 2.74 2.03 α Lactalbumin 1.93 2.20 1.14 2.40 2.00 1.90 1.65 5.50 2.00 Soya Protein Isolate 1.30 0.90 1.11 1.59 1.29 1.85 1.37 1.67 1.16 29 29 Conclusions 1. Protein (and especially dairy protein) is central to maintaining a healthy body weight, body composition and metabolism. 2. The new score DIAAS is better able to promote dairy’s superior ability. 3. DIAA ratios can emphasise high delivery of key amino acids (eg isoleucine, branched chain group, arginine, glutamine) 4. Dairy proteins have a major advantage around lysine ‘bioavailability’. 5. True ileal digestibility and DIAAS remove ability to mask dairy/vegetable protein quality differences 30 Thank you