Effect of dietary branched-chain amino acids on dyslipidemia in children and adolescents

CHEN Yao; LIU Changqing; ZHU Qianrang; LIU Yiya; TIAN Meina; WANG Hongwei; YU Lianlong

doi:10.11852/zgetbjzz2025-0236

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Chinese Journal of Child Health Care ›› 2025, Vol. 33 ›› Issue (10) : 1101-1107. DOI: 10.11852/zgetbjzz2025-0236

Pediatric Metabolic Diseases Column

Effect of dietary branched-chain amino acids on dyslipidemia in children and adolescents

CHEN Yao¹, LIU Changqing², ZHU Qianrang³, LIU Yiya⁴, TIAN Meina², WANG Hongwei⁵, YU Lianlong⁶

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Abstract

Objective To analyze the relationship between dietary branched-chain amino acids (BCAAs) intake and the risk of dyslipidemia in children and adolescents aged 6 - 18 years, in order to provide new insights for the prevention and treatment of dyslipidemia. Methods Dietary survey and blood biochemical data of 11 019 children and adolescents aged 6 - 18 years in four provinces of the China Children and Lactating Women Nutrition and Health Surveillance (CCLWNHS) project were analyzed.Dietary BCAAs intake was calculated using food frequency questionnaires combined with the China Food Composition Table.Differences in the prevalence of dyslipidemia subtypes across different BCAAs intake levels were compared.Logistic regression models were used to assess the association between BCAAs and dyslipidemia, and multiplicative interaction models were employed to evaluate the effects of interactions between BCAAs and age, sex, or body mass index (BMI) on dyslipidemia. Results Among the participants, 9,389 were in the normal control group, while 1 630 had dyslipidemia, including 470 cases of hypercholesterolemia.The hypercholesterolemia prevalence was significantly higher in the high total BCAAs and high BCAAs density groups compared to the low-intake groups (χ²=9.554, 18.109, P<0.01).Stratified analysis showed that, compared to the low-intake group, the high BCAAs intake group (OR=1.781, 95% CI: 1.326 - 2.391) and high BCAAs density group (OR=2.011, 95% CI: 1.493 - 2.708) had increased hypercholesterolemia risk in the normal-weight subgroup (P<0.05).Compared to the low-intake group, females in the high BCAAs intake group (OR=1.721, 95% CI: 1.243 - 2.384) and high BCAAs density group (OR=1.899, 95% CI: 1.361 - 2.651) also exhibited elevated hypercholesterolemia risk (P<0.05).In the 6 - 12 age group, high BCAAs intake was associated with increased hypercholesterolemia risk (OR=1.447, 95% CI: 1.100 - 1.905) compared to the low-intake group, while high BCAAs density elevated hypercholesterolemia risk across all age groups (6 - 12 years old OR=1.636, 95% CI: 1.242 - 2.155; 13-18 years old OR=1.881, 95% CI: 1.170 - 3.024) (P<0.05).A significant interaction effect was observed between BCAAs density and BMI on hypercholesterolemia risk (P=0.027).Mediation analysis revealed heterogeneous mediating effects of BMI on the relationship among total BCAAs intake, BCAAs density, and hypercholesterolemia risk. Conclusions Increased BCAAs intake is an independent risk factor for hypercholesterolemia.Adjusting dietary patterns by reducing red meat and processed meat consumption to limit BCAAs intake may lower the risk of hypercholesterolemia.

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branched-chain amino acids / dyslipidemia / cholesterol / hypercholesterolemia / metabolic diseases / children and adolescents

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CHEN Yao, LIU Changqing, ZHU Qianrang, LIU Yiya, TIAN Meina, WANG Hongwei, YU Lianlong. Effect of dietary branched-chain amino acids on dyslipidemia in children and adolescents[J]. Chinese Journal of Child Health Care. 2025, 33(10): 1101-1107 https://doi.org/10.11852/zgetbjzz2025-0236

References

[1] Zeljkovic A, Vekic J, Stefanovic A.Obesity and dyslipidemia in early life: Impact on cardiometabolic risk[J].Metabolism, 2024, 156:155919.
[2] 中国血脂管理指南修订联合专家委员会.中国血脂管理指南(2023年)[J].中华心血管病杂志,2023,51(3):221-255.
Joint Committee on the Chinese Guidelines for Lipid Management.Chinese guidelines for lipid management (2023)[J].Chin J Cardiol, 2023, 51(3):221-255.(in Chinese)
[3] Nie C, He T, Zhang W, et al.Branched chain amino acids: Beyond nutrition metabolism[J].IntJ Mol Sci, 2018, 19(4):954.
[4] Choi BH, Hyun S, Koo SH.The role of BCAA metabolism in metabolic health and disease[J].Exp Mol Med, 2024, 56(7):1552-1559.
[5] 中国人民共和国卫生部.人群健康监测人体测量方法:WS/T 424-2013[S].北京:中国标准出版社,2018.
[6] 中华人民共和国国家卫生和计划生育委员会.学龄儿童青少年超重与肥胖筛查:WS/T 586—2018[S].北京:中国标准出版社,2018.
[7] 《中华儿科杂志》编辑委员会,中华医学会儿科学分会儿童保健学组,中华医学会儿科学分会心血管学组,等.儿童青少年血脂异常防治专家共识[J].中华儿科杂志,2009,47(6):426-428.
The Editorial Board of Chinese Journal of Pediatrics, The Subspecialty Group of Child Health Care, The Society of Pediatrics, Chinese Medical Association, The Subspecialty Group of Cardiovascular Disease, The Society of Pediatrics, Chinese Medical Association, et al.Experts consensus for prevention and treatment of dyslipidemia in children and adolescents[J].Chin J Pediatr, 2009, 47(6):426-428.(in Chinese)
[8] Yu L, Zhu Q, Song P, et al.Dietary branched-chain amino acids intake and new-onset hypertension: A nationwide prospective cohort study in China[J].Amino Acids, 2024, 56 (1):19.
[9] Liu Y, Zhang C, Zhang Y, et al.Association between excessive dietary branched-chain amino acids intake and hypertension risk in Chinese population[J].Nutrients, 2022, 14 (13):2582.
[10] Lu J, Gu Y, Liu H, et al.Daily branched-chain amino acid intake and risks of obesity and insulin resistance in children: A cross-sectional study[J].Obes (Silver Spring), 2020, 28(7):1310-1316.
[11] Nagata C, Nakamura K, Wada K, et al.Branched-chain amino acid intake and the risk of diabetes in a Japanese community: the Takayama study[J].Am J Epidemiol, 2013, 178 (8):1226-1232.
[12] Li YC, Li Y, Liu LY, et al.The ratio of dietary branched-chain amino acids is associated with a lower prevalence of obesity in young northern Chinese adults: An internet-based cross-sectional study[J].Nutrients, 2015, 7(11):9573-9589.
[13] Yu L, Zhu Q, Li Y, et al.Dietary branched-chain amino acids (BCAAs) and risk of dyslipidemia in a Chinese population[J].Nutrients, 2022, 14(9):1824.
[14] Laamanen SE, Eloranta AM, Haapala EA, et al.Associations of diet quality and food consumption with serum biomarkers for lipid and amino acid metabolism in Finnish children: The PANIC study[J].Eur J Nutr, 2024, 63(2):623-637.
[15] Shen QM, Wang J, Li ZY, et al.Sex-specific correlation analysis of branched-chain amino acids in dietary intakes and plasma among Chinese adults[J].J Nutr, 2023, 153(9):2709-2716.
[16] Hamaya R, Mora S, Lawler PR, et al.Association of modifiable lifestyle factors with plasma branched-chain amino acid metabolites in women[J].J Nutr, 2022, 152(6):1515-1524.
[17] Schmidt JA, Rinaldi S, Scalbert A, et al.Plasma concentrations and intakes of amino acids in male meat-eaters, fish-eaters, vegetarians and vegans: A cross-sectional analysis in the EPIC-Oxford cohort[J].Eur J Clin Nutr, 2016, 70(3): 306-312.
[18] Ding C, Egli L, Bosco N, et al.Plasma branched-chain amino acids are associated with greater fasting and postprandial insulin secretion in non-diabetic Chinese adults[J].Front Nutr, 2021, 8:664939.
[19] Jakobsen LH, Kondrup J, Zellner M, et al.Effect of a high protein meat diet on muscle and cognitive functions: A randomised controlled dietary intervention trial in healthy men[J].Clin Nutr, 2011, 30(3):303-311.
[20] Karusheva Y, Koessler T, Strassburger K, et al.Short-term dietary reduction of branched-chain amino acids reduces meal-induced insulin secretion and modifies microbiome composition in type 2 diabetes: A randomized controlled crossover trial[J].Am J Clin Nutr, 2019, 110(5):1098-1107.
[21] Ramzan I, Taylor M, Phillips B, et al.A novel dietary intervention reduces circulatory branched-chain amino acids by 50%: A pilot study of relevance for obesity and diabetes[J].Nutrients, 2020, 13(1):95.
[22] Zheng Y, Li Y, Qi Q, et al.Cumulative consumption of branched-chain amino acids and incidence of type 2 diabetes[J].Int J Epidemiol, 2016, 45(5):1482-1492.
[23] Yang P, Hu W, Fu Z, et al.The positive association of branched-chain amino acids and metabolic dyslipidemia in Chinese Han population[J].Lipids Health Dis, 2016, 15:120.
[24] Mook-Kanamori DO, Römisch-Margl W, Kastenmüller G, et al.Increased amino acids levels and the risk of developing of hypertriglyceridemia in a 7-year follow-up[J].J Endocrinol Invest, 2014, 37(4):369-374.
[25] Kubacka J, Cembrowska P, Sypniewska G, et al.The Association between branched-chain amino acids(BCAAs) and cardiometabolic risk factors in middle-aged caucasian women stratified according to glycemic status[J].Nutrients, 2021, 13(10):3307.
[26] Moran-Ramos S, Ocampo-Medina E, Gutierrez-Aguilar R, et al.An amino acid signature associated with obesity predicts 2-year risk of hypertriglyceridemia in school-age children[J].Sci Rep, 2017, 7(1):5607.
[27] Wiklund P, Zhang X, Tan X, et al.Serum amino acid profiles in childhood predict triglyceride level in adulthood: A 7-year longitudinal study in girls[J].J Clin Endocrinol Metab, 2016, 101(5):2047-2055.
[28] Lee JH, Cho YR, Kim JH, et al.Branched-chain amino acids sustain pancreaticcancer growth by regulating lipid metabolism[J].Exp Mol Med, 2019, 51(11):1-11.
[29] Cummings NE, Williams EM, Kasza I, et al.Restoration of metabolic health by decreased consumption of branched-chain amino acids[J].J Physiol, 2018, 596(4):623-645.
[30] Cuomo P,Capparelli R, Iannelli A, et al.Role of branched-chain amino acid metabolism in type 2 diabetes, obesity, cardiovascular disease and non-alcoholic fatty liver disease[J].Int J Mol Sci, 2022, 23(8):4325.
[31] McGarrah RW, Zhang GF, Christopher BA, et al.Dietary branched-chain amino acid restriction alters fuel selection and reduces triglyceride stores in hearts of Zucker fatty rats[J].Am J Physiol Endocrinol Metab, 2020, 318(2):E216-E223.
[32] Neinast M, Murashige D, Arany Z.Branched chain amino acids[J].Annu Rev Physiol, 2019, 81:139-164.
[33] Che L, Xu M, Gao K, et al.Valine increases milk fat synthesis in mammary gland of gilts through stimulating AKT/MTOR/SREBP1 pathway[J].Biol Reprod, 2019, 101(1):126-137.
[34] Anderson JG, Hintze K, Marchant ED.Restricting branched-chain amino acids: An approach to improve metabolic health[J].J Physiol, 2018, 596(13):2469-2470.
[35] Polidori N, Grasso EA, Chiarelli F, et al.Amino acid-related metabolic signature in obese children and adolescents[J].Nutrients, 2022, 14(7):1454.
[36] Abdualkader AM, Karwi QG, Lopaschuk GD, et al.The role of branched-chain amino acids and their downstream metabolites in mediating insulin resistance[J].J Pharm Pharm Sci, 2024, 27:13040.
[37] Wang J, Liu Y, Lian K, et al.BCAA catabolic defect alters glucose metabolism in lean mice[J].Front Physiol, 2019, 10:1140.
[38] Solon-Biet SM, Cogger VC, Pulpitel T, et al.Branched chain amino acids impact health and lifespan indirectly via amino acid balance and appetite control[J].Nat Metab, 2019, 1(5):532-545.
[39] Yu L, Song P, Zhu Q, et al.The dietary branched-chain amino acids transition and risk of type 2 diabetes among chinese adults from 1997 to 2015: Based on seven cross-sectional studies and a prospective cohort study[J].Front Nutr, 2022, 9: 881847.