METHODS AND FORMULATIONS PROMOTING TISSUE/ORGAN REGENERATION, LONGEVITY AND HEALTHSPAN
A method includes a step of identifying a subject in need of diet modification; and administering a first diet to the subject for a first time period. The first diet provides 4.5 to 7 kilocalories per pound of subject for a first day and 3 to 5 kilocalories per pound of subject per day for a second to fifth day of the first diet. The first diet includes less than 30 g of sugar on the first day; less than 20 g of sugar on the second to fifth days; less than 28 g of proteins on the first day; less than 18 g of proteins on days the second to fifth days; 20 to 30 grams of monounsaturated fats on the first day; 10 to 15 grams of monounsaturated fats on the second to fifth days; and between 6 and 10 grams of polyunsaturated fats on the first day.
This application claims the benefit of U.S. provisional application Ser. No. 61/716,676 filed Oct. 22, 2012, Ser. No. 61/736,308 filed Dec. 12, 2012, and Ser. No. 61/746,787 filed Dec. 28, 2012, the disclosures of which are incorporated in their entirety by reference herein.
STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENTThe invention was made with Government support under Contract Nos. PO1AG034906, P01 AG 034906-01, and PO1AG020642. The Government has certain rights to the invention.
TECHNICAL FIELDThe present invention relates to a method of promoting tissue and/or organ regeneration.
BACKGROUNDRegenerative therapies may be used in the replenishment of damaged tissues/organs caused by chemotherapy or radiotherapy, associated with degenerative diseases or aging.
Conventional regenerative therapies commonly rely on the introduction of donor-derived regenerative cells and/or the administration of biologically active molecules that stimulate regeneration. Besides ethical issues, technical and safety challenges in stem cell isolation, maintenance, expansion, donor-recipient matching and transplantation persist and limit the usefulness and practicability of existing conventional regenerative therapies. Conventional therapies typically have not utilized dietary protocol has effective treatments for patients in need of tissue regeneration. Although diet has been known to provide tissue protection in various circumstances. The major limitation of conventional therapies is the lack of a coordinated regenerative process that is reminiscent of the developmental process leading to tissue generation in the embryo. The formulations and methods described in this application can overcome these limitations.
Caloric Restriction (CR) without malnutrition is effective in protecting the brain against aging and oxidative stress (Martin et al. 2006). Several studies support a beneficial role for this dietary intervention in protecting against age dependent decay in cognitive performance in rodents (Fontan-Lozano et al. 2008). In addition CR shows remarkable neuroprotective properties against neurodegenerative diseases including stroke, Parkinson's disease (PD), Huntington's disease (HD) and Alzheimer's Disease (AD) in several animal models (Mattson 2005; Patel et al. 2005).
Recent studies in different AD mouse models reported that reducing food intake can diminish AD-related neuropathologies and cognitive dysfunction. For example, CR reduces the progression of β amyloid (Aβ) deposition in the hippocampus and cerebral cortex of AD mice carrying mutations for FAD (Wang et al. 2005), APP (amyloid precursor protein) and APP+PS-1 (presenilin 1) (Patel et al. 2005; Mouton et al. 2009). CR ameliorates neurodegenerative phenotypes assessed by object recognition and contextual fear conditioning tests in cDKO (conditional double knockout) AD mice (Wu et al. 2008). Mattson and coworkers have shown that CR can also ameliorate age-related memory impairment and decrease Aβ and phosphorylated tau accumulation in a triple transgenic mouse (3×Tg-AD) that overexpress mutations linked to AD (PS-1, APP) and frontotemporal dementia (tau) (Halagappa et al. 2007). Also studies in human populations suggest that diet plays an important role in AD and reduced food intake may protect against this pathology. For example, an epidemiological study by Luchsinger and colleagues provided evidence that individuals with a low calorie intake have a reduced risk of developing AD (Luchsinger et al. 2002).
Among the large number of metabolic and physiological changes caused by CR, reduction of growth hormone (GH)/insulin-like factor (IGF-1) signaling axis may be important for its protective effects (Fontana et al. 2010). Circulating IGF-1 is a hormone produced primarily by the liver that regulates energy metabolism, cell proliferation, cell differentiation, body size and longevity. IGF-1 levels are regulated by calorie and/or protein availability and long-term CR decreases serum IGF-1 concentration by approximately 30-40% in rodents (Thissen et al. 1994) but not in humans unless protein intake is also reduced (Fontana et al. 2008). Mutations that decrease the activity of the growth hormone receptor (GHR)/IGF-1 signaling pathways, similarly to CR, can extend longevity and enhance stress resistance in a wide range of organisms and tissues (Kenyon 2005) including mammalian central nervous system (CNS) (Parrella & Longo 2010). Although the overlap between the pathways altered by these nutritional and genetic interventions seems to be only partial, it has been proposed that the decline in IGF-1 levels can mediate part of the beneficial effects produced by CR (Sonntag et al. 1999). In support of this theory, recently it has been shown that reducing IGF-1 signaling in an AD mouse carrying APP and PS-1 mutations protects against Alzheimer's-like disease symptoms including cognitive deficits and neuroinflammation (Cohen et al. 2009). Notably, GH receptor-deficient (GHRD) mice and humans are protected from major diseases (Guevara-Aguirre et al. 2011; Ikeno et al. 2009; Masternak et al. 2009) and GHRD mice consistently live 40% longer (Coschigano et al. 2000). Moreover, a study carried out on a cohort of Ashkenazi Jewish centenarians identified genetic alterations on human IGF-1 receptor (IGF-1R) that result in reduced IGF-1 signaling among the centenarians compared to controls (Suh et al. 2008). On the other hand the effect of IGF-1 or IGF-1R deficiency on lifespan is inconsistent (Bokov et al. 2011), suggesting that reduced IGF-1 may be only one of the mediators of the anti-aging effects of GHR deficiency.
Protein and amino acid (AA) availability is fundamental in regulating IGF-1 gene expression. Moreover, protein restriction not only decreases IGF-1 production rate, but also accelerates its clearance, regulates IGF-1 interaction with IGF binding proteins (IGFBPs) and attenuates IGF-1 biological actions (Ketelslegers et al. 1995). Because CR is very difficult to maintain, and is unavoidably associated with weight loss, loss of sex drive, hunger, feeling cold at normal room temperature and possible immune system side effects.
Accordingly, there is a need for dietary protocols to alleviate symptoms of Alzheimer's disease and/or other degenerative diseases and to promote tissue regeneration.
SUMMARY OF THE INVENTIONThe present invention solves one or more problems of the prior art by providing in at least one embodiment a method of treating a subject in need of diet modification. The method includes steps of identifying a subject in need of diet modification and administering a first diet to the subject for a first time period. The first diet provides 4.5 to 7 kilocalories per pound of subject for a first day and 3 to 5 kilocalories per pound of subject per day for a second to fifth day of the first diet. The first diet includes less than 30 g of sugar on the first day; less than 20 g of sugar on the second to fifth days; less than 28 g of proteins on the first day; less than 18 g of proteins on days the second to fifth days; 20 to 30 grams of monounsaturated fats on the first day; 10 to 15 grams of monounsaturated fats on the second to fifth days; between 6 and 10 grams of polyunsaturated fats on the first day; 3 to 5 grams of polyunsaturated fats on the second to fifth days; less than 12 g of saturated fats on the first day; less than 6 grams of saturated fats on the second to fifth days; and 12 to 25 grams of glycerol per day on the second to fifth days.
In another embodiment, a diet package implementing the diet protocol set forth above is provided. The diet package includes a first set of rations for a first diet to be administered for a first time period to a subject, the first diet providing from 4.5 to 7 kilocalories per pound of subject for a first day and 3 to 5 kilocalories per pound of subject per day for a second to fifth day of the first diet. The diet package includes rations that provide less than 30 g of sugar on the first day; less than 20 g of sugar on the second to fifth days; less than 28 g of proteins on the first day; less than 18 g of proteins on days the second to fifth days; 20 to 30 grams of monounsaturated fats on the first day; 10 to 15 grams of monounsaturated fats on the second to fifth days; between 6 and 10 grams of polyunsaturated fats on the first day; 3 to 5 grams of polyunsaturated fats on the second to fifth days; less than 12 g of saturated fats on the first day; less than 6 grams of saturated fats on the second to fifth days; and 12 to 25 grams of glycerol per day on the second to fifth days.
In another embodiment, a method of increasing the number of stem cells and/or progenitor cells in a subject is provided. In accordance with the method, a subject requiring increased numbers of stem cells and/or progenitor cells is identified and a reduction in protein kinase A (PKA) activity is induced.
In another embodiment, a method of alleviating a symptom in an immuno-compromised subject or boosting the immune status of a subject is provided. The method includes a step of identifying an immuno-compromised subject or a subject desiring an improved immune status and then inducing reduction in PKA activity in the immuno-compromised subject.
In yet another embodiment, a method of transferring cell hematopoietic stem/progenitor cells to a subject is provided. The method includes a step of identifying an immuno-compromised subject. A reduction in protein kinase A activity and/or IGF-I receptor level is induced in bone marrow or stem cells of a donor. After the treatment, the cells are then grafted into the immuno-compromised or other subject in need of regeneration.
In still another embodiment, a method of promoting growth of regenerative cells is provided. The method includes a step of administering a diet protocol to a subject for a first time period and a second time period. During the first time period, a reduced caloric diet is provided to the subject with at least 50 percent calories derived from fat. During the second time period, a second reduced caloric diet of at most 900 kcal/day is provided to the subject. Optionally, the regenerative cells are isolated from the subject and transferred to a recipient.
In still another embodiment, a method of alleviating a symptom of Alzheimer's Disease is provided. The method includes a step of administering an amino acid specific diet having certain amino acids. In this embodiment, a long-term alternation of cycles of a normal and a protein restricted diet (protein restriction cycles, PRC) is found to reduce GHR/IGF-1 levels/signaling and ameliorate the AD-like symptoms in a 3×Tg-AD mouse that accumulates both Aβ and tau pathologies.
Reference will now be made in detail to presently preferred compositions, embodiments and methods of the present invention. The Figures are not necessarily to scale. The disclosed embodiments are merely exemplary of the invention that may be embodied in various and alternative forms. Therefore, specific details disclosed herein are not to be interpreted as limiting, but merely as a representative basis for any aspect of the invention and/or as a representative basis for teaching one skilled in the art to variously employ the present invention.
Except in the examples, or where otherwise expressly indicated, all numerical quantities in this description indicating amounts of material or conditions of reaction and/or use are to be understood as modified by the word “about” in describing the broadest scope of the invention. Practice within the numerical limits stated is generally preferred. Also, unless expressly stated to the contrary: percent, “parts of,” and ratio values are by weight; the description of a group or class of materials as suitable or preferred for a given purpose in connection with the invention implies that mixtures of any two or more of the members of the group or class are equally suitable or preferred; description of constituents in chemical terms refers to the constituents at the time of addition to any combination specified in the description, and does not necessarily preclude chemical interactions among the constituents of a mixture once mixed; the first definition of an acronym or other abbreviation applies to all subsequent uses herein of the same abbreviation and applies mutatis mutandis to normal grammatical variations of the initially defined abbreviation; and, unless expressly stated to the contrary, measurement of a property is determined by the same technique as previously or later referenced for the same property.
This invention is not limited to the specific embodiments and methods described below, as specific components and/or conditions may, of course, vary. Furthermore, the terminology used herein is used only for the purpose of describing particular embodiments of the present invention and is not intended to be limiting in any way.
As used in the specification and the appended claims, the singular form “a,” “an,” and “the” comprise plural referents unless the context clearly indicates otherwise. For example, reference to a component in the singular is intended to comprise a plurality of components.
The term “essential amino acid” refers to amino acids that cannot be synthesized by an organism. In humans, essential amino acids include isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, valine. In addition, the following amino acids are also essential in humans under certain conditions—histidine, tyrosine, and selenocysteine.
The terms “kilocalorie” (kcal) and “Calorie” refer to the food calorie. The term “calorie” refers to the so-called small calorie.
The term “subject” refers to a human or animal, including all mammals such as primates (particularly higher primates), sheep, dog, rodents (e.g., mouse or rat), guinea pig, goat, pig, cat, rabbit, and cow.
Embodiments of the present invention relate to methods for tissue and/or organ regeneration, and, in particular, to stem cell-based regeneration. As will be detailed herein below, and without wanting to be limited to any particular theory, it is believed that the present invention in one or more embodiments may enhance the availability and functionality of regenerative cells including stem cells and progenitor cells and promotes tissue/organ regeneration and reconstitution, and in particular, hematopoietic stem/progenitor cells and other immune cells. In a variation, the regenerative cells include brain cells, muscle cells, liver cells, and cells derived therefrom. Inhibition of growth hormone receptor (GHR), Insulin-like growth factor 1 (IGF-I), insulin-like growth factor 1 (IGF-1) receptor (IGF-IR), and protein kinase A (PKA) enhances the availability and functionality of regenerative cells in mammals. Such inhibition is achieved by gene silencing, pharmaceutical inhibition, and administering of low calorie dietary protocols as set forth below. This tissue and/or regeneration is applicable to both residential regeneration, wherein the donor to and the recipient of the regenerative cells are the same individual, and transplant regeneration, where the donor to and the recipient of the regenerative cells are two different individuals. In this regard, the present invention is particularly advantageous in effectuating the residential regeneration in a relatively less offensive approach, which can be more cost effective and reduce the occurrences of certain issues including donor-recipient matching difficulties.
In an embodiment, a method for modifying a subject's diet is provided. The method includes a step of identifying a subject in need of diet modification. A first diet is administered for a first time period to the subject. As used herein, sometimes the first diet of this embodiment is referred to as a fasting mimicking diet (FMD). In a refinement, the first diet provides from 4.5 to 7 kilocalories per pound of subject for a first day (day 1) and then 3 to 5 kilocalories per pound of subject per day for a second to fifth day (days 2-5) of the first diet. A second diet is administered to the subject for a second time period. In a refinement, the second diet provides an overall calorie consumption that is within 20 percent of a subject's normal calorie consumption for 25 to 26 days (e.g., immediately) following the first diet. In one refinement, the subject is in need of weight loss with method resulting in weight loss. In another refinement, the subject is in need of tissue regeneration with the method resulting is such tissue regeneration. Characteristically, it is observed that the level of IGF-I decreases and the level of IGFBP1 increases. In a refinement, the method of this embodiment is repeated from 1 to 5 times. In another refinement, the method of this embodiment is repeated from 2 to 3 times. In still another refinement, the method of this embodiment is repeated for a period of years or throughout the subject's entire life. In another refinement, the combination of the first diet and the second diet provide the subject with a total number of calories within 10 percent of the subject's normal caloric intake. In another refinement, the combination of the first diet and the second diet provides the subject with a total number of calories within 5 percent of the subject's normal caloric intake. In still another refinement, the combination of the first diet and the second diet provides the subject with a total number of calories within 1 percent of the subject's normal caloric intake.
In the context of the present embodiment, a subject in need of diet modification includes subject requiring weight reduction. In other variations, a subject in need of diet modification includes subjects in need of stem cell, progenitor cell and embryonic-like stem cell regeneration; subjects in need of WBC regeneration and a balanced lymphoid/myeloid ratio; subjects in need of reversal of immunosuppression, immunodeficiency and immunodepression; subjects in need of neurogenesis and improvement of cognitive performance both related to short-term memory, long-term memory and motor coordination in both young and old mammals; subjects in need of reversal of cognitive decline; subjects having cancer; subjects having an inflammatory disease (e.g., skin dermatitis); subjects having loss of bone density (e.g., osteoporosis); and subjects having liver damage. Examples of such symptoms of Alzheimer's Disease include, but are not limited to, impairment of learning and memory, speech difficulties, agnosia, apraxia, paraphasias, short term memory loss, and the like. Examples of such symptoms of immunosuppression, immunodeficiency and immunodepression include, but are not limited to, susceptibility to infections and susceptibility to cancer. Examples of such symptoms of inflammatory disease include, but are not limited to, inflammation, swelling, redness, pain, calor, and loss of function. Examples of such symptoms of liver damage include, but are not limited to, elevation of ALT, elevation of ALP, bilirubin, itching, jaundice, neoplasm, hepatocellular necrosis, zonal necrosis, and the like.
In a refinement, the method reduces the risk for loss of bone density or reduces a symptom of bone loss. In still another example, the method reduces the risk of liver damage or alleviates a symptom of liver damage. In a further refinement, the method with respect to assessing liver damage further includes a step of monitoring the levels of liver markers. In particular, the levels of aminotransferase (ALT) and aspartate aminotransferase (AST) are measured in a blood test as is known to one skilled in the art.
In another refinement, the subject requires stem cell, progenitor cell or embryonic-like stem cell regeneration. In still another refinement, the subject requires white blood cell (WBC) regeneration and/or a balanced lymphoid/myeloid ratio analogous to that observed in young and healthy mammals/humans. In still another refinement, the subject is at a risk for immunosuppression, immunodeficiency and immunodepression or the subject has one of these conditions and the method alleviates at least one symptom thereof.
In yet another refinement, the subject is in need of neurogenesis and improvement of cognitive performance both related to short-term memory, long-term memory and motor coordination in both young and old mammals. Subject in this category include those in need of reversal of cognitive decline. Examples of such cognitive conditions include, but are not limited to Alzheimer's Disease and related conditions.
In a variation, the fasting mimicking diet (FMD) program involves completely substituting a subject's diet for 5 days. During this 5 day period, subjects consume plenty of water. For healthy subjects of normal weight (Body Mass Index or BMI between 18.5-25), the diet is consumed once a month (5 days on the diet and 25-26 days on their normal diet) for the first 3 months and every 3 months thereafter (5 days every 3 months). The weight of the subject is measured and the subject must regain at least 95% of the weight lost during the diet before the next cycle is begun. Subjects with BMI of less than 18.5 should not undertake the FMD unless recommended and supervised by a physician. The same regimen (once every month for 3 months followed by once every 3 months thereafter) can be adopted for the treatment, or in support of the treatment, of all of the conditions presented in the patent applications.
A refinement of the FMD for overweight subjects (BMI: 25-30), entails following the diet once/month or as frequently as twice/month until the ideal weight is reached, while under medical supervision. In a further refinement of the FMD for obese subjects (BMI>30), physicians recommend consumption of the diet as frequently as once a week (5 days on the diet, 2 days off) with the appropriate medical supervision.
The consumption guidelines for the FMD include Nutrition Facts relative to calories, macronutrients and micronutrients. Calories are consumed according to the user's body weight. Total calorie consumption is 4.5-7 calorie per pound (or 10-16 calorie per kilogram) for day 1 and 3-5 calorie per pound (or 7-11 calorie per kilogram) for day 2 to 5.
In a variation, the FMD includes the following micronutrients (at least 95% non-animal based): over 5,000 IU of vitamin A per day (days 1-5); 60-240 mg of vitamin C per day (days 1-5); 400-800 mg of Calcium per day (days 1-5); 7.2-14.4 mg of Iron per day (days 1-5); 200-400 mg of Magnesium per day (days 1-5); 1-2 mg of copper per day (days 1-5); 1-2 mg of Manganese per day (days 1-5); 3.5-7 mcg of Selenium per day (days 1-5); 2-4 mg of Vitamin B1 per day (days 1-5); 2-4 mg of Vitamin B2 per day (days 1-5); 20-30 mg of Vitamin B3 per day (days 1-5); 1-1.5 mg of Vitamin B5 per day (days 1-5); 2-4 mg of Vitamin B6 per day (days 1-5); 240-480 mcg of Vitamin B9 per day (days 1-5); 600-1000 IU of Vitamin D per day (days 1-5); 14-30 mg of Vitamin E per day (days 1-5); over 80 mcg of Vitamin K per day (days 1-5); 16-25 mcg Vitamin B12 are provided during the entire 5-day period; 600 mg of Docosahexaenoic acid (DHA, algae-derived) are provided during the entire 5-day period. The FMD diet provides high micronutrient content mostly (i.e., greater than 50 percent by weight) from natural sources including: Kale, Cashews, Yellow Bell Pepper, Onion, Lemon Juice, Yeast, Turmeric. Mushroom, Carrot, Olive Oil, Beet Juice, Spinach, Tomato, Collard, Nettle, Thyme, Salt, Pepper, Vitamin B12 (Cyanocobalamin), Beets, Butternut Squash, Collard, Tomato, Oregano, Tomato Juice, Orange Juice, Celery, Romaine Lettuce, Spinach, Cumin, Orange Rind, Citric Acid, Nutmeg, Cloves, and combinations thereof. Table 1 provides an example of additional micronutrient supplementation that can be provided in the FMD diet:
In another embodiment, a diet package for implemented the diet protocol set forth above is provided. The diet package includes a first set of rations for a first diet to be administered for a first time period to a subject, the first diet providing from 4.5 to 7 kilocalories per pound of subject for a first day and 3 to 5 kilocalories per pound of subject per day for a second to fifth day of the first diet. The diet package includes rations that provide less than 30 g of sugar on the first day; less than 20 g of sugar on the second to fifth days; less than 28 g of proteins on the first day; less than 18 g of proteins on days the second to fifth days; 20 to 30 grams of monounsaturated fats on the first day; 10 to 15 grams of monounsaturated fats on the second to fifth days; between 6 and 10 grams of polyunsaturated fats on the first day; 3 to 5 grams of polyunsaturated fats on the second to fifth days; less than 12 g of saturated fats on the first day; less than 6 grams of saturated fats on the second to fifth days; and 12 to 25 grams of glycerol per day on the second to fifth days. In a refinement, the diet package further includes sufficient rations to provide the micronutrients set forth above. In a further refinement, the diet package provides instructions providing details of the methods set forth above.
In another embodiment, a method for inhibiting GHR, IGF-I, IGF-IR or PKA is provided. The method of this embodiment includes a step of identifying a subject in need of inhibition of GHR, IGF-I, IGF-IR or PKA and then inhibiting at least one of GHR, IGF-I, IGF-IR or PKA. In a refinement, at least two of GHR, IGF-I, IGF-IR or PKA are inhibited. In another refinement, at least three of GHR, IGF-I, IGF-IR or PKA are inhibited. In still another embodiment, all of GHR, IGF-I, IGF-IR or PKA are inhibited.
In the context of the present embodiment, a subject in need of inhibition of GHR, IGF-I, IGF-IR or PKA includes subjects in need of diet modification or weight reduction. Indeed, the diet protocols set forth above accomplishes inhibition of GHR, IGF-I, IGF-IR or PKA. In other variations, a subject in need of GHR, IGF-I, IGF-IR or PKA inhibition includes subjects in need of stem cell, progenitor cell and embryonic-like stem cell regeneration; subjects in need of WBC regeneration and a balanced lymphoid/myeloid ratio; subjects in need of reversal of immunosuppression, immunodeficiency and immunodepression; subjects in need of neurogenesis and improvement of cognitive performance both related to short-term memory, long-term memory and motor coordination in both young and old mammals; subjects in need of reversal of cognitive decline; subjects having cancer; subjects having an inflammatory disease (e.g., skin dermatitis); subjects having loss of bone density (e.g., osteoporosis); and subjects having liver damage. Examples of such symptoms of Alzheimer's Disease include, but are not limited to, impairment of learning and memory, speech difficulties, agnosia, apraxia, paraphasias, short term memory loss, and the like. Examples of such symptoms of immunosuppression, immunodeficiency and immunodepression include, but are not limited to, susceptibility to infections and susceptibility to cancer. Examples of such symptoms of inflammatory disease include, but are not limited to, inflammation, swelling, redness, pain, calor, and loss of function. Examples of such symptoms of liver damage include, but are not limited to, elevation of ALT, elevation of ALP, bilirubin, itching, jaundice, neoplasm, hepatocellular necrosis, zonal necrosis, and the like.
In a variation of the present embodiment, the step of inhibiting GHR, IGF-I, IGF-IR or PKA includes administering a small drug, antagonist, inhibitory RNA or DNA or antibody to the subject. In a refinement, the step of inhibiting GHR, IGF-I, IGF-IR and/or PKA includes administering a GH/IGF-1 Axis inhibitory composition to the subject. Examples of suitable GH/IGF-1 Axis inhibitory compositions include growth hormone receptor antagonists, an IGF-I receptor antagonists, GH-releasing hormone (GHRH) receptor antagonists, and combinations thereof.
In another embodiment, a method of alleviating a symptom in an immuno-compromised subject is provided. The method includes a step of identifying a subject that is immuno-compromised or a subject that desires an improvement in immune status. A reduction in protein kinase A (PKA) activity and/or IGF-I levels is induced in the subject. Optionally, progress of the subject is monitored by measuring the PKA activity and/or IGF level to verify that at target level of each is achieved. In one refinement, the reduction in protein kinase A (PKA) activity and/or IGF-I levels are reduced by administering a low calorie diet protocol as set forth below. A particularly useful diet protocol is provided by WIPO Pub. No. WO2011/050302, the entire disclosure of which is hereby incorporated by reference. In another refinement, the reduction in protein kinase A (PKA) activity and/or IGF-I levels are reduced by administering a low calorie diet protocol as set forth below.
In another embodiment, a method of transferring hematopoietic stem/progenitor cells to a subject is provided. The method includes a step of identifying an immuno-compromised subject. A reduction in protein kinase A activity and/or IGF-I level is induced in a donor as set forth above. Optionally, regenerative hematopoietic stem/regenerator cells are isolated from the donor and then grafted into the immuno-compromised subject.
In still another embodiment, a method of promoting growth of regenerative cells is provided. The method includes a step of administering a dietary protocol to a subject for a first time period and a second time period. During the first time period, a reduced caloric diet is provided to the subject with at least 50 percent calories derived from fat. During the second time period, a second reduced caloric diet of at most 900 kcal/day is provided to the subject. A particularly useful diet protocol is provided by WIPO Pub. No. WO2011/050302 as set forth above. Optionally, the regenerative cells are isolated from the subject and transferred to a recipient.
In still another embodiment, a method of promoting tissue regeneration in a subject is provided. The method may include the steps of isolating a population of regenerative cells from a donor, the donor having a target PKA level or activity in the tissue in which regeneration is desired. The donor is pretreated to lower PKA activity to reach the target PKA activity. In a refinement, the population of regenerative cells is delivered into a part of the subject where tissue regeneration is desirable. In another refinement, the subject and the donor are the same individual. In these instances, the population of regenerative cells can be isolated from a first body part of the subject and later deposited to a second body part of the subject different from the first body part. Without wanting to be limited to any particular theory, it is believed that resident regeneration with the regenerative cells isolated from and deposited to the same individual provides relief to certain issues such as donor-recipient matching issues mentioned herein elsewhere. In another refinement, the donor and the subject are different individuals. The population of regenerative cells that are isolated include at least one of a stem cell and a progenitor cell. Examples of regenerative cells are obtained from bone marrow, brain, liver, and the like. To obtain the target PKA activity, the donor may have been pretreated with a pharmaceutical composition to reduce PKA activity to be within the pre-determined value range. Alternatively, the donor may have been pretreated with a dietary protocol with components provided from a diet package to reduce PKA activity to be within a pre-determined value range as adapted from WIPO Pub. No. WO2011/050302. In the instances where the diet package is used, the diet package includes components for a first diet and a second diet. The first diet is administered to the donor at a first time period and the second diet for a second time period. Characteristically, the first diet is different in composition than the second diet. In a refinement, the diet package may include components for a third diet administered to the donor for a third time period. Typically, a body weight of the donor is measured prior to the second diet. The second diet may not be administered until the body weight of the donor is within a pre-determined weight range. Typically, the body weight of the donor is measured prior to administration of the third diet. The third diet may not be administered until the body weight of the donor is within a pre-determined weight range. The pre-determined weight range may be 70 to 99 percent of a body weight of the donor/subject prior to the first diet. The first time period may be of between 20 to 120 hours, 20 to 100 hours, 20 to 80 hours, 20 to 70 hours, 20 to 60 hours, 20 to 50 hours, 20 to 40 hours, or 20 to 30 hours. In certain instances, the first time period is 20 to 28 hours. The second time period may be of between 20 to 120 hours, 30 to 110 hours, 40 to 100 hours, 50 to 90 hours, or 60 to 80 hours. In certain instances, the second time period is 68 to 76 hours. The time difference between the start of the first diet and the start of the second diet is typically from 1 to 4 weeks. The first diet may be administered to provide the donor/subject with at most 50% of the subject's normal caloric intake wherein at least 50% of the kilocalories are derived from fat. The first diet may be administered to the donor/subject with from 700 to 1200 kcal/day. The second diet may be administered to provide the donor/subject with a calorie input of at most 500 kcal/day, 400 kcal/day, 300 kcal/day, or 200 kcal/day. The third diet may be administered to provide the donor/subject with greater than 50% of the donor's normal caloric intake. The third diet may be administered to provide the donor/subject with one or more essential amino acids. In a refinement, the third time period may be greater than 120 hours.
As set forth above, embodiments of the invention seek to decrease PKA activity. A decrease in PKA activity and/or a decrease in IGF-I level are achieved by administering a diet protocol of complete food deprivation (i.e. fasting or starvation) or the FMD diet set forth above. Intensive but brief form of calorie restriction, can effectively (48 hrs in mice and 120 hrs in human) reach the essential physiological conditions (e.g. reduction of blood glucose and circulating IGF-I level and reduction of IGF-I signaling) which may be important for promoting the regenerative effects and an increase in stems and/or progenitor cells. The fasting condition induced several stem cell populations with documented therapeutic applications, including the multipotent adult tissue-specific stem/progenitor cells and the rare pluripotent fetal/embryonic like stem cells. The fasting conditions reverse the decline of stem cell number and correct occurred regenerative disorder with no special requirements for initial conditions (e.g., age) and without compromising the long-term regenerative capacity. This high efficiency, broad effects on classes of stem cells, low initial requirements and long-term safety/benefits allow this invention to be practically incorporated with various types of therapy, including chemotherapy and radiotherapy. With no need of invasive approach, it can benefit the conventional regenerative approach in the way that directly stimulates the resident stem cells and/or may indirectly change the microenvironments for promoting the regeneration of the transplanted stem cells in the recipients.
In another variation, a substitution diet is provided to a subject in order to decrease PKA activity and or IGF-I levels. The present variation is particularly useful in that a 120-hr fasting may be difficult for human subjects to achieve due to low compliance and the side-effects of malnutrition. The substitution diet of the present variation maximizes micronutrients without interfering with the beneficial effect of fasting condition in promoting regeneration. The fasting conditions promoting stem cell-based regeneration have been achieved by in vivo fasting/fasting cycles and partially by ii) in vivo substitution diets and ex vivo inhibition of IGF-I or PKA signaling. For human subjects, the substitution diets set forth below mimic the condition achieved by human subjects fasting for 72 to 120 hours, while minimizing malnutrition. Moreover, the diet consists of ingredients which are Generally Regarded As Safe (GRAS). A particularly useful diet protocol is provided by WIPO Pub. No. WO2011/050302 as set forth above. It should be appreciated that substitution diets for subjects other than humans are analogous to those described herein for humans. Such diets are adjusted by taking into consideration the weight and normal food intake of the non-human subjects.
In refinement of the embodiments set forth above, a 5-day supply of diet includes: soups/broths, soft drinks, nut bars and supplements. The diet is administered as follows: 1) on the first day a 1000-1200 kcal diet with high micronutrient nourishment is provided; 2) for the next 4 days a daily diet of 650-800 kcal plus a drink containing a glucose substitution carbon source providing between 60-120 kcal are provided. The substitution carbon source does not interfere with the effect of fasting on stem cell activation.
In another refinement of the embodiments set forth above, a 6-day low-protein diet protocol includes: soups/broths, soft drinks, nut bars, and supplements. The diet is administered as follows: 1) on the first day a 1000-1200 kcal diet plus with high micronutrient nourishment is provided; 2) for the next 3 days a daily diet of less than 200 kcal plus a drink containing a glucose substitution carbon source providing between 60 and 120 kcal. This substitution carbon source does not interfere with the effect of fasting on stem cell activation; 3) on the 5th day the subject consumes a normal diet; and 4) on day 6 an additional replenishment foods consisting of a high fat source of 300 kcal and a micronutrient nourishment mix on day 6 replenishment foods consisting of a high fat source of 300 kcal and a micronutrient nourishment mix are provided in addition to normal diet.
In still another refinement, a diet protocol includes: 6-day supply of low-protein diet includes: soups/broths, soft drinks, nut bars, and supplements. 1) on the first day a 1000-1200 kcal diet with high micronutrient nourishment is provided; 2) for the next 3 days a daily diet of 600 to 800 kcal which contains less than 10 grams of protein and less than 200 kcal from sugars; 3) on the 5th day the subject receives a normal diet; and 4) on day 6 an additional replenishment foods consisting of a high fat source of 300 kcal and a micronutrient nourishment mix on day 6 replenishment foods consisting of a high fat source of 300 kcal and a micronutrient nourishment mix are provided in addition to normal diet.
The present invention, in one or more embodiments, provides nutritional formulations and methods for tissue and organ regeneration. Specific embodiments of methods and compositions that achieve this goal are set forth below. Although the operation of the present invention is not limited to any particular mechanism, the protection observed in various embodiments of the present invention is due in part to modulation of the PKA pathway. The foundation for the protective effect of fasting appears to be based on the ability to reallocate energy to protection/maintenance from reproduction/growth when nutrients are scarce or absent. It should be pointed out, long-term dietary restriction causes a much more modest reduction in IGF-I and glucose compared to fasting. Moreover, unlike fasting, long-term dietary restriction is not feasible for the great majority of the population since it causes chronic weight loss and is very difficult to maintain. Instead, an average of about 62 hours of fasting prior to and 24 hours post-treatment can be well tolerated by subjects receiving treatments.
The embodiments and variations of the present invention achieve a reduction in PKA activity and/or IGF-I levels in a subject by administration of a dietary protocol. As set forth above, a particularly useful diet protocol and dietary packages are provided by WIPO Pub. No. WO2011/050302 and the dietary protocols herein. In particular, subjects are provided with a first diet for a first time period, a second diet for a second time period, and an optional third diet for a third time period. The first diet provides the subject with at most 50% of the subject's normal caloric intake with at least 50% of the kilocalories being derived from fat, preferably monounsaturated fats. The subject's normal caloric intake is the number of kcal that the subject consumes to maintain his/her weight. The subject's normal caloric intake may be estimated by interviewing the subject or by consideration of a subject's weight. As a rough guide, subject's normal caloric intake is on average 2600 kcal/day for men and 1850 kcal/day for women. In certain instances, the first diet provides the subject with from 700 to 1200 kcal/day. In a particularly useful refinement, the first diet provides the male subject of average weight with about 1100 kcal/day and the female subject of average weight with 900 kcal/day. Typically, the first predetermined period of time is from about 1 to 5 days. In certain instances, the first predetermined period of time is 1 day. In order to put the level of fat in the first diet in perspective, the U.S. Food and Drug Administration recommends the following nutritional breakdown for a typical 2000 kilocalorie a day diet: 65 gram fat (about 585 kilocalories), 50 grams protein (about 200 kilocalories), 300 grams total carbohydrates (about 1200 kilocalories). Therefore, in one version of the first diet, a majority of the calories from carbohydrates and proteins are eliminated.
Although the first diet encompasses virtually any source of fat, sources high in unsaturated fat, including monounsaturated and polyunsaturated fat sources, are particularly useful (e.g., omega-3/6 essential fatty acids). Suitable examples of monounsaturated food sources include, but are not limited to, peanut butter, olives, nuts (e.g., almonds, pecans, pistachios, cashews), avocado, seeds (e.g., sesame), oils (e.g., olive, sesame, peanut, canola), etc. Suitable examples of polyunsaturated food sources include, but are not limited to, walnuts, seeds (e.g., pumpkin, sunflower), flaxseed, fish (e.g., salmon, tuna, mackerel), oils (e.g., safflower, soybean, corn). The first diet also includes a component selected from the group consisting of vegetable extracts, minerals, omega-3/6 essential fatty acids, and combinations thereof. In one refinement, such a vegetable extract provides the equivalent of 5 recommended daily servings of vegetables. Suitable sources for the vegetable extract include, but are not limited to, bokchoy, kale, lettuce, asparagus, carrot, butternut squash, alfalfa, green peas, tomato, cabbage, cauliflower, beets. Suitable sources for the omega-3/6 essential fatty acids include fish such as salmon, tuna, mackerel, bluefish, swordfish, and the like.
The subject is then provided the second diet for a second time period. The second diet provides the subject with at most 900 kcal/day. In certain instances, the second diet provides the subject with at most 200 kcal/day. Typically, the second predetermined period of time is from about 2 to 7 days. In certain particular instances, the second predetermined period of time is 3 days. In still another refinement, the second diet includes a component selected from the group consisting of vegetable extracts, minerals, omega-3/6 essential fatty acids, and combinations thereof. In one refinement, such a vegetable extract provides the equivalent of 5 recommended daily servings of vegetable. Suitable sources for the vegetable extract include, but are not limited to, bokchoy, kale, lettuce, asparagus, carrot, butternut squash, alfalfa, green peas, tomato, cabbage, cauliflower, beets. Suitable sources for the omega-3/6 essential fatty acids include fish oils from salmon, tuna, mackerel, bluefish, swordfish, and the like.
The effectiveness of the dietary protocols herein is monitored by measurement of a number of subject parameters. For example, it is desirable that the subject's serum concentration of IGF-I be reduced by 25-90% by the end of the second diet period. It is also desirable that the blood glucose concentration in the subject be reduced by 25-75% by the end of the second diet period. In a refinement, the PKA activity in the tissue or cells of interest to ensure a reduction is PKA activity of at least 15 percent. In other refinements, the PKA activity in the tissue or cells of interest to ensure a reduction is PKA activity of at least 25 percent, 30 percent, or 50 percent. PKA activity may be determined by any number of methods known to those skilled in the art. The ProFluor® PKA Assay commercially available from Promega is one assay that this useful for this purpose.
In a variation of the present embodiment, the subject is provided with a third diet for a third predetermined period of time. The third diet is to supplement the normal diet of the subject. Characteristically, the replenishing composition includes essential amino acids, minerals, and essential fats. Advantageously, the third diet will allow the subject to regain the normal weight and maximize strength. Typically, the third predetermined period of time is at least 5 days. The replenishing composition will also optionally include a number of additional components. For example, the replenishing composition may include a vegetable extract. In one refinement, such a vegetable extract provides the equivalent of 5 recommended daily servings of vegetable. Suitable sources for the vegetable extract include, but are not limited to, bokchoy, kale, lettuce, asparagus, carrot, butternut squash, alfalfa, green peas, tomato, cabbage, cauliflower, beets. The replenishing composition may also include omega-3/6 essential fatty acids, and non-essential amino acids. Examples of suitable non-essential amino acids include, but are not limited to, histidine, serine, taurine, tyrosine, cysteine, glutamine, and combinations thereof. The replenishing composition may also include a multi-mineral tablet containing iron, zinc, copper, magnesium, and calcium and may also contain a vitamin B complex including vitamin B12.
As set forth above, the third diet together with the subject's normal diet will allow the subject to regain the normal weight and maximize strength. Typically, the third predetermined period of time is at least 5 days and may continue indefinitely. In certain instances, the third predetermined period of time is from about 4 days to about 14 days. A week is estimated to be nearly optimal for this purpose. The replenishing composition will also optionally include a number of additional components. For example, the replenishing composition may include a vegetable extract. In one refinement, such a vegetable extract provides the equivalent of 5 recommended daily servings of vegetable. Suitable sources for the vegetable extract include, but are not limited to, bokchoy, kale, lettuce, asparagus, carrot, butternut squash, alfalfa, green peas, tomato, cabbage, cauliflower, beets. The replenishing composition may also include omega-3/6 essential fatty acids, and non-essential amino acids. Examples of suitable non-essential amino acids include, but are not limited to, histidine, serine, taurine, tyrosine, cysteine, glutamine, and combinations thereof. Additional details of the third diet are the same as those set forth above.
In another embodiment, a method of alleviating a symptom of Alzheimer's Disease is provided. The method includes a step of administering an amino acid specific diet having certain amino acids for a first time period. Although the first time period may be for any desired time period, in a refinement, the first time period is from about 5 days to 14 day with 7 days being typical. In a variation, the amino acid specific diet substantially excludes the following amino acids isoleucine, leucine, lysine, methionine, phenyalanine, threonine, tryptophan, valine, and arginine. In this context, “substantially excludes” means that the total of the excluded amino acids is less than, increasing order of preference, 5 weight percent, 3 weight percent, 1 weight percent, and 0.5 weight percent of the total weight of the subject's diet. Instead, the amino acid specific diet provides one or more of the following amino acids as a source of nitrogen: alanine, aspartic acid, cysteine, glutamic acid, glycine, histidine, proline, serine, and tyrosine. Tables 2 to 4 provide characteristics of an amino acid specific diet for a mouse which is also a protein restricted as set forth below. A typical mouse diet provides about 19 kcal per day. For other mammals such as humans, the protein restricted (PR) diet is scaled to provide the requisite calories. For example, a typical caloric intake for adults in the United States is about 2200 calories per day. Table 5 provides the kilocalories per day from each source for human subjects while Table 6 provides the grams per day from each source for humans.
In a refinement, a kilogram of the amino acid specific diet for a mouse includes from about 2 g to 20 g alanine, 10 g to 30 g aspartic acid, 2 g to 20 g cysteine, 40 g to 80 g glutamic acid, 2 g to 20 g glycine, 2 g to 20 g histidine, 15 g to 50 g proline, 5 g to 30 g serine, and 5 to 30 g tyrosine. For human subjects, these ranges are multiplied by a factor (i.e., about 0.572) to provide the composition of the dietary formulation per day for human subjects. For example, the daily amounts of the specified amino acids for humans (2200 Calorie/day diet) in the amino acid specific diet are about 2 to 12 g alanine, 5 g to 30 g aspartic acid, 1 g to 7 g cysteine, 18 g to 73 g glutamic acid, 2 g to 9 g glycine, 2 g to 10 g histidine, 9 g to 37 g proline, 5 g to 21 g serine, and 5 to 21 g tyrosine. In another refinement, the amino acid specific diet includes from about 160 to about 240 g of the specified amino acids per kilogram of the diet. Therefore, for humans the amino acid specific diet provides from about 80 to 160 g of the specified amino acids per day using a factor (0.572) to convert the per kilogram of diet value to a value representative of a human diet of about 2200 Calories/day. In another variation, the amino acid specific diet includes at least 6 amino acids selected from the group consisting of alanine, aspartic acid, cysteine, glutamic acid, glycine, histidine, proline, serine, and tyrosine in the amounts set forth above. In still another variation, the amino acid specific diet provides the amounts of amino acids in grams per Kg of human body weight per day set forth in Table 7. In particular, the amino acid specific diet provided the following grams per Kg of human body weight per day 0.06 g alanine, 0.14 g aspartic acid, 0.04 g cysteine, 0.45 g glutamic acid, 0.05 g glycine, 0.06 g histidine, 0.23 g proline, 0.13 serine, and 0.13 g tyrosine. In another refinement, each of these amino acids is within a range of plus or minus 30 percent of the specified value.
In another embodiment, another method for alleviating a symptom of Alzheimer's Disease is provided. The method includes a step of administering a protein restricted (PR) diet to a subject for a first time period. In a variation, the PR diet includes a dietary supplement of specific amino acids. In a refinement, the first time period is from about 5 days to 14 day with 7 days being typical. Moreover, the low protein diet provides the subject with from 70 to 100 percent of the subject's normal caloric intake. The PR diet includes substantially only amino acids as a source of nitrogen. For example, the protein restricted diet derives less than 10 percent of its calories from proteins. In another refinement, the protein restricted diet derives less than 5 percent of its calories from proteins. In another refinement, the protein restricted diet derives zero percent of its calories from proteins. In particular, the protein restricted diet substantially excludes the following amino acids isoleucine, leucine, lysine, methionine, phenyalanine, threonine, tryptophan, valine, and arginine. In this context, “substantially excludes” means that the total of the excluded amino acids is less than, increasing order of preference, 5 weight percent, 3 weight percent, 1 weight percent, and 0.5 weight percent. Instead, the protein restricted diet provides one or more of the following amino acids as a source of nitrogen: alanine, aspartic acid, cysteine, glutamic acid, glycine, histidine, proline, serine, and tyrosine. Tables 2 to 4 provide characteristics a protein restricted diet including the dietary supplement for the mouse studies that are set forth below. A typical mouse diet provides about 19 kcal per day. For other mammals such as humans, the PR diet is scaled to provide the requisite calories. For example, a typical caloric intake for adults in the United States is about 2200 kcalories per day. Table 5 provides the kilocalories per day from each source for human subjects while Table 6 provides the grams per day from each source for humans.
In a refinement, the amino acids in a kilogram of the PR diet for a mouse are provided in Table 8. In a refinement, a kilogram of the PR diet for a mouse includes from about 2 g to 20 g alanine, 10 g to 30 g aspartic acid, 2 g to 20 g cysteine, 40 g to 80 g glutamic acid, 2 g to 20 g glycine, 2 g to 20 g histidine, 15 g to 50 g proline, 5 g to 30 g serine, and 5 to 30 g tyrosine. For human subjects, these ranges are multiplied by a factor (i.e., about 0.572) to provide the daily requirements for these amino acids per day for human subjects. For example, the daily amounts of the specified amino acids for humans (2200 Calorie/day diet) in the PR diet are about 2 to 12 g alanine, 5 g to 30 g aspartic acid, 1 g to 7 g cysteine, 18 g to 73 g glutamic acid, 2 g to 9 g glycine, 2 g to 10 g histidine, 9 g to 37 g proline, 5 g to 21 g serine, and 5 to 21 g tyrosine. In another refinement, the protein restricted diet includes from about 160 to about 240 g of the specified amino acids per kilogram of the diet. Therefore, for humans the PR diet provides from about 80 to 160 g of the specified amino acids per day using a factor (0.572) to convert the per kilogram of diet value to a value representative of a human diet of about 2200 Calories/day. In another variation, the protein restricted diet includes at least 6 amino acids selected from the group consisting of alanine, aspartic acid, cysteine, glutamic acid, glycine, histidine, proline, serine, and tyrosine in the amounts set forth above. Table 8 provides an example of the amino acid content in the protein restricted diet for a mouse diet. Table 8 also provides a factor which is the ratio of a specified amino acid in the protein restricted diet to that of the control (normal diet). These ratios are equally applicable to other mammals such as human subjects. In still another variation, the PR diet provides the amounts of amino acids in grams per Kg of human body weight per day set forth in table 8. In particular, the PK diet provided the following grams per Kg of human body weight per day 0.06 g alanine, 0.14 g aspartic acid, 0.04 g cysteine, 0.45 g glutamic acid, 0.05 g glycine, 0.06 g histidine, 0.23 g proline, 0.13 serine, and 0.13 g tyrosine. In another refinement, each of these amino acids is within a range of plus or minus 30 percent of the specified value.
In some variations, the methods set forth above further include a step of administering a normal diet (i.e., a control diet) to a subject for a second time period which follows the first period of time. The normal diet provides the subject with a normal caloric intake without any restrictions regarding protein. Moreover, no amino acid is explicitly excluded from the normal diet. Typically, the second time period is from 5 day to 28 days or more. In a variation, the subject is provided alternating protein restricted diets plus amino acid supplement and normal diets for 1 or more iterations through the protein restricted diet and the normal diet. Table 2 provides an example of the amino acid content in a normal diet. Tables 2 to 4 provide characteristics a normal diet for the mouse studies that are set forth below. For other mammals such as humans, the diet is scaled to provide the requisite calories. For example, a typical caloric intake for adults in the United States is about 2200 calories per day therefore the mouse data is multiplied by a factor (0.585) to provide data relevant to human subjects. Table 5 provides the kilocalories per day from each source for the normal diet for human subjects while Table 6 provides the grams per day for each source for the normal diet for human subjects.
In another embodiment, a dietary supplement to be combined with a subject's diet is provided. In a variation, the subject's diet has low (e.g. less than 5, 3, 1, or 0.5 weight percent) or zero percent proteins. Therefore in this variation, the dietary supplement plus the subject's diet form the PR diet set forth above. In another variation, the subject diet is the subject's normal diet (e.g., 2200 Calories/day for humans) or any diet to which addition of the specified amino acids is desired. The dietary supplement includes sufficient amounts of the specified amino acids to meet the dietary requirements set forth above. In particular, the dietary supplement includes alanine, aspartic acid, cysteine, glutamic acid, glycine, histidine, proline, serine, and tyrosine while substantially excluding isoleucine, leucine, lysine, methionine, phenyalanine, threonine, tryptophan, valine, and arginine. In a refinement, the dietary supplement includes sufficient amounts of the specified amino acids to provide these amino acids in the amounts set forth above. Table 8 provides the ranges of the amino acid ratios to cysteine in the dietary supplement. In a variation, the dietary supplement includes sufficient amount of amino acids for one or more cycles through the first time period. Typically, the dietary supplement includes instructions for carrying out the dietary protocol set forth above.
The following examples illustrate the various embodiments of the present invention. Those skilled in the art will recognize many variations that are within the spirit of the present invention and scope of the claims.
Dietary and/or calorie restriction (CR) promotes the self-renewal of intestinal stem cells and neural regeneration, reduces the decline of HSC number during aging and preserves their long-term regenerative capacity (1-4). However, the effects of either CR or fasting on immunodeficiency and the stem cell-based regeneration of the hematopoietic system were previously unknown. Also, CR is a chronic intervention which cannot be separated from weight loss and which causes moderate effects on IGF-I and glucose levels (5). By contrast, we show that fasting cycles, which allow mice to regain and maintain normal weight, promote major increases in pluripotent CD45− MSC/EPC and multipotent adult HSPCs, accompanied with the regeneration of multiple systems, including brain, liver and blood, even under conditions that cause its severe depletion. These results suggest that cycles of complete food deprivation may serve as the trigger for either the stem cell self-renewal or dedifferentiation/reprogramming in a hierarchical fashion.
Based on the evidence from animal and human studies, lifestyles that incorporate various forms of fasting during adult life promote health while simultaneously reducing the risk of many chronic diseases, particularly for those who are overweight and sedentary. Notably, various fasting approaches remain to be a challenge e.g. due to major interventions into the subject's lifestyle and eating habits, low compliance and the side-effects of malnutrition. As such, low calorie fasting-mimicking diets (FMD) that induce fasting-like effects in subjects present an alternative to fasting. In addition, diets, rather than fasting, allow providing micronutrient nourishment, preferably as much as possible through natural food sources. We here show examples that repeated cycles of a FMD promote health span, adult neurogenesis, cognitive performance and tissue maintenance as well as tissue regeneration in subjects.
PRC regimen does not cause a chronic low weight state nor an overall decrease in calorie intake. Differently from control animals fed with a normal diet, after seven days of PR diet both 3×Tg-AD and WT mice lost between 13 and 17% of the initial body weight, which was fully recovered during the following seven days of re-feeding with the normal diet (
Next, in order to investigate a possible impact of CR on the diet regimen, we monitored the calories intake at the beginning of the treatment (weeks 1 and 2) and at the end (weeks 17 and 18). At the beginning of the treatment (weeks 1 and 2), during the initial seven days of PR diet (days 1-7), average calorie intake was reduced by 24.3% in WT and 24.2% in 3×Tg-AD mice (
The average caloric intake calculated by combining the values for the periods of both PR and normal diet re-feeding was similar to the average for the control regimen for both the first and the final weeks of the treatment (
PRC regimen does not cause a significant reduction of blood glucose levels. Blood glucose levels undergo remarkable changes during food restriction. For example, prolonged 20-40% CR in rodents can cause blood glucose reduction between 20 and 40% (Lee & Longo 2011). PRC regimen, however, did not promote a significant change in blood glucose levels, but caused a trend for glucose concentration reduction (17% in WT and 8% in 3×Tg-AD mice) only at the end of the PR diet-feeding period (
PRC regimen reduces circulating IGF-1 levels by 30-70%, IGFBP-3 by 20-40% and increases IGFBP-1 by 3-8 folds in 3×Tg-AD mice. Approximately 95% of the IGF-1 that acts on the brain has been shown to be derived from the liver (Yamamoto & Murphy 1995). Although IGF-1, its receptor and binding proteins are also present and locally produced in the brain, IGF-1 is actively transported across the blood-brain barrier, and therefore changes in circulating IGF-1 can lead to changes in IGF-1 input to the brain (Carro et al. 2000). The bioavailability and bioactivity of IGF-1 is regulated by IGF binding proteins (IGFBPs), a family of six proteins acting as carriers for IGFs (Jones & Clemmons 1995). Among the different binding proteins, IGFBP-3 and IGFBP-1 play a prominent role in IGF-1 bioavailability.
IGFBP-3 is quantitatively the most represented IGFBP, binding more than 80% of the circulating IGF-1 and protecting it from rapid degradation or elimination from the serum (Jones & Clemmons 1995).
Differently from the other IGFBPs, IGFBP-1 inhibits IGF-1 action by binding to IGF-1 itself and preventing its binding to IGF receptors (Jones & Clemmons 1995).
IGF-1 measurement revealed that 3×Tg-AD had higher circulating levels of the hormone compared to WT (
Taken together, these results clearly indicate that 18-19 weeks of PRC regimen promoted a strong modulation of IGF-1 and IGFBPs whose final effect was a reduction of circulating levels of IGF-1. The effect was greater in 3×Tg-AD mice.
PRC regimen alleviates age-dependent working memory deficits in 3×Tg-AD mice. In order to determine whether the PRC regimen is associated with improved cognitive performances, we performed the Y-maze (hippocampus dependent working memory) in both 3×Tg-AD and WT mice. The mice were tested before the initiation of the dietary intervention (age 8-9 months) and every month of the treatment. In agreement with the literature (Rosario et al. 2006), 8-9 month old 3×Tg-AD male mice showed cognitive impairment detectable with Y-maze when compared with age-matched WT (
PRC regimen alleviates short term spatial memory deficits in 3×Tg-AD mice. The described mice were tested for short term spatial memory using the Novel Object Recognition (NOR) test. NOR test was performed once at the end of the treatment (age 12.5-13-5 months of age). The test relies on the natural rodent behavior to preferentially explore novel objects and has been used to study working spatial memory in 3×Tg-AD mice (Gulinello et al. 2009). On trial 1 of the test the rodents were allowed to explore a box containing two identical objects and the time spent exploring them was recorded. As expected, no significant preference between the two objects was detected in the different experimental groups (
PRC regimen does not affect anxiety in the studied mice. To function properly, the CNS requires the AA found in the diet, including Tryptophan, Phenylalanine, Tyrosine, Histidine, Glutamine and Arginine, as substrates for the synthesis of various neurotransmitters and neuromodulators and the availability of some of them can play an important role in mood regulation (Young 1996).
To analyze the impact of the diet on anxiety, we tested WT and 3×Tg-AD mice on the Elevated Plus Maze (EPM), a test used to analyze behavioral modifications caused by proteins undernutrition (Young 1996). The test was performed before the treatment (age 8-9 months) and after 18 weeks of dietary intervention (age 12.5-13.5) and the time spent in the open arms scored. More time spent in the open arms reflects a lower level of anxiety.
Before the diet intervention no significant difference was detected in the scored parameter among the experimental groups in both 3×Tg-AD and WT (
PRC regimen reduces tau phosphorylation in 3×Tg-AD mice hippocampus. In addition to Aβ accumulation, 3×Tg-AD mice develop an age-dependent accumulation of phosphorylated tau that is believed to be central in the progressive cognitive impairment observed in AD. In order to investigate the effect of PRC regimen on levels of tau phosphorylation, we quantified the number of cells immunoreactive with the AT8 antibody, which recognizes the phosphorylation of tau protein at Ser 202 and 305 that is associated with AD pathology (Goedert et al. 1995). We found that mice subjected to PRC regimen showed a significant reduction in phosphorylated tau levels compared with mice fed with the normal diet (
PRC regimen does not reduce microglia activation in 3×Tg-AD mice hippocampus. Next we decided to investigate whether the PRC regimen can affect brain inflammation. Neuroinflammation is a prominent feature of AD and an increase of markers of microglia activation has been reported in AD rodent models including 3×Tg-AD mice. First, we quantified the presence of activated microglia in the hippocampus of the studied mice using the microglia-specific marker CD11b. Our data confirmed a dramatic increase of the total number of CD11b-ir cells in the hippocampus of 3×Tg-AD mice compared with WT (
Second, we quantified microglial activation based on a four-stage morphological classification ranging from resting, activated ramified, amoeboid, to phagocytic cells (Zhang et al. 2011). 3×Tg-AD control mice showed a prevalence of more activated stages when compared with WT (
Our findings provide evidence that weekly cycles of normal diet and protein restriction regulate circulating levels of IGF-1 and IGFBPs but also reduce tau phosphorylation, and alleviate age-dependent memory deficits in an animal model of AD.
Although PRC could not completely reverse the cognitive decline in the AD mouse model, the results are important in light of the fact that we started the PRC treatment on mice already showing significant cognitive impairment and AD-like pathology. 3×TgAD mice fed with normal diet displayed hampered working and spatial memory when compared to non-transgenic control mice. In contrast, 3×TgAD mice maintained on PRC regimen for 18-19 weeks did not perform significantly worse than WT mice. Moreover, it is worth noting that all the behavioural tests were performed during the normal diet re-feeding period. Assuming a connection between transient circulating hormones level and positive memory performance, we cannot exclude that we could score even better results during the PR cycle. Interestingly, two important features of AD pathology, Aβ accumulation and microglia activation, were not modified in the hippocampus of protein restricted 3×Tg-AD mice. On the other hand, we found that 3×Tg-AD subjected to PRC regimen exhibited reduced phosphorylated tau levels when compared with 3×Tg-AD mice fed with normal diet. Evidence indicates a strong association between phosphorylated tau levels and cognitive deficits in human subjects affected by AD and mild cognitive impairment (MCI) (de Leon et al. 2006). A reduction of tau phosphorylation may alleviate memory impairment as indicated by studies conducted on AD models (Roberson et al. 2007).
The beneficial effect of reduced tau phosphorylation independently of Aβ deposition may be explained by the fact that Aβ pathology precedes tau pathology in this AD model (Oddo et al. 2003). In fact, whereas Aβ deposition is present by 6 months of age in hippocampus of 3×Tg-AD mice, it is not until approximately 12 months that AT8 immunoreactivity for phosphorylated tau is easily detectable (Oddo et al. 2003). Thus, levels of Aβ in 3×Tg-AD brains may not have been influenced by PRC intervention, as also reported in previous studies on CR (Patel et al. 2005; Wang et al. 2005; Halagappa et al. 2007; Mouton et al. 2009), because of the advanced stage of Aβ pathology at the starting of the treatment.
In 3×Tg-AD brains extraneuronal Aβ also precedes microglia activation and plays a major role in the onset of inflammation (Kitazawa et al. 2005). Therefore, the failure to detect a beneficial effect of protein restriction on microglia activation, as observed in previous studies on CR (Wang et al. 2005), may be caused by the late onset of the dietary intervention or by the effects of other components of the diet (glucose etc.) on inflammation.
The protein restriction regimen was coupled to a modulation of circulating levels of IGF-1, IGFBP-3 and IGFBP-1 that, at least in part, could be responsible for the improved outcome in AD mice.
Recently, we have published on the reduced incidence of cancer and diabetes in GHR and IGF-1 deficient subjects (Guevara-Aguirre et al. 2011), in agreement with results from dwarf GHR/IGF-1 deficient mice and Tor/Sch9 deficient yeast (Brown-Borg et al. 1996; Coschigano et al. 2000; Fabrizio et al. 2001; Fontana et al. 2010). Although the known world population of GHRDs is small (less than 400) and few of them have reached ages above 90, no cases of AD have yet been reported for GHRDs, raising the possibility that their nervous system may also be protected from aging and dementia. Thus, methods that down-regulate GHR/IGF-1 signalling should be tested for their potential to protect against aging and age-related diseases.
On the other hand, IGF-1 is critical in brain maintenance and is involved in major aspects of CNS, such as neuronal development and plasticity. Local IGF-1 availability in the brain can play a neuroprotective role in AD increasing neurogenesis and neuronal survival and modulating brain Aβ clearance (Carro et al. 2002).
Our serum IGF-1 measurement showed significantly higher levels of the circulating hormone in 3×Tg-AD mice compared to WT group. Increased circulating IGF-1 has been also observed in AD patients (Vardy et al. 2007) and may be caused by an attempt to overcome a state of resistance to IGF-1 signalling characterized by the loss of sensitivity to the hormone's action (Carro & Torres-Aleman 2004). Recently, Arnold and co-workers provided direct demonstration that AD brain is IGF-1 resistant and showed that activated forms of molecules downstream the insulin/IGF-1 signalling are dramatically elevated in AD patients brain (Talbot et al. 2012).
Although in this study we did not analyse brain IGF-1 signalling, we speculate that the chronic systemic reduction in IGF-1 levels induced by the PRC regimen may increase IGF-1 sensitivity in 3×Tg-AD brain leading to a significant beneficial effect on cognition and tau pathology. In agreement with our results, organotypic slices from hippocampi of adult Ames dwarf mice, characterized by increased IGF-1 protein levels in the hippocampus and circulating IGF-1 deficiency, are resistant to Aβ induced tau hyperphosphorylation (Schrag et al. 2008). In addition, aged Ames and GHR-KO mice show better memory performance compared to age-matched WT (Kinney et al. 2001, Sharma et al. 2010) and Ames mice exhibit increased neurogenesis following a hippocampal insults (Sharma et al. 2012), suggesting that reduction of circulating IGF-1 together with higher level of the hormone in the brain may provide additional protection and promote cognitive function via neuronal proliferation.
In conclusion, the results presented here show that PRC regimen is an intervention able to alleviate AD-like symptoms in 3×Tg-AD mice possibly by modulating tau phosphorylation. Notably, the diet intervention is not coupled to CR and does not cause apparent side effects in 3×Tg-AD mice. These findings, combined to the fact that the dietary intervention was effective on mice already showing significant AD-like symptoms, raise the possibility that PRC, more than CR intervention, could be clinically translatable into a long-term treatment for patients affected by early-moderate AD. Treatment conditions applicable to patients should be established by determining the length of time required to have similar changes in IGF-1 and IGFBP-1 in humans as it is achieved by 1 week protein restriction in mice. In the future more studies are needed to further investigate the safety of this promising treatment and to elucidate its mechanism of action.
Experimental Procedures Diet CompositionThe following experimental diets have been used:
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- Normal diet (Harlan Teklad LM-485, Indianapolis, Ind., USA).
- Protein Restriction (PR) Diet (diet lacking 9 AA: Isoleucine, Leucine, Lysine, Methionine, Phenyalanine, Threonine, Tryptophan, Valine, Arginine) (Teklad, Indianapolis, Ind., USA).
Differently from the normal diet, PR diet does not contain proteins and the nitrogen sources are represented only by free AA. The two diets are similar in nitrogen content, thus similar in caloric density (Table 2). In order to maintain equivalent nitrogen content in normal and PR diets, we balanced the lack of designated AA by increasing the quantity of the remaining ones (Table 7).
Essential AA cannot be synthesized de novo by mammals and therefore must be supplied through the diet. Long-term essential AA depletion can cause severe health problems and eventually lead to death. Regimen of alternating normal and PR diets was chosen to overcome chronological depletion of essential AA. The following dietary regimens were used (
3×Tg-AD and corresponding wild-type (WT) (C57BL/6/129S) mice were used in this study. 3×Tg-AD mice overexpress three human genes harbouring mutations linked to AD (presenelin-1, APP) and frontotemporal dementia (tau), that result in the development of both Aβ plaques, hyperphosphorylated tau tangles as well as the age-dependent Alzheimer-like cognitive impairment (Oddo et al. 2003). Colonies of the described mice were bred and maintained at the University of Southern California in accordance with National Institutes of Health guidelines on use of laboratory animals and an approved protocol by the University of Southern California (Los Angeles, Calif.) Institutional Animal Care and Use Committee. Male 3×Tg-AD and WT mice were single caged (in order to monitor the food intake) few days before the beginning of the diet regimen. At the age of 8-9 months (at this age cognitive deficits, such as working memory impairment, are detectable in 3×Tg-AD mice
Mice were randomly assigned to dietary groups based on body weight (mean body weight of 29.6 g for 3×Tg-AD, 32.4 g for WT). The rodents were maintained on 12 h light/dark cycles and provided ad libitum access to water and the described diets. Food was refreshed according with dietary regimen every 2 or 3 days (day 0, 2 and 4 of 7 days diet cycle). The animals were subjected to the alternate regimen for 18 to 19 weeks.
During the different dietary regimes body weights were measured weekly. Furthermore, mice weight and food intake were measured every day at the beginning of dietary treatment, on week 1 and 2, and at the end, on week 17 and 18. Mice subjected to the different diet regimens that failed to regain weight during the re-feeding period or showed signs of discomfort were removed from the study (one 3×Tg-AD mouse from Control group and one from PRC group were excluded).
Before the start of the treatment and every 4 weeks during the dietary regimen, the mice were tested with Y-maze (hippocampus dependent working memory) and Elevated Plus Maze (anxiety detection). At the end of the dietary intervention, the animals were tested also with Object Recognition Test (short term spatial memory). In order to minimize any possible abnormal behaviour caused by difference in diet compositions, the behavioral tests were performed during the normal diet re-feeding period.
At the end of diet treatment the mice were sacrificed under isoflurane anesthesia and blood and brains collected. Blood was collected by tail-snip for glucose measurement and by heart puncture for hormones analysis. All the serum obtained was kept at −80° C. until assayed. The brain was divided in two: one hemisphere was dissected, frozen and stored at −80° C., the other was immersion-fixed in fresh 4% paraformaldehyde/0.1 M PBS for 48 hours and then stored at 4° C. in 0.1 M PBS/0.2% sodium azide.
Glucose MeasurementGlucose levels were measured before the sacrifice on blood collected by tail-snip using a Precision Xtra blood glucose monitoring system (Abbott, Abbott Park, Ill., USA).
IGF-1, IGFBP-3 and IGFBP-1 MeasurementMouse serum IGF-1 and IGFBP-3 levels were measured by in-house mIGF-1 and mIGFBP-3 ELISAs, as previously described (Hwang et al. 2008). The IGF-1 assay has a sensitivity of 0.1 ng/ml and no cross reactivity with IGF-2. The intra-assay and inter-assay coefficients of variations (CV) were <10% in the range from 1 to 10 ng/ml. The mouse IGFBP-3 assay has a sensitivity of 0.2 ng/ml. The CVs of intra-assay and inter-assay were <6% and <8%, respectively, in the range of 1 to 6 ng/mL. Mouse IGFBP-1 serum levels were measured by in-house ELISA assays using recombinant mouse proteins and antibodies from R&D Systems (MAB 1240 as capture antibody and BAF 1240 as detection antibody, R&D Systems, Minneapolis, Minn., USA). The assay has a sensitivity of 0.1 ng/ml and the CVs of in intra- and inter-assay were <10%, respectively.
Behavioural Tests: Y-Maz:12-14 mice per group were tested for working memory using a Y-maze (arms 21 cm (long) by 4 cm (wide) with 40-cm walls). The mice were tested before the dietary intervention, at the age of 8-9 months, and every month of treatment till the age of 12.5-13.5 months. The test started by placing the rodent in one of the arms of the maze. The mouse was allowed to explore freely the environment for 8 minutes and the total numbers of arm entries and arm choices were recorded. An arm choice was defined as both forepaws and hindpaws fully entering the arm. Spontaneous alternation behaviour (SAB) score was calculated as the proportion of alternations (an arm choice differing from the previous two choices) to the total number of alternation opportunities (Carroll et al. 2010; Rosario et al. 2006).
Novel Object Recognition (NOR) Test12-14 mice per group were tested for short-term spatial memory using the Novel Object Recognition (NOR) test. The mice were tested once at the end of dietary treatment at the age of 12.5-13.5 months. The maze consists in an opaque plastic box measuring 61 cm (length)×36 cm (width)×30 cm (height). The test is based on the protocol described by Gulinello and co-workers (Gulinello et al. 2009). Briefly, on the first day of the test (habituation day) the mice were placed into the box and allowed to explore the field for 5 minutes. Twenty-four hours later (test day) habituated mice were placed again into the box at the presence of two identical, non-toxic objects and let to freely explore them for 5 minutes (trial 1). The time spent exploring the objects was recorded, considering exploration any physical contact with an object and/or approach with obvious orientation to it within 5 cm. At the end of trial 1 the animals were returned to the home cage. After 3 minutes the mice were returned to the testing field where one of the familiar objects was replaced by a novel object. The mice were allowed to explore the arena for 5 minutes and time exploring the objects monitored again. Recognition index (RI) was calculated as time the animals spent exploring the novel object to the total time spent exploring both the objects.
Elevated Plus Maze (EPM):12-14 mice per group were tested for anxiety using an Elevated Plus Maze (EPM). The mice were tested before the dietary intervention, at the age of 8-9 months, and every month of treatment until the age of 12.5-13.5 months. The EPM has the shape of a cross formed by two alternate open and two alternate closed arms extending from a central platform, each arm measuring 30 cm length, 5 cm width and 15 cm height (Carroll et al. 2010). The test is based on rodent exploratory behavior, balanced by natural rodent aversion against open space. The avoidance of elevated open arms is an indication of the intensity of anxiety. During the test the mouse was placed onto the center field and allowed to freely explore the maze for 5 minutes, and the time spent in the open arms, corresponding to lower anxiety levels, was measured.
Immunohistochemistry8-10 fixed hemibrains per group were sectioned (40 μm) exhaustively in the horizontal plane using a vibratome Leica V1000S (Leica) and then processed for immunohistochemistry. Every seventh section (10 per brain) was immunostained with antibodies directed against Aβ (71-5800 Aβ, Zymed Laboratories, San Francisco, Calif., USA), hyperphosphorylated tau (AT8, Pierce, Rockford, Ill., USA) or CD11b (MCA711, Serotec, Kidlington, UK) using ABC Vector Elite and DAB kits (Vector Laboratories, Burlingame, Calif., USA). For all the experiments the immunoreactivity quantification was assessed by two observers blind to sample identity and the values were averaged.
Aβ:To enhance Aβ immunoreactivity (IR), sections were rinsed for 5 min in 99% formic acid. Aβ IR was calculated as load values. Briefly, selected fields of non-overlapping immunolabeled sections of hippocampus (two fields for subiculum and three for CA1—Cornu Ammonis area 1—) were captured and digitized using a video capture system coupled to a microscope. Using NIH Scion image 1.62C software images were converted into binary/negative data and the positive pixels (equivalent to IR area) quantified (Carroll et al. 2010). Also, Aβ plaques were defined as extracellular Aβ-immunoreactive deposits exhibiting a spherical shape and morphology distinct from intraneuronal Aβ IR (Rosario et al. 2006). For quantification combined hippocampal CA1 and subiculum regions from the sections defined above were examined under light microscopy and the total number of extracellular plaques was counted. The area of each plaque was quantified using ImageJ software.
TauAT8-immunoreactive neurons were defined as cells showing strong AT8 immunolabeling over most of the cell surface. The positive cells were been counted within the combined hippocampal CA1 and subiculum regions (Carroll et al. 2010).
CD11b:CD11b-immunoreactive (ir) positive microglia cells were defined as cells covered by CD11b immunostaining over the cell body and processes. CD11b-ir cells were been counted in two adjacent non-overlapping immunolabeled sections (five sections in total) of the combined hippocampal subiculum and CA1 regions. Moreover, the stage of cells activation was identified by their morphology. Briefly, we defined four stages of microglia activation (Zhang et al. 2011):
-
- Stage 1: Resting microglia. Rod-shaped soma with many long thin ramified processes.
- Stage 2: Activated ramified microglia. Elongated cell body, the processes are thicker.
- Stage 3: Amoeboid microglia showing a marked cellular hypertrophy and short and thick processes
- Stage 4: Phagocytic cells. Round cells, processes are not detectable.
CD11b-ir cells in the different activation stages were counted and plotted as percentage of the total ir cell number.
Body weight and calories intake changes over the time were analyzed by repeated measures ANOVA followed by Newman-Keuls test. Raw behavioral data were analyzed by One-way ANOVA followed by between-group comparisons using the Fisher's least significant difference test. T-test was used when suitable. All the data represent mean values+/−SEM.
While exemplary embodiments are described above, it is not intended that these embodiments describe all possible forms of the invention. Rather, the words used in the specification are words of description rather than limitation, and it is understood that various changes may be made without departing from the spirit and scope of the invention. Additionally, the features of various implementing embodiments may be combined to form further embodiments of the invention.
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Claims
1-31. (canceled)
32. A diet package comprising:
- a first set of rations for a first diet to be administered for a first time period to a subject, the first diet providing from 4.5 to 7 kilocalories per pound of subject for a first day and 3 to 5 kilocalories per pound of subject per day for a second to fifth day of the first diet, the diet package including: less than 30 g of sugar for the first day; less than 20 g of sugar for the second to fifth days; less than 28 g of proteins for the first day; less than 18 g of proteins for the second to fifth days; 20 to 30 grams of monounsaturated fats for the first day; 10 to 15 grams of monounsaturated fats for the second to fifth days; between 6 and 10 grams of polyunsaturated fats for the first day; 3 to 5 grams of polyunsaturated fats for the second to fifth days; less than 12 g of saturated fats for the first day; less than 6 grams of saturated fats for the second to fifth days; and 12 to 25 grams of glycerol per day for the second to fifth days.
33. The diet package of claim 32 further comprising a second set of rations for a second diet to be administered to the subject for a second time period, the second diet providing an overall calorie consumption that is within 10 percent of a subject's normal calorie consumption for 25 to 26 days following the first diet.
34-36. (canceled)
37. The diet package of claim 32 wherein the first set of rations provide 400-800 mg of calcium per day for days 1-5; 7.2-14.4 mg of iron per day for days 1-5; 200-400 mg of magnesium per day for days 1-5; 1-2 mg of copper per day for days 1-5; 1-2 mg of manganese per day for days 1-5; and 3.5-7 mcg of selenium per day for days 1-5.
38. The diet package of claim 32 wherein the first set of rations provide 2-4 mg of Vitamin B1 per day for days 1-5; 2-4 mg of Vitamin B2 per day for days 1-5; 20-30 mg of Vitamin B3 per day for days 1-5; 1-1.5 mg of Vitamin B5 per day for days 1-5; 2-4 mg of Vitamin B6 per day for days 1-5; 240-480 mcg of Vitamin B9 per day for days 1-5; 600-1000 IU of Vitamin D per day for days 1-5; 14-30 mg of Vitamin E per day for days 1-5; over 80 mcg of Vitamin K per day for days 1-5; and 16-25 mcg Vitamin B12 are provided during the first time period.
39. The diet package of claim 32 wherein the first set of rations provide 600 mg of Docosahexaenoic acid (DHA, algae-derived) during the first time period.
40. The diet package of claim 32 further comprising a component having vitamin A in an amount of 900-1600 IU; Ascorbic Acid in an amount of 10-20 mg; calcium carbonate in an amount of 60-100 mg; ferrous fumarate in an amount of 3-6 mg; cholecalciferol in an amount of 0.001-0.005 mg; dl-alpha tocopheryl acetate in an amount 3-7 mg; phytonadione in an amount of 0.1-0.04 mg; thiamine mononitrate in an amount of 0.15-0.5 mg; riboflavin in an amount 0.2-0.6 mg; and niacinamide in an amount of 3-7 mg.
41. The diet package of claim 40 further comprising a component having calcium pantothenate in an amount of 1.5-4.0 mg; pyridoxine hydrochloride in an amount of 0.3-0.7 mg; biotin in an amount of 0.01-0.02 mg; folic acid in an amount of 0.07-0.14 mg; cyanocobalamin in an amount of 0.001-0.002 mg; chromium picolinate in an amount of 0.014-0.022 mg; cupric sulfate in an amount of 0.18-0.32 mg; potassium iodide in an amount of 0.03-0.045 mg; magnesium oxide in an amount of 20-32 mg; manganese sulfate of 0.3-0.7 mg; sodium molybdate in an amount of 0.014-0.023 mg; sodium selenate in an amount of 0.014-0.023 mg; and zinc oxide in an amount of 3-5 mg.
Type: Application
Filed: Oct 19, 2016
Publication Date: Feb 9, 2017
Inventors: VALTER D. LONGO (PLAYA DEL REY, CA), CHIA-WEI CHENG (LOS ANGELES, CA), SEBASTIAN BRANDHORST (REDONDO BEACH, CA), MIN WEI (WEST COVINA, CA)
Application Number: 15/297,672
