Interplay Between Diet, Branched-Chain Amino Acids, and Myokines in Children: Vegetarian Versus Traditional Eating Habits.

The quality and composition of dietary proteins are crucial during growth, particularly in children who follow vegetarian diets. Branched-chain amino acids (BCAAs: leucine, isoleucine, and valine) and lysine play essential roles in muscle growth, repair, and metabolism and are involved in the regulation of muscle-derived proteins known as myokines. This study aimed to compare the dietary intake and circulating levels of BCAAs, lysine, and myokines-follistatin-like protein 1 (FSTL-1), myostatin, and myonectin-between vegetarian and omnivorous prepubertal children and to explore the impact of diet on muscle metabolism. Sixty-four healthy Caucasian children aged 4-9 years (forty-two vegetarians and twenty-two omnivores) were assessed for dietary intake using the Dieta 5 (extended version Dieta 5.0) software. Circulating BCAAs and lysine were measured using high-performance liquid chromatography, while myokine concentrations were determined using enzyme-linked immunosorbent assays. Vegetarian children showed significantly lower intakes of total protein, animal protein, BCAAs, and lysine than omnivores. Correspondingly, the circulating levels of isoleucine, valine, lysine, and albumin were significantly reduced in vegetarians. Among myokines, serum myostatin and myonectin levels were comparable between the groups, but vegetarians had significantly lower median FSTL-1 levels 7.7 (6.5-9.4) ng/mL than omnivores 9.7 (7.5-13.9) ng/mL ( = 0.012). In the entire group of children, positive correlations were observed between dietary total and animal protein intake and circulating valine and lysine levels. Dietary animal protein intake was also positively associated with the serum levels of all myokines, whereas plant protein intake was negatively correlated with myonectin concentration. In conclusion, vegetarian diets in prepubertal children are associated with reduced dietary protein quality and lower circulating BCAAs, lysine, and FSTL-1 levels, which may impact muscle metabolism. Optimizing vegetarian diets using high-quality plant proteins with proper essential amino acids could mitigate their deficiencies and support muscle development during critical growth periods.