Increases in protein intake, protein distribution score, and micronutrient intakes in older adults in response to a whole food-based dietary intervention

Abstract Background: Optimization of intentional weight loss in obese older adults, through preferential fat mass reduction, is challenging, as the concomitant lean mass loss may exacerbate sarcopenia. Here, we assessed whether changes in within-day protein intake distribution are related to improvements in body composition in overweight/obese older adults during a hypocaloric and exercise intervention. Methods: Thirty-six community-dwelling, overweight-to-obese (BMI 28.0-39.9 kg/m2), sedentary older adults (aged 70.6±6.1 years) were randomized into either physical activity plus successful aging health education (PA+SA; n=15) or physical activity plus weight loss (PA+WL; n=21) programs. Body composition (by CT and DXA) and dietary intake (by three-day food records) were determined at baseline, 6-month, and 12-month follow-up visits. Within-day protein distribution was calculated as the coefficient of variation of protein ingested at breakfast [5:00–10:59], lunch [11:00–16:59] and dinner [17:00–1:00]. Secondary analysis was performed to determine associations between changes in protein intake distribution and body composition. Results: In both groups, baseline protein intake was skewed towards dinner. The pattern of protein intake changed towards a more even within-day distribution in PA+WL, but it remained unchanged in PA+SA. Transition towards a more even pattern of protein intake was independently associated with a greater decline in BMI (P<0.05) and abdominal subcutaneous fat (P<0.05) in PA+WL. However, changes in protein CV were not associated with weight loss in PA+SA. Conclusion: Our results show that mealtime distribution of protein intake throughout the day was associated with improved weight and fat loss under hypocaloric diet combined with physical activity.

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Effect of a Tailored Dietary Intervention with High or Standard Protein Intake on B-Vitamin and One Carbon Metabolism Status in Healthy Older Males: A 10 Week Randomised Controlled Trial

Proceedings ◽

10.3390/proceedings2019008036 ◽

2019 ◽

Vol 8 (1) ◽

pp. 36

Author(s):

Nicola Gillies ◽

Amber M. Milan ◽

Pankaja Sharma ◽

Brenan Durainayagam ◽

Sarah M. Mitchell ◽

...

Keyword(s):

Older Adults ◽

Carbon Metabolism ◽

Protein Intake ◽

Dietary Intervention ◽

Controlled Trial ◽

One Carbon Metabolism ◽

Randomised Controlled ◽

B Vitamin ◽

Standard Protein ◽

Older Males

Background: Maintaining optimal status of folate and metabolically related vitamins (riboflavinand vitamins B6 and B12) is increasingly important for older adults [...]

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Increased Leg Strength After Concurrent Aerobic and Resistance Exercise Training in Older Adults Is Augmented by a Whole Food-Based High Protein Diet Intervention

Frontiers in Sports and Active Living ◽

10.3389/fspor.2021.653962 ◽

2021 ◽

Vol 3 ◽

Author(s):

James F. Timmons ◽

Michelle Hone ◽

Karl E. Cogan ◽

Orlaith Duffy ◽

Brendan Egan

Keyword(s):

Older Adults ◽

Exercise Training ◽

Resistance Exercise ◽

Physical Function ◽

Interaction Effect ◽

Protein Intake ◽

Dietary Intervention ◽

High Protein ◽

Resistance Exercise Training ◽

Whole Foods

Most studies in older adults have utilized powdered protein supplements or oral nutrition solutions as a source of additional dietary protein, but whole foods may provide a greater anabolic stimulus than protein isolated from food matrices. Therefore, the present study investigated a concurrent aerobic and resistance exercise training program in older adults, in the absence or presence of a high protein whole food-based dietary intervention, for effects on strength, physical function, and body composition. Community-dwelling older adults (n = 56; M/F, 28/28; age, 69.3 ± 4.0 years; BMI, 26.6 ± 3.7 kg m−2) participated in a 12-week intervention after randomization to either nutrition only (NUTR; n = 16), exercise only (EX, n = 19), or nutrition plus exercise (NUTR + EX, n = 21) groups. NUTR and NUTR + EX followed a dietary intervention targeting an increase in protein-rich meals at breakfast, lunch, and dinner. Exercise training in EX and NUTR + EX consisted of 24 min sessions of concurrent aerobic and resistance exercise performed three times per week. Daily protein intake increased in NUTR and NUTR + EX, but not EX. The increase in 1RM leg press strength was greater (Interaction effect, P = 0.012) in NUTR + EX [29.6 (18.1, 41.0) kg] than increases observed in NUTR [11.1 (−1.3, 23.6) kg] and EX [12.3 (0.9, 23.8) kg]. The increase in 1RM chest press strength was greater (interaction effect, P = 0.031) in NUTR + EX [6.3 (4.0, 8.6) kg] than the increase observed in NUTR [2.9 (0.3, 5.5) kg], but not EX [6.3 (3.9, 8.7) kg]. Hand-grip strength and sit-to-stand performance were each improved in all three groups, with no differences observed between groups (interaction effect, P = 0.382 and P = 0.671, respectively). An increase in percentage body fat was observed in NUTR, but not in EX or NUTR + EX (interaction effect, P = 0.018). No between-group differences were observed for change in lean body mass (interaction effect, P = 0.402). Concurrent aerobic and resistance exercise training improves strength and physical function in older adults, but combining this training with an increase in daily protein intake through whole foods may be advantageous to increase lower limb strength.

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Do Aspects of Protein Intake Vary Across the Week in Healthy Community-Dwelling Older Adults?—An enable Study

Nutrients ◽

10.3390/nu10091217 ◽

2018 ◽

Vol 10 (9) ◽

pp. 1217 ◽

Cited By ~ 1

Author(s):

Anne Gingrich ◽

Rachel Rennekamp ◽

Beate Brandl ◽

Thomas Skurk ◽

Hans Hauner ◽

...

Keyword(s):

Older Adults ◽

Protein Intake ◽

Community Dwelling ◽

Protein Distribution ◽

Protein Sources ◽

Food Records ◽

Friedman's Test ◽

Healthy Community ◽

Community Dwelling Older Adults ◽

Main Meals

Various aspects of protein intake are thought to be crucial for the prevention of sarcopenia in older adults. Information about the day-to-day variation in these aspects is lacking. Our objective was to examine whether daily protein intake, protein distribution across meals, number of meals providing adequate protein, and protein sources vary across the week in healthy community-dwelling older adults. In 140 persons (51% women) that were aged 75–85 years, protein intake was assessed by seven-day food records. On average across the week, protein intake (median [IQR]) was 0.93 [0.79–1.10] g/kg body weight (BW) and the coefficient of variation across the three main meals was 0.50 [0.40–0.61]. The number of meals per day providing ≥0.4 g protein/kg BW was 0.57 [0.43–1.00] and 60.0 [52.4–65.2]% of protein intake was animal-based. According to Friedman’s test, differences throughout the week were observed in women for daily protein intake (p = 0.038; Sunday: 0.99 [0.78–1.31] vs. Tuesday: 0.79 [0.68–1.12] g/kg BW) and number of meals with adequate protein (p = 0.019; ≥1 daily meal: Sunday: 69.4% vs. Tuesday: 41.7%). On Sunday, protein intake was most in agreement with suggestions to prevent sarcopenia. In men, protein intake did not differ throughout the week.

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Protein-Related Dietary Parameters and Frailty Status in Older Community-Dwellers across Different Frailty Instruments

Nutrients ◽

10.3390/nu12020508 ◽

2020 ◽

Vol 12 (2) ◽

pp. 508 ◽

Cited By ~ 5

Author(s):

Hélio J. Coelho-Júnior ◽

Riccardo Calvani ◽

Anna Picca ◽

Ivan O. Gonçalves ◽

Francesco Landi ◽

...

Keyword(s):

Older Adults ◽

Body Weight ◽

Protein Intake ◽

Study Participant ◽

Community Dwelling ◽

Assessment Tools ◽

Protein Distribution ◽

Frailty Phenotype ◽

Dietary Recall ◽

Frailty Status

The present study investigated the associations between frailty status and (a) daily protein intake, (b) daily body weight-adjusted protein intake, (c) branched-chain amino acid (BCAA) consumption, (d) evenness of protein distribution across main meals, (e) number of daily meals providing at least 30 g of protein, and (f) number of daily meals providing at least 0.4 g protein/kg of body weight in community-dwelling older adults. The relationship between frailty status and protein-related dietary parameters was explored across different frailty assessment tools. Two hundred older adults were enrolled in the study. Participant frailty status was determined according to a modified Fried’s frailty phenotype (mFP), the FRAIL scale, and the Study of Osteoporotic Fracture (SOF) index. Diet was assessed by 24-h dietary recall, while diet composition was estimated using a nutritional software. A frailty instrument-dependent relationship was observed between frailty status and protein-related dietary parameters. Protein consumption was associated with frailty status only in participants identified as frail according to the mFP. In addition, protein and BCAA intake was found to be greater in robust and pre-frail participants relative to their frail counterparts. Our findings suggest that the association between frailty and protein-related dietary parameters is tool dependent. Specifically, protein and BCAA consumption appears to be lower only in older adults identified as frail by the mFP.

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Effect of a Tailored Dietary Intervention with High or Standard Protein Intake on B-Vitamin and One Carbon Metabolism Status in Healthy Older Males: A 10 Week Randomised Controlled Trial

Proceedings ◽

10.3390/proceedings2019008019 ◽

2019 ◽

Vol 8 (1) ◽

pp. 19

Author(s):

Nicola Gillies ◽

Amber M. Milan ◽

Pankaja Sharma ◽

Brenan Durainayagam ◽

Sarah M. Mitchell ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Carbon Metabolism ◽

Protein Intake ◽

Dietary Intervention ◽

Controlled Trial ◽

One Carbon Metabolism ◽

Randomised Controlled ◽

B Vitamin ◽

Standard Protein ◽

Older Males

Background: Maintaining optimal status of folate and metabolically [...]

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PP243-SUN: Outstanding abstract: Higher than 1.2 G/KG/D Protein Intake is Associated with Increased Fat Mass Loss During Weight Loss in Obese Older Adults

Clinical Nutrition ◽

10.1016/s0261-5614(14)50284-1 ◽

2014 ◽

Vol 33 ◽

pp. S110

Author(s):

R. Memelink ◽

A. Verreijen ◽

M. Engberink ◽

P. Weijs

Keyword(s):

Older Adults ◽

Weight Loss ◽

Mass Loss ◽

Fat Mass ◽

Protein Intake ◽

Fat Mass Loss

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Animal protein intake is inversely associated with mortality in older adults: the InCHIANTI study

The Journals of Gerontology Series A ◽

10.1093/gerona/glab334 ◽

2021 ◽

Author(s):

Tomás Meroño ◽

Raúl Zamora-Ros ◽

Nicole Hidalgo-Liberona ◽

Montserrat Rabassa ◽

Stefania Bandinelli ◽

...

Keyword(s):

Older Adults ◽

Total Energy ◽

Cardiovascular Mortality ◽

Protein Intake ◽

Cox Regression ◽

Clinical Information ◽

Community Dwelling ◽

Animal Protein ◽

Plant Protein

Abstract Background In general, plant protein intake was inversely associated with mortality in studies in middle-aged adults. Our aim was to evaluate the long-term associations of animal and plant protein intake with mortality in older adults. Methods A prospective cohort study including 1,139 community-dwelling older adults (mean age 75 years, 56% women) living in Tuscany, Italy, followed for 20 years (InCHIANTI study) was analyzed. Dietary intake by food frequency questionnaires and clinical information were assessed five times during the follow-up. Protein intakes were expressed as percentages of total energy. Time-dependent Cox regression models adjusted for confounders were used to assess the association between plant and animal protein intake, and mortality. Results During the 20-years of follow up (mean: 12y), 811 deaths occurred (292 of cardiovascular- and 151 of cancer-related causes). Animal protein intake was inversely associated with all-cause (HR per 1% of total energy from protein increase, 95%CI: 0.96, 0.93-0.99) and cardiovascular mortality (HR per 1% of total energy from protein increase, 95%CI: 0.93, 0.87-0.98). Plant protein intake showed no association with any of the mortality outcomes, but an interaction with baseline hypertension was found for all-cause and cardiovascular mortality (p<0.05). Conclusions Animal protein was inversely associated with all-cause and cardiovascular mortality in older adults. Further studies are needed to provide recommendations on dietary protein intake for older adults.

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A 12-week intervention with protein-enriched foods and drinks improved protein intake but not physical performance of older patients during the first 6 months after hospital release: a randomised controlled trial

British Journal Of Nutrition ◽

10.1017/s0007114517001477 ◽

2017 ◽

Vol 117 (11) ◽

pp. 1541-1549 ◽

Cited By ~ 10

Author(s):

Janne Beelen ◽

Nicole M. de Roos ◽

Lisette C. P. G. M. de Groot

Keyword(s):

Older Adults ◽

Body Weight ◽

Physical Performance ◽

Protein Intake ◽

Controlled Trial ◽

Leg Extension ◽

Hand Grip ◽

Randomised Controlled ◽

Chair Rise ◽

Physical Recovery

AbstractDuring and after hospitalisation, older adults are recommended to consume 1·2–1·5 g of protein/kg body weight per d (g/kg per d) to improve recovery. This randomised controlled trial studied the effectiveness of a 12-week intervention with protein-enriched foods and drinks by following-up seventy-five older patients (mean age: 76·8 (sd 6·9) years) during their first 6 months after hospital discharge. Primary outcomes were protein intake and physical performance (measured with Short Physical Performance Battery (SPPB)). Secondary outcomes for physical recovery were gait speed, chair-rise time, leg-extension strength, hand-grip strength, body weight, nutritional status (Mini Nutritional Assessment), independence in activities of daily living (ADL) and physical activity. The intervention group consumed more protein during the 12-week intervention period compared with the control group (P<0·01): 112 (sd 34) g/d (1·5 (sd 0·6) g/kg per d) v. 78 (sd 18) g/d (1·0 (sd 0·4) g/kg per d). SPPB total score, gait speed, chair-rise time, body weight and nutritional status improved at week 12 compared with baseline (time effect P<0·05), but were not different between groups. Leg-extension strength, hand-grip strength and independence in ADL did not change. In conclusion, protein-enriched products enabled older adults to increase their protein intake to levels that are higher than their required intake. In these older adults with already adequate protein intakes and limited physical activity, protein enrichment did not enhance physical recovery in the first 6 months after hospital discharge.

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