Digitally supported dietary counseling increases protein intake in community dwelling older adults: Preliminary results of the vitamin RCT

IntroductionShort-term metabolic and observational studies suggest that protein intake above the recommended dietary allowance of 0.83 g/kg body weight (BW)/day may support preservation of lean body mass and physical function in old age, but evidence from randomised controlled trials is inconclusive.Methods and analysisThe PRevention Of Malnutrition In Senior Subjects in the EU (PROMISS) trial examines the effect of personalised dietary advice aiming at increasing protein intake with or without advice regarding timing of protein intake to close proximity of usual physical activity, on change in physical functioning after 6 months among community-dwelling older adults (≥65 years) with a habitual protein intake of <1.0 g/kg adjusted (a)BW/day. Participants (n=264) will be recruited in Finland and the Netherlands, and will be randomised into three groups; two intervention groups and one control group. Intervention group 1 (n=88) receives personalised dietary advice and protein-enriched food products in order to increase their protein intake to at least 1.2 g/kg aBW/day. Intervention group 2 (n=88) receives the same advice as described for intervention group 1, and in addition advice to consume 7.5–10 g protein through protein-(en)rich(ed) foods within half an hour after performing usual physical activity. The control group (n=88) receives no intervention. All participants will be invited to attend lectures not related to health. The primary outcome is a 6-month change in physical functioning measured by change in walk time using a 400 m walk test. Secondary outcomes are: 6-month change in the Short Physical Performance Battery score, muscle strength, body composition, self-reported mobility limitations, quality of life, incidence of frailty, incidence of sarcopenia risk and incidence of malnutrition. We also investigate cost-effectiveness by change in healthcare costs.DiscussionThe PROMISS trial will provide evidence whether increasing protein intake, and additionally optimising the timing of protein intake, has a positive effect on the course of physical functioning after 6 months among community-dwelling older adults with a habitual protein intake of <1.0 g/kg aBW/day.Ethics and disseminationThe study has been approved by the Ethics Committee of the Helsinki University Central Hospital, Finland (ID of the approval: HUS/1530/2018) and The Medical Ethical Committee of the Amsterdam UMC, location VUmc, Amsterdam, the Netherlands (ID of the approval: 2018.399). All participants provided written informed consent prior to being enrolled onto the study. Results will be submitted for publication in peer-reviewed journals and will be made available to stakeholders (ie, older adults, healthcare professionals and industry).Trial registration numberClinicalTrials.gov Registry (NCT03712306).

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Protein Intake among Community-Dwelling Older Adults: The Influence of (Pre-) Motivational Determinants

Nutrients ◽

10.3390/nu14020293 ◽

2022 ◽

Vol 14 (2) ◽

pp. 293

Author(s):

Marije H. Verwijs ◽

Annemien Haveman-Nies ◽

Jos W. Borkent ◽

Joost O. Linschooten ◽

Annet J. C. Roodenburg ◽

...

Keyword(s):

Social Support ◽

Older Adults ◽

Protein Intake ◽

Community Dwelling ◽

Online Questionnaire ◽

Behavioral Determinants ◽

Low Protein ◽

Personal Approach ◽

Increase Protein Intake ◽

Community Dwelling Older Adults

An adequate protein intake is important for healthy ageing, yet nearly 50% of Dutch community-dwelling older adults do not meet protein recommendations. This study explores protein intake in relation to eight behavioral determinants (I-Change model) among Dutch community-dwelling older adults. Data were collected through an online questionnaire from October 2019–October 2020. Protein intake was assessed by the Protein Screener 55+, indicating a high/low chance of a low protein intake (<1.0 g/kg body weight/day). The behavioral determinants of cognizance, knowledge, risk perception, perceived cues, attitude, social support, self-efficacy and intention were assessed by evaluating statements on a 7-point Likert scale. A total of 824 Dutch community-dwelling older adults were included, recruited via online newsletters, newspapers and by personal approach. Poisson regression was performed to calculate quartile-based prevalence ratios (PRs). Almost 40% of 824 respondents had a high chance of a low protein intake. Univariate analyses indicated that lower scores for all different behavioral determinants were associated with a higher chance of a low protein intake. Independent associations were observed for knowledge (Q4 OR = 0.71) and social support (Q4 OR = 0.71). Results of this study can be used in future interventions aiming to increase protein intake in which focus should lie on increasing knowledge and social support.

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Personalized Protein Supplementation Improves Total Protein, Leucine, and Energy Intake in (Pre)Sarcopenic Community-Dwelling Older Adults in the ENHANce RCT

Frontiers in Nutrition ◽

10.3389/fnut.2021.672971 ◽

2021 ◽

Vol 8 ◽

Author(s):

Lenore Dedeyne ◽

Jolan Dupont ◽

Sabine Verschueren ◽

Katrien Koppo ◽

Jos Tournoy ◽

...

Keyword(s):

Older Adults ◽

Dietary Intake ◽

Energy Intake ◽

Body Mass ◽

Dietary Protein ◽

Total Protein ◽

Protein Intake ◽

Protein Supplementation ◽

Community Dwelling ◽

Community Dwelling Older Adults

Recommendations concerning protein quantity, source, and leucine intake for older adults are difficult to reach by regular dietary intake. This randomized clinical trial assesses in sarcopenic community-dwelling older adults (i) the regular (non-supplemented) daily protein and leucine intake; and (ii) the effect of personalized protein supplementation (aiming for an evenly distributed total protein intake of 1.5 g·kg−1·d−1 of body mass, accounting for energy intake) on regular and total (dietary and supplemental) intake. A preliminary feasibility study in participants of the ongoing Exercise and Nutrition for Healthy AgeiNg (ENHANce) study was performed with the objective to assess the intake and distribution of regular dietary protein and leucine, protein source and energy intake in (pre)sarcopenic community-dwelling older adults. Moreover, this study aimed to assess if personalized protein supplementation was feasible without negatively affecting regular dietary intake. ENHANce (NCT03649698) is a 5-armed RCT that assesses the effect of anabolic interventions on physical performance in (pre)sarcopenic older adults. In August 2019, n = 51 participants were included in ENHANce with complete available data on dietary intake at screening and thus eligible for inclusion in present analysis. Of these, n = 35 participants completed the intervention period of ENHANce at the moment of analysis, allowing an exploration of the effect of supplementation on regular dietary intake. The regular dietary protein intake of 51 (pre)sarcopenic adults (73.6 ± 6.5 years) was 1.06 ± 0.3 g·kg−1·d−1 of body mass. Protein supplementation (n = 20) improved total protein intake to 1.55 ± 0.3 g·kg−1·d−1 of body mass (P < 0.001) without affecting regular dietary protein (P = 0.176) or energy intake (P = 0.167). Placebo supplementation (n = 15) did not affect regular dietary protein intake (P = 0.910) but decreased regular dietary energy intake (P = 0.047). Regular leucine intake was unevenly distributed over the day, but increased by supplementation at breakfast (P < 0.001) and dinner (P = 0.010) to at least 2.46 g leucine·meal−1, without reducing regular dietary leucine intake (P = 0.103). Animal-based protein intake—the main protein source—was not affected by supplementation (P = 0.358). Personalized protein supplementation ensured an adequate quantity and even distribution of protein and leucine over the day, without affecting regular dietary protein or energy intake.

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The effectiveness of protein-rich ready-made meals and dairy products in increasing protein intake of community-dwelling older adults after switching from self-prepared to ready-made meals

Clinical Nutrition ◽

10.1016/j.clnu.2018.06.1087 ◽

2018 ◽

Vol 37 ◽

pp. S5

Author(s):

J.W. Borkent ◽

J. Beelen ◽

J.O. Linschooten ◽

A.J.C. Roodenburg ◽

M.A.E. de van der Schueren

Keyword(s):

Older Adults ◽

Dairy Products ◽

Protein Intake ◽

Community Dwelling ◽

Protein Rich ◽

Community Dwelling Older Adults

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A 12-week multimodal exercise program can improve physical and cognitive functioning risk factors for falls in community-dwelling older adults: preliminary results of a psychomotor intervention

European Journal of Public Health ◽

10.1093/eurpub/ckz034 ◽

2019 ◽

Vol 29 (Supplement_1) ◽

Author(s):

H Rosado ◽

J Bravo ◽

A Raimundo ◽

F Mendes ◽

L Branco ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Cognitive Functioning ◽

Exercise Program ◽

Community Dwelling ◽

Preliminary Results ◽

Risk Factors For Falls ◽

Community Dwelling Older Adults

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The provision of recipes and single-use herb/spice packets to increase egg and protein intake in community-dwelling older adults: a randomised controlled trial

Public Health Nutrition ◽

10.1017/s1368980020002712 ◽

2020 ◽

pp. 1-14

Author(s):

E van den Heuvel ◽

JL Murphy ◽

KM Appleton

Keyword(s):

Older Adults ◽

Lean Body Mass ◽

Body Mass ◽

Protein Intake ◽

Community Dwelling ◽

High Protein ◽

Single Use ◽

Randomised Controlled ◽

The Impact ◽

Community Dwelling Older Adults

Abstract Objective: This study investigated the impact of recipe and single-use herb/spice packet provision on egg intake and protein intake in community-dwelling individuals aged over 55 years. Design: Using a randomised-controlled intervention design, 100 older adults were randomised to receive (n 53) or not receive (n 47) high-protein egg-based recipes and herb/spice packets through the post for 12 weeks, from June to December 2016. Egg intake, protein intake, adverse events, lean body mass and functional measures of lean body mass were measured at baseline, after the 12 weeks and after a further 12 weeks. Setting: Bournemouth, UK. Participants: Community-dwelling older adults. Results: Intention-to-treat data were analysed using regression, controlling for various demographic and lifestyle characteristics. Ninety-three individuals (intervention, n 50; control, n 43) completed assessments at all three time points. Egg intakes increased by end of intervention in both groups (mean: 4–5 eggs/month). After a further 12 weeks, higher egg intakes were sustained in the intervention group, while egg intakes in the control group returned to baseline levels (between-group difference: β = −0·124, P = 0·047). No differences were found in other measures (largest β = −0·106, P = 0·12). Conclusions: The provision of high-protein egg-based recipes and single-use herb/spice packets over 12 weeks increased egg intakes up to 12 weeks after end of intervention. Other factors may explain increased egg intakes during the intervention, but the sustained effects most plausibly result directly from recipe provision. Limited effects in other measures suggest that the recipes may have replaced as opposed to added to existing protein intakes.

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