The Relationship Between Healthy Eating Motivation and Protein Intake in Community-Dwelling Older Adults With Varying Functional Status

In older adults, the relationship between healthy eating motivation (HEM) and protein intake as key component of a healthy diet is poorly understood. Therefore, we investigate the association of HEM with (1) total protein intake and (2) intake of different protein sources in older adults with varying functional status. In this cross-sectional study including 250 adults (≥70 years), we assessed HEM with “The Eating Motivation Survey” and protein intake by 7-day food records. In addition, gender, age, Body Mass Index (BMI), energy intake and functional status were considered. Regression analyses revealed that HEM was neither related to total (β = −0.02; p = 0.723) nor to relative protein intake (β = 0.04; p = 0.370). Notwithstanding this, participants with stronger HEM showed lower intake of protein from meat and meat products (β = −0.14; p = 0.018), higher intake of overall plant-based protein (β = 0.11; p = 0.032), protein from fruit and vegetables (β = 0.20; p = 0.002) and from pulses, nuts an seeds (β = 0.16; p = 0.016). Our findings suggest HEM as a valuable indicator for intake of distinct protein sources. However, since HEM is not related to total protein intake, the importance of sufficient protein consumption should be emphasized by promoting healthy eating, regardless of self-perceived HEM.

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Protein intake pattern over the day and its association with low total protein intake in Dutch community-dwelling older adults

Public Health Nutrition ◽

10.1017/s1368980020000026 ◽

2020 ◽

pp. 1-13

Author(s):

Teuni H Rooijackers ◽

Marga C Ocké ◽

Linda M Hengeveld ◽

Marjolein Visser ◽

Jolanda MA Boer

Keyword(s):

Older Adults ◽

Total Protein ◽

Protein Intake ◽

Community Dwelling ◽

High Protein ◽

Cross Sectional ◽

High Protein Intake ◽

Total Protein Intake ◽

Low Protein ◽

Dietary Record

Abstract Objective: Investigate protein intake patterns over the day and their association with total protein intake in older adults. Design: Cross-sectional study utilising the dietary data collected through two non-consecutive, dietary record-assisted 24-h recalls. Days with low protein intake (n 290) were defined using the RDA (<0·8 g protein/kg adjusted BW/d). For each day, the amount and proportion of protein ingested at every hour of the day and during morning, mid-day and evening hours was calculated. Amounts and proportions were compared between low and high protein intake days and related to total protein intake and risk of low protein intake. Setting: Community. Participants: 739 Dutch community-dwelling adults ≥70 years. Results: The mean protein intake was 76·3 (sd 0·7) g/d. At each hour of the day, the amount of protein ingested was higher on days with a high protein intake than on days with a low protein intake and associated with a higher total protein intake. The proportion of protein ingested during morning hours was higher (22 v. 17 %, P < 0·0001) on days with a low protein intake, and a higher proportion of protein ingested during morning hours was associated with a lower total protein intake (P < 0·0001) and a higher odds of low protein intake (OR 1·04, 95 % CI 1·03, 1·06). For the proportion of protein intake during mid-day or evening hours, opposite but weaker associations were found. Conclusions: In this sample, timing of protein intake was associated with total protein intake. Additional studies need to clarify the importance of these findings to optimise protein intake.

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Association of Daily Physical Activity and Sedentary Behaviour with Protein Intake Patterns in Older Adults: A Multi-Study Analysis across Five Countries

Nutrients ◽

10.3390/nu13082574 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2574

Author(s):

Ilianna Lourida ◽

Jolanda M. A. Boer ◽

Ruth Teh ◽

Ngaire Kerse ◽

Nuno Mendonça ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Sedentary Behaviour ◽

Energy Intake ◽

Total Protein ◽

Protein Intake ◽

Community Dwelling ◽

Study Analysis ◽

Total Protein Intake ◽

Eating Occasions

Physical activity and protein intake are associated with ageing-related outcomes, including loss of muscle strength and functional decline, so may contribute to strategies to improve healthy ageing. We investigated the cross-sectional associations between physical activity or sedentary behaviour and protein intake patterns in community-dwelling older adults across five countries. Self-reported physical activity and dietary intake data were obtained from two cohort studies (Newcastle 85+ Study, UK; LiLACS, New Zealand Māori and Non-Māori) and three national food consumption surveys (DNFCS, The Netherlands; FINDIET, Finland; INRAN-SCAI, Italy). Associations between physical activity and total protein intake, number of eating occasions providing protein, number of meals with specified protein thresholds, and protein intake distribution over the day (calculated as a coefficient of variance) were assessed by regression and repeated measures ANOVA models adjusting for covariates. Greater physical activity was associated with higher total protein intake and more eating occasions containing protein, although associations were mostly explained by higher energy intake. Comparable associations were observed for sedentary behaviour in older adults in Italy. Evidence for older people with higher physical activity or less sedentary behaviour achieving more meals with specified protein levels was mixed across the five countries. A skewed protein distribution was observed, with most protein consumed at midday and evening meals without significant differences between physical activity or sedentary behaviour levels. Findings from this multi-study analysis indicate there is little evidence that total protein and protein intake patterns, irrespective of energy intake, differ by physical activity or sedentary behaviour levels in older adults.

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Relationship between Oral Hypofunction and Sarcopenia in Community-Dwelling Older Adults: The Otassha Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126666 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6666

Author(s):

Yoshihiro Kugimiya ◽

Masanori Iwasaki ◽

Yuki Ohara ◽

Keiko Motokawa ◽

Ayako Edahiro ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Cross Sectional Study ◽

Albumin Level ◽

Community Dwelling ◽

Tongue Pressure ◽

Swallowing Function ◽

Cross Sectional ◽

Community Dwelling Older Adults ◽

The Relationship

Oral hypofunction, resulting from a combined decrease in multiple oral functions, may affect systemic-condition deterioration; however, few studies have examined the association between oral hypofunction and general health among older adults. In this cross-sectional study, we examined the relationship between oral hypofunction and sarcopenia in community-dwelling older adults. We included 878 adults (268 men and 610 women, mean age 76.5 ± 8.3 years). Tongue coating index, oral moisture, occlusal force, oral diadochokinesis (/pa/,/ta/,/ka/), tongue pressure, mas-ticatory function, and swallowing function were evaluated as indicators of oral hypofunction. Grip strength, gait speed, and skeletal muscle mass index were measured as diagnostic sarcopenia parameters. The association between oral hypofunction and sarcopenia was examined via logistic regression using sarcopenia as the dependent variable. Oral hypofunction prevalence was 50.5% overall, 40.3% in men, and 54.9% in women. The prevalence of sarcopenia was 18.6% overall, 9.7% in men, and 22.5% in women. A logistic regression showed oral hypofunction, age, body mass index, higher-level functional capacity, and serum albumin level were significantly associated with sarcopenia. Sarcopenia occurred at an increased frequency in patients diagnosed with oral hypofunction (odds ratio: 1.59, 95% confidence interval: 1.02–2.47); accordingly, oral hypofunction appears to be significantly associated with sarcopenia.

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The Relationships between Total Protein Intake, Protein Sources, Physical Activity, and Lean Mass in a Representative Sample of the US Adults

Nutrients ◽

10.3390/nu12103151 ◽

2020 ◽

Vol 12 (10) ◽

pp. 3151

Author(s):

Furong Xu ◽

Jacob E. Earp ◽

Maya Vadiveloo ◽

Alessandra Adami ◽

Matthew J. Delmonico ◽

...

Keyword(s):

Physical Activity ◽

Lean Mass ◽

Total Protein ◽

Representative Sample ◽

Protein Intake ◽

Large Scale ◽

Weight Status ◽

Protein Sources ◽

Total Protein Intake ◽

Study Results

Background: Although dietary protein and physical activity play essential roles in developing and preserving lean mass, studies exploring these relationships are inconsistent, and large-scale studies on sources of protein and lean mass are lacking. Accordingly, the present study examined the relationship between total protein intake, protein sources, physical activity, and lean mass in a representative sample of US adults. Methods: This cross-sectional study analyzed data from 2011–2016 US National Health and Nutrition Examination Survey and corresponding Food Patterns Equivalents Database (n = 7547). Multiple linear regression models were performed to examine the sex-specific associations between total protein intake, protein sources (Dairy, Total Protein Foods, Seafood, and Plant Proteins), physical activity, and lean mass adjusting for demographics, weight status, and total daily energy intake. Results: Total protein intake was inversely related to lean mass in females only (Lean mass index: β= −0.84, 95%CI: −1.06–−0.62; Appendicular lean mass index: β= −0.35, 95%CI: −0.48–−0.22). However, protein sources and physical activity was positively associated with lean mass in males and/or females (p < 0.05). Conclusion. Study results suggest that consuming more protein daily had a detrimental influence on lean mass in females whereas eating high-quality sources of proteins and being physically active are important for lean mass for men and women. However, the importance of specific protein sources appears to differ by sex and warrants further investigation.

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Religiosity and self-rated health among older adults in Colombia

Colombia Medica ◽

10.25100/cm.v50i2.4012 ◽

2019 ◽

pp. 67-76

Author(s):

Carlos A Reyes Ortiz ◽

Claudia Payan ◽

Geraldine Altamar ◽

Jose F Gomez Montes ◽

Harold G Koenig

Keyword(s):

Older Adults ◽

Rural Areas ◽

Community Dwelling ◽

Cross Sectional Survey ◽

Significant Interaction Effect ◽

Cross Sectional ◽

Self Rated Health ◽

Urban And Rural Areas ◽

Fair Poor ◽

The Relationship

Objective: To identify the relationship between religiosity and self-rated health among older adults in Colombia. Methods: Data are drawn from the SABE (Salud, Bienestar y Envejecimiento) Colombia Study, a cross-sectional survey conducted in 2015 involving 18,871 community-dwelling adults aged 60 years and older living in urban and rural areas of Colombia. Religiosity was assessed by self-rated religiosity (how religious are you: not at all, somewhat or very). Self-rated health during previous 30 days was assessed as very good, good, fair, poor or very poor, analyzed as an ordinal variable(1-5) using weighted logistic regression, adjusting for confounders. Results: Those who were more religious were older, female, had lower socioeconomic status, and were more likely to be married. Multivariate analyses demonstrated that older adults who were more religious had better self-rated health (OR 0.92 95% CI 0.86- 0.99, p= 0.038); however, there was a significant interaction effect between gender and religiosity on self-rated health (p= 0.002), such that the relationship between religiosity and health was stronger in men (OR 0.86, 95% CI: 0.79-0.94, p= 0.001) but not significant in women. Conclusion: Older adults in Colombia who consider themselves more religious, especially men, are less likely to perceive their physical health as poor compared to those who are less religious.

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Is the prevalence of dehydration among community-dwelling older adults really low? Informing current debate over the fluid recommendation for adults aged 70+years

Public Health Nutrition ◽

10.1079/phn2005829 ◽

2005 ◽

Vol 8 (8) ◽

pp. 1275-1285 ◽

Cited By ~ 59

Author(s):

Jodi Dunmeyer Stookey ◽

Carl F Pieper ◽

Harvey Jay Cohen

Keyword(s):

Older Adults ◽

Functional Status ◽

The Elderly ◽

Community Dwelling ◽

Plasma Sodium ◽

Current Debate ◽

Creatinine Ratio ◽

Cross Sectional ◽

Low Prevalence ◽

Community Dwelling Older Adults

AbstractObjectiveThe fluid recommendation for adults aged 70+ years has been criticised on the basis of a low prevalence of dehydration in community-dwelling older adults. This study explores whether the low prevalence might reflect limitations of individual dehydration indices.DesignCross-sectional data on plasma sodium, blood urea nitrogen (BUN), creatinine, glucose and potassium were used to classify 1737 participants of the 1992 Established Populations for Epidemiologic Studies of the Elderly (EPESE) (70+ years) according to multiple dehydration indices. Associations between dehydration indices, health and functional status were evaluated.ResultsDepending on the indicator used, the prevalence of dehydration ranged from 0.5% for hypotonic hypovolaemia only (plasma tonicity <285 mOsm l−1 with orthostatic hypotension) to 60% with dehydration defined as either plasma sodium ≥145 mEq l−1, BUN/creatinine ratio ≥20, tonicity ≥295 mOsm l−1, or hypotonic hypovolaemia. Elevated tonicity and BUN/creatinine ratio were respectively associated with chronic disease and functional impairment.ConclusionsThe true prevalence of dehydration among community-dwelling adults may be low or high, depending on the indicator(s) used to define dehydration. Before we can pinpoint a generalisable prevalence of dehydration for community-dwelling seniors and draw conclusions about fluid recommendations, validation studies of dehydration indices and longitudinal studies of dehydration, health and functional status are needed.

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The association between motor capacity and mobility performance: frailty as a moderator

European Review of Aging and Physical Activity ◽

10.1186/s11556-019-0223-4 ◽

2019 ◽

Vol 16 (1) ◽

Cited By ~ 4

Author(s):

Carl-Philipp Jansen ◽

Nima Toosizadeh ◽

M. Jane Mohler ◽

Bijan Najafi ◽

Christopher Wendel ◽

...

Keyword(s):

Older Adults ◽

Frailty Index ◽

Community Dwelling ◽

Daily Routine ◽

Cross Sectional ◽

Mobility Performance ◽

Frailty Status ◽

Walking Performance ◽

And Performance ◽

The Relationship

Abstract Background In older adults, the linkage between laboratory-assessed ‘motor capacity’ and ‘mobility performance’ during daily routine is controversial. Understanding factors moderating this relationship could help developing more valid assessment as well as intervention approaches. We investigated whether the association between capacity and performance becomes evident with transition into frailty, that is, whether frailty status moderates their association. Methods We conducted a cross-sectional analysis of the observational Arizona Frailty Cohort Study (ClinicalTrials.gov identifier: NCT01880229) in a community-dwelling cohort in Tucson, Arizona. Participants were N = 112 older adults aged 65 years or older who were categorized as non-frail (n = 40), pre-frail (n = 53) or frail (n = 19) based on the Fried frailty index. Motor capacity was quantified as normal (NWS) and fast walking speed (FWS). Mobility performance was quantified as 1) cumulated physical activity (PA) time and 2) everyday walking performance (average steps per walking bout; maximal number of steps in one walking bout), measured by a motion sensor over a 48 h period. Hierarchical linear regression analyses were performed to evaluate moderation effects. Results Unlike in non-frail persons, the relationship between motor capacity and mobility performance was evident in pre-frail and frail persons, confirming our hypothesis. A moderating effect of frailty status was found for 1) the relationship between both NWS and FWS and maximal number of steps in one bout and 2) NWS and the average steps per bout. No moderation was found for the association between NWS and FWS with cumulated PA. Conclusion In pre-frail and frail persons, motor capacity is associated with everyday walking performance, indicating that functional capacity seems to better represent mobility performance in this impaired population. The limited relationship found in non-frail persons suggests that other factors account for their mobility performance. Our findings may help to inform tailored assessment approaches and interventions taking into consideration a person’s frailty status.

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Hope As A Motivator For Healthy Behaviors In Older Adults: Findings From A Cross-Sectional Survey

Innovation in Aging ◽

10.1093/geroni/igab046.3606 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 1016-1016

Author(s):

Mushira Khan ◽

Patrick Hill ◽

Catherine O'Brien ◽

Dugan O'Connor

Keyword(s):

Older Adults ◽

Health Behaviors ◽

Community Dwelling ◽

Strong Positive Correlation ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Demographic Groups ◽

Healthy Behaviors ◽

Future Selves ◽

The Relationship

Abstract Hope can be understood as a motivational state that enables people to move toward their goals. Yet, how hope may act as a motivator for healthy behaviors in older adults is not well-understood. Further, the extant literature utilizes varied conceptualizations of hope, and a better understanding of the constructs that underlie the relationship between hope and health behaviors is needed. This study examined the relationship between hope and health behaviors, explored how this relationship may differ across different socio-demographic groups, and considered how hope relates to perceived future selves among older adults. Community-dwelling adults 55 years and older (n = 711; mean age 67.38 years; 280 men, 431 women) completed an online, cross-sectional survey. Survey measures included, along with the Adult Hope Scale (AHS) and the Herth Hope Index (HHI), a health behaviors checklist, self-reported health, and a future self scale. We found a moderately strong positive correlation between hope and healthy behaviors in older adults (AHS r = 0.46, p < .01; HHI r = 0.50, p < .01). Participants with higher levels of hope also reported more positive future selves and better health. The associations were similar across different racial/ethnic groups and the magnitude of this effect held even after controlling for gender, education, marital status, and income. Of the two hope scales, we recommend the AHS measure given its relative parsimony, greater use in the field, and the fact that the associations were fairly similar to the HHI with respect to health and health behavior.

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Effectiveness and acceptance of commercially available protein-rich meals and dairy products in increasing protein intake of community-dwelling older adults

Proceedings of The Nutrition Society ◽

10.1017/s0029665120004309 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Joost O. Linschooten ◽

Janne Beelen ◽

Jos Borkent ◽

Marian A. E. de van der Schueren ◽

Annet J. C. Roodenburg

Keyword(s):

Older Adults ◽

Focus Groups ◽

Healthy Eating ◽

Dairy Products ◽

Protein Intake ◽

Community Dwelling ◽

High Protein ◽

Eating Attitude ◽

Group I ◽

Main Meal

AbstractIntroductionHome-delivered hot meals and dairy could possibly prevent community-dwelling (CD) older adults from becoming malnourished when they are no longer able to cook themselves. Ideally, these products contribute to an intake of 1.2 grams of protein per kg bodyweight per day (g/kg BW/d) and ≥ 25 grams of protein per main meal. This study evaluated the effectiveness of these products on protein intake and explored the acceptance of these products.MethodsThe study was a single-blind RCT with CD older adults switching from self-prepared to commercially-available home-delivered hot meals and dairy products during 28 days. The intervention group (I) received meals and dairy products high in (≥ 20EN%) protein; the control group (C) received standard meals and dairy products low(er) in protein. Dietary intake was measured at baseline, two weeks (T1) and four weeks (T2) by a three-day food diary. After study completion, 25 participants (aged > 80y, 16 female/9 male) participated in focus groups discussing information on healthy eating, attitude towards high protein products, product acceptance.ResultsNinety-eight CD older adults (mean age: 80.4 years ± 6.8). Baseline protein intake was 1.09 (SE 0.05) (I) and 0.99 (SE 0.05) (C) g/kg BW/d. During the trial, protein intake of I remained stable at 1.12 g/kg BW/d (SE 0.05) while intake decreased in C to 0.87 (SE 0.03). More I participants reached the threshold of ≥ 25 grams protein at dinner compared to C but not at breakfast and lunch. In the focus groups, participants indicated to be aware of the importance of healthy eating (less salt and less fat). However, knowledge on high-protein products was low and participants did not know why intake of protein should be increased. Less social interaction was indicated as one of the main causes of deterioration of eating behaviour. Further, participants indicated that they primarily would like to enjoy eating instead of focusing on functionality. The ready-made meals were generally considered to be too large and low in vegetables.ConclusionsSwitching from self-prepared meals to ready-made meals carries the risk of a decreasing protein intake in CD older adults. To stimulate a healthy dietary pattern, focus should be on behavioural change and knowledge improvement. Besides awareness for healthy eating, food enjoyment is essential. Finally, meal composition could be improved to enhance acceptance.

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Dietary proteins and protein sources and risk of death: the Kuopio Ischaemic Heart Disease Risk Factor Study

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqz025 ◽

2019 ◽

Vol 109 (5) ◽

pp. 1462-1471 ◽

Cited By ~ 26

Author(s):

Heli E K Virtanen ◽

Sari Voutilainen ◽

Timo T Koskinen ◽

Jaakko Mursu ◽

Petra Kokko ◽

...

Keyword(s):

Total Protein ◽

Protein Intake ◽

Disease Risk ◽

Plant Protein ◽

Disease Risk Factor ◽

Protein Sources ◽

Total Protein Intake ◽

Risk Factor Study ◽

Factor Study ◽

Heart Disease Risk

ABSTRACT Background Previous studies investigating protein intake in relation to mortality have provided conflicting results. Objective We investigated the associations of dietary protein and protein sources with risk of disease death in the prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor Study. Methods The study population consisted of 2641 Finnish men, aged 42–60 y at baseline in 1984–1989. We estimated protein intakes with 4-d dietary records at baseline and collected data on disease deaths from the national Causes of Death Register. Cox proportional hazards regression models were used to estimate HRs and 95% CIs. Results During the average follow-up of 22.3 y, we observed 1225 deaths due to disease. Higher intakes of total protein and animal protein had borderline statistically significant associations with increased mortality risk: multivariable-adjusted HR (95% CI) in the highest compared with the lowest quartile for total protein intake = 1.17 (0.99, 1.39; P-trend across quartiles = 0.07) and for animal protein intake = 1.13 (0.95, 1.35; P-trend = 0.04). Higher animal-to-plant protein ratio (extreme-quartile HR = 1.23; 95% CI: 1.02, 1.49; P-trend = 0.01) and higher meat intake (extreme-quartile HR = 1.23; 95% CI: 1.04, 1.47; P-trend = 0.01) were associated with increased mortality. When evaluated based on disease history at baseline, the association of total protein with mortality appeared more evident among those with a history of type 2 diabetes, cardiovascular disease, or cancer (n = 1094) compared with those without disease history (n = 1547) (P-interaction = 0.05 or 0.07, depending on the model). Intakes of fish, eggs, dairy, or plant protein sources were not associated with mortality. Conclusions Higher ratio of animal to plant protein in diet and higher meat intake were associated with increased mortality risk. Higher total protein intake appeared to be associated with mortality mainly among those with a predisposing disease. This trial was registered at clinicaltrials.gov as NCT03221127.

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