Low protein intake, muscle strength and physical performance in the very old: the Newcastle 85+ Study
Antoneta Granic, Nuno Mendonca, Avan Aihie Sayer, Tom R Hill, Karen Davies, Ashley Adamson, Mario Siervo, John C Mathers, Carol Jagger
Clinical Nutrition 2017 Nov 9 (Article in Press).
As they age adults experience a progressive decline in muscle mass and strength which puts them at increased risk of falls, frailty, disability and death. Physical inactivity and a poor diet can accelerate this loss of muscle mass and strength. We aimed to investigate the relationship between an important part of the diet for muscle, protein intake, and muscle strength and physical performance in very old adults (aged 85 years) as they aged further. Our study, the Newcastle 85+ Study, was based in North East England, and involved 722 people aged 85 years old, with diet assessed by 24h recalls on two non-consecutive days. Low protein intake was defined as less than 1 g per kg of adjusted body weight per day (or around 65 g per day for an average weight individual). Muscle strength was measured by grip strength (squeezing a dynamometer for 5s) and physical performance was measured by the Timed Up-and-Go test (getting up, walking 3 m, walking back, and sitting again). Both grip strength and Timed-Up-and-Go were measured at age 85, 87.5, 88 and 90 years of age.
We found that very old women who had low protein intake had lower grip strength and Timed-Up-and-Go at baseline, but grip strength and Timed-Up-and-Go declined at the same rate as in women with adequate protein intake (1 g per kg of adjusted body weight or more). For men, there was no difference in the baseline measures or decline in grip strength and Timed-Up-and-Go between those with low or adequate protein intake. We found an added benefit of combining adequate protein intake (above 1 g per kg of adjusted body weight per day) with medium/high physical activity on muscle strength. This positive effect was not observed if medium/high physical activity was combined with low protein intake. We conclude that (a) low protein intake may negatively affect muscle strength and physical performance in late life, especially in older women and before age 85, independently of other important factors; and (b) a combination of adequate protein intake and physical activity may be necessary to reduce the loss of muscle strength in the very old.
Read the whole scientific paper here.
Prevalence and determinants of low protein intake in very old adults: Insights from the Newcastle 85+ Study
Nuno Mendonça, Antoneta Granic, John C. Mathers, Tom R. Hill, Mario Siervo, Ashley J. Adamson, Carol Jagger
European Journal of Nutrition 2017 Sep 25. doi: 10.1007/s00394-017-1537-5. [Epub ahead of print]
The very old, those aged 85 years and older, are the fastest growing age group in most western societies and are at especially high risk of malnutrition, as well as loss of muscle mass and strength. The amount of protein that the very old get from their diet, which foods provide the best source of protein and the time of day that such foods are eaten, are all factors that may play important roles in delaying or even preventing malnutrition and such information is essential to develop new food products and public health policies to better tackle the problem of malnutrition. Our study, the Newcastle 85+ Study, was based in North East England, and involved 722 people aged 85 years old, whose diet was estimated by a 24 hour multiple pass recall (people are asked what foods and drinks were consumed in the past 24 hours) on two non-consecutive days. We found that 28% of our population were below the commonly used protein intake target (0.8g of protein per kg of adjusted bodyweight per day) and that this group ate less meat, more cereals and had more non-alcoholic beverages than those who had adequate protein intake. After accounting for other factors, people in the low protein group were more likely to be men, had lower energy intake and fewer teeth. People with low protein also took more of their protein during the morning than those in the adequate protein intake group. This study provides new evidence of the magnitude of low protein intake in the very old, the sources of protein and the diurnal patterning of protein intake.
Read the whole scientific paper here.
Join the CRN-I 8th Annual Scientific Symposium
Join the Council for Responsible Nutrition-International (CRN-I) in Berlin for its 8th annual Scientific Symposium—convenient to the Codex Committee on Nutrition and Foods for Special Dietary Uses (CCNFSDU) meeting taking place 4–8 December in Berlin.
Healthy Aging, the Natural Consequences of Good Nutrition
Saturday, 2 December, 0800 – 1700
Sunday, 3 December, 1830 – 2100
H4 Hotel Berlin Alexanderplatz (the CCNFSDU host hotel)
See the CRN-I website for agenda and registration details.
PROMISS Consortium Meeting in Nice, France (SEP 2017)
During the 19th and 20th of September 2017, a PROMISS Consortium Meeting has been hosted at the premises of the Hôtel Novotel Nice Centre Vieux in Nice, France. All project partners where represented by experts in the fields of epidemiology, clinical trials, geriatrics, nutrition, physical activity, microbiomics, and behaviour, consumer, sensory and computer sciences, as well as industry, SMEs, European stakeholder organisations and representatives of older adults themselves.
The meeting consisted of a set of plenary sessions with topics ranging from reports from the project work packages and the second General Assembly, as well as a set of parallel breakout group sessions, which results where shared in a plenary session. All in one, the result was a very fruitful Consortium Meeting.
In addition to the working sessions, the group also had the opportunity to participate in a social program, including a visit to Saint Paul de Vence and a dinner in a restaurant of this beautiful village which medieval walls encircle pitoresque narrow streets.
Poor appetite and dietary intake in community-dwelling older adults
S. van der Meij , H. A.H. Wijnhoven , J. S. Lee, D. K. Houston, T. Hue, T. B. Harris, S. B. Kritchevsky , B. Newman , M. Visser
Journal of the American Geriatrics Society, accepted for publication on 31-5-2017
Poor appetite is a problem in many older adults and is associated with unintentional weight loss and lower quality of life. Insight in food preferences of these older adults could be used to improve dietary intake and develop meals, drinks and snacks that are specifically adapted to these preferences. It can also be used to identify the risk of nutrient deficiencies.
In this study we investigated differences in food intake by appetite level among 2.597 older adults (70-79 years) who are living in the United States and who participated in the second year of the Health, Aging and Body Composition Study. The dietary intake of the older adults was measured with a “food frequency questionnaire” that consisted of 108 items on frequency and amount of different foods.
In total, 22% of the older adults reported that they had a poor appetite, 38% reported a good appetite and 40% a very good appetite. The older adults with a poor appetite were more often female, black, lower educated, and reported a poorer general health status, more biting/chewing problems, unintentional weight loss, and a lower Healthy Eating Index score.
The older adults with a poor appetite consumed less protein and dietary fiber, less solid foods, smaller portion sizes, less wholegrains, and less fruits and vegetables than older adults with a very good appetite. They consumed more dairy foods, fats, oils, sweets and soda’s.
This study shows that older adults with a poor appetite report a different dietary intake pattern compared to those with very good appetite. The study results can be used for nutrition interventions to enhance food intake, diet variety and diet quality in older adults with a poor appetite.
Read the whole scientific paper here.
PROMISS at the 39th ESPEN congress in The Hague!
At the very well attended PROMISS symposium, which took place during the 39th ESPEN congress, our researchers presented their work on potential dietary risk factors for the development of malnutrition and on nutritional interventions to prevent malnutrition in community-dwelling older adults.
PROMISS Job offer: Dutch speaking research dietician
The VU university Amsterdam is looking for a Dutch-speaking research dietician to assist in Work Package 6 “Feasibility and short term impact” (See here the list of Work Packages). He/she will perform interviews and measurements, and will provide dietetic counseling to participants from the pilot experiments. Please find more information here (only available in Dutch).
PROMISS Newsletter #1 – June 2017
Thanks to a multi-disciplinary international consortium (23 partners from 11 countries), the PROMISS project is eager to:
- Provide insight in the causal links between diet, physical activity, appetite and malnutrition among older adults;
- Develop evidence-based dietary and physical activity strategies to prevent malnutrition and enhance active and healthy ageing;
- Deliver food concepts and products, as well as persuasive technology to support adherence to these strategies.
In this newsletter:
A sneak peek into PROMISS research
- The lower the protein intake, the greater the risk of developing mobility limitations
- Vary your activities and perform them regularly in order to age well!
- Towards new food products and concepts
What do older people think?
- Some opinions of experts, carers and seniors
What happens beyond research?
- The ESPEN congress on nutrition of older adults
- EFAD’s “Working together across health professions to combat malnutrition”
- EUGMS Congress and PROMISS General Assembly
Enjoy reading the first PROMISS newsletter here.
Protein Intake and Mobility Limitation in Community-Dwelling Older Adults: the Health ABC Study.
Houston DK, Tooze JA, Garcia K, Visser M, Rubin S, Harris TB, Newman AB, Kritchevsky SB; Health ABC Study.
J Am Geriatr Soc. 2017 Mar 17. doi: 10.1111/jgs.14856
In this study we investigated the protein intake of 1.998 older adults (70-79 years) who are living in the United States and who participate in the Health, Aging and Body Composition Study. On average, the older adults consumed 66.2 gram of protein per day. Of the men, 27.3% consumed less protein than the current Recommended Dietary Allowance, which indicates a consumption of at least 0.8 gram protein per kilogram of body weight. For women this was 26.5%.
All adults were well-functioning at baseline. The older adults were followed over 6 years, during which 45.5% developed a new mobility limitation, indicating they reported to experience difficulties walking one-quarter of a mile or climbing 10 steps without resting.
Older adults who consumed less than 0.70 grams of protein per kilogram of body weight at baseline, and those who consumed between 0.70 and 1.0 grams of protein per kilogram of body weight at baseline, were more likely to developed mobility limitation during the 6 years compared to older adults who consumed 1.0 or more grams of protein per kilogram body weight. These findings were similar when the animal protein consumption or the vegetable protein consumption were investigated separately.
The results of this research suggest that older adults with a lower protein intake are at greater risk of developing mobility limitations. They also suggest that consuming 1.0 or more grams of protein per kilogram body weight might be optimal for older persons to maintain physical function.
Read the whole scientific paper here.
The intestinal microbiota, energy balance, and malnutrition: emphasis on the role of short-chain fatty acids.
Fluitman, K. S., De Clercq, N. C., Keijser, B. J. F., Visser, M., Nieuwdorp, M., & Ijzerman, R. G. (2017). The intestinal microbiota, energy balance, and malnutrition: emphasis on the role of short-chain fatty acids. Expert Review of Endocrinology & Metabolism, 12(3), 215-226. doi: 10.1080/17446651.2017.1318060
Over the last decades, increasing attention is being directed toward the vast amount of bacteria inhabiting the human gut: the intestinal microbiota.
These microbiota have been demonstrated to actively influence human energy balance.
Thus, a disruption of the normal microbiota can contribute to the development of malnutrition.
Accordingly, it was demonstrated that microbial composition differs between subjects with and without malnutrition.
This review of the literature summarizes the pathways through which the intestinal microbiota might contribute to malnutrition, how the microbiota differs in over- and undernutrion, and how the microbiota could be manipulated in a way to promote a healthy nutritional state.
Read the whole scientific paper here.
Upcoming Congresses and PROMISS General Assembly 2017
September 2017 will be a hectic month for the PROMISS consortium.
Three congresses will host PROMISS symposia and the project General Assembly will take place right before one of these events.
Consult our “Event” webpage for all details.
PROMISS leaflet is now available
The PROMISS leaflet is meant to introduce the audience to PROMISS activities and ambition, and let it become familiar with its content and visual identity. It will be distributed during every relevant event organised by PROMISS partners, such as the EUGMS Congress, the EFAD conference, the ESPEN Conference, the AGE annual conference, and during external events where PROMISS is represented.
You can find it here.
Do not hesitate to share it as well!
PROMISS kicks-off its activities in Amsterdam
Last 6 and 7 June 2016, PROMISS partners gathered in Amsterdam, the Netherlands, to officially kick-off the project.
It was the occasion for partners to meet, exchange their views on PROMISS activities and officially start the work towards the first PROMISS deliverables.
We look forward to seeing PROMISS reach tangible results on how to prevent malnutrition among community-dwelling older adults. Keep an eye on the website and PROMISS social media accounts to learn about the project’s developments, and subscribe to the newsletters to directly receive regular updates.
PROMISS becomes member of the European Innovation Partnership on Active and Healthy Ageing
Last February, the European Innovation Partnership on Active and Healthy Ageing (EIP AHA) opened new calls inviting organisations to get involved in developing, promoting or deploying innovative solutions and ecosystems for active and healthy ageing. The Call for Commitments targeted innovative solutions for active and healthy ageing.
The call received a strong support. The European Commission has recorded over 850 commitments from 28 Member States (and beyond) while 78 Reference Site applications (from 22 Member States) were submitted, representing regional and national alliances of stakeholders invested in the scaling up of innovation for active and healthy ageing.
We are very happy that the commitment submitted by PROMISS has been accepted, letting us become one of the official members of the EIP AHA, and more precisely of the A3 action group on Functional decline and frailty.