With the European population growing older, the challenge is to keep an increasing number of seniors across all European countries healthy and active. In Europe, between 13.5 % and 29.7 % of older adults living at home are malnourished or at risk of protein energy malnutrition. PROMISS aims to better understand and ultimately prevent protein energy malnutrition in seniors. Thereby, PROMISS will contribute to improve active and healthy ageing.
Nutrition for healthy ageing
Prevalence of protein intake below recommended in community-dwelling older adults: a meta-analysis across cohorts from the PROMISS consortium
Linda M. Hengeveld, Jolanda M.A. Boer, Pierrette Gaudreau, Martijn W. Heymans, Carol Jagger, Nuno Mendonça, Marga C. Ocké, Nancy Presse, Stefania Sette, Eleanor M. Simonsick, Heli Tapanainen, Aida Turrini, Suvi M. Virtanen, Hanneke A.H. Wijnhoven, Marjolein Visser
Journal of Cachexia, Sarcopenia and Muscle
Adequate protein intake is required to maintain muscle health, which contributes to the prevention or delay of disability and mortality. At present, the European Food Safety Authority advises older adults to consume at least 0.8 grams of protein per kilogram of body weight (BW). Experts in the field believe that older adults need even more protein (1.0 to 1.2 g/kg BW.) Little is known about the proportion of older adults that does not reach these recommended levels of protein intake.
In this study we estimated the proportion of community-dwelling older adults (≥55 years) that consumed less protein than recommended. We were also interested in whether these proportions differed across subgroups of age, sex, body mass index, education level, living status, appetite and recent weight loss. For example, do women less often meet recommended protein intake levels then men? We used data on 8103 older adults from European and North-American countries.
We found that 22% of the older adults had a protein intake below 0.8 g/kg BW. Nearly half (47%) and three-quarters (71%) of the older adults had a protein intake below 1.0 and 1.2 g/kg BW, respectively. Women, older adults with a higher body mass index and older adults with poor appetite were more likely to have a protein intake below the recommendation. The proportions differed only marginally by subgroups according to age, education level, living status and recent weight loss.
This study shows that a substantial proportion of older adults does not meet the recommended levels of protein intake, which make them at risk for inadequate protein intake and potential health problems. This stresses the need for awareness and for dietary strategies in order to increase protein intake in older adults.
You can access the full scientific article here
Sex- and race-specific associations of protein intake with change in muscle mass and physical function in older adults of the Health ABC Study
Liset E.M. Elstgeest, Laura A. Schaap, Martijn W. Heymans, Linda M. Hengeveld, Elke Naumann, Denise K. Houston, Stephen B. Kritchevsky, Eleanor M. Simonsick, Anne B. Newman, Samaneh Farsijani, Marjolein Visser, Hanneke A.H. Wijnhoven for the Health ABC Study
The American Journal of Clinical Nutrition. 2020. doi.org/10.1093/ajcn/nqaa099
The current dietary guidelines recommend a protein intake of ≥0.8 g protein per kg body weight per day (g/kg BW/d), but experts propose a higher intake for older adults (1.0 to 1.2 g/kg BW/d). Since there are differences in body composition and hormonal milieu between sex and race, protein needs may also differ between men and women or blacks and whites. It is unknown whether optimal protein intake differs by sex or race.
We aimed to examine sex- and race-specific associations of dietary protein intake with 3- and 6-year changes in muscle mass and gait speed, and the development of mobility limitation during 6 years in US older men and women.
Data were from 2400 community-dwelling men and women aged 70-81 years and living in the areas of Memphis, TN, and Pittsburgh, PA (US), who participated in the Health, Aging, and Body Composition (Health ABC) Study.
We found that a higher protein intake was associated with less muscle mass loss over 3 years in women, specifically black women, but not over 6 years or with a decline in gait speed. In men, protein intake was not associated with changes in muscle mass and gait speed. A higher protein intake was associated with a lower risk of mobility limitation in both men and women, specifically white women. In conclusion, associations between protein intake and physical outcomes may vary by sex and race. Therefore, it is important to consider sex and race in future studies regarding protein needs in older adults.
You can access the full scientific article here
PROMISS adapts to Covid-19
The outbreak of COVID-19, a new form of coronavirus, and its rapid spread around the world has required the PROMISS project partners to adapt to keep everyone safe and healthy.
- Our annual PROMISS consortium meeting was held virtually and although we couldn’t meet up face-to-face, we were able to have virtual in-depth discussions and decide effectively on the project’s next steps.
- Our PROMISS long-term (cost)effectiveness study also had to adapt its final tests to ensure participants’ health and safety. Starting from March 16 2020, the final follow-up measurement was postponed until further notice. Final measurements were resumed in April (through interview by phone) except for the physical measurements. Starting from the beginning of June, the physical measurements at the clinic site were also resumed in both Finland and the Netherlands. Those with no health complaints potentially caused by the coronavirus were allowed to visit the clinic site.
- The way PROMISS results are disseminated is impacted too. Our partners’ conferences European Geriatric Medicine Society – EuGMS and European Society for Clinical Nutrition & Metabolism – ESPEN are going virtual and the International Congress of Dietetics has been postponed to 2021. Nevertheless, we will make sure that the strategies developed based on our PROMISS research findings will be shared with the relevant target audiences.
The PROMISS consortium encourages everyone to follow the guidance of the World Health Organisation and government measures taken in our respective countries. For reliable information about the pandemic, please visit only trusted sources among which:
- European Commission (available in all EU languages) and European Centre for Disease Control
- World Health Organisation(available in different languages), including: WHO recommendation how to maintain good mental health during COVID-19
- COVID-19 and older people in Europe (from our partner AGE Platform Europe)
- Covid-19 and nutrition page from the American Society for Nutrition