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
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.
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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
Protein intake pattern over the day and its association with low total protein intake in Dutch community-dwelling older adults
Teuni H Rooijackers, Marga C Ocké, Linda M Hengeveld , Marjolein Visser, Jolanda MA Boer
Public Health Nutrition 2020, 1-13. doi:10.1017/S1368980020000026
Adequate protein intake is important for the health and physical functioning of older adults. There are indications that the timing of protein intake may influence total protein intake, but evidence is limited so far. Therefore we studied the association between timing of protein intake and the total amount of protein ingested in 739 community-dwelling Dutch older adults (70+), who participated in the Dutch National Food consumption Survey 2010-2012. Participants were interviewed at home by trained dieticians twice, with a mean interval of four weeks about all food and drinks they had eaten the day before. For all foods and drinks consumed, the amount and time of consumption was recorded. For each day we calculated how much protein the participant ingested. If the participant ingested less than 0.8 g protein per kilogram of body weight, protein intake was considered to be low that day.
The results showed that protein intake differed across hours of the day with peaks between 08:30-09:29h (mostly breakfast), 12:30-13:29h (mostly lunch), and 17:30-18:29h (mostly dinner). On the 290 days that protein intake was low, for each hour of the day the average amount of protein ingested was lower compared to the 1188 days with a higher protein intake. This lower intake at either time of day may, however, just reflect a lower food consumption and does not necessarily provide information on the distribution of protein intake over the day. Therefore, we also investigated how much of the total protein was ingested in the morning, midday or in the evening. On days with a low protein intake, a larger part of the total protein intake was ingested in the morning (22%), compared to days with a higher protein intake (17%). If a larger part of total protein was consumed in the morning, there was a higher change that the total protein intake of that day was low. Weaker associations were observed for the part of protein that was ingested midday or in the evening. These results confirm results of other studies on this topic and suggest that timing of protein intake may influence total protein intake. Drawing final conclusions on the effect of timing of protein on total protein intake from our study is difficult. It is important to look in more depth into the timing of protein intake in experimental studies actively manipulating protein intake at different hours of the day, to see if timing of protein intake can be used to increase the likelihood of an adequate protein intake among older adults.
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