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.

Project information

Nutrition for healthy ageing


16th August 2019

Older Consumers’ Readiness to Accept Alternative, More Sustainable Protein Sources in the European Union

Alessandra C. Grasso, Yung Hung, Margreet R. Olthof, Wim Verbeke and Ingeborg A. Brouwer

Nutrients 2019, 11, 1904; doi:10.3390/nu11081904doi.org/10.1111/jgs.16011


Considering today’s environmental challenges such as climate change and biodiversity loss, sustainable dietary strategies are needed to meet the high protein requirement of a growing aging population. This study investigated the readiness of older adults to accept the consumption of the following alternative, more sustainable protein sources: plant-based protein, insects, single-cell protein, and in vitro meat. We used data from a survey that was conducted among 1825 older adults aged 65 years or above living in the United Kingdom, the Netherlands, Poland, Spain, and Finland.

Dairy-based protein was the most accepted protein source among older adults, with 75% of the respondents reporting dairy to be acceptable or very acceptable. When it came to alternative, more sustainable protein sources, 58% of the respondents reported to accept plant-based protein, 20% reported to accept single-cell protein, 9% reported to accept insect-based protein, and 6% reported to accept in vitro meat-based protein. We found that fussy eaters were less likely to accept eating alternative, more sustainable protein sources. Older adults who were more active in sustainable food consumption (e.g. purchases organic food) and who were highly educated were more likely to accept eating alternative, more sustainable sources. Valuing health, sensory appeal, and price when making food choices, as well as gender and country of residence were found to influence acceptance, although not consistently across all the protein sources.

This paper concludes that a relatively high acceptance of plant-based protein sources provides an opportunity to increase protein intake in an environmentally sustainable way in EU older adults. More research is needed to determine ways to increase acceptance of more innovative, technology-driven protein sources such as single-cell protein and in vitro meat among older adults.

You can also read the scientific article here.

30th July 2019

Prospective Associations of Diet Quality With Incident Frailty in Older Adults: The Health, Aging, and Body Composition Study

Linda M. Hengeveld, Hanneke A.H. Wijnhoven, Margreet R. Olthof, Ingeborg A. Brouwer, Eleanor M. Simonsick, Stephan B. Kritchevsky, Denise K. Houston, Anne B. Newman, Marjolein Visser.

Journal of the American Geriatrics Society. (2019) 00:1-8 doi.org/10.1111/jgs.16011


Frailty can be described as a fragile health state that makes a person very vulnerable for health problems. Frail older persons are at higher risk for developing mobility problems, becoming institutionalized and losing independence. For older adults and their families, the possibility to postpone or prevent the development of frailty is likely highly desirable.

Diet is one of the modifiable factors that are supposed to contribute to the prevention of frailty in older adults. Moreover, previous studies have shown that many older adults consume a diet that is of insufficient quality (i.e., their diet does not fully conform to national dietary guidelines) or that is low in protein. We investigated whether poor diet quality and low protein intake would increase the risk of developing frailty in the future.

The data are from the Health, Aging, and Body Composition (Health ABC) Study, which consists of community-dwelling older adults aged 70 years and over, who live in the areas of Memphis, TN, and Pittsburgh, PA (USA).

We found that older adults with a poor-quality diet had a higher risk of developing frailty compared to older adults with a good-quality diet. We found no relationship between protein intake and risk of frailty. In conclusion, our study suggests that it is important to adhere as much as possible to the national dietary guidelines for older adults to postpone or prevent the development of frailty.

You can also read the scientific article here

Contribution of protein intake and its interaction with physical activity to transitions between disability states and to death in very old adults: the Newcastle 85+ Study

Nuno Mendonça, Andrew Kingston, Antoneta Granic, Tom R. Hill, John C. Mathers, Carol Jagger

European Journal of Nutrition 2019 Jan 10. doi.org/10.1007/s00394-019-02041-1


We aimed to determine the contribution of protein intake, and the interaction between protein intake and physical activity, to the transition between disability free and disability using the Newcastle 85+ Study. We included more than 700 older adults living in the community and turning 85 in 2006/2007 and we followed them until 90 years of age. Protein intake was estimated with a 24-hour multiple pass recall (people were asked what foods and drinks were consumed in the past 24 hours) on two different occasions in 2006/2007. Study participants were also asked about their ability to perform 17 activities of daily living (ADL) (able to get in and out of a chair, cut own toenails, manage own medications, etc.) in 2006/2007, and after 18, 36 and 60 months. A simple score was derived by summing the number of ADLs that the participant had difficulty with and a score >1 was considered as disability. We found that an increase in protein intake, especially ≥0.8 or 1g of protein per kg of adjusted body weight per day (g/kg aBW/d) decreased the likelihood of developing disability. An average 85-year-old with protein intake <1g/kg aBW/d was expected to spend 0.86 years disability free and 3.63 years disabled over 5 years while another participant with ≥1.0 g/kg aBW/d was expected to spend 1.58 years disability free and 3.01 years disabled. We also found that those physically active and with a good protein intake were less likely to transition from disability-free to disability than those within the same physical activity level but with worse protein intake. This means that higher protein intake, especially in combination with higher physical activity may delay the incidence of disability in very old adults.

You can also read the scientific article here.


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