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Fonte FK, Spinoza ED, Carvalho VA, Albuquerque RADS, Nebuloni CC, Santos FCD, Cendoroglo MS. Relationship of protein, calcium and vitamin D consumption with body composition and fractures in oldest-old independent people. Clin Nutr ESPEN 2024; 59:398-403. [PMID: 38220402 DOI: 10.1016/j.clnesp.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 11/28/2023] [Accepted: 12/07/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND & AIM Some studies state that the protein intake has a protective effect against bone mass loss, while others show that the combination of low calcium intake and high protein consumption increases the risk of fractures. Perhaps this phenomenon is also altered by the consumption of vitamin D after the age 80 years. This study aimed to identify if there is an association of protein, calcium and vitamin D intake with body composition and fractures in community dwelling 80 years or older independent people. METHODS This is a cross-sectional observational analytic study. We invited community dwelling 80 years or older independent people, with chronic diseases under control, according to the scientific guidelines. The food intake was obtained through a one-day food record (FR) and Avanutri software (4.1 version) was used to calculate the intake of total calories, calcium, protein, and other food nutrients. The body composition and bone densitometry were evaluated by whole-body Dual Energy X-ray Absorptiometry (DXA). The morphometric vertebral fractures were assessed through conventional X-ray of the vertebral, level T4 to L4, on side face position - semi quantitative technique. RESULTS One hundred and fifty-nine 80 years or older independent people, mean age 87.0 ± 3.9 years old were studied. The mean calcium intake was 834.6 ± 374.7 mg/day and vitamin D was 6.1 ± 24.3 μg/day, in both cases they were complemented by supplements to reach the recommendations. The mean protein intake was 72.9 ± 26.8 g/day, we found that 48.4% had low muscle mass; there was a frequency of 45.3% of osteoporosis; and vertebral fractures in 24.7% of them. The estimates of the logistic regression model with the outcome variable obesity and low muscle mass with reference to "low muscle mass" showed that the 80 years or older independent people who have a fracture are more likely to be obese with low muscle mass compared to those with only low muscle mass. CONCLUSION In the studied population of 80 years or older independent people, we observed that among all the nutrients studied, only dietary protein per g/kg/day was associated with body composition and bone mineral density, but not with fracture, although the elderly who have fracture are more likely to be obese with low muscle mass compared to those not obese with low muscle mass. More studies about nutrients intakes and its relationship with muscle and bone health in this population is necessary.
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Affiliation(s)
- Flávia Kurebayashi Fonte
- Postgraduate Program in Nutrition Sciences at Division of Geriatrics and Gerontology, Paulista Medical School of the Federal University of São Paulo, São Paulo, Brazil.
| | - Evelyn Dearo Spinoza
- Postgraduate Program in Nutrition Sciences at Division of Geriatrics and Gerontology, Paulista Medical School of the Federal University of São Paulo, São Paulo, Brazil
| | - Vanessa Amarante Carvalho
- Postgraduate Program in Nutrition Sciences at Division of Geriatrics and Gerontology, Paulista Medical School of the Federal University of São Paulo, São Paulo, Brazil
| | | | - Clarice Cavalero Nebuloni
- Division of Geriatrics and Gerontology, Paulista Medical School of the Federal University of São Paulo, São Paulo, Brazil
| | - Fânia Cristina Dos Santos
- Division of Geriatrics and Gerontology, Paulista Medical School of the Federal University of São Paulo, São Paulo, Brazil
| | - Maysa Seabra Cendoroglo
- Division of Geriatrics and Gerontology, Paulista Medical School of the Federal University of São Paulo, São Paulo, Brazil
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Lingman M, Kerse N, Muru-Lanning M, Teh R. Dietary Protein Intake and Physical Function in Māori and Non-Māori Adults of Advanced Age in New Zealand: LiLACS NZ. Nutrients 2023; 15:nu15071664. [PMID: 37049504 PMCID: PMC10096528 DOI: 10.3390/nu15071664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 04/14/2023] Open
Abstract
The population of older adults is growing exponentially. Research shows that current protein intake recommendations are unlikely to meet the ageing requirements and may be linked to reduced physical function. Ensuring optimal function levels is crucial for independence and quality of life in older age. This study aims to quantify the protein intake in those over 90 years of age and determine the association between historical protein intake (2011) and subsequent physical function at ten years follow-up (2021). Eighty-one participants (23 Māori and 54 non-Māori) undertook dietary assessment 24 h multiple-pass recall (MPR) and a standardised health and social questionnaire with physical assessment in 2011 and 2021. Intake24, a virtual 24 h MPR, was utilised to analyse dietary intake. Functional status was measured using the Nottingham Extended Activities of Daily Living Scale (NEADL), and physical performance was the Short Physical Performance Battery (SPPB). Māori men and women consumed less protein (g/day) in 2021 than in 2011 (P = 0.043 in men), but weight-adjusted protein intake in Māori participants over the ten years was not significantly reduced. Both non-Māori men and women consumed significantly less protein (g/day) between 2011 and 2021 (p = 0.006 and p = 0.001, respectively), which was also significant when protein intake was adjusted for weight in non-Māori women (p = 0.01). Weight-adjusted protein intake in 2011 was independently associated with functional status (NEADL score) in 2021 (p =< 0.001). There was no association between past protein intake and SPPB score (p = 0.993). Animal protein was replaced with plant-based protein over time. In conclusion, a reduction in protein intake was seen in all participants. The independent association between past protein intake and future functional status supports recommendations to keep protein intake high in advanced age.
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Affiliation(s)
- Maia Lingman
- Te Whatu Ora, Waitematā, Auckland 0622, New Zealand
| | - Ngaire Kerse
- School of Population Health, The University of Auckland, Auckland 1023, New Zealand
| | - Marama Muru-Lanning
- James Henare Māori Research Centre, The University of Auckland, Auckland 1023, New Zealand
| | - Ruth Teh
- School of Population Health, The University of Auckland, Auckland 1023, New Zealand
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Sobotka O, Ticha M, Kubickova M, Adamek P, Polakova L, Mezera V, Sobotka L. Should Carbohydrate Intake Be More Liberal during Oral and Enteral Nutrition in Type 2 Diabetic Patients? Nutrients 2023; 15:nu15020439. [PMID: 36678311 PMCID: PMC9863670 DOI: 10.3390/nu15020439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/05/2023] [Accepted: 01/11/2023] [Indexed: 01/19/2023] Open
Abstract
Carbohydrate (CHO) intake in oral and enteral nutrition is regularly reduced in nutritional support of older patients due to the high prevalence of diabetes (usually type 2-T2DM) in this age group. However, CHO shortage can lead to the lack of building blocks necessary for tissue regeneration and other anabolic processes. Moreover, low CHO intake decreases CHO oxidation and can increase insulin resistance. The aim of our current study was to determine the extent to which an increased intake of a rapidly digestible carbohydrate-maltodextrin-affects blood glucose levels monitored continuously for one week in patients with and without T2DM. Twenty-one patients (14 T2DM and seven without diabetes) were studied for two weeks. During the first week, patients with T2DM received standard diabetic nutrition (250 g CHO per day) and patients without diabetes received a standard diet (350 g of CHO per day). During the second week, the daily CHO intake was increased to 400 in T2DM and 500 g in nondiabetic patients by addition of 150 g maltodextrin divided into three equal doses of 50 g and given immediately after the main meal. Plasma glucose level was monitored continually with the help of a subcutaneous sensor during both weeks. The increased CHO intake led to transient postprandial increase of glucose levels in T2DM patients. This rise was more manifest during the first three days of CHO intake, and then the postprandial peak hyperglycemia was blunted. During the night's fasting period, the glucose levels were not influenced by maltodextrin. Supplementation of additional CHO did not influence the percentual range of high glucose level and decreased a risk of hypoglycaemia. No change in T2DM treatment was indicated. The results confirm our assumption that increased CHO intake as an alternative to CHO restriction in type 2 diabetic patients during oral and enteral nutritional support is safe.
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Affiliation(s)
- Ondrej Sobotka
- 3rd Department of Medicine, Metabolic Care and Gerontology, Medical Faculty, Charles University, 50005 Hradec Kralove, Czech Republic
| | - Marie Ticha
- 3rd Department of Medicine, Metabolic Care and Gerontology, Medical Faculty, Charles University, 50005 Hradec Kralove, Czech Republic
| | - Marketa Kubickova
- 3rd Department of Medicine, Metabolic Care and Gerontology, Medical Faculty, Charles University, 50005 Hradec Kralove, Czech Republic
| | - Petr Adamek
- Levit’s Aftercare Centre, 50801 Horice, Czech Republic
| | | | - Vojtech Mezera
- 3rd Department of Medicine, Metabolic Care and Gerontology, Medical Faculty, Charles University, 50005 Hradec Kralove, Czech Republic
- Geriatric Center, Pardubice Hospital, 53203 Pardubice, Czech Republic
| | - Lubos Sobotka
- 3rd Department of Medicine, Metabolic Care and Gerontology, Medical Faculty, Charles University, 50005 Hradec Kralove, Czech Republic
- Correspondence:
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Adamson A, Davies K, Wham C, Kepa M, Foster E, Jones A, Mathers J, Granic A, Teh R, Moyes S, Hayman K, Siervo M, Maxted E, Redwood K, Collerton J, Jagger C, Kirkwood T, Dyall L, Kerse N. Assessment of Dietary Intake in Three Cohorts of Advanced Age in Two Countries: Methodology Challenges. J Nutr Health Aging 2023; 27:59-66. [PMID: 36651487 DOI: 10.1007/s12603-023-1878-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Dietary intake information is key to understanding nutrition-related outcomes. Intake changes with age and some older people are at increased risk of malnutrition. Application, difficulties, and advantages of the 24-hour multiple pass recall (24hr-MPR) dietary assessment method in three cohorts of advanced age in the United Kingdom (UK) and New Zealand (NZ) is described. PARTICIPANTS The Newcastle 85+ study (UK) recruited a single year birth cohort of people aged 85 years during 2006-7. LiLACS NZ recruited a 10-year birth cohort of Māori (indigenous New Zealanders) aged 80-90 years and a single year birth cohort of non-Māori aged 85 years in 2010. MEASUREMENTS Two 24hr-MPR were conducted on non-consecutive days by trained assessors. Pictorial resources and language were adapted for the New Zealand and Māori contexts. Detailed methods are described. RESULTS In the Newcastle 85+ study, 805 (93%) participants consented to the 24-MPR, 95% of whom completed two 24hr-MPR; in LiLACS NZ, 218 (82%) consented and 203 (76%) Māori and 353 (90%) non-Māori completed two 24hr-MPR. Mean time to complete each 24hr-MPR was 22 minutes in the Newcastle 85+ study, and 45 minutes for Māori and 39 minutes for non-Māori in LiLACS NZ. Dietary assessment of participants residing in residential care and those requiring proxy respondents were successfully included in both studies. Most participants (83-94%) felt that data captured by the 24hr-MPR reflected their usual dietary intake. CONCLUSIONS Dietary assessment using 24hr-MPR was successful in capturing detailed dietary data including information on portion size and time of eating for over 1300 octogenarians in the UK and New Zealand (Māori and non- Māori). The 24hr-MPR is an acceptable method of dietary assessment in this age group.
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Affiliation(s)
- A Adamson
- Professor Ngaire Kerse, Department of General Practice and Primary Health Care, University of Auckland, New Zealand,
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Puglisi MJ, Fernandez ML. The Health Benefits of Egg Protein. Nutrients 2022; 14:nu14142904. [PMID: 35889862 PMCID: PMC9316657 DOI: 10.3390/nu14142904] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 12/31/2022] Open
Abstract
Once the general public accepts that dietary cholesterol is not a concern for cardiovascular disease risk, foods that have been labeled as high-cholesterol sources, including eggs, may be appreciated for their various other dietary components. One of the nutrients in eggs that deserves further discussion is egg protein. Egg protein has been recognized to be highly digestible and an excellent source of essential amino acids, with the highest attainable protein digestibility-corrected amino acid score. Egg protein has been shown to decrease malnutrition in underdeveloped countries, possibly increase height in children, and protect against kwashiorkor. Egg protein has been demonstrated to be important to skeletal muscle health and protective against sarcopenia. Egg protein also can decrease appetite, resulting in a reduction in the caloric intake from the next meal and weight reduction. Other protective effects of egg protein addressed in this review include protection against infection as well as hypotensive and anti-cancer effects.
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Mendonça NMP, Hengeveld LM, Presse N, Canhão H, Simonsick E, Kritchevsky SB, Farsijani S, Gaudreau P, Jagger C, Visser M. Protein intake, physical activity and grip strength in European and North American community-dwelling older adults: a pooled analysis of individual participant data from four longitudinal ageing cohorts. Br J Nutr 2022; 129:1-26. [PMID: 35791789 PMCID: PMC9816353 DOI: 10.1017/s0007114522002033] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 05/19/2022] [Accepted: 06/27/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Higher dietary protein, alone or in combination with physical activity (PA), may slow the loss of age-related muscle strength in older adults. We investigated the longitudinal relationship between protein intake and grip strength, and the interaction between protein intake and PA, using four longitudinal ageing cohorts. METHODS Individual participant data from 5584 older adults (52% women; median: 75, IQR: 71.6, 79.0 years) with up to 8.5 years (mean: 4.9, SD: 2.3 years) of follow-up from the Health ABC, NuAge, LASA and Newcastle 85+ cohorts were pooled. Baseline protein intake was assessed with food frequency questionnaires and 24h recalls and categorized into <0.8, 0.8-<1.0, 1.0-<1.2 and ≥1.2 g/kg adjusted body weight (aBW)/d. The prospective association between protein intake, its interaction with PA, and grip strength (sex- and cohort-specific) was determined using joint models (hierarchical linear mixed effects and a link function for Cox proportional hazards models). RESULTS Grip strength declined on average by 0.018 SD (95%CI: -0.026, -0.006) every year. No associations were found between protein intake, measured at baseline, and grip strength, measured prospectively, or rate of decline of grip strength in models adjusted for sociodemographic, anthropometric, lifestyle and health variables (e.g., protein intake ≥1.2 vs <0.8 g/kg aBW/d: β= -0.003, 95%CI: -0.014,0.005 SD per year). There also was no evidence of an interaction between protein intake and PA. CONCLUSIONS We failed to find evidence in this study to support the hypothesis that higher protein intake, alone or in combination with higher PA, slowed the rate of grip strength decline in older adults.
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Affiliation(s)
- Nuno M. P. Mendonça
- EpiDoC Unit, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre (CHRC), Lisbon, Portugal
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Linda M. Hengeveld
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Health Council of the Netherlands, The Hague, the Netherlands
| | - Nancy Presse
- Research Centre on Aging, CIUSSS de l’Estrie-CHUS, Sherbrooke, QC, Canada
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Helena Canhão
- EpiDoC Unit, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre (CHRC), Lisbon, Portugal
| | - Eleanor Simonsick
- National Institute on Aging Intramural Research Program, Baltimore, MD, USA
| | | | - Samaneh Farsijani
- Center for Aging and Population Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Pierrette Gaudreau
- Department of Medicine, University of Montréal and Research Centre of the University of Montréal Hospital Centre, Montréal, QC, Canada
| | - Carol Jagger
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Yan LL, Li C, Zou S, Li Y, Gong E, He Z, Shao S, Jin X, Hua Y, Gallis JA, Turner EL. Healthy eating and all-cause mortality among Chinese aged 80 years or older. Int J Behav Nutr Phys Act 2022; 19:60. [PMID: 35619133 PMCID: PMC9137098 DOI: 10.1186/s12966-022-01280-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 03/21/2022] [Indexed: 11/28/2022] Open
Abstract
Background There is little evidence of the influence of dietary patterns on mortality risk among adults 80 years or older (“oldest-old”). We evaluated the association between the Simplified Healthy Eating index (SHE-index) and mortality among Chinese oldest-old. Methods Population-based cohort study from the Chinese Longitudinal Healthy Longevity Survey (CLHLS 1998–2014, n = 35 927), conducted in 22 Chinese provinces, were pooled for analysis. The first seven waves of the CLHLS (1998, 2000, 2002, 2005, 2008–09, 2011–12, and 2013–2014) were utilized, with follow-up to the last wave (2018) (range 0–21 years). The SHE-index was collected in each wave, and was constructed from intake frequency of nine dietary variables, with a higher score indicating better diet quality. Cox proportional hazards model with dietary patterns as a time-varying exposure was employed to analyze the relationship between SHE-index and mortality. Results At baseline, the median age of all participants was 92 years (25th percentile, 85 years; 75th percentile, 100 years). In multivariable models, the hazard ratios (95% confidence intervals) for SHE-index quartile 2, quartile 3 and quartile 4 versus quartile1 were 0.91 (0.88, 0.93), 0.89 (0.86, 0.92) and 0.82 (0.78, 0.85), respectively. Results were generally consistent for men and women and in a large number of sensitivity analyses. Conclusions Healthier eating patterns were associated with a significant reduction in the risk of all-cause mortality among Chinese oldest-old, lending support to the importance of life-long adherence to healthy diet into advanced old age. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01280-6.
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Affiliation(s)
- Lijing L Yan
- Global Heath Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, Jiangsu Province, 215316, China. .,School of Public Health, Wuhan University, Wuhan, Hubei Province, 430072, China. .,The George Institute for Global Health, Chaoyang District, Beijing, 100600, China. .,Ningbo Eye Hospital (affiliated with Wenzhou Medical University), Yinzhou District, 315040, Ningbo, China.
| | - Chaoyun Li
- Global Heath Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, Jiangsu Province, 215316, China
| | - Siyu Zou
- School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yaxi Li
- Global Heath Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, Jiangsu Province, 215316, China.,Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 3210 Humin Rd, Shanghai, 201108, China
| | - Enying Gong
- Global Heath Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, Jiangsu Province, 215316, China.,Department of Population Medicine and Public Health, Peking Union Medical College, Beijing, China
| | - Zhengting He
- Global Heath Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, Jiangsu Province, 215316, China.,Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, 21205, USA
| | - Shuai Shao
- Nossal Institute for Global Health, University of Melbourne, Melbourne, VIC, 3004, Australia
| | - Xurui Jin
- MindRank AI Ltd, Hangzhou, Zhejiang, 311113, China
| | - Yechu Hua
- Department of Public Health Sciences, University of Rochester, Rochester, NY, 14623, USA
| | - John A Gallis
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA.,Department of Biostatistics and Bioinformatics, Duke University, Hock Plaza, 2424 Erwin Road, Durham, NC, 27710, USA
| | - Elizabeth L Turner
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA.,Department of Biostatistics and Bioinformatics, Duke University, Hock Plaza, 2424 Erwin Road, Durham, NC, 27710, USA
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Domić J, Grootswagers P, van Loon LJC, de Groot LCPGM. Perspective: Vegan Diets for Older Adults? A Perspective On the Potential Impact On Muscle Mass and Strength. Adv Nutr 2022; 13:712-725. [PMID: 35108354 PMCID: PMC9156387 DOI: 10.1093/advances/nmac009] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/17/2021] [Accepted: 01/31/2022] [Indexed: 12/22/2022] Open
Abstract
Consumers are increasingly encouraged to consume more plant-based foods and lower their consumption of foods from animal origin. Concurrently, older adults are recommended to consume an adequate amount of high-quality dietary protein for the prevention of age-related muscle loss. In the current Perspective article, we discuss why it may not be preferred to consume a vegan diet at an older age. Our perspective is based on the proposed lower bioavailability and functionality of proteins in a vegan diet due to the matrix of the whole-food protein sources, the lower essential amino acid (EAA) content, and specific EAA deficiencies in proteins derived from plant-based foods. We propose that a vegan diet increases the risk of an inadequate protein intake at an older age and that current strategies to improve the anabolic properties of plant-based foods are not feasible for many older adults. We provide recommendations for further research to substantiate the remaining knowledge gaps regarding the consequences of a vegan diet on skeletal muscle mass and strength at an older age.
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Affiliation(s)
| | - Pol Grootswagers
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Luc J C van Loon
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands,Institute of Sports and Exercise Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
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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 2021; 13:nu13082574. [PMID: 34444732 PMCID: PMC8398631 DOI: 10.3390/nu13082574] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 01/04/2023] Open
Abstract
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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Wham C, Moyes SA, Rolleston A, Adamson A, Kerse N, Teh R. Association between dietary protein intake and change in grip strength over time among adults of advanced age: Life and Living in Advanced Age: A Cohort Study in New Zealand (LiLACS NZ). Australas J Ageing 2021; 40:430-437. [PMID: 34124824 DOI: 10.1111/ajag.12968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To determine the association between dietary protein intake and change in grip strength (GS) over time among Māori and non-Māori of advanced age. METHODS Protein intake was estimated from 2×24h multiple pass recall (MPR) in 554 participants, and GS was measured yearly over five years. Anthropometric, physical activity and health data were collected. RESULTS The median weight-adjusted protein intake was low (for Māori and non-Māori men 1.05 and 0.98g/kg/day; for Māori and non-Māori women 0.87 and 0.91g/kg/day, respectively). There was a general decrease in GS over five years (mean % change of -2.38 ± 15.32 and -4.49 ± 21.92 for Māori and non-Māori women and -5.47 ± 16.09 and -1.81 ± 13.16 for Māori and non-Māori men yearly). Intake of protein was not related to GS at any of the five-year assessment points nor was it related to change over time. CONCLUSION Protein intake was low in this cohort of octogenarians and was not protective against loss of GS over five years.
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Affiliation(s)
- Carol Wham
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Simon A Moyes
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Anna Rolleston
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Ashley Adamson
- Institute of Health and Society and Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK
| | - Ngaire Kerse
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Ruth Teh
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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11
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Zhao F, He L, Zhao L, Guo Q, Yu D, Ju L, Fang H. The Status of Dietary Energy and Nutrients Intakes among Chinese Elderly Aged 80 and Above: Data from the CACDNS 2015. Nutrients 2021; 13:1622. [PMID: 34066082 PMCID: PMC8150709 DOI: 10.3390/nu13051622] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/01/2021] [Accepted: 05/10/2021] [Indexed: 11/16/2022] Open
Abstract
This study analyzed the status of dietary energy and nutrients intakes among the oldest-old in China. Data was obtained from the China Adult Chronic Disease and Nutrition Surveillance in 2015 (CACDNS 2015). We enrolled 1929 Chinese elderly people aged 80 and above who participated in both 3-day 24-h dietary recalls and household condiments weighing. The dietary intakes were calculated based on Chinese Food Composition Tables and assessed using Chinese Dietary Reference Intakes (DRIs). The dietary intakes of energy and most nutrients were all below the EAR or AI, except for fat, vitamin E, niacin, iron and sodium. As a result, daily dietary intakes of energy and most nutrients were inadequate in the oldest-old in China, especially vitamin A, vitamin B1, vitamin B2, folate and calcium, with the prevalence of deficiency more than 90%. Furthermore, the prevalence of inadequacy of vitamin C, zinc, selenium and magnesium was also high with the proportion below the EAR more than 60%. Approximately 30% of the subjects with dietary vitamin E intake did not reach AI, and more than 90% of subjects have reached AI in the intake of sodium, while more than 90% did not reach AI in potassium. The mean intakes of niacin and iron have reached EAR, but around 15% were still faced with the risk of deficiency. In addition, although the dietary energy intake was below EER, the energy contribution from fat in total population and all subgroups (region, age, gender, education level, material status, household income level groups) all exceeded the recommended proportion of 30% from the DRIs and close to or over 35%, is a significant concern. For the majority of nutrients, higher daily dietary intakes and lower prevalence of deficiencies were found in the oldest-old living in urban areas, aged 80-84 years, with high school and above education level, living with spouse and from high household income family. These findings indicates that the dietary intakes of energy and nutrients were inadequate, while the energy contribution from fat and dietary sodium intake were too high among the oldest-old in China. Most oldest-old were at high risk of nutritional deficiency, particularly for those who living in rural areas, with lower education level and from low household income.
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Affiliation(s)
| | | | | | | | | | | | - Hongyun Fang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China; (F.Z.); (L.H.); (L.Z.); (Q.G.); (D.Y.); (L.J.)
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12
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Mendonça N, Hengeveld LM, Visser M, Presse N, Canhão H, Simonsick EM, Kritchevsky SB, Newman AB, Gaudreau P, Jagger C. Low protein intake, physical activity, and physical function in European and North American community-dwelling older adults: a pooled analysis of four longitudinal aging cohorts. Am J Clin Nutr 2021; 114:29-41. [PMID: 33829238 PMCID: PMC8246618 DOI: 10.1093/ajcn/nqab051] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 02/09/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Dietary protein may slow the decline in muscle mass and function with aging, making it a sensible candidate to prevent or modulate disability progression. At present, studies providing reliable estimates of the association between protein intake and physical function, and its interaction with physical activity (PA), in community-dwelling older adults are lacking. OBJECTIVES We investigated the longitudinal relation between protein intake and physical function, and the interaction with PA. METHODS We undertook a pooled analysis of individual participant data from cohorts in the PROMISS (PRevention Of Malnutrition In Senior Subjects in the European Union) consortium (the Health Aging and Body Composition Study, Quebec Longitudinal Study on Nutrition and Successful Aging, Longitudinal Aging Study Amsterdam, and Newcastle 85+) in which 5725 community-dwelling older adults were followed up to 8.5 y. The relation between protein intake and walking speed was determined using joint models (linear mixed-effects and Cox proportional hazards models) and the relation with mobility limitation was investigated using multistate models. RESULTS Higher protein intake was modestly protective of decline in walking speed in a dose-dependent manner [e.g., protein intake ≥1.2 compared with 0.8 g/kg adjusted body weight (aBW)/d: β = 0.024, 95% CI: 0.009, 0.032 SD/y], with no clear indication of interaction with PA. Participants with protein intake ≥0.8 g/kg aBW/d had also a lower likelihood of incident mobility limitation, which was observed for each level of PA. This association seemed to be dose-dependent for difficulty walking but not for difficulty climbing stairs. No associations between protein intake and other mobility limitations transitions were observed. CONCLUSIONS Higher daily protein intake can reduce physical function decline not only in older adults with protein intake below the current RDA of 0.8 g/kg BW/d, but also in those with a protein intake that is already considered sufficient. This dose-dependent association was observed for each level of PA, suggesting no clear synergistic association between protein intake and PA in relation to physical function.
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Affiliation(s)
| | - Linda M Hengeveld
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Nancy Presse
- Research Centre on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, Quebec, Canada,Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada,Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, Quebec, Canada
| | - Helena Canhão
- EpiDoC Unit, CEDOC, NOVA Medical School, Universidade Nova de Lisboa (UNL), Lisbon, Portugal,Comprehensive Health Research Centre (CHRC), NOVA Medical School, Lisbon, Portugal
| | | | | | - Anne B Newman
- Center for Aging and Population Health, Department of Epidemiology, University of Pittsburgh, PA, USA
| | - Pierrette Gaudreau
- Department of Medicine, University of Montréal, H3T 1J4, Montréal, Quebec, Canada,Research Centre of the Centre hospitalier de l'Université de Montréal (CHUM), H2X 0A9, Montréal, Quebec, Canada
| | - Carol Jagger
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, United Kingdom
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Kehoe L, Walton J, McNulty BA, Nugent AP, Flynn A. Energy, Macronutrients, Dietary Fibre and Salt Intakes in Older Adults in Ireland: Key Sources and Compliance with Recommendations. Nutrients 2021; 13:nu13030876. [PMID: 33800312 PMCID: PMC8001736 DOI: 10.3390/nu13030876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/03/2021] [Accepted: 02/22/2021] [Indexed: 12/15/2022] Open
Abstract
The global population is rapidly ageing. Adequate nutritional status can play a key role in preventing or delaying the progression of age-related diseases. The aim of this study was to estimate the usual intake of energy, macronutrients, dietary fibre and salt in order to determine compliance with recommendations and to identify the sources of these nutrients in older adults (≥65 years) in Ireland. This study is based on data from the cohort of older adults aged ≥65 years (n = 226) in the Irish National Adult Nutrition Survey (NANS) (2008-2010) which estimated food and nutrient intakes in a representative sample of adults 18-90 years using a 4 day weighed food record. This study found that while intakes of macronutrients are generally sufficient in this population group, older adults in Ireland have high intakes of total fat, saturated fat, sugar and salt and low intakes of dietary fibre. Future strategies to address the nutritional issues identified in older adults could include the promotion of healthy food choices together with improvements of the food supply including reformulation (fat, sugar and salt) to support successful ageing of our population.
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Affiliation(s)
- Laura Kehoe
- School of Food & Nutritional Sciences, University College Cork, T12 K8AF Cork, Ireland; (J.W.); (A.F.)
- Correspondence: ; Tel.: +353-(0)21-490-3387
| | - Janette Walton
- School of Food & Nutritional Sciences, University College Cork, T12 K8AF Cork, Ireland; (J.W.); (A.F.)
- Department of Biological Sciences, Munster Technological University, T12 P928 Cork, Ireland
| | - Breige A. McNulty
- UCD Institute of Food & Health, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland; (B.A.M.); (A.P.N.)
| | - Anne P. Nugent
- UCD Institute of Food & Health, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland; (B.A.M.); (A.P.N.)
- Institute for Global Food Security, Queens University Belfast, Belfast BT7 1NN, UK
| | - Albert Flynn
- School of Food & Nutritional Sciences, University College Cork, T12 K8AF Cork, Ireland; (J.W.); (A.F.)
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14
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Hengeveld LM, Boer JMA, Gaudreau P, Heymans MW, Jagger C, Mendonça N, Ocké MC, Presse N, Sette S, Simonsick EM, Tapanainen H, Turrini A, Virtanen SM, Wijnhoven HAH, Visser M. Prevalence of protein intake below recommended in community-dwelling older adults: a meta-analysis across cohorts from the PROMISS consortium. J Cachexia Sarcopenia Muscle 2020; 11:1212-1222. [PMID: 32548960 PMCID: PMC7567142 DOI: 10.1002/jcsm.12580] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 03/22/2020] [Accepted: 04/07/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Lower protein intake in older adults is associated with loss of muscle mass and strength. The present study aimed to provide a pooled estimate of the overall prevalence of protein intake below recommended (according to different cut-off values) among community-dwelling older adults, both within the general older population and within specific subgroups. METHODS As part of the PRevention Of Malnutrition In Senior Subjects in the EU (PROMISS) project, a meta-analysis was performed using data from four cohorts (from the Netherlands, UK, Canada, and USA) and four national surveys [from the Netherlands, Finland (two), and Italy]. Within those studies, data on protein and energy intake of community-dwelling men and women aged ≥55 years were obtained by either a food frequency questionnaire, 24 h recalls administered on 2 or 3 days, or food diaries administered on 3 days. Protein intake below recommended was based on the recommended dietary allowance of 0.8 g/kg body weight (BW)/d, by using adjusted BW (aBW) instead of actual BW. Cut-off values of 1.0 and 1.2 were applied in additional analyses. Prevalences were also examined for subgroups according to sex, age, body mass index (BMI), education level, appetite, living status, and recent weight loss. RESULTS The study sample comprised 8107 older persons. Mean ± standard deviation protein intake ranged from 64.3 ± 22.3 (UK) to 80.6 ± 23.7 g/d [the Netherlands (cohort)] or from 0.94 ± 0.38 (USA) to 1.17z ± 0.30 g/kg aBW/d (Italy) when related to BW. The overall pooled prevalence of protein intake below recommended was 21.5% (95% confidence interval: 14.0-30.1), 46.7% (38.3-55.3), and 70.8% (65.1-76.3) using the 0.8, 1.0, and 1.2 cut-off value, respectively. A higher prevalence was observed among women, individuals with higher BMI, and individuals with poor appetite. The prevalence differed only marginally by age, education level, living status, and recent weight loss. CONCLUSIONS In community-dwelling older adults, the prevalence of protein intake below the current recommendation of 0.8 g/kg aBW/d is substantial (14-30%) and increases to 65-76% according to a cut-off value of 1.2 g/kg aBW/d. To what extent the protein intakes are below the requirements of these older people warrants further investigation.
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Affiliation(s)
- Linda M Hengeveld
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Jolanda M A Boer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Pierrette Gaudreau
- Department of Medicine, University of Montreal, Montreal, Quebec, Canada.,Research Centre, Hospital of the University of Montreal, Montreal, Quebec, Canada
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU Medical Center, Amsterdam, The Netherlands
| | - Carol Jagger
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Nuno Mendonça
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.,Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK.,EpiDoC Unit, CHRC, NOVA Medical School, Universidade Nova de Lisboa (NMS-UNL), Lisbon, Portugal
| | - Marga C Ocké
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Nancy Presse
- Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Sherbrooke, Quebec, Canada.,Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Stefania Sette
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Heli Tapanainen
- Unit of Health Promotion, Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Aida Turrini
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Suvi M Virtanen
- Unit of Health Promotion, Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland.,Faculty of Social Sciences, Tampere University, Tampere, Finland.,Centre for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.,Science Centre, Pirkanmaa Hospital District, Tampere, Finland
| | - Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit, Amsterdam, The Netherlands
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15
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Asamane EA, Greig CA, Thompson JL. The association between nutrient intake, nutritional status and physical function of community-dwelling ethnically diverse older adults. BMC Nutr 2020; 6:36. [PMID: 32864152 PMCID: PMC7447572 DOI: 10.1186/s40795-020-00363-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 07/20/2020] [Indexed: 01/06/2023] Open
Abstract
Background There are limited longitudinal data regarding nutrient intake, nutritional status and physical function in community-dwelling ethnically diverse older adults. This study explored these variables and their relationship at baseline (n = 100) and 8-months' follow-up (n = 81) among community-dwelling ethnically diverse older adults (≥60 years) in Birmingham, United Kingdom. Methods Multiple-pass 24-h dietary recalls and the Mini Nutritional Assessment-Short Form assessed nutritional intake and status, respectively. Short Physical Performance Battery (SPPB) and handgrip strength measured physical function. Linear and multinomial regressions were used to predict relationships between physical function, nutritional status and nutrient intake. Results Complete data were collected at baseline (n = 100) and 8-months' follow-up (n = 81). Mean (SD) age was 70 (8.1) years (60% male), with 62% being obese. Statistically significant decreases in intakes of vitamin B6, vitamin B1, iron, folate, and magnesium occurred over time. Daily intake of all micronutrients except vitamin B12, phosphorus and manganese were below the Recommended Nutrient Intakes (RNI). SPPB (Z = -4.01, p < 0.001) and nutritional status (Z = -2.37, p = 0.018) declined over time. Higher SPPB scores at baseline (OR = 0.54 95% CI 0.35, 0.81) were associated with a slower decline in nutritional status. Conclusion The observed declines and inadequate nutrient intakes in the absence of weight loss in just 8 months may pose serious challenges to healthy ageing, identifying an urgent need to re-evaluate and tailor appropriate dietary advice for this population. Additionally, the associations of nutrition and physical function observed in this study serves as an essential resource to design and implement community/faith-based interventions targeting early screening of nutritional status and physical function to ensure most older adults are assessed and treated accordingly.
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Affiliation(s)
- Evans A Asamane
- School of Sports, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK.,School Primary, Community and Social Care, Keele University, Keele, UK
| | - Carolyn A Greig
- School of Sports, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK.,MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK
| | - Janice L Thompson
- School of Sports, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
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16
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Mendonça N, Kingston A, Granic A, Hill TR, Mathers JC, Jagger C. 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. Eur J Nutr 2020; 59:1909-1918. [PMID: 31292749 PMCID: PMC7351810 DOI: 10.1007/s00394-019-02041-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 06/30/2019] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Growth in the number of very old (≥ 85 years) adults will likely lead to increased prevalence of disability. Our aim was to determine the contribution of protein intake, and the interaction between protein intake and physical activity (PA), to the transition between disability states and to death in the very old using the Newcastle 85+ Study. METHODS The analytic sample comprised of 717 older adults aged 85 years at baseline and living in the community. Protein intake was estimated with 2 × 24-h multiple pass recalls (24 h-MPR) at baseline. Disability was measured as difficulty performing 17 activities of daily living (ADL) at baseline, at 18, 36, and 60 months, and defined as having difficulties in one or more ADL. The contribution of protein intake [g/kg adjusted body weight/day (g/kg aBW/d)] to transition probabilities to and from disability, and to death over 5 years was examined by multi-state models adjusted for key health covariates. RESULTS Participants were expected to spend 0.8 years (95% CI 0.6-1.0) disability-free and 2.8 years (95% CI 2.6-2.9) with disability between the ages 85 and 90 years. One unit increase in protein intake (g/kg aBW/d) halved the likelihood of incident disability (HR 0.44, 95% CI 0.24-0.83) but not for other transitions. Similar reductions in disability incidence were also found in individuals with protein intake ≥ 0.8 (HR 0.50, 95% CI 0.31-0.80) and ≥ 1 g/kg aBW/d (HR 0.49, 95% CI 0.33-0.73). Participants with high PA and protein intake ≥ 1 g/kg aBW/d were less likely to transition from disability-free to disability than those within the same PA level but with protein intake < 1 g/kg aBW/d (HR 0.45, 95% CI 0.28-0.72). CONCLUSION Higher protein intake, especially in combination with higher physical activity, may delay the incidence of disability in very old adults.
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Affiliation(s)
- Nuno Mendonça
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK.
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK.
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK.
| | - Andrew Kingston
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Antoneta Granic
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- NIHR Newcastle Biomedical Research Centre in Ageing and Chronic Disease, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, NE4 5PL, UK
| | - Tom R Hill
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - John C Mathers
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Carol Jagger
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
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Perri G, Mendonça N, Jagger C, Walsh J, Eastell R, Mathers JC, Hill TR. Dietary Selenium Intakes and Musculoskeletal Function in Very Old Adults: Analysis of the Newcastle 85+ Study. Nutrients 2020; 12:E2068. [PMID: 32664662 PMCID: PMC7400825 DOI: 10.3390/nu12072068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 12/30/2022] Open
Abstract
Background: Selenium is a trace element essential for health. Severe selenium deficiencies are associated with poor musculoskeletal (MSK) function. However, the effects of moderate deficiency on MSK function, especially in older adults, is unclear. Objectives: To determine the associations between selenium intake and MSK function in very old adults. Methods: Selenium intake at baseline and, hand-grip strength (HGS) and timed-up-and-go (TUG) at four phases over 5 years, were available in 791 participants in the Newcastle 85+ Study, a community-based, longitudinal cohort of ≥85 year old individuals. We investigated relationships between selenium intake and HGS and TUG in cross-sectional analyses at baseline using multivariate analyses and, prospectively using linear mixed models to explore HGS and TUG changes over 5 years in association with baseline selenium intake. Results: At baseline, 53% of participants had selenium intakes that were classified as low. These individuals had 2.80 kg lower HGS and were 2.30 s slower performing the TUG, cross-sectionally. In multivariate, baseline analyses, selenium intake had no significant impact on HGS or TUG. Selenium intake had no significant effect on MSK function, prospectively. Conclusion: Low selenium intake is common among very old adults and, in cross-sectional analyses, is associated with poorer MSK function.
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Affiliation(s)
- Giorgia Perri
- The MRC-Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Newcastle upon Tyne NE2 4HH, UK; (J.W.); (R.E.); (J.C.M.); (T.R.H.)
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, UK;
| | - Nuno Mendonça
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, UK;
- EpiDoC Unit, NOVA Medical School, Universidade Nova de Lisboa (NMS-UNL), 1150-082 Lisbon, Portugal
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, Universidade Nova de Lisboa, 1150-082 Lisbon, Portugal
| | - Carol Jagger
- Population Health Sciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK;
| | - Jennifer Walsh
- The MRC-Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Newcastle upon Tyne NE2 4HH, UK; (J.W.); (R.E.); (J.C.M.); (T.R.H.)
- Department of Oncology and Metabolism, University of Sheffield, Sheffield S5 7AU, UK
| | - Richard Eastell
- The MRC-Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Newcastle upon Tyne NE2 4HH, UK; (J.W.); (R.E.); (J.C.M.); (T.R.H.)
- Department of Oncology and Metabolism, University of Sheffield, Sheffield S5 7AU, UK
| | - John C. Mathers
- The MRC-Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Newcastle upon Tyne NE2 4HH, UK; (J.W.); (R.E.); (J.C.M.); (T.R.H.)
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, UK;
| | - Tom R. Hill
- The MRC-Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Newcastle upon Tyne NE2 4HH, UK; (J.W.); (R.E.); (J.C.M.); (T.R.H.)
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, UK;
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Meal patterns in relation to energy and protein intake in older adults in home health care. Clin Nutr ESPEN 2020; 35:180-187. [DOI: 10.1016/j.clnesp.2019.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 09/24/2019] [Accepted: 10/02/2019] [Indexed: 12/17/2022]
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Mendonça N, Kingston A, Granic A, Jagger C. Protein intake and transitions between frailty states and to death in very old adults: the Newcastle 85+ study. Age Ageing 2019; 49:32-38. [PMID: 31711099 PMCID: PMC6939283 DOI: 10.1093/ageing/afz142] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 01/24/2019] [Indexed: 11/14/2022] Open
Abstract
Objectives To examine the association of protein intake with frailty progression in very old adults. Design The Newcastle 85+ study, a prospective longitudinal study of people aged 85 years old in Northeast England and followed over 5 years. Setting and Participants 668 community-dwelling older adults (59% women) at baseline, with complete dietary assessment and Fried frailty status (FFS). Measures Dietary intake was estimated with 2 × 24-h multiple pass recalls at baseline. FFS was based on five criteria: shrinking, physical endurance/energy, low physical activity, weakness and slow walking speed and was available at baseline and 1.5, 3 and 5 years. The contribution of protein intake (g/kg adjusted body weight/day [g/kg aBW/d]) to transitions to and from FFS (robust, pre-frail and frail) and to death over 5 years was examined by multi-state models. Results Increase in one unit of protein intake (g/kg aBW/d) decreased the likelihood of transitioning from pre-frail to frail after adjusting for age, sex, education and multimorbidity (hazard ratios [HR]: 0.44, 95% confidence interval [CI]: 0.25–0.77) but not for the other transitions. Reductions in incident frailty were equally present in individuals with protein intake ≥0.8 (HR: 0.60, 95% CI: 0.43–0.84) and ≥1 g/kg aBW/d (HR: 0.63, 95% CI: 0.44–0.90) from 85 to 90 years. This relationship was attenuated after adjustment for energy intake, but the direction of the association remained the same (e.g. g/kg aBW/d model: HR: 0.71, 95% CI: 0.36–1.41). Conclusion High protein intake, partly mediated by energy intake, may delay incident frailty in very old adults. Frailty prevention strategies in this age group should consider adequate provision of protein and energy.
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Affiliation(s)
- Nuno Mendonça
- Institute for Ageing, Faculty of Medical Sciences, Newcastle University, NE2 4AX, UK
- EpiDoC Unit, CHRC, NOVA Medical School, Universidade Nova de Lisboa (NMS-UNL),1050 082, Portugal
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, NE4 5PL, UK
| | - Andrew Kingston
- Institute for Ageing, Faculty of Medical Sciences, Newcastle University, NE2 4AX, UK
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, NE4 5PL, UK
| | - Antoneta Granic
- AGE Research Group, Institute of Neuroscience, Faculty of Medical Sciences, Newcastle University, NE2 4HH, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle University, NE4 5PL, UK
| | - Carol Jagger
- Institute for Ageing, Faculty of Medical Sciences, Newcastle University, NE2 4AX, UK
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, NE4 5PL, UK
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Parsons TJ, Papachristou E, Atkins JL, Papacosta O, Ash S, Lennon LT, Whincup PH, Ramsay SE, Wannamethee SG. Physical frailty in older men: prospective associations with diet quality and patterns. Age Ageing 2019; 48:355-360. [PMID: 30668624 PMCID: PMC6503938 DOI: 10.1093/ageing/afy216] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 08/15/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND increasing numbers of older adults are living with frailty and its adverse consequences. We investigated relationships between diet quality or patterns and incident physical frailty in older British men and whether any associations were influenced by inflammation. METHODS prospective study of 945 men from the British Regional Heart Study aged 70-92 years with no prevalent frailty. Incident frailty was assessed by questionnaire after 3 years of follow-up. Frailty was defined as having at least three of: low grip strength, low physical activity, slow walking speed, unintentional weight loss and feeling of low energy, all based on self-report. The Healthy Diet Indicator (HDI) based on WHO dietary guidelines and the Elderly Dietary Index (EDI) based on a Mediterranean-style dietary intake were computed from questionnaire data and three dietary patterns were identified using principal components analysis: prudent, high fat/low fibre and high sugar. RESULTS men in the highest EDI category and those who followed a prudent diet were less likely to become frail [top vs bottom category odds ratio (OR) (95% CI) 0.49 (0.30, 0.82) and 0.53 (0.30, 0.92) respectively] after adjustment for potential confounders including BMI and prevalent cardiovascular disease. No significant association was seen for the HDI. By contrast those who had a high fat low fibre diet pattern were more likely to become frail [OR (95% CI) 2.54 (1.46, 4.40)]. These associations were not mediated by C-reactive protein (marker of inflammation). CONCLUSIONS the findings suggest adherence to a Mediterranean-style diet is associated with reduced risk of developing frailty in older people.
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Affiliation(s)
- Tessa J Parsons
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, UK
| | | | - Janice L Atkins
- Epidemiology and Public Health Group, Medical School, University of Exeter, RILD Building, Barrack Road, Exeter, UK
| | - Olia Papacosta
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, UK
| | - Sarah Ash
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, UK
| | - Lucy T Lennon
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, UK
| | - Peter H Whincup
- Population Health Research Institute, St George’s University of London, Cranmer Terrace, London, UK
| | - Sheena E Ramsay
- Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne, UK
| | - S Goya Wannamethee
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, UK,Address correspondence to: P S. Goya Wannamethee. Tel: +44 20 7830 2335; Fax: +44 20 7472 6871.
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21
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Hung Y, Wijnhoven HAH, Visser M, Verbeke W. Appetite and Protein Intake Strata of Older Adults in the European Union: Socio-Demographic and Health Characteristics, Diet-Related and Physical Activity Behaviours. Nutrients 2019; 11:nu11040777. [PMID: 30987278 PMCID: PMC6521269 DOI: 10.3390/nu11040777] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/24/2019] [Accepted: 03/28/2019] [Indexed: 12/25/2022] Open
Abstract
Considerable efforts have been directed towards stimulating healthy ageing regarding protein intake and malnutrition, yet large-scale consumer studies are scarce and fragmented. This study aims to profile older adults in the European Union (EU) according to appetite (poor/good) and protein intake (lower/higher) strata, and to identify dietary and physical activity behaviours. A survey with older (aged 65 years or above) adults (n = 1825) in five EU countries (Netherlands, United Kingdom, Finland, Spain and Poland) was conducted in June 2017. Four appetite and protein intake strata were identified based on simplified nutritional appetite questionnaire (SNAQ) scores (≤14 versus >14) and the probability of a protein intake below 1.0 g/kg adjusted BW/day (≥0.3 versus <0.3) based on the 14-item Pro55+ screener: "appi"-Poor appetite and lower level of protein intake (12.2%); "APpi"-Good appetite but lower level of protein intake (25.5%); "apPI"-Poor appetite but higher level of protein intake (14.8%); and "APPI"-Good appetite and higher level of protein intake (47.5%). The stratum of older adults with a poor appetite and lower level of protein intake (12.2%) is characterized by a larger share of people aged 70 years or above, living in the UK or Finland, having an education below tertiary level, who reported some or severe financial difficulties, having less knowledge about dietary protein and being fussier about food. This stratum also tends to have a higher risk of malnutrition in general, oral-health related problems, experience more difficulties in mobility and meal preparation, lower confidence in their ability to engage in physical activities in difficult situations, and a lower readiness to follow dietary advice. Two multivariate linear regression models were used to identify the behavioural determinants that might explain the probability of lower protein intake, stratified by appetite status. This study provides an overview and highlights the similarities and differences in the strata profiles. Recommendations for optimal dietary and physical activity strategies to prevent protein malnutrition were derived, discussed and tailored according to older adults' profiles.
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Affiliation(s)
- Yung Hung
- Department of Agricultural Economics, Ghent University, Coupure links 653, 9000 Ghent, Belgium.
| | - Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands.
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands.
| | - Wim Verbeke
- Department of Agricultural Economics, Ghent University, Coupure links 653, 9000 Ghent, Belgium.
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22
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Granic A, Mendonça N, Sayer AA, Hill TR, Davies K, Siervo M, Mathers JC, Jagger C. Effects of dietary patterns and low protein intake on sarcopenia risk in the very old: The Newcastle 85+ study. Clin Nutr 2019; 39:166-173. [PMID: 30709690 PMCID: PMC6961212 DOI: 10.1016/j.clnu.2019.01.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 12/10/2018] [Accepted: 01/10/2019] [Indexed: 02/06/2023]
Abstract
Background Sarcopenia, a progressive age-related loss of skeletal muscle mass and strength, leads to disability, falls, and hospitalisation. Individual variation in sarcopenia onset may be partly explained by lifestyle factors such as physical activity and diet. Healthy dietary patterns (DPs) have been linked to better physical functioning in older adults, but their role in sarcopenia in the very old (aged ≥85) is unknown. Aims To investigate the association between DPs and the risk of sarcopenia over 3 years, and to determine whether protein intake influences this relationship in community-dwelling older adults from the Newcastle 85 + Study. Methods The analytic sample consisted of 757 participants (61.2% women) who had dietary assessment at baseline. After two-step clustering with 30 food groups to derive DPs, we used logistic regression to determine the risk of prevalent and incident sarcopenia across DPs in all participants, and in those with low (<1 g/kg adjusted body weight/day [g/kg aBW/d]) and good protein intake (≥1 g/kg aBW/d). Results We identified three DPs (DP1: ‘Low Red Meat’, DP2: ‘Traditional British’ and DP3: ‘Low Butter’) that varied by unsaturated fat spreads/oils, butter, red meat, gravy and potato consumption. Compared with participants in DP3, those in DP2 had an increased risk of prevalent (OR = 2.42, 95% CI: 1.15–5.09, p = 0.02) but not 3-year incident sarcopenia (OR = 1.67, 0.59–4.67, p = 0.33) adjusted for socio-demographic, anthropometry, health and lifestyle factors. Furthermore, DP2 was associated with an increased risk of prevalent sarcopenia at baseline (OR = 2.14, 1.01–4.53, p = 0.05) and 3-year follow-up (OR = 5.45, 1.81–16.39, p = 0.003) after adjustment for key covariates in participants with good protein intake. Conclusion A DP high in foods characteristic of a traditional British diet (butter, red meat, gravy and potato) was associated with an increased risk of sarcopenia even when overall protein intake was good. The results need to be replicated in other cohorts of the very old to understand the role of DPs in sarcopenia onset and management.
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Affiliation(s)
- Antoneta Granic
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, United Kingdom; NIHR Newcastle Biomedical Research Centre, Newcastle Upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle Upon Tyne, United Kingdom; Newcastle University Institute for Ageing, Newcastle Upon Tyne, United Kingdom.
| | - Nuno Mendonça
- Newcastle University Institute for Ageing, Newcastle Upon Tyne, United Kingdom; Institute of Health & Society, Newcastle University, Newcastle Upon Tyne, United Kingdom; Human Nutrition Research Centre, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Avan A Sayer
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, United Kingdom; NIHR Newcastle Biomedical Research Centre, Newcastle Upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle Upon Tyne, United Kingdom; Newcastle University Institute for Ageing, Newcastle Upon Tyne, United Kingdom
| | - Tom R Hill
- Human Nutrition Research Centre, Newcastle University, Newcastle Upon Tyne, United Kingdom; Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Karen Davies
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, United Kingdom; NIHR Newcastle Biomedical Research Centre, Newcastle Upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle Upon Tyne, United Kingdom; Newcastle University Institute for Ageing, Newcastle Upon Tyne, United Kingdom
| | - Mario Siervo
- Newcastle University Institute for Ageing, Newcastle Upon Tyne, United Kingdom; Human Nutrition Research Centre, Newcastle University, Newcastle Upon Tyne, United Kingdom; Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - John C Mathers
- Newcastle University Institute for Ageing, Newcastle Upon Tyne, United Kingdom; Human Nutrition Research Centre, Newcastle University, Newcastle Upon Tyne, United Kingdom; Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Carol Jagger
- Newcastle University Institute for Ageing, Newcastle Upon Tyne, United Kingdom; Institute of Health & Society, Newcastle University, Newcastle Upon Tyne, United Kingdom
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23
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Mendonça N, Granic A, Mathers JC, Hill TR, Siervo M, Adamson AJ, Jagger C. Prevalence and determinants of low protein intake in very old adults: insights from the Newcastle 85+ Study. Eur J Nutr 2018; 57:2713-2722. [PMID: 28948346 PMCID: PMC6267410 DOI: 10.1007/s00394-017-1537-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 09/17/2017] [Indexed: 12/25/2022]
Abstract
PURPOSE The very old (aged ≥ 85 years), fastest growing age group in most western societies, are at especially high risk of muscle mass and strength loss. The amount, sources and timing of protein intake may play important roles in the aetiology and management of sarcopenia. This study investigated the prevalence and determinants of low protein intake in 722 very old adults participating in the Newcastle 85+ Study. METHODS Protein intake was estimated with 2 × 24-h multiple pass recalls (24 h-MPR) and contribution (%) of food groups to protein intake was calculated. Low protein intake was defined as intake < 0.8 g of protein per adjusted body weight per day. A backward stepwise multivariate linear regression model was used to explore socioeconomic, health and lifestyle predictors of protein intake. RESULTS Twenty-eight percent (n = 199) of the community-living very old in the Newcastle 85+ Study had low protein intake. Low protein intake was less likely when participants had a higher percent contribution of meat and meat products to total protein intake (OR 0.97, 95% CI 0.95, 1.00) but more likely with a higher percent contribution of cereal and cereal products and non-alcoholic beverages. Morning eating occasions contributed more to total protein intake in the low than in the adequate protein intake group (p < 0.001). Being a woman (p < 0.001), having higher energy intake (p < 0.001) and higher tooth count (p = 0.047) was associated with higher protein intake in adjusted models. CONCLUSION This study provides novel evidence on the prevalence of low protein intake, diurnal protein intake patterns and food group contributors to protein intake in the very old.
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Affiliation(s)
- Nuno Mendonça
- School of Agriculture Food and Rural Development, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK.
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK.
| | - Antoneta Granic
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- NIHR Newcastle Biomedical Research Centre in Ageing and Chronic Disease, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, NE4 5PL, UK
| | - John C Mathers
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Tom R Hill
- School of Agriculture Food and Rural Development, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Mario Siervo
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Ashley J Adamson
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Carol Jagger
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
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24
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Granic A, Mendonça N, Sayer AA, Hill TR, Davies K, Adamson A, Siervo M, Mathers JC, Jagger C. Low protein intake, muscle strength and physical performance in the very old: The Newcastle 85+ Study. Clin Nutr 2018; 37:2260-2270. [PMID: 29191494 PMCID: PMC6295979 DOI: 10.1016/j.clnu.2017.11.005] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 10/28/2017] [Accepted: 11/09/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND Low protein intake has been linked to reduced muscle strength and physical performance in older adults but little is known about how it may affect muscle health and subsequent functional decline in the very old (aged 85+), who are at enhanced risk of malnutrition and loss of muscle mass and strength. AIMS To investigate the associations between low protein intake, defined as the intake of <1 g protein/kg adjusted body weight/day (<1 g/kg aBW/d) and decline in muscle strength and physical performance in the very old. METHODS The analytic sample consisted of 722 community-dwelling participants (60% women) from the Newcastle 85+ Study who had protein intake at baseline. Participants were followed-up for change in grip strength (GS) and Timed Up-and-Go (TUG) test over 5 years (baseline, 18, 36, and 60 months). We used mixed models to determine the effects of low protein intake on muscle strength and physical performance in all participants, and also stratified by sex. RESULTS At baseline, 390 (54%) participants (261 women, p < 0.001) reported low protein intake, and these differed from participants with good intake (≥1 g/kg aBW/d) on several measures of health and function. In the model adjusted for protein intake, consuming <1 g/kg aBW/d of protein was associated with a 1.62 kg lower GS (p = 0.008) in all participants, and especially in women (β (SE) = -0.83 (0.41), p = 0.05) after adjusting for key baseline covariates (anthropometry, multimorbidity, arthritis in hands, cognitive status and physical activity). The rate of decline in GS over 5 years was not associated with protein intake. Women, but not men, with low protein intake had worse baseline TUG (β (SE) = 0.04 (0.02), p = 0.03) compared with those with good protein intake in the fully adjusted model, but the rate of decline in TUG was not affected by daily protein status. CONCLUSIONS Intake of <1 g protein/kg aBW/d may negatively affect muscle strength and physical performance in late life, especially in older women, independently of important covariates. More research is needed in the very old to define the optimal protein intake for maintenance of muscle health and function.
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Affiliation(s)
- Antoneta Granic
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom; NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne, United Kingdom; Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom.
| | - Nuno Mendonça
- Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom; Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom; School of Agriculture, Food and Rural Development, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Avan Aihie Sayer
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom; NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne, United Kingdom; Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom; Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Tom R Hill
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom; School of Agriculture, Food and Rural Development, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Karen Davies
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom; NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne, United Kingdom; Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom
| | - Ashley Adamson
- Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom; School of Agriculture, Food and Rural Development, Newcastle University, Newcastle upon Tyne, United Kingdom; Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Mario Siervo
- Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom; Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom; Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - John C Mathers
- Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom; Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom; Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Carol Jagger
- Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom; Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
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25
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Mendonça N, Granic A, Hill TR, Siervo M, Mathers JC, Kingston A, Jagger C. Protein Intake and Disability Trajectories in Very Old Adults: The Newcastle 85+ Study. J Am Geriatr Soc 2018; 67:50-56. [PMID: 30382594 PMCID: PMC6334273 DOI: 10.1111/jgs.15592] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/26/2018] [Accepted: 08/07/2018] [Indexed: 01/02/2023]
Abstract
Objectives To determine whether protein intake is associated with better disability trajectories in the oldest adults (≥85) and whether muscle mass and muscle strength would partially mediate this. Design Prospective cohort study. Setting Newcastle‐upon‐Tyne and North Tyneside, United Kingdom. Participants Community‐dwelling older adults aged 85 at baseline (N=722). Methods Protein intake was estimated using two 24‐hour multiple‐pass recalls at baseline. Disability was measured as difficulty performing 17 activities of daily living at baseline and 18, 36, and 60 months. Trajectories were derived using mortality‐adjusted group‐based trajectory modelling. The effect of protein intake (g/kg of adjusted body weight (aBW)/d) on disability trajectories was examined using multinomial logistic regression. Results Participants had 4 distinct disability trajectories (between the ages of 85 and 90: constant very low (AT1), mild (AT2), moderate (AT3), and severe (AT4). Each unit increase in protein (g) per kg of aBW/d was associated with greater odds of AT1 (odds ratio (OR=7.97, 95% confidence interval (CI)=1.96–32.43, p = .004) and AT2 (OR=3.28, 95% CI=1.09–9.87, p = .03) than of AT4 over 5 years in models adjusted for selected covariates. Participants with protein intake of 1.0 g/kg aBW/d or more were more likely to belong to AT1 (OR=3.65, 95% CI=1.59–8.38, p = .009) and AT2 (OR=2.12, 95% CI=1.16–3.90, p = .01) than to AT4. Conclusion Higher protein intake, especially 1.0 g/kg aBW/d or more, was associated with better disability trajectories in the oldest adults. These findings will inform new dietary strategies to support active, healthy ageing. J Am Geriatr Soc 67:50–56, 2019.
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Affiliation(s)
- Nuno Mendonça
- Institute for Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom.,Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom.,Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Antoneta Granic
- Institute for Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom.,AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom.,NIHR Newcastle Biomedical Research Centre in Ageing and Chronic Disease, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Tom R Hill
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom.,Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Mario Siervo
- Institute for Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom.,Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom.,Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - John C Mathers
- Institute for Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom.,Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom.,Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Andrew Kingston
- Institute for Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom.,Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Carol Jagger
- Institute for Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom.,Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
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26
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Relative validity of brief-type self-administered diet history questionnaire among very old Japanese aged 80 years or older. Public Health Nutr 2018; 22:212-222. [PMID: 30274565 DOI: 10.1017/s1368980018002331] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Dietary questionnaires for assessing dietary intakes among populations of individuals aged 80 years or older (the very old) are very limited. We examined the relative validity of forty-three nutrients and twenty-seven food groups estimated by a brief-type self-administered diet history questionnaire (BDHQ) targeting very old Japanese, using semi-weighed dietary records (DR) as a reference. DESIGN Between June and August 2012 and between June 2015 and February 2016, a three-day non-consecutive DR (at two-week intervals) and a BDHQ were completed. SETTING Tokyo, the capital prefecture of Japan. SUBJECTS Eighty very old Japanese (thirty-six men and forty-four women) aged 82-94 years. RESULTS The median intakes of 40-70 % of the crude and energy-adjusted nutrients estimated by the BDHQ were significantly different from those estimated by the DR. The median Spearman's correlation coefficient of nutrient intakes between the BDHQ and the DR was 0·39-0·46. About half (48-56 %) of the food groups were significantly different in terms of the median intakes estimated by the BDHQ and the DR in crude and energy-adjusted values. The median Spearman's correlation coefficient between the BDHQ and the DR was 0·45-0·48. CONCLUSIONS Acceptable Spearman's correlations (≥0·3) were obtained for many dietary intakes among the very old Japanese population. The BDHQ is a good candidate for epidemiological studies among very old Japanese, although, for some nutrients and food groups, the difficulty of estimating accurate median intakes is one of the limitations for the tool. Further efforts to enhance the validity of the BDHQ for very old populations are needed.
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27
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Ostan R, Guidarelli G, Giampieri E, Lanzarini C, Berendsen AAM, Januszko O, Jennings A, Lyon N, Caumon E, Gillings R, Sicinska E, Meunier N, Feskens EJM, Pietruszka B, de Groot LCPGM, Fairweather-Tait S, Capri M, Franceschi C, Santoro A. Cross-Sectional Analysis of the Correlation Between Daily Nutrient Intake Assessed by 7-Day Food Records and Biomarkers of Dietary Intake Among Participants of the NU-AGE Study. Front Physiol 2018; 9:1359. [PMID: 30327612 PMCID: PMC6174234 DOI: 10.3389/fphys.2018.01359] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 09/07/2018] [Indexed: 12/02/2022] Open
Abstract
Methods for measuring diet composition and quantifying nutrient intake with sufficient validity are essential to study the association between nutrition and health outcomes and risk of diseases. 7-day food records provides a quantification of food actually and currently consumed and is interesting for its use in intervention studies to monitor diet in a short-term period and to guide participants toward changing their intakes. The objective of this study is to analyze the correlation/association between the daily intake of selected nutrients (collected by a 7-day food records plus a mineral/vitamin supplementation questionnaire) and estimates of energy expenditure as well as blood and urine biomarkers of dietary intakes in 1,140 healthy elderly subjects (65–79 years) at baseline of the NU-AGE intervention study (NCT01754012, clinicaltrials.gov). The results show that: the daily intake of energy correlated significantly with predicted total energy expenditure (pTEE) (ρ = 0.459, p < 0.001, and q < 0.001); protein intake correlated significantly with the ratio of 24 h urinary urea to creatinine excretion (ρ = 0.143 for total protein intake, ρ = 0.296 for animal protein intake, and ρ = 0.359 for protein intake/body weight, p < 0.001 and q < 0.001 for each correlation); vitamin B12 and folate intakes correlated significantly with their serum concentrations (ρ = 0.151 and ρ = 0.363, respectively; p < 0.001 and q < 0.001 for each correlation); sodium and potassium intakes correlated significantly with their 24 h urinary excretion (ρ = 0.298 and ρ = 0.123, respectively; p < 0.001 and q < 0.001 for each correlation); vitamin B12 and folate intakes were negatively associated with plasma homocysteine measure (p = 0.001 and p = 0.004, respectively); stratifying subjects by gender, the correlations between energy intake and pTEE and between potassium intake and its 24 h urinary excretion lost their significance in women. Even if the plasma and urinary levels of these nutrients depend on several factors, the significant correlations between daily reported intake of nutrients (protein, vitamin B12, folate, and sodium) and their blood/urinary markers confirmed that the 7-day food records (plus a supplementation questionnaire) provides reliable data to evaluate short-term current dietary intake in European elderly subjects and it can be exploited to guide and monitor NU-AGE participants through the shift of their diet according NU-AGE recommendations.
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Affiliation(s)
- Rita Ostan
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Interdepartmental Centre "L. Galvani" (CIG), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Giulia Guidarelli
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Enrico Giampieri
- Department of Physics and Astronomy, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Catia Lanzarini
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Agnes A M Berendsen
- Department of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | - Olga Januszko
- Department of Human Nutrition, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
| | - Amy Jennings
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Noëlle Lyon
- Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Elodie Caumon
- Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Rachel Gillings
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Ewa Sicinska
- Department of Human Nutrition, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
| | - Nathalie Meunier
- Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Edith J M Feskens
- Department of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | - Barbara Pietruszka
- Department of Human Nutrition, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
| | | | | | - Miriam Capri
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Interdepartmental Centre "L. Galvani" (CIG), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - Aurelia Santoro
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Interdepartmental Centre "L. Galvani" (CIG), Alma Mater Studiorum, University of Bologna, Bologna, Italy
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Franzke B, Neubauer O, Cameron-Smith D, Wagner KH. Dietary Protein, Muscle and Physical Function in the Very Old. Nutrients 2018; 10:E935. [PMID: 30037048 PMCID: PMC6073115 DOI: 10.3390/nu10070935] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 07/17/2018] [Accepted: 07/18/2018] [Indexed: 02/06/2023] Open
Abstract
There is an ongoing debate as to the optimal protein intake in older adults. An increasing body of experimental studies on skeletal muscle protein metabolism as well as epidemiological data suggest that protein requirements with ageing might be greater than many current dietary recommendations. Importantly, none of the intervention studies in this context specifically investigated very old individuals. Data on the fastest growing age group of the oldest old (aged 85 years and older) is very limited. In this review, we examine the current evidence on protein intake for preserving muscle mass, strength and function in older individuals, with emphasis on data in the very old. Available observational data suggest beneficial effects of a higher protein intake with physical function in the oldest old. Whilst, studies estimating protein requirements in old and very old individuals based on whole-body measurements, show no differences between these sub-populations of elderly. However, small sample sizes preclude drawing firm conclusions. Experimental studies that compared muscle protein synthetic (MPS) responses to protein ingestion in young and old adults suggest that a higher relative protein intake is required to maximally stimulate skeletal muscle MPS in the aged. Although, data on MPS responses to protein ingestion in the oldest old are currently lacking. Collectively, the data reviewed for this article support the concept that there is a close interaction of physical activity, diet, function and ageing. An attractive hypothesis is that regular physical activity may preserve and even enhance the responsiveness of ageing skeletal muscle to protein intake, until very advanced age. More research involving study participants particularly aged ≥85 years is warranted to better investigate and determine protein requirements in this specific growing population group.
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Affiliation(s)
- Bernhard Franzke
- Research Platform Active Ageing, University of Vienna, 1090 Vienna, Austria.
| | - Oliver Neubauer
- Research Platform Active Ageing, University of Vienna, 1090 Vienna, Austria.
- School of Biomedical Sciences, Tissue Repair and Translational Physiology Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD 4059, Australia.
| | - David Cameron-Smith
- Liggins Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Karl-Heinz Wagner
- Research Platform Active Ageing, University of Vienna, 1090 Vienna, Austria.
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Reduced plasma concentration of branched-chain amino acids in sarcopenic older subjects: a cross-sectional study. Br J Nutr 2018; 120:445-453. [PMID: 29909813 DOI: 10.1017/s0007114518001307] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Branched-chain amino acids (BCAA) are essential amino acids that are necessary for muscle mass maintenance. Little is known about the plasma concentrations of BCAA and the protein intake in relation to sarcopenia. We aimed to compare the non-fasting plasma concentrations of the BCAA and the dietary protein intake between sarcopenic and non-sarcopenic older adults. Norwegian older home-dwelling adults (≥70 years) were invited to a cross-sectional study with no other exclusion criteria than age. Sarcopenic subjects were defined by the diagnostic criteria by the European Working Group on Sarcopenia in Older People. Non-fasting plasma concentrations of eight amino acids were quantified using NMR spectroscopy. Protein intake was assessed using 2×24-h dietary recalls. In this study, ninety out of 417 subjects (22 %) were sarcopenic, and more women (32 %) than men (11 %) were sarcopenic (P<0·0001). Sex-adjusted non-fasting plasma concentrations of leucine and isoleucine, and the absolute intake of protein (g/d), were significantly lower among the sarcopenic subjects, when compared with non-sarcopenic subjects (P=0·003, P=0·026 and P=0·003, respectively). A similar protein intake was observed in the two groups when adjusted for body weight (BW) and sex (1·1 g protein/kg BW per d; P=0·50). We show that sarcopenia is associated with reduced non-fasting plasma concentration of the BCAA leucine and isoleucine, and lower absolute intake of protein. More studies are needed to clarify the clinical relevance of these findings, related to maintenance of muscle mass and prevention of sarcopenia.
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Selected B vitamins and their possible link to the aetiology of age-related sarcopenia: relevance of UK dietary recommendations. Nutr Res Rev 2018; 31:204-224. [DOI: 10.1017/s0954422418000045] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
AbstractThe possible roles of selected B vitamins in the development and progression of sarcopenia are reviewed. Age-related declines in muscle mass and function are associated with huge and increasing costs to healthcare providers. Falls and loss of mobility and independence due to declining muscle mass/function are associated with poor clinical outcomes and their prevention and management are attractive research targets. Nutritional status appears a key modifiable and affordable intervention. There is emerging evidence of sarcopenia being the result not only of diminished anabolic activity but also of declining neurological integrity in older age, which is emerging as an important aspect of the development of age-related decline in muscle mass/function. In this connection, several B vitamins can be viewed as not only cofactors in muscle synthetic processes, but also as neurotrophic agents with involvements in both bioenergetic and trophic pathways. The B vitamins thus selected are examined with respect to their relevance to multiple aspects of neuromuscular function and evidence is considered that requirements, intakes or absorption may be altered in the elderly. In addition, the evidence base for recommended intakes (UK recommended daily allowance) is examined with particular reference to original datasets and their relevance to older individuals. It is possible that inconsistencies in the literature with respect to the nutritional management of sarcopenia may, in part at least, be the result of compromised micronutrient status in some study participants. It is suggested that in order, for example, for intervention with amino acids to be successful, underlying micronutrient deficiencies must first be addressed/eliminated.
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31
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Granic A, Mendonça N, Hill TR, Jagger C, Stevenson EJ, Mathers JC, Sayer AA. Nutrition in the Very Old. Nutrients 2018; 10:E269. [PMID: 29495468 PMCID: PMC5872687 DOI: 10.3390/nu10030269] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 02/21/2018] [Accepted: 02/26/2018] [Indexed: 12/15/2022] Open
Abstract
The population of older adults aged 85 years and over (the very old) is growing rapidly in many societies because of increases in life expectancy and reduced mortality at older ages. In 2016, 27.3 million very old adults were living in the European Union, and in the UK, 2.4% of the population (1.6 million) were aged 85 and over. Very old age is associated with increased risks of malnutrition, multimorbidity, and disability. Diet (nutrition) is a modifiable risk factor for multiple age-related conditions, including sarcopenia and functional decline. Dietary characteristics and nutrient intakes of the very old have been investigated in several European studies of ageing to better understand their nutritional requirements, which may differ from those in the young-old. However, there is a major gap in regard to evidence for the role of dietary patterns, protein, vitamin D and other nutrients for the maintenance of physical and cognitive functioning in later life. The Newcastle 85+ Study, UK and the Life and Living in Advanced Age, New Zealand are unique studies involving single birth cohorts which aim to assess health trajectories in very old adults and their biological, social and environmental influences, including nutrition. In this review, we have updated the latest findings in nutritional epidemiology with results from these studies, concentrating on the diet-physical functioning relationship.
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Affiliation(s)
- Antoneta Granic
- Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK.
- Newcastle University Institute for Ageing, Newcastle upon Tyne NE2 4AX, UK.
| | - Nuno Mendonça
- Newcastle University Institute for Ageing, Newcastle upon Tyne NE2 4AX, UK.
- Institute for Health and Society, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne NE2 4AX, UK.
| | - Tom R Hill
- Human Nutrition Research Centre, Newcastle University, William Leech Building, Newcastle upon Tyne NE2 4HH, UK.
- Institute of Cellular Medicine, Newcastle University, William Leech Building, Newcastle upon Tyne NE2 4HH, UK.
| | - Carol Jagger
- Newcastle University Institute for Ageing, Newcastle upon Tyne NE2 4AX, UK.
- Institute for Health and Society, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne NE2 4AX, UK.
| | - Emma J Stevenson
- Human Nutrition Research Centre, Newcastle University, William Leech Building, Newcastle upon Tyne NE2 4HH, UK.
- Institute of Cellular Medicine, Newcastle University, William Leech Building, Newcastle upon Tyne NE2 4HH, UK.
| | - John C Mathers
- Newcastle University Institute for Ageing, Newcastle upon Tyne NE2 4AX, UK.
- Human Nutrition Research Centre, Newcastle University, William Leech Building, Newcastle upon Tyne NE2 4HH, UK.
- Institute of Cellular Medicine, Newcastle University, William Leech Building, Newcastle upon Tyne NE2 4HH, UK.
| | - Avan A Sayer
- Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK.
- Newcastle University Institute for Ageing, Newcastle upon Tyne NE2 4AX, UK.
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK.
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Zhao J, Su C, Wang H, Wang Z, Wang Y, Zhang B. Secular Trends in Energy and Macronutrient Intakes and Distribution among Adult Females (1991-2015): Results from the China Health and Nutrition Survey. Nutrients 2018; 10:E115. [PMID: 29364176 PMCID: PMC5852691 DOI: 10.3390/nu10020115] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 01/09/2018] [Accepted: 01/12/2018] [Indexed: 01/18/2023] Open
Abstract
With rapid nutrition transition in China, dietary intake and nutritional status of women has gained more and more attention in the past decades. This study aimed to investigate temporal trends of total energy and macronutrient intakes among Chinese adult females. The longitudinal data are from the Chinese Health and Nutrition Survey (CHNS, 1991-2015). Information on the intake of energy and macronutrient was obtained from consecutive three-day dietary recall techniques and compared with the Chinese Dietary Reference Intakes (DRI). Mixed-effect models were performed to evaluate temporal trends of total energy and macronutrient intake. From 1991 to 2015, a significant reduction in daily energy, protein and carbohydrate intakes was seen among all adult females (p < 0.001). Daily fat intake, the proportion of energy from fat, the proportion of females consuming more than 30% of energy from fat and less than 50% of energy from carbohydrate were observed significant increment in the present study (p < 0.001). In 2015, the proportion met the DRI for energy and protein intakes were 47.0% and 48.0%, respectively; the proportion with lower carbohydrate and higher fat intakes compare with the DRI were 45.5% and 66.9%, respectively. Further nutritional education and policy interventions still needed to improve nutrition status for Chinese females.
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Affiliation(s)
- Jian Zhao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Chang Su
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Zhihong Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Yun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
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Mendonça N, Granic A, Mathers JC, Martin-Ruiz C, Wesnes KA, Seal CJ, Jagger C, Hill TR. Homocysteine, Tryptophan, and Cognition in the Very Old. J Am Med Dir Assoc 2017; 18:895-896. [PMID: 28843524 DOI: 10.1016/j.jamda.2017.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 07/13/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Nuno Mendonça
- School of Agriculture Food and Rural Development, Newcastle University, Newcastle-upon-Tyne, United Kingdom; Newcastle University Institute for Aging, Newcastle-upon-Tyne, United Kingdom; Human Nutrition Research Center, Newcastle University, Newcastle-upon-Tyne, United Kingdom; Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | - Antoneta Granic
- Newcastle University Institute for Aging, Newcastle-upon-Tyne, United Kingdom; Institute of Neuroscience, Newcastle University, Newcastle-upon-Tyne, United Kingdom; NIHR Newcastle Biomedical Research Center, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | - John C Mathers
- Newcastle University Institute for Aging, Newcastle-upon-Tyne, United Kingdom; Human Nutrition Research Center, Newcastle University, Newcastle-upon-Tyne, United Kingdom; Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | - Carmen Martin-Ruiz
- Newcastle University Institute for Aging, Newcastle-upon-Tyne, United Kingdom
| | - Keith A Wesnes
- Wesnes Cognition Ltd, Streatley-on-Thames, United Kingdom; Department of Psychology, Northumbria University, Newcastle-upon-Tyne, United Kingdom; Medical School, University of Exeter, Exeter, United Kingdom
| | - Chris J Seal
- School of Agriculture Food and Rural Development, Newcastle University, Newcastle-upon-Tyne, United Kingdom; Human Nutrition Research Center, Newcastle University, Newcastle-upon-Tyne, United Kingdom; Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | - Carol Jagger
- Newcastle University Institute for Aging, Newcastle-upon-Tyne, United Kingdom; Institute of Health and Society, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | - Tom R Hill
- School of Agriculture Food and Rural Development, Newcastle University, Newcastle-upon-Tyne, United Kingdom; Newcastle University Institute for Aging, Newcastle-upon-Tyne, United Kingdom; Human Nutrition Research Center, Newcastle University, Newcastle-upon-Tyne, United Kingdom; Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, United Kingdom
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Mendonça N, Granic A, Mathers JC, Martin-Ruiz C, Wesnes KA, Seal CJ, Jagger C, Hill TR. One-Carbon Metabolism Biomarkers and Cognitive Decline in the Very Old: The Newcastle 85+ Study. J Am Med Dir Assoc 2017. [PMID: 28647580 PMCID: PMC5576913 DOI: 10.1016/j.jamda.2017.05.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objectives Although the biological rationale for the association between folate, vitamin B12, and homocysteine with cognitive function seems plausible, conflicting results have been reported. This study aimed to determine the associations between 1-carbon (1-C) metabolism biomarkers (folate, vitamin B12, and homocysteine), and cognitive impairment at baseline and the rate of cognitive decline over 5 years in the very old. Design The Newcastle 85+ Study was a prospective longitudinal study of people 85 years old and followed over 5 years in Northeast England. Setting Community-dwelling and institutionalized. Participants The analytical sample included 765 very old participants with 1-C metabolism biomarkers and cognitive measures. Measurements Global cognition was measured by the Standardized Mini-Mental State Examination (SMMSE) at baseline, and at 3 and 5 years of follow-up and, attention-specific cognition with the Cognitive Drug Research (CDR) System at baseline, and at 1.5 and 3.0 years of follow-up. Baseline red blood cell folate (RBC folate), plasma vitamin B12, and total homocysteine (tHcy) concentrations were determined by immunoassay. Linear mixed models were used to estimate the associations between quartiles of 1-C metabolism biomarkers and cognition over 3 (CDR) and 5 years (SMMSE). Results Compared with participants in the lowest quartile of RBC folate concentrations (<612 nmol/L), those in the highest quartile of RBC folate concentrations (>1280 nmol/L) had 1 more point on the SMMSE at baseline (β = +1.02, SE = 0.43, P = .02). Those in quartile 4 of tHcy (>21.4 μmol/L) had 1 point less in the SMMSE at baseline than those in the lowest quartile (<13.5 μmol/L) (β = −1.05, SE = 0.46, P = .02). Plasma vitamin B12 was not predictive of global or attention-specific cognition at baseline and at follow-up. None of the 1-C metabolism biomarkers except tHcy was associated with the rate of decline in attention scores over 3 years. Conclusion RBC folate and tHcy, but not plasma vitamin B12, were associated with better global cognition in the very old at baseline but were not predictive of rate of decline over 5 years.
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Affiliation(s)
- Nuno Mendonça
- School of Agriculture, Food, and Rural Development, Newcastle University, Newcastle-upon-Tyne, UK; Newcastle University Institute for Ageing, Newcastle-upon-Tyne, UK; Human Nutrition Research Centre, Newcastle University, Newcastle-upon-Tyne, UK; Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, UK.
| | - Antoneta Granic
- Newcastle University Institute for Ageing, Newcastle-upon-Tyne, UK; Institute of Neuroscience, Newcastle University, Newcastle-upon-Tyne, UK; NIHR Newcastle Biomedical Research Centre in Ageing and Chronic Disease, Newcastle University and Newcastle-upon-Tyne NHS Foundation Trust, Newcastle-upon-Tyne, UK
| | - John C Mathers
- Newcastle University Institute for Ageing, Newcastle-upon-Tyne, UK; Human Nutrition Research Centre, Newcastle University, Newcastle-upon-Tyne, UK; Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, UK
| | | | - Keith A Wesnes
- Wesnes Cognition Ltd, Streatley-on-Thames, UK; Department of Psychology, Northumbria University, Newcastle-upon-Tyne, UK; Medical School, University of Exeter, Exeter, UK
| | - Chris J Seal
- School of Agriculture, Food, and Rural Development, Newcastle University, Newcastle-upon-Tyne, UK; Human Nutrition Research Centre, Newcastle University, Newcastle-upon-Tyne, UK; Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, UK
| | - Carol Jagger
- Newcastle University Institute for Ageing, Newcastle-upon-Tyne, UK; Institute of Health and Society, Newcastle University, Newcastle-upon-Tyne, UK
| | - Tom R Hill
- School of Agriculture, Food, and Rural Development, Newcastle University, Newcastle-upon-Tyne, UK; Newcastle University Institute for Ageing, Newcastle-upon-Tyne, UK; Human Nutrition Research Centre, Newcastle University, Newcastle-upon-Tyne, UK; Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, UK
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35
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Mendonça N, Mathers JC, Adamson AJ, Martin-Ruiz C, Seal CJ, Jagger C, Hill TR. Intakes of Folate and Vitamin B12 and Biomarkers of Status in the Very Old: The Newcastle 85+ Study. Nutrients 2016; 8:E604. [PMID: 27690091 PMCID: PMC5083992 DOI: 10.3390/nu8100604] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 09/20/2016] [Accepted: 09/21/2016] [Indexed: 12/12/2022] Open
Abstract
Very old adults are at increased risk of folate and vitamin B12 deficiencies due to reduced food intake and gastrointestinal absorption. The main aim was to determine the association between folate and vitamin B12 intake from total diets and food groups, and status. Folate or vitamin B12 intakes (2 × 24 h multiple pass recalls) and red blood cell (RBC) folate or plasma vitamin B12 (chemiluminescence immunoassays) concentrations were available at baseline for 731 participants aged 85 from the Newcastle 85+ Study (North-East England). Generalized additive and binary logistic models estimated the associations between folate and vitamin B12 intakes from total diets and food groups, and RBC folate and plasma B12. Folate intake from total diets and cereal and cereal products was strongly associated with RBC folate (p < 0.001). Total vitamin B12 intake was weakly associated with plasma vitamin B12 (p = 0.054) but those with higher intakes from total diets or meat and meat products were less likely to have deficient status. Women homozygous for the FUT2 G allele had higher concentrations of plasma vitamin B12. Cereals and cereal products are a very important source of folate in the very old. Higher intakes of folate and vitamin B12 lower the risk of "inadequate" status.
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Affiliation(s)
- Nuno Mendonça
- School of Agriculture Food and Rural Development, Newcastle University, Newcastle upon Tyne NE1 7RU, UK.
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne NE2 4AX, UK.
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
| | - John C Mathers
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne NE2 4AX, UK.
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
- Institute of Cellular Medicine, Newcastle upon Tyne NE2 4HH, UK.
| | - Ashley J Adamson
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne NE2 4AX, UK.
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne NE2 5PL, UK.
| | - Carmen Martin-Ruiz
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne NE2 4AX, UK.
| | - Chris J Seal
- School of Agriculture Food and Rural Development, Newcastle University, Newcastle upon Tyne NE1 7RU, UK.
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
| | - Carol Jagger
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne NE2 4AX, UK.
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne NE2 5PL, UK.
| | - Tom R Hill
- School of Agriculture Food and Rural Development, Newcastle University, Newcastle upon Tyne NE1 7RU, UK.
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne NE2 4AX, UK.
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
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Abstract
A number of socio-economic, biological and lifestyle characteristics change with advancing age and place very old adults at increased risk of micronutrient deficiencies. The aim of this study was to assess vitamin and mineral intakes and respective food sources in 793 75-year-olds (302 men and 491 women) in the North-East of England, participating in the Newcastle 85+ Study. Micronutrient intakes were estimated using a multiple-pass recall tool (2×24 h recalls). Determinants of micronutrient intake were assessed with multinomial logistic regression. Median vitamin D, Ca and Mg intakes were 2·0 (interquartile range (IQR) 1·2-6·5) µg/d, 731 (IQR 554-916) mg/d and 215 (IQR 166-266) mg/d, respectively. Fe intake was 8·7 (IQR 6·7-11·6) mg/d, and Se intake was 39·0 (IQR 27·3-55·5) µg/d. Cereals and cereal products were the top contributors to intakes of folate (31·5 %), Fe (49·2 %) and Se (46·7 %) and the second highest contributors to intakes of vitamin D (23·8 %), Ca (27·5 %) and K (15·8 %). More than 95 % (n 756) of the participants had vitamin D intakes below the UK's Reference Nutrient Intake (10 µg/d). In all, >20 % of the participants were below the Lower Reference Nutrient Intake for Mg (n 175), K (n 238) and Se (n 418) (comparisons with dietary reference values (DRV) do not include supplements). As most DRV are not age specific and have been extrapolated from younger populations, results should be interpreted with caution. Participants with higher education, from higher social class and who were more physically active had more nutrient-dense diets. More studies are needed to inform the development of age-specific DRV for micronutrients for the very old.
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37
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Intakes of folate and vitamin B12 from total diets and from specific food groups and biomarkers of status in the very old. Proc Nutr Soc 2016. [DOI: 10.1017/s0029665116001749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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