Appetite and Protein Intake Strata of Older Adults in the European Union: Socio-Demographic and Health Characteristics, Diet-Related and Physical Activity Behaviours

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.

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

“…The major strengths of this study include the use of a cross-European large-scale survey and the investigation of various determinants of acceptance to eat sustainable protein sources in older adults. Our study has a few limitations, which were also previously described in Hung et al [34]. In short, these include potential selection bias and limited generalizability, as the sample was restricted to older adults with online access and a certain level of skills to access and complete the online survey and potential social desirability bias of the self-reported measures.…”

“…However, the relatively high acceptance to eat more familiar plant-based protein sources may provide a window of opportunity to increase protein intake in an environmentally sustainable way. Recommendations to increase consumption of plant-based protein sources will be widely accepted by older adults, although other barriers to increasing food consumption in general, such as poor appetite, may arise [34]. The negative relationship between food fussiness and acceptability to consume sustainable protein sources also provides an opportunity.…”

“…The development of the questionnaire regarding translation and pretesting has been elaborated in Hung et al [34]. The questionnaire started with a short description of the PROMISS project and an informed consent and was followed by a screening for sample selection based on gender, age, region, and current living condition.…”

Effects of Leucine-Enriched Whey Protein Supplementation on Physical Function in Post-Hospitalized Older Adults Participating in 12-Weeks of Resistance Training Program: A Randomized Controlled Trial

“…Energy and protein intake are key nutritional factors to achieve protein balance [7]. However, due to several physiological and social factors, elderly people tend to reduce food intake and, in consequence, often fail to meet energy and protein requirements [9]. Likewise, protein-energy malnutrition is frequent in elderly patients [9].…”

“…However, due to several physiological and social factors, elderly people tend to reduce food intake and, in consequence, often fail to meet energy and protein requirements [9]. Likewise, protein-energy malnutrition is frequent in elderly patients [9]. Besides total daily protein intake [10], dietary protein quality and its anabolic potential have also received increased interest with the goal of optimizing skeletal muscle anabolism in the elderly [10,11].…”