Distribution of daily protein intake across meals and lower extremity functioning in community-dwelling Spanish older adults: a prospective cohort study

Estrada-deLeón, Daniela B; Struijk, Ellen A; Caballero, F.F.; Rodríguez‐Artalejo, Fernando; López-Garcı́a, Esther

doi:10.1007/s00394-020-02273-6

Cited by 6 publications

(5 citation statements)

References 52 publications

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“…A previous study found that a higher intake of dietary animal-protein in combination with physical activity was associated with higher skeletal muscle mass and a lower likelihood of functional limitation development [40]. In our study, participants on TRF had lower intake of dietary protein and energy in comparison with participants with fasting time <9 hours/day; however, all participants in the 3 fasting groups had a protein intake above the current recommended dietary allowance (RDA), of 0.8 g protein/kg/d [41,42]. Despite participants on TRF are meeting their adequate intake of proteins and are physically active, it is possible that it is not enough to halt the detrimental effects of TRF in older adults.…”

Section: Discussionmentioning

confidence: 50%

Time-restricted feeding and lower-extremity functioning in community-dwelling older adults

Estrada-deLeón

Struijk

Caballero

et al. 2020

Clinical Nutrition ESPEN

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Section: Discussionmentioning

confidence: 50%

Time-restricted feeding and lower-extremity functioning in community-dwelling older adults

Estrada-deLeón

Struijk

Caballero

et al. 2020

Clinical Nutrition ESPEN

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“…A previous study found that a higher intake of dietary animal protein in combination with physical activity was associated with higher skeletal muscle mass and a lower likelihood of functional limitation development (40) . In our study, participants on prolonged nightly fasting had lower intake of dietary protein and energy in comparison with participants with fasting time <9 h/d; however, all participants in the three fasting groups had a protein intake above the current RDA, of 0•8 g protein/kg per d (41,42) . Despite participants on prolonged nightly fasting were meeting their adequate intake of proteins, prolonged fasting might reduce the intake of other relevant nutrients for older adults resulting in reduced function.…”

Section: Discussionmentioning

confidence: 63%

Prolonged nightly fasting and lower-extremity functioning in community-dwelling older adults

et al. 2020

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It is unknown if time-restricted feeding confers a protective effect on the physical function of older adults. The aim of this study was to assess prolonged nightly fasting in association with performance-based lower-extremity function (LEF) in a large population of community-dwelling older adults. A cross-sectional study was carried out among 1226 individuals ≥64 years from the Seniors-ENRICA-II (Study on Nutrition and Cardiovascular Risk in Spain) cohort. Habitual diet was assessed through a validated diet history. Fasting time was classified into the following categories: ≤9, 10–11 and ≥12 h/d (prolonged nightly fasting). Performance-based LEF was assessed with the Short Physical Performance Battery (SPPB). After adjusting for potential confounders, a longer fasting period was associated with a higher likelihood of impaired LEF (OR for the second and third categories v. ≤ 9 h/d fasting: 2·27 (95 % CI 1·56, 3·33) and 2·70 (95 % CI 1·80, 4·04), respectively; Ptrend < 0·001). Fasting time showed a significant association with the SPPB subtests balance impairment (OR for highest v. shortest fasting time: 2.48; 95 % CI 1·51, 4·08; Ptrend = 0·001) and difficulty to rise from a chair (OR 1·47; 95 % CI 1·05, 2·06; Ptrend = 0·01). The risk associated with ≥12 h fasting among those with the lowest levels of physical activity was three times higher than among those with ≤9 h fasting with the same low level of physical activity. Prolonged nightly fasting was associated with a higher likelihood of impaired LEF, balance impairment, and difficulty to rise from a chair in older adults, especially among those with low levels of physical activity.

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“…In that study, mean protein CV did not differ in men and women at baseline ((0·55 ± 0·24 and 0·54 ± 24, respectively ( P = 0·31)) and after follow-up (19) . Additionally, three recent studies among older adults examined the association between mealtime protein distribution and physical function, as assessed with the Short Physical Performance Battery, and found no association (20,23,31) .…”

Section: Discussionmentioning

confidence: 99%

“…Most of the studies about daily protein intake distribution have investigated muscle-and weight-related outcomes, with inconsistent results (17)(18)(19)(20)23) . A cross-sectional study among older adults found that frail, pre-frail and non-frail participants presented different protein CV values (P < 0•05) (17) .…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have associated an even distribution of protein intake with various health outcomes in older adults, including lower risk of frailty, lean mass loss, and physical impairment and with a higher muscle strength (17)(18)(19)(20) . However, other studies have not found a benefit (21)(22)(23) . Beyond functional outcomes, to our knowledge, there is no evidence on the effect of mealtime distribution of protein intake on hard outcomes such as total mortality, which would be a surrogate of overall health status.…”

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confidence: 90%

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Distribution of daily protein intake across meals and all-cause mortality in community-dwelling older adults

et al. 2022

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Recent findings suggest that the distribution of protein intake throughout the day has an impact on various health outcomes in older adults, independently of the amount consumed. We evaluated the association between the distribution of dietary protein intake across meals and all-cause mortality in community-dwelling older adults. Data from 3225 older adults aged ≥60 years from the Seniors-ENRICA-1 cohort were examined. Habitual dietary protein consumption was collected in 2008-2010 and in 2012 through a validated diet history. Protein distribution across meals was calculated for each participant as the coefficient of variation (CV) of protein intake per meal, in sex-specific tertiles. Vital status was obtained from the National Death Index up to January 30, 2020. Cox proportional hazards regression was performed to determine the hazard ratios (HR) and their 95% confidence intervals (CI) for the association between the distribution of daily protein intake across meals and all-cause mortality. Over a median follow-up of 10.6 years, 591 deaths occurred. After adjustment for potential confounders, the CV of total protein intake was not associated with all-cause mortality [HRs and 95% CI in the second and third tertile versus the lowest tertile: 0.94 (0.77-1.15) and 0.88 (0.72–1.08); p trend= 0.22]. Similarly, the HRs of all-cause mortality when comparing extreme tertiles of CV for types of protein were 0.89 (0.73–1.10) for animal-protein intake, and 1.02 (0.82-1.25) for plant-protein intake. Dietary protein distribution across meals was not associated with all-cause mortality, regardless of protein source and amount, among older adults. Further studies should investigate whether this picture holds for specific causes of death.

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Distribution of daily protein intake across meals and lower extremity functioning in community-dwelling Spanish older adults: a prospective cohort study

Cited by 6 publications

References 52 publications

Time-restricted feeding and lower-extremity functioning in community-dwelling older adults

Time-restricted feeding and lower-extremity functioning in community-dwelling older adults

Prolonged nightly fasting and lower-extremity functioning in community-dwelling older adults

Distribution of daily protein intake across meals and all-cause mortality in community-dwelling older adults

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