Impact of protein pulse feeding on lean mass in malnourished and at-risk hospitalized elderly patients: A randomized controlled trial

Bouillanne, O.; Curis, Emmanuel; Hamon-Vilcot, Brigitte; Nicolis, Ioannis; Chrétien, Pascale; Schauer, N.; Vincent, Jean‐Pierre; Cynober, Luc; Aussel, Christian

doi:10.1016/j.clnu.2012.08.015

Cited by 126 publications

(105 citation statements)

References 38 publications

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“…Methodological differences and limitations aside, these short-term studies quantify acute effects on protein anabolism that remain to be translated into gains of lean mass or function. One longer term study of 42 days was performed in malnourished hospitalized elderly persons consuming on average 1.3 g/(kg·day) either as a pulse feeding pattern, with >70% of protein provided at lunch, or spread into 4 meals (Bouillanne et al 2013). Significant gains in body cell mass and lean mass, but not handgrip strength, were found only in the pulse-fed group.…”

Section: Protein Distributionmentioning

confidence: 99%

Protein “requirements” beyond the RDA: implications for optimizing health

Phillips

Chevalier

Leidy

2016

Appl. Physiol. Nutr. Metab.

260

252

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Substantial evidence supports the increased consumption of high-quality protein to achieve optimal health outcomes. A growing body of research indicates that protein intakes well above the current Recommended Dietary Allowance help to promote healthy aging, appetite regulation, weight management, and goals aligned with athletic performance. Higher protein intakes may help prevent age-related sarcopenia, the loss of muscle mass, and strength that predisposes older adults to frailty, disability, and loss of autonomy. Higher protein diets also improve satiety and lead to greater reductions in body weight and fat mass compared with standard protein diets, and may therefore serve as a successful strategy to help prevent and/or treat obesity. Athletes can also benefit from higher protein intakes to maximize athletic performance given the critical role protein plays in stimulating muscle protein remodelling after exercise. Protein quality, per meal dose, and timing of ingestion are also important considerations. Despite persistent beliefs to the contrary, we can find no evidence-based link between higher protein diets and renal disease or adverse bone health. This brief synopsis highlights recent learnings based on presentations at the 2015 Canadian Nutrition Society conference, Advances in Protein Nutrition across the Lifespan. Current evidence indicates intakes in the range of at least 1.2 to 1.6 g/(kg·day) of high-quality protein is a more ideal target for achieving optimal health outcomes in adults.Key words: protein, protein recommendations, protein quality, sarcopenia, elderly, weight management, obesity, muscle, athletes, exercise, satiety.Résumé : Beaucoup d'études probantes appuient la thèse selon laquelle l'augmentation de la consommation de protéines de haute qualité améliore la santé. De plus en plus d'études rapportent qu'une consommation de protéines bien supérieure aux rations alimentaires recommandées favorise le vieillissement en santé, la régulation de l'appétit, le contrôle du poids et les objectifs en matière de performance sportive. Une plus grande consommation de protéines pourrait prévenir la sarcopénie associée à l'âge, la perte de masse musculaire et de force musculaire qui prédispose les personnes âgées à la fragilité, l'incapacité et la perte de l'autonomie. Un régime alimentaire riche en protéines améliore la satiété et favorise une plus grande diminution de la masse corporelle et graisseuse comparativement aux régimes protéiques standards et pourrait constituer une stratégie gagnante pour la prévention et le traitement de l'obésité. Les athlètes ont aussi à gagner en consommant plus de protéines afin de maximiser leur performance sportive compte tenu du rôle essentiel des protéines dans la stimulation du remodelage des protéines musculaires à la suite de l'exercice physique. La qualité des protéines, la dose par repas et le moment de la consommation sont aussi à prendre en compte. Malgré les croyances ancrées du contraire, on ne trouve aucune donnée probante présentant une associa...

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Section: Protein Distributionmentioning

confidence: 99%

Protein “requirements” beyond the RDA: implications for optimizing health

Phillips

Chevalier

Leidy

2016

Appl. Physiol. Nutr. Metab.

260

252

View full text Add to dashboard Cite

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“…To help older people maintain muscle mass and function, the ESPEN expert group and the PROT-AGE international study group recently recommended a higher protein intake, with at least 1-1.2 g of proteins/kg of body weight/day for healthy older individuals [17,18]. Several authors propose that this protein intake would be more efficient if it were distributed equally between 3 daily meals [17,19,20], while others favor protein pulse feeding with 80% of the protein intake in one meal [21,22]. However, high-protein levels in a single meal can be hard to achieve in elderly people with diminished appetites and chewing difficulties.…”

Section: Discussionmentioning

confidence: 99%

Effect of supplementing meals with soluble milk proteins on plasma leucine levels in healthy older people: A randomized pilot study

Schnebelen-Berthier

Baudry

Clerc

et al. 2016

NUA

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Abstract. BACKGROUND:The muscle protein synthetic response to food intake is reduced in aging, contributing to a progressive muscle loss. This anabolic resistance results from a decreased sensitivity to anabolic signals, especially leucinemia, a potent activator of protein synthesis. Nutritional strategies are needed to reach the anabolic threshold of leucinemia and stimulate muscle anabolism. OBJECTIVES: This study sought to evaluate the effect of supplementing meals with soluble milk proteins (SMP) on postprandial leucinemia in elders. METHODS: During 3 successive experimental sessions, 6 healthy older men (66.7 ± 0.7y) consumed a standardized lunch (27 g of proteins; 2.2 g of leucine) supplemented with a beverage containing 0 g, 5 g or 8.2 g of SMP (0 g, 0.6 g and 1.1 g of leucine, respectively). RESULTS: The supplementation with 5 g or 8.2 g of SMP induced an increase of 1.9 × and 2.5 × in plasma leucine levels, compared to the control meal (without additional SMP). The leucine area under the curve over 3h20 had an increase of 2.1 × and 2.3 ×, respectively, as compared to the control meal. CONCLUSIONS: Ingesting SMP in addition to a meal strongly increased postprandial plasma leucine, and could be an effective strategy to reach anabolic thresholds and optimize the anabolic effect of each meal.

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“…Mamerow et al (2014) recently reported that consuming a moderate amount of protein at each meal stimulated 24-h muscle protein synthesis more effectively than skewing the same total amount of protein intake towards the evening meal. While some data supporting a pulsed (i.e., skewed) delivery of protein appear to superficially conflict with the even-distribution theory, many of the conclusions are in fact supportive and likely only hidden by related issues, such as the quantity of protein consumed at each meal (Arnal et al 1999;Bouillanne et al 2013). For example, in a 6-week trial in hospitalized, older adults, Bouillanne et al (2013) noted that patients who consumed a "pulsed" protein diet (0800 hours: 4.5 g; 1200 hours: 47.8 g; 1600 hours: 2.3 g; 1900 hours: 10.9 g protein) experienced a modest, but significant improvement in lean mass compared with the "spread" protein diet (0800 hours: 12.2 g; 1200 hours: 21 g; 1600 hours: 13.5 g; 1900 hours: 21.2 g protein).…”

Section: Protein Dose and Distributionmentioning

confidence: 99%

“…While some data supporting a pulsed (i.e., skewed) delivery of protein appear to superficially conflict with the even-distribution theory, many of the conclusions are in fact supportive and likely only hidden by related issues, such as the quantity of protein consumed at each meal (Arnal et al 1999;Bouillanne et al 2013). For example, in a 6-week trial in hospitalized, older adults, Bouillanne et al (2013) noted that patients who consumed a "pulsed" protein diet (0800 hours: 4.5 g; 1200 hours: 47.8 g; 1600 hours: 2.3 g; 1900 hours: 10.9 g protein) experienced a modest, but significant improvement in lean mass compared with the "spread" protein diet (0800 hours: 12.2 g; 1200 hours: 21 g; 1600 hours: 13.5 g; 1900 hours: 21.2 g protein). In this patient population, we would argue that the quantity of protein consumed at each meal in the "spread/distributed" protein group (i.e., 12-21 g/meal) was likely insufficient to optimally stimulate muscle protein synthesis across all meals.…”

Section: Protein Dose and Distributionmentioning

confidence: 99%

Protein: A nutrient in focus

Arentson-Lantz

Clairmont

Paddon‐Jones

et al. 2015

Appl. Physiol. Nutr. Metab.

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Abstract:Protein is an essential component of a healthy diet and is a focus of research programs seeking to optimize health at all stages of life. The focus on protein as a nutrient often centers on its thermogenic and satiating effect, and when included as part of a healthy diet, its potential to preserve lean body mass. A growing body of literature, including stable isotope based studies and longer term dietary interventions, suggests that current dietary protein recommendations may not be sufficient to promote optimal muscle health in all populations. A protein intake moderately higher than current recommendations has been widely endorsed by many experts and working groups and may provide health benefits for aging populations. Further, consuming moderate amounts of high-quality protein at each meal may optimally stimulate 24-h muscle protein synthesis and may provide a dietary platform that favors the maintenance of muscle mass and function while promoting successful weight management in overweight and obese individuals. Dietary protein has the potential to serve as a key nutrient for many health outcomes and benefits might be increased when combined with adequate physical activity. Future studies should focus on confirming these health benefits from dietary protein with long-term randomized controlled studies.Key words: protein, requirement, IAAO, aging, sarcopenia, intake distribution, satiety, weight management.Résumé : Les protéines, des composantes essentielles d'un régime sain, sont au centre de programmes de recherche pour optimiser la santé à tous les stades de la vie. On met l'accent concernant les protéines en tant que nutriment surtout sur l'effet thermogène et rassasiant; intégrés dans un régime sain, les protéines pourraient préserver la masse corporelle maigre. De plus en plus d'études dont celles sur les isotopes stables et les interventions alimentaires à long terme suggèrent que les recommandations alimentaires actuelles en matière de protéines ne conviendraient pas à la promotion d'une santé musculaire optimale dans toutes les strates de la population. Un apport protéique modérément supérieur aux recommandations actuelles et soutenu par plusieurs experts et groupes de travail pourrait procurer des bienfaits sanitaires aux populations vieillissantes. De plus, la consommation de quantités modérées de protéines de haute qualité à chaque repas pourrait stimuler durant 24 h la synthèse des protéines musculaires et pourrait constituer une plateforme alimentaire favorisant le maintien de la masse et des fonctions musculaires tout en permettant une gestion du poids avec succès chez les personnes en surpoids et obèses. Les protéines alimentaires ont le potentiel de nutriments essentiels pour de nombreuses problématiques de santé et leurs bénéfices seraient accrus lorsque combinées à suffisamment d'activité physique. Les prochaines études devraient se concentrer sur la validation des bénéfices sanitaires des protéines alimentaires au moyen d'études à long terme contrôlées et aléatoires. [Traduit par l...

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Impact of protein pulse feeding on lean mass in malnourished and at-risk hospitalized elderly patients: A randomized controlled trial

Cited by 126 publications

References 38 publications

Protein “requirements” beyond the RDA: implications for optimizing health

Protein “requirements” beyond the RDA: implications for optimizing health

Effect of supplementing meals with soluble milk proteins on plasma leucine levels in healthy older people: A randomized pilot study

Protein: A nutrient in focus

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