Insufficient amounts and inadequate distribution of dietary protein intake in apparently healthy older adults in a developing country: implications for dietary strategies to prevent sarcopenia

Abstract

BackgroundBoth low dietary protein intake and inadequate distribution of protein over the three mealtimes have been reported in older Caucasian adults, but the association between protein intake at each meal and muscle mass has not been studied. The purpose of this study was to evaluate dietary protein intake and distribution by mealtimes, and to explore their association with appendicular skeletal muscle mass in apparently healthy older adults.MethodsThis was a cross-sectional pilot study that included 78 people over the age of 60 years. Caloric and protein intake were estimated on the basis of three nonconsecutive 24-hour diet recalls and appendicular skeletal muscle mass by dual-energy X-ray absorptiometry.ResultsMen consumed 13.4 g of protein/day more than women (P < 0.05). The estimated value of dietary protein intake was 0.9 g/kg/day. In this sample, 28% of subjects did not cover 100% of the dietary reference intake for protein. Lower consumption of dietary protein was found at breakfast and dinnertime compared with the recommended amount of 25–30 g (P < 0.05). Also, the study observed that appendicular skeletal muscle mass in men and women who consumed <25 g of protein at each mealtime was different from that found in the group that consumed >25 g of protein at one, two, or three mealtimes.ConclusionWhile protein intake was higher than current recommendations, it failed to achieve the values reported as necessary to prevent sarcopenia. In addition, there was under-consumption of protein per mealtime, especially at breakfast and dinner.

Factors associated with protein consumption in elderly

“…It is important to highlight this result, since protein is not ingested in isolation, but within a composition of different foods and nutrients. In addition, notwithstanding the need for protein consumption in sufficient quantity, the inadequacy of other nutrients or in the fractionation and amount of protein per meal will influence the optimization of protein metabolism [9]. Moreover, a higher protein value among the older people who consumed three main meals was observed; however, no statistically significant difference was found when there was consumption of an intermediate snack.…”

“…Some factors that may influence the consumption of protein include low energy intake, tooth loss, anorexia, food insecurity, and an increase in physical dependence. All these factors may be pronounced in older people living in longstay institutions or hospitals and in developing countries [2,9].…”

Nutrient-rich dairy proteins improve appendicular skeletal muscle mass and physical performance, and attenuate the loss of muscle strength in older men and women subjects: a single-blind randomized clinical trial

“…In their studies of malnourished and frail elderly subjects, Bos et al26 and Chevalier et al27 point out that an increase in the total amount of dietary protein from 0.5 to 2.0 g/kg/day produces higher rates of whole-body protein synthesis and improves nitrogen balance. In the present single-blind, randomized clinical trial we did not apply any dietary study; however, we have local evidence of dietary protein intake in older people, since we recently reported on older men and women volunteers who ingested 0.9 g of protein/kg of body weight/day 3. Considering that body weight was similar in the cited study and in our study groups, we estimated that adding ricotta cheese increased protein intake from 0.9 g to 1.2 g of protein/kg of body weight/day.…”

“…The causes of loss of skeletal muscle are unclear, but may include a lower basal rate of protein synthesis in aged muscle and/or an increased rate of protein breakdown, lower sensitivity to insulin-induced stimulation of protein synthesis, and a reduced sensitivity to amino acid feeding 2. Also, an insufficient amount and inadequate distribution of dietary protein could contribute to the age-related loss of skeletal muscle and lead to sarcopenia 3,4. However, as other, nondietary factors are also involved, sarcopenia syndrome is considered a multifactorial disorder 1.…”

Excesso de peso influencia negativamente a capacidade funcional de idosos em atividades cotidianas

“…Apesar da dificuldade em alimentar-se, quando avaliado o consumo alimentar da amostra, a média de ingestão de proteínas por kg de peso foi de 0,93 gramas, valor superior à ingestão dietética recomendada (RDA) de 0,8 g/kg de peso corporal por dia 23 (IOM, 2006). No entanto, Valenzuela et al 24 sugerem que a ingestão proteica seja de 1,2 g/kg/dia para a redução de perda de massa muscular em idosos. Os dados de consumo proteico da amostra vão ao encontro do comprometimento da capacidade funcional.…”