Paddon-Jones Douglas, Campbell Wayne W, Jacques Paul F, Kritchevsky Stephen B, Moore Lynn L, Rodriguez Nancy R, van Loon Luc Jc
From the Department of Nutrition and Metabolism, University of Texas Medical Branch, Galveston, TX (DP-J); the Department of Nutrition Science, Purdue University, West Lafayette, IN (WWC); the Jean Mayer USDA Human Nutrition Research Center, Tufts University, Boston, MA (PFJ); Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC (SBK); the Department of Medicine, Boston University, Boston, MA (LLM); the Department of Nutritional Sciences, University of Connecticut, Storrs, CT (NRR); and the NUTRIM School for Nutrition, Toxicology, and Metabolism, Maastricht University, Maastricht, The Netherlands (LJCvL).
Am J Clin Nutr. 2015 Jun;101(6):1339S-1345S. doi: 10.3945/ajcn.114.084061. Epub 2015 Apr 29.
Our understanding of the potential benefits and challenges of optimizing dietary protein intake in older adults continues to evolve. An overarching hypothesis generated during Protein Summit 2.0 was that consuming an adequate amount of high-quality protein at each meal, in combination with physical activity, may delay the onset of sarcopenia, slow its progression, reduce the magnitude of its functional consequences, or all of these. The potential benefits of young and middle-aged adults adopting a diet pattern whereby adequate protein is consumed at each meal as a countermeasure to sarcopenia are presented and discussed. For example, meeting a protein threshold (∼25-30 g/meal) represents a promising, yet still largely unexplored dietary strategy to help maintain muscle mass and function. For many older adults, breakfast is a carbohydrate-dominated lower-protein meal and represents an opportunity to improve and more evenly distribute daily protein intake. Although both animal and plant-based proteins can provide the required essential amino acids for health, animal proteins generally have a higher proportion of the amino acid leucine. Leucine plays a key role in stimulating translation initiation and muscle protein anabolism and is the focus of ongoing research. Protein requirements should be assessed in the light of habitual physical activity. An evenly distributed protein diet provides a framework that allows older adults to benefit from the synergistic anabolic effect of protein and physical activity. To fully understand the role of dietary protein intake in healthy aging, greater efforts are needed to coordinate and integrate research design and data acquisition and interpretation from a variety of disciplines.
我们对优化老年人膳食蛋白质摄入量的潜在益处和挑战的理解仍在不断发展。蛋白质峰会2.0期间提出的一个总体假设是，每餐摄入适量的优质蛋白质，并结合体育活动，可能会延缓肌肉减少症的发病，减缓其进展，减轻其功能后果的严重程度，或兼而有之。本文介绍并讨论了年轻和中年成年人采用每餐摄入适量蛋白质的饮食模式作为应对肌肉减少症的对策的潜在益处。例如，达到蛋白质阈值（约每餐25 - 30克）是一种有前景但仍在很大程度上未被探索的饮食策略，有助于维持肌肉质量和功能。对许多老年人来说，早餐是以碳水化合物为主的低蛋白餐，这是一个改善并更均匀分配每日蛋白质摄入量的机会。虽然动物蛋白和植物蛋白都能为健康提供所需的必需氨基酸，但动物蛋白通常亮氨酸的比例更高。亮氨酸在刺激翻译起始和肌肉蛋白合成代谢中起关键作用，也是正在进行的研究的重点。应根据习惯性身体活动来评估蛋白质需求。均匀分布的蛋白质饮食提供了一个框架，使老年人能够从蛋白质和体育活动的协同合成代谢作用中受益。为了充分理解膳食蛋白质摄入在健康老龄化中的作用，需要做出更大努力来协调和整合来自各个学科的研究设计、数据采集和解释。
