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观点:蛋白质的需求和老龄化人群的最佳摄入量:我们是否已经准备好推荐超过每日推荐摄入量的量?

Perspective: Protein Requirements and Optimal Intakes in Aging: Are We Ready to Recommend More Than the Recommended Daily Allowance?

机构信息

Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada.

出版信息

Adv Nutr. 2018 May 1;9(3):171-182. doi: 10.1093/advances/nmy003.

Abstract

The Dietary Reference Intakes set the protein RDA for persons >19 y of age at 0.8 g protein ⋅ kg body weight-1 ⋅ d-1. A growing body of evidence suggests, however, that the protein RDA may be inadequate for older individuals. The evidence for recommending a protein intake greater than the RDA comes from a variety of metabolic approaches. Methodologies centered on skeletal muscle are of paramount importance given the age-related decline in skeletal muscle mass and function (sarcopenia) and the degree to which dietary protein could mitigate these declines. In addition to evidence from short-term experimental trials, observational data show that higher protein intakes are associated with greater muscle mass and, more importantly, better muscle function with aging. We are in dire need of more evidence from longer-term intervention trials showing the efficacy of protein intakes that are higher than the RDA in older persons to support skeletal muscle health. We propose that it should be recommended that older individuals consume ≥1.2 g protein · kg-1 · d-1 and that there should be an emphasis on the intake of the amino acid leucine, which plays a central role in stimulating skeletal muscle anabolism. Critically, the often-cited potential negative effects of consuming higher protein intakes on renal and bone health are without a scientific foundation in humans.

摘要

膳食参考摄入量将 19 岁以上人群的蛋白质 RDA 设定为 0.8 克蛋白质 ⋅ 公斤体重-1 ⋅ 天-1。然而,越来越多的证据表明,蛋白质 RDA 可能不足以满足老年人的需求。推荐摄入高于 RDA 的蛋白质摄入量的证据来自各种代谢方法。鉴于与年龄相关的骨骼肌质量和功能下降(肌少症)以及饮食蛋白质可以在多大程度上减轻这些下降,以骨骼肌为中心的方法至关重要。除了短期实验试验的证据外,观察性数据表明,较高的蛋白质摄入量与更大的肌肉质量有关,更重要的是,与衰老相关的肌肉功能更好。我们迫切需要更多来自长期干预试验的证据,这些试验表明,老年人摄入高于 RDA 的蛋白质摄入量对骨骼肌肉健康有效,以支持这一观点。我们建议,老年人应摄入≥1.2 克蛋白质 ⋅ 公斤体重-1 ⋅ 天-1,并且应强调摄入亮氨酸,亮氨酸在刺激骨骼肌合成代谢方面起着核心作用。至关重要的是,经常被引用的摄入较高蛋白质摄入量对肾脏和骨骼健康的潜在负面影响在人类中没有科学依据。

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