Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands.
Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam Public Health research institute, Amsterdam, the Netherlands.
PLoS One. 2018 May 23;13(5):e0196406. doi: 10.1371/journal.pone.0196406. eCollection 2018.
In old age, sufficient protein intake is important to preserve muscle mass and function. Around 50% of older adults (65+ y) consumes ≤1.0 g/kg adjusted body weight (BW)/day (d). There is no rapid method available to screen for low protein intake in old age. Therefore, we aimed to develop and validate a short food questionnaire to screen for low protein intake in community-dwelling older adults. We used data of 1348 older men and women (56-101 y) of the LASA study (the Netherlands) to develop the questionnaire and data of 563 older men and women (55-71 y) of the HELIUS study (the Netherlands) for external validation. In both samples, protein intake was measured by the 238-item semi-quantitative HELIUS food frequency questionnaire (FFQ). Multivariable logistic regression analysis was used to predict protein intake ≤1.0 g/kg adjusted BW/d (based on the HELIUS FFQ). Candidate predictor variables were FFQ questions on frequency and amount of intake of specific foods. In both samples, 30% had a protein intake ≤1.0 g/kg adjusted BW/d. Our final model included adjusted body weight and 10 questions on the consumption (amount on average day or frequency in 4 weeks) of: slices of bread (number); glasses of milk (number); meat with warm meal (portion size); cheese (amount and frequency); dairy products (like yoghurt) (frequency); egg(s) (frequency); pasta/noodles (frequency); fish (frequency); and nuts/peanuts (frequency). The area under the receiver operating characteristic curve (AUC) was 0.889 (95% CI 0.870-0.907). The calibration slope was 1.03 (optimal slope 1.00). At a cut-off of ≤0.8 g/kg adjusted BW/d, the AUC was 0.916 (96% CI 0.897-0.936). Applying the regression equation to the HELIUS sample, the AUC was 0.856 (95% CI 0.824-0.888) and the calibration slope 0.92. Regression coefficients were therefore subsequently shrunken by a linear factor 0.92. To conclude, the short food questionnaire (Pro55+) can be used to validly screen for protein intake ≤1.0 g/kg adjusted BW/d in community-dwelling older adults. An online version can be found at www.proteinscreener.nl. External validation in other countries is recommended.
在老年时，摄入足够的蛋白质对于维持肌肉质量和功能非常重要。大约 50%的老年人（65 岁以上）的蛋白质摄入量≤1.0 g/kg 调整后的体重（BW）/天（d）。目前尚无快速方法可用于筛查老年人的低蛋白摄入。因此，我们旨在开发和验证一种用于筛查社区居住的老年人低蛋白摄入的简短食物问卷。我们使用了来自 LASA 研究（荷兰）的 1348 名男女老年人（56-101 岁）的数据来开发问卷，并使用来自 HELIUS 研究（荷兰）的 563 名男女老年人（55-71 岁）的数据进行外部验证。在这两个样本中，蛋白质摄入量均通过 238 项半定量 HELIUS 食物频率问卷（FFQ）进行测量。多变量逻辑回归分析用于预测蛋白质摄入量≤1.0 g/kg 调整后的 BW/d（基于 HELIUS FFQ）。候选预测变量是特定食物摄入频率和数量的 FFQ 问题。在这两个样本中，有 30%的人蛋白质摄入量≤1.0 g/kg 调整后的 BW/d。我们的最终模型包括调整后的体重和 10 个关于以下食物摄入量的问题：面包片（片数）；牛奶（杯数）；热餐中的肉（份）；奶酪（量和频率）；乳制品（如酸奶）（频率）；鸡蛋（个）（频率）；意大利面/面条（频率）；鱼（频率）；坚果/花生（频率）。接收者操作特征曲线下面积（AUC）为 0.889（95%CI 0.870-0.907）。校准斜率为 1.03（最佳斜率 1.00）。在≤0.8 g/kg 调整后的 BW/d 的截止值下，AUC 为 0.916（96%CI 0.897-0.936）。将回归方程应用于 HELIUS 样本，AUC 为 0.856（95%CI 0.824-0.888），校准斜率为 0.92。因此，回归系数随后通过线性因子 0.92 缩小。总之，简短的食物问卷（Pro55+）可用于有效筛查社区居住的老年人中蛋白质摄入量≤1.0 g/kg 调整后的 BW/d。在线版本可在 www.proteinscreener.nl 上找到。建议在其他国家进行外部验证。
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