Porter Starr Kathryn N, McDonald Shelley R, Jarman Aubrey, Orenduff Melissa, Sloane Richard, Pieper Carl F, Bales Connie W
a Center for the Study of Aging , Duke University School of Medicine , Durham , NC , USA.
b Department of Medicine , Duke University School of Medicine , Durham , NC , USA.
J Nutr Gerontol Geriatr. 2018 Apr-Jun;37(2):117-129. doi: 10.1080/21551197.2018.1478696. Epub 2018 Jun 20.
Increases in rates of obesity in the older population are hastening the development of chronic illnesses, including chronic kidney disease (CKD). However, obesity reduction in older adults is besought with concerns about the long-term benefit/risk, especially regarding loss of muscle mass and its impact on function. Higher protein intakes have been advocated to help offset the tendency for loss of muscle during weight reduction but this raises concerns about possible negative effects on older kidneys. We assessed markers of renal function in venous blood samples collected during a six-month randomized controlled weight loss trial of higher protein intake in obese (n = 67; BMI ≥ 30 kg/m) older (≥60 years) adults with physical frailty and age-normal renal status (glomerular filtration rate [GFR] ≥ 45); the Control diet (0.8 g protein/kg body weight/day; n = 21) was compared to a protein-enhanced (1.2 g/g protein/kg body weight/day with 30 g protein/meal; n = 41; Protein) diet. Results showed no group effect of the Protein treatment on markers of renal function (estimated GFR, blood urea nitrogen, and creatinine), either upon intervention completion or one year later. Our findings align with literature support for the benefits of higher protein in the diets of older individuals during obesity reduction and help to confirm the safety of moderate increases in protein intake during weight loss in this population.
老年人群肥胖率的上升正在加速包括慢性肾脏病（CKD）在内的慢性疾病的发展。然而，老年人减肥面临着对长期益处/风险的担忧，尤其是关于肌肉量的减少及其对功能的影响。有人主张增加蛋白质摄入量，以帮助抵消体重减轻期间肌肉流失的趋势，但这引发了对老年肾脏可能产生负面影响的担忧。在一项为期六个月的随机对照减肥试验中，我们评估了肥胖（n = 67；BMI≥30 kg/m）、身体虚弱且肾脏状况正常（肾小球滤过率[GFR]≥45）的老年人（≥60岁）在静脉血样本中的肾功能指标；将对照饮食（0.8 g蛋白质/千克体重/天；n = 21）与蛋白质强化饮食（1.2 g/千克体重/天，每餐30 g蛋白质；n = 41；蛋白质组）进行了比较。结果显示，无论是在干预完成时还是一年后，蛋白质治疗对肾功能指标（估计GFR、血尿素氮和肌酐）均无组间效应。我们的研究结果与文献中关于老年人在减肥期间饮食中蛋白质含量较高有益的观点一致，并有助于证实该人群在减肥期间适度增加蛋白质摄入量的安全性。
