Hengeveld Linda M, Pelgröm Anouk D A, Visser Marjolein, Boer Jolanda M A, Haveman-Nies Annemien, Wijnhoven Hanneke A H
Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, the Netherlands.
Division of Human Nutrition, Wageningen University & Research, Wageningen, the Netherlands.
Clin Nutr ESPEN. 2019 Feb;29:165-174. doi: 10.1016/j.clnesp.2018.10.013. Epub 2018 Nov 9.
BACKGROUND & AIMS: Adequate protein intake is required to maintain muscle health in old age, but a low protein intake is very common in older adults. There is little insight in the general and dietary profile of older adults with a low protein intake. Therefore, this study aimed to compare community-dwelling older adults with a low and a high protein intake with regard to protein intake per eating occasion, food sources of protein and general participant characteristics.
Data were used from 727 Dutch community-dwelling older adults aged ≥70 years. Protein intake at meal and snack moments was measured with two non-consecutive dietary record assisted 24-h recalls. Low protein intake was defined as below the Recommended Dietary Allowance of 0.8 g protein per kg adjusted body weight per day (g/kg aBW/d). Differences in protein and food intakes between those with a low and a high protein intake were assessed with the Mann-Whitney U test and Chi-square test. Eating occasions were compared with regard to differences between the low and high protein intake group by using MANOVA. Characteristics of older adults with low protein intake were selected by using a multiple logistic backward elimination procedure.
Low protein intake was present in 15% of the participants. At all eating occasions, median protein intake was lower in the low compared to the high protein intake group (breakfast, 7.8 vs. 10.8 g; lunch, 12.6 vs. 24.3 g; dinner, 21.8 vs. 31.1 g; snack moments, 6.7 vs. 9.7 g; P < 0.001), and was also consistently lower relative to energy intake. The contribution of animal protein to total protein intake was lower among the low protein intake group. Both groups obtained most protein from dairy, meat and cereals, but meat contributed less (21.5 vs. 28.2%) and cereals more (21.9 vs. 19.6%) among the low than the high protein intake group (all P < 0.01). Differences in protein intake, percentage of energy from protein and contribution of animal to total protein intake between the groups were largest at lunch compared to the other eating occasions. Out of a long list of variables, low protein intake was only associated with following a diet, being obese vs. normal-weight and drinking alcohol on none vs. some but <5 days/week (P < 0.05).
At all eating occasions, Dutch community-dwelling older adults with a protein intake <0.8 g/kg aBW/d ate less protein (also relative to their energy intake) and a lower proportion of animal protein compared to those with a high protein intake. These differences were largest at lunch. Major food sources of protein - in both groups - were dairy, meat and cereals. We could only identify following a diet, being obese and not drinking alcohol as general characteristics of older adults with a low protein intake.
老年人需要摄入足够的蛋白质以维持肌肉健康,但蛋白质摄入量低在老年人中非常普遍。对于蛋白质摄入量低的老年人的总体和饮食情况了解甚少。因此,本研究旨在比较蛋白质摄入量低和高的社区居住老年人在每次进食时的蛋白质摄入量、蛋白质的食物来源以及一般参与者特征。
使用了727名年龄≥70岁的荷兰社区居住老年人的数据。通过两次非连续的饮食记录辅助24小时回忆法测量正餐和零食时的蛋白质摄入量。低蛋白质摄入量定义为低于每日每千克调整体重0.8克蛋白质的推荐膳食摄入量(克/千克调整体重/天)。采用曼-惠特尼U检验和卡方检验评估蛋白质摄入量低和高的人群之间蛋白质和食物摄入量的差异。使用多变量方差分析比较低蛋白质摄入量组和高蛋白质摄入量组在进食方面的差异。通过多因素逻辑回归向后逐步淘汰法选择蛋白质摄入量低的老年人的特征。
15%的参与者存在低蛋白质摄入量。在所有进食场合,低蛋白质摄入量组的蛋白质摄入量中位数均低于高蛋白质摄入量组(早餐,7.8克对10.8克;午餐,12.6克对24.3克;晚餐,21.8克对31.1克;零食时,6.7克对9.7克;P<0.001),并且相对于能量摄入量也一直较低。低蛋白质摄入量组中动物蛋白占总蛋白摄入量的比例较低。两组的蛋白质大多来自乳制品、肉类和谷物,但低蛋白质摄入量组中肉类的贡献较少(21.5%对28.2%),谷物的贡献较多(21.9%对19.6%)(所有P<0.01)。与其他进食场合相比,两组之间蛋白质摄入量、蛋白质能量百分比以及动物蛋白占总蛋白摄入量的比例差异在午餐时最大。在一长串变量中,低蛋白质摄入量仅与遵循某种饮食、肥胖与正常体重以及不饮酒与有时饮酒但每周<5天相关(P<0.05)。
在所有进食场合,与蛋白质摄入量高的荷兰社区居住老年人相比,蛋白质摄入量<0.8克/千克调整体重/天的老年人摄入的蛋白质较少(相对于他们的能量摄入量),动物蛋白比例较低。这些差异在午餐时最大。两组的主要蛋白质食物来源都是乳制品、肉类和谷物。我们只能确定遵循某种饮食、肥胖和不饮酒是蛋白质摄入量低的老年人的一般特征。