老年人特定餐次的每日蛋白质摄入量与瘦体重的关系：横断面 BASE-II 研究的结果。

Association between meal-specific daily protein intake and lean mass in older adults: results of the cross-sectional BASE-II study.

机构信息

Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Department of Endocrinology, Diabetes and Metabolism, Berlin Institute of Health, Berlin, Germany.

Department of Geriatrics, Intensive Care Unit, St. Joseph Hospital Berlin Tempelhof, Berlin, Germany.

出版信息

Am J Clin Nutr. 2021 Sep 1;114(3):1141-1147. doi: 10.1093/ajcn/nqab144.

DOI:10.1093/ajcn/nqab144

PMID:33963728

Abstract

BACKGROUND

Adequate total and meal-specific protein intake is considered an important prerequisite to preserve appendicular lean mass (ALM) in older adults and to prevent sarcopenia.

OBJECTIVES

We analyzed the meal-specific protein intake across the main meals between participants with normal vs. low ALM to BMI ratio (ALMBMI).

METHODS

782 participants [59.6% men; median 69 (IQR: 65, 71) y] of the Berlin Aging Study II have been included in this analysis. ALM was assessed by dual X-ray absorptiometry. Low lean mass was defined as ALMBMI using recommended sex-specific cut-offs. A 5-day nutritional protocol was used to assess total and meal-specific protein intake.

RESULTS

Median total protein intake was 0.89 (IQR: 0.74, 1.05) g/kg/d body weight (BW) in participants with low ALMBMI and 1.02 (IQR: 0.86, 1.21) g/kg BW in participants with normal ALMBMI (P < 0.001). Daily protein intake at breakfast was similar in both groups [0.23 (95% CI: 0.20, 0.26) vs. 0.24 (95% CI: 0.23, 0.26) g/kg BW; P = 0.245]. Subjects with low ALMBMI reported a lower protein intake at lunch and dinner compared with those with normal ALMBMI [0.29 (95% CI: 0.27, 0.32) vs. 0.35 (95% CI: 0.34, 0.36) g/kg BW; P = 0.001 and 0.32 (95% CI: 0.30, 0.35) vs. 0.36 (95% CI: 0.35, 0.37) g/kg BW; P = 0.027, respectively]. In a stepwise regression model, a higher total protein intake was positively associated with ALMBMI [ß = 0.10 (95% CI: 0.07, 0.13) P < 0.001]. The protein intake at dinner was positively associated with ALMBMI [ß = 0.14 (95% CI: 0.08, 0.19) P < 0.001] irrespective of protein intake at breakfast and lunch. This association disappeared after additional adjustment for total protein intake.

CONCLUSION

Our data highlight an association of total protein intake and ALMBMI in older adults. Although current data support an association of high ALMBMI with protein intake at dinner in particular, this was not independent from total protein intake and the findings do not allow a conclusion on causality.

摘要

背景

足够的总蛋白和每餐特定蛋白摄入量被认为是维持老年人四肢瘦体重（ALM）和预防肌肉减少症的重要前提。

目的

我们分析了正常 ALM 与 BMI 比值（ALMBMI）的参与者与低 ALMBMI 参与者之间的主要餐次的每餐特定蛋白摄入量。

方法

本研究纳入了柏林老龄化研究 II 的 782 名参与者[59.6%为男性；中位年龄 69（IQR：65，71）岁]。通过双能 X 线吸收法评估 ALM。使用推荐的性别特异性截断值，将低瘦体重定义为 ALMBMI。采用 5 天营养方案评估总蛋白和每餐特定蛋白摄入量。

结果

低 ALMBMI 参与者的总蛋白摄入量中位数为 0.89（IQR：0.74，1.05）g/kg/d 体重（BW），而正常 ALMBMI 参与者的总蛋白摄入量中位数为 1.02（IQR：0.86，1.21）g/kg BW（P<0.001）。两组早餐的每日蛋白质摄入量相似[0.23（95%CI：0.20，0.26）与 0.24（95%CI：0.23，0.26）g/kg BW；P=0.245]。与正常 ALMBMI 参与者相比，低 ALMBMI 参与者报告午餐和晚餐的蛋白质摄入量较低[0.29（95%CI：0.27，0.32）与 0.35（95%CI：0.34，0.36）g/kg BW；P=0.001 和 0.32（95%CI：0.30，0.35）与 0.36（95%CI：0.35，0.37）g/kg BW；P=0.027]。在逐步回归模型中，较高的总蛋白摄入量与 ALMBMI 呈正相关[β=0.10（95%CI：0.07，0.13）P<0.001]。晚餐的蛋白质摄入量与 ALMBMI 呈正相关[β=0.14（95%CI：0.08，0.19）P<0.001]，无论早餐和午餐的蛋白质摄入量如何。这种关联在额外调整总蛋白摄入量后消失。