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基于网络的烹饪医学对提高老年人蛋白质摄入量及肌肉质量的影响:随机对照试验

The Effect of Web-Based Culinary Medicine to Enhance Protein Intake on Muscle Quality in Older Adults: Randomized Controlled Trial.

作者信息

Salas-Groves Emily, Alcorn Michelle, Childress Allison, Galyean Shannon

机构信息

Nutritional Sciences, Texas Tech University, Lubbock, TX, United States.

Hospitality and Retail Management, Texas Tech University, Lubbock, TX, United States.

出版信息

JMIR Form Res. 2024 Feb 13;8:e49322. doi: 10.2196/49322.

Abstract

BACKGROUND

The most common age-related musculoskeletal disorder is sarcopenia. Sarcopenia is the progressive and generalized loss of muscle mass, strength, and function. The causes of sarcopenia can include insufficient nutritional status, which may be due to protein-energy malnutrition, anorexia, limited food access and eating ability, or malabsorption. In the United States, 15.51% of older adults have been diagnosed with sarcopenia. Culinary medicine (CM) is a novel evidence-based medical field that combines the science of medicine with food and cooking to prevent and treat potential chronic diseases. CM helps individuals learn and practice culinary skills while tasting new recipes. Therefore, this program could successfully reduce barriers to protein intake, enabling older adults to enhance their diet and muscle quality.

OBJECTIVE

This study aimed to examine how a web-based CM intervention, emphasizing convenient ways to increase lean red meat intake, could improve protein intake with the promotion of physical activity to see how this intervention could affect older adults' muscle strength and mass.

METHODS

A 16-week, single-center, parallel-group, randomized controlled trial was conducted to compare a web-based CM intervention group (CMG) with a control group (CG) while monitoring each group's muscle strength, muscle mass, and physical activity for muscle quality. The CMG received weekly web-based cooking demonstrations and biweekly nutrition education videos about enhancing protein intake, whereas the CG just received the recipe handout. Anthropometrics, muscle mass, muscle strength, dietary habits, physical activity, and cooking effectiveness were established at baseline and measured after the intervention. The final number of participants for the data analysis was 24 in the CMG and 23 in the CG.

RESULTS

No between-group difference in muscle mass (P=.88) and strength (dominant P=.92 and nondominant P=.72) change from the prestudy visit was detected. No statistically significant difference in protein intake was seen between the groups (P=.50). A nonsignificant time-by-intervention interaction was observed for daily protein intake (P=.08). However, a statistically significant time effect was observed (P≤.001). Post hoc testing showed that daily protein intake was significantly higher at weeks 1 to 16 versus week 0 (P<.05). At week 16, the intake was 16.9 (95% CI 5.77-27.97) g higher than that at the prestudy visit.

CONCLUSIONS

This study did not affect protein intake and muscle quality. Insufficient consistent protein intake, low physical activity, intervention adherence, and questionnaire accuracy could explain the results. These studies could include an interdisciplinary staff, different recruitment strategies, and different muscle mass measurements. Future research is needed to determine if this intervention is sustainable in the long term and should incorporate a follow-up to determine program efficacy on several long-term behavioral and health outcomes, including if the participants can sustain their heightened protein intake and how their cooking skills have changed.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05593978; https://clinicaltrials.gov/ct2/show/NCT05593978.

摘要

背景

与年龄相关的最常见肌肉骨骼疾病是肌肉减少症。肌肉减少症是肌肉质量、力量和功能的进行性全身性丧失。肌肉减少症的病因可能包括营养状况不足,这可能是由于蛋白质 - 能量营养不良、厌食、食物获取和进食能力受限或吸收不良。在美国,15.51% 的老年人被诊断患有肌肉减少症。烹饪医学(CM)是一个新兴的循证医学领域,它将医学科学与食物和烹饪相结合,以预防和治疗潜在的慢性疾病。烹饪医学帮助个人在品尝新食谱的同时学习和实践烹饪技能。因此,该项目可以成功减少蛋白质摄入的障碍,使老年人能够改善饮食和肌肉质量。

目的

本研究旨在探讨基于网络的烹饪医学干预措施,强调增加瘦红肉摄入量的便捷方法,如何通过促进身体活动来改善蛋白质摄入,以及这种干预措施如何影响老年人的肌肉力量和质量。

方法

进行了一项为期16周的单中心、平行组、随机对照试验,将基于网络的烹饪医学干预组(CMG)与对照组(CG)进行比较,同时监测每组的肌肉力量、肌肉质量和身体活动以评估肌肉质量。CMG每周接受基于网络的烹饪示范,并每两周接受一次关于增加蛋白质摄入的营养教育视频,而CG只收到食谱手册。在基线时确定人体测量学、肌肉质量、肌肉力量、饮食习惯、身体活动和烹饪效果,并在干预后进行测量。用于数据分析的最终参与者数量为CMG组24人,CG组23人。

结果

未检测到两组之间肌肉质量(P = 0.88)和力量(优势侧P = 0.92,非优势侧P = 0.72)自研究前访视以来的变化差异。两组之间的蛋白质摄入量无统计学显著差异(P = 0.50)。观察到每日蛋白质摄入量存在非显著的时间×干预交互作用(P = 0.08)。然而,观察到有统计学显著的时间效应(P≤0.001)。事后检验表明,第1至16周的每日蛋白质摄入量显著高于第0周(P < 0.05)。在第16周,摄入量比研究前访视时高16.9(95% CI 5.77 - 27.97)g。

结论

本研究未影响蛋白质摄入量和肌肉质量。蛋白质摄入持续不足、身体活动水平低、干预依从性以及问卷准确性可能解释了这些结果。这些研究可能需要跨学科工作人员、不同的招募策略以及不同的肌肉质量测量方法。未来需要进行研究以确定这种干预措施从长期来看是否可持续,并且应该纳入随访以确定该项目对多种长期行为和健康结果的疗效,包括参与者是否能够维持增加的蛋白质摄入量以及他们的烹饪技能有何变化。

试验注册

ClinicalTrials.gov NCT05593978;https://clinicaltrials.gov/ct2/show/NCT05593978

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a77/10900082/4817c073907a/formative_v8i1e49322_fig1.jpg

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