Protein Intake and Its Association With Meal Patterns and Dietary Patterns in a Swedish Population of Older Adults.

Meeting protein intake recommendations is relevant for maintaining muscle mass. This study aimed to describe protein intake and its association with meal patterns and dietary patterns. An in-house designed, web-based 4-day record was used in the national dietary survey (in 2010/2011). Participants 60 years and older were included in the analysis (n = 533). Protein intake was described by hour of consumption, self-indicated meals and food source. Eating and drinking occasion (EDO) and food groups were defined, from which meal patterns and three a posteriori dietary patterns (using principal component analysis) were assessed. We observed a mean protein intake of just over 1 g/kg body weight (bw) in both men and women. Over 50% of the protein intake was sourced from the food groups meat, fish and milk/yoghurt. A bolus intake of 30 g protein per meal was observed in a small proportion of participants at breakfast and lunch, but was most common at dinner (41% women and 56% men). No strong correlations were observed between protein intake and neither dietary patterns nor the number of EDOs. A 5 g higher protein intake at any meal, but not higher EDO frequency, was associated with higher odds of meeting a protein intake over 1.1 g/kg bw. Protein intake over 1.1 g/kg bw was met by 44% of the participants. Lunch and dinner were the highest contributors to protein intake. Dietary and meal patterns were weakly associated with protein intake. Only total daily protein intake was associated with reaching > 1.1 g/kg bw.

Engelheart S ，Karlsson M ，Lentjes MAH 《-》

Comparison of protein intake per eating occasion, food sources of protein and general characteristics between community-dwelling older adults with a low and high protein intake.

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.

Hengeveld LM ，Pelgröm ADA ，Visser M ，Boer JMA ，Haveman-Nies A ，Wijnhoven HAH ... -  《Clinical Nutrition ESPEN》

Dietary protein intake, protein sources & distribution patterns in community-dwelling older adults: A harmonized analysis of eight studies.

Sufficient protein intake is important for older adults to prevent sarcopenia. Better insight into dietary characteristics may be helpful to improve daily protein intake. Therefore, this study aimed to compare characteristics of community-dwelling older adults with distinct amounts of daily protein intake. Baseline data of older adults (age >55 years) from eight intervention studies were pooled. Protein intake was measured using 24-h recalls or 3-day food records. Participants were stratified into one of four different groups based on their habitual protein intake (<0.8 g per kilogram bodyweight per day (g/kg/d), 0.8-0.99 g/kg/d, 1.0-1.2 g/kg/d and >1.2 g/kg/d). Protein intake per meal, animal-versus plant-based protein intake, daily protein distribution patterns (e.g. spread or pulse) and the protein intake from distinct protein-rich food categories (meat, fish, dairy, grains and others) were assessed. Among 814 participants (69 ± 9 years, 54 % male), mean protein intake was 0.98 ± 0.30 g/kg/d. 28 % (n = 227) of the population had a protein intake <0.8 g/kg/d, 29 % (n = 240) 0.8-0.99 g/kg/d, 22 % (n = 179) 1.0-1.2 g/kg/d and 21 % (n = 168) >1.2 g/kg/d. Higher protein intake groups had a lower body weight and BMI and a higher energy intake per day. Although protein intake distribution patterns did not differ across groups, meals with >20 g or >0.4 g protein per kilogram bodyweight per meal more often occurred in the higher protein intake groups. Protein intake was the lowest at breakfast followed by lunch and dinner, in all groups. Higher protein intake groups consumed a higher proportion of animal-based protein sources. Distinct protein intake groups showed comparable intake distribution patterns, with lowest protein consumption at breakfast and highest at dinner. Nevertheless, the highest protein intake group more often consumed >20 gr of protein per meal, indicating that a focus on the absolute amount of protein per meal, particularly at breakfast, could further optimize daily protein intake in older adults.

Koopmans L ，van Oppenraaij S ，Heijmans MWF ，Verlaan S ，Schoufour JD ，Ten Haaf DSM ，van der Avoort CMT ，van den Helder J ，Memelink R ，Verreijen A ，Weijs PJM ，Eijsvogels TMH ，Hopman MTE ... -  《-》

Meal-specific dietary patterns and their contribution to overall dietary patterns in the Japanese context: Findings from the 2012 National Health and Nutrition Survey, Japan.

Most studies on dietary patterns have focused on the total daily intake of foods without differentiating intake at specific eating occasions. The aim of this study was to identify meal-specific (breakfast, lunch, and dinner) dietary patterns and examine their contribution to overall dietary patterns, using data from the 2012 National Health and Nutrition Survey, Japan. Dietary intake was assessed with a 1-d weighed dietary record for 15 618 Japanese adults ≥20 y of age. Using principal component analysis based on daily consumption of 22 food groups, four overall dietary patterns were identified: vegetable/fruit/fish/pulse, bread/dairy, meat/fat, and noodle/seasoning patterns. Four meal-specific dietary patterns, which were independently identified in the same manner based on consumption at each eating occasion, were as follows: • Breakfast: rice/vegetable/fish/pulse/seasoning, bread/dairy/fruit/sugar, meat/egg/fat, and tea/coffee patterns; • Lunch: bread/dairy, noodle/seasoning, meat/fat, and vegetable/pulse/potato/sugar patterns; and • Dinner: meat/vegetable/seasoning, noodle/alcoholic beverage, fish/sugar/alcoholic beverage, and other grains/fat patterns. The major contributors to interindividual variation in the vegetable/fruit/fish/pulse overall dietary pattern included the rice/vegetable/fish/pulse/seasoning breakfast (28%), the vegetable/pulse/potato/sugar lunch (15%), and the fish/sugar/alcoholic beverage dinner (19%). For other overall dietary patterns, the major contributors were generally patterns with similar characteristics, namely the bread/dairy/fruit/sugar breakfast (33%) and the bread/dairy lunch (24%) for the bread/dairy overall dietary pattern; the meat/egg/fat breakfast (13%), the meat/fat lunch (33%), the meat/vegetable/seasoning dinner (28%), and the other grains/fat dinner (11%) for the meat/fat overall dietary pattern; and the noodle/seasoning lunch (51%) and the noodle/alcoholic beverage dinner (25%) for the noodle/seasoning overall dietary pattern. Major meal-specific dietary patterns were identified in the Japanese context, which differentially contributed to major overall dietary patterns.

Murakami K ，Livingstone MBE ，Sasaki S 《-》

Habitual protein intake, protein distribution patterns and dietary sources in Irish adults with stratification by sex and age.

Given the importance of habitual dietary protein intake, distribution patterns and dietary sources in the aetiology of age-related declines of muscle mass and function, the present study examined these factors as a function of sex and age in Irish adults aged 18-90 years comprising The National Adult Nutrition Survey (NANS). In total, 1051 (males, n = 523; females, n = 528) undertook a 4-day semi-weighed food diary. Total, body mass relative intake and percentage contribution to total energy intake of dietary protein were determined in addition to protein distribution scores (PDS), as well as the contribution of food groups, animal- and plant-based foods to total protein intake. Total and relative protein intake [mean (SD)] were highest in those aged 18-35 years [96 (3) g day-1 , 1.32 (0.40) g kg-1  day-1 ], with lower protein intakes with increasing age (i.e. in adults aged ≥65 years [82 (22) g, 1.15 (0.34) g kg-1  day-1 , P < 0.001 for both]. Differences in protein intake between age groups were more pronounced in males compared to females. Protein distribution followed a skewed pattern for all age groups [breakfast, 15 (10) g; lunch, 30 (15) g; dinner, 44 (17) g]. Animal-based foods were the dominant protein source within the diet [63% (11%) versus 37% (11%) plant protein, P < 0.001]. Protein intake and the number of meals reaching the purported threshold for maximising post-prandial anabolism were highest in young adults, and lower with increasing age. For main meals, breakfast provided the lowest quantity of protein across all age categories and may represent an opportunity for improving protein distribution, whereas, in older adults, increasing the number of meals reaching the anabolic threshold regardless of distribution pattern may be more appropriate.

Hone M ，Nugent AP ，Walton J ，McNulty BA ，Egan B ... -  《-》