Objective: To evaluate the effects of nutrition education, diet coaching, and a protein prescription (PP) on protein intake, and associations with muscle strength and function. Design: Prospective pretest posttest single-arm study. Setting: Urban area, East coast of South Florida. Participants: 20 white, non-Hispanic adults, aged 73.3 + 10.4 years. Intervention: 10-week telephone-based diet coaching, nutrition education and a per-meal PP. Measurements: Protein and energy intakes, weight, grip strength (GS), and 5-chair-rise (5CR), timed up and go (TUG), 3-meter walk (3mW) tests at baseline and 10 weeks. Results: Pre to 10-week post values significantly improved (p<0.05) for protein intake/kg body weight (0.8 + 0.3 to 1.2 + 0.3g), protein intake/meal (17.2 ± 4.8g to 26.4 ± 6.g), protein intake/100 kcal (3.74 + 1.16 to 5.97 + 0.98g), GS (22.4 to 23.4kg), and times for TUG (10 to 8sec), 3mW (4 to 3sec), and 5CR (13 to 11sec). Conclusions: Given the positive findings of this unique pilot investigation, additional studies, which include a larger more diverse group of participants and provide for control group(s), are needed to better investigate the effectiveness of this approach and its effects on muscle strength and function.

Sufficient dietary protein intake is vital to maintaining muscle health with aging. Yet protein intake among adults is often inadequate. This study’s main objective was to examine the impact of nutrition education (NE) and a per-meal protein prescription (PRx) with versus without diet coaching on protein intake. A secondary objective examined its effects on muscle health. Participants included 53 women, age 45–64 years. All participants received NE and PRx; those randomized to coached-group received 10-weeks of diet coaching. Assessments included: protein intake at baseline, weeks 4 and 12 and muscle health (muscle mass, grip strength, five-chair rise test, 4 mgait speed test). The Chi-square test examined percentages of participants meeting PRx between groups. Repeated measures analysis of variance assessed within group and intervention effects on protein intake and muscle health parameters. Protein intake (g/kg body weight) increased (p < 0.001): not-coached (n = 28) 0.8 ± 0.2 to 1.2 ± 0.3 and coached (n = 25) 1.0 ± 0.2 to 1.4 ± 0.3 with no significant difference between groups. A greater percentage of coached-group participants met (p = 0.04) breakfast (72%) and met (p < 0.001) three-meal (76%) PRx versus not-coached participants (25% and 53%, respectively). Participants in both groups exhibited significantly (p < 0.001) improved times for the five-chair rise test and 4 mgait speed test. Diet coaching in conjunction with a PRx and NE should be considered to assist individuals in improving protein intake through self-selection of protein-rich foods.

Objective: Sarcopenia is a disease of low skeletal muscle mass and strength that occurs with aging. It is most commonly seen in individuals aged 50 years and over. Nurse practitioners can take a proactive approach to the understanding and screening of this disease in attempts to prolong its onset or to treat the condition before it leads to additional adverse consequences. Methods: A comprehensive review of the literature, including evidence-based literature from peer-reviewed articles, including randomized controlled trials, was conducted.Results: This review of the literature indicated patients can benefit greatly from nurse practitioner's awareness and intervention by screening for sarcopenia as well as offering appropriate education and treatment to their patients. Once a diagnosis is reached, the nurse practitioner can then collaborate with other disciplines such as nutrition, medicine, exercise physiology and/or physical therapy to develop an intervention strategy that can treat or prevent this condition before it leads to decreased independence, early onset disability and decreased quality of life, among other adverse health outcomes. Conclusions: There is a call to action on the part of nurse practitioners in efforts to prevent and/or slow the onset of age-related sarcopenia and its adverse consequences.

Theoretical frameworks have successfully guided researchers in implementing coaching interventions to effect dietary changes in adults for both prevention and management of chronic diseases. Three such frameworks include the Transtheoretical Model (TTM), Social Cognitive Theory (SCT), and the Theory of Integrative Nurse Coaching (TINC). This article introduces each theory, followed by an overview of the coaching interventions used to effect dietary behaviour changes within each theory. A condensed version of Turner's synthesis methodology is used to determine if a conceptual connection exists among the three models/theories. The condensed version includes synthesis preparation, synthesis (comparison of converging and diverging components), synthesis refinement (conceptual connection), and a concluding discussion of all three theories related to nursing practice. This synthesis will inform the focus of interventions that aim to promote dietary changes in adults at risk of developing sarcopenia.

Background and objective: An adequate dietary protein intake is critical to preventing sarcopenia, a condition characterized by reductions in muscle mass, strength, and function. The objectives of this investigation were to determine the effectiveness and how telephone-based diet coaching by a nurse practitioner contributed to improving dietary protein intakes in middle-aged women.Methods: Middle-aged women were recruited, and those randomized to receive nutrition education (including a protein prescription) and weekly diet coaching (focused on improving protein intake) provided weekly responses to three semi-structured interview questions. Qualitative content analysis was used to examine the responses to these questions. Dietary protein intake was analyzed at baseline and the end of the 12-week study from three 24-hour diet recalls at each time point using diet-analysis software and repeated measures analysis of variance.Results: Coached participants (n = 25) significantly increased dietary protein intake (55.3 ± 10.3 g at baseline to 83.7 ± 14.5 g/day at the end of the study); 19 of the 25 participants (76%) met their recommended dietary protein prescription by the study’s end. Three themes “Identifying Opportunities for Behavior Change”, “Beneficial Behavior Changes”, and “Tailoring Individual Interventions” were identified as a result of the coaching and led to the overarching theme “Empowered by Knowledge, Successful by Support” depicting how coaching contributed to the behavior changes.Conclusions: Nurse-led coaching is an effective approach enabling middle-aged women to improve dietary protein intake. These improvements are especially important in reducing the risk for the development of sarcopenia.