Increasing Protein Intake to Help Older Adults Increase Muscle Strength and Function: A Pilot, Single-Arm Investigation Using Coaching and a Per-Meal Protein Prescription

Abstract

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.

Nurse-led coaching to improve dietary protein intake and reduce the risk of sarcopenia in middle-aged women

“…Either alone, or in combination, these three key components have been identified in aforementioned studies examining determinants of successful coaching delivered by nurses. [25,26,35,36,38] Limitations This study's relatively small sample size of only women, and who were generally highly educated and primarily non-Hispanic White, pose limitations with regards to the generalizability of the study findings. Coaching, however, continues to emerge in the scientific literature as an effective means of promoting behavior change.…”

“…[21][22][23][24][25] In addition, it has also been shown to be effective when used in combination with nutrition education in a single-arm pilot study aimed at increasing protein intake in a group of older adults. [26] Given the effectiveness of coaching in these aforementioned studies, this study sought to determine the effectiveness and how coaching by a nurse practitioner contributed to middle-aged women making changes in dietary protein intake. This study fills a gap in the scientific literature; given while there are numerous studies demonstrating the effectiveness of coaching, published studies-to-date have not examined how coaching helped to effect the observed behavior changes.…”

The impact of a pilot telehealth coaching intervention to improve caregiver stress and well-being and to increase dietary protein intake of caregivers and their family members with dementia – Interrupted by COVID-19

“…The use of diet coaching, with the provision of a protein prescription and nutrition education, has not been previously studied with FCGs and has not been previously conducted using computer/ipad-based video teleconferencing. Diet coaching to improve protein intakes, however, has been employed in two other studies with the coaching conducted via telephone along with some in person participant contacts (Gropper et al, 2020; Jackson et al, 2022). The findings from the present study were consistent with the findings of the two previous studies which demonstrated that diet coaching significantly improved dietary protein intake in middle- and older-aged adults (Gropper et al, 2020; Jackson et al, 2022) as well as improved muscle strength and function in middle-aged adults (Jackson et al, 2022).…”

Effectiveness of a Per-Meal Protein Prescription and Nutrition Education with versus without Diet Coaching on Dietary Protein Intake and Muscle Health in Middle-Aged Women

“…Sufficient dietary protein intake is critical to the maintenance of muscle mass, strength, and physical function (i.e., muscle health) or attenuating losses of muscle health that commonly occur with aging. Yet, protein intake among adults is often inadequate [1][2][3][4][5][6][7][8]. National Health and Nutrition Examination Surveys 2005-2014 data from a group of 11,680 adults reported an inadequate protein intake (less than the recommended dietary allowance (RDA) of 0.8 g/kg body weight) among 45% of females and 31% of males aged 51-60 years and among 48% of females and 37% of males aged 61-70 years [4,6].…”

“…Another approach that has been used successfully to help adults change dietary behaviors associated with chronic diseases (such as type 2 diabetes and heart disease) is diet coaching [39][40][41][42]. Only one study, a single-arm pilot investigation, has assessed its use in improving protein consumption but this was examined in older adults [3]. Absent from the literature, but fulfilled from this study, is an examination of the impact of a per-meal protein prescription and nutrition education that utilized diet coaching in improving protein intake among middle-aged women.…”