The protein gap—increasing protein intake in the diet of community-dwelling older adults: a simulation study

Abstract

Objective: Approximately 50% of Dutch community-dwelling older adults does not meet protein recommendations. This study assesses the effect of replacing low protein foods with protein-rich alternatives on protein intake of Dutch community-dwelling older adults. Design: The Dutch National Food Consumption Survey – Older Adults 2010-2012 was used for scenario modelling. Dietary intake was estimated for 727 adults aged 70+ based on two 24-h recalls. Commonly consumed products were replaced by comparable products rich in protein (scenario 1), foods enriched in protein (scenario 2), and a combination of both (scenario 3). Replacement scenarios were confined to participants whose dietary protein intake was <1.0g/kg BW/day (n=391). Habitual protein intake of all older adults was estimated, adjusting for effects of within-person variation in the 2-days intake data. Results: Mean protein intake of the total population increased from 1.0 to 1.2 g/kg BW/day (scenarios 1 and 2) and to 1.3 g/kg BW/day (scenario 3). The percentage of participants with intakes of ≥1.0 g/kg BW/day increased from 47.1% to 91.4%, 90.2%, and 94.6% respectively in scenarios 1, 2 and 3. The largest increases in protein intake were due to replacements in food groups Yoghurt, cream desserts and pudding, Potatoes, vegetables and legumes and Non-alcoholic beverages and milk in scenario 1 and Bread; Yoghurt, cream desserts and pudding and Soups in scenario 2. Conclusions: This simulation model shows that replacing low protein foods with comparable alternatives rich in protein can increase the protein intake of Dutch community-dwelling older adults considerably. Results can be used as a basis for nutritional counseling.

The Metabolic Syndrome, a Human Disease

“…These complex processes occur within the context of omnivorous feeding, which includes the use of protein as a common/usual staple for energy generation. Our bodies need to maintain their total protein mass/pool as fully functional at any time, despite senescence [507,508] and even under the influence of MS [509,510]. This issue has, so far, been poorly studied for obvious methodological constrictions and even within the context of dietary needs, since many "recommendations" are no longer sustained by current knowledge.…”

How Can Older Consumers Become More Conscious of an Optimal Protein Intake—Outcomes of the ConsuBETER Study

“…Different protein intake scenarios were calculated using the Dutch food consumption survey, in which regular food products were replaced by products (1) with a higher natural protein content, (2) enriched with protein, or (3) a combination of protein-rich and protein-enriched products. This theoretical approach showed that it is possible to increase protein intake (>1.0 g/kg bw/day) without a significant increase in the amount of food consumed [2]. We also studied different aspects of behaviour which influence the protein intake of older adults living at home.…”

Malnutrition during the journey of ageing

“…Another intervention to increase protein intake is to replace low-protein foods with alternative protein-enriched foods. In a simulation study by Verwijs et al [280] in com-munity-dwelling older adults, the percentage that reached the 1.0 gram of protein kg/ bw/day increased from 41.1% to 91.4% when products low in protein were substituted with protein-rich alternatives. However, these results were based on simulation data in the community and it remains unclear how effective this would be in practice.…”

“…One of the first steps is to optimize product choice by choosing energy/protein dense products [74]. A simulation study by Verwijs et al showed that optimization of food choice or the use of energy/ protein-enriched products could increase protein intake towards recommended levels [280], but research towards the effectiveness of increasing energy/protein density in the malnourished community-dwelling older adults is scarce [161]. When appetite is low and requirements are high, the use of oral nutritional support in the form of supplements is advised [74].…”

“…Products that are protein-dense (such as dairy products) are good options to increase protein intake. As most older adults drink high quantities of nutrient-empty products such as coffee and tea (approximately 1.5 litres per day) [339], switching to dairy products is expected to increase protein intake [280]. Switching from empty towards nutrient-dense products will likely result in lower intakes of other products (i.e.…”