Nutritional Adequacy and Protein Intake in Older Adults at Risk of Undernutrition with Subjective Memory Decline Enrolled in the Protein-Enriched Mediterranean Diet, with or without Exercise (PROMED-EX) Trial

Older adults are vulnerable to undernutrition, resulting in weight loss and adverse health outcomes, including a loss of independence and a lower quality of life. Adequate protein intake is particularly important for the maintenance of muscle health during ageing. The UK population reference intake...

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Main Authors: Nicola Ann Ward, Lorraine Brennan, Lisette C. P. G. M. de Groot, Federica Prinelli, Dorothee Volkert, Jayne V. Woodside, Claire T. McEvoy
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Language:English
Published: MDPI AG 2024-02-01
Series:Proceedings
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Online Access:https://www.mdpi.com/2504-3900/91/1/205
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author Nicola Ann Ward
Lorraine Brennan
Lisette C. P. G. M. de Groot
Federica Prinelli
Dorothee Volkert
Jayne V. Woodside
Claire T. McEvoy
author_facet Nicola Ann Ward
Lorraine Brennan
Lisette C. P. G. M. de Groot
Federica Prinelli
Dorothee Volkert
Jayne V. Woodside
Claire T. McEvoy
author_sort Nicola Ann Ward
collection DOAJ
description Older adults are vulnerable to undernutrition, resulting in weight loss and adverse health outcomes, including a loss of independence and a lower quality of life. Adequate protein intake is particularly important for the maintenance of muscle health during ageing. The UK population reference intake for protein (0.75 g/kg/day) may not be sufficient to counteract the reduced responsiveness of older skeletal muscle to anabolic stimulus. Research suggests that 1.2 g/kg/day of protein may be optimal, considering distribution (25–30 g/meal) and leucine-rich sources typically found in animal protein, especially for those at high nutritional risk. PROMED-EX is a randomised controlled trial testing a PROtein-enriched MEDiterranean Diet, with or without Exercise on nutritional status and memory, in older adults (60+) at risk of undernutrition, with subjective memory decline. The current aim is to determine the baseline nutritional adequacy of adults enrolled in PROMED-EX. Participants completed 4-day food diaries at baseline. Diaries were analysed for energy and nutrients using Nutritics. Nutritional adequacy was determined by comparing sex- and age-specific UK dietary reference values (DRVs). Protein intake was also compared to higher recommended DRVs for older adults. Fifty participants (60% female; age 67 ± 6.0 years; BMI: 23.5 ± 2.8 kg/m<sup>2</sup>) were included. Insufficient energy intake in men (1803.4 ± 510.7 kcal/d) and women (1776.2 ± 508.7 kcal/d)) in the sample, with 22.0% meeting the energy DRVs. The risk of nutrient inadequacy was highest for fibre and vitamin D, with almost all failing to meet the DRVs. Less than 50% met nutritional adequacy for vitamin A, iodine, iron, magnesium, potassium, and selenium. Over 35% had suboptimal intakes for selected B vitamins (niacin, folate) and calcium. Most (82%) of the sample achieved the UK protein target of 0.75 g/kg/day, with only 34% meeting the higher 1.2 g/kg/day target. The mean protein intake was less than optimal for breakfast (12.3 ± 7.0 g) and lunch (17.1 ± 8.8 g), accounting for 17.3% and 24.1% total daily protein intake, and highest at dinner time (48.2%) at 34.3 ± 18.3 g. The primary protein contributors were ‘cereals’ (15.7%), followed by ‘dairy’ (14.9%), ‘processed meat’ (10.9%), ‘poultry’ (10.8%), and ‘red meat’ (10.5%). Increasing protein intakes at breakfast and lunch alongside leucine-rich sources could help achieve the optimal protein intake. The nutrient-dense PROMED-EX intervention may be beneficial for this at- risk population with suboptimal nutrient intakes.
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spelling doaj-art-465cc44aba0f494abd4481b8d5da38812025-08-20T03:44:04ZengMDPI AGProceedings2504-39002024-02-0191120510.3390/proceedings2023091205Nutritional Adequacy and Protein Intake in Older Adults at Risk of Undernutrition with Subjective Memory Decline Enrolled in the Protein-Enriched Mediterranean Diet, with or without Exercise (PROMED-EX) TrialNicola Ann Ward0Lorraine Brennan1Lisette C. P. G. M. de Groot2Federica Prinelli3Dorothee Volkert4Jayne V. Woodside5Claire T. McEvoy6Centre for Public Health, Queen’s University Belfast, Grosvenor Road, Belfast BT12 6BJ, UKSchool of Agriculture and Food Science, Institute of Food and Health and Conway Institute, University College Dublin, D04 V1W8 Dublin, IrelandDivision of Human Nutrition, Wageningen University & Research, 6703 HE Wageningen, The NetherlandsEpidemiology Unit, Institute of Biomedical Technologies, National Research Council (CNR), 20054 Segrate, ItalyInstitute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, 90408 Nuremberg, GermanyCentre for Public Health, Queen’s University Belfast, Grosvenor Road, Belfast BT12 6BJ, UKCentre for Public Health, Queen’s University Belfast, Grosvenor Road, Belfast BT12 6BJ, UKOlder adults are vulnerable to undernutrition, resulting in weight loss and adverse health outcomes, including a loss of independence and a lower quality of life. Adequate protein intake is particularly important for the maintenance of muscle health during ageing. The UK population reference intake for protein (0.75 g/kg/day) may not be sufficient to counteract the reduced responsiveness of older skeletal muscle to anabolic stimulus. Research suggests that 1.2 g/kg/day of protein may be optimal, considering distribution (25–30 g/meal) and leucine-rich sources typically found in animal protein, especially for those at high nutritional risk. PROMED-EX is a randomised controlled trial testing a PROtein-enriched MEDiterranean Diet, with or without Exercise on nutritional status and memory, in older adults (60+) at risk of undernutrition, with subjective memory decline. The current aim is to determine the baseline nutritional adequacy of adults enrolled in PROMED-EX. Participants completed 4-day food diaries at baseline. Diaries were analysed for energy and nutrients using Nutritics. Nutritional adequacy was determined by comparing sex- and age-specific UK dietary reference values (DRVs). Protein intake was also compared to higher recommended DRVs for older adults. Fifty participants (60% female; age 67 ± 6.0 years; BMI: 23.5 ± 2.8 kg/m<sup>2</sup>) were included. Insufficient energy intake in men (1803.4 ± 510.7 kcal/d) and women (1776.2 ± 508.7 kcal/d)) in the sample, with 22.0% meeting the energy DRVs. The risk of nutrient inadequacy was highest for fibre and vitamin D, with almost all failing to meet the DRVs. Less than 50% met nutritional adequacy for vitamin A, iodine, iron, magnesium, potassium, and selenium. Over 35% had suboptimal intakes for selected B vitamins (niacin, folate) and calcium. Most (82%) of the sample achieved the UK protein target of 0.75 g/kg/day, with only 34% meeting the higher 1.2 g/kg/day target. The mean protein intake was less than optimal for breakfast (12.3 ± 7.0 g) and lunch (17.1 ± 8.8 g), accounting for 17.3% and 24.1% total daily protein intake, and highest at dinner time (48.2%) at 34.3 ± 18.3 g. The primary protein contributors were ‘cereals’ (15.7%), followed by ‘dairy’ (14.9%), ‘processed meat’ (10.9%), ‘poultry’ (10.8%), and ‘red meat’ (10.5%). Increasing protein intakes at breakfast and lunch alongside leucine-rich sources could help achieve the optimal protein intake. The nutrient-dense PROMED-EX intervention may be beneficial for this at- risk population with suboptimal nutrient intakes.https://www.mdpi.com/2504-3900/91/1/205undernutritionsubjective cognitive declinedietary reference valuesolder adultsprotein
spellingShingle Nicola Ann Ward
Lorraine Brennan
Lisette C. P. G. M. de Groot
Federica Prinelli
Dorothee Volkert
Jayne V. Woodside
Claire T. McEvoy
Nutritional Adequacy and Protein Intake in Older Adults at Risk of Undernutrition with Subjective Memory Decline Enrolled in the Protein-Enriched Mediterranean Diet, with or without Exercise (PROMED-EX) Trial
Proceedings
undernutrition
subjective cognitive decline
dietary reference values
older adults
protein
title Nutritional Adequacy and Protein Intake in Older Adults at Risk of Undernutrition with Subjective Memory Decline Enrolled in the Protein-Enriched Mediterranean Diet, with or without Exercise (PROMED-EX) Trial
title_full Nutritional Adequacy and Protein Intake in Older Adults at Risk of Undernutrition with Subjective Memory Decline Enrolled in the Protein-Enriched Mediterranean Diet, with or without Exercise (PROMED-EX) Trial
title_fullStr Nutritional Adequacy and Protein Intake in Older Adults at Risk of Undernutrition with Subjective Memory Decline Enrolled in the Protein-Enriched Mediterranean Diet, with or without Exercise (PROMED-EX) Trial
title_full_unstemmed Nutritional Adequacy and Protein Intake in Older Adults at Risk of Undernutrition with Subjective Memory Decline Enrolled in the Protein-Enriched Mediterranean Diet, with or without Exercise (PROMED-EX) Trial
title_short Nutritional Adequacy and Protein Intake in Older Adults at Risk of Undernutrition with Subjective Memory Decline Enrolled in the Protein-Enriched Mediterranean Diet, with or without Exercise (PROMED-EX) Trial
title_sort nutritional adequacy and protein intake in older adults at risk of undernutrition with subjective memory decline enrolled in the protein enriched mediterranean diet with or without exercise promed ex trial
topic undernutrition
subjective cognitive decline
dietary reference values
older adults
protein
url https://www.mdpi.com/2504-3900/91/1/205
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