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Distribution but not amount of protein intake is associated with frailty: a cross-sectional investigation in the region of Nürnberg.

Bollwein J, Diekmann R, Kaiser MJ, Bauer JM, Uter W, Sieber CC, Volkert D - Nutr J (2013)

Bottom Line: The risk of frailty did not differ significantly between participants in the higher compared to the lowest quartile of protein intake.The median (min.-max.) CV of protein distribution was highest in frail (0.76 (0.18-1.33)) compared to pre-frail (0.74 (0.07-1.29)) and non-frail (0.68 (0.15-1.24)) subjects (p = 0.024).In this sample of healthy older persons, amount of protein intake was not associated with frailty, but distribution of protein intake was significantly different between frail, pre-frail and non-frail participants.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Background: To preserve muscle mass and therefore limit the risk of disability in older adults protein intake is seen as important factor. Besides the amount of protein, its distribution over the day is thought to affect protein anabolism. This cross-sectional study investigates the association between the amount and distribution of protein intake and frailty in older adults.

Methods: In 194 community-dwelling seniors (≥75 years) amount of protein intake and its distribution over the day (morning, noon, evening) were assessed using a food frequency questionnaire. Unevenness of protein distribution was calculated as coefficient of variation (CV). Frailty was defined as the presence of at least three, pre-frailty as the presence of one or two of the following criteria: weight loss, exhaustion, low physical activity, low handgrip strength and slow walking speed.

Results: 15.4% of the participants were frail, 40.5% were pre-frail. Median (min.-max.) daily protein intake was 77.5 (38.5-131.5) g, 1.07 (0.58-2.27) g/kg body weight (BW) and 15.9 (11.2-21.8) % of energy intake without significant differences between the frailty groups. The risk of frailty did not differ significantly between participants in the higher compared to the lowest quartile of protein intake. Frail participants consumed significantly less protein in the morning (11.9 vs. 14.9 vs. 17.4%, p = 0,007), but more at noon (61.4 vs. 60.8 vs. 55.3%, p = 0.024) than pre-frail and non-frail. The median (min.-max.) CV of protein distribution was highest in frail (0.76 (0.18-1.33)) compared to pre-frail (0.74 (0.07-1.29)) and non-frail (0.68 (0.15-1.24)) subjects (p = 0.024).

Conclusions: In this sample of healthy older persons, amount of protein intake was not associated with frailty, but distribution of protein intake was significantly different between frail, pre-frail and non-frail participants. More clinical studies are needed to further clarify the relation between protein intake and frailty.

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Related in: MedlinePlus

Boxplots of coefficient of variation (CV) of protein distribution over the three daily mealtimes in non-frail, pre-frail and frail participants. The boxes represent the interquartile range with the bold horizontal lines denoting median CV. The whiskers show the highest and lowest values within 1.5 box lengths from either end of the box and the circles represent outliers. Kruskall-Wallis testing showed that the median CV differed significantly between the three frailty groups (P < 0.05).
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Figure 1: Boxplots of coefficient of variation (CV) of protein distribution over the three daily mealtimes in non-frail, pre-frail and frail participants. The boxes represent the interquartile range with the bold horizontal lines denoting median CV. The whiskers show the highest and lowest values within 1.5 box lengths from either end of the box and the circles represent outliers. Kruskall-Wallis testing showed that the median CV differed significantly between the three frailty groups (P < 0.05).

Mentions: The median CV of frail (0.77 (0.18–1.33)), pre-frail (0.74 (0.07–1.23)) and non-frail (0.68 (0.15–1.24)) persons differed significantly (P < 0.05) (Figure 1). The CV was significantly higher in subjects with low walking speed and exhaustion (P < 0.05) than in participants without these impairments (Table 5).


Distribution but not amount of protein intake is associated with frailty: a cross-sectional investigation in the region of Nürnberg.

Bollwein J, Diekmann R, Kaiser MJ, Bauer JM, Uter W, Sieber CC, Volkert D - Nutr J (2013)

Boxplots of coefficient of variation (CV) of protein distribution over the three daily mealtimes in non-frail, pre-frail and frail participants. The boxes represent the interquartile range with the bold horizontal lines denoting median CV. The whiskers show the highest and lowest values within 1.5 box lengths from either end of the box and the circles represent outliers. Kruskall-Wallis testing showed that the median CV differed significantly between the three frailty groups (P < 0.05).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750269&req=5

Figure 1: Boxplots of coefficient of variation (CV) of protein distribution over the three daily mealtimes in non-frail, pre-frail and frail participants. The boxes represent the interquartile range with the bold horizontal lines denoting median CV. The whiskers show the highest and lowest values within 1.5 box lengths from either end of the box and the circles represent outliers. Kruskall-Wallis testing showed that the median CV differed significantly between the three frailty groups (P < 0.05).
Mentions: The median CV of frail (0.77 (0.18–1.33)), pre-frail (0.74 (0.07–1.23)) and non-frail (0.68 (0.15–1.24)) persons differed significantly (P < 0.05) (Figure 1). The CV was significantly higher in subjects with low walking speed and exhaustion (P < 0.05) than in participants without these impairments (Table 5).

Bottom Line: The risk of frailty did not differ significantly between participants in the higher compared to the lowest quartile of protein intake.The median (min.-max.) CV of protein distribution was highest in frail (0.76 (0.18-1.33)) compared to pre-frail (0.74 (0.07-1.29)) and non-frail (0.68 (0.15-1.24)) subjects (p = 0.024).In this sample of healthy older persons, amount of protein intake was not associated with frailty, but distribution of protein intake was significantly different between frail, pre-frail and non-frail participants.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Background: To preserve muscle mass and therefore limit the risk of disability in older adults protein intake is seen as important factor. Besides the amount of protein, its distribution over the day is thought to affect protein anabolism. This cross-sectional study investigates the association between the amount and distribution of protein intake and frailty in older adults.

Methods: In 194 community-dwelling seniors (≥75 years) amount of protein intake and its distribution over the day (morning, noon, evening) were assessed using a food frequency questionnaire. Unevenness of protein distribution was calculated as coefficient of variation (CV). Frailty was defined as the presence of at least three, pre-frailty as the presence of one or two of the following criteria: weight loss, exhaustion, low physical activity, low handgrip strength and slow walking speed.

Results: 15.4% of the participants were frail, 40.5% were pre-frail. Median (min.-max.) daily protein intake was 77.5 (38.5-131.5) g, 1.07 (0.58-2.27) g/kg body weight (BW) and 15.9 (11.2-21.8) % of energy intake without significant differences between the frailty groups. The risk of frailty did not differ significantly between participants in the higher compared to the lowest quartile of protein intake. Frail participants consumed significantly less protein in the morning (11.9 vs. 14.9 vs. 17.4%, p = 0,007), but more at noon (61.4 vs. 60.8 vs. 55.3%, p = 0.024) than pre-frail and non-frail. The median (min.-max.) CV of protein distribution was highest in frail (0.76 (0.18-1.33)) compared to pre-frail (0.74 (0.07-1.29)) and non-frail (0.68 (0.15-1.24)) subjects (p = 0.024).

Conclusions: In this sample of healthy older persons, amount of protein intake was not associated with frailty, but distribution of protein intake was significantly different between frail, pre-frail and non-frail participants. More clinical studies are needed to further clarify the relation between protein intake and frailty.

Show MeSH
Related in: MedlinePlus