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Distribution of daily protein intake across meals and all-cause mortality in community-dwelling older adults

Published online by Cambridge University Press:  17 November 2022

Daniela B. Estrada-deLeón*
Affiliation:
Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz) and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
Ellen A. Struijk
Affiliation:
Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz) and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
Francisco Félix Caballero
Affiliation:
Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz) and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
Humberto Yévenes-Briones
Affiliation:
Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz) and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
José Ramón Banegas
Affiliation:
Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz) and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
Fernando Rodríguez-Artalejo
Affiliation:
Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz) and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
Esther Lopez-Garcia
Affiliation:
Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz) and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
*
*Corresponding author: Daniela B. Estrada-deLeón, email danniestrada@gmail.com

Abstract

Recent findings suggest that the distribution of protein intake throughout the day has an impact on various health outcomes in older adults, independently of the amount consumed. We evaluated the association between the distribution of dietary protein intake across meals and all-cause mortality in community-dwelling older adults. Data from 3225 older adults aged ≥ 60 years from the Seniors-ENRICA-1 cohort were examined. Habitual dietary protein consumption was collected in 2008–2010 and in 2012 through a validated diet history. Protein distribution across meals was calculated for each participant as the coefficient of variation (CV) of protein intake per meal, in sex-specific tertiles. Vital status was obtained from the National Death Index up to 30 January 2020. Cox proportional hazards regression was performed to determine the hazard ratios (HR) and their 95 % CI for the association between the distribution of daily protein intake across meals and all-cause mortality. Over a median follow-up of 10·6 years, 591 deaths occurred. After adjustment for potential confounders, the CV of total protein intake was not associated with all-cause mortality (HR and 95 % CI in the second and third tertile v. the lowest tertile: 0·94 (0·77, 1·15) and 0·88 (0·72, 1·08); Ptrend = 0·22). Similarly, the HR of all-cause mortality when comparing extreme tertiles of CV for types of protein were 0·89 (0·73, 1·10) for animal-protein intake and 1·02 (0·82, 1·25) for plant-protein intake. Dietary protein distribution across meals was not associated with all-cause mortality, regardless of protein source and amount, among older adults. Further studies should investigate whether this picture holds for specific causes of death.

Type
Research Article
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Nutrition Society

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References

Song, M, Fung, TT, Hu, FB, et al. (2016) Association of animal and plant protein intake with all-cause and cause-specific mortality. JAMA Intern Med 176, 14531463.CrossRefGoogle ScholarPubMed
Hernández-Alonso, P, Salas-Salvadó, J, Ruiz-Canela, M, et al. (2016) High dietary protein intake is associated with an increased body weight and total death risk. Clin Nutr 35, 496506.CrossRefGoogle ScholarPubMed
Chen, Z, Glisic, M, Song, M, et al. (2020) Dietary protein intake and all-cause and cause-specific mortality: results from the Rotterdam Study and a meta-analysis of prospective cohort studies. Eur J Epidemiol 35, 411429.CrossRefGoogle Scholar
Huang, J, Liao, LM, Weinstein, SJ, et al. (2020) Association between plant and animal protein intake and overall and cause-specific mortality. JAMA Intern Med 180, 11731184.CrossRefGoogle ScholarPubMed
Budhathoki, S, Sawada, N, Iwasaki, M, et al. (2019) Association of animal and plant protein intake with all-cause and cause-specific mortality in a Japanese cohort. JAMA Intern Med 179, 15091518.CrossRefGoogle Scholar
Villegas, R, Takata, Y, Murff, H, et al. (2015) Fish, n-3 long-chain fatty acids, and all-cause mortality in a low-income US population: results from the Southern Community Cohort Study. Nutr Metab Cardiovasc Dis 25, 651658.CrossRefGoogle Scholar
Farvid, MS, Malekshah, AF, Pourshams, A, et al. (2017) Dietary protein sources and all-cause and cause-specific mortality: the Golestan cohort study in Iran. Am J Prev Med 52, 237248.CrossRefGoogle ScholarPubMed
Bao, Y, Han, J, Hu, FB, et al. (2013) Association of nut consumption with total and cause-specific mortality. N Engl J Med 369, 20012011.CrossRefGoogle ScholarPubMed
Wu, H, Flint, AJ, Qi, Q, et al. (2015) Association between dietary whole grain intake and risk of mortality: two large prospective studies in US men and women. JAMA Intern Med 175, 373384.CrossRefGoogle ScholarPubMed
van den Brandt, PA (2019) Red meat, processed meat, and other dietary protein sources and risk of overall and cause-specific mortality in The Netherlands Cohort Study. Eur J Epidemiol 34, 351369.CrossRefGoogle ScholarPubMed
Sinha, R, Cross, AJ, Graubard, BI, et al. (2009) Meat intake and mortality: a prospective study of over half a million people. Arch Intern Med 169, 562571.CrossRefGoogle ScholarPubMed
Cruz-Jentoft, AJ, Bahat, G, Bauer, J, et al. (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48, 601.CrossRefGoogle ScholarPubMed
Landi, F, Picca, A, Calvani, R, et al. (2017) Anorexia of aging: assessment and management. Clin Geriatr Med 33, 315323.CrossRefGoogle ScholarPubMed
Paddon-Jones, D & Rasmussen, BB (2009) Dietary protein recommendations and the prevention of sarcopenia. Curr Opin Clin Nutr Metab Care 12, 8690.CrossRefGoogle ScholarPubMed
Schoenfeld, BJ & Aragon, AA (2018) How much protein can the body use in a single meal for muscle-building? Implications for daily protein distribution. J Int Soc Sports Nutr 15, 10.CrossRefGoogle Scholar
Symons, TB, Sheffield-Moore, M, Wolfe, RR, et al. (2009) A moderate serving of high-quality protein maximally stimulates skeletal muscle protein synthesis in young and elderly subjects. J Am Diet Assoc 109, 15821586.CrossRefGoogle Scholar
Bollwein, J, Diekmann, R, Kaiser, MJ, et al. (2013) Distribution but not amount of protein intake is associated with frailty: a cross-sectional investigation in the region of Nürnberg. Nutr J 12, 109.CrossRefGoogle Scholar
Farsijani, S, Morais, JA, Payette, H, et al. (2016) Relation between mealtime distribution of protein intake and lean mass loss in free-living older adults of the NuAge study. Am J Clin Nutr 104, 694703.CrossRefGoogle ScholarPubMed
Farsijani, S, Payette, H, Morais, JA, et al. (2017) Even mealtime distribution of protein intake is associated with greater muscle strength, but not with 3-year physical function decline, in free-living older adults: the Quebec longitudinal study on Nutrition as a Determinant of Successful Aging (NuAge study). Am J Clin Nutr 106, 113124.CrossRefGoogle ScholarPubMed
Ten Haaf, DSM, van Dongen, EJI, Nuijten, MAH, et al. (2018) Protein intake and distribution in relation to physical functioning and quality of life in community-dwelling elderly people: acknowledging the role of physical activity. Nutrients 10, 506.CrossRefGoogle ScholarPubMed
Loenneke, JP, Loprinzi, PD, Murphy, CH, et al. (2016) Per meal dose and frequency of protein consumption is associated with lean mass and muscle performance. Clin Nutr 35, 15061511.CrossRefGoogle ScholarPubMed
Loprinzi, PD, Loenneke, JP & Hamilton, DL (2017) Leisure time sedentary behavior, physical activity and frequency of protein consumption on lower extremity strength and lean mass. Eur J Clin Nutr 71, 13991404.CrossRefGoogle ScholarPubMed
Estrada-DeLeón, DB, Struijk, EA, Caballero, F, et al. (2020) Distribution of daily protein intake across meals and lower extremity functioning in community-dwelling Spanish older adults: a prospective cohort study. Eur J Nutr 60, 665675.CrossRefGoogle ScholarPubMed
Rodríguez-Artalejo, F, Graciani, A, Guallar-Castillón, P, et al. (2011) Rationale and methods of the study on nutrition and cardiovascular risk in Spain (ENRICA). Rev Esp Cardiol 64, 876882.CrossRefGoogle Scholar
Guallar-Castillón, P, Sagardui-Villamor, J, Balboa-Castillo, T, et al. (2014) Validity and reproducibility of a Spanish dietary history. PLoS One 9, e86074.CrossRefGoogle ScholarPubMed
Willet, WC (2012) Nutritional Epidemiology. New York: Oxford University Press.CrossRefGoogle Scholar
Schröder, H, Fitó, M, Estruch, R, et al. (2011) A short screener is valid for assessing Mediterranean diet adherence among older Spanish men and women. J Nutr 141, 11401145.CrossRefGoogle Scholar
Ortolá, R, García-Esquinas, E, López-García, E, et al. (2019) Alcohol consumption and all-cause mortality in older adults in Spain: an analysis accounting for the main methodological issues. Addict 114, 5968.CrossRefGoogle ScholarPubMed
Pols, MA, Peeters, PH, Ocké, MC, et al. (1997) Estimation of reproducibility and relative validity of the questions included in the EPIC Physical Activity Questionnaire. Int J Epidemiol 26, S181S189.CrossRefGoogle ScholarPubMed
Elstgeest, LEM, Schaap, LA, Heymans, MW, et al. (2020) Sex-and race-specific associations of protein intake with change in muscle mass and physical function in older adults: the Health, Aging, and Body Composition (Health ABC) Study. Am J Clin Nutr 112, 8495.CrossRefGoogle ScholarPubMed
Nygård, LK, Dahl, L, Mundal, I, et al. (2020) Protein intake, protein mealtime distribution and seafood consumption in elderly Norwegians: associations with physical function and strength. Geriatrics 5, 100.CrossRefGoogle ScholarPubMed
Institute of Medicine (2005) Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). Washington, DC: The National Academies Press.Google Scholar
Landi, F, Liperoti, R, Fusco, D, et al. (2012) Sarcopenia and mortality among older nursing home residents. J Am Med Dir Assoc 13, 121126.CrossRefGoogle ScholarPubMed
Katsoulis, M, Benetou, V, Karapetyan, T, et al. (2017) Excess mortality after hip fracture in elderly persons from Europe and the USA: the CHANCES project. J Intern Med 281, 300310.CrossRefGoogle ScholarPubMed
Moore, DR, Churchward-Venne, TA, Witard, O, et al. (2015) Protein ingestion to stimulate myofibrillar protein synthesis requires greater relative protein intakes in healthy older versus younger men. J Gerontol A Biol Sci Med Sci 70, 5762.CrossRefGoogle ScholarPubMed
Kim, IY, Schutzler, S, Schrader, AM, et al. (2018) Protein intake distribution pattern does not affect anabolic response, lean body mass, muscle strength or function over 8 weeks in older adults: a randomized-controlled trial. Clin Nutr 37, 488493.CrossRefGoogle ScholarPubMed
Farsijani, S, Cauley, JA, Santanasto, AJ, et al. (2020) Transition to a more even distribution of daily protein intake is associated with enhanced fat loss during a hypocaloric and physical activity intervention in obese older adults. J Nutr Health Aging 24, 210217.CrossRefGoogle ScholarPubMed
Cardon-Thomas, DK, Riviere, T, Tieges, Z, et al. (2017) Dietary protein in older adults: adequate daily intake but potential for improved distribution. Nutrients 9, 184.CrossRefGoogle ScholarPubMed
Bo, S, Musso, G, Beccuti, G, et al. (2014) Consuming more of daily caloric intake at dinner predisposes to obesity. A 6-year population-based prospective cohort study. PLoS One 9, e108467.CrossRefGoogle ScholarPubMed
Han, T, Gao, J, Wang, L, et al. (2020) The association of energy and macronutrient intake at dinner versus breakfast with disease-specific and all-cause mortality among people with diabetes: the U.S. National Health and Nutrition Examination Survey, 2003–2014. Diabetes Care 43, 14421448.CrossRefGoogle ScholarPubMed
Jakubowicz, D, Barnea, M, Wainstein, J, et al. (2013) High caloric intake at breakfast vs. dinner differentially influences weight loss of overweight and obese women. Obesity 21, 25042512.CrossRefGoogle ScholarPubMed
Struijk, EA, Fung, TT, Sotos-Prieto, M, et al. (2022) Red meat consumption and risk of frailty in older women. J Cachexia Sarcopenia Muscle 13, 210219.CrossRefGoogle ScholarPubMed
Ortolá, R, Struijk, EA, García-Esquinas, E, et al. (2020) Changes in dietary intake of animal and vegetable protein and unhealthy aging. Am J Med 133, 231239.e7.CrossRefGoogle ScholarPubMed
Tieland, M, Beelen, J, Laan, ACM, et al. (2018) An even distribution of protein intake daily promotes protein adequacy but does not influence nutritional status in institutionalized elderly. J Am Med Dir Assoc 19, 3339.CrossRefGoogle Scholar
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