The Acute Effects of Breakfast Drinks with Varying Protein and Energy Contents on Appetite and Free-Living Energy Intake in UK Older Adults.

Daniel Crabtree,Claire Fyfe,Alexandra Johnstone,William Buosi,Adrian Holliday,Graham Horgan

doi:10.3390/geriatrics7010016

Abstract

Proposed strategies for preventing protein deficiencies in older patients include increasing protein intake at breakfast. However, protein is highly satiating and the effects of very high protein intakes at breakfast on subsequent appetite and free-living energy intake (EI) in older adults are unclear. This study compared the acute effects of two breakfast drinks varying in protein and energy contents on appetite and free-living EI in healthy older adults using a randomized 2 × 2 crossover design. Participants (n = 48 (20 men, 28 women); mean ± SD age: 69 ± 3 years; BMI: 22.2 ± 2.0 kg·m−2; fat-free mass: 45.5 ± 8.0 kg) consumed two drinks for breakfast (high-protein (30.4 ± 5.3 g), low-energy (211.2 ± 37.1 kcal) content (HPLE) and very high-protein (61.8 ± 9.9 g), fed to energy requirements (428.0 ± 68.9 kcal) (VHPER)) one week apart. Appetite perceptions were assessed for 3 h post-drink and free-living EI was measured for the remainder of the day. Appetite was lower in VHPER than HPLE from 30 min onwards (p < 0.01). Free-living energy and protein intake did not differ between conditions (p = 0.814). However, 24 h EI (breakfast drink intake + free-living intake) was greater in VHPER than HPLE (1937 ± 568 kcal vs. 1705 ± 490 kcal; p = 0.001), as was 24 h protein intake (123.0 ± 26.0 g vs. 88.6 ± 20.9 g; p < 0.001). Consuming a very high-protein breakfast drink acutely suppressed appetite more than a low-energy, high-protein drink in older adults, though free-living EI was unaffected. The long-term effects of adopting such a breakfast strategy in older adults at high risk of energy and protein malnutrition warrants exploration.

Highlights

Advancing age alters food reward signals [1], reduces food craving behavior [2], and suppresses appetite and energy intake (EI) [3], all of which contribute to a condition termed the “anorexia of ageing” [4]
Post hoc pairwise comparisons revealed that subjective appetite was lower in VHPER than HPLE at 30 min and remained lower for rest of the trial (p < 0.001 at 30, 150 and 180 min; p < 0.01 at 60, 90 and 120 min)
Doubling what is generally considered as a “high” protein intake and ensuring an adequate energy content at breakfast resulted in a greater appetite suppression, but did not affect food intake later in the day

Summary

Introduction

Advancing age alters food reward signals [1], reduces food craving behavior [2], and suppresses appetite and energy intake (EI) [3], all of which contribute to a condition termed the “anorexia of ageing” [4]. The World Health Organization recommends that adults consume 0.8 g protein·kg body mass−1·day−1 [9], while in the UK, the Reference Nutrient Intake is 0.75 g protein·kg body mass−1·day−1 [10]. Muscle protein synthesis research supports alternative daily recommendations for older adults, suggesting that a dietary protein intake of 20–30 g per meal of high-quality protein would sufficiently stimulate MPS in older adults [15,16], though further increasing protein intake may optimize muscle anabolism acutely [17]

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