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

Marije H Verwijs,Joost O Linschooten,Jacco Ditewig,Annet Jc Roodenburg,Marian Ae De Van Der Schueren,Marga C Ocké,Lisette Cpgm De Groot

doi:10.1017/s1368980021004134

Abstract

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 the protein intake of Dutch community-dwelling older adults. The Dutch National Food Consumption Survey-Older Adults 2010-2012 (DNFCS-OA) was used for scenario modelling. Dietary intake was estimated 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 < 1·0 g/kg BW/d (n 391). Habitual protein intake of all older adults was estimated, adjusting for effects of within-person variation in the 2-d intake data. A simulation study based on the DNFCS-OA. 727 Dutch community-dwelling older adults aged 70+. Mean protein intake of the total population increased from 1·0 to 1·2 g/kg BW/d (scenarios 1 and 2) and to 1·3 g/kg BW/d (scenario 3). The percentage of participants with intakes of ≥ 1·0 g/kg BW/d 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. 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 counselling.

Highlights

Replacing foods from nine different food groups in participants with a protein intake < 1·0 g/kg BW/d (n 391) with protein-rich alternatives resulted in an increase in mean habitual protein intake in the total population (n 727) from 1·0 to 1·2 g/kg BW/d or 76·5 to 89·7 g/d
Outcomes showed that replacing low protein foods within six to nine food groups with similar high protein alternatives for participants with a mean protein intake < 1·0 g/kg BW/d, the protein intake of Dutch community-dwelling older adults can be increased considerably
This study has revealed successful strategies to increase protein intake in the diet of community-dwelling older adults by replacing currently consumed foods low in protein with protein-rich and protein-enriched alternatives

Summary

Methods

Food replacements in all three scenarios were restricted to participants with an average protein intake < 1·0 g/kg BW/d (n 391). Food groups were included in the different scenarios based on the results of the DNFCS-OA[7] and a study by Hung et al[15] and their role in the eating pattern in the Netherlands. The alternative foods have a protein content > P75 in that food group and foods had to be familiar to older adults, that is, be similar to the foods they replace Choice of food groups and alternative foods was based on the top 3 food groups of scenarios 1 and 2 for which replacements resulted in the largest increase in protein intake. Besides the SPADE software, data were analysed using SAS Software (SAS version 9.4, SAS Institute)

Results

Discussion

Strengths and limitations

Conclusion