Distribution Of Protein Intake Research Articles

Are higher protein intake and distribution of protein intake related to higher appendicular muscle mass among an older Japanese population?: A cross-sectional analysis of the National Health and Nutrition Survey 2017.

Protein intake is an important component in retaining muscle mass, especially among older people. This study examined the relationship between total protein intake and/or the distribution of protein intake in each meal and appendicular muscle mass, using data from the National Health and Nutrition Survey (NHNS) in Japan. Data from the NHNS were re-analyzed in this study. We used data from a one-day dietary record, physical examination, and lifestyle questionnaire completed by 1766 participants aged over 60 years. Appendicular muscle mass was assessed by multiple-frequency bioimpedance measurement. Leucine intake was calculated by the weighted average amino acid content from all 98 food subcategories used in the NHNS, based on amino acid composition data in the 2020 Standard Tables of Food Composition. Participants with higher protein intake showed significantly higher appendicular muscle mass. This relationship was independent of physical activity, including steps taken per day, exercise habit, and physical labor. Frequent intake of ≥0.4 g protein/kg/meal was not related to appendicular muscle mass. The combination of higher total protein intake and higher physical activity seemed to have the largest association with appendicular muscle mass. Higher protein intake may be related to higher appendicular muscle mass, independent of higher physical activity, among older Japanese people. Geriatr Gerontol Int 2024; 24: 634-640.

Distribution of daily protein intake and appendicular skeletal muscle mass in healthy free-living Chinese older adults.

Evidence regarding impact of protein intake distribution on skeletal muscle mass in older adults is limited and inconsistent. This study aims to investigate the relationship of evenness of dietary protein distribution and number of meals exceeding a threshold with appendicular skeletal muscle mass (ASM) in healthy and free-living Chinese older adults. Repeated measured data of 5689 adult participants aged ≥ 60 years from the China Health and Nutrition Survey (CHNS) 2015 and 2018 waves were analyzed. Mixed-effects linear regression model was performed to examine the relationship between coefficient of variance (CV) of protein intake across meals, number of meals ≥ 0.4g protein/kg BW and ASM, respectively. Analyses were conducted separately for male and female. The average CV of protein intake in each wave was in the range of 0.34-0.35. More than 40% male and female participants in each wave had no meal reaching 0.4g protein/kg BW. Female participants in the highest quartile of protein intake CV had significantly lower ASM (β = -0.18, 95%CI = -0.32, -0.04) compared with those in the lowest quartile, after adjustment for multiple confounders. Significant negative trends were observed across dietary protein CV quartiles with ASM both in male (P trend = 0.043) and female (P trend = 0.007). Significant positive association between number of meals exceeding 0.4g protein /kg BW and relative ASM were observed in females (2 meals vs. 0 meal: β = 0.003, 95%CI = 0.0007,0.006;≥3 meals vs. 0 meal: β = 0.008, 95%CI = 0.003,0.013), after adjusting for multiple covariates. A more even-distributed protein intake pattern and more meals reaching protein intake threshold were respectively associated with higher appendicular skeletal muscle mass in healthy and free-living older Chinese adults. Prospective studies and intervention trials are needed to confirm these cross-sectional findings.

Nutritional aspects of prehabilitation in adults with cirrhosis awaiting liver transplant.

Malnutrition, sarcopenia (low muscle mass), and physical frailty have gained increasing recognition in candidates for liver transplant (LT) as these conditions can impact postoperative functional capacity. Multidimensional prehabilitation programs have been proposed as a safe intervention in adults awaiting LT but the nutritional pillar of prehabilitation has been understudied. This review summarizes the nutritional recommendations for prehabilitation for individuals with cirrhosis awaiting LT. Three major aspects of nutritional prehabilitation are discussed: (1) Assess: Evaluate nutritional status and assess for malnutrition, sarcopenia, and frailty to guide the nutritional prehabilitation intervention intensity, increasing across universal, targeted, and specialist levels; (2) Intervene: Prescribe a nutritional prehabilitation intervention to meet established nutrition guidelines in cirrhosis with a targeted focus on improving nutritional status and muscle health; (3) Reassess: Follow-up based on the required intensity of nutritional care with as needed intervention adjustment. Topics covered in the review include nutritional care levels for prehabilitation, energy prescriptions across body mass index strata, detailed considerations around protein intake (amount, distribution, and quality), carbohydrate and fat intake, other nutritional considerations, and the potential role of dietary supplements and nutraceuticals. Future research is warranted to more accurately evaluate energy needs, evaluate emerging dietary supplementation strategies, and establish the role of nutraceuticals alongside food-based interventions. While the general principles of nutritional prehabilitation are ready for immediate application, future large-scale randomized controlled trials in this space will help to quantify the benefit that can be gained by transitioning the LT approach from passive "transplant waitlist time" to active "transplant preparation time."

Effect of breakfast protein intake on muscle mass and strength in adults: a scoping review.

The distribution of protein intake throughout the day is frequently skewed, with breakfast having the lowest protein intake across all age groups. There is no review that addresses the association between breakfast protein intake and muscle mass and strength. This scoping review aims to summarize the literature on the relationship between protein intake during breakfast and muscle mass and strength in adults. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Two independent reviewers screened and appraised the articles identified from 3 electronic databases (Medline, Web of Science, and Scopus) that focused on protein intake per meal and its impact on muscle-related outcomes. A total of 14 763 articles were retrieved from 3 databases, and after the screening process, 15 articles were included for analysis. Approximately 58.8% of findings from 11 studies examining the association between high protein intake during breakfast and muscle mass indicated an increase in muscle mass among participants. Half of 6 studies (50.0%) exploring the relationship between high protein intake at breakfast and muscle strength demonstrated an increase in muscle strength. Consuming high amounts of protein at breakfast or more protein in the morning than in the evening was associated with an increase in the skeletal muscle index and lean body mass. Protein consumption at breakfast revealed potential benefits in increasing muscle mass across 5 studies involving an elderly population and 2 studies encompassing middle-aged women and young men in our review. However, the relationship between protein intake at breakfast and muscle strength remains unclear. Further high-quality randomized controlled trials are required to examine whether adults can preserve skeletal muscle health outcomes by consuming higher amounts of protein at breakfast.

Protein Intake Distribution: Beneficial, Detrimental, or Inconsequential for Muscle Anabolism? Response to Witard & Mettler.

Protein Intake Distribution: Beneficial, Detrimental, or Inconsequential for Muscle Anabolism? Response to Witard & Mettler.

Evidence for the protein leverage hypothesis in preschool children prone to obesity

The protein leverage hypothesis (PLH) proposed that strict regulation of protein intake drives energy overconsumption and obesity when diets are diluted by fat and/or carbohydrates. Evidence about the PLH has been found in adults, while studies in children are limited. Thus, we aimed to test the PLH by assessing the role of dietary protein on macronutrients, energy intake, and obesity risk using data from preschool children followed for 1.3 years. 553 preschool children aged 2-6 years from the 'Healthy Start' project were included. The proportion of energy intake from protein, fat, and carbohydrates collected from a 4-day dietary record. Energy intake, BMI z-score, fat mass (FM) %, waist- (WHtR) and hip-height ratio (HHtR). Power function analysis was used to test the leverage of protein on energy intake. Mixture models were used to explore interactive associations of macronutrient composition on all these outcomes, with results visualized as response surfaces on the nutritional geometry. Evidence for the PLH was confirmed in preschool children. The distribution of protein intake (% of MJ, IQR: 3.2) varied substantially less than for carbohydrate (IQR: 5.7) or fat (IQR: 6.3) intakes, suggesting protein intake is most tightly regulated. Absolute energy intake varied inversely with dietary percentage energy from protein (L=-0.14, 95% CI:-0.25,-0.04). Compared to children with high fat or carbohydrate intakes, children with high dietary protein intake (>20% of MJ) had a greater decrease in WHtR and HHtR over the 1.3-year follow-up, offering evidence for the PLH in prospective analysis. But no association was observed between macronutrient distribution and changes in BMI z-score or FM%. In this study in preschool children, protein intake was the most tightly regulated macronutrient, and energy intake was an inverse function of dietary protein concentration, indicating the evidence for protein leverage. Increases in WHtR and HHtR were principally associated with the dietary protein dilution, supporting the PLH. These findings highlight the importance of protein in children's diets, which seems to have significant implications for childhood obesity risk and overall health.

Protein and Leucine Intake at Main Meals in Elderly People with Type 2 Diabetes

The recommended protein intake for the elderly is 25-30 g at main meals, with at least 2500-2800 mg of leucine at each meal. There is still little evidence regarding the amount and distribution of protein and leucine intake with meals in the elderly with type 2 diabetes (T2D). In this cross-sectional study, we evaluated protein and leucine intake at each meal in elderly patients with T2D. A total of 138 patients (91 men and 47 women) with T2D, aged 65 years or older, were included. Participants performed three 24-h dietary recalls for the evaluation of their dietary habits and protein and leucine intake at meals. The average protein intake was 0.9 ± 0.2 g/kg body weight/day, and only 23% of patients complied with the recommendations. The average protein intake was 6.9 g at breakfast, 29 g at lunch, and 21 g at dinner. None of the patients reached the recommended protein intake at breakfast; 59% of patients complied with the recommendations at lunch; and 32% at dinner. The average leucine intake was 579 mg at breakfast, 2195 g at lunch, and 1583 mg at dinner. The recommended leucine intake was not reached by any patient at breakfast, by 29% of patients at lunch, and by 13% at dinner. Our data show that, in elderly patients with T2D, the average protein intake is low, particularly at breakfast and dinner, and that leucine intake is remarkably lower than the recommended levels. These data raise the need to implement nutritional strategies capable of increasing protein and leucine intake in the elderly with T2D.

Association of Dietary Protein Intake with Muscle Mass in Elderly Chinese: A Cross-Sectional Study.

Most data regarding the association between dietary protein intake and muscle mass come from developed Western countries. This cross-sectional study investigates the association between the amount and distribution of dietary protein intake and muscle mass in elderly Chinese adults. This analysis includes 4826 participants aged 60 years and above from the dataset of the China Health and Nutrition Survey (CHNS) 2018. Protein intake data were assessed using 3-day, 24 h dietary recalls. Appendicular skeletal muscle mass (ASM) was obtained using the bioelectrical impedance analysis (BIA). Two-thirds of dietary protein intake comes from plant sources in the elderly Chinese population. The median total dietary protein intake was 60.5 g/d in low muscle mass participants for males and 52.5 g/d for females, which was lower than for their respective counterparts. Compared to the lowest quartile of protein intake, the highest total protein intake group had increased muscle mass by 0.96 kg among men and by 0.48 kg among women (p < 0.0001), and the highest vegetable protein intake group had increased muscle mass by 0.76 kg among men and by 0.35 kg among women (p < 0.0001). The amount of dietary protein intake with each meal was less than 20 g. High total protein intake and high plant-based protein intake were positively associated with higher muscle mass. A U-shape was observed between total dietary protein intake and low muscle mass risk in elderly Chinese adults. It should be encouraged to increase total daily protein intake to maintain muscle health.

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

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.

Impact of COVID-19 Infection and Persistent Lingering Symptoms on Patient Reported Indicators of Nutritional Risk and Malnutrition.

Persistent malnutrition after COVID-19 infection may worsen outcomes, including delayed recovery and increased risk of rehospitalization. This study aimed to determine dietary intakes and nutrient distribution patterns after acute COVID-19 illness. Findings were also compared to national standards for intake of energy, protein, fruit, and vegetables, as well as protein intake distribution recommendations. Participants (≥18 years old, n = 92) were enrolled after baseline visit at the Post-COVID Recovery Clinic. The broad screening battery included nutritional assessment and 24-h dietary recall. Participants were, on average, 53 years old, 63% female, 69% non-Hispanic White, and 59% obese/morbidly obese. Participants at risk for malnutrition (48%) experienced significantly greater symptoms, such as gastric intestinal issues, loss of smell, loss of taste, or shortness of breath; in addition, they consumed significantly fewer calories. Most participants did not meet recommendations for fruit or vegetables. Less than 39% met the 1.2 g/kg/day proposed optimal protein intake for recovery from illness. Protein distribution throughout the day was skewed; only 3% met the recommendation at all meals, while over 30% never met the threshold at any meal. Our findings highlight the need for nutritional education and support for patients to account for lingering symptoms and optimize recovery after COVID-19 infection.

Association of Daily Physical Activity and Sedentary Behaviour with Protein Intake Patterns in Older Adults: A Multi-Study Analysis across Five Countries.

Physical activity and protein intake are associated with ageing-related outcomes, including loss of muscle strength and functional decline, so may contribute to strategies to improve healthy ageing. We investigated the cross-sectional associations between physical activity or sedentary behaviour and protein intake patterns in community-dwelling older adults across five countries. Self-reported physical activity and dietary intake data were obtained from two cohort studies (Newcastle 85+ Study, UK; LiLACS, New Zealand Māori and Non-Māori) and three national food consumption surveys (DNFCS, The Netherlands; FINDIET, Finland; INRAN-SCAI, Italy). Associations between physical activity and total protein intake, number of eating occasions providing protein, number of meals with specified protein thresholds, and protein intake distribution over the day (calculated as a coefficient of variance) were assessed by regression and repeated measures ANOVA models adjusting for covariates. Greater physical activity was associated with higher total protein intake and more eating occasions containing protein, although associations were mostly explained by higher energy intake. Comparable associations were observed for sedentary behaviour in older adults in Italy. Evidence for older people with higher physical activity or less sedentary behaviour achieving more meals with specified protein levels was mixed across the five countries. A skewed protein distribution was observed, with most protein consumed at midday and evening meals without significant differences between physical activity or sedentary behaviour levels. Findings from this multi-study analysis indicate there is little evidence that total protein and protein intake patterns, irrespective of energy intake, differ by physical activity or sedentary behaviour levels in older adults.

Association between dietary protein intake and skeletal muscle mass in older Korean adults.

We investigated the association of low and high daily protein intakes on skeletal muscle mass status in Korean adults aged 60years and older. This cross-sectional study used data from the Korean National Health and Nutrition Examination Survey conducted between 2008 and 2011. The participants' dietary protein intake was assessed using the 24-h dietary recall method and was classified as low (< 0.8g/kg body weight/day), moderate (0.8-1.2g/kg/day), and high (> 1.2g/kg/day). Amount of skeletal muscle mass was measured using whole-body dual-energy X-ray absorptiometry. Low skeletal muscle mass was defined as appendicular skeletal muscle mass index < 7.0kg/m2 in men and < 5.4kg/m2 in women. The study included data from 4585 participants (2022 men and 2563 women). All skeletal muscle parameters in women and total lean mass in men decreased as the amount of protein consumed daily increased. However, there was no association between high or low protein intake and low skeletal muscle mass in men or women. No association was found between the amount of daily protein intake and skeletal muscle mass status in older Korean adults. Gender-specific further studies focussing on the interactions of dietary protein intake under specific conditions including physical activity status and the daily distribution of protein intake and the quality and source of the protein are needed to evaluate the impact of protein intake status on muscle health in older Koreans.

Chrono-Nutrition Has Potential in Preventing Age-Related Muscle Loss and Dysfunction.

The mammalian circadian clock systems regulate the day–night variation of several physiological functions such as the sleep/wake cycle and core body temperature. Disturbance in the circadian clock due to shiftwork and chronic jetlag is related to the risk of several disorders such as metabolic syndrome and cancer. Recently, it has been thought that shiftwork increases the risk of sarcopenia which is characterized by age-related decline of muscle mass and its dysfunctions including muscle strength and/or physical performance. First, we summarize the association between circadian rhythm and the occurrence of sarcopenia and discuss its mechanistic insight by focusing on the muscle function and molecular clock gene in knockout or mutant mice. The clock gene knockout or mutant mice showed early aging phenotypes, including low survival rate and muscle loss. It suggests that improvement in the disturbance of the circadian clock plays an important role in the aging process of healthy muscles. Nutritional intake has the potential to augment muscle growth and entrain the peripheral clock. Second, we discuss the potential of chrono-nutrition in preventing aging-related muscle loss and dysfunction. We also focus on the effects of time-restricted feeding (TRF) and the distribution of protein intake across three meals.

Understanding the effects of nutrition and post-exercise nutrition on skeletal muscle protein turnover: Insights from stable isotope studies

Understanding the effects of nutrition and post-exercise nutrition on skeletal muscle protein turnover: Insights from stable isotope studies

Protein Amount, Quality and Distribution in Active Older Adults and Its Effects on Outcomes of Fat Free Mass, Skeletal Muscle Strength and Power

This study aimed to investigate the associations of habitual protein intake in a cohort of active older adults including: daily relative protein intake, distribution of protein intake across main meals, and number of meals providing ≥0.4 g/kg body mass (BM) on outcomes of fat free mass (FFM), leg power, leg strength, and handgrip strength (HGS). This was a cross-sectional study (2018-2020) where data were obtained and analysed from n= 53 active older adults (≥50 yrs; ≥90 min/week of self-reported physical activity). Daily absolute (g) and relative protein (g/kgBM/day) intake, absolute and relative protein intake per meal, the number of meals that provided 0.4 g/kgBM, and the protein intake distribution were calculated for each participant through a 3-day food diary assessment and analysis. Appendicular muscle mass index (ALM/ht2; dual x-ray absorptiometry), leg strength (1-repetition maximum using leg press), leg power (force plate countermovement jump) and HGS (dynamometer) were assessed. An independent t-test was used to test statistical significance between groups based on protein intake. Pearson’s correlation determined differences between protein intakes with lean muscle mass and strength outcomes. Results:Daily protein intake was (mean ± SD) 1.4 ± 0.4 g/kg BM/day, with the coefficient of variation of main meals calculated at 0.46 (0.41-0.51), and the average number of meals that provided ≥0.4g/kgBM was 1.1 ± 0.8 meals. There was a moderate but significant positive correlation between number of meals per day providing ≥0.4g/kgBM, and number and leg press (r= .301,p< .05), significant for males (r= .591, p= .029), but not females (r=.262, p= .196). There was also a small significant association between the number of total protein and dairy serves per day and leg strength ((r= .290, p= .035; r= .372, p= .006, respectively). No significant correlations were observed for outcomes of HGS or FFM and any of the dietary protein measures. Conclusion: In a cohort of active older adults who achieve greater protein intakes than the current recommendations, a minimum of 1 meal containing ≥0.4 g/kg BM of protein and higher intakes of dairy based foods may be required to achieve favourable outcomes in leg strength.

Daily Protein and Energy Intake Are Not Associated with Muscle Mass and Physical Function in Healthy Older Individuals-A Cross-Sectional Study.

Dietary protein has a pivotal role in muscle mass maintenance with advancing age. However, an optimal dose and distribution of protein intake across the day as well as the interaction with energy intake for the maintenance of muscle mass and physical function in healthy older adults remain to be fully elucidated. The purpose of this study was to examine the association between muscle mass, strength, and physical function, and the total amount and distribution of protein and energy intake across the day in healthy older individuals. The research question was addressed in a cross-sectional study including 184 Danish men and woman (age: 70.2 ± 3.9 years, body mass: 74.9 ± 12.1 kg, Body Mass Index (BMI): 25.4 ± 3.7 kg/m2) where a 3-day dietary registration, muscle mass, strength, and functional measurements were collected. We found that neither daily total protein intake nor distribution throughout the day were associated with muscle mass, strength, or physical function. Consequently, we do not provide an incentive for healthy older Danish individuals who already adhere to the current internationally accepted recommended dietary protein intake (0.83 g/kg/day) to change dietary protein intake or its distribution pattern throughout the day.

Dietary Protein Intake and Determinants in Māori and Non-Māori Octogenarians. Te Puāwaitanga o Ngā Tapuwae Kia Ora Tonu: Life and Living in Advanced Age: A Cohort Study in New Zealand.

Protein intake, food sources and distribution are important in preventing age-related loss of muscle mass and strength. The prevalence and determinants of low protein intake, food sources and mealtime distribution were examined in 214 Māori and 360 non-Māori of advanced age using two 24 h multiple pass recalls. The contribution of food groups to protein intake was assessed. Low protein intake was defined as ≤0.75 g/kg for women and ≤0.86 g/kg for men. A logistic regression model was built to explore predictors of low protein intake. A third of both women (30.9%) and men (33.3%) had a low protein intake. The main food group sources were beef/veal, fish/seafood, milk, bread though they differed by gender and ethnicity. For women and men respectively protein intake (g/meal) was lowest at breakfast (10.1 and 13.0), followed by lunch (14.5 and 17.8) and dinner (23.3 and 34.2). Being a woman (p = 0.003) and having depressive symptoms (p = 0.029) were associated with consuming less protein. In adjusted models the odds of adequate protein intake were higher in participants with their own teeth or partial dentures (p = 0.036). Findings highlight the prevalence of low protein intake, uneven mealtime protein distribution and importance of dentition for adequate protein intake among adults in advanced age.

Protein intake is more stable than carbohydrate or fat intake across various US demographic groups and international populations

ABSTRACTBackgroundThe optimal macronutrient composition of the diet is controversial and many adults attempt to regulate the intake of specific macronutrients for various health-related reasons.ObjectiveThe objective was to compare stability and ranges of intakes of different macronutrients across diverse adult populations in the USA and globally.MethodsUS dietary intake data from NHANES 2009–2014 were used to determine macronutrient intake as a percentage of total energy intake. Variability in macronutrient intake was estimated by calculating the difference between 75th and 25th percentile (Q3–Q1) IQRs of macronutrient intake distributions. In addition, intake data from 13 other countries with per capita gross domestic product (GDP) over $10,000 US dollars (USD) were used to assess variability of intake internationally since there are large differences in types of foods consumed in different countries.ResultsProtein, carbohydrate, and fat intake (NHANES 2009–2014) was 15.7 ± 0.1, 48.1 ± 0.1, and 32.9 ± 0.1% kcal, respectively, in US adults. The IQR of protein intake distribution (3.73 ± 0.11% kcal) was 41% of carbohydrate intake distribution (9.18 ± 0.20% kcal) and 58% of fat intake distribution (6.40 ± 0.14% kcal). The IQRs of carbohydrate and fat intake distributions were significantly (P <0.01) influenced by age and race; however, the IQR of protein intake was not associated with demographic and lifestyle factors including sex, race, income, physical activity, and body weight. International mean protein intake was 16.3 ± 0.2% kcal, similar to US intake, and there was less variation in protein than carbohydrate or fat intake.ConclusionProtein intake of the US population and multiple international populations, regardless of demographic and lifestyle factors, was consistently ∼16% of total energy, suggesting biological control mechanism(s) tightly regulate protein intake and, consequently, influence intake of other macronutrients and food constituents. Substantial differences in intake of the other macronutrients observed in US and international populations had little influence on protein intake. This trial was registered at the ISRCTN registry as ISRCTN46157745 (https://www.isrctn.com/ISRCTN4615774).

Age and Racial/Ethnic Differences in Dietary Sources of Protein, NHANES, 2011–2016

Background: Dietary protein serves a pivotal role in providing the body with essential amino acids, which are required for the maintenance of body proteins, and the assimilation of structural and functional components required for basic survival. Understanding how dietary protein sources potentially vary for different population subgroups will allow for future nutrition interventions to be more targeted for specific needs.Objective: The purpose of this analysis was to identify the top ten food category sources of dietary protein by age and race and ethnicity in a nationally representative sample.Methods: Cross-sectional data on adults (18+ years) from the National Health and Nutrition Examination Survey (NHANES) 2011–2016 with one 24-h dietary recall were analyzed (n = 15,697). Population proportions were calculated based on protein intake (g/day) for What We Eat In America food categories.Results: The analytic sample (n = 15,697) was 15.0% Hispanic (95% CI [12.1, 17.9], 65.0% non-Hispanic White (95% CI [60.8, 69.3]), 11.5% non-Hispanic Black (95% CI [9.1, 13.9]), 5.4% non-Hispanic Asian (95% CI [4.3, 6.6]), and 3.1% other (95% CI [2.5, 3.6]). In all racial and ethnic groups, as well as age categories, chicken (whole pieces) was the top-ranked source of dietary protein. In addition to chicken (whole pieces), beef (excludes ground), eggs and omelets, and meat mixed dishes food categories ranked in the top ten sources of protein for every race/ethnicity. Only two solely plant-based proteins appeared in the top ten sources: beans, peas and legumes for Hispanics, and nuts and seeds for Other. For all age categories, beef (excludes ground) was among the top five sources and egg/omelets appear in the top ten sources.Conclusion: The top ten sources of protein accounted for over 40% of dietary protein irrespective of race/ethnicity or age category, having major implications for the sustainability of our nation's food supply. Public health strategies that encourage diversity in protein sources in food preparation and incorporate legumes and nuts along with poultry have the potential to shift the overall population protein intake distribution toward improving overall diet quality.

During Hospitalization, Older Patients at Risk for Malnutrition Consume

BackgroundMalnutrition is prevalent in hospitalized patients. To support muscle maintenance in older and chronically ill patients, a protein intake of 1.2–1.5 g/kg/d has been recommended during hospitalization. We assessed daily protein intake levels and distribution in older patients at risk for malnutrition during hospitalization.MethodsIn this prospective, observational study, we measured actual food and food supplement consumption in patients (n = 102; age, 68 ± 14 years; hospital stay, 14 [8–28] days) at risk of malnutrition during hospitalization. Food provided by hospital meals, ONS, and snacks and the actual amount of food (not) consumed were weighed and recorded for all patients.ResultsHospital meals provided 1.03 [0.77–1.26] protein, whereas actual protein consumption was only 0.65 [0.37–0.93] g/kg/d. Protein intake at breakfast, lunch, and dinner was 10 [6–15], 9 [5–14], and 13 [9–18] g, respectively. The use of ONS (n = 62) resulted in greater energy (1.26 [0.40–1.79] MJ/d, 300 [100–430] kcal/d) and protein intake levels (11 [4–16] g/d), without changing the macronutrient composition of the diet.ConclusionDespite protein provision of ∼1.0 g/kg/d, protein intake remains well below these values (∼0.65 g/kg/d), as 30%–40% of the provided food and supplements is not consumed. Provision of ONS may increase energy and protein intake but does not change the macronutrient composition of the diet. Current nutrition strategies to achieve the recommended daily protein intake in older patients during their hospitalization are not as effective as generally assumed.