More Protein in Diet Linked to Slower Disability Decline in Oldest Old

MedicalResearch.com Interview with:
""Trash Fish" Sustanable Seafood Dinner" by Edsel Little is licensed under CC BY-SA 2.0Nuno Mendonça RD, PhD

Campus for Ageing and Vitality
Newcastle‐upon –Tyne
United Kingdom 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Very old adults, those aged 85 and older, are the fastest growing age group in most western societies and are more likely to develop disability. Dietary protein is a sensible candidate because it may slow decreases in muscle mass and functional decline with aging. Although we know that protein intake is, on average, lower in older adults (a mean of 66 grams per day) compared to younger adults (a mean of 91 grams per day), research exploring protein intake and disability progression in very old adults is limited. We found that our participants from North-East England had four different disability trajectories between the ages of 85 and 90: a) a constant very low disability trajectory (difficulty with none or 1 activity of daily living (ADL))  over the 5 years; b) a low disability trajectory (difficulty with 2 ADLs) that steadily progressed to mild disability (5 ADLs); c) a mild disability score (4 ADLs) at 85 that increased to moderate disability (10 ADLs) by age 90; and d) a moderate disability score (9 ADLs) at baseline that progressed to severe disability (14 ADLs) after 5 years. We found that those with higher protein intake, especially those at or above 1 g per kg of body weight per day (70g of protein per day for a 70 kg person), were less likely to belong to a worse disability trajectory.

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Diet of Plant Protein Associated With Reduced Mortality

MedicalResearch.com Interview with:
Mingyang Song Sc.D, research fellow
Clinical and Translational Epidemiology Unit and Division of Gastroenterology MGH and Department of Nutrition
Harvard T.H. Chan School of Public Health

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Previous studies have been focused on the amount of protein intake, while little is known regarding the health effect of different food sources for protein intake. In this study, we found that high animal protein intake was associated with higher mortality, whereas high plant-based protein was associated with lower mortality. Replacement of animal protein with plant protein was associated with lower mortality. Overall, the findings support the importance of food sources for protein intake for long-term health outcomes.

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Excessive Intake Non-Dairy Protein Could Raise Risk of Kidney Stones

MedicalResearch.com Interview with:

Pietro Manuel Ferraro, MD MSc PhD Assistant Professor Fondazione Policlinico Universitario A. Gemelli Catholic University of the Sacred Heart Senior Collaborator in the Nurses' Health Study Brigham and Women's Hospital Channing Division of Network Medicine

Dr. Ferraro

Pietro Manuel Ferraro, MD MSc PhD
Assistant Professor
Fondazione Policlinico Universitario A. Gemelli
Catholic University of the Sacred Heart
Senior Collaborator in the Nurses’ Health Study
Brigham and Women’s Hospital
Channing Division of Network Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In our study, we looked at the association between dietary intake of different sources of protein (vegetable, dairy and non-dairy animal), potassium (a marker of fruits and vegetables) and their interaction and the risk of forming kidney stones. We looked at their interaction because some protein is a source of acid, whereas fruits and vegetables are a source of alkali, thus their relationship could potentially impact acid-base status and in turn the risk of stones by modifying the metabolism of calcium and other elements such as urine citrate and uric acid.

We found that the risk of forming stones depends not only on the amount of protein but also on the source, with no risk associated with intake of vegetable and dairy protein, and a modestly higher risk for excessive non-dairy animal protein; on the other hand, intake of potassium was associated with a markedly lower risk. Interestingly, the interaction between intake of protein and potassium, the so called net acid load, was also associated with higher risk of forming kidney stones, suggesting that the effect of acid intake is modulated by that of alkali and vice versa.

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Higher Protein Intake Plus Exercise Preserves Muscle Mass During Weight Loss

MedicalResearch.com Interview with:

Professor Stuart M. Phillips Ph.D., FACSM, FACN Department of Kinesiology, McMaster University, CANADA Exercise Metabolism Research Group – Protein Metabolism Research Lab Director, Physical Activity Centre for Excellence

Prof. Stuart Phillips

Professor Stuart M. Phillips Ph.D.,
FACSM, FACN

Department of Kinesiology, McMaster University, Canada
Exercise Metabolism Research Group – Protein Metabolism Research Lab
Director, Physical Activity Centre for Excellence

Medical Research: What is the background for this study? What are the main findings?

Prof. Phillips: During weight loss with diet only people lose both muscle and fat and muscle. The long-term health consequences of losing metabolically active muscle versus fat are not likely to be beneficial. In the context of this study we thought perhaps the preservation of muscle would also be important in very active young men. We wanted to see whether when men were in a very large energy deficit (40% less energy than they required) higher protein (2.4 g/kg/d) could preserve muscle mass and still result in increased function (strength) and fitness.

Our results show that during a marked energy deficit that consumption of 2.4 g protein/kg/d was more effective than consumption of a diet containing 1.2 g protein/kg/d in promoting increases in LBM (1.2 vs 0.1kg increase) and losses of fat mass (-4.8kg vs. -3.5kg) when combined with a high volume of resistance and anaerobic exercise.

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Protein Suppresses Appetite More Than Fat or Carbohydrates

Anestis Dougkas, MSc, PhD Food for Health Science Centre Lund University Lund, SwedenMedicalResearch.com Interview with:
Anestis Dougkas, MSc, PhD
Food for Health Science Centre
Lund University Lund, Sweden

MedicalResearch: What is the background for this study?

Dr. Dougkas: There has been an increased interest in the macronutrient profile of diets and meals as a factor that influences appetite. Dietary protein is considered as the most satiating macronutrient, yet there is little evidence on whether the effects observed are attributed to the protein or to the concomitant manipulation of carbohydrates and fat. The aim was to examine the effect of consumption of beverages varying in macronutrient content on appetite ratings, energy intake and appetite-regulating hormones.

MedicalResearch: What are the main findings?

Dr. Dougkas: Increased protein content suppressed more average appetite than carbohydrate and fat with a more pronounced effect of protein intake on subjective ratings of prospective consumption. Protein was also the most influential macronutrient for postprandial glucagon like peptide-1 (GLP-1, an appetite- suppressing hormone) response. This appetite-suppressing effect of protein was independent of the changes in fat and carbohydrates.
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Vegetarian Protein Sufficient For Appetite Control and Weight Loss

dr alex johnstoneMedicalResearch.com Interview with:
Dr. Alex Johnstone PhD

Rowett Institute of Nutrition and Health
Aberdeen

 

Medical Research: What is the background for this study?
Response:

  • Previous work has indicated that high-protein (30% of diet as protein) meat-based weight loss diets are highly satiating, and reduce the free food intake over a four-week period (1,2).
  • There is limited data on assessing the effect of different types of protein on appetite in weight loss studies (3). Previously, a mixed meat source of protein was used in our high protein diets, but this approach has been criticised both from a policy and public health perspective because of potential negative side effects, especially on gut health (4).
  • There is acceptance that vegetable based weight loss diet may offer protection from diseases (5).
  • It may be that alternative vegetable sources of protein could be satiating, and yet maintain a healthy gut during weight loss, and we set up a study to test this, using soya (plant) protein
  1. Westerterp-Plantenga MS, Nieuwenhuizen A, Tomé D, Soenen S, Westerterp KR. Annu Rev Nutr 2009; 29:21-41.
  2. Johnstone AM, Horgan GW, Murison SD, Bremner DM, Lobley GE. Am J Clin Nutr 2008; 87(1):44-55.
  3. Due A, Toubro S, Skov AR, Astrup A.. Int J Obes Rel Metab Disord 2004; 28(10):1283-90.
  4. Russell WR, Gratz SW, Duncan SH, Holtrop G, Ince J, Scobbie L, Duncan G, Johnstone AM, Lobley GE, Wallace RJ, et al.. Am J Clin Nutr 2011; 93(5):1062-1072.
  5. Clifton P. Brit J Nutr 2012; 108:122–129.

Medical Research: What are the main findings?
Response:

  • Over the two weeks, subjects lost similar amounts of weight, on average 2.41 and 2.27 kg on the vegetarian high-protein weight loss and meat based high-protein weight loss diets respectively, with similar reduction in fat-mass and preservation of fat-free mass, due to the high protein component.
  • The vegetarian high-protein weight loss had a similar impact on appetite and motivation to eat as the meat based high-protein weight loss diet.
  • Blood biomarkers improved with weight loss for both high protein diets (plasma cholesterol, low density lipoproteins (LDL), high density lipoproteins (HDL), triglycerides and glucose)
  • There was a greater reduction in total cholesterol with the plant based diet for cholesterol and LDL cholesterol. This finding could be attributed to the composition of vegetarian source of protein (soya), (i.e. fibre, phytochemicals, and other micro and macro nutrients).

Medical Research: What should clinicians and patients take away from your report?

Response: Since appetite control and weight loss was similar in both weight loss diets, vegetarian meals are acceptable to  include in a high-protein moderate carbohydrate weight loss diet. In this context, the diets were 30% protein, 30% fat and 40% carbohydrate from energy. A diet that contains mixed sources of protein is acceptable, to feel fuller for longer during calorie restriction for weight loss.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Alternative plant sources of protein in the context of weight loss is of interest to achieve a healthy body weight but also sustainable sources for the environment. Also the role of dietary protein with carbohydrate in promoting body weight maintenance after weight loss.

Read more here about our research on sustainable protein :  http://www.abdn.ac.uk/rowett/research/strategic-partnership.php

Citation:

Research presented at the Association for the Study of Obesity (ASO) in London, UK

 

MedicalResearch.com Interview with: Dr. Alex Johnstone PhD, Rowett Institute of Nutrition and Health, & Aberdeen (2015). Vegetarian Protein Sufficient For Appetite Control and Weight Loss 

Higher Protein Intake Linked To Lower Blood Pressure

Lynn L. Moore, DSc, MPH Co-Director, Nutrition and Metabolism Assoc Prof of Medicine Preventive Medicine & Epidemiology Department of Medicine Boston University School of Medicine Boston, MA 02118MedicalResearch.com Interview with:
Lynn L. Moore, DSc, MPH
Co-Director, Nutrition and Metabolism
Assoc Prof of Medicine
Preventive Medicine & Epidemiology Department of Medicine
Boston University School of Medicine
Boston, MA 02118

Medical Research: What are the main findings of the study?

Response: Our data were derived from 1,361 adults (aged 30-54 years) enrolled in the Framingham Offspring Study and showed that men and women who consumed higher amounts of protein had lower blood pressures (both systolic and diastolic blood pressures) after four years of follow-up. We then followed them for an average of about 11 years and found that those who consumed the most protein (approximately 103 g/day) had about a 40% lower risk of developing high blood pressure than those consuming about half that amount. These beneficial effects were even more pronounced when higher protein intakes were combined with high fiber intakes.
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Muscle Wasting in Critical Illness

Zudin Puthucheary MBBS B.Med.Sci D.UHM EDICM MRCP FHEA NIHR Research Fellow, Respiratory and Critical Care Institute of Health and Human Performance, UCL Post-CCT Fellow in Trauma and Critical Care, Kings College HospitalMedicalResearch.com Interview with:
Zudin Puthucheary MBBS B.Med.Sci D.UHM EDICM MRCP FHEA
NIHR Research Fellow, Respiratory and Critical Care
Institute of Health and Human Performance, UCL
Post-CCT Fellow in Trauma and Critical Care,
Kings College Hospital

MedicalResearch.com: What are the main findings of the study?

Answer: That muscle wasting occurs rapidly and early in critical illness, with up to 2-3% loss of muscle mass per day. This is related to the numbers of organs failed, and is made worse by the degree of acute lung injury, and increased protein delivery. Muscle wasting is the result of both decreased muscle protein synthesis and increased muscle protein breakdown. In addition 40% of these patients developed muscle necrosis over the study period.
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