Association between dietary protein intake and changes in health-related quality of life in older adults: findings from the AusDiab 12-year prospective study

Association of plant and animal protein intake with sleep quality and quality of life in hemodialysis patients: a multicenter cross-sectional study

Background

The current study aimed to evaluate the association between the intake of plant-based protein, animal-based protein, total protein, and the ratio of plant to animal protein with sleep quality and quality of life in patients undergoing hemodialysis.

Methods

In this cross-sectional study, 479 adult patients undergoing dialysis for a minimum of 3 months were included. The dietary intake was calculated using information from a validated 168-item semi-quantitative food frequency questionnaire. Quality of life (QOL) was assessed using the Kidney Disease Quality of Life Short Form (KDQOL-SF 1.3). and the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality.

Results

In this study, the mean age of the participants was 58.18 years (± 14.25 years), with the majority being male (58.2%). After adjusting for potential confounders, significant positive associations were observed between total protein intake (β = 0.12, p = 0.03) and quality of life (QOL). Conversely, there were significant negative associations between the ratio of plant to animal protein intake (β = -0.94, p < 0.01) and QOL. Furthermore, significant negative associations were found between total protein intake (β = -0.02, p < 0.05) and animal protein intake (β = -0.19, p < 0.05) with poor sleep quality. Additionally, there were significant positive associations between the ratio of plant to animal protein intake (β = 0.188, p < 0.05) and poor sleep quality.

Conclusion

Increased consumption of animal protein is associated with improved sleep quality and Quality of Life (QOL) in patients undergoing hemodialysis (HD). Further research, especially prospective studies, is required to confirm these associations.

The association between ultra-processed food consumption and health-related quality of life differs across lifestyle and socioeconomic strata

BACKGROUND

In this prospective study, we aimed to examine the association between ultra-processed foods and health-related quality of life (HRQoL) and to evaluate the effect of lifestyle and socioeconomic factors on this association.

METHODS

This study included 1766 adults (aged 18 to 78, 54.3% women), who took part in the Tehran Lipid and Glucose study. The Short-Form 12-Item Health Survey version 2 was used to determine HRQoL, which includes the physical component summary (PCS) and mental component summary (MCS) scores. Ultra-processed food consumption was assessed using a validated semi-quantitative food frequency questionnaire. Lifestyle (physical activity and smoking status) and socioeconomic factors (education level and employment status) were also determined. General linear models (GLM) were applied to estimate the mean (95% confidence interval) for MCS and PCS scores across the ultra-processed foods tertiles. Additionally, the effect of lifestyle and socioeconomic factors on the relationship between ultra-processed foods and HRQoL was examined using GLM.

RESULTS

The median consumption of ultra-processed foods was 11.9% (IQR: 8.2 to 16.8) of total energy intake. There was a significant inverse association between ultra-processed foods consumption and PCS, but not MCS, after adjustment for confounding factors. Significant interactions were observed between ultra-processed food consumption, sex, and occupation on PCS score (all P values < 0.001). The interaction test tended to be significant for smoking status, education levels, and physical activity levels. As ultra-processed food consumption increased, the PCS score significantly decreased in women (P = 0.043), low physical active subjects (P = 0.014), smokers (P = 0.015), and lower-educated individuals (P = 0.022). Non-employed individuals with higher ultra-processed food intake showed a decline in their PCS and MCS scores. While there was no significant difference in MCS score among different strata of lifestyle and socioeconomic status across tertiles of ultra-processed foods.

CONCLUSIONS

Higher intake of ultra-processed foods was associated with poorer physical health, particularly among women, those with unhealthy lifestyles, and low socioeconomic conditions.

Dietary protein intake in midlife in relation to healthy aging - results from the prospective Nurses' Health Study cohort

BACKGROUND

Protein intake plays an important role in maintaining the health status of older adults. However, few epidemiologic studies examined midlife protein intake in relation to healthy aging.

OBJECTIVES

The objective of this study was to evaluate the long-term role of dietary protein intake in healthy aging among female participants in the prospective Nurses' Health Study (NHS) cohort.

METHODS

We included 48,762 NHS participants aged <60 y in 1984. Total protein, animal protein, dairy protein (a subset of animal protein), and plant protein were derived from validated food frequency questionnaires. Healthy aging was defined as being free from 11 major chronic diseases, having good mental health, and not having impairments in either cognitive or physical function, as assessed in the 2014 or 2016 NHS participant questionnaires. We used multivariate logistic regression adjusted for lifestyle, demographics, and health status to estimate the odds ratios (ORs) and 95% confidence intervals for protein intake in relation to healthy aging.

RESULTS

A total of 3721 (7.6%) NHS participants met our healthy aging definition. Protein intake was significantly associated with higher odds of healthy aging. The ORs (95% confidence intervals) per 3%-energy increment with healthy aging were 1.05 (1.01, 1.10) for total protein, 1.07 (1.02, 1.11) for animal protein, 1.14 (1.06, 1.23) for dairy protein, and 1.38 (1.24, 1.54) for plant protein. Plant protein was also associated with higher odds of absence of physical function limitations and good mental status. In substitution analyses, we observed significant positive associations for the isocaloric replacement of animal or dairy protein, carbohydrate, or fat with plant protein (ORs for healthy aging: 1.22-1.58 for 3% energy replacement with plant protein).

CONCLUSIONS

Dietary protein intake, especially plant protein, in midlife, is associated with higher odds of healthy aging and with several domains of positive health status in a large cohort of female nurses.

Composition of healthy diets for older persons

PURPOSE OF REVIEW

This study aims to review recent evidence (2022-2023) on the role of diet in promoting healthy aging in older adults.

RECENT FINDINGS

Current evidence of diet and healthy aging is limited to epidemiological studies. A healthy diet is beneficial for individual domains of intrinsic capacity, that is, cognition, locomotion, vitality, psychological, and/or sensory functions, with sex-specific differences reported. Only a few studies used the multidimensional concept of intrinsic capacity as an outcome. This review supports that a healthy diet for older adults consists of plenty of plant-based foods, adequate protein-rich foods, and healthy fats. Next to quantity, improving the quality and variety within food groups play a role in optimizing health. Data on the associations between adherence to national food-based dietary guidelines and intrinsic capacity are scarce.

SUMMARY

A healthy diet, centered on plant-based foods, adequate protein-rich foods and healthy fats, potentially promotes healthy aging. Future studies may evaluate the association between adherence to healthy dietary patterns (particularly national food-based dietary guidelines) and the multidimensional concept of intrinsic capacity, with consideration of sex-specific differences. Clinical trials are warranted to inform the causal effects of diet and outcomes related to intrinsic capacity.

Hispidin-enriched Sanghuangporus sanghuang mycelia SS-MN4 ameliorate disuse atrophy while improving muscle endurance

BACKGROUND

Disuse atrophy is a frequent cause of muscle atrophy, which can occur in individuals of any age who have been inactive for a prolonged period or immobilization. Additionally, acute diseases such as COVID-19 can cause frequent sequelae and exacerbate muscle wasting, leading to additional fatigue symptoms. It is necessary to investigate potent functional nutrients for muscle reinforcement in both disuse atrophy and fatigue to ensure better physical performance.

METHODS

The effects of Sanghuangporus sanghuang SS-MN4 mycelia were tested on two groups of 6-week-old male mice-one with disuse atrophy and the other with fatigue. The disuse atrophy group was divided into three sub-groups: a control group, a group that underwent hind limb casting for 7 days and then recovered for 7 days and a group that was administered with SS-MN4 orally for 14 days, underwent hind limb casting for 7 days and then recovered for 7 days. The fatigue group was divided into two sub-groups: a control group that received no SS-MN4 intervention and an experimental group that was administered with SS-MN4 orally for 39 days and tested for exhaustive swimming and running on Day 31 and Day 33, respectively. RNA sequencing (RNA-seq) and western blot analysis were conducted on C2C12 cell lines to identify the therapeutic effects of SS-MN4 treatment.

RESULTS

In a disuse atrophy model induced by hind limb casting, supplementing with 250 mg/kg of SS-MN4 for 14 days led to 111.2% gastrocnemius muscle mass recovery and an 89.1% improvement in motor function on a treadmill (P < 0.05). In a fatigue animal model, equivalent SS-MN4 dosage improved swimming (178.7%) and running (162.4%) activities (P < 0.05) and reduced blood urea nitrogen levels by 18% (P < 0.05). SS-MN4 treatment also increased liver and muscle glycogen storage by 34.36% and 55.6%, respectively, suggesting a higher energy reserve for exercise. RNA-seq and western blot studies from the C2C12 myotube showed that SS-MN4 extract upregulates Myh4 and helps sustain myotube integrity against dexamethasone damage.

CONCLUSIONS

Supplementation of SS-MN4 (250-mg/kg body weight) with hispidin as active compound revealed a potential usage as a muscle nutritional supplement enhancing muscle recovery, fast-twitch fibre regrowth and fatigue resistance.

The value of dietary plant protein in older people

PURPOSE OF REVIEW

The current review provides an update on recent research regarding plant-based protein and their nutritional quality for older people.

RECENT FINDINGS

There is growing evidence that plant-based proteins may be a valuable strategy for older people to prevent the health risks associated with consuming animal products and to promote better protein intake, as plant-based protein sources are rich in fibres and micronutrients. Although plant-based proteins are less anabolic than animal-derived proteins due to lower digestibility and deficiencies in some essential amino acids, several innovations in food processing and nutritional strategies have been developed to improve the quality of plant-based proteins. For example, the use of protein blends or green-processes as fermentation or germination could improve the nutritional qualities of plant-based foods that could be beneficial for older people, especially to prevent sarcopenia or metabolic disorders such as diabetes, obesity and cardiovascular diseases.

SUMMARY

The use of plant-based protein sources could help older people diversify their protein sources and more easily meet recommended nutritional intake. Recent literature highlights several health benefits associated with increased consumption of vegetable foods. However, their efficiency on postprandial muscle protein synthesis remains to be evaluated and long-term studies are needed.

Age and cohort trends of the impact of socioeconomic status on dietary diversity among Chinese older adults from the perspective of urban–rural differences: A prospective cohort study based on CLHLS 2002–2018

The association between socioeconomic status (SES) and dietary diversity score (DDS) has been widely discussed, but little is known about the age and cohort effects on DDS and how the SES effect on DDS varies with age and across successive cohorts among urban and rural older adults in China. Thus, this study aimed to examine the temporal change in DDS among Chinese older adults and SES heterogeneities in such change from the perspective of urban–rural differentiation. Data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) between 2002 and 2018 were used, and a total of 13,728 participants aged between 65 and 105 years were included in this study. A total of eight food groups were used to assess DDS, while education, family income, and perceived income status were used to assess SES. A linear mixed model was used to estimate the age and cohort effects on DDS and their urban–rural and SES disparities. The results show that higher SES, including more education, family income, and perceived income status, was associated with higher DDS (for urban older adults, β = 0.1645, p = 0.0003, β = 0.2638, p < 0.0001, β = 0.2917, p < 0.0001, respectively; for rural older adults, β = 0.0932, p = 0.0080, β = 0.4063, p < 0.0001, β = 0.2921, p < 0.0001, respectively). The DDS of older adults increased with age and across successive cohorts in both urban and rural China. Moreover, we found the three-way interaction effect of SES, age, and cohort was statistically significant in both urban and rural China. Thus, living in an urban area and having higher SES are associated with higher DDS, but these associations change with age and across successive cohorts. The dietary health of earlier cohorts and rural oldest-old in China deserves more attention.

Interactions between nutrient intake and comorbidities for quality of life in premenopausal and postmenopausal women

OBJECTIVE

This study aimed to identify the associations between nutrient intake and health-related quality of life (HRQOL) in premenopausal and postmenopausal women.

METHODS

Using data from Korean National Health and Nutrition Examination Surveys (2019-2020), EQ-5D-3L, and multivariate logistic and linear regression models, we analyzed the association and interaction between nutrient intake, comorbidities, and HRQOL among 4,027 Korean women.

RESULTS

Nutrient intake levels were lower in postmenopausal women than in premenopausal women. Interactions were observed between numerous nutrient intakes and comorbidities for HRQOL among premenopausal and postmenopausal women. Higher intakes of various nutrients (particularly, folic acid and vitamin A) were related to higher HRQOL scores in premenopausal women with comorbidities (log of inverse HRQOL scores, β = -0.31 [95% confidence interval [CI], -0.58 to -0.05] and β = -0.19 [95% CI, -0.37 to -0.001]) and postmenopausal women with comorbidities (log of inverse HRQOL scores, β = -0.34 [95% CI, -0.61 to -0.07] and β = -0.19 [95% CI, -0.38 to -0.01]), respectively. Regular exercise was associated with a lower risk of mobility problems (odds ratio [OR], 0.59; 95% CI, 0.44-0.81), self-care problems (OR, 0.53; 95% CI, 0.28-0.99), usual activity problems (OR, 0.42; 95% CI, 0.26-0.67), and any problem (OR, 0.71; 95% CI, 0.56-0.90), as well as an increase in HRQOL score (log of inverse HRQOL scores, β = -0.42; 95% CI, -0.68 to -0.16) in postmenopausal women. Smoking was related to a higher prevalence of depression and anxiety problems (OR, 2.51; 95% CI, 1.53-4.13) and any problem (OR, 1.67; 95% CI, 1.11-2.52), as well as a decrease in HRQOL scores (log of inverse HRQOL scores, β = 0.51; 95% CI, 0.14-0.88) in premenopausal women.

CONCLUSIONS

Given the lower nutrient intake levels in postmenopausal women, it is critical to establish HRQOL-improving approaches for this population, including regular exercise, nutrient intake, and smoking cessation.