Association of Dietary Protein Intake and Grip Strength Among Adults Aged 19+ Years: NHANES 2011–2014 Analysis

The Association of Isocaloric Substitution of Dietary Protein in Middle Age with Muscle Mass and Strength in Old Age: The Hordaland Health Study

Background

Age-associated loss of muscle mass and strength is an important predictor of disability in older persons. Although several mechanisms contribute to the decline in muscle mass and function seen with aging, the process is thought to be accelerated by an inadequate protein intake. However, the optimal amount and source of protein and the role of dietary protein intake over the life course remain uncertain.

Objectives

In a sample of community-dwelling adults in Western Norway, the current study examined both cross-sectional and longitudinal associations over 20 y of dietary protein intake with appendicular skeletal muscle mass (ASMM) and muscle strength measured by handgrip strength (HGS) in older age.

Methods

Dietary intake was assessed using food frequency questionnaires (FFQs) in middle age (46-49 y) and older age (67-70 y) within the community-based Hordaland Health Study.

Results

Adjusted, multivariate linear regression analyses revealed a negative cross-sectional association between the substitution of total protein (TP) and animal protein (AP), with fat and carbohydrates, on ASMM in women but not in men. No longitudinal associations were found between substitution of dietary protein intake and ASMM in either sex in adjusted models. Similarly, no cross-sectional or longitudinal associations were evident between substitution of dietary protein intake and HGS in either sex in adjusted models.

Conclusion

The findings in the current study highlight the need to clarify the role of dietary protein intake in the maintenance of muscle mass and muscle strength in healthy older adults.

Dietary protein intake and changes in muscle mass measurements in community-dwelling middle-aged and older adults: A prospective cohort study

BACKGROUND & AIMS

Increasing dietary protein intake can be an efficient strategy to prevent sarcopenia. Nevertheless, due to the discrepancy in the population and their dietary pattern, evidence suggested the effects of dietary protein amount or source on sarcopenia prevention varies. This prospective cohort study investigated the correlation between dietary protein intakes or sources and changes in muscle mass measurements. Additionally, the study explored the link between dietary protein and the prevalence of sarcopenia.

METHODS

Participants aged 40 to 75 were from Guangzhou Nutrition and Health Study (GNHS) 2011-2013 and returned in 2014-2017. Validated 79-item food frequency questionnaires were applied to calculate the amount of total, animal, and plant protein intakes and animal-to-plant protein ratio (APR). The body composition was examined by dual-energy x-ray absorptiometry (DXA) to calculate the appendicular lean mass (ALM) and its index (ASMI). Sarcopenia was diagnosed based on the 2019 Asia Working Group of Sarcopenia's criteria. ANCOVA was utilized to compare the differences of Δ ALM and Δ ASMI across the quartiles of the dietary protein, and linear regression was employed to examine dose-response associations. Multilinear mixed-effect models were employed to evaluate whether protein intake relates to annual changes in ALM and ASMI. Multivariable logistic regressions were performed to analyze the associations between dietary protein and sarcopenia.

RESULTS

In total, 2709 participants during the 3.2-year follow-up period were considered eligible for analysis. Higher dietary protein intakes (total, animal, plant) in both sexes could preserve more ALM and ASMI in a dose-response manner (all P-trend < 0.05). The annual estimated preservations of ASMI were greater in the highest dietary protein intakes (total, animal, plant) quartile than the lowest (0.05-0.13 kg/m2/y, all P < 0.05). In women, the risk of sarcopenia was reduced by 35%-50 % in the highest protein intake (total, animal, plant) quartile than the lowest. The APR did not display any significant associations.

CONCLUSIONS

Higher dietary protein intake, regardless of animal or plant sources, is associated with less muscle loss and a lower prevalence of sarcopenia in middle-aged and older Chinese, particularly women.

CLINICALTRIALS

GOV IDENTIFIER

NCT03179657.

Osteoarthritis and sarcopenia-related traits: the cross-sectional study from NHANES 2011-2014 and Mendelian randomization study

BACKGROUND

Osteoarthritis (OA) and sarcopenia are common musculoskeletal disorders in the aged population, and a growing body of evidence indicated that they mutually influence one another. Nevertheless, there was still substantial controversy and uncertainty about the causal relationship between sarcopenia and OA. We explored the complex association between sarcopenia-related traits and OA using cross-sectional analysis and Mendelian randomization (MR).

METHODS

The cross-sectional study used the data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014. Weighted multivariable-adjusted logistic regression and subgroup analyses were used to evaluate the correlation between sarcopenia, grip, appendicular lean mass (ALM) and the risk of OA. Then, we further performed MR analysis to examine the causal effect of sarcopenia-related traits (grip strength, ALM) on OA. Instrumental variables for grip strength and ALM were from the UK Biobank, and the summary-level data for OA was derived from the Genetics of Osteoarthritis (GO) Consortium GWAS (n = 826,690).

RESULTS

In this cross-sectional analysis, we observed that sarcopenia, grip were significantly linked with the risk of OA (OR 1.607, 95% CI 1.233-2.094, P < 0.001), (OR 0.972, 95% CI 0.964-0.979, P < 0.001). According to subgroup analyses stratified by gender, body mass index (BMI), and age, the significant positive relationship between sarcopenia and OA remained in males, females, the age (46-59 years) group, and the BMI (18.5-24.9 kg/m²) group (P < 0.05). Furthermore, MR analysis and sensitivity analyses showed causal associations between right grip, left grip and KOA (OR 0.668; 95% CI 0.509 to 0.877; P = 0.004), (OR 0.786; 95% CI 0.608 to 0.915; P = 0.042). Consistent directional effects for all analyses were observed in both the MR-Egger and weighted median methods. Subsequently, sensitivity analyses revealed no heterogeneity, directional pleiotropy or outliers for the causal effect of grip strength on KOA (P > 0.05).

CONCLUSIONS

Our research provided evidence that sarcopenia is correlated with an increased risk of OA, and there was a protective impact of genetically predicted grip strength on OA. These findings needed to be verified in further prospective cohort studies with a large sample size.

Consumption Patterns and the Nutritional Contribution of Total, Processed, Fresh, and Fresh-Lean Pork to the U.S. Diet

Pork has the potential to provide several macro and micronutrients to the diet, as it is a commonly consumed protein in the United States and across many cultures worldwide. There is an absence of clinical and observational studies that isolate the nutritional contribution of various types of pork intake from that of other red and/or processed meats. The objective of this study was to assess consumption patterns and the nutritional contribution of total, processed, fresh, and fresh-lean pork to the diets of participants aged 2+ years enrolled in the National Health and Nutrition Examination Survey (NHANES) 2007-2018 data cycles. The recent National Cancer Institute method was used to disaggregate fresh and processed pork intake from the USDA Food Patterns Equivalents Database. The mean intake of total pork among consumers was estimated to be 79.5 ± 0.82, 54.2 ± 0.69, 54.6 ± 0.93, and 45.9 ± 0.73, g/d for men, women, boys, and girls, respectively. Total pork consumption subtly increased intakes of total energy and several macro and micronutrients, decreased diet quality (HEI-2015) scores (adults only), and consumption of other "healthful" food groups. Only subtle but clinically insignificant effects of pork intake on biomarkers of nutritional status were shown. These trends were largely driven by processed pork consumption and the co-consumption of foods such as condiments. Increasing the availability and education around fresh-lean cuts may help to increase intake of protein and other key nutrients across certain subpopulations, without adversely affecting diet quality and biomarkers of health status.

Important Concepts in Protein Nutrition, Aging, and Skeletal Muscle: Honoring Dr Douglas Paddon-Jones (1969-2021) by Highlighting His Research Contributions

This review is a tribute to honor Dr Douglas Paddon-Jones by highlighting his career research contributions. Dr Paddon-Jones was a leader in recognizing the importance of muscle health and the interactions of physical activity and dietary protein for optimizing the health span. Aging is characterized by loss of muscle mass and strength associated with reduced rates of muscle protein synthesis (MPS) and the ability to repair and replace muscle proteins. Research from the team at the University of Texas Medical Branch in Galveston discovered that the age-related decline in MPS could be overcome by increasing the quantity or quality of dietary protein at each meal. Dr Paddon-Jones was instrumental in proposing and testing a "protein threshold" of ∼30 g protein/meal to optimize MPS in older adults. Dr Paddon-Jones demonstrated that physical inactivity greatly accelerates the loss of muscle mass and function in older adults. His work in physical activity led him to propose the "Catabolic Crisis Model" of muscle size and function losses, suggesting that age-related muscle loss is not a linear process, but the result of acute periods of disuse associated with injuries, illnesses, and bed rest. This model creates the opportunity to provide targeted interventions via protein supplementation and/or increased dietary protein through consuming high-quality animal-source foods. He illustrated that nutritional support, particularly enhanced protein quantity, quality, and meal distribution, can help preserve muscle health during periods of inactivity and promote health across the life course.

Amino Acid Intake and Conformance With the Dietary Reference Intakes in the United States: Analysis of the National Health and Nutrition Examination Survey, 2001-2018

BACKGROUND

The lack of complete amino acid composition data in food composition databases has made determining population-wide amino acid intake difficult.

OBJECTIVES

This cross-sectional study characterizes habitual intakes of each amino acid and adherence to dietary requirements for each essential amino acid (EAA) in the US population.

METHODS

Food and Nutrient Database for Dietary Studies ingredient codes with missing amino acid composition data were matched to similar ingredients with available data so that amino acid composition could be determined for 100% of foods reported in the dietary intake assessment component of NHANES. Amino acid intakes during NHANES 2001-2018 (n = 72,831; ≥2 y) were calculated as relative (mg·kg of ideal body weight^-1·d^-1) intakes. Data from NHANES 2011-2018 were used to determine the percentage of population consuming less than that recommended by the DRIs for each EAA by age, sex, and race/ethnicity.

RESULTS

Relative intakes of EAAs and NEAAs were greatest in those 2-3 y and lowest in older individuals (≥71 y or ≥80 y). In females aged 2-18 y, relative intakes of EAAs were lowest in non-Hispanic White (NHW; histidine, lysine, threonine, methionine, and cysteine) and non-Hispanic Black (NHB; valine, isoleucine, leucine, phenylalanine, tryptophan, and tyrosine) populations and highest in the Asian population. In females aged ≥19 y, relative intakes were lowest in NHW (lysine and methionine only) and NHB populations and highest in the Asian population. In males aged 2-18 y, relative intakes of EAAs were lowest in the NHB population and highest in the Asian population. In males ≥19 y, relative intakes were lowest in NHB and NHW (lysine only) populations and highest in the Hispanic population. Less than 1% of individuals aged ≥19 y did not meet the Estimated Average Requirements for each EAA.

CONCLUSIONS

EAA intakes in the US population exceed recommended minimum population requirements. Future studies can use the method described here to quantify amino acid intake and examine relationships with health and disease.

Protein Intake in NCAA Division 1 Soccer Players: Assessment of Daily Amounts, Distribution Patterns, and Leucine Levels as a Quality Indicator

Dietary protein is required to support recovery and adaptation following exercise training. While prior research demonstrates that many athletes meet total daily protein needs, intake seems to be predominantly skewed toward the evening meal. An even distribution of protein doses of ≥0.24 g/kg BW consumed throughout the course of a day is theorized to confer greater skeletal muscle anabolism outcomes compared to a skewed pattern of intake. Protein quality is also an important dietary consideration for athletes, with the amino acid leucine seemingly serving as the primary driver of the postprandial anabolic response. The present study investigates protein consumption characteristics among a cohort of NCAA D1 soccer players and evaluates differences between male and female athletes. Athletes were instructed to complete 3-day food diaries, which were subsequently analyzed and compared to UEFA expert group-issued nutrition guidelines for soccer players. Breakfast, lunch, and dinner accounted for 81.4% of the total daily dietary protein intake. Most athletes (77.8%) ingested optimum amounts of protein at dinner but not at breakfast (11.1%) or lunch (47.2%). In addition, statistically significant sex-based differences in daily dietary protein intake, meal-specific protein amounts, and protein quality measures were detected. Findings indicate suboptimal dietary protein intake practices among the collegiate soccer athletes.

Reply to Grant, W.B. Comment on "Coelho-Junior et al. Protein Intake and Frailty in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients 2022, 14, 2767"

We recently conducted a systematic review and meta-analysis to assess the association between protein consumption and frailty in older adults [...].

Associations between dietary magnesium intake and handgrip strength were modified by serum vitamin D level among the US elderly

Objective

The present study aimed to evaluate the associations between dietary magnesium intake and handgrip strength, and whether these associations were affected by serum vitamin D status.

Methods

A total of 2,127 participants aged 60 and above from the National Health and Nutrition Examination Survey (NHANES) of the 2011-2014 cycles were included in the analyses. Magnesium intake was obtained by 24-h dietary recalls and 30-day dietary supplement. Participants in the lowest sex-specific tertile of magnesium intake were defined as having low magnesium intake. Serum 25-hydroxyvitamin D [25(OH)D)] concentrations were examined by using ultra-high performance liquid chromatography tandem mass spectrometry and categorized into three levels: deficient, suboptimal, and sufficient. Handgrip strength was determined by using a dynamometer. Multivariable linear regression models were used to investigate the associations between dietary magnesium intake and handgrip strength.

Results

Low magnesium intake was not associated with handgrip strength, but interactions between low magnesium intake and serum 25(OH)D level existed on handgrip strength. The stratified analyses found that only in participants with deficient serum 25(OH)D, low magnesium intake was associated with reduced handgrip strength. The combined analyses shown that participants with both low magnesium intake and deficient serum 25(OH)D had highest decrease of handgrip strength.

Conclusion

Findings suggested that low magnesium intake was associated with reduced handgrip strength only in participants with deficient serum 25(OH)D. Increased magnesium intake was recommended for participants with deficient serum 25(OH)D in maintaining muscle strength.