Association of Plant Protein Intake with Change in Physical Performance in Chinese Community-Dwelling Older Adults

Plant proteins: are they a good alternative to animal proteins in older people?

PURPOSE OF REVIEW

This review provides the latest insight into the impact of consuming plant-based protein for older people.

RECENT FINDINGS

According to the latest data, a healthy diet rich in plant-based-protein-rich-food could promote healthy aging. This health effect is partly because of the amino acid composition of proteins, as well as to the important constituents such as fiber and bioactive compounds found in the matrix. Furthermore, even though animal protein is more effective at stimulating muscle protein synthesis, a high consumption of plant protein (beyond 31 g/day) appears to enhance physical performance and reduce the risk of frailty in older individuals.

SUMMARY

Recent literature highlights numerous health benefits for older people associated with a substantial intake of plant-based vs. animal-based protein, both in preventing and mitigating chronic age-related diseases and reducing the risk of all-cause mortality. However, a high intake of plant-based protein-rich products could pose risks of malnutrition and fiber-related intestinal intolerances. Further research is needed to assess the risk-benefit ratio of a high consumption of plant proteins in older individuals before we can make robust recommendations on how far animal proteins can be healthfully replaced with plant proteins.

Identification of novel biomarkers for frailty diagnosis via serum amino acids metabolomic analysis using UPLC-MS/MS

PURPOSE

This study was aimed to analyze serum amino acid metabolite profiles in frailty patients, gain a better understanding of the metabolic mechanisms in frailty, and assess the diagnostic value of metabolomics-based biomarkers of frailty.

EXPERIMENTAL DESIGN

This study utilized the ultra-performance liquid chromatography tandem mass spectrometry to examine amino acids associated with frailty. Additionally, we employed multivariate statistical methods, metabolomic data analysis, receiver operating characteristic (ROC) curve analysis, and pathway enrichment analysis.

RESULTS

Among the assayed amino acid metabolites, we identified biomarkers for frailty. ROC curve analysis for frailty diagnosis based on the modified Fried's frailty index showed that the areas under ROC curve of tryptophan, phenylalanine, aspartic acid, and combination were 0.775, 0.679, 0.667, and 0.807, respectively. ROC curve analysis for frailty diagnosis based on Frail Scale showed that the areas under ROC curve of cystine, phenylalanine, and combination of amino acids (cystine, L-Glutamine, citrulline, tyrosine, kynurenine, phenylalanine, glutamin acid) were 0.834, 0.708, and 0.854 respectively.

CONCLUSION AND CLINICAL RELEVANCE

In this study, we explored the serum amino acid metabolite profiles in frailty patients. These present metabolic analyses may provide valuable information on the potential biomarkers and the possible pathogenic mechanisms of frailty.

CLINICAL SIGNIFICANCE

Frailty is a clinical syndrome, as a consequence it is challenging to identify at early course of the disease, even based on the existing frailty scales. Early diagnosis and appropriate patient management are the key to improve the survival and limit disabilities in frailty patients. Proven by the extensive laboratory and clinical studies on frailty, comprehensive analysis of metabolic levels in frail patients, identification of biomarkers and study of pathogenic pathways of metabolites contribute to the prediction and early diagnosis of frailty. In this study, we explored the serum amino acid metabolite profiles in frailty patients. These present metabolic analyses may provide valuable information on the potential biomarkers and the possible pathogenic mechanisms of frailty.

Association of dietary protein intake, inflammation with muscle mass, physical performance and incident sarcopenia in Chinese community-dwelling older adults

OBJECTIVES

Inflammation and impaired muscle synthesis are important factors of sarcopenia. Plant protein may reduce inflammation but may not be as efficient as animal protein in providing essential amino acids. We therefore examined the associations between dietary protein intake and changes in muscle mass and physical performance, incident sarcopenia, and the interaction effect of inflammation.

DESIGN

Prospective cohort study.

SETTING

The Mr. OS and Ms. OS (Hong Kong) cohort.

PARTICIPANTS

A total of 2,811 sarcopenia-free participants and 569 sarcopenia participants aged ≥65 years were recruited from communities.

MEASUREMENTS

Dietary protein intake was assessed using a validated food frequency questionnaire. Serum high-sensitivity C-reactive protein (hs-CRP) was measured. Linear regression examined the associations between dietary protein intake and 4-year changes in muscle mass and physical performance. Cox regression examined the association between dietary protein intake and incident sarcopenia.

RESULTS

Higher plant protein intake, but not total and animal protein, was associated with less decline in muscle mass and gait speed among sarcopenia-free participants. Conversely, higher ratio of animal-to-plant protein was associated with reduced muscle mass loss among participants with sarcopenia. The highest tertile of plant protein intake was associated with lower incident sarcopenia risk (HR: 0.75, 95% CI: 0.57-0.98; P-trend = 0.034) compared to the lowest tertile. Notably, this association was observed among participants with higher serum hs-CRP levels (HR: 0.57, 95% CI: 0.34-0.95), but not in those with lower hs-CRP levels.

CONCLUSION

Dietary animal and plant protein intake have differential associations with muscle mass and physical performance in older adults with and without sarcopenia. The role of plant protein in preventing sarcopenia involves modulation of inflammation.

The relationship between the quantity and type of macronutrients in diet and frailty in older outpatients

BACKGROUND AND AIM

The aim of this study is to determine the relationship between the quantity and type of macronutrients in the diet and frailty.

MATERIAL AND METHODS

A total of 106 patients were included in the study. Exclusion criteria included patients with pacemakers, edema, advanced dementia, acute infectious and inflammatory disease, and those using oral or enteral nutritional supplements. Frailty was assessed using the Fried Frailty Phenotype. Three-day dietary records were taken, 2 days on weekdays and 1 day on weekends. The Nutrition Information System (BeBis) 8.2 full version program was used to analyze the average energy and nutrient values of the consumed foods. Insufficient protein and energy intake were defined as taking less than 1 or 1.2 g/kg/day for protein and less than 30 kcal/kg/day for energy, respectively.

RESULTS

The mean age of the participants was 74.3 (± 6.75), and 68.9% (n = 73) of them were women. 26.4% (n = 28) of the patients were classified as frail. There was no difference between the energy consumption of < 30 kcal/kg/day in the frail and non-frail groups. Protein consumption of less than 1.2 g/kg/day had a significant relationship with frailty. There was no significant difference between the consumed plant/animal protein ratio and frailty, but plant protein, polyunsaturated fatty acids, and fiber intake were significantly lower in frail patients. Decreased consumption of polyunsaturated fatty acids (PUFAs), advanced age, and increased number of medications were identified as independently associated factors with frailty.

CONCLUSION

This study found that frailty was associated with less than 1.2 g/kg/day protein consumption, lower fiber, and PUFA consumption.

Vegan diet: nutritional components, implementation, and effects on adults' health

Vegan diet has emerged as a popular dietary choice for people worldwide in recent times, due to concerns such as health issues, animal rights and welfare, and the sustainability of the environment. The purpose of this literature review was to explain how a vegan diet may affect the health of adults and to point out beneficial components found in it as well as any difficulties associated with its implementation. Evidence supports that a vegan diet can reduce the risk of chronic diseases, such as type 2 diabetes, hypertension, and certain types of cancer. A well-planned vegan diet must include adequate calories and nutrients, as well as the necessary supplements, such as vitamin B12, vitamin D and EPA/DHA. Given the current growing interest in plant-based diets among the general population, it is crucial to understand both the barriers, risks, and benefits of the vegan diet among physicians, policy makers, and the general population.

Combined Aerobic Training and Mediterranean Diet Is Not Associated with a Lower Prevalence of Sarcopenia in Italian Older Adults

Previous studies found a lower prevalence of sarcopenia in older adults engaged in regular aerobic training (AT) or with greater adherence to a Mediterranean (MED) diet. However, the effect of their combination on sarcopenia indices is unknown. The present study tested the association between AT plus a MED diet and the presence of sarcopenia and its defining elements in a sample of Italian older adults enrolled in the Longevity Check-up 7+ (Lookup 7+) project. Analyses were conducted in participants 65+ years, with a body mass index of at least 18.5 kg/m2, engaged in regular AT, and without missing information for the variables of interest. MED diet adherence was evaluated via a modified version of the MEDI-LITE score and categorized as low, moderate, or high. The presence of sarcopenia was established by handgrip strength and appendicular skeletal muscle mass (ASM) values below sex-specific cut-points recommended by the European Working Group on Sarcopenia in Older People 2. Data from 491 older adults were analyzed for the present study. The mean age was 72.7 ± 5.7 years, and 185 (37.7%) were women. MED diet adherence was low in 59 (12.0%) participants, moderate in 283 (57.6%), and high in 149 (30.3%). Sarcopenia was identified in 26 participants (5.3%), with no differences across MED diet adherence groups. The results of binary logistic regression showed no significant associations between AT plus adherence to a MED diet and dynapenia, low ASM, or sarcopenia. The findings of the present study indicate that the combination of AT with a MED diet is not associated with a lower probability of sarcopenia or its defining elements in Italian older adults enrolled in Lookup 7+. Further research is warranted to establish whether exercise frequency, volume, intensity, and length of engagement in AT impact the association between MED diet and sarcopenia.