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. 2018 Dec;37(6 Pt A):2260-2270.
doi: 10.1016/j.clnu.2017.11.005. Epub 2017 Nov 16.

Low protein intake, muscle strength and physical performance in the very old: The Newcastle 85+ Study

Antoneta Granic  1 , Nuno Mendonça  2 , Avan Aihie Sayer  3 , Tom R Hill  4 , Karen Davies  5 , Ashley Adamson  6 , Mario Siervo  7 , John C Mathers  7 , Carol Jagger  8
Affiliations

Low protein intake, muscle strength and physical performance in the very old: The Newcastle 85+ Study

Antoneta Granic et al. Clin Nutr. 2018 Dec.

Abstract

Background: Low protein intake has been linked to reduced muscle strength and physical performance in older adults but little is known about how it may affect muscle health and subsequent functional decline in the very old (aged 85+), who are at enhanced risk of malnutrition and loss of muscle mass and strength.

Aims: To investigate the associations between low protein intake, defined as the intake of <1 g protein/kg adjusted body weight/day (<1 g/kg aBW/d) and decline in muscle strength and physical performance in the very old.

Methods: The analytic sample consisted of 722 community-dwelling participants (60% women) from the Newcastle 85+ Study who had protein intake at baseline. Participants were followed-up for change in grip strength (GS) and Timed Up-and-Go (TUG) test over 5 years (baseline, 18, 36, and 60 months). We used mixed models to determine the effects of low protein intake on muscle strength and physical performance in all participants, and also stratified by sex.

Results: At baseline, 390 (54%) participants (261 women, p < 0.001) reported low protein intake, and these differed from participants with good intake (≥1 g/kg aBW/d) on several measures of health and function. In the model adjusted for protein intake, consuming <1 g/kg aBW/d of protein was associated with a 1.62 kg lower GS (p = 0.008) in all participants, and especially in women (β (SE) = -0.83 (0.41), p = 0.05) after adjusting for key baseline covariates (anthropometry, multimorbidity, arthritis in hands, cognitive status and physical activity). The rate of decline in GS over 5 years was not associated with protein intake. Women, but not men, with low protein intake had worse baseline TUG (β (SE) = 0.04 (0.02), p = 0.03) compared with those with good protein intake in the fully adjusted model, but the rate of decline in TUG was not affected by daily protein status.

Conclusions: Intake of <1 g protein/kg aBW/d may negatively affect muscle strength and physical performance in late life, especially in older women, independently of important covariates. More research is needed in the very old to define the optimal protein intake for maintenance of muscle health and function.

Keywords: Aged 80 and over; Grip strength; Low protein intake; Newcastle 85+ Study; Physical activity; Timed Up-and-Go test.

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Figures

Fig. 1
Fig. 1
A similar rate of decline in GS by protein intake. We found no association between low protein intake (<1 g/kg aBW/d; grey line) and grip strength (GS) at baseline or GS decline compared with good protein intake (≥1 g/kg aBW/d; black line) in all participants (panel A) and in men (panel B). In women (panel C), low protein intake (grey line) was associated with lower GS at baseline, but not with the rate of GS decline over 5 years. The growth curves represent β estimates of the fully adjusted model (Model 3). Greater β estimates indicate higher muscle strength (GS).
Fig. 2
Fig. 2
A similar rate of decline in TUG by protein intake. Low protein intake (<1 g/kg aBW/d; grey line) was associated with worse Timed Up-and-Go (TUG) test scores at baseline in all participants (panel A) and in women (panel C), but not in men (panel B) compared with those consuming ≥1 g/kg aBW/d (black lines) of protein. The rate of decline in TUG did not vary by protein intake (panels A, B, and C) over 5 years. The growth curves represent β estimates of the fully adjusted model (Model 3). Greater log10-s indicated worse (slower) TUG performance.
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