Dietary protein intake in sarcopenic obese older women

Espedita Muscariello, Gilda Nasti, Mario Siervo, Martina Di Maro, Dominga Lapi, Gianni D'Addio, Antonio Colantuoni, Espedita Muscariello, Gilda Nasti, Mario Siervo, Martina Di Maro, Dominga Lapi, Gianni D'Addio, Antonio Colantuoni

Abstract

Objective: To determine the prevalence of sarcopenia in a population of obese older women and to assess the effect of a diet moderately rich in proteins on lean mass in sarcopenic obese older women.

Materials and methods: A total of 1,030 females, >65 years old, body mass index >30 kg/m(2), were investigated about their nutritional status. Muscle mass (MM) was estimated according to the Janssen equation (MM =0.401× height(2)/resistance measured at 50 kHz +3.825× sex -0.071× age +5.102). Sarcopenia was defined according to the MM index, MM/height2 (kg/m(2)), as two standard deviations lower than the obesity-derived cutoff score (7.3 kg/m(2)). A food-frequency questionnaire was used to measure participants' usual food intake during the previous 3 months. Moreover, a group of sarcopenic obese older women (n=104) was divided in two subgroups: the first (normal protein intake [NPI], n=50) administered with a hypocaloric diet (0.8 g/kg desirable body weight/day of proteins), and the second treated with a hypocaloric diet containing 1.2 g/kg desirable body weight/day of proteins (high protein intake [HPI], n=54), for 3 months. Dietary ingestion was estimated according to a daily food diary, self-administered, and three reports of nonconsecutive 24-hour recall every month during the follow-up.

Results: The 104 women were classified as sarcopenic. After dieting, significant reductions in body mass index were detected (NPI 30.7±1.3 vs 32.0±2.3 kg/m(2), HPI 30.26±0.90 vs 31.05±2.90 kg/m(2); P<0.01 vs baseline). The MM index presented significant variations in the NPI as well as in the HPI sarcopenic group (NPI 6.98±0.1 vs 7.10±0.2 kg/m(2), HPI 7.13±0.4 vs 6.96±0.1 kg/m(2); P<0.01 vs baseline).

Conclusion: A diet moderately rich in proteins was able to preserve MM in sarcopenic women. Therefore, adequate protein intake could contribute to the prevention of lean-mass loss associated with weight reduction in obese older people.

Keywords: aging; lean body mass; obesity; protein intake; sarcopenia.

Figures

Figure 1
Figure 1
Study population. Abbreviations: BMI, body mass index (kg/m2); MMI, muscle mass index (kg/m2); DBW, desirable body weight.
Figure 2
Figure 2
Cutoff scores to define sarcopenia. Note: Data reported as mean ± SD. Abbreviations: BMI, body mass index (kg/m2); MMI, muscle mass index (kg/m2); SD, standard deviation.
Figure 3
Figure 3
Variations in muscle mass index in the NPI and HPI groups, after 3 months’ dieting and physical activity. Note: *P<0.01. Abbreviations: NPI, normal protein intake (0.8 g/kg DBW/day); HPI, high protein intake (1.2 g/kg DBW/day); t0, basal condition; t1, after 3 months’ dieting; DBW, desirable body weight.

References

    1. Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA. 2006;295(13):1549–1555.
    1. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis. Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39(4):412–423.
    1. Han TS, Tajar A, Lean ME. Obesity and weight management in the elderly. Br Med Bull. 2011;97(1):169–196.
    1. Janssen I, Ross R. Linking age-related changes in skeletal muscle mass and composition with metabolism and disease. J Nutr Health Aging. 2005;9(6):408–419.
    1. Rosenberg IH. Sarcopenia: origins and clinical relevance. J Nutr. 1997;127(5 Suppl):990S–991S.
    1. Clark BC, Manini TM. Sarcopenia =/= dynapenia. J Gerontol A Biol Sci Med Sci. 2008;63(8):829–834.
    1. Doherty TJ. Invited review: aging and sarcopenia. J Appl Physiol (1985) 2003;95(4):1717–1727.
    1. Jarosz PA, Bellar A. Sarcopenic obesity: an emerging cause of frailty in older adults. Geriatr Nurs. 2009;30(1):64–70.
    1. Morley JE, Baumgartner RN, Roubenoff R, Mayer J, Nair KS. Sarcopenia. J Lab Clin Med. 2001;137(4):231–243.
    1. Rolland Y, Lauwers-Cances V, Cournot M, et al. Sarcopenia, calf circumference and physical function of elderly women: a cross sectional study. J Am Geriatr Soc. 2003;51(8):1120–1124.
    1. Roubenoff R. Sarcopenic obesity: the confluence of two epidemics. Obes Res. 2004;12(6):887–888.
    1. Waters DL, Baumgartner RN, Garry PJ. Sarcopenia: current perspectives. J Nutr Health Aging. 2000;4(3):133–139.
    1. Zamboni M, Mazzali G, Fantin F, Rossi A, Di Francesco V. Sarcopenic obesity: a new category of obesity in the elderly. Nutr Metab Cardiovasc Dis. 2008;18(5):388–395.
    1. Bales CW, Buhr G. Is obesity bad for older persons? A systematic review of the pros and cons of weight reduction in later life. J Am Med Dir Assoc. 2008;9(5):302–312.
    1. Janssen I, Heymsfield SB, Ross R. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc. 2002;50(5):889–896.
    1. Tipton KD. Muscle protein metabolism in the elderly: influence of exercise and nutrition. Can J Appl Physiol. 2001;26(6):588–606.
    1. Trumbo P, Schlicker S, Yates AA, Poos M. Dietary reference intakes for energy, carbohydrates, fiber, fat acids, cholesterol, protein and amino acids. J Am Diet Assoc. 2002;102(11):1621–1630.
    1. Volpi E, Campbell WW, Dwyer JT, et al. Is the optimal level of protein intake for older adults greater than the recommended dietary allowance? J Gerontol A Biol Sci Med Sci. 2013;68(6):677–681.
    1. Campbell WW, Crim MC, Dallal GE, Young VR, Evans WJ. Increased protein requirements in elderly people: new data and retrospective reassessments. Am J Clin Nutr. 1994;60(4):501–509.
    1. Campbell WW, Johnson CA, McCabe GP, Carnell NS. Dietary protein requirements of younger and older adults. Am J Clin Nutr. 2008;88(5):1322–1329.
    1. Deutz NE, Bauer JM, Barazzoni R, et al. Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group. Clin Nutr. 2014;33(6):929–936.
    1. Bauer J, Biolo G, Cederholm T, et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE study group. J Am Med Dir Assoc. 2013;14(8):542–559.
    1. Kurpad AV, Vaz M. Protein and amino acid requirements in the elderly. Eur J Clin Nutr. 2000;54(Suppl 3):S131–S142.
    1. Rand WM, Pellett PL, Young VR. Meta-analysis of nitrogen balance studies for estimating protein requirements in healthy adults. Am J Clin Nutr. 2003;77(1):109–127.
    1. Siervo M, Stephan BC, Nasti G, Colantuoni A. Ageing, adiposity indexes and low muscle mass in a clinical sample of overweight and obese women. Obes Res Clin Pract. 2012;6(1):e1–e90.
    1. Piccoli A. Patterns of bioelectrical impedance vector analysis: learning from electrocardiography and forgetting electric circuit models. Nutrition. 2002;18(6):520–521.
    1. Frontera WR, Meredith CN, O’Reilly KP, Evans WJ. Strength training and determinants of VO2max in older men. J Appl Physiol (1985) 1990;68(1):329–333.
    1. Tichet J, Vol S, Goxe D, Salle A, Berrut G, Ritz P. Prevalence of sarcopenia in the French senior population. J Nutr Health Aging. 2008;12(3):202–206.
    1. VanItallie TB, Yang MU, Heymsfield SB, Funk RC, Boileau RA. Height-normalised indices of the body’s fat free mass and fat mass: potentially useful indicators of nutritional status. Am J Clin Nutr. 1990;52(6):953–959.
    1. Lauretani F, Russo CR, Bandinelli S, et al. Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol (1985) 2003;95(5):1851–1860.
    1. Incel NA, Ceceli E, Durukan PB, Erdem HR, Yorgancioglu ZR. Grip strength: effect of hand dominance. Singapore Med J. 2002;43(5):234–237.
    1. Armstrong CA, Oldham JA. A comparison of dominant and non-dominant hand strengths. J Hand Surg Br. 1999;24(4):421–425.
    1. Pala V, Sieri S, Palli D, et al. Diet in the Italian EPIC cohorts: presentation of data and methodological issues. Tumori. 2003;89(6):594–607.
    1. Panico S, Dello Iacovo R, Celentano E, et al. Progetto ATENA, a study on the etiology of major chronic diseases in women: design, rationale and objectives. Eur J Epidemiol. 1992;8(4):601–608.
    1. Harris J, Benedict F. A Biometric Study of Basal Metabolism in Man. Washington: Carnegie Institution; 1919.
    1. Symons TB, Schutzler SE, Cocke TL, Chinkes DL, Wolfe RR, Paddon-Jones D. Aging does not impair the anabolic response to a protein-rich meal. Am J Clin Nutr. 2007;86(2):451–456.
    1. Paddon-Jones D, Rasmussen BB. Dietary protein recommendations and the prevention of sarcopenia. Curr Opin Clin Nutr Metab Care. 2009;12(1):86–90.
    1. Frontera WR, Meredith CN, O’Reilly KP, Knuttgen HG, Evans WJ. Strength conditioning in older men: skeletal muscle hypertrophy and improved function. J Appl Physiol (1985) 1988;64(3):1038–1044.
    1. Lee PH, Macfarlane DJ, Lam TH, Stewart SM. Validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF): a systematic review. Int J Behav Nutr Phys Act. 2011;8:115.
    1. van Poppel MN, Chinapaw MJ, Mokkink LB, van Mechelen W, Terwee CB. Physical activity questionnaires for adults: a systematic review of measurement properties. Sports Med. 2010;40(7):565–600.
    1. Baumgartner RN, Koehler KM, Gallagher D, et al. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol. 1998;147(8):755–763.
    1. Kim YS, Lee Y, Chung YS, et al. Prevalence of sarcopenia and sarcopenic obesity in the Korean population based on the Fourth Korean National Health and Nutritional Examination Surveys. J Gerontol A Biol Sci Med Sci. 2012;67(10):1107–1113.
    1. Merriwether EN, Host HH, Sinacore DR. Sarcopenic indices in community-dwelling older adults. J Geriatr Phys Ther. 2012;35(3):118–125.
    1. Prado CM, Wells JC, Smith SR, Stephan BC, Siervo M. Sarcopenic obesity: a critical appraisal of the current evidence. Clin Nutr. 2012;31(5):583–601.
    1. Waters DL, Baumgartner RN. Sarcopenia and obesity. Clin Geriatr Med. 2011;27(3):401–421.

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