Barriers to and Facilitators of the Consumption of Animal-Based Protein-Rich Foods in Older Adults

K M Appleton, K M Appleton

Abstract

Protein intakes in the older population can be lower than recommended for good health, and while reasons for low protein intakes can be provided, little work has attempted to investigate these reasons in relation to actual intakes, and so identify those of likely greatest impact when designing interventions. Questionnaires assessing: usual consumption of meat, fish, eggs and dairy products; agreement/disagreement with reasons for the consumption/non-consumption of these foods; and several demographic and lifestyle characteristics; were sent to 1000 UK community-dwelling adults aged 65 years and over. In total, 351 returned questionnaires, representative of the UK older population for gender and age, were suitable for analysis. Different factors were important for consumption of the four food groups, but similarities were also found. These similarities likely reflect issues of particular concern to both the consumption of animal-based protein-rich foods and the consumption of these foods by older adults. Taken together, these findings suggest intakes to be explained by, and thus that strategies for increasing consumption should focus on: increasing liking/tastiness; improving convenience and the effort required for food preparation and consumption; minimizing spoilage and wastage; and improving perceptions of affordability or value for money; freshness; and the healthiness of protein-rich foods.

Keywords: animal-based foods; food intake; older adults; protein; questionnaire.

References

    1. De Souza G.P., Martini L.A. Effect of protein intake on bone and muscle mass in the elderly. Nutr. Rev. 2010;68:616–623. doi: 10.1111/j.1753-4887.2010.00321.x.
    1. Wolfe R.R. The role of dietary protein in optimizing muscle mass, function and health outcomes in older individuals. Br. J. Nutr. 2012;108:S88–S93. doi: 10.1017/S0007114512002590.
    1. Wolfe R.R., Miller S.L., Miller K.B. Optimal protein intake in the elderly. Clin. Nutr. 2008;27:675–684. doi: 10.1016/j.clnu.2008.06.008.
    1. Ozaki A., Uchiyama M., Tagaya H., Ohida T., Ogihara R. The Japanese Centenarian Study: Autonomy was associated with health practices as well as physical status. J. Am. Geriatr. Soc. 2007;55:95–101. doi: 10.1111/j.1532-5415.2006.01019.x.
    1. Deutz N.E.P., Bauer J.M., Barazzoni R., Biolo G., Boirie Y., Bosy-Westphal A., Cederholm T., Cruz-Jentoft A., Krznariç Z., Nair K.S., et al. Protein intake and exercise for optimal muscle function with aging: Recommendations from the ESPEN Expert Group. Clin. Nutr. 2014;33:929–936. doi: 10.1016/j.clnu.2014.04.007.
    1. Chevalier S., Gougeon R., Nayar K., Morais J.A. Frailty amplifies the effects of aging on protein metabolism: Role of protein intake. Am. J. Clin. Nutr. 2003;78:422–429.
    1. Gweon H.-S., Sung H.J., Lee D.H. Short-term protein intake increases fractional synthesis rate of muscle protein in the elderly. Nutr. Res. Pract. 2010;4:375–382. doi: 10.4162/nrp.2010.4.5.375.
    1. Paddon-Jones D., Rasmussen B.B. Dietary protein recommendations and the prevention of sarcopenia. Curr. Opin. Clin. Nutr. Metab. Care. 2009;12:86–90. doi: 10.1097/MCO.0b013e32831cef8b.
    1. Pannemans D.L.E., Halliday D., Westerterp K.R. Whole-body protein turnover in elderly men and women: Responses to two protein intakes. Am. J. Clin. Nutr. 1995;61:33–38.
    1. Pannemans D.L.E., Wagenmakers J.M., Westerterp K.R., Schaafsma G., Halliday D. The effect of an increase of protein intake on whole-body protein turnover in elderly women is tracer dependent. J. Nutr. 1997;127:1788–1794.
    1. Pennings B., Boirie Y., Senden J.M.G., Gijsen A.P., Kuipers H., van Loon L.J.C. Whey protein stimulates postprandial muscle protein accretion more effectively than do casein and casein hydrolysate in older men. Am. J. Clin. Nutr. 2011;93:997–1005. doi: 10.3945/ajcn.110.008102.
    1. Pennings B., Koopman R., Beelen M., Senden J.M.G., Saris W.H.M., van Loon L.J.C. Exercising before protein intake allows for greater use of dietary protein-derived amino acids for de novo muscle protein synthesis in both young and elderly men. Am. J. Clin. Nutr. 2011;93:322–331. doi: 10.3945/ajcn.2010.29649.
    1. Devine A., Dick I.M., Islam A.F.M., Dhaliwal S.S., Prince R.L. Protein consumption is an important predictor of lower limb bone mass in elderly women. Am. J. Clin. Nutr. 2005;81:1423–1428.
    1. Houston D.K., Nicklas B.J., Ding J., Harris T.B., Tylavsky F.A., Newman A.B., Lee J.S., Sahyoun N.R., Visser M., Kritchevsky S.B. Dietary protein intake is associated with lean mass change in older community-dwelling adults: The Health, Aging and Body Composition (Health ABC) Study. Am. J. Clin. Nutr. 2008;87:150–155.
    1. Imai E., Tsubota-Utsugi M., Kikuya M., Satoh M., Inoue R., Hosaka M., Metoki H., Fukushima N., Kurimoto A., Hirose T., et al. Animal protein intake is associated with higher-level functional capacity in elderly adults: The Ohasama Study. J. Am. Geriatr. Soc. 2014;62:426–434. doi: 10.1111/jgs.12690.
    1. Kobayashi S., Asakura K., Suga H., Saski S., the Three generation study of women on diets and health study group High protein intake is associated with low prevalence of frailty among old Japanese women: A multi center cross sectional study. Nutr. J. 2013;12:164. doi: 10.1186/1475-2891-12-164.
    1. Martinez-Ramirez M.J., Delgado-Martinez A.D., Ruiz-Bailen M., de la Fuente C., Martinez-Gonzalez M.A., Delgado-Rodriguez M. Protein intake and fracture risk in elderly people: A case control study. Clin. Nutr. 2012;31:391–395. doi: 10.1016/j.clnu.2011.11.016.
    1. Meng X., Zhu K., Devine A., Kerr D.A., Binns C.W., Prince R.L. A 5-year cohort study of the effects of high protein intake on lean mass and BMC in elderly postmenopausal women. J. Bone Miner. Res. 2009;24:1827–1834. doi: 10.1359/jbmr.090513.
    1. Promislow J.H.E., Goodman-Gruen D., Slymne D.J., Barrett-Connor E. Protein consumption and bone mineral density in the elderly: The Rancho Bernardo Study. Am. J. Epidemiol. 2002;155:636–644. doi: 10.1093/aje/155.7.636.
    1. Zoltick E.S., Sahni S., McLean R.R., Quach L., Casey V.A., Hannan M.T. Dietary protein intake and subsequent falls in older men and women: The Framingham Study. J. Nutr. Health Aging. 2011;15:147–152. doi: 10.1007/s12603-011-0028-2.
    1. Bauer J., Bioli G., Cederholm T., Cesari M., Cruz-Jentoft A.J., Morley J.E., Phillips S., Sieber C., Stehle P., Teta D., et al. Evidence-based recommendations for optimal dietary protein intake in older people: A position paper from the PROT-AGE Study Group. JAMDA. 2013;14:542–559. doi: 10.1016/j.jamda.2013.05.021.
    1. Delmi M., Rapin C.H., Bengoa J.M., Bonjour J.P., Vasey H., Delmas P.D. Dietary supplementation in elderly patients with fractured neck of the femur. Lancet. 1990;335:1013–1016. doi: 10.1016/0140-6736(90)91073-J.
    1. Milne A.C., Potter J., Vivanti A., Avenell A. Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane Database Syst. Rev. 2009;2:CD003288.
    1. Tkatch L., Rapin C.H., Rizzoli R., Slosman D., Nydegger V., Vasey H., Bonjour J.P. Benefits of oral protein supplementation in elderly patients with fracture of the proximal femur. J. Am. Coll. Nutr. 1992;11:519–525. doi: 10.1080/07315724.1992.10718256.
    1. Wouters-Wesseling W., van Hooijdonk C., Wagenaar L., Bindels J., de Groot L., van Staveren W. The effect of a liquid nutrition supplement on body composition and physical functioning in elderly people. Clin. Nutr. 2003;22:371–377. doi: 10.1016/S0261-5614(03)00034-7.
    1. Nowson C., O’Connell S. Protein requirements and recommendations for older people: A review. Nutrients. 2015;7:6874–6899. doi: 10.3390/nu7085311.
    1. Tieland M., Borgonjen-van den Berg K.J., van Loon L.J.C., de Groot L.C.P.G.M. Dietary protein intake in community-dwelling frail and institutionalized elderly people: Scope for improvement. Eur. J. Nutr. 2012;51:173–179. doi: 10.1007/s00394-011-0203-6.
    1. Jyvakorpi S.K., Pitkala K.H., Puranen T.M., Björkman M.P., Kautiainen H., Strandberg T.E., Soini H., Suominen M.H. Low protein and micronutrient intakes in heterogeneous older population samples. Arch. Gerontol. Geriatr. 2015;61:464–471. doi: 10.1016/j.archger.2015.06.022.
    1. BAPEN Putting Patients at the Centre of Good Nutritional Care. [(accessed on 10 December 2015)]. Available online: .
    1. Berner L.A., Becker G., Wise M., Doi J. Characterization of dietary protein among older adults in the United States: Amount, animal sources and meal patterns. J. Acad. Nutr. Diet. 2013;113:809–815. doi: 10.1016/j.jand.2013.01.014.
    1. Smithers G., Finch S., Doyle W., Lowe C., Bates C.J., Prentice A., Clarke P.C. National Diet and Nutrition Survey: People Aged 65 Years and Over. HM Stationary Office; London, UK: 1998.
    1. Fulgoni V.L. Current protein intake in America: Analysis of the National Health and Nutrition Examination Survey, 2003–2004. Am. J. Clin. Nutr. 2008;87:1554S–1557S.
    1. Kennedy O.B., Law C., Methven L., Mottram D., Gosney M. Investgiating age-related changes in taste and affects on sensory perceptions of oral nutritional supplements. Age Ageing. 2010;39:733–738. doi: 10.1093/ageing/afq104.
    1. Nieuwenhuizen W.F., Weenen H., Rigby P., Hetherington M.M. Older adults and patients in need of nutritional support: Review of current treatment options and factors influencing nutritional intake. Clin. Nutr. 2010;29:160–169. doi: 10.1016/j.clnu.2009.09.003.
    1. Van der Zanden L.D.T., van Kleef E., de Wijk R.A., van Trijp H.C.M. Examining heterogeneity in elderly consumers’ acceptance of carriers for protein-enriched food: A segmentation study. Food Qual. Prefer. 2015;42:130–138. doi: 10.1016/j.foodqual.2015.01.016.
    1. Van der Zanden L.D.T., van Kleef E., de Wijk R.A., van Trijp H.C.M. Knowledge, perceptions and preferences of elderly regarding protein-enriched functional food. Appetite. 2014;80:16–22. doi: 10.1016/j.appet.2014.04.025.
    1. Pasiakos S.M., Agarwal S., Lieberman H.R., Fulgoni V.L. Sources and amounts of animal, dairy, and plant protein intake of US adults in 2007–2010. Nutrients. 2015;7:7058–7069. doi: 10.3390/nu7085322.
    1. Cowan D.T., Roberts J.D., Fitzpatrick J.M., While A.E., Baldwin J. Nutritional status of older people in long term care settings: Current status and future directions. Int. J. Nurs. Stud. 2004;41:225–237. doi: 10.1016/S0020-7489(03)00131-7.
    1. Duffy V.B., Backstrand J.R., Ferris A.M. Olfactory dysfunction and related nutritional risk in free-living elderly women. J. Am. Diet Assoc. 1995;95:879–884. doi: 10.1016/S0002-8223(95)00244-8.
    1. Hetherington M.M. Taste and appetite regulation in the elderly. Proc. Nutr. Soc. 1998;57:625–631. doi: 10.1079/PNS19980091.
    1. Kossioni A., Bellou O. Eating habits in older people in Greece: The role of age, dental status and chewing difficulties. Arch. Gerontol. Geriatr. 2011;62:197–201. doi: 10.1016/j.archger.2010.03.017.
    1. Mojet J., Christ-Hazelhof E., Heidema J. Taste perception with age: Generic or specific losses in threshold sensitivity to the five basic tastes? Chem. Sens. 2001;26:845–860. doi: 10.1093/chemse/26.7.845.
    1. Morley J.E. Anorexia of aging: Physiologic and pathologic. Am. J. Clin. Nutr. 1997;66:760–773.
    1. Morley J.E. Protein-energy malnutrition in older subjects. Proc. Nutr. Soc. 1998;57:587–592. doi: 10.1079/PNS19980085.
    1. Sheiham A., Steele J.G., Marcenes W., Finch S., Walls A.W.G. The impact of oral health on stated ability to eat certain foods. Gerodontology. 1999;16:11–20. doi: 10.1111/j.1741-2358.1999.00011.x.
    1. Van der Pols-Vijlbrief R., Wijnhoven H.A.H., Schaap L.A., Terwee C.B., Visser M. Determinants of protein-energy malnutrition in community-dwelling older adults: A systematic review of observational studies. Ageing Res. Rev. 2014;18:112–131. doi: 10.1016/j.arr.2014.09.001.
    1. Winter F.L., Bisogni C.A., Sobal J. Food choice processes of older adults: A qualitative investigation. J. Nutr. Educ. 1996;28:257–265. doi: 10.1016/S0022-3182(96)70098-5.
    1. Wylie C., Copeman J., Kirk S.F.L. Health and social factors affecting the food choice and nutritional intake of elderly people with restricted mobility. J. Hum. Nutr. Diet. 1999;12:375–380. doi: 10.1046/j.1365-277x.1999.00177.x.
    1. Best R.L., Appleton K.M. Investigating protein consumption in older adults: A focus group study. J. Nutr. Educ. Behav. 2013;45:751–755. doi: 10.1016/j.jneb.2013.03.008.
    1. Margetts B.M., Cade J.E., Osmond C. Comparison of a food frequency questionnaire with a diet record. Int. J. Epidemiol. 1989;18:868–873. doi: 10.1093/ije/18.4.868.
    1. Department for Communities and Local Government Index of Multiple Deprivation (England) [(accessed on 29 February 2016)]; Available online: .
    1. Welsh Government Index of Multiple Deprivation (Wales) [(accessed on 29 February 2016)]; Available online: .
    1. The Scottish Government Index of Multiple Deprivation (Scotland) [(accessed on 29 February 2016)]; Available online: .
    1. Northern Ireland Statistics and Research Agency Index of Multiple Deprivation (Northern Ireland) [(accessed on 29 February 2016)]; Available online: .
    1. Appleton K.M., McGill R., Woodside J.V. Fruit and vegetable consumption in older people in Northern Ireland: Levels and patterns. Br. J. Nutr. 2009;102:949–953. doi: 10.1017/S0007114509332122.
    1. Donkin A.J.M., Johnson A.E., Lilley J.M., Morgan K., Neale R.J., Page R.M., Silburn R.L. Gender and living alone as determinants of fruit and vegetable consumption among the elderly living at home in urban Nottingham. Appetite. 1998;30:39–51. doi: 10.1006/appe.1997.0110.
    1. Fowke J.H., Schlundt D., Gong Y., Jin F., Shu X.O., Wen W.Q., Liu D.K., Gao Y.T., Zheng W. Impact of season of Food Frequency Questionnaire administration on dietary reporting. Ann. Epidemiol. 2004;14:778–785. doi: 10.1016/j.annepidem.2004.02.002.
    1. Wang Y., Beydoun M.A., Caballero B., Gary T.L., Lawrence R. Trends and correlates in meat consumption patterns in the US adult population. Public Health Nutr. 2010;13:1333–1345. doi: 10.1017/S1368980010000224.
    1. Kelsheimer H.L., Hawkins S.T. Older adult women find food preparation easier with specialized kitchen tools. J. Am. Diet. Assoc. 2000;100:950–952. doi: 10.1016/S0002-8223(00)00273-X.
    1. Steptoe A., Pollard T.M., Wardle J. Development of a measure of the motives underlying the selection of food: The Food Choice Questionnaire. Appetite. 1995;25:267–284. doi: 10.1006/appe.1995.0061.
    1. Appleton K.M., McGill R., Neville C., Woodside J.V. Barriers to increasing fruit and vegetable intakes in the older population of Northern Ireland: Low levels of liking and low awareness of current recommendations. Public Health Nutr. 2010;13:514–521. doi: 10.1017/S1368980009991790.
    1. Appleton K.M., Smith E. A role for identification in the gradual decline in the pleasantness of flavours with age. J. Gerontol. Psychol. Sci. 2016 in press.
    1. Appleton K.M. Increases in energy, protein and fat intake following the addition of sauce to an older person’s meal. Appetite. 2009;52:161–165. doi: 10.1016/j.appet.2008.09.009.
    1. Best R.L., Appleton K.M. Comparable increases in energy, protein and fat intakes following the addition of seasonings and sauces to an older person’s meal. Appetite. 2011;56:179–182. doi: 10.1016/j.appet.2010.10.011.
    1. Henry C.J., Woo J., Lightowler H.J., Yip R., Lee R., Hui E., Shing S., Seyoum T.A. Use of natural food flavours to increase food and nutrient intakes in hospitalized elderly in Hong Kong. Int. J. Food Sci. Nutr. 2003;54:321–327. doi: 10.1080/0963748031000148718.
    1. Mathey M.A.M., Sieblink E., de Graaf C., van Staveren W.A. Flavor enhancement of food improves dietary intake and nutritional status of elderly nursing home residents. J. Gerontol. 2001;56:M200–M205. doi: 10.1093/gerona/56.4.M200.
    1. Schiffman S.S., Warwick Z.S. Effect of flavor enhancement of foods for the elderly on nutritional status: Food intake, biochemical indices and anthropometric measures. Physiol. Behav. 1993;53:395–402. doi: 10.1016/0031-9384(93)90224-4.
    1. Henchion M., McCarthy M., Resconi V.C., Troy D. Meat consumption: Trends and quality matters. Meat Sci. 2014;98:561–568. doi: 10.1016/j.meatsci.2014.06.007.
    1. McCarthy M., O’Reilly S., Cotter L., de Boer M. Factors influencing consumption of pork and poultry in the Irish market. Appetite. 2004;43:19–28. doi: 10.1016/j.appet.2004.01.006.
    1. Font-i-Furnois M., Guerrero L. Consumer preference, behavior and perceptions about meat and meat products: An overview. Meat Sci. 2014;96:361–371. doi: 10.1016/j.meatsci.2014.06.025.
    1. Roininen K., Lahteenmaki L., Tuorila H. Quantification of consumer attitudes to health and hedonic characteristics of foods. Appetite. 1999;33:71–88. doi: 10.1006/appe.1999.0232.
    1. Rousset S., Boirie Y., Droit-Volet S. Change in protein intake in elderly French people living at home after a nutritional information program targeting protein consumption. J. Am. Diet. Assoc. 2006;106:253–261. doi: 10.1016/j.jada.2005.10.037.
    1. Bejaei M., Wiseman K., Cheng K.M. Influences of demographic characteristics, attitudes, and preferences of consumers on table egg consumption in British Columbia, Canada. Poult. Sci. 2011;90:1088–1095. doi: 10.3382/ps.2010-01129.
    1. Chollet M., Gille D., Piccinali P., Bütikofer U., Schmid A., Stoffers H., Altintzoglou T., Walther B. Dairy consumption among middle-aged and elderly adults in Switzerland. J. Dairy Sci. 2014;97:5387–5392. doi: 10.3168/jds.2014-8193.
    1. Grieger J.A., Miller M., Cobiac L. Knowledge and barriers relating to fish consumption in older Australians. Appetite. 2012;59:456–463. doi: 10.1016/j.appet.2012.06.009.
    1. Mobley A.R., Jensen J.D., Maulding M.K. Attitudes, beleifs, and barriers related to milk consumption in older, low-income women. J. Nutr. Educ. Behav. 2014;46:554–559. doi: 10.1016/j.jneb.2013.11.018.
    1. Weiss S., Davis E., Wojtanowski A.C., Foster G.D., Glanz K., Karpyn A. Consumer taste tests and milk preference in low-income, urban supermarkets. Public Health Nutr. 2014;18:1419–1422. doi: 10.1017/S1368980014001980.
    1. Skuland S.E. Healthy eating and barriers related to social class. The case of vegetable and fish consumption in Norway. Appetite. 2015;92:217–226. doi: 10.1016/j.appet.2015.05.008.
    1. Appleton K.M., Peters T.J., Hayward R.C., Heatherley S.V., McNaughton S.A., Rogers P.J., Gunnell D., Ness A.R., Kessler D. Depressed mood and n-3 polyunsaturated fatty acid intake from fish: Non-linear or confounded association? Soc. Psychiatry Psychiatr. Epidemiol. 2007;42:100–104. doi: 10.1007/s00127-006-0142-3.
    1. Appleton K.M., Woodside J.V., Yarnell J.W.G., Arveiler D., Haas B., Amouyel P., Montaye M., Ferrieres J., Ruidavets J.B., Ducimetiere P., et al. Depressed mood and dietary fish intake: Direct relationship or indirect relationship as a result of diet and lifestyle? J. Affect. Disord. 2007;104:217–223.
    1. Carlucci D., Nocella G., de Devitis B., Viscecchia R., Bimbo F., Nardone G. Consumer purchasing behaviour towards fish and seafood products. Patterns and insights from a sample of international studies. Appetite. 2015;84:212–227. doi: 10.1016/j.appet.2014.10.008.
    1. Trondsen T., Braaten T., Lund E., Eggen A.E. Health and seafood consumption patterns among women aged 45–69 years. A Norwegian seafood consumption study. Food Qual. Prefer. 2004;15:117–128. doi: 10.1016/S0950-3293(03)00038-7.
    1. Nash C., Stevenson S., Brereton A., Jolliffe N. Food Safety for Supervisors. Chadwick House Group Ltd.; London, UK: 2007.
    1. Trondsen T., Scholderer J., Lund E., Eggen A.E. Perceived barriers to consumption of fish among Norwegian women. Appetite. 2003;41:301–314. doi: 10.1016/S0195-6663(03)00108-9.
    1. Becker T., Benner E., Glitsch K. Consumer perception of fresh meat quality in Germany. Br. Food J. 2000;102:246–266. doi: 10.1108/00070700010324763.
    1. Lewis B.R., Bashin A. Retailing policies for eggs: The implications of changes in consumer attitudes and behaviour. Br. Food J. 1988;90:172–177. doi: 10.1108/eb011825.
    1. Van den Heuvel E., Murphy J.L., Appleton K.M. Exploring the barriers and facilitators to the consumption of eggs and other protein-rich foods using focus groups. Proc. Nutr. Soc. 2015;74:169. doi: 10.1017/S0029665115003614.
    1. McAlpine S.J., Harper J., McMurdo M.E., Bolton-Smith C., Hetherington M.M. Nutritional supplementation in older adults. Br. J. Health Psychol. 2003;8:57–66. doi: 10.1348/135910703762879200.
    1. Nijs K.A., de Graaf C., Siebelink E., Blauw Y.H., Vanneste V., Kok F.J., van Staveren W.A. Effect of family-style meals on energy intake and risk of malnutrition in Dutch nursing home residents: A randomized controlled trial. J. Gerontol. A Biol. Med. Sci. 2006;61:935–942. doi: 10.1093/gerona/61.9.935.
    1. Dermiki M., Mounayar R., Suwankanit C., Scott J., Kennedy O.B., Mottram D.S., Gosney M.A., Blumenthal H., Methven L. Maximising umami taste in meat using natural ingredients: Effects on chemistry, sensory perception and hedonic liking in young and old consumers. J. Sci. Food Agric. 2013;93:3312–3321. doi: 10.1002/jsfa.6177.
    1. Pennings B., Groen B.B.L., van Dijk J.W., de Lange A., Kiskini A., Kuklinski M., Senden J.M.G., van Loon L.G.C. Minced beef is more rapidly digested and absorbed than beef steak, resulting in greater postprandial protein retention in older men. Am. J. Clin. Nutr. 2013;98:121–128. doi: 10.3945/ajcn.112.051201.
    1. Sayhoun N.R., Pratt C.A., Andersen A. Evaluation of nutrition education interventions for older adults: A proposed framework. J. Am. Diet. Assoc. 2004;104:58–69. doi: 10.1016/j.jada.2003.10.013.
    1. McKie L., MacInnes A., Hendry J., Donald S., Peace H. The food consumption patterns and perceptions of dietary advice of older people. J. Hum. Nutr. Diet. 2000;13:173–183. doi: 10.1046/j.1365-277x.2000.00226.x.
    1. Molag M.L., de Vries J.H., Ocke M.C., Dagnelie P.C., van den Brandt P.A., Jansen M.C.J.F., van Staveren W.A., van’t Veer P. Design characteristics of food frequency questionnaires in relation to their validity. Am. J. Epidemiol. 2007;166:1468–1478. doi: 10.1093/aje/kwm236.
    1. Tjonneland A., Haraldsdottir J., Overvad K., Stripp C., Ewertz M., Jensen O.M. Influence of individually estimated portion size data on the validity of a semi-quantitative food frequency questionnaire. Int. J. Epidemiol. 1992;21:770–777. doi: 10.1093/ije/21.4.770.
    1. Walrand S., Short K.R., Bigelow M.L., Sweatt A.J., Hutson S.M., Sreekumaran N.K. Functional impact of high protein intake on heathy elderly people. Am. J. Phyiol. Endocrinol. Metab. 2008;295:E921–E928. doi: 10.1152/ajpendo.90536.2008.
    1. Bajzelj B., Richards K.S., Allwood J.M., Smith P., Dennis J.S., Curmi E., Gilligan C.A. Importance of food-demand management for climate migration. Nat. Clim. Chang. 2014;4:924–929. doi: 10.1038/nclimate2353.
    1. Eshel G., Shepon A., Makov T., Milo R. Land, irrigation water, greenhouse gas, and reactive nitrogen burdens of meat, eggs and dairy production in the United States. PNAS. 2014;111:11996–12001. doi: 10.1073/pnas.1402183111.
    1. Larsson S.C., Orsini N. Red meat and processed meat consumption and all-cause mortality: A meta-analysis. Am. J. Epidemiol. 2014;179:282–289. doi: 10.1093/aje/kwt261.
    1. Michia R., Wallace S.K., Mozaffarian D. Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: A systematic review and meta-analysis. Circulation. 2010;12:2271–2283. doi: 10.1161/CIRCULATIONAHA.109.924977.

Source: PubMed

3
S'abonner