Nutrition assistance improves skeletal muscle function and performance in community-dwelling older women

Objective: To analyze the effects of nutritional assistance focusing on protein intake (in the individual’s usual diet) in relation to muscle mass, and the muscle strength and functional performance of community-dwelling older women. Methods: This is a non-randomized controlled clinical trial. Forty-three community-dwelling older women, who were allocated to the Control Group (CG; n = 20) or the Nutrition Group (NG; n = 23). The NG received individualized nutrition assistance and participated in group activities that focused on dietary protein intake once a week for 12 weeks. Main outcome measures: protein and energy intake; handgrip strength (HGS); gait speed (GS); quadriceps cross-sectional area (CSA); and intramuscular non-contractile tissue (IMNCT). The Student’s t-test for independent samples, the Mann-Whitney U test, and a mixed model ANOVA with two factors (group and time) were adopted, followed by a post hoc Bonferroni test. A Spearman’s correlation test was performed on tests for HGS; GS; CSA; IMNCT; age; and protein intake adjusted for weight (g/kg) (p ≤ 0.050). Results: Participants in the NG showed higher CSA values than those in the CG (p < 0.001). NG participants also had higher HGS (p < 0.001) and GS (p = 0.037) when compared to pre-intervention. Correlations were observed between IMNCT and protein intake adjusted for weight (g/kg) (r = -0.517; p = 0.020); HGS, and CSA (r = 0.827; p = 0.000); and CSA and age (r = -0.520, p = 0.009). Conclusions: A nutrition assistance program focusing on protein intake resulted in enhanced muscle function and physical performance.

[1]  Hongxuan Xu,et al.  Exercise and Nutritional Intervention for Physical Function of the Prefrail: A Systematic Review and Meta-Analysis. , 2022, Journal of the American Medical Directors Association.

[2]  D. Kiel,et al.  What cut-point in gait speed best discriminates community dwelling older adults with mobility complaints from those without? A pooled analysis from the Sarcopenia Definitions and Outcomes Consortium. , 2021, The journals of gerontology. Series A, Biological sciences and medical sciences.

[3]  C. Hofer,et al.  Resistance Exercise, Electrical Muscle Stimulation, and Whole-Body Vibration in Older Adults: Systematic Review and Meta-Analysis of Randomized Controlled Trials , 2020, Journal of clinical medicine.

[4]  E. Mandel,et al.  The importance of protein intake and strength exercises for older adults. , 2019, JAAPA : official journal of the American Academy of Physician Assistants.

[5]  C. Albala,et al.  Considerations for the Development of Innovative Foods to Improve Nutrition in Older Adults , 2019, Nutrients.

[6]  C. Cooper,et al.  Sarcopenia: revised European consensus on definition and diagnosis , 2019, Age and ageing.

[7]  E. Cyrino,et al.  Effects of higher habitual protein intake on resistance-training-induced changes in body composition and muscular strength in untrained older women: A clinical trial study , 2019, Nutrition and health.

[8]  René Rizzoli,et al.  Sarcopenia: revised European consensus on definition and diagnosis , 2018, Age and ageing.

[9]  D. Silva,et al.  The association between muscle strength and sociodemographic and lifestyle factors in adults and the younger segment of the older population in a city in the south of Brazil. , 2018, Ciencia & saude coletiva.

[10]  H. Sánchez,et al.  Reference values of hand-grip dynamometry and the relationship between low strength and mortality in older Chileans , 2018, Clinical interventions in aging.

[11]  F. Corbella,et al.  Nutritional counseling with or without systematic use of oral nutritional supplements in head and neck cancer patients undergoing radiotherapy. , 2017, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[12]  Aline Martins dos Santos,et al.  EDUCAÇÃO A DISTÂNCIA NO IBGE: O USO DE VÍDEO AULAS NO TREINAMENTO DA PESQUISA DE ORÇAMENTOS FAMILIARES 2017/2018 , 2017 .

[13]  F. Corbella,et al.  Oral Communication VI: Liver, Gastrointestinal Tract and CancerOR59: Nutritional Counseling with or without Systematic Use of Oral Nutritional Supplements in Head and Neck Cancer Patients Undergoing Radiotherapy , 2017 .

[14]  T. Travison,et al.  Nutritional supplementation with physical activity improves muscle composition in mobility‐limited older adults, the VIVE2 study: a randomized, double‐blind, placebo‐controlled trial , 2017, The journals of gerontology. Series A, Biological sciences and medical sciences.

[15]  S. Cummings,et al.  Body Composition Remodeling and Mortality: The Health Aging and Body Composition Study , 2016, The journals of gerontology. Series A, Biological sciences and medical sciences.

[16]  P. Jakeman,et al.  Twelve weeks’ progressive resistance training combined with protein supplementation beyond habitual intakes increases upper leg lean tissue mass, muscle strength and extended gait speed in healthy older women , 2016, Biogerontology.

[17]  C. Cooper,et al.  Prevalence and risk factors for falls in older men and women: The English Longitudinal Study of Ageing , 2016, Age and ageing.

[18]  Priyam Sharma,et al.  Effect of Digital Nutrition Education Intervention on the Nutritional Knowledge Levels of Information Technology Professionals , 2016, Ecology of food and nutrition.

[19]  R. Dickerson Nitrogen Balance and Protein Requirements for Critically Ill Older Patients , 2016, Nutrients.

[20]  D. Kiel,et al.  Dietary Protein Intake Is Protective Against Loss of Grip Strength Among Older Adults in the Framingham Offspring Cohort. , 2016, The journals of gerontology. Series A, Biological sciences and medical sciences.

[21]  J. Farthing,et al.  Lower leg muscle density is independently associated with fall status in community-dwelling older adults , 2016, Osteoporosis International.

[22]  J. Mursu,et al.  Dietary protein intake is associated with better physical function and muscle strength among elderly women , 2016, British Journal of Nutrition.

[23]  C. Bunker,et al.  Myosteatosis increases with aging and is associated with incident diabetes in African ancestry men , 2016, Obesity.

[24]  S. Kritchevsky,et al.  Protein and healthy aging. , 2015, The American journal of clinical nutrition.

[25]  Silva-Couto MA, Prado-Medeiros CL, Oliveira AB, et al. Muscle atrophy, voluntary activation disturbances, and low concentrations of IGF-1 and IGFBP-3 are associated with weakness in people with chronic stroke. Phys Ther. 2014;94:957–967. , 2015, Physical Therapy.

[26]  G. Gensini,et al.  Efficacy of a nutritional education program to improve diet in patients attending a cardiac rehabilitation program: outcomes of a one-year follow-up , 2015, Internal and Emergency Medicine.

[27]  Leslie G. Portney Dpt PhD Fapta,et al.  Foundations of Clinical Research: Applications to Practice , 2015 .

[28]  K. Nair,et al.  Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group. , 2014, Clinical nutrition.

[29]  A. Oliveira,et al.  Muscle Atrophy, Voluntary Activation Disturbances, and Low Serum Concentrations of IGF-1 and IGFBP-3 Are Associated With Weakness in People With Chronic Stroke , 2014, Physical Therapy.

[30]  R. Prentice,et al.  Biomarker‐Calibrated Protein Intake and Physical Function in the Women's Health Initiative , 2013, Journal of the American Geriatrics Society.

[31]  M. Cesari,et al.  Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. , 2013, Journal of the American Medical Directors Association.

[32]  L. V. van Loon,et al.  Anabolic Resistance of Muscle Protein Synthesis with Aging , 2013, Exercise and sport sciences reviews.

[33]  R. Barroso,et al.  Effects of strength and power training on neuromuscular variables in older adults. , 2012, Journal of aging and physical activity.

[34]  P. Abizanda,et al.  Validity and usefulness of hand-held dynamometry for measuring muscle strength in community-dwelling older persons. , 2012, Archives of gerontology and geriatrics.

[35]  D. Moher,et al.  CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials , 2010, Journal of clinical epidemiology.

[36]  D. Moher,et al.  CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials , 2010, Journal of pharmacology & pharmacotherapeutics.

[37]  T. Manini,et al.  Longitudinal study of muscle strength, quality, and adipose tissue infiltration. , 2009, The American journal of clinical nutrition.

[38]  James E. Graham,et al.  Assessing walking speed in clinical research: a systematic review. , 2008, Journal of evaluation in clinical practice.

[39]  J. Li,et al.  Pelvic body composition measurements by quantitative computed tomography: association with recent hip fracture. , 2008, Bone.

[40]  Bárbara Miranda Ferreira Costa,et al.  Estudo prospectivo do impacto da intervenção nutricional educativa em uma empresa privada no Brasil A prospective study of the impact of an educational nutrition intervention in a private company in Brazil , 2008 .

[41]  L. Teixeira-Salmela,et al.  [Cross-cultural adaptation and analysis of the psychometric properties in the Brazilian version of the Human Activity Profile]. , 2006, Cadernos de saude publica.

[42]  P. Ravasco,et al.  Dietary counseling improves patient outcomes: a prospective, randomized, controlled trial in colorectal cancer patients undergoing radiotherapy. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[43]  Maria Cristina Faber Boog,et al.  Resgate do conceito de aconselhamento no contexto do atendimento nutricional , 2005 .

[44]  F. Meyer,et al.  Atendimento ambulatorial individualizado versus programa de educação em grupo : qual oferece mais mudança de hábitos alimentares e de atividade física em crianças obesas? , 2004 .

[45]  Hermesson Daniel Medeiros da Silva Análise do orçamento de uma amostra de famílias brasileiras: um estudo baseado na pesquisa de orçamentos familiares do IBGE , 2004 .

[46]  M. Rogers,et al.  Methods to assess and improve the physical parameters associated with fall risk in older adults. , 2003, Preventive medicine.

[47]  P. Trumbo,et al.  Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. , 2002, Journal of the American Dietetic Association.

[48]  W. Frontera,et al.  Skeletal muscle fiber quality in older men and women. , 2000, American journal of physiology. Cell physiology.

[49]  D. Sellen,et al.  Genetics of Criminal and Antisocial Behaviour. Ciba Foundation Symposium 194. Pp. 283. Edited by G. R. Bock & J. A. Goode. (Wiley, Chichester, 1996.) £50.00. , 1998, Journal of Biosocial Science.

[50]  E. Loken,et al.  Methods for data collection at an individual level. , 1988 .