Abstract
Objective
Although it has been established that sufficient protein is required to maintain good
nutritional status and support healthy aging, it is not clear if the pattern of protein
consumption may also influence nutritional status, especially in institutionalized
elderly who are at risk of malnutrition. Therefore, we aim to determine the association
between protein intake distribution and nutritional status in institutionalized elderly
people.
Design
Cross-sectional study among 481 institutionalized older adults.
Methods
Dietary data from 481 ambulant elderly people (68.8% female, mean age 87.5 ± 6.3 years)
residing in 52 aged-care facilities in Victoria, Australia, were assessed over 2 days
using plate waste analysis. Nutritional status was determined using the Mini-Nutritional
Assessment tool and serum (n = 208) analyzed for albumin, hemoglobin, and IGF-1. Protein
intake distribution was classified as: spread (even distribution across 3 meals, n = 65),
pulse (most protein consumed in one meal, n = 72) or intermediate (n = 344). Regression
analysis was used to investigate associations.
Results
Mean protein intakes were higher in the spread (60.5 ± 2.0 g/d) than intermediate
group (56.0 ± 0.8 g/d, P = .037), and tended to be higher than those in the pulse group (55.9 ± 1.9 g/d, P = .097). Residents with an even distribution of protein intake achieved a higher
level of the recommended daily intake for protein (96.2 ± 30.0%) than the intermediate
(86.3 ± 26.2%, P = .008) and pulse (87.4 ± 30.5%, P = .06) groups, and also achieved a greater level of their estimated energy requirements
(intermediate; P = .039, pulse; P = .001). Nutritional status (Mini-Nutritional Assessment score) did not differ between
groups (pulse; 20.5 ± 4.5, intermediate; 21.0 ± 2.5, spread; 20.5 ± 3.5), nor did
any other indices of nutritional status.
Conclusions
Meeting protein requirements is required before protein distribution may influence
nutritional status in institutionalized elderly. Achieving adequate protein and energy
intakes is more likely when protein is distributed evenly throughout the day. Provision
of high protein foods especially at breakfast, and in the evening, may support protein
adequacy and healthy aging, especially for institutionalized elderly.
Keywords
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Article info
Publication history
Published online: November 21, 2017
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
