Abstract
PURPOSE: To examine the cost effectiveness of dietary advice to increase protein intake on 6-month change in physical functioning among older adults.
METHODS: In this multicenter randomized controlled trial, 276 community-dwelling older adults with a habitual protein intake < 1.0 g/kg adjusted body weight (aBW)/d were randomly assigned to either Intervention 1; advice to increase protein intake to ≥ 1.2 g/kg aBW/d (PROT, n = 96), Intervention 2; similar advice and in addition advice to consume protein (en)rich(ed) foods within half an hour after usual physical activity (PROT + TIMING, n = 89), or continue the habitual diet with no advice (CON, n = 91). Primary outcome was 6-month change in 400-m walk time. Secondary outcomes were 6-month change in physical performance, leg extension strength, grip strength, body composition, self-reported mobility limitations and quality of life. We evaluated cost effectiveness from a societal perspective.
RESULTS: Compared to CON, a positive effect on walk time was observed for PROT; - 12.4 s (95%CI, - 21.8 to - 2.9), and for PROT + TIMING; - 4.9 s (95%CI, - 14.5 to 4.7). Leg extension strength significantly increased in PROT (+ 32.6 N (95%CI, 10.6-54.5)) and PROT + TIMING (+ 24.3 N (95%CI, 0.2-48.5)) compared to CON. No significant intervention effects were observed for the other secondary outcomes. From a societal perspective, PROT was cost effective compared to CON.
CONCLUSION: Dietary advice to increase protein intake to ≥ 1.2 g/kg aBW/d improved 400-m walk time and leg strength among older adults with a lower habitual protein intake. From a societal perspective, PROT was considered cost-effective compared to CON. These findings support the need for re-evaluating the protein RDA of 0.8 g/kg BW/d for older adults.
TRIAL REGISTRATION: The trial has been registered at ClinicalTrials.gov (NCT03712306). Date of registration: October 2018. Registry name: The (Cost) Effectiveness of Increasing Protein Intake on Physical Functioning in Older Adults. Trial Identifier: NCT03712306.
| Original language | English |
|---|---|
| Pages (from-to) | 505-520 |
| Number of pages | 16 |
| Journal | European journal of nutrition |
| Volume | 61 |
| Issue number | 1 |
| Early online date | 5 Oct 2021 |
| DOIs | |
| Publication status | Published - Feb 2022 |
Bibliographical note
© 2021. The Author(s).Funding
Funding for this research is provided by EU Horizon 2020 PROMISS Project ‘Prevention of Malnutrition. In Senior Subjects in the EU’, Grant agreement no. 678732. Funding sponsors did not participate in the study design, collection, management, analysis and interpretation of data; or writing of the manuscript. They did not participate in the decision to submit the report for publication, nor had ultimate authority over any of these activities. Protein-enriched food products were provided by Kellogg and Fonterra. Costs for these products were funded through the EU Horizon 2020 PROMISS grant. We acknowledge the members of the PROMISS trial group (please see Supplement) and we thank the study participants. We thank Paolo Caserotti and Mathias Skj?dt (Center for Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark) and Jan Br?nd (Department of Sports Science and Clinical Biomechanics, University of Southern Denmark) for analyzing the accelerometer data.
| Funders | Funder number |
|---|---|
| Department of Sports Science and Clinical Biomechanics, University of Southern Denmark | |
| Horizon 2020 Framework Programme | 678732 |
| Horizon 2020 |