Abstract
Background:
Dietary-induced weight loss is generally accompanied by a decline in skeletal muscle mass. The loss of muscle mass leads to a decline in muscle strength and impairs physical performance. A high dietary protein intake has been suggested to allow muscle mass preservation during energy intake restriction.
Objective:
To investigate the impact of increasing dietary protein intake on lean body mass, strength and physical performance during 12 weeks of energy intake restriction in overweight older adults.
Design:
Sixty-one overweight and obese men and women (63±5 years) were randomly assigned to either a high protein diet (HP; 1.7âgâkgâ1 per day; n=31) or normal protein diet (NP; 0.9âgâkgâ1 per day; n=30) during a 12-week 25% energy intake restriction. During this controlled dietary intervention, 90% of the diet was provided by the university. At baseline and after the intervention, body weight, lean body mass (dual-energy X-ray absorptiometry), leg strength (1-repetition maximum), physical performance (Short Physical Performance Battery, 400âm) and habitual physical activity (actigraph) were assessed.
Results:
Body weight declined in both groups with no differences between the HP and NP groups (â8.9±2.9 versus â9.1±3.4âkg, respectively; P=0.584). Lean body mass declined by 1.8±2.2 and 2.1±1.4âkg, respectively, with no significant differences between groups (P=0.213). Leg strength had decreased during the intervention by 8.8±14.0 and 8.9±12.8âkg, with no differences between groups (P=0.689). Physical performance as measured by 400âm walking speed improved in both groups, with no differences between groups (P=0.219).
Conclusions:
Increasing protein intake above habitual intake levels (0.9âgâkgâ1 per day) does not preserve lean body mass, strength or physical performance during prolonged energy intake restriction in overweight older adults.
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References
Villareal DT, Apovian CM, Kushner RF, Klein S . Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society. Am J Clin Nutr 2005; 82: 923â934.
Ballor DL, Katch VL, Becque MD, Marks CR . Resistance weight training during caloric restriction enhances lean body weight maintenance. Am J Clin Nutr 1988; 47: 19â25.
Koopman R, Saris WH, Wagenmakers AJ, van Loon LJ . Nutritional interventions to promote post-exercise muscle protein synthesis. Sports Med (Auckland, NZ) 2007; 37: 895â906.
Paddon-Jones D, Rasmussen BB . Dietary protein recommendations and the prevention of sarcopenia. Curr Opin Clin Nutr Metab Care 2009; 12: 86â90.
Moore DR, Tang JE, Burd NA, Rerecich T, Tarnopolsky MA, Phillips SM . Differential stimulation of myofibrillar and sarcoplasmic protein synthesis with protein ingestion at rest and after resistance exercise. J Physiol 2009; 587: 897â904.
Leidy HJ, Carnell NS, Mattes RD, Campbell WW . Higher protein intake preserves lean mass and satiety with weight loss in pre-obese and obese women. Obesity (Silver Spring, MD) 2007; 15: 421â429.
Soenen S, Martens EA, Hochstenbach-Waelen A, Lemmens SG, Westerterp-Plantenga MS . Normal protein intake is required for body weight loss and weight maintenance, and elevated protein intake for additional preservation of resting energy expenditure and fat free mass. J Nutr 2013; 143: 591â596.
Pasiakos SM, Cao JJ, Margolis LM, Sauter ER, Whigham LD, McClung JP et al. Effects of high-protein diets on fat-free mass and muscle protein synthesis following weight loss: a randomized controlled trial. FASEB J 2013; 27: 3837â3847.
Parker B, Noakes M, Luscombe N, Clifton P . Effect of a high-protein, high-monounsaturated fat weight loss diet on glycemic control and lipid levels in type 2 diabetes. Diabetes Care 2002; 25: 425â430.
Mojtahedi MC, Thorpe MP, Karampinos DC, Johnson CL, Layman DK, Georgiadis JG et al. The effects of a higher protein intake during energy restriction on changes in body composition and physical function in older women. The journals of gerontology. J Gerontol Ser A 2011; 66: 1218â1225.
Piatti PM, Monti F, Fermo I, Baruffaldi L, Nasser R, Santambrogio G et al. Hypocaloric high-protein diet improves glucose oxidation and spares lean body mass: comparison to hypocaloric high-carbohydrate diet. Metab Clin Exp 1994; 43: 1481â1487.
Farnsworth E, Luscombe ND, Noakes M, Wittert G, Argyiou E, Clifton PM . Effect of a high-protein, energy-restricted diet on body composition, glycemic control, and lipid concentrations in overweight and obese hyperinsulinemic men and women. Am J Clin Nutr 2003; 78: 31â39.
Layman DK, Evans E, Baum JI, Seyler J, Erickson DJ, Boileau RA . Dietary protein and exercise have additive effects on body composition during weight loss in adult women. J Nutr 2005; 135: 1903â1910.
Evans EM, Mojtahedi MC, Thorpe MP, Valentine RJ, Kris-Etherton PM, Layman DK . Effects of protein intake and gender on body composition changes: a randomized clinical weight loss trial. Nutr Metab 2012; 9: 55.
Griffin HJ, Cheng HL, O'Connor HT, Rooney KB, Petocz P, Steinbeck KS . Higher protein diet for weight management in young overweight women: a 12-month randomized controlled trial. Diabetes Obes Metab 2013; 15: 572â575.
Noakes M, Keogh JB, Foster PR, Clifton PM . Effect of an energy-restricted, high-protein, low-fat diet relative to a conventional high-carbohydrate, low-fat diet on weight loss, body composition, nutritional status, and markers of cardiovascular health in obese women. Am J Clin Nutr 2005; 81: 1298â1306.
Janssen I, Ross R . Linking age-related changes in skeletal muscle mass and composition with metabolism and disease. J Nutr Health Aging 2005; 9: 408â419.
Wycherley TP, Moran LJ, Clifton PM, Noakes M, Brinkworth GD . Effects of energy-restricted high-protein, low-fat compared with standard-protein, low-fat diets: a meta-analysis of randomized controlled trials. Am J Clin Nutr 2012; 96: 1281â1298.
Breen L, Phillips SM . Skeletal muscle protein metabolism in the elderly: interventions to counteract the 'anabolic resistance' of ageing. Nutr Metab 2011; 8: 68.
Wycherley TP, Noakes M, Clifton PM, Cleanthous X, Keogh JB, Brinkworth GD . A high-protein diet with resistance exercise training improves weight loss and body composition in overweight and obese patients with type 2 diabetes. Diabetes Care 2010; 33: 969â976.
Villareal DT, Chode S, Parimi N, Sinacore DR, Hilton T, Armamento-Villareal R et al. Weight loss, exercise, or both and physical function in obese older adults. N Engl J Med 2011; 364: 1218â1229.
Alhassan S, Kim S, Bersamin A, King AC, Gardner CD . Dietary adherence and weight loss success among overweight women: results from the A TO Z weight loss study. Int J Obes 2008; 32: 985â991.
Stubbs RJ, O'Reilly LM, Whybrow S, Fuller Z, Johnstone AM, Livingstone MB et al. Measuring the difference between actual and reported food intakes in the context of energy balance under laboratory conditions. Br J Nutr 2014; 111: 2032â3043.
Houston DK, Nicklas BJ, Ding J, Harris TB, Tylavsky FA, Newman AB et al. 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: 150â155.
Tieland M, Borgonjen-Van den Berg KJ, van Loon LJ, de Groot LC . Dietary protein intake in community-dwelling, frail, and institutionalized elderly people: scope for improvement. Eur J Nutr 2012; 51: 173â179.
World Health Organization. Waist Circumference and WaistâHip Ratio. World Health Organization: Geneva, Switzerland, 2011.
Levey AS, Eckardt KU, Tsukamoto Y, Levin A, Coresh J, Rossert J et al. Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 2005; 67: 2089â2100.
World Health Organization Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycemia: Report of a WHO/IDF Consultation World Health Organization: Geneva, Switzerland 2006.
Siebelink E, Geelen A, de Vries JH . Self-reported energy intake by FFQ compared with actual energy intake to maintain body weight in 516 adults. Br J Nutr 2011; 106: 274â281.
Schofield WN . Predicting basal metabolic rate, new standards and review of previous work. Human nutrition. Clin Nutr 1985; 39: 5â41.
RIVM. NEVO-tabel. RIVM: Bilthoven, 2011.
Corder K, Ekelund U, Steele RM, Wareham NJ, Brage S . Assessment of physical activity in youth. J Appl Physiol (Bethesda, MD) 2008; 105: 977â987.
Reilly JJ, Penpraze V, Hislop J, Davies G, Grant S, Paton JY . Objective measurement of physical activity and sedentary behaviour: review with new data. Arch Dis Childhood 2008; 93: 614â619.
De Vries SI, Van Hirtum HW, Bakker I, Hopman-Rock M, Hirasing RA, Van Mechelen W . Validity and reproducibility of motion sensors in youth: a systematic update. Med Sci Sports Exerc 2009; 41: 818â827.
Josse AR, Atkinson SA, Tarnopolsky MA, Phillips SM . Increased consumption of dairy foods and protein during diet- and exercise-induced weight loss promotes fat mass loss and lean mass gain in overweight and obese premenopausal women. J Nutr 2011; 141: 1626â1634.
Belobrajdic DP, Frystyk J, Jeyaratnaganthan N, Espelund U, Flyvbjerg A, Clifton PM et al. Moderate energy restriction-induced weight loss affects circulating IGF levels independent of dietary composition. Eur J Endocrinol/Eur Fed Endocr Soc 2010; 162: 1075â1082.
Wall BT, Cermak NM, van Loon LJ . Dietary protein considerations to support active aging. Sports Med (Auckland, NZ) 2014; 44: 185â194.
Hector AJ, Marcotte GR, Churchward-Venne TA, Murphy CH, Breen L, von Allmen M et al. Whey protein supplementation preserves postprandial myofibrillar protein synthesis during short-term energy restriction in overweight and obese adults. J Nutr 2015; 145: 246â252.
Coker RH, Miller S, Schutzler S, Deutz N, Wolfe RR . Whey protein and essential amino acids promote the reduction of adipose tissue and increased muscle protein synthesis during caloric restriction-induced weight loss in elderly, obese individuals. Nutr J 2012; 11: 105.
Shab-Bidar S, Bours S, Geusens PP, Kessels AG, van den Bergh JP . Serum 25(OH)D response to vitamin D3 supplementation: a meta-regression analysis. Nutrition (Burbank, Los Angeles County, CA) 2014; 30: 975â985.
Dawson-Hughes B, Dallal GE, Krall EA, Harris S, Sokoll LJ, Falconer G . Effect of vitamin D supplementation on wintertime and overall bone loss in healthy postmenopausal women. Ann Intern Med 1991; 115: 505â512.
Black AE, Cole TJ . Biased over- or under-reporting is characteristic of individuals whether over time or by different assessment methods. J Am Diet Assoc 2001; 101: 70â80.
Shaneshin M, Jessri M, Rashidkhani B . Validity of energy intake reports in relation to dietary patterns. J Health Popul Nutr 2014; 32: 36â45.
Clifton PM, Keogh JB, Noakes M . Long-term effects of a high-protein weight-loss diet. Am J Clin Nutr 2008; 87: 23â29.
Bauer J, Biolo G, Cederholm T, Cesari M, Cruz-Jentoft AJ, Morley JE 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: 542â559.
Pennings B, Groen B, de Lange A, Gijsen AP, Zorenc AH, Senden JM et al. Amino acid absorption and subsequent muscle protein accretion following graded intakes of whey protein in elderly men. Am J Physiol Endocrinol Metab 2012; 302: E992âE999.
Murphy CH, Churchward-Venne TA, Mitchell CJ, Kolar NM, Kassis A, Karagounis LG et al. Hypoenergetic diet-induced reductions in myofibrillar protein synthesis are restored with resistance training and balanced daily protein ingestion in older men. Am J Physiol Endocrinol Metab 2015; 308: E734âE743.
Adechian S, Balage M, Remond D, Migne C, Quignard-Boulange A, Marset-Baglieri A et al. Protein feeding pattern, casein feeding, or milk-soluble protein feeding did not change the evolution of body composition during a short-term weight loss program. American journal of physiology. Endocrinol Metab 2012; 303: E973âE982.
Weinheimer EM, Sands LP, Campbell WW . A systematic review of the separate and combined effects of energy restriction and exercise on fat-free mass in middle-aged and older adults: implications for sarcopenic obesity. Nutr Rev 2010; 68: 375â388.
Verreijen AM, Verlaan S, Engberink MF, Swinkels S, de Vogel-van den Bosch J, Weijs PJ . A high whey protein-, leucine-, and vitamin D-enriched supplement preserves muscle mass during intentional weight loss in obese older adults: a double-blind randomized controlled trial. Am J Clin Nutr 2015; 101: 279â286.
Miller SL, Wolfe RR . The danger of weight loss in the elderly. J Nutr Health Aging 2008; 12: 487â491.
Chomentowski P, Dube JJ, Amati F, Stefanovic-Racic M, Zhu S, Toledo FG et al. Moderate exercise attenuates the loss of skeletal muscle mass that occurs with intentional caloric restriction-induced weight loss in older, overweight to obese adults. The journals of gerontology. J Gerontol Ser A 2009; 64: 575â580.
Acknowledgements
We thank the dedication and cooperation of the participants of the study. Similarly, we acknowledge the help of all dietitians and students involved in the practical work.
Author contributions
EB, MT, LL and LG designed research; EB, MT, KB and PC conducted research; EB analyzed data; EB, MT, LL and LG wrote the paper; LG had primary responsibility for final content. All authors read and approved the final manuscript.
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The project is funded by TI Food and Nutrition, a publicâprivate partnership on precompetitive research in food and nutrition. The researchers are responsible for the study design, data collection and analysis, decision to publish and preparation of the manuscript. The industrial partners have contributed to the project through regular discussion. The authors declare no conflict of interest.
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Backx, E., Tieland, M., Borgonjen-van den Berg, K. et al. Protein intake and lean body mass preservation during energy intake restriction in overweight older adults. Int J Obes 40, 299â304 (2016). https://doi.org/10.1038/ijo.2015.182
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DOI: https://doi.org/10.1038/ijo.2015.182
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