The effect of additional protein intake via dietary education combined with recording on physical performance in sarcopenic elderly: A randomized controlled trial
Keywords:
additional protein intake via dietary, recording, physical performance, sarcopenic elderlyAbstract
Objective : This study aims to investigate the improvement of nutritional knowledge and physical performance in sarcopenic elderly individuals through increased protein intake facilitated by dietary counseling and record-keeping, comparing a group receiving only nutritional education with a group that additionally keeps dietary records.
Methodology: This was a randomized controlled trial conducted in San Sai Hospital from October to November 2022, involving 152 participants divided into two groups of 76 each. One group received nutritional education while the other group also kept food diary records. The study followed participants for a period of 10 months, with data collected at 4 and 6 months. Outcomes included the 4-Meter Gait Speed Test, Timed Up and Go test, Short Physical Performance Battery (SPPB), Mini Nutritional Assessment (MNA), Morse Fall Scale, Thai Mini-Mental State Examination (TMSE), and WHO Quality of Life (WHOQOL) questionnaire.
Results : A total of 152 participants were included in the study, with 60.5% being female and an average age of 64.90 ± 3.42 years. The average BMI was 22.54 ± 1.88 kg/m². Both groups showed no statistical difference at baseline. Outcomes measured at 4 weeks, 8 weeks, 12 weeks, and 6 months showed significant improvements from 4 weeks of follow-up in all measured aspects in the experimental group compared to the control group. At 4 weeks, the results in the experimental group compared to the control group were as follows: 4-Meter Gait Speed Test: 2.77 ± 0.06 vs. 2.86 ± 0.05 seconds (p < 0.001),Timed Up and Go Test: 12.77 ± 0.06 vs. 14.39 ± 0.30 seconds (p < 0.001),Short Physical Performance Battery (SPPB): 7.00 ± 0.00 vs. 6.00 ± 0.00 points (p < 0.001),Mini Nutritional Assessment (MNA): 9.61 ± 2.89 vs. 9.08 ± 0.73 points (p < 0.001),Morse Fall Scale: 75.00 ± 0.00 vs. 90.00 ± 0.00 points (p < 0.001),Thai Mini-Mental State Examination (TMSE): 25.55 ± 0.60 vs. 24.77 ± 0.59 points (p < 0.001), and WHO Quality of Life (WHOQOL): 80.00 ± 0.00 vs. 76.00 ± 0.00 points (p < 0.001). These results indicate significant improvements in the experimental group compared to the control group.
Conclusion : Providing education on additional protein intake via dietary counseling, combined with meticulous recording, enables sarcopenic elderly individuals at San Sai Hospital in Chiang Mai Province to significantly improve physical performance and retain nutritional knowledge. This approach proves to be statistically more effective compared to providing education alone.
References
Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. doi: 10.1093/ageing/afy169.
Ardeljan AD, Hurezeanu R. Sarcopenia. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560813/
Termvorakul R. Elderly people….why? risk falling? [Internet]. Nakhonpathom: Faculty of Physical Therapy, Mahidol University; 2024 [update 2024 Mar 29; cited 2024 Jun 8]. Available from: https://pt.mahidol.ac.th/ptcenter/knowledge-article/elderly-risk-of-falling/ [In Thai]
Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K, et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc. 2020;21(3):300-7.e2. doi: 10.1016/j.jamda.2019.12.012.
Rondanelli M, Cereda E, Klersy C, Faliva MA, Peroni G, Nichetti M, et al. Improving rehabilitation in sarcopenia: a randomized-controlled trial utilizing a muscle-targeted food for special medical purposes. J Cachexia Sarcopenia Muscle. 2020;11(6):1535-47. doi: 10.1002/jcsm.12532.
Rondanelli M, Cereda E, Klersy C, Faliva MA, Peroni G, Nichetti M, et al. Improving rehabilitation in sarcopenia: a randomized-controlled trial utilizing a muscle-targeted food for special medical purposes. J Cachexia Sarcopenia Muscle. 2020;11(6):1535-47. doi: 10.1002/jcsm.12532.
Björkman MP, Suominen MH, Kautiainen H, Jyväkorpi SK, Finne-Soveri HU, Strandberg TE, et al. Effect of Protein Supplementation on Physical Performance in Older People With Sarcopenia-A Randomized Controlled Trial. J Am Med Dir Assoc. 2020;21(2):226-32.e1. doi: 10.1016/j.jamda.2019.09.006.
Patrick H, Williams GC. Self-determination theory: its application to health behavior and complementarity with motivational interviewing. Int J Behav Nutr Phys Act. 2012;9:18. doi: 10.1186/1479-5868-9-18.
Thanasupakornkul P, Wongsuttilert A, Jaidee W, Punyamana U, Thararam S. SARC-F scores correlated with low physical performance and muscle strength in older Thai adults. Burapha Journal of Medicine. 2018;5(2):87-93. [In Thai]
Björkman MP, Suominen MH, Kautiainen H, Jyväkorpi SK, Finne-Soveri HU, Strandberg TE, Pitkälä KH, Tilvis RS. Effect of Protein Supplementation on Physical Performance in Older People With Sarcopenia-A Randomized Controlled Trial. J Am Med Dir Assoc. 2020;21(2):226-32.e1. doi: 10.1016/j.jamda.2019.09.006.
The Pennsylvania State University. 9.4 - Comparing Two Proportions | STAT 415 [Internet]. 2019 [cited 2024 Feb 27]. Available from: https://online.stat.psu.edu/stat415/lesson/9/9.4
Grygiel-Górniak B, Tomczak A, Krulikowska N, Przysławski J, Seraszek-Jaros A, Kaczmarek E. Physical activity, nutritional status, and dietary habits of students of a medical university. Sport Sci Health. 2016;12:261-7. doi: 10.1007/s11332-016-0285-x.
Ding B, Xiao R, Ma W, Zhao L, Bi Y, Zhang Y. The association between macronutrient intake and cognition in individuals aged under 65 in China: a cross-sectional study. BMJ Open. 2018 Jan 9;8(1):e018573. doi: 10.1136/bmjopen-2017-018573.
Lieberman HR, Wurtman JJ, Teicher MH. Aging, nutrient choice, activity, and behavioral responses to nutrients. Ann N Y Acad Sci. 1989;561:196-208. doi: 10.1111/j.1749-6632.1989.tb20982.x.
Bernstein M, Munoz N. Position of the Academy of Nutrition and Dietetics: food and nutrition for older adults: promoting health and wellness. J Acad Nutr Diet. 2012;112(8):1255-77. doi: 10.1016/j.jand.2012.06.015.
Jedrusek-Golinska A, Górecka D, Buchowski M, Wieczorowska-Tobis K, Gramza-Michałowska A, Szymandera-Buszka K. Recent progress in the use of functional foods for older adults: A narrative review. Compr Rev Food Sci Food Saf. 2020;19(2):835-56. doi: 10.1111/1541-4337.12530.
Tucker, K. Nutrition Concerns for Aging Populations. In: Pray L, Boon C, Mille EA, Pillsbury L. Providing Healthy and Safe Foods As We Age. Washington (DC): National Academies Press (US); 2010. p. 87-108. Available from: https://www.ncbi.nlm.nih.gov/books/NBK51837/
Verwijs MH, Haveman-Nies A, Borkent JW, Linschooten JO, Roodenburg AJC, de Groot LCPGM, et al. Protein Intake among Community-Dwelling Older Adults: The Influence of (Pre-) Motivational Determinants. Nutrients. 2022;14(2):293. doi: 10.3390/nu14020293.
Visvanathan R, Yu S. Sarcopenia Management for Clinicians. In: Cruz-Jentoft AJ, Morley JE. Sarcopenia. New Jersey: John Wiley & Sons; 2021. p. 433–9. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1002/9781119597896.ch28
Kim JS, Wilson JM, Lee SR. Dietary implications on mechanisms of sarcopenia: roles of protein, amino acids and antioxidants. J Nutr Biochem. 2010;21(1):1-13. doi: 10.1016/j.jnutbio.2009.06.014.
General Administration Division, Mahidol University. Is Thailand ready to become a fully-aged society? [Internet]. 2022 [updated 2022 Jun 28; cited 2024 May 25]. Available from: https://op.mahidol.ac.th/ga/posttoday-22-2/ [In Thai]
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