Health Effects of Increasing Protein Intake Above the Current Population Reference Intake in Older Adults: A Systematic Review of the Health Council of the Netherlands
Whether older adults need more protein than younger adults is debated. The population reference intake for adults set by the European Food Safety Authority is 0.83 g/kg body weight (BW)/d based primarily on nitrogen balance studies, but the underlying data on health outcomes are outdated. An expert...
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| creator | Hengeveld, Linda M de Goede, Janette Afman, Lydia A Bakker, Stephan J L Beulens, Joline W J Blaak, Ellen E Boersma, Eric Geleijnse, Johanna M van Goudoever, Johannes (Hans) B Hopman, Maria T E Iestra, Jolein A Kremers, Stef P J Mensink, Ronald P de Roos, Nicole M Stehouwer, Coen D A Verkaik-Kloosterman, Janneke de Vet, Emely Visser, Marjolein |
| description | Whether older adults need more protein than younger adults is debated. The population reference intake for adults set by the European Food Safety Authority is 0.83 g/kg body weight (BW)/d based primarily on nitrogen balance studies, but the underlying data on health outcomes are outdated. An expert committee of the Health Council of the Netherlands conducted a systematic review (SR) of randomized controlled trials (RCTs) examining the effect of increased protein intake on health outcomes in older adults from the general population with an average habitual protein intake ≥0.8 g/(kg BW · d). Exposures were the following: 1) extra protein compared with no protein and 2) extra protein and physical exercise compared with physical exercise. Outcomes included lean body mass, muscle strength, physical performance, bone health, blood pressure, serum glucose and insulin, serum lipids, kidney function, and cognition. Data of >1300 subjects from 18 RCTs were used. Risk of bias was judged as high (n = 9) or “some concerns” (n = 9). In 7 of 18 RCTs, increased protein intake beneficially affected ≥1 of the tested outcome measures of lean body mass. For muscle strength, this applied to 3 of 8 RCTs in the context of physical exercise and in 1 of 7 RCTs without physical exercise. For the other outcomes, |
| doi_str_mv | 10.1093/advances/nmab140 |
| format | Article |
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Statement of Significance: This systematic review provides a comprehensive, transparent, and up-to-date overview of randomized controlled trials that explicitly focus on potential health effects of protein intakes above the nitrogen-balance studies-based population reference intake of 0.8 g/(kg BW · d) in older adults from the general population. This review also serves as an additional source of evidence for deriving a recommended protein intake for older adults.</description><identifier>ISSN: 2161-8313</identifier><identifier>EISSN: 2156-5376</identifier><identifier>DOI: 10.1093/advances/nmab140</identifier><identifier>PMID: 35016214</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; aging ; amino acids ; Body Composition ; dietary protein ; Dietary Proteins - pharmacology ; dietary reference value ; Humans ; intervention studies ; Lipids ; muscle mass ; Muscle Strength ; Netherlands ; physical function ; protein supplements ; resistant exercise ; Review ; systematic literature review</subject><ispartof>Advances in nutrition (Bethesda, Md.), 2022-08, Vol.13 (4), p.1083-1117</ispartof><rights>2022 American Society for Nutrition</rights><rights>The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.</rights><rights>The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c447t-e1f030e6dd637c86cc089750cc90e9e8669c2172615eb9aafe4306e6ecf101163</citedby><cites>FETCH-LOGICAL-c447t-e1f030e6dd637c86cc089750cc90e9e8669c2172615eb9aafe4306e6ecf101163</cites><orcidid>0000-0002-2559-7128 ; 0000-0002-7547-5030 ; 0000-0002-5136-298X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9340973/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9340973/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35016214$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hengeveld, Linda M</creatorcontrib><creatorcontrib>de Goede, Janette</creatorcontrib><creatorcontrib>Afman, Lydia A</creatorcontrib><creatorcontrib>Bakker, Stephan J L</creatorcontrib><creatorcontrib>Beulens, Joline W J</creatorcontrib><creatorcontrib>Blaak, Ellen E</creatorcontrib><creatorcontrib>Boersma, Eric</creatorcontrib><creatorcontrib>Geleijnse, Johanna M</creatorcontrib><creatorcontrib>van Goudoever, Johannes (Hans) B</creatorcontrib><creatorcontrib>Hopman, Maria T E</creatorcontrib><creatorcontrib>Iestra, Jolein A</creatorcontrib><creatorcontrib>Kremers, Stef P J</creatorcontrib><creatorcontrib>Mensink, Ronald P</creatorcontrib><creatorcontrib>de Roos, Nicole M</creatorcontrib><creatorcontrib>Stehouwer, Coen D A</creatorcontrib><creatorcontrib>Verkaik-Kloosterman, Janneke</creatorcontrib><creatorcontrib>de Vet, Emely</creatorcontrib><creatorcontrib>Visser, Marjolein</creatorcontrib><title>Health Effects of Increasing Protein Intake Above the Current Population Reference Intake in Older Adults: A Systematic Review of the Health Council of the Netherlands</title><title>Advances in nutrition (Bethesda, Md.)</title><addtitle>Adv Nutr</addtitle><description>Whether older adults need more protein than younger adults is debated. The population reference intake for adults set by the European Food Safety Authority is 0.83 g/kg body weight (BW)/d based primarily on nitrogen balance studies, but the underlying data on health outcomes are outdated. An expert committee of the Health Council of the Netherlands conducted a systematic review (SR) of randomized controlled trials (RCTs) examining the effect of increased protein intake on health outcomes in older adults from the general population with an average habitual protein intake ≥0.8 g/(kg BW · d). Exposures were the following: 1) extra protein compared with no protein and 2) extra protein and physical exercise compared with physical exercise. Outcomes included lean body mass, muscle strength, physical performance, bone health, blood pressure, serum glucose and insulin, serum lipids, kidney function, and cognition. Data of >1300 subjects from 18 RCTs were used. Risk of bias was judged as high (n = 9) or “some concerns” (n = 9). In 7 of 18 RCTs, increased protein intake beneficially affected ≥1 of the tested outcome measures of lean body mass. For muscle strength, this applied to 3 of 8 RCTs in the context of physical exercise and in 1 of 7 RCTs without physical exercise. For the other outcomes, <30% (0–29%) of RCTs showed a statistically significant effect. The committee concluded that increased protein intake has a possible beneficial effect on lean body mass and, when combined with physical exercise, muscle strength; likely no effect on muscle strength when not combined with physical exercise, or on physical performance and bone health; an ambiguous effect on serum lipids; and that too few RCTs were available to allow for conclusions on the other outcomes. This SR provides insufficiently convincing data that increasing protein in older adults with a protein intake ≥0.8 g/(kg BW · d) elicits health benefits.
Statement of Significance: This systematic review provides a comprehensive, transparent, and up-to-date overview of randomized controlled trials that explicitly focus on potential health effects of protein intakes above the nitrogen-balance studies-based population reference intake of 0.8 g/(kg BW · d) in older adults from the general population. This review also serves as an additional source of evidence for deriving a recommended protein intake for older adults.</description><subject>Aged</subject><subject>aging</subject><subject>amino acids</subject><subject>Body Composition</subject><subject>dietary protein</subject><subject>Dietary Proteins - pharmacology</subject><subject>dietary reference value</subject><subject>Humans</subject><subject>intervention studies</subject><subject>Lipids</subject><subject>muscle mass</subject><subject>Muscle Strength</subject><subject>Netherlands</subject><subject>physical function</subject><subject>protein supplements</subject><subject>resistant exercise</subject><subject>Review</subject><subject>systematic literature review</subject><issn>2161-8313</issn><issn>2156-5376</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1v3CAQhlHVKInS3HOqOPbiBoyNTQ6VVqu0iRQ1UT_OiIUhS2vDFvBW-UX9m8Xa3ag9hAOg4Zl3ZngRuqDkPSWCXSqzVV5DuvSjWtGGvEKnNW151bKOv57vnFY9o-wEnaf0g5TV1n3H2TE6YS2hvKbNKfpzA2rIa3xtLeiccLD41usIKjn_iB9iyOB8CWX1E_BiFbaA8xrwcooRfMYPYTMNKrvg8RewUGIaDnTJux8MRLww05DTFV7gr08pw1h4XfCtg99zvVlv38UyTF674RD9DGWPg_ImvUFHVg0JzvfnGfr-8frb8qa6u_90u1zcVbppulwBtYQR4MZw1umea0160bVEa0FAQM-50DXtak5bWAmlLDSMcOCgLSWUcnaGPux0N9NqBKPLkFENchPdqOKTDMrJ_1-8W8vHsJWCNUR0rAi82wvE8GuClOXokoahTAFhSrKUFqWDXvQFJTtUx5BSBPtchhI5WywPFsu9xSXl7b_tPSccDC3A1Q6A8knlh6NM2s2uGBeLwdIE97L6X1h_vVU</recordid><startdate>20220801</startdate><enddate>20220801</enddate><creator>Hengeveld, Linda M</creator><creator>de Goede, Janette</creator><creator>Afman, Lydia A</creator><creator>Bakker, Stephan J L</creator><creator>Beulens, Joline W J</creator><creator>Blaak, Ellen E</creator><creator>Boersma, Eric</creator><creator>Geleijnse, Johanna M</creator><creator>van Goudoever, Johannes (Hans) B</creator><creator>Hopman, Maria T E</creator><creator>Iestra, Jolein A</creator><creator>Kremers, Stef P J</creator><creator>Mensink, Ronald P</creator><creator>de Roos, Nicole M</creator><creator>Stehouwer, Coen D A</creator><creator>Verkaik-Kloosterman, Janneke</creator><creator>de Vet, Emely</creator><creator>Visser, Marjolein</creator><general>Elsevier Inc</general><general>Oxford University Press</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2559-7128</orcidid><orcidid>https://orcid.org/0000-0002-7547-5030</orcidid><orcidid>https://orcid.org/0000-0002-5136-298X</orcidid></search><sort><creationdate>20220801</creationdate><title>Health Effects of Increasing Protein Intake Above the Current Population Reference Intake in Older Adults: A Systematic Review of the Health Council of the Netherlands</title><author>Hengeveld, Linda M ; 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The population reference intake for adults set by the European Food Safety Authority is 0.83 g/kg body weight (BW)/d based primarily on nitrogen balance studies, but the underlying data on health outcomes are outdated. An expert committee of the Health Council of the Netherlands conducted a systematic review (SR) of randomized controlled trials (RCTs) examining the effect of increased protein intake on health outcomes in older adults from the general population with an average habitual protein intake ≥0.8 g/(kg BW · d). Exposures were the following: 1) extra protein compared with no protein and 2) extra protein and physical exercise compared with physical exercise. Outcomes included lean body mass, muscle strength, physical performance, bone health, blood pressure, serum glucose and insulin, serum lipids, kidney function, and cognition. Data of >1300 subjects from 18 RCTs were used. Risk of bias was judged as high (n = 9) or “some concerns” (n = 9). In 7 of 18 RCTs, increased protein intake beneficially affected ≥1 of the tested outcome measures of lean body mass. For muscle strength, this applied to 3 of 8 RCTs in the context of physical exercise and in 1 of 7 RCTs without physical exercise. For the other outcomes, <30% (0–29%) of RCTs showed a statistically significant effect. The committee concluded that increased protein intake has a possible beneficial effect on lean body mass and, when combined with physical exercise, muscle strength; likely no effect on muscle strength when not combined with physical exercise, or on physical performance and bone health; an ambiguous effect on serum lipids; and that too few RCTs were available to allow for conclusions on the other outcomes. This SR provides insufficiently convincing data that increasing protein in older adults with a protein intake ≥0.8 g/(kg BW · d) elicits health benefits.
Statement of Significance: This systematic review provides a comprehensive, transparent, and up-to-date overview of randomized controlled trials that explicitly focus on potential health effects of protein intakes above the nitrogen-balance studies-based population reference intake of 0.8 g/(kg BW · d) in older adults from the general population. This review also serves as an additional source of evidence for deriving a recommended protein intake for older adults.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>35016214</pmid><doi>10.1093/advances/nmab140</doi><tpages>35</tpages><orcidid>https://orcid.org/0000-0002-2559-7128</orcidid><orcidid>https://orcid.org/0000-0002-7547-5030</orcidid><orcidid>https://orcid.org/0000-0002-5136-298X</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Advances in nutrition (Bethesda, Md.), 2022-08, Vol.13 (4), p.1083-1117 |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Aged aging amino acids Body Composition dietary protein Dietary Proteins - pharmacology dietary reference value Humans intervention studies Lipids muscle mass Muscle Strength Netherlands physical function protein supplements resistant exercise Review systematic literature review |
| title | Health Effects of Increasing Protein Intake Above the Current Population Reference Intake in Older Adults: A Systematic Review of the Health Council of the Netherlands |
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