DOI QR코드

DOI QR Code

Association between plant protein intake and grip strength in Koreans aged 50 years or older: Korea National Health and Nutrition Examination Survey 2016-2018

  • Sook-Hyun Jun (Department of Human Ecology, Graduate School, Korea University) ;
  • Jung Woo Lee (BK21 FOUR Research & Education Center for Sustainable Living System, Korea University) ;
  • Woo-Kyoung Shin (Department of Preventive Medicine, College of Medicine, Seoul National University) ;
  • Seung-Yeon Lee (Department of Rehabilitation, Exercise, and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati) ;
  • Yookyung Kim (Department of Human Ecology, Graduate School, Korea University)
  • Received : 2023.03.13
  • Accepted : 2023.06.06
  • Published : 2023.10.01

Abstract

BACKGROUND/OBJECTIVES: We investigated the association of plant and animal protein intake with grip strength in Koreans aged ≥ 50 yrs. SUBJECTS/METHODS: The data was collected from 3,610 men and 4,691 women (≥ 50 yrs) from the 2016-2018 Korea National Health and Nutrition Examination Survey. We calculated the total energy intake, and the intake of animal and plant protein and collected dietary data using 1-day 24-h dietary recalls. Low grip strength (LGS) was defined as the lowest quintile (men: up to 26.8 kg, women: up to 15.7 kg). The association of protein intake with grip strength was examined using Pearson's correlation and multiple linear regression analysis. RESULTS: The results proved that participants with LGS had lower daily energy, protein and fat intake, and percent energy from protein than those with normal or high grip strength (P < 0.0001). Total energy intake, animal protein, and plant protein were positively associated with grip strength. A higher intake of total plant protein (P for trend = 0.004 for men, 0.05 for women) and legumes, nuts, and seeds (LNS) protein (P for trend = 0.01 for men, 0.02 for women) was significantly associated with a lower prevalence of LGS. However, non-LNS plant protein intake was not associated with LGS (P for trend = 0.10 for men, 0.15 for women). In women, a higher total animal protein intake was significantly associated with decreased LGS (P for trend = 0.03). CONCLUSIONS: Higher total plant protein and LNS protein intake are negatively associated with LGS.

Keywords

References

  1. Beaudart C, Reginster JY, Petermans J, Gillain S, Quabron A, Locquet M, Slomian J, Buckinx F, Bruyere O. Quality of life and physical components linked to sarcopenia: the SarcoPhAge study. Exp Gerontol 2015;69:103-10. https://doi.org/10.1016/j.exger.2015.05.003
  2. Janssen I, Heymsfield SB, Ross R. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc 2002;50:889-96. https://doi.org/10.1046/j.1532-5415.2002.50216.x
  3. Hughes VA, Frontera WR, Roubenoff R, Evans WJ, Singh MA. Longitudinal changes in body composition in older men and women: role of body weight change and physical activity. Am J Clin Nutr 2002;76:473-81. https://doi.org/10.1093/ajcn/76.2.473
  4. Kim M, Won CW. Sarcopenia in Korean community-dwelling adults aged 70 years and older: application of screening and diagnostic tools from the Asian Working Group for Sarcopenia 2019 Update. J Am Med Dir Assoc 2020;21:752-8. https://doi.org/10.1016/j.jamda.2020.03.018
  5. Goates S, Du K, Arensberg MB, Gaillard T, Guralnik J, Pereira SL. Economic impact of hospitalizations in US adults with sarcopenia. J Frailty Aging 2019;8:93-9. https://doi.org/10.14283/jfa.2019.10
  6. Newman AB, Kupelian V, Visser M, Simonsick EM, Goodpaster BH, Kritchevsky SB, Tylavsky FA, Rubin SM, Harris TB. Strength, but not muscle mass, is associated with mortality in the health, aging and body composition study cohort. J Gerontol A Biol Sci Med Sci 2006;61:72-7. https://doi.org/10.1093/gerona/61.1.72
  7. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyere O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019;48:16-31. https://doi.org/10.1093/ageing/afy169
  8. Norman K, Stobaus N, Gonzalez MC, Schulzke JD, Pirlich M. Hand grip strength: outcome predictor and marker of nutritional status. Clin Nutr 2011;30:135-42. https://doi.org/10.1016/j.clnu.2010.09.010
  9. Ibrahim K, May C, Patel HP, Baxter M, Sayer AA, Roberts H. A feasibility study of implementing grip strength measurement into routine hospital practice (GRImP): study protocol. Pilot Feasibility Stud 2016;2:27.
  10. Tan LJ, Liu SL, Lei SF, Papasian CJ, Deng HW. Molecular genetic studies of gene identification for sarcopenia. Hum Genet 2012;131:1-31. https://doi.org/10.1007/s00439-011-1040-7
  11. Rom O, Kaisari S, Aizenbud D, Reznick AZ. Lifestyle and sarcopenia-etiology, prevention, and treatment. Rambam Maimonides Med J 2012;3:e0024.
  12. Jang EH, Han YJ, Jang SE, Lee S. Association between diet quality and sarcopenia in older adults: systematic review of prospective cohort studies. Life (Basel) 2021;11:811.
  13. Deutz NE, Bauer JM, Barazzoni R, Biolo G, Boirie Y, Bosy-Westphal A, Cederholm T, Cruz-Jentoft A, Krznaric Z, Nair KS, et al. Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group. Clin Nutr 2014;33:929-36. https://doi.org/10.1016/j.clnu.2014.04.007
  14. Houston DK, Tooze JA, Garcia K, Visser M, Rubin S, Harris TB, Newman AB, Kritchevsky SB; Health ABC Study. Protein intake and mobility limitation in community-dwelling older adults: the Health A.B.C. Study. J Am Geriatr Soc 2017;65:1705-11. https://doi.org/10.1111/jgs.14856
  15. Montiel-Rojas D, Nilsson A, Santoro A, Bazzocchi A, de Groot LC, Feskens EJ, Berendsen AA, Madej D, Kaluza J, Pietruszka B, et al. Fighting sarcopenia in ageing european adults: the importance of the amount and source of dietary proteins. Nutrients 2020;12:3601.
  16. Schaafsma G. The protein digestibility-corrected amino acid score. J Nutr 2000;130:1865S-7S. https://doi.org/10.1093/jn/130.7.1865S
  17. Berrazaga I, Salles J, Laleg K, Guillet C, Patrac V, Giraudet C, Le Bacquer O, Gueugneau M, Denis P, Pouyet C, et al. Anabolic properties of mixed wheat-legume pasta products in old rats: impact on wholebody protein retention and skeletal muscle protein synthesis. Nutrients 2020;12:1596.
  18. FAO UN Statistics Division. FAOSTAT Food Balance Sheets. Rome: FAO UN Statistics Division; 2009.
  19. Mariotti F, Gardner CD. Dietary protein and amino acids in vegetarian diets-a review. Nutrients 2019;11:2661.
  20. Kojima N, Kim M, Saito K, Yoshida H, Yoshida Y, Hirano H, Obuchi S, Shimada H, Suzuki T, Kim H. Lifestyle-related factors contributing to decline in knee extension strength among elderly women: a cross-sectional and longitudinal cohort study. PLoS One 2015;10:e0132523.
  21. Chan R, Leung J, Woo J, Kwok T. Associations of dietary protein intake on subsequent decline in muscle mass and physical functions over four years in ambulant older Chinese people. J Nutr Health Aging 2014;18:171-7. https://doi.org/10.1007/s12603-013-0379-y
  22. Miki A, Hashimoto Y, Matsumoto S, Ushigome E, Fukuda T, Sennmaru T, Tanaka M, Yamazaki M, Fukui M. Protein intake, especially vegetable protein intake, is associated with higher skeletal muscle mass in elderly patients with type 2 diabetes. J Diabetes Res 2017;2017:7985728.
  23. Lim MT, Pan BJ, Toh DW, Sutanto CN, Kim JE. Animal protein versus plant protein in supporting lean mass and muscle strength: a systematic review and meta-analysis of randomized controlled trials. Nutrients 2021;13:661.
  24. Haub MD, Wells AM, Tarnopolsky MA, Campbell WW. Effect of protein source on resistive-training-induced changes in body composition and muscle size in older men. Am J Clin Nutr 2002;76:511-7. https://doi.org/10.1093/ajcn/76.3.511
  25. Korea Centers for Disease Control and Prevention. The Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII). Cheongju: Korea Centers for Disease Control and Prevention; 2016-2018.
  26. Rural Development Administration (KR). The Korean Food Composition Database. (KFCT) 9.1. Jeonju: National Institute of Agricultural Science; 2019.
  27. Brown CC, Kipnis V, Freedman LS, Hartman AM, Schatzkin A, Wacholder S. Energy adjustment methods for nutritional epidemiology: the effect of categorization. Am J Epidemiol 1994;139:323-38. https://doi.org/10.1093/oxfordjournals.aje.a117000
  28. Ministry of Health and Welfare (KR). Dietary Reference Intakes for Koreans 2020. Sejong: Ministry of Health and Welfare; 2020.
  29. Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K, Jang HC, Kang L, Kim M, Kim S, et al. Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc 2020;21:300-307.e2. https://doi.org/10.1016/j.jamda.2019.12.012
  30. Kim CR, Jeon YJ, Kim MC, Jeong T, Koo WR. Reference values for hand grip strength in the South Korean population. PLoS One 2018;13:e0195485.
  31. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, Grassi G, Heagerty AM, Kjeldsen SE, Laurent S, et al. 2007 guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2007;28:1462-536. https://doi.org/10.1097/HJH.0b013e3281fc975a
  32. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363:157-63. https://doi.org/10.1016/S0140-6736(03)15268-3
  33. Gavin II Jr, Alberti KG, Davidson MB, DeFronzo RA. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 1997;20:1183-97. https://doi.org/10.2337/diacare.20.7.1183
  34. McLean RR, Mangano KM, Hannan MT, Kiel DP, Sahni S. dietary protein intake is protective against loss of grip strength among older adults in the framingham offspring cohort. J Gerontol A Biol Sci Med Sci 2016;71:356-61. https://doi.org/10.1093/gerona/glv184
  35. Koeth RA, Wang Z, Levison BS, Buffa JA, Org E, Sheehy BT, Britt EB, Fu X, Wu Y, Li L, et al. Intestinal microbiota metabolism of L-carnitine, a nutrient in red meat, promotes atherosclerosis. Nat Med 2013;19:576-85. https://doi.org/10.1038/nm.3145
  36. Campos AM, Moura FA, Santos SN, Freitas WM, Sposito AC; Brasilia Study on Healthy Aging and Brasilia Heart Study. Sarcopenia, but not excess weight or increased caloric intake, is associated with coronary subclinical atherosclerosis in the very elderly. Atherosclerosis 2017;258:138-44. https://doi.org/10.1016/j.atherosclerosis.2017.01.005
  37. Islam M, Alam F, Solayman M, Khalil M, Kamal MA, Gan SH. Dietary phytochemicals: natural swords combating inflammation and oxidation-mediated degenerative diseases. Oxid Med Cell Longev 2016;2016:5137431.
  38. Simioni C, Zauli G, Martelli AM, Vitale M, Sacchetti G, Gonelli A, Neri LM. Oxidative stress: role of physical exercise and antioxidant nutraceuticals in adulthood and aging. Oncotarget 2018;9:17181-98. https://doi.org/10.18632/oncotarget.24729
  39. Carter CS, Hofer T, Seo AY, Leeuwenburgh C. Molecular mechanisms of life- and health-span extension: role of calorie restriction and exercise intervention. Appl Physiol Nutr Metab 2007;32:954-66. https://doi.org/10.1139/H07-085
  40. Madsen L, Myrmel LS, Fjaere E, Liaset B, Kristiansen K. Links between dietary protein sources, the gut microbiota, and obesity. Front Physiol 2017;8:1047.
  41. Przewlocka K, Folwarski M, Kazmierczak-Siedlecka K, Skonieczna-Zydecka K, Kaczor JJ. Gut-muscle axis exists and may affect skeletal muscle adaptation to training. Nutrients 2020;12:1451.
  42. Koh A, De Vadder F, Kovatcheva-Datchary P, Backhed F. From dietary fiber to host physiology: shortchain fatty acids as key bacterial metabolites. Cell 2016;165:1332-45. https://doi.org/10.1016/j.cell.2016.05.041
  43. Young VR, Pellett PL. Plant proteins in relation to human protein and amino acid nutrition. Am J Clin Nutr 1994;59:1203S-12S. https://doi.org/10.1093/ajcn/59.5.1203S
  44. Margier M, George S, Hafnaoui N, Remond D, Nowicki M, Du Chaffaut L, Amiot MJ, Reboul E. Nutritional composition and bioactive content of legumes: characterization of pulses frequently consumed in France and effect of the cooking method. Nutrients 2018;10:1668.
  45. Kimball SR, Jefferson LS. Control of protein synthesis by amino acid availability. Curr Opin Clin Nutr Metab Care 2002;5:63-7. https://doi.org/10.1097/00075197-200201000-00012
  46. de Gavelle E, Huneau JF, Bianchi CM, Verger EO, Mariotti F. Protein adequacy is primarily a matter of protein quantity, not quality: modeling an increase in plant: animal protein ratio in French adults. Nutrients 2017;9:1333.
  47. Messina M, Lynch H, Dickinson JM, Reed KE. No difference between the effects of supplementing with soy protein versus animal protein on gains in muscle mass and strength in response to resistance exercise. Int J Sport Nutr Exerc Metab 2018;28:674-85. https://doi.org/10.1123/ijsnem.2018-0071
  48. Bechthold A, Boeing H, Schwedhelm C, Hoffmann G, Knuppel S, Iqbal K, De Henauw S, Michels N, Devleesschauwer B, Schlesinger S, et al. Food groups and risk of coronary heart disease, stroke and heart failure: a systematic review and dose-response meta-analysis of prospective studies. Crit Rev Food Sci Nutr 2019;59:1071-90. https://doi.org/10.1080/10408398.2017.1392288
  49. Schwingshackl L, Schwedhelm C, Hoffmann G, Lampousi AM, Knuppel S, Iqbal K, Bechthold A, Schlesinger S, Boeing H. Food groups and risk of all-cause mortality: a systematic review and meta-analysis of prospective studies. Am J Clin Nutr 2017;105:1462-73. https://doi.org/10.3945/ajcn.117.153148
  50. Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Microbial ecology: human gut microbes associated with obesity. Nature 2006;444:1022-3. https://doi.org/10.1038/4441022a
  51. Pannemans DL, Wagenmakers AJ, Westerterp KR, Schaafsma G, Halliday D. Effect of protein source and quantity on protein metabolism in elderly women. Am J Clin Nutr 1998;68:1228-35. https://doi.org/10.1093/ajcn/68.6.1228
  52. Jang W, Ryu HK. Association of low hand grip strength with protein intake in Korean female elderly: based on the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII), 2016-2018. Korean J Community Nutr 2020;25:226-35. https://doi.org/10.5720/kjcn.2020.25.3.226