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Transition to a More even Distribution of Daily Protein Intake is Associated with Enhanced Fat Loss during a Hypocaloric & Physical Activity Intervention in Obese Older Adults

Abstract

Background

Optimization of intentional weight loss in obese older adults, through preferential fat mass reduction, is challenging, as the concomitant lean mass loss may exacerbate sarcopenia. Recent studies have suggested within-day distribution of protein intake plays a role in determining body composition remodeling. Here, we assessed whether changes in within-day protein intake distribution are related to improvements in body composition in overweight/obese older adults during a hypocaloric and exercise intervention.

Methods

Thirty-six community-dwelling, overweight-to-obese (BMI 28.0-39.9 kg/m2), sedentary older adults (aged 70.6±6.1 years) were randomized into either physical activity plus successful aging health education (PA+SA; n=15) or physical activity plus weight loss (PA+WL; n=21) programs. Body composition (by CT and DXA) and dietary intake (by three-day food records) were determined at baseline, 6-month, and 12-month follow-up visits. Within-day protein distribution was calculated as the coefficient of variation (CV) of protein ingested per defined time periods (breakfast [5:00−10:59], lunch [11:00−16:59] and dinner [17:00−1:00]). Secondary analysis was performed to determine associations between changes in protein intake distribution and body composition.

Results

In both groups, baseline protein intake was skewed towards dinner (PA+SA: 49.1%; PA+WL: 54.1%). The pattern of protein intake changed towards a more even within-day distribution in PA+WL during the intervention period, but it remained unchanged in PA+SA. Transition towards a more even pattern of protein intake was independently associated with a greater decline in BMI (P<0.05) and abdominal subcutaneous fat (P<0.05) in PA+WL. However, changes in protein CV were not associated with changes in body weight in PA+SA.

Conclusion

Our results show that mealtime distribution of protein intake throughout the day was associated with improved weight and fat loss under hypocaloric diet combined with physical activity. This finding provides a novel insight into the potential role of within-day protein intake on weight management in obese older people.

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Abbreviations

BMI:

Body mass index

PA:

Physical activity

SA:

Successful aging health education

WL:

Weight loss

CV:

Coefficient of variation

WELL:

Wellness for Elders through Lifestyle and Learning

CHAMPS:

Community Healthy Activities Model Program for Seniors

DXA:

Dual Energy X-ray Absorptiometry

aLM:

Appendicular lean mass

CT:

Computed Tomography

CSA:

Cross-sectional areas

NDSR:

Nutrition Data System for Research

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Acknowledgement & Author Contributions

The authors’ contributions were as follows—SF and JAC: designed the research; ABN, NWG, and AJS: designed and conducted the WELL study; SF: analyzed the data and wrote the manuscript; RMB: provided statistical advice; SF and ABN had primary responsibility for the final content. All authors: read and approved the final manuscript.

Author information

Correspondence to Anne B. Newman.

Ethics declarations

Conflict of Interest: SF, JAC, AJS, NWG, RMB, ABN have no conflicts of interest to declare.

Ethical standards: This study was approved by the University of Pittsburgh’s Institutional Review Board. All participants signed informed consent after demonstrating a basic understanding of the role and responsibilities of a study participant.

Additional information

Sources of support: This work was supported by a Center for Disease Control cooperative agreement (1 U48 DP000025). ClinicalTrials.gov identifier: NCT00714506. SF is supported by the Epidemiology of Aging training grant at the University of Pittsburgh (NIA T32-AG0001810).

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Farsijani, S., Cauley, J.A., Santanasto, A.J. et al. Transition to a More even Distribution of Daily Protein Intake is Associated with Enhanced Fat Loss during a Hypocaloric & Physical Activity Intervention in Obese Older Adults. J Nutr Health Aging 24, 210–217 (2020). https://doi.org/10.1007/s12603-020-1313-8

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Key words

  • Circadian timing of protein intake
  • weight
  • exercise
  • aging