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.
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.
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.
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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Body mass index
Successful aging health education
Coefficient of variation
Wellness for Elders through Lifestyle and Learning
Community Healthy Activities Model Program for Seniors
Dual Energy X-ray Absorptiometry
Appendicular lean mass
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.
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.
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
- Circadian timing of protein intake