2022, Article / Letter to editor (Public Health Nutrition, vol. 25, iss. 2, (2022), pp. 248-256)OBJECTIVE: Approximately 50 % of Dutch community-dwelling older adults does not meet protein recommendations. This study assesses the effect of replacing low protein foods with protein-rich alternatives on the protein intake of Dutch community-dwelling older adults. DESIGN: The Dutch National Food Consumption Survey-Older Adults 2010-2012 (DNFCS-OA) was used for scenario modelling. Dietary intake was estimated based on two 24-h recalls. Commonly consumed products were replaced by comparable products rich in protein (scenario 1), foods enriched in protein (scenario 2) and a combination of both (scenario 3). Replacement scenarios were confined to participants whose dietary protein intake was < 1•0 g/kg BW/d (n 391). Habitual protein intake of all older adults was estimated, adjusting for effects of within-person variation in the 2-d intake data. SETTING: A simulation study based on the DNFCS-OA. PARTICIPANTS: 727 Dutch community-dwelling older adults aged 70+. RESULTS: Mean protein intake of the total population increased from 1•0 to 1•2 g/kg BW/d (scenarios 1 and 2) and to 1•3 g/kg BW/d (scenario 3). The percentage of participants with intakes of ≥ 1•0 g/kg BW/d increased from 47•1 % to 91•4 %, 90•2 % and 94•6 %, respectively, in scenarios 1, 2 and 3. The largest increases in protein intake were due to replacements in food groups: yoghurt, cream desserts and pudding, potatoes, vegetables and legumes and non-alcoholic beverages and milk in scenario 1 and bread; yoghurt, cream desserts and pudding and soups in scenario 2. CONCLUSIONS: This simulation model shows that replacing low protein foods with comparable alternatives rich in protein can increase the protein intake of Dutch community-dwelling older adults considerably. Results can be used as a basis for nutritional counselling.
2022, Article / Letter to editor (Nutrients, vol. 14, iss. 2, (2022))An adequate protein intake is important for healthy ageing, yet nearly 50% of Dutch community-dwelling older adults do not meet protein recommendations. This study explores protein intake in relation to eight behavioral determinants (I-Change model) among Dutch community-dwelling older adults. Data were collected through an online questionnaire from October 2019-October 2020. Protein intake was assessed by the Protein Screener 55+, indicating a high/low chance of a low protein intake (<1.0 g/kg body weight/day). The behavioral determinants of cognizance, knowledge, risk perception, perceived cues, attitude, social support, self-efficacy and intention were assessed by evaluating statements on a 7-point Likert scale. A total of 824 Dutch community-dwelling older adults were included, recruited via online newsletters, newspapers and by personal approach. Poisson regression was performed to calculate quartile-based prevalence ratios (PRs). Almost 40% of 824 respondents had a high chance of a low protein intake. Univariate analyses indicated that lower scores for all different behavioral determinants were associated with a higher chance of a low protein intake. Independent associations were observed for knowledge (Q4 OR = 0.71) and social support (Q4 OR = 0.71). Results of this study can be used in future interventions aiming to increase protein intake in which focus should lie on increasing knowledge and social support.
2020, Article / Letter to editor (Clinical nutrition ESPEN, vol. 38, (2020), pp. 172-177)Background: Over the last decade, different screening tools for malnutrition have been developed. Within these tools, a distinction can be made between tools that assess nutritional risk and tools that assess protein energy malnutrition. Insights in differences in characteristics of participants at risk and in differences in prevalence rates will aid in deciding which tool(s) to use in daily practice. Methods: Dutch community-dwelling older adults (n = 200, 78.2 +/- 6.9 years), not known to have specific nutrition problems, were recruited to participate in this cross-sectional study. SNAQ(65+) (low risk vs moderate/high risk) was used to assess risk of protein energy malnutrition and SCREEN II was used to assess nutrition risk (score <54 out of 64). Chi-square tests were used to test associations between demographic, health, physical and social factors and outcome of SNAQ(65+) and SCREEN II. Results: Of all participants 69.0% were at nutrition risk (SCREEN II), while 13.5% were at risk of protein energy malnutrition (SNAQ(65+)). Agreement between the two tools was poor (kappa < 0.20). Gender, BMI, living status, income, activity level and protein/energy intake were associated with SCREEN II; age, BMI, comorbidities, medication use, help at home, activity level and low basic mobility were associated with SNAQ(65+). Conclusion: SCREEN II and SNAQ(65+) measure different concepts of malnutrition and therefore identify different persons at risk. SCREEN II is more inclusive and comprises both undernutrition and overnutrition as well as different determinants that can impact on food intake, while SNAQ(65+) is solely focused on protein-energy malnutrition. (C) 2020 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.