Protein-enriched ‘regular products’ and their effect on protein intake in acute hospitalized older adults; a randomized controlled trial

  • S. Stelten
    Affiliations
    Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands
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  • I.M. Dekker
    Affiliations
    Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands
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  • E.M. Ronday
    Affiliations
    Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands
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  • A. Thijs
    Affiliations
    Department of Internal Medicine, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands
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  • E. Boelsma
    Affiliations
    Wageningen UR Food & Biobased Research, PO Box 17, 6700 AA Wageningen, The Netherlands
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  • H.W. Peppelenbos
    Affiliations
    Wageningen UR Food & Biobased Research, PO Box 17, 6700 AA Wageningen, The Netherlands
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  • M.A.E. de van der Schueren
    Correspondence
    Corresponding author. VU University Medical Center, Department of Nutrition and Dietetics, Internal Medicine, PO Box 7057, 1007 MB Amsterdam, The Netherlands. Tel.: +31 204443410; fax: +31 20 4444143.
    Affiliations
    Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands

    HAN University of Applied Sciences, Faculty of Health and Social Studies, Department Nutrition, Sports and Health, PO Box 6960, 6503 GL Nijmegen, The Netherlands
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Published:August 14, 2014DOI:https://doi.org/10.1016/j.clnu.2014.08.007

      Summary

      Background & aims

      Especially in older adults, maintaining muscle mass is essential to perform activities of daily living. This requires a sufficient protein intake. However, protein intake in hospitalized older adults is often insufficient. Thus far different nutrition intervention strategies have failed to show success in reaching sufficient protein intake in hospitalized older adults. The effect of recently developed protein-enriched bread and drinking yoghurt on protein intake is still unknown. Therefore, the objective of this study was to examine the effect of protein-enriched bread and drinking yoghurt on the protein intake of acute hospitalized older adults (≥55 years).

      Methods

      This study was performed as a single blind randomized controlled trial in 47 hospitalized elderly acutely admitted to a university hospital. During three consecutive days participants received either ad libitum protein-enriched bread and drinking yoghurt or normal, non-enriched products as part of their daily meals. The protein-enriched bread contained 6.9 g of protein per serving and the normal bread 3.8 g of protein. For drinking yoghurt this was 20.0 g and 7.5 g of protein per serving respectively. The products were almost isocaloric. Food intake of participants was measured and nutritional values were calculated according to the Dutch Food Composition Table. An independent sample t-test was used to compare protein intake between the intervention and control group.

      Results

      Analyses illustrate a protein intake in the intervention group of 75.0 ± 33.2 g per day versus 58.4 ± 14.5 g in the control group (p = 0.039). Intervention patients had a mean protein intake of 1.1 g/kg/day, with 36% of the patients reaching the minimum requirement of 1.2 g/kg/day; in control patients this was 0.9 g/kg/day (p = 0.041) and 8% (p = 0.030). Bread and drinking yoghurt contributed almost equally to the increased intake of protein in the intervention group.

      Conclusions

      The use of protein-enriched bread and drinking yoghurt, consumed as part of regular meals, is a promising and feasible solution to increase the protein intake of acutely ill patients. It needs to be confirmed whether the use of these products will also result in a better clinical outcome.
      ClinicalTrials.gov ID number: NCT01907152.

      Keywords

      Abbreviations:

      ADL (activities of daily living), BMI (body mass index), MNA (mini nutritional assessment), eGFR (estimated glomerular filtration rate), HACCP (hazard analysis of critical control points), ONS (oral nutrition supplements)
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