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Distribution of daily protein intake and appendicular skeletal muscle mass in healthy free-living Chinese older adults

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Abstract

Aims

Evidence regarding impact of protein intake distribution on skeletal muscle mass in older adults is limited and inconsistent. This study aims to investigate the relationship of evenness of dietary protein distribution and number of meals exceeding a threshold with appendicular skeletal muscle mass (ASM) in healthy and free-living Chinese older adults.

Methods

Repeated measured data of 5689 adult participants aged ≥ 60 years from the China Health and Nutrition Survey (CHNS) 2015 and 2018 waves were analyzed. Mixed-effects linear regression model was performed to examine the relationship between coefficient of variance (CV) of protein intake across meals, number of meals ≥ 0.4 g protein/kg BW and ASM, respectively. Analyses were conducted separately for male and female.

Results

The average CV of protein intake in each wave was in the range of 0.34–0.35. More than 40% male and female participants in each wave had no meal reaching 0.4 g protein/kg BW. Female participants in the highest quartile of protein intake CV had significantly lower ASM (β = -0.18, 95%CI = -0.32, -0.04) compared with those in the lowest quartile, after adjustment for multiple confounders. Significant negative trends were observed across dietary protein CV quartiles with ASM both in male (P trend = 0.043) and female (P trend = 0.007). Significant positive association between number of meals exceeding 0.4 g protein /kg BW and relative ASM were observed in females (2 meals vs. 0 meal: β = 0.003, 95%CI = 0.0007,0.006;≥3 meals vs. 0 meal: β = 0.008, 95%CI = 0.003,0.013), after adjusting for multiple covariates.

Conclusions

A more even-distributed protein intake pattern and more meals reaching protein intake threshold were respectively associated with higher appendicular skeletal muscle mass in healthy and free-living older Chinese adults. Prospective studies and intervention trials are needed to confirm these cross-sectional findings.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding authors (B.Z.) on reasonable request.

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Acknowledgements

The authors would like to thank all the teams and staffs who have worked on the China Health and Nutrition Survey (CHNS) and all of the participants who involved in this survey.

Funding

This work was funded in part by National Institute for Health (NIH), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) for [R01 HD30880 and R01 HD38700], National Institute on Aging (NIA) for [R01 AG065357], National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) for [R01 DK104371 and P30 DK056350], National Heart, Lung, and Blood Institute (NHLBI) for [R01 HL108427], the NIH Fogarty grant [D43 TW009077], the Carolina Population Center, University of North Carolina at Chapel Hill [P2 CHD050924 and P30 AG066615] since 1989 and National Financial Projects of China (102393220020070000012).

Author information

Authors and Affiliations

  1. Dalian Center for Disease Control and Prevention, Dalian, 116035, China

    Xiaoyun Song, Mei Zhang, Lei Zhang & Jun Meng

  2. National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China

    Huijun Wang, Chang Su & Bing Zhang

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  1. Xiaoyun Song
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Contributions

Conceptualization, H.W. and B.Z.; formal analysis and original draft preparation, X.S.; data preparation, X.S., C.S., M.Z.; review, editing, and interpretation of data, H.W., C.S., B.Z, L.Z., J.M.; All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Bing Zhang.

Ethics declarations

Ethics approval and consent to participate

The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Institutional Review Committees of the University of North Carolina at Chapel Hill (UNC-CH), National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention. Written informed consent was obtained from each study participants (ethical approval number: 2015-024).

Competing interests

The authors declare no conflict of interest.

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394_2024_3364_MOESM1_ESM.docx

Additional file 1 Supplemental Table S1. Association between CV of protein intake and ASM (kg) stratified by daily protein intake. Table S2. Association between number of meals ≥ 0.4 g protein/kg BW and relative ASM (kg/kg BW) stratified by relative total protein intake. Table S3. Association between number of meals ≥ 25 or 30 g protein and ASM (kg).

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Song, X., Wang, H., Su, C. et al. Distribution of daily protein intake and appendicular skeletal muscle mass in healthy free-living Chinese older adults. Eur J Nutr (2024). https://doi.org/10.1007/s00394-024-03364-4

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