Posted by ProPortion Foods Blog on Jan 23, 2018 in Bones, Muscle, Nutrition, Protein, Research
Nature, in her infinite intelligence, has gifted us millions of different proteins that supply the music and instruments of the body’s orchestra. These proteins are assembled from twenty amino acids joined in fifty to tens of thousands of different combinations.
Proteins carry most of the trillions of body cells’ workload. Proteins provide bodily tissues and organs, from the executive brain and mighty muscle to the modest skin, hair and nails, with structure and regulate their activities—including thousands of chemical reactions, enzyme production, signal transmission, and physical movement.
Amino acids can’t be stored, so need to regularly come from food. If consulting recommended daily allowances (RDAs), or recommended daily intakes (RDIs—Australian version), popular discourse claims we eat too much protein. Nutrition experts who congregated for two Protein Summits in Washington, US, disagree.
The RDA, or RDI, is calculated to estimate how much of a nutrient will fulfil the body’s basic nutritional needs. Recommended protein intakes average 0.8 grams per kilogram of body weight per day in healthy adults, equating to 10% of most people’s daily calories.
The average person consumes 16% of their daily calories as protein. Although this exceeds the RDA, the Protein Summit consensus, published in the American Journal of Clinical Nutrition in 2015, suggests people should eat at least double that, or around 15% to 25% of daily calories from protein depending on age and activity levels for optimal health—particularly preservation of muscle mass, strength and fat-burning capacity.
Every year, a third of Australians over 65 fall at least once—that’s around a million older adults falling over, potentially increasing to 2.7 million by 2050 as the population ages. Not only can falls cause cuts, bruises, broken bones, disability and even death, costs are estimated to blow out to $1.4 billion by 2051.
That muscles need protein is well-known—less well appreciated is that 50% of bone volume and about a third of bone mass is made from protein. Dietary protein is critical for making and maintaining bones throughout life, but this has not been considered in recommended intakes.
Protein’s importance for bone health is further suggested by its ability to increase insulin-like growth factor (IGF-1; a growth hormone), calcium absorption and muscle mass.
A systematic review and meta-analysis, April 2017, found high compared to low protein intake was associated with 16% reduced incidence of hip fractures. They reported correlations between protein intake and bone mineral density, warranting further investigation. Also meriting research is whether increased protein can prevent or treat osteoporosis.
All in all, the review supports protein intakes above the RDA for preventing hip fractures and bone mineral density loss, concluding “This is the first systematic review of its kind that shows consuming protein above current recommended levels is beneficial for bone health.”
The review did not find any difference between plant and animal protein sources for preventing bone loss, but noted a dearth of data from which to draw definitive recommendations. However, protein quality matters.
https://www.health.harvard.edu/blog/how-much-protein-do-you-need-every-day-201506188096
https://www.nrv.gov.au/introduction
http://ajcn.nutrition.org/content/101/6/1317S.full
http://www.anzfallsprevention.org/info/
http://www.tandfonline.com/doi/full/10.1080/07315724.2017.1322924
https://www.futuremedicine.com/doi/abs/10.2217/ahe.10.16
http://www.proportionfoods.com.au/protein-quality-matters/
http://www.proportionfoods.com.au/determine-protein-quality-diet/
Posted by ProPortion Foods Blog on Nov 22, 2017 in Muscle, Nutrition, Protein, Research, Sarcopenia
Unless you are suffering a prolonged midlife crisis, life really does get better after 40—we can start to enjoy the fruits of our labour, care less about what people think, and (hopefully) have life worked out. Physically, things are still okay. But the average person would have lost 3-8% muscle mass since turning 30, and this trend will continue each decade.
Nearly half of our body weight consists of muscles—over 600 different types. Muscles are made of fibres, and more fibres mean greater muscle strength. They all stretch and contract, but distinct muscle groups have very different functions.
Smooth muscles keep organs working behind the scenes (e.g. digesting food, expelling the solid and fluid by-products, maintaining blood flow, delivering babies, and even helping eyes see), and cardiac muscle works 24/7 to keep the heart beating.
Skeletal muscle contains the most tissue and is the body’s largest protein store. Skeletal muscle gives bodies their shape, maintains posture, moves the body on command and generates heat. It even mediates insulin production, supporting evidence that improved muscle tone can help control blood sugar levels.
Severe muscle loss affects 5-13% of people by 60-70 years, increasing to 11-50% of people over 80. As skeletal muscle mass declines with age, so does muscle strength, power and balance. Professor Irwin Rosenberg, of the Jean Mayer USDA Human Nutrition Research Center on Aging, proclaimed, “no decline with age is more dramatic or potentially more functionally significant than the decline in muscle mass.”
Lost muscle mass can increase risk of sudden falls, fractures and mortality. Sarcopenia—age-related loss of lean tissue mass and function—is a serious, multifactorial condition that can creep up unexpectedly. It affects an estimated 29% and 33% of older people living in the community and in long-term care, respectively—and this is likely to increase with our aging population.
Forced hospital rest can worsen sarcopenia. Some older adults may never recover from extra muscle mass lost from injury and hospitalisation, leading to accelerated breakdown of body tissues, poor clinical outcomes and increased hospital costs. When severe, sarcopenia results in 79% increased risk of disability.
Lifestyle behaviours make up much of the difference between healthy and unhealthy aging: most notably diet quality and exercise. Age-related and severe loss of muscle mass can be reduced with physical activity (especially resistance training) and nutrition.
Protein and amino acids (protein building blocks) from absorbable sources like whey are key nutritional targets for improving muscle mass, strength and physical performance. Adults with protein-energy malnutrition and unintended weight loss also need extra calories from food to prevent their body breaking down muscle protein for energy.
Vitamin D may improve muscle strength, especially in patients over 65 with low Vitamin D (<30 nmol/L). Creatine supplementation, combined with resistance training, might increase upper body strength and reduce muscle aging, and one study reports possible benefits of leucine (an amino acid that stimulates muscle protein synthesis). A recent review further identified a potential role for minerals (particularly magnesium, selenium and zinc) in preventing and treating sarcopenia.
Increased muscle strength can not only enhance treatment outcomes, morbidity and blood sugar control, it may also improve sleep and mental health—hence better quality of life with aging.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3276215/
https://www.ncbi.nlm.nih.gov/pubmed/9164280
https://www.ncbi.nlm.nih.gov/pubmed/29045254
https://www.ncbi.nlm.nih.gov/pubmed/28549707
http://www.sciencedirect.com.access.library.unisa.edu.au/science/article/pii/S8756328217303459
Posted by ProPortion Foods Blog on Nov 10, 2017 in Aged Care, Food Science, Nutrition, Packaging, Research
When people think about causes of malnutrition, they might consider poor appetite, chewing difficulties or illness as likely candidates. Yet many health professionals would know that even something seemingly trivial, like not being able to open food packaging, can be a major obstacle to eating well.
Opening food packaging can require strength, dexterity and fine motor skills that many vulnerable people don’t have—especially older adults.
Inaccessible food packaging is often an issue in hospitals, particularly when there is no-one to help patients open single serve and portion-controlled food items. The NSW Special Commission of Inquiry into Acute Care Services found that many patients need help to open food packaging, and reported that this can be a significant barrier to nutrition.
A Canadian study of 132 cognitively healthy nursing home residents found that 37.4% of residents were at risk of malnutrition—and food packaging was identified as one of the primary contributing factors.
Disabilities like arthritis can present a major obstacle to opening food packaging for people of all ages.
Arthritis Australia’s Consumer Director, Wendy Favorito suffers from arthritis herself and has experienced the resulting emotional struggles, like public embarrassment and lack of independence by having to rely on other people, and physical obstacles to basic daily tasks like cooking simple meals for her family.
If her husband weren’t there to help her, Favorito writes that it would just mean going without. “It is unacceptable that common items are so difficult to open for a large portion of people in our community when some simple packaging solutions exist.”
As Fergal Barry, Partnerships Manager of Arthritis Australia, stressed in a CHOICE interview, this problem will keep growing along with our aging population if it is not addressed.
Even in the general population, food packaging is not a trivial issue. Researchers at Nottingham University in the UK reported that over 60,000 people needed hospital treatment for injuries from trying to open difficult packaging, often resorting to using scissors or knives. Other injuries include wrist strain from trying to loosen jam jar lids. According to CHOICE interviews, experts believed Australians would face a similar problem.
This phenomenon has a name. ‘Wrap Rage’ is defined by Wikipedia as “the common name for heightened levels of anger or frustration resulting from the inability to open packaging’.
A healthy 30-year old male expressed frustration trying to open the plastic wrapping on crumpets, according to a more recent UK report which claimed that “Millions suffer ‘wrap rage’ battling to open modern-day packaging.”
For vulnerable people, accessible design is even more vital. The Nottingham University inquiry’s main finding was that packaging is easier to open when there is a larger surface area to grab onto. But there is much more complexity to making packaging accessible. Guidelines published by Arthritis Australia further include ease of grip and control, avoiding sharp edges, adequate grasping points on seals, texture, and salient, legible fonts.
For organisations seeking user-friendly products for vulnerable populations, Arthritis Australia set up an Initial Scientific Review (IRS) which rates products according to their accessibility. A database of these ratings is available for various pre-packaged and portion-controlled foods used by the food service industry.
http://dcjournal.ca.www.nrcresearchpress.com/doi/abs/10.3148/68.1.2007.14
https://en.wikipedia.org/wiki/Wrap_rage
http://www.telegraph.co.uk/news/uknews/1421698/60000-are-injured-by-opening-packaging.html
https://www.choice.com.au/shopping/packaging-labelling-and-advertising/packaging/articles/wrap-rage
Posted by ProPortion Foods Blog on Oct 25, 2017 in Aged Care, Nutrition, Research
Just $6.08 per resident per day is the average spent on food and ingredients in Australian aged care facilities, according to a recent study. The prevalence of malnutrition in aged care facilities is estimated to range anywhere between 32-72 percent, and a decrease in food budget and expenditure could further negatively affect the nutritional status of aged care residents [1].
A recent nutrition and dietetics study examined the 2015-16 financial year expenditure on catering within Australian residential aged care facilities. The study comprised of 817 aged care facilities, representing 64,256 residential beds.
The study reported that average food expenditure decreased 5 per cent from $6.39 to $6.08 per resident per day. Expenditure on oral nutritional supplements and food replacements, however, increased by 128 per cent [1].
Supplements can provide a short-term benefit to complement the nutrition intake for residents suffering malnourishment or weight loss. This is particularly the case where older adults require an increase in energy and good quality protein.
However, supplements do not improve the resident’s long-term quality of life, nor do they address the underlying cause of the malnutrition or weight loss [1]. Aged care experts agree that a nourishing, food-first approach will have a better long-term impact on the resident’s quality of life [2].
Figure 1 [1].