Even Mealtime Distribution of Protein Intake Is Associated with Greater Muscle Strength, But Not with 3‐Year Decline, in Free‐Living Older Adults: The Nuage Study
Bibliographic record
Abstract
Background Functional status declines with aging, impeding autonomy. Mealtime distribution of dietary protein was recently associated with muscle mass, yet its relation to physical performance remains unknown. Objective We examined the relationship between protein intake distribution and physical performance and its 3‐y decline, in community‐dwelling older adults. Design Three‐year follow‐up data from 827 men and 914 women (aged 67–84 y) participating in the longitudinal study on nutrition and successful aging (NuAge; Quebec, Canada) were analyzed. Physical performance, measured yearly, was grouped into 2 functional composite scores: muscle strength (handgrip, arm and leg) and mobility (timed up‐and‐go, chair stand, normal and fast walking speed). Dietary data were collected in 2 sets of 3×24‐h food recalls, at baseline and year 2. Individual mealtime protein distribution was calculated as the coefficient of variation (CV= SD/ χ̄) of grams of protein per meal. Mixed model analysis was used to examine trajectories of muscle strength and mobility across time, by sex, as conditioned by protein distribution, adjusted for age, protein quantity, education level, disease status, BMI, depression, cognitive function, smoking and mid‐upper arm muscle area. Results Physical performance deteriorated over 3 years, with muscle strength declining more than mobility score in men (−1.51±1.68 vs. −0.66±2.81) and women (−1.35±1.77 vs. −0.78±2.63), P <0.001. More evenly distributed protein intake, independently of total quantity, was cross‐sectionally associated with higher muscle strength score in men ( β ±SE; 0.44±0.18) and women (0.68±0.19), P <0.05 throughout follow‐up, before and after controlling for covariates. It was also associated with greater mobility score, only in men and before adjusting for covariates. Strength and mobility rates of decline were not affected by protein intake distribution in either sex. Also, higher protein quantity (g/d adjusted for energy) was independently associated with higher mobility score in both sexes and higher muscle strength in women (with a statistical trend in men) at each yearly follow‐up, but not with the longitudinal rate of decline over 3 years. Age was the only confounder affecting muscle strength decline over time. Conclusions In addition to the previously observed association with lean mass, an even distribution of daily protein intake across meals was independently associated with greater muscle strength, but not mobility score or functional decline, in older adults. Longer‐term investigation of the role of protein intake and its distribution, combined with other modifiable lifestyle factors, on physical performance is warranted. Support or Funding Information Dairy Farmers of Canada.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".