Protein-Enriched Bread and Readymade Meals Increase Community-Dwelling Older Adults' Protein Intake in a Double-Blind Randomized Controlled Trial
Open accessAbstract
Objectives Sufficient protein intake can decrease undernutrition risk among community-dwelling older adults. This study aimed to increase community-dwelling older adults' daily protein intake with acceptable and applicable protein-enriched bread and readymade meals at home. Design Double-blind randomized controlled trial of 2 weeks. Setting Senior residential center in the Netherlands. Participants Forty-two community-dwelling elderly residents (≥65 years) participated, with a mean age of 74.0 ± 6.9 years and mean body mass index of 28.5 ± 3.45 kg/m 2. Intervention The intervention group (n = 22) received 5 protein-enriched readymade meals and plentiful protein-enriched bread during 2 weeks, whereas the control group (n = 20) received the regular equivalents during these 2 weeks. Measurements Food intake was assessed by using dietary food record-assisted 24-hour recalls and by weighing meal leftovers. Acceptability of the enriched products was assessed with product evaluation questionnaires and in-depth interviews. Results Mean intake of food products (g) and energy (kJ) did not differ significantly between the control and the intervention groups. Total daily protein intake in the intervention group was 14.6 g higher than in the control group (87.7 vs 73.1 g/d, P = .004). Expressed in g/kg body weight per day, protein intake was significantly higher in the intervention group than in the control group (1.25 vs 0.99 g/kg/d, P = .003). The enriched products were equally liked, scoring 7.7 of 10.0. The in-depth interviews with participants indicated high acceptability of the enriched products. Conclusion This study showed that community-dwelling older adults' protein intake can be increased to recommended levels with highly acceptable and applicable protein-enriched products that fit into the normal eating pattern. Future studies should investigate whether this effect is maintained in the long-term among a frailer population.
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Eight studies investigate the effect of dietary enrichment.
“Eight studies investigate the effect of dietary enrichment [25-32].”
From ESPEN guideline on hospital nutrition (2021) · cites this paper as [29]
In community-dwelling older adults, protein intake could be increased by acceptable and applicable protein-enriched products.
“protein intake could be increased by acceptable and 444 applicable protein-enriched products.”
From ESPEN guideline on hospital nutrition (2021) · cites this paper as [29]
The recommended level for protein intake varies between studies but most studies referring to a recommendation are in the span between 1.0 and 1.5 g/kg BW/day.
“The recommended level for protein intake varies between 513 studies but most studies referring to a recommendation are in the span between 1.0 – 1.5 g/kg 514 BW/day [28, 29, 32, 36].”
From ESPEN guideline on hospital nutrition (2021) · cites this paper as [29]
The supplied passages contain no match. Searches of our copy for protein-intake recommendations and the 1.0–1.5 g/kg BW/day range returned no passages, so I cannot verify what recommendation this paper gives or whether it supports the claim about most studies. (LLM, conf=0.70)
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Podsakoff, P. M., MacKenzie, S. B., Lee, J.-Y., & Podsakoff, N. P. (2003) · Journal of Applied Psychology · doi:10.1037/0021-9010.88.5.879 · Cited by 82,194 · see citing works
Bauer, J., Biolo, G., Cederholm, T., Cesari, M., Cruz-Jentoft, A. J., Morley, J. E., Phillips, S., Sieber, C., Stehle, P., Teta, D., et al. (2013) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2013.05.021 · Cited by 2,553 · cited 1× · see citing works
“Residents were eligible when we established after screening that they (1) were aged 65 years or older; (2) were able to choose and eat their food by themselves; (3) liked whole-wheat bread and at least 5 of the 8 offered meals; (4) did not have an allergy/intolerance for milk, lactose, soy, or gluten; (5) were not fol…”
Protein and energy supplementation in elderly people at risk from malnutrition
Milne, A. C., Potter, J., Vivanti, A., & Avenell, A. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003288.pub3 · Cited by 849 · see citing works
Tieland, M., Borgonjen-Van den Berg, K. J., van Loon, L. J. C., & de Groot, L. C. P. G. M. (2012) · European Journal of Nutrition · doi:10.1007/s00394-011-0203-6 · Cited by 297 · see citing works
Trabal, J., & Farran-Codina, A. (2015) · Nutrition Reviews · doi:10.1093/nutrit/nuv023 · Cited by 55 · see citing works
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ESPEN guideline on hospital nutrition
Thibault, R., Abbasoglu, O., Ioannou, E., Meija, L., Ottens-Oussoren, K., Pichard, C., Rothenberg, E., Rubin, D., Siljamäki-Ojansuu, U., Vaillant, M.-F., et al. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2021.09.039 · Cited by 259 · see citing works
Moloney, L., & Jarrett, B. (2021) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2020.09.026 · Cited by 21 · see citing works
- Authors
- Ziylan, C., Haveman-Nies, A., Kremer, S., & de Groot, L. C. P. G. M.
- Affiliations
- Wageningen University & Research (NL)
- Corresponding author
- Ziylan, Canan
- ORCID
- Ziylan, Canan
- Venue
- Journal of the American Medical Directors Association
- Publisher
- Elsevier BV
- Published
- 2017-02
- Volume
- 18
- Issue
- 2
- Pages
- 145-151
- ISSN
- 1525-8610 (ISSN-L)
- OpenAlex
- W2535640736
- Cited by
- 24
- References
- 5
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 1 · 2022: 2 · 2021: 7 · 2020: 3 · 2019: 4 · 2017: 1
- FWCI
- 1.14
- Type
- journal article
- Language
- en
- Open access
- green
- research.wur.nl
- Locations
- Journal of the American Medical Directors Association (publishedVersion)
- PubMed (publishedVersion)
- Socio-Environmental Systems Modeling (acceptedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
- Keywords
- protein intake, community-dwelling older adults, undernutrition prevention, dietary supplementation, energy intake
- MeSH terms
- Aged, Aged, 80 and over, Bread, Dietary Proteins, Double-Blind Method, Feeding Behavior, Female, Food, Fortified, Homes for the Aged, Humans, Male, Malnutrition, Meals
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