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Published in: BMC Geriatrics 1/2023

Open Access 01-12-2023 | Sarcopenia | Research

Relationship between protein intake and grip strength in qualitative and quantitative aspects among the elderly in Korea: results from the Korea National Health and Nutrition Examination Survey

Authors: Mi‑Hyun Kim, Mi‑Kyeong Choi, Yun‑Jung Bae

Published in: BMC Geriatrics | Issue 1/2023

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Abstract

Background

This study investigated the association between quantitative and qualitative protein intake and grip strength (GS) in the South Korean population to explore nutritional management for the prevention of sarcopenia.

Methods

This cross-sectional study was based on data from a nationally representative sample of the South Korean elderly population, consisting of 1,531 men and 1,983 women aged 65 years and older who participated in the Korean National Health and Nutrition Examination Survey from 2016 to 2019. Low GS was defined as GS < 28 kg in men and GS < 18 kg in women. Protein intake was assessed using 1-day 24-h recall, and we analyzed absolute protein intake, protein intake by food source, and protein intake compared to dietary reference intake with per body weight or absolute daily recommended value.

Results

The total and animal protein intake and protein intake from legumes, fish and shellfish were significantly lower in women with a low GS than in those with a normal GS. After adjusting for confounding factors, women who consumed more protein than the estimated average requirement (EAR, 40 g/day for women) were 0.528 times less likely to have low GS than women consuming less protein than the EAR (95% CI: 0.373–0.749), and consuming any amount of protein from legumes were 0.656 times less likely (95% CI: 0.500–0.860) to have low GS than women who did not consume any amount of legume protein.

Conclusions

This study provides epidemiological evidence that adequate protein intake above EAR and protein intake from legumes should be guided for preventing low GS, especially in elderly women.
Literature
1.
go back to reference Bohannon RW. Muscle strength: clinical and prognostic value of hand-grip dynamometry. Curr Opin Clin Nutr Metab Care. 2015;18:465–70.CrossRefPubMed Bohannon RW. Muscle strength: clinical and prognostic value of hand-grip dynamometry. Curr Opin Clin Nutr Metab Care. 2015;18:465–70.CrossRefPubMed
2.
go back to reference Kuczmarski MF, Pohlig RT, Shupe ES, Zonderman AB, Evans MK. Dietary protein intake and overall diet quality are associated with handgrip strength in african american and white adults. J Nutr Health Aging. 2018;22:7009.CrossRef Kuczmarski MF, Pohlig RT, Shupe ES, Zonderman AB, Evans MK. Dietary protein intake and overall diet quality are associated with handgrip strength in african american and white adults. J Nutr Health Aging. 2018;22:7009.CrossRef
3.
go back to reference Houston DK, Cesari M, Ferrucci L, Cherubini A, Maggio D, Bartali B, Johnson MA, Schwartz GG, Kritchevsky SB. Association between vitamin D status and physical performance: the InCHIANTI study. J Gerontol Ser A Biol Sci Med Sci. 2007;62:440–6.CrossRef Houston DK, Cesari M, Ferrucci L, Cherubini A, Maggio D, Bartali B, Johnson MA, Schwartz GG, Kritchevsky SB. Association between vitamin D status and physical performance: the InCHIANTI study. J Gerontol Ser A Biol Sci Med Sci. 2007;62:440–6.CrossRef
4.
go back to reference Lauretani F, Semba RD, Bandinelli S, Dayho-Brannigan M, Giacomini V, Corsi AM, Guralnik JM, Ferrucci L. Low plasma carotenoids and skeletal muscle strength decline over 6 years. J Gerontol Ser A Biol Sci Med Sci. 2008;63:376–83.CrossRef Lauretani F, Semba RD, Bandinelli S, Dayho-Brannigan M, Giacomini V, Corsi AM, Guralnik JM, Ferrucci L. Low plasma carotenoids and skeletal muscle strength decline over 6 years. J Gerontol Ser A Biol Sci Med Sci. 2008;63:376–83.CrossRef
5.
go back to reference Beasley JM, LaCroix AZ, Neuhouser ML, Huang Y, Tinker L, Woods N, Michael Y, Curb JD, Prentice RL. Protein intake and incident frailty in the Women’s Health Initiative observational study. J Am Geriatr Soc. 2010;58:1063–71.CrossRefPubMedPubMedCentral Beasley JM, LaCroix AZ, Neuhouser ML, Huang Y, Tinker L, Woods N, Michael Y, Curb JD, Prentice RL. Protein intake and incident frailty in the Women’s Health Initiative observational study. J Am Geriatr Soc. 2010;58:1063–71.CrossRefPubMedPubMedCentral
6.
go back to reference Houston DK, Nicklas BJ, Ding J, Harris TB, Tylavsky FA, Newman AB, Lee JS, Sahyoun NR, Visser M, Kritchevsky SB, Health ABC, Study. Dietary protein intake is associated with lean mass change in older, community-dwelling adults: the Health, Aging, and body composition (Health ABC) Study. Am J Clin Nutr. 2008;87:150–5.CrossRefPubMed Houston DK, Nicklas BJ, Ding J, Harris TB, Tylavsky FA, Newman AB, Lee JS, Sahyoun NR, Visser M, Kritchevsky SB, Health ABC, Study. Dietary protein intake is associated with lean mass change in older, community-dwelling adults: the Health, Aging, and body composition (Health ABC) Study. Am J Clin Nutr. 2008;87:150–5.CrossRefPubMed
7.
go back to reference Tieland M, van de Rest O, Dirks ML, van der Zwaluw N, Mensink M, van Loon LJ, de Groot LC. Protein supplementation improves physical performance in frail elderly people: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc. 2012;13:720–6.CrossRefPubMed Tieland M, van de Rest O, Dirks ML, van der Zwaluw N, Mensink M, van Loon LJ, de Groot LC. Protein supplementation improves physical performance in frail elderly people: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc. 2012;13:720–6.CrossRefPubMed
8.
go back to reference Ham H, Ha K. Trends in dietary protein intake and its adequacy among korean adults: data from the 2010–2019 Korea National Health and Nutrition Examination Survey (KNHANES). Korean J Community Nutr. 2022;27:47–60.CrossRef Ham H, Ha K. Trends in dietary protein intake and its adequacy among korean adults: data from the 2010–2019 Korea National Health and Nutrition Examination Survey (KNHANES). Korean J Community Nutr. 2022;27:47–60.CrossRef
9.
go back to reference Tak YJ, Lee JG, Yi YH, Kim YJ, Lee S, Cho BM, Cho YH. Association of handgrip strength with dietary intake in the korean population: findings based on the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII-1). Nutrients. 2016;10:1180.CrossRef Tak YJ, Lee JG, Yi YH, Kim YJ, Lee S, Cho BM, Cho YH. Association of handgrip strength with dietary intake in the korean population: findings based on the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII-1). Nutrients. 2016;10:1180.CrossRef
11.
go back to reference Choi MK, Bae YJ. Protein intake and osteosarcopenic adiposity in korean adults aged 50 years and older. Osteoporos Int. 2020;31:2363–72.CrossRefPubMed Choi MK, Bae YJ. Protein intake and osteosarcopenic adiposity in korean adults aged 50 years and older. Osteoporos Int. 2020;31:2363–72.CrossRefPubMed
12.
go back to reference Jung HW, Kim SW, Kim IY, Lim JY, Park HS, Song W, Yoo HJ, Jang HC, Kim K, Park Y, Park YJ, Yang SJ, Lee HJ, Won CW. Protein intake recommendation for Korean older adults to prevent sarcopenia: Expert Consensus by the Korean Geriatric Society and the Korean Nutrition Society. Ann Geriatr Med Res. 2018;22:167–75.CrossRefPubMedPubMedCentral Jung HW, Kim SW, Kim IY, Lim JY, Park HS, Song W, Yoo HJ, Jang HC, Kim K, Park Y, Park YJ, Yang SJ, Lee HJ, Won CW. Protein intake recommendation for Korean older adults to prevent sarcopenia: Expert Consensus by the Korean Geriatric Society and the Korean Nutrition Society. Ann Geriatr Med Res. 2018;22:167–75.CrossRefPubMedPubMedCentral
13.
go back to reference Sahni S, Mangano KM, Hannan MT, Kiel DP, McLean RR. Higher protein intake is associated with higher lean mass and quadriceps muscle strength in adult men and women. J Nutr. 2015;145:1569–75.CrossRefPubMedPubMedCentral Sahni S, Mangano KM, Hannan MT, Kiel DP, McLean RR. Higher protein intake is associated with higher lean mass and quadriceps muscle strength in adult men and women. J Nutr. 2015;145:1569–75.CrossRefPubMedPubMedCentral
14.
go back to reference Lord C, Chaput JP, Aubertin-Leheudre M, Labonte M, Dionne IJ. Dietary animal protein intake: association with muscle mass index in older women. J Nutr Health Aging. 2007;11:383–7.PubMed Lord C, Chaput JP, Aubertin-Leheudre M, Labonte M, Dionne IJ. Dietary animal protein intake: association with muscle mass index in older women. J Nutr Health Aging. 2007;11:383–7.PubMed
15.
go back to reference Chan R, Leung J, Woo J, Kwok T. Associations of dietary protein intake on subsequent decline in muscle mass and physical functions over four years in ambulant older chinese people. J Nutr Health Aging. 2014;18:171–7.CrossRefPubMed Chan R, Leung J, Woo J, Kwok T. Associations of dietary protein intake on subsequent decline in muscle mass and physical functions over four years in ambulant older chinese people. J Nutr Health Aging. 2014;18:171–7.CrossRefPubMed
16.
go back to reference Kweon S, Kim Y, Jang MJ, Kim Y, Kim K, Choi S, Chun C, Khang YH, Oh K. Data resource profile: the Korea National Health and Nutrition Examination Survey (KNHANES). Int J Epidemiol. 2014;43:69–77.CrossRefPubMedPubMedCentral Kweon S, Kim Y, Jang MJ, Kim Y, Kim K, Choi S, Chun C, Khang YH, Oh K. Data resource profile: the Korea National Health and Nutrition Examination Survey (KNHANES). Int J Epidemiol. 2014;43:69–77.CrossRefPubMedPubMedCentral
17.
go back to reference Roberts HC, Denison HJ, Martin HJ, Patel HP, Syddall H, Cooper C, Sayer AA. A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardized approach. Age Ageing. 2011;40:423–9.CrossRefPubMed Roberts HC, Denison HJ, Martin HJ, Patel HP, Syddall H, Cooper C, Sayer AA. A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardized approach. Age Ageing. 2011;40:423–9.CrossRefPubMed
18.
go back to reference Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K, Jang HC, Kang L, Kim M, Kim S, Kojima T, Kuzuya M, Lee JSM, Lee SY, Lee WJ, Lee Y, Liang CK, Lim JY, Lim WS, Peng LN, Sugimoto K, Tanaka T, Won CW, Yamada M, Zhang T, Akishita M, Arai H. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 2020;21:300–7.CrossRefPubMed Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K, Jang HC, Kang L, Kim M, Kim S, Kojima T, Kuzuya M, Lee JSM, Lee SY, Lee WJ, Lee Y, Liang CK, Lim JY, Lim WS, Peng LN, Sugimoto K, Tanaka T, Won CW, Yamada M, Zhang T, Akishita M, Arai H. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 2020;21:300–7.CrossRefPubMed
19.
go back to reference Ministry of Health and Welfare. The korean Nutrition Society. Dietary reference intakes for Koreans 2020. Ministry of Health and Welfare; 2020. Ministry of Health and Welfare. The korean Nutrition Society. Dietary reference intakes for Koreans 2020. Ministry of Health and Welfare; 2020.
20.
go back to reference World Health Organization. The Asia-Pacific perspective: redefining obesity and its treatment. World Health Organization; 2000. World Health Organization. The Asia-Pacific perspective: redefining obesity and its treatment. World Health Organization; 2000.
21.
go back to reference Cruz-Jentoft AJ, Landi F, Schneider SM, Zúñiga C, Arai H, Boirie Y, Chen LK, Fielding RA, Martin FC, Michel JP, Sieber C, Stout JR, Studenski SA, Vellas B, Woo J, Zamboni M, Cederholm T. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing. 2014;43:748–59.CrossRefPubMedPubMedCentral Cruz-Jentoft AJ, Landi F, Schneider SM, Zúñiga C, Arai H, Boirie Y, Chen LK, Fielding RA, Martin FC, Michel JP, Sieber C, Stout JR, Studenski SA, Vellas B, Woo J, Zamboni M, Cederholm T. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing. 2014;43:748–59.CrossRefPubMedPubMedCentral
22.
go back to reference Arvandi M, Strasser B, Meisinger C, Volaklis K, Gothe RM, Siebert U, Ladwig K-H, Grill E, Horsch A, Laxy M, Peters A, Thorand B. Gender differences in the association between grip strength and mortality in older adults: results from the KORA-age study. BMC Geriatr. 2016;16:201.CrossRefPubMedPubMedCentral Arvandi M, Strasser B, Meisinger C, Volaklis K, Gothe RM, Siebert U, Ladwig K-H, Grill E, Horsch A, Laxy M, Peters A, Thorand B. Gender differences in the association between grip strength and mortality in older adults: results from the KORA-age study. BMC Geriatr. 2016;16:201.CrossRefPubMedPubMedCentral
23.
go back to reference Pratt J, De Vito G, Narici M, Segurado R, Dolan J, Conroy J, Boreham C. Grip strength performance from 9431 participants of the GenoFit study: normative data and associated factors. GeroScience. 2021;43:2533–46.CrossRefPubMedPubMedCentral Pratt J, De Vito G, Narici M, Segurado R, Dolan J, Conroy J, Boreham C. Grip strength performance from 9431 participants of the GenoFit study: normative data and associated factors. GeroScience. 2021;43:2533–46.CrossRefPubMedPubMedCentral
25.
go back to reference Gregorio L, Brindisi J, Kleppinger A, Sullivan R, Mangano KM, Bihuniak JD, Kenny AM, Kerstetter JE, Insogna KL. Adequate dietary protein is associated with better physical performance among post-menopausal women 60–90 years. J Nutr Health Aging. 2014;18:155–60.CrossRefPubMedPubMedCentral Gregorio L, Brindisi J, Kleppinger A, Sullivan R, Mangano KM, Bihuniak JD, Kenny AM, Kerstetter JE, Insogna KL. Adequate dietary protein is associated with better physical performance among post-menopausal women 60–90 years. J Nutr Health Aging. 2014;18:155–60.CrossRefPubMedPubMedCentral
26.
go back to reference Beasley JM, Wertheim BC, LaCroix AZ, Prentice RL, Neuhouser ML, Tinker LF, Kritchevsky S, Shikany JM, Eaton C, Chen Z, Thomson CA. Biomarker-calibrated protein intake and physical function in the Women’s Health Initiative. J Am Geriatr Soc. 2013;61:1863–71.CrossRefPubMedPubMedCentral Beasley JM, Wertheim BC, LaCroix AZ, Prentice RL, Neuhouser ML, Tinker LF, Kritchevsky S, Shikany JM, Eaton C, Chen Z, Thomson CA. Biomarker-calibrated protein intake and physical function in the Women’s Health Initiative. J Am Geriatr Soc. 2013;61:1863–71.CrossRefPubMedPubMedCentral
27.
go back to reference Cholewa JM, Dardevet D, Lima-Soares F, de Araújo Pessôa K, Oliveira PH, Dos Santos Pinho JR, Nicastro H, Xia Z, Cabido CE, Zanchi NE. Dietary proteins and amino acids in the control of the muscle mass during immobilization and aging: role of the MPS response. Amino Acids. 2017;49:811–20.CrossRefPubMed Cholewa JM, Dardevet D, Lima-Soares F, de Araújo Pessôa K, Oliveira PH, Dos Santos Pinho JR, Nicastro H, Xia Z, Cabido CE, Zanchi NE. Dietary proteins and amino acids in the control of the muscle mass during immobilization and aging: role of the MPS response. Amino Acids. 2017;49:811–20.CrossRefPubMed
28.
go back to reference Mishra S, Goldman JD, Sahyoun NR, Moshfegh AJ. Association between dietary protein intake and grip strength among adults aged 51 years and over: what we eat in America, National Health and Nutrition Examination Survey 2011–2014. PLoS ONE. 2018;13:e0191368.CrossRefPubMedPubMedCentral Mishra S, Goldman JD, Sahyoun NR, Moshfegh AJ. Association between dietary protein intake and grip strength among adults aged 51 years and over: what we eat in America, National Health and Nutrition Examination Survey 2011–2014. PLoS ONE. 2018;13:e0191368.CrossRefPubMedPubMedCentral
29.
go back to reference Taekema DG, Ling CH, Blauw GJ, Meskers CG, Westendorp RG, de Craen AJ, Maier AB. Circulating levels of IGF1 are associated with muscle strength in middle-aged and oldest-old women. Eur J Endocrinol. 2011;164:189–96.CrossRefPubMed Taekema DG, Ling CH, Blauw GJ, Meskers CG, Westendorp RG, de Craen AJ, Maier AB. Circulating levels of IGF1 are associated with muscle strength in middle-aged and oldest-old women. Eur J Endocrinol. 2011;164:189–96.CrossRefPubMed
30.
go back to reference Yeung SSY, Reijnierse EM, Deen PJJF, Trappenburg MC, Meskers CGM, Maier AB. Nutrient intake and muscle measures in geriatric outpatients. J Am Coll Nutr. 2021;40:589–97.CrossRefPubMed Yeung SSY, Reijnierse EM, Deen PJJF, Trappenburg MC, Meskers CGM, Maier AB. Nutrient intake and muscle measures in geriatric outpatients. J Am Coll Nutr. 2021;40:589–97.CrossRefPubMed
31.
go back to reference Deshpande SS. Food legumes in human nutrition: a personal perspective. Crit Rev Food Sci Nutr. 1992;32:333–63.CrossRefPubMed Deshpande SS. Food legumes in human nutrition: a personal perspective. Crit Rev Food Sci Nutr. 1992;32:333–63.CrossRefPubMed
32.
go back to reference Kim J, Lee Y, Lee SY. Legumes and soy products consumption and functional disability in older women. Maturitas. 2011;69:268–72.CrossRefPubMed Kim J, Lee Y, Lee SY. Legumes and soy products consumption and functional disability in older women. Maturitas. 2011;69:268–72.CrossRefPubMed
Metadata
Title
Relationship between protein intake and grip strength in qualitative and quantitative aspects among the elderly in Korea: results from the Korea National Health and Nutrition Examination Survey
Authors
Mi‑Hyun Kim
Mi‑Kyeong Choi
Yun‑Jung Bae
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2023
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-023-04016-8

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