The protein gap: Increasing protein intake in the diet of community-dwelling older adults - A simulation study

Objective: Approximately 50% of Dutch community-dwelling older adults does not meet protein recommendations. This study assesses the effect of replacing low protein foods with protein-rich alternatives on protein intake of Dutch community-dwelling older adults. Design: The Dutch National Food Consumption Survey - Older Adults 2010-2012 was used for scenario modelling. Dietary intake was estimated for 727 adults aged 70+ based on two 24-h recalls. Commonly consumed products were replaced by comparable products rich in protein (scenario 1), foods enriched in protein (scenario 2), and a combination of both (scenario 3). Replacement scenarios were confined to participants whose dietary protein intake was <1.0g/kg BW/day (n=391). Habitual protein intake of all older adults was estimated, adjusting for effects of within-person variation in the 2-days intake data. Results: Mean protein intake of the total population increased from 1.0 to 1.2 g/kg BW/day (scenarios 1 and 2) and to 1.3 g/kg BW/day (scenario 3). The percentage of participants with intakes of ≥1.0 g/kg BW/day increased from 47.1% to 91.4%, 90.2%, and 94.6% respectively in scenarios 1, 2 and 3. The largest increases in protein intake were due to replacements in food groups Yoghurt, cream desserts and pudding, Potatoes, vegetables and legumes and Non-alcoholic beverages and milk in scenario 1 and Bread; Yoghurt, cream desserts and pudding and Soups in scenario 2. Conclusions: This simulation model shows that replacing low protein foods with comparable alternatives rich in protein can increase the protein intake of Dutch community-dwelling older adults considerably. Results can be used as a basis for nutritional counseling.