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Semin Thromb Hemost 2014; 40(06): 695-703
DOI: 10.1055/s-0034-1389081
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Nutrition As a Part of Healthy Aging and Reducing Cardiovascular Risk: Improving Functionality in Later Life Using Quality Protein, with Optimized Timing and Distribution

Beryl M. Dawson
1   Department of Nutrition and Dietetics, Gerontology and Rehabilitation, Balmain Hospital, Balmain New South Wales, Australia
,
Samantha Axford
1   Department of Nutrition and Dietetics, Gerontology and Rehabilitation, Balmain Hospital, Balmain New South Wales, Australia
› Author Affiliations
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Publication History

Publication Date:
24 August 2014 (online)

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Abstract

Aging is associated with many physiological changes, which may in time lead to numerous pathophysiological outcomes, including adverse vascular events. For example, senescence of the immune system and cellular senescence both contribute to rising inflammation with age, potentially induced by the overall burden of comorbid illness, adipose tissue mass, diet, socioeconomic status, and physical activity. In turn, this chronic inflammation decreases physical and cognitive performance, and promotes sarcopenia and the syndrome of frailty. These events and others decrease the functionality of life as we age and include an increased risk of thrombosis and adverse cardiovascular outcomes. In this review, we aim to overview the aging process primarily as related to functional impairment, and provide evidence for the role of protein, and specifically differential quality protein, in particular whey protein, and timing and distribution of intake, to help reduce some of the morbid effects of aging, including reducing obesity, improving glycemic control, and improving vascular function.

Keywords

aging - frailty - protein quality - protein timing - protein distribution
 

  • References

  • 1 Phrasefinder. http://www.phrases.org.uk/meanings/you%20are%20what%20you%20eat.html . Accessed June 29, 2014.
    PubMed
  • 2 Schlaudecker J, Becker R. Inflammatory response and thrombosis in older individuals. Semin Thromb Hemost 2014; 40 (6) 669-674
    Thieme ConnectPubMedSearch in Google Scholar
  • 3 Cunningham M, Marks N, Barnado A, Wirth JR, Gilkeson G, Markiewicz M. Are microparticles the missing link between thrombosis and autoimmune diseases? Involvement in selected rheumatologic diseases. Semin Thrombos Hemos 2014; 40 (6) 675-681
    PubMedSearch in Google Scholar
  • 4 Deitelzweig SB, Johnson BH, Lin J, Schulman KL. Prevalence of clinical venous thromboembolism in the USA: current trends and future projections. Am J Hematol 2011; 86 (2) 217-220
    CrossrefPubMedSearch in Google Scholar
  • 5 Montagnana M, Favaloro EJ, Franchini M, Guidi GC, Lippi G. The role of ethnicity, age and gender in venous thromboembolism. J Thromb Thrombolysis 2010; 29 (4) 489-496
    CrossrefPubMedSearch in Google Scholar
  • 6 White RH. The epidemiology of venous thromboembolism. Circulation 2003; 107 (23) (Suppl. 01) I4-I8
    PubMedSearch in Google Scholar
  • 7 Phang M, Lazarus S, Wood LG, Garg M. Diet and thrombosis risk: nutrients for prevention of thrombotic disease. Semin Thromb Hemost 2011; 37 (3) 199-208
    Thieme ConnectPubMedSearch in Google Scholar
  • 8 McEwen BJ. The influence of diet and nutrients on platelet function. Semin Thromb Hemost 2014; 40 (2) 214-226
    Thieme ConnectPubMedSearch in Google Scholar
  • 9 Allman-Farinelli MA, Dawson B. Diet and aging: bearing on thrombosis and hemostasis. Semin Thromb Hemost 2005; 31 (1) 111-117
    Thieme ConnectPubMedSearch in Google Scholar
  • 10 Lippi G, Franchini M, Favaloro EJ, Targher G. Moderate red wine consumption and cardiovascular disease risk: beyond the “French paradox”. Semin Thromb Hemost 2010; 36 (1) 59-70
    Thieme ConnectPubMedSearch in Google Scholar
  • 11 Ruiz M, Cefalu C, Reske T. Frailty syndrome in geriatric medicine. Am J Med Sci 2012; 344 (5) 395-398
    PubMedSearch in Google Scholar
  • 12 Cruz-Jentoft AJ, Baeyens JP, Bauer JM , et al; European Working Group on Sarcopenia in Older People. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010; 39 (4) 412-423
    CrossrefPubMedSearch in Google Scholar
  • 13 Fujita S, Volpi E. Amino acids and muscle loss with aging. J Nutr 2006; 136 (1, Suppl) 277S-280S
    PubMedSearch in Google Scholar
  • 14 Bartali B, Frongillo EA, Bandinelli S , et al. Low nutrient intake is an essential component of frailty in older persons. J Gerontol A Biol Sci Med Sci 2006; 61 (6) 589-593
    CrossrefPubMedSearch in Google Scholar
  • 15 Wolfe RR. The underappreciated role of muscle in health and disease. Am J Clin Nutr 2006; 84 (3) 475-482
    PubMedSearch in Google Scholar
  • 16 Breen L, Phillips SM. Skeletal muscle protein metabolism in the elderly: Interventions to counteract the 'anabolic resistance' of ageing. Nutr Metab (Lond) 2011; 8: 68
    CrossrefPubMedSearch in Google Scholar
  • 17 Volpi E, Kobayashi H, Sheffield-Moore M, Mittendorfer B, Wolfe RR. Essential amino acids are primarily responsible for the amino acid stimulation of muscle protein anabolism in healthy elderly adults. Am J Clin Nutr 2003; 78 (2) 250-258
    CrossrefPubMedSearch in Google Scholar
  • 18 Anthony JC, Anthony TG, Kimball SR, Jefferson LS. Signaling pathways involved in translational control of protein synthesis in skeletal muscle by leucine. J Nutr 2001; 131 (3) 856S-860S
    PubMedSearch in Google Scholar
  • 19 Fiatarone MA, O'Neill EF, Ryan ND , et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med 1994; 330 (25) 1769-1775
    CrossrefPubMedSearch in Google Scholar
  • 20 Cermak NM, Res PT, de Groot LC, Saris WH, van Loon LJ. Protein supplementation augments the adaptive response of skeletal muscle to resistance-type exercise training: a meta-analysis. Am J Clin Nutr 2012; 96 (6) 1454-1464
    CrossrefPubMedSearch in Google Scholar
  • 21 Millward DJ. Knowledge gained from studies of leucine consumption in animals and humans. J Nutr 2012; 142 (12) 2212S-2219S
    CrossrefPubMedSearch in Google Scholar
  • 22 English KL, Paddon-Jones D. Protecting muscle mass and function in older adults during bed rest. Curr Opin Clin Nutr Metab Care 2010; 13 (1) 34-39
    CrossrefPubMedSearch in Google Scholar
  • 23 Tang JE, Phillips SM. Maximizing muscle protein anabolism: the role of protein quality. Curr Opin Clin Nutr Metab Care 2009; 12 (1) 66-71
    CrossrefPubMedSearch in Google Scholar
  • 24 Kim TN, Park MS, Lim KI , et al. Relationships between sarcopenic obesity and insulin resistance, inflammation, and vitamin D status: the Korean Sarcopenic Obesity Study. Clin Endocrinol (Oxf) 2013; 78 (4) 525-532
    CrossrefPubMedSearch in Google Scholar
  • 25 Phillips F. Nutrition for healthy ageing. Nutr Bull 2003; 28: 253-263
    CrossrefPubMedSearch in Google Scholar
  • 26 Tieland M, Borgonjen-Van den Berg KJ, van Loon LJC, de Groot LCPMG. Dietary protein intake in community-dwelling, frail, and institutionalized elderly people: scope for improvement. Eur J Nutr 2012; 51 (2) 173-179
    CrossrefPubMedSearch in Google Scholar
  • 27 Symons TB, Sheffield-Moore M, Wolfe RR, Paddon-Jones D. A moderate serving of high-quality protein maximally stimulates skeletal muscle protein synthesis in young and elderly subjects. J Am Diet Assoc 2009; 109: 1582-1586
    CrossrefPubMedSearch in Google Scholar
  • 28 Symons TB, Schutzler SE, Cocke TL, Chinkes DL, Wolfe RR, Paddon-Jones D. Aging does not impair the anabolic response to a protein-rich meal. Am J Clin Nutr 2007; 86 (2) 451-456
    PubMedSearch in Google Scholar
  • 29 Katsanos CS, Kobayashi H, Sheffield-Moore M, Aarsland A, Wolfe RR. Aging is associated with diminished accretion of muscle proteins after the ingestion of a small bolus of essential amino acids. Am J Clin Nutr 2005; 82 (5) 1065-1073
    CrossrefPubMedSearch in Google Scholar
  • 30 Mudge AM, Ross LJ, Young AM, Isenring EA, Banks MD. Helping understand nutritional gaps in the elderly (HUNGER): a prospective study of patient factors associated with inadequate nutritional intake in older medical inpatients. Clin Nutr 2011; 30 (3) 320-325
    CrossrefPubMedSearch in Google Scholar
  • 31 Biolo G, Agostini F, Simunic B , et al. Positive energy balance is associated with accelerated muscle atrophy and increased erythrocyte glutathione turnover during 5.  wk of bed rest. Am J Clin Nutr 2008; 88 (4) 950-958
    PubMedSearch in Google Scholar
  • 32 Coker RH, Miller S, Schutzler S, Deutz N, Wolfe RR. Whey protein and essential amino acids promote the reduction of adipose tissue and increased muscle protein synthesis during caloric restriction-induced weight loss in elderly, obese individuals. Nutr J 2012; 11: 105
    CrossrefPubMedSearch in Google Scholar
  • 33 Tieland M, van de Rest O, Dirks ML , et al. Protein supplementation improves physical performance in frail elderly people: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc 2012; 13 (8) 720-726
    CrossrefPubMedSearch in Google Scholar
  • 34 Ferrando AA, Paddon-Jones D, Hays NP , et al. EAA supplementation to increase nitrogen intake improves muscle function during bed rest in the elderly. Clin Nutr 2010; 29 (1) 18-23
    CrossrefPubMedSearch in Google Scholar
  • 35 Rondanelli M, Opizzi A, Antoniello N , et al. Effect of essential amino acid supplementation on quality of life, amino acid profile and strength in institutionalized elderly patients. Clin Nutr 2011; 30 (5) 571-577
    CrossrefPubMedSearch in Google Scholar
  • 36 Bollwein J, Diekmann R, Kaiser MJ , et al. Distribution but not amount of protein intake is associated with frailty: a cross-sectional investigation in the region of Nurnberg. Nutr J 2013; 12 (1) 109
    CrossrefPubMedSearch in Google Scholar
  • 37 Cawood AL, Elia M, Stratton RJ. Systematic review and meta-analysis of the effects of high protein oral nutritional supplements. Ageing Res Rev 2012; 11 (2) 278-296
    CrossrefPubMedSearch in Google Scholar
  • 38 Bjorkman MP, Finne-Soveri H, Tilvis RS. Whey protein supplementation in nursing home residents. A Randomized controlled trial. Eur Geri Med 2012; 3: 161-166
    PubMedSearch in Google Scholar
  • 39 McGregor RA, Poppitt SD. Milk protein for improved metabolic health: a review of the evidence. Nutr Metab (Lond) 2013; 10 (1) 46
    CrossrefPubMedSearch in Google Scholar
  • 40 Solerte SB, Gazzaruso C, Bonacasa R , et al. Nutritional supplements with oral amino acid mixtures increases whole-body lean mass and insulin sensitivity in elderly subjects with sarcopenia. Am J Cardiol 2008; 101 1A 69E-77E
    PubMedSearch in Google Scholar
  • 41 Børsheim E, Bui QU, Tissier S, Kobayashi H, Ferrando AA, Wolfe RR. Effect of amino acid supplementation on muscle mass, strength and physical function in elderly. Clin Nutr 2008; 27 (2) 189-195
    CrossrefPubMedSearch in Google Scholar
  • 42 Scognamiglio R, Piccolotto R, Negut C, Tiengo A, Avogaro A. Oral amino acids in elderly subjects: effect on myocardial function and walking capacity. Gerontology 2005; 51 (5) 302-308
    CrossrefPubMedSearch in Google Scholar
  • 43 Sousa GT, Lira FS, Rosa JC , et al. Dietary whey protein lessens several risk factors for metabolic diseases: a review. Lipids Health Dis 2012; 11: 67
    CrossrefPubMedSearch in Google Scholar
  • 44 Cribb PJ, Williams AD, Stathis CG, Carey MF, Hayes A. Effects of whey isolate, creatine, and resistance training on muscle hypertrophy. Med Sci Sports Exerc 2007; 39 (2) 298-307
    CrossrefPubMedSearch in Google Scholar
  • 45 Mah E, Noh SK, Ballard KD, Matos ME, Volek JS, Bruno RS. Postprandial hyperglycemia impairs vascular endothelial function in healthy men by inducing lipid peroxidation and increasing asymmetric dimethylarginine:arginine. J Nutr 2011; 141 (11) 1961-1968
    CrossrefPubMedSearch in Google Scholar
  • 46 Ballard KD, Kupchak BR, Volk BM , et al. Acute effects of ingestion of a novel whey-derived extract on vascular endothelial function in overweight, middle-aged men and women. Br J Nutr 2013; 109 (5) 882-893
    CrossrefPubMedSearch in Google Scholar
  • 47 Pal S, Ellis V. Acute effects of whey protein isolate on blood pressure, vascular function and inflammatory markers in overweight postmenopausal women. Br J Nutr 2011; 105 (10) 1512-1519
    CrossrefPubMedSearch in Google Scholar
  • 48 Ballard KD. Cardiovascular effects of chronic and acute whey protein ingestion. Br J Nutr 2011; 105 (10) 1415-1417
    CrossrefPubMedSearch in Google Scholar
  • 49 Larsen RN, Mann NJ, Maclean E, Shaw JE. The effect of high-protein, low-carbohydrate diets in the treatment of type 2 diabetes: a 12.  month randomised controlled trial. Diabetologia 2011; 54 (4) 731-740
    CrossrefPubMedSearch in Google Scholar
  • 50 Bauer J, Biolo G, Cederholm T , et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc 2013; 14 (8) 542-559
    CrossrefPubMedSearch in Google Scholar
  • 51 Katsanos CS, Kobayashi H, Sheffield-Moore M, Aarsland A, Wolfe RR. A high proportion of leucine is required for optimal stimulation of the rate of muscle protein synthesis by essential amino acids in the elderly. Am J Physiol Endocrinol Metab 2006; 291 (2) E381 E387.
    CrossrefPubMedSearch in Google Scholar
  • 52 Rieu I, Balage M, Sornet C , et al. Leucine supplementation improves muscle protein synthesis in elderly men independently of hyperaminoacidaemia. J Physiol 2006; 575 (Pt 1) 305-315
    CrossrefPubMedSearch in Google Scholar
  • 53 Balage M, Dardevet D. Long-term effects of leucine supplementation on body composition. Curr Opin Clin Nutr Metab Care 2010; 13 (3) 265-270
    CrossrefPubMedSearch in Google Scholar
  • 54 Norton LE, Layman DK. Leucine regulates translation initiation of protein synthesis in skeletal muscle after exercise. J Nutr 2006; 136 (2) 533S-537S
    PubMedSearch in Google Scholar
  • 55 Layman DK, Walker DA. Potential importance of leucine in treatment of obesity and the metabolic syndrome. J Nutr 2006; 136 (1, Suppl) 319S-323S
    PubMedSearch in Google Scholar
  • 56 Layman DK. The role of leucine in weight loss diets and glucose homeostasis. J Nutr 2003; 133 (1) 261S-267S
    PubMedSearch in Google Scholar
  • 57 Drummond MJ, Rasmussen BB. Leucine-enriched nutrients and the regulation of mammalian target of rapamycin signalling and human skeletal muscle protein synthesis. Curr Opin Clin Nutr Metab Care 2008; 11 (3) 222-226
    CrossrefPubMedSearch in Google Scholar
  • 58 Casperson SL, Sheffield-Moore M, Hewlings SJ, Paddon-Jones D. Leucine supplementation chronically improves muscle protein synthesis in older adults consuming the RDA for protein. Clin Nutr 2012; 31 (4) 512-519
    CrossrefPubMedSearch in Google Scholar
  • 59 Leenders M, Verdijk LB, van der Hoeven L , et al. Prolonged leucine supplementation does not augment muscle mass or affect glycemic control in elderly type 2 diabetic men. J Nutr 2011; 141 (6) 1070-1076
    CrossrefPubMedSearch in Google Scholar
  • 60 van Loon LJC. Leucine as a pharmaconutrient in health and disease. Curr Opin Clin Nutr Metab Care 2012; 15 (1) 71-77
    CrossrefPubMedSearch in Google Scholar
  • 61 Katsanos CS, Chinkes DL, Paddon-Jones D, Zhang XJ, Aarsland A, Wolfe RR. Whey protein ingestion in elderly persons results in greater muscle protein accrual than ingestion of its constituent essential amino acid content. Nutr Res 2008; 28 (10) 651-658
    CrossrefPubMedSearch in Google Scholar
  • 62 Pennings B, Groen B, de Lange A , et al. Amino acid absorption and subsequent muscle protein accretion following graded intakes of whey protein in elderly men. Am J Physiol Endocrinol Metab 2012; 302: E992-E999
    CrossrefPubMedSearch in Google Scholar
  • 63 Dangin M, Guillet C, Garcia-Rodenas C , et al. The rate of protein digestion affects protein gain differently during aging in humans. J Physiol 2003; 549 (Pt 2) 635-644
    CrossrefPubMedSearch in Google Scholar
  • 64 Phillips SM, Tang JE, Moore DR. The role of milk- and soy-based protein in support of muscle protein synthesis and muscle protein accretion in young and elderly persons. J Am Coll Nutr 2009; 28 (4) 343-354
    CrossrefPubMedSearch in Google Scholar
  • 65 Pennings B, Boirie Y, Senden JMG, Gijsen AP, Kuipers H, van Loon LJC. Whey protein stimulates postprandial muscle protein accretion more effectively than do casein and casein hydrolysate in older men. Am J Clin Nutr 2011; 93 (5) 997-1005
    CrossrefPubMedSearch in Google Scholar
  • 66 Dawson B, Foster T. Selection Criteria for oral nutritional support (ONS) products used by dietitians involved in aged care. Are professionals using evidenced based selection criteria?. Nutr Diet 2012; 69 (Suppl. 01) 80
    CrossrefPubMedSearch in Google Scholar
  • 67 Jukkola K, MacLennan P. Improving the efficacy of nutritional supplementation in the hospitalised elderly. Australas J Ageing 2005; 24 (2) 119-124
    CrossrefPubMedSearch in Google Scholar
  • 68 Mojtahedi MC, Thorpe MP, Karampinos DC , et al. The effects of a higher protein intake during energy restriction on changes in body composition and physical function in older women. J Gerontol A Biol Sci Med Sci 2011; 66 (11) 1218-1225
    PubMedSearch in Google Scholar
  • 69 Cook Z, Kirk S, Lawrenson S, Sandford S. Use of BMI in the assessment of undernutrition in older subjects: reflecting on practice. Proc Nutr Soc 2005; 64 (3) 313-317
    CrossrefPubMedSearch in Google Scholar
  • 70 Ferreira RS, da Silva Coqueiro R, Barbosa AR, Pinheiro PA, Fernandes MH. Relationship between BMI and physical performance among older adults. Geriatr Nurs 2013; 34 (6) 465-468
    CrossrefPubMedSearch in Google Scholar
  • 71 Janssen I, Katzmarzyk PT, Ross R. Body mass index is inversely related to mortality in older people after adjustment for waist circumference. J Am Geriatr Soc 2005; 53 (12) 2112-2118
    CrossrefPubMedSearch in Google Scholar
  • 72 Hirani V, Aresu M. Development of new demi-span equations from a nationally representative sample of older people to estimate adult height. J Am Geriatr Soc 2012; 60 (3) 550-554
    CrossrefPubMedSearch in Google Scholar