Protein intake and incident frailty in the women's health initiative observational study

Jeannette M. Beasley, Andrea Z. Lacroix, Marian L. Neuhouser, Ying Huang, Lesley Tinker, Nancy Woods, Yvonne Michael, J. David Curb, Ross L. Prentice

Research output: Contribution to journalArticle

162 Citations (Scopus)

Abstract

Objectives: To evaluate the association between protein intake and incident frailty. Design: Prospective cohort study. Setting: Subset of the Women's Health Initiative Observational Study conducted at 40 clinical centers. Participants: Twenty-four thousand four hundred seventeen women aged 65 to 79 who were free of frailty at baseline with plausible self-reported energy intakes (600-5,000 kcal/day) according to the Food Frequency Questionnaire (FFQ). Measurements: Baseline protein intake was estimated from the FFQ. Calibrated estimates of energy and protein intake were corrected for measurement error using regression calibration equations estimated from objective measures of total energy expenditure (doubly labeled water) and dietary protein (24-hour urinary nitrogen). After 3 years of follow-up, frailty was defined as having at least three of the following components: low physical function (measured using the Rand-36 questionnaire), exhaustion, low physical activity, and unintended weight loss. Multinomial logistic regression models estimated associations for uncalibrated and calibrated protein intake. Results: Of the 24,417 eligible women, 3,298 (13.5%) developed frailty over 3 years. After adjustment for confounders, a 20% increase in uncalibrated protein intake (%kcal) was associated with a 12% (95% confidence interval (CI)=8-16%) lower risk of frailty, and a 20% increase in calibrated protein intake was associated with a 32% (95% CI=23-50%) lower risk of frailty. Conclusion: Higher protein consumption, as a fraction of energy, is associated with a strong, independent, dose-responsive lower risk of incident frailty in older women. Using uncalibrated measures underestimated the strength of the association. Incorporating more protein into the diet may be an intervention target for frailty prevention.

Original languageEnglish (US)
Pages (from-to)1063-1071
Number of pages9
JournalJournal of the American Geriatrics Society
Volume58
Issue number6
DOIs
StatePublished - 2010
Externally publishedYes

Fingerprint

Women's Health
Observational Studies
Proteins
Energy Intake
Logistic Models
Confidence Intervals
Food
Dietary Proteins
Energy Metabolism
Calibration
Weight Loss
Cohort Studies
Nitrogen
Prospective Studies
Exercise
Diet
Water
Surveys and Questionnaires

Keywords

  • Calibration
  • Essential amino acids
  • Frailty
  • Measurement error
  • Protein

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Medicine(all)

Cite this

Beasley, J. M., Lacroix, A. Z., Neuhouser, M. L., Huang, Y., Tinker, L., Woods, N., ... Prentice, R. L. (2010). Protein intake and incident frailty in the women's health initiative observational study. Journal of the American Geriatrics Society, 58(6), 1063-1071. https://doi.org/10.1111/j.1532-5415.2010.02866.x

Protein intake and incident frailty in the women's health initiative observational study. / Beasley, Jeannette M.; Lacroix, Andrea Z.; Neuhouser, Marian L.; Huang, Ying; Tinker, Lesley; Woods, Nancy; Michael, Yvonne; Curb, J. David; Prentice, Ross L.

In: Journal of the American Geriatrics Society, Vol. 58, No. 6, 2010, p. 1063-1071.

Research output: Contribution to journalArticle

Beasley, JM, Lacroix, AZ, Neuhouser, ML, Huang, Y, Tinker, L, Woods, N, Michael, Y, Curb, JD & Prentice, RL 2010, 'Protein intake and incident frailty in the women's health initiative observational study', Journal of the American Geriatrics Society, vol. 58, no. 6, pp. 1063-1071. https://doi.org/10.1111/j.1532-5415.2010.02866.x
Beasley, Jeannette M. ; Lacroix, Andrea Z. ; Neuhouser, Marian L. ; Huang, Ying ; Tinker, Lesley ; Woods, Nancy ; Michael, Yvonne ; Curb, J. David ; Prentice, Ross L. / Protein intake and incident frailty in the women's health initiative observational study. In: Journal of the American Geriatrics Society. 2010 ; Vol. 58, No. 6. pp. 1063-1071.
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abstract = "Objectives: To evaluate the association between protein intake and incident frailty. Design: Prospective cohort study. Setting: Subset of the Women's Health Initiative Observational Study conducted at 40 clinical centers. Participants: Twenty-four thousand four hundred seventeen women aged 65 to 79 who were free of frailty at baseline with plausible self-reported energy intakes (600-5,000 kcal/day) according to the Food Frequency Questionnaire (FFQ). Measurements: Baseline protein intake was estimated from the FFQ. Calibrated estimates of energy and protein intake were corrected for measurement error using regression calibration equations estimated from objective measures of total energy expenditure (doubly labeled water) and dietary protein (24-hour urinary nitrogen). After 3 years of follow-up, frailty was defined as having at least three of the following components: low physical function (measured using the Rand-36 questionnaire), exhaustion, low physical activity, and unintended weight loss. Multinomial logistic regression models estimated associations for uncalibrated and calibrated protein intake. Results: Of the 24,417 eligible women, 3,298 (13.5{\%}) developed frailty over 3 years. After adjustment for confounders, a 20{\%} increase in uncalibrated protein intake ({\%}kcal) was associated with a 12{\%} (95{\%} confidence interval (CI)=8-16{\%}) lower risk of frailty, and a 20{\%} increase in calibrated protein intake was associated with a 32{\%} (95{\%} CI=23-50{\%}) lower risk of frailty. Conclusion: Higher protein consumption, as a fraction of energy, is associated with a strong, independent, dose-responsive lower risk of incident frailty in older women. Using uncalibrated measures underestimated the strength of the association. Incorporating more protein into the diet may be an intervention target for frailty prevention.",
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