Low protein intake tied to functional limitations, independent of diabetes status
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More than half of adults with diabetes did not meet recommended protein intake guidelines, which was associated with increased functional limitations during tasks such as stooping and kneeling, according to findings published in Nutrients.
In an analysis of more than 23,000 U.S. adults with and without diabetes, researchers also found that participants with low protein intake — regardless of diabetes status —were more likely to have poorer overall diet quality and increased functional limitations.
“We have known that protein and other key nutrients are important for everyone, and especially for individuals with diabetes,” Christopher A. Taylor, PhD, RDN, LD, FAND, professor of medical dietetics and family medicine at The Ohio State University College of Medicine, told Healio. “We wanted to understand how people with diabetes are meeting that protein intake goal. We know protein plays a role in physical functionality, and we wanted to learn how not meeting the protein intake goal could impact physical functioning in people with diabetes.”
Taylor and colleagues analyzed data from 23,487 adults aged at least 31 years who participated in the 2005-2016 National Health and Nutrition Examination Survey. Researchers used HbA1c to classify participants as having prediabetes (n = 5,869; HbA1c from 5.7% to 6.4%), diabetes (n = 2,888; HbA1c 6.4%) or no diabetes (n = 14,730). Dietary data were collected from a single, 24-hour dietary recall; diet quality was assessed using the Healthy Eating Index-2015, which measures the alignment of dietary intakes with the 2015-2020 Dietary Guidelines for Americans. Participants were categorized as meeting or below the protein recommendation of 0.8 g/kg of body weight per day. Physical functioning was assessed across 19 discrete physical tasks.
Within the cohort, 51.2% of participants with diabetes, 45.4% of participants with prediabetes and 34.2% of participants without diabetes did not meet the individual protein recommendation.
Researchers found that adults below the protein recommendation consumed significantly more carbohydrates and had lower diet quality across all glycemic groups compared with those who met the protein recommendation (P < .001). Adults with diabetes who did not meet protein recommendations also had poorer diet quality and a higher mean number of functional limitations.
Additionally, a greater percentage of adults with diabetes who did not meet the protein recommendation reported being physically limited for most activities, with 52% reporting limitations for stooping, crouching and kneeling.
“We see more limitations in these activities of daily living among those that did not meet their recommended protein intake for the day,” Taylor told Healio.
The researchers wrote that the findings underscore the potential for physical limitations associated with low protein intakes, especially in adults with diabetes.
“With diabetes, the focus on education tends to be heavy on sugar and carbohydrate intake,” Taylor said. “With dietary intake, for every action there is an equal and opposite reaction. For everything you remove, there needs to be an addition. We want to promote education for making healthy choices around meeting protein intakes. Our previous work also shows this is happening in middle age as well. This is not just an issue among older adults. We need to focus on education and assessment on the prevention side, even before diabetes.”
Taylor said dietary, strength and mobility assessments can help identify patients who may have dietary or functional challenges and can benefit from nutrition counseling.
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