Combination Effect of Increased Amount of High Animal Protein Food Intake and Resistance Exercise on Frail Prevention : Intended for Elderly People Covered by Long-term Care Insurance in Japan
Previous studies in interventions for frail elderly people have reported that increased protein intake by nutrition supplements with exercise training improved grip strength. However, there are few intervention studies that demonstrated whether increased the amount of protein intake by the dietary f...
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| Published in | JOURNAL OF JAPAN HEALTH MEDICINE ASSOCIATION Vol. 31; no. 2; pp. 159 - 169 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
JAPAN HEALTH MEDICINE ASSOCIATION
25.07.2022
日本健康医学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1343-0025 2423-9828 |
| DOI | 10.20685/kenkouigaku.31.2_159 |
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| Abstract | Previous studies in interventions for frail elderly people have reported that increased protein intake by nutrition supplements with exercise training improved grip strength. However, there are few intervention studies that demonstrated whether increased the amount of protein intake by the dietary foods improved frailty. In this study, we examined the combination effects of providing high animal protein foods (20 g of protein/day) and exercise on body composition and physical function in the elderly person cared. Providing high animal protein foods significantly increased the estimated animal protein intake evaluated by the brief self-administered diet history questionnaire, compared to that of before intervention. The muscle mass and grip strength (right hand) were significantly increased and the body fat percentage was significantly decreased, following increased high animal protein foods intake plus exercise once or twice a week (180 min each time) for 3 months, compared to that before intervention. However, 3-months after interruption of food intervention, muscle mass was significantly lower than that after food intake plus exercise intervention. There was a significant positive correlation between the changes of muscle mass and estimated dairy products intakes increased by food intervention. Furthermore, our hearing survey indicated that 78% of subjects ingested high protein dairy products at breakfast. Previous studies demonstrated that increased protein intake at breakfast is better for the maintenance and enhancement of muscle mass. Therefore, we considered that consumption of the high protein dairy products in the morning was partially related with the increases in muscle mass. These results suggested that having the high protein at the right time of the day with proper exercise is important for preventing frailty in elderly people. |
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| AbstractList | Previous studies in interventions for frail elderly people have reported that increased protein intake by nutrition supplements with exercise training improved grip strength. However, there are few intervention studies that demonstrated whether increased the amount of protein intake by the dietary foods improved frailty. In this study, we examined the combination effects of providing high animal protein foods (20 g of protein/day) and exercise on body composition and physical function in the elderly person cared. Providing high animal protein foods significantly increased the estimated animal protein intake evaluated by the brief self-administered diet history questionnaire, compared to that of before intervention. The muscle mass and grip strength (right hand) were significantly increased and the body fat percentage was significantly decreased, following increased high animal protein foods intake plus exercise once or twice a week (180 min each time) for 3 months, compared to that before intervention. However, 3-months after interruption of food intervention, muscle mass was significantly lower than that after food intake plus exercise intervention. There was a significant positive correlation between the changes of muscle mass and estimated dairy products intakes increased by food intervention. Furthermore, our hearing survey indicated that 78% of subjects ingested high protein dairy products at breakfast. Previous studies demonstrated that increased protein intake at breakfast is better for the maintenance and enhancement of muscle mass. Therefore, we considered that consumption of the high protein dairy products in the morning was partially related with the increases in muscle mass. These results suggested that having the high protein at the right time of the day with proper exercise is important for preventing frailty in elderly people.
フレイルまたはサルコペニアを有する高齢者を対象とした介入試験において，運動に加えてたんぱく質を負荷することで握力が高くなる報告がある。これらの介入試験では，たんぱく質としてサプリメントを用いており，実際の食事から摂取するたんぱく質量を増やして身体組成を評価した研究はほとんど見当たらない。そこで本研究では，介護保険を用いてデイリハビリセンターを利用している要支援・要介護高齢者に対して，高たんぱく質乳製品および食肉含有加工食品の提供（たんぱく質20 g/日分）と週1～2回の運動（1回180分間）の複合的介入を行い，身体組成および身体機能に及ぼす影響を検討した。対象者27名に対して，食品の提供および運動介入を3ヶ月行い（食事+運動介入），続いて運動介入のみを3ヶ月間行った（運動のみ介入）。簡易型自記式食事歴法質問票を用いた食事調査の結果，介入前と比較して，食事介入によって，動物性たんぱく質の推定摂取量が有意に増加した。また介入前と比較して，食事+運動介入後には対象者の筋肉量および握力（右手）が有意に上昇し，さらに体脂肪率が有意に低下した。運動のみ介入後は，食事+運動介入後と比較して，筋肉量が有意に低かった。筋肉量と乳類の推定摂取量の変化量との間に有意な正の相関が見られた。高たんぱく質乳製品摂取のタイミングを調査したところ，対象者の78％が朝食時に摂取していた。朝食時のたんぱく質摂取量を増やすことが筋肉量を高めることに有効である報告があることから，食事介入で提供した高たんぱく質乳製品を朝食時に摂取して，たんぱく質摂取量を増やしたことが，筋肉量の増加に関与したと考えた。これらのことから，運動負荷に加え，食事内容を改善することによって，筋肉量の増加を介して，高齢者のフレイルの予防が可能であると考えた。 Previous studies in interventions for frail elderly people have reported that increased protein intake by nutrition supplements with exercise training improved grip strength. However, there are few intervention studies that demonstrated whether increased the amount of protein intake by the dietary foods improved frailty. In this study, we examined the combination effects of providing high animal protein foods (20 g of protein/day) and exercise on body composition and physical function in the elderly person cared. Providing high animal protein foods significantly increased the estimated animal protein intake evaluated by the brief self-administered diet history questionnaire, compared to that of before intervention. The muscle mass and grip strength (right hand) were significantly increased and the body fat percentage was significantly decreased, following increased high animal protein foods intake plus exercise once or twice a week (180 min each time) for 3 months, compared to that before intervention. However, 3-months after interruption of food intervention, muscle mass was significantly lower than that after food intake plus exercise intervention. There was a significant positive correlation between the changes of muscle mass and estimated dairy products intakes increased by food intervention. Furthermore, our hearing survey indicated that 78% of subjects ingested high protein dairy products at breakfast. Previous studies demonstrated that increased protein intake at breakfast is better for the maintenance and enhancement of muscle mass. Therefore, we considered that consumption of the high protein dairy products in the morning was partially related with the increases in muscle mass. These results suggested that having the high protein at the right time of the day with proper exercise is important for preventing frailty in elderly people. |
| Author | Kudo, Kazuyuki Nishiyama, Toshimasa Umemura, Koji Murakami, Yuki Miyake, Mari Hosomi, Ryota |
| Author_FL | 村上 由希 工藤 和幸 西山 利正 三宅 眞理 梅村 享司 細見 亮太 |
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| Author_xml | – sequence: 1 fullname: Murakami, Yuki organization: Department of Hygiene and Public Health, Kansai Medical University – sequence: 1 fullname: Kudo, Kazuyuki organization: Lifestyle Research Office, NH Foods Ltd – sequence: 1 fullname: Miyake, Mari organization: Department of Hygiene and Public Health, Kansai Medical University – sequence: 1 fullname: Umemura, Koji organization: Lifestyle Research Office, NH Foods Ltd – sequence: 1 fullname: Hosomi, Ryota organization: Department of Life Science and Biotechnology, Kansai University – sequence: 1 fullname: Nishiyama, Toshimasa organization: Department of Hygiene and Public Health, Kansai Medical University |
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| DocumentTitle_FL | たんぱく質含有食品の提供および運動の複合的介入によるフレイル予防効果 |
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| References | 12) Park Y, Choi JE, Hwang HS : Protein supplementation improves muscle mass and physical performance in undernourished prefrail and frail elderly subjects : a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr 108 : 1026-1033, 2018 27) 厚生労働省：令和元年国民健康・栄養調査報告, 第1部 栄養素等摂取状況調査の結果，https://www.mhlw.go.jp/content/000711006.pdf（アクセス2022年1月17日） 18) 運動器の機能向上マニュアル分担研究班：運動器の機能向上マニュアル（改訂版），https://www.mhlw.go.jp/topics/2009/05/dl/tp0501-1d.pdf（アクセス2022年1月17日） 19) 文部科学省：食品成分データベース，https://fooddb.mext.go.jp/index.pl（アクセス2022年1月17日） 8) Ahlskog JE, Geda YE, Graff-Radford NR, Petersen RC : Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. Mayo Clin Proc 86 : 876-884, 2011 11) Liao CD, Lee PH, Hsiao DJ, Huang SW, Tsauo JY, Chen HC, Liou TH : Effects of Protein Supplementation Combined with Exercise Intervention on Frailty Indices, Body Composition, and Physical Function in Frail Older Adults. Nutrients 10 : 1916, 2018 28) Aoyama S, Kim HK, Hirooka R, Tanaka M, Shimoda T, Chijiki H, Kojima S, Sasaki K, Takahashi K, Makino S, Takizawa M, Takahashi M, Tahara Y, Shimba S, Shinohara K, Shibata S : Distribution of dietary protein intake in daily meals influences skeletal muscle hypertrophy via the muscle clock. Cell Rep 36 : 109336, 2021 20) Rosenberg IH : Sarcopenia : origins and clinical relevance. J Nutr 127 : 990S-991S, 1997 24) Ten Haaf DSM, Nuijten MAH, Maessen MFH, Horstman AMH, Eijsvogels TMH, Hopman MTE : Effects of protein supplementation on lean body mass, muscle strength, and physical performance in nonfrail community-dwelling older adults : a systematic review and meta-analysis. Am J Clin Nutr 108 : 1043-1059, 2018 29) Mamerow MM, Mettler JA, English KL, Casperson SL, Arentson-Lantz E, Sheffield-Moore M, Layman DK, Paddon-Jones D : Dietary protein distribution positively influences 24-h muscle protein synthesis in healthy adults. J Nutr 144 : 876-880, 2014 21) Seino S, Sumi K, Narita M, Yokoyama Y, Ashida K, Kitamura A, Shinkai S : Effects of low-dose dairy protein plus micronutrient supplementation during resistance exercise on muscle mass and physical performance in older adults : A randomized, controlled trial. J Nutr Health Aging 22 : 59-67, 2018 23) Mertz KH, Reitelseder S, Bechshoeft R, Bulow J, Højfeldt G, Jensen M, Schacht SR, Lind MV, Rasmussen MA, Mikkelsen UR, Tetens I, Engelsen SB, Nielsen DS, Jespersen AP, Holm L : The effect of daily protein supplementation, with or without resistance training for 1 year, on muscle size, strength, and function in healthy older adults : A randomized controlled trial. Am J Clin Nutr 113 : 790-800, 2021 1) 内閣府：令和3年版高齢社会白書（全体版）第1章 高齢化の状況，https://www8.cao.go.jp/kourei/whitepaper/w-2021/zenbun/pdf/1s1s_01.pdf（アクセス2022年1月17日） 26) Kobayashi S, Murakami K, Sasaki S, Okubo H, Hirota N, Notsu A, Fukui M, Date C : Comparison of relative validity of food group intakes estimated by comprehensive and brief-type self-administered diet history questionnaires against 16 d dietary records in Japanese adults. Public Health Nutr 14 : 1200-1211, 2011 16) Satake S, Shimada H, Yamada M, Kim H, Yoshida H, Gondo Y, Matsubayashi K, Matsushita E, Kuzuya M, Kozaki K, Sugimoto K, Senda K, Sakuma M, Endo N, Arai H : Prevalence of frailty among community-dwellers and outpatients in Japan as defined by the Japanese version of the Cardiovascular Health Study criteria. Geriatr Gerontol Int 17 : 2629-2634, 2017 13) 厚生労働省：日本人の食事摂取基準［2020年版］，pp114-117，第一出版，東京，2019 9) サルコペニア診療ガイドライン作成委員会編：サルコペニア診療ガイドライン2017版一部改訂．84 pp，ライフサイエンス出版，東京，2020 5) Fried LP, Tangen CM, Walston J, Newman AB, HirschC, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA, Cardiovascular Health Study Collaborative Research Group : Frailty in older adults: evidence fora phenotype. J Gerontol A Biol Sci Med Sci 56 : M146-156, 2001 10) Walrand S, Short KR, Bigelow ML, Sweatt AJ, Hutson SM, Nair KS : Functional impact of high protein intake on healthy elderly people. Am J Physiol Endocrinol Metab 295 : E921-E928, 2008 7) 荒木 厚：フレイルと認知機能障害．老年精医誌 27：497-503，2016 4) Ishikawa-Takata K, Takimoto H : Current protein and amino acid intakes among Japanese people : Analysis of the 2012 National Health and Nutrition Survey. Geriatr Gerontol Int 18 : 723-731, 2018 2) 内閣府：平成30年版高齢社会白書（全体版）第2節 高齢期の暮らしの動向（2），https://www8.cao.go.jp/kourei/whitepaper/w-2018/html/zenbun/s1_2_2.html（アクセス2022年1月17日） 3) 荒井秀典：フレイルの意義，日老医誌 51：497-501，2014 6) Shimada H, Makizako H, Doi T, Yoshida D, Tsutsumimoto K, Anan Y, Uemura K, Ito T, Lee S, Park H, Suzuki T : Combined prevalence of frailty and mild cognitive impairment in a population of elderly Japanese people. J Am Med Dir Assoc 14 : 518-524, 2013 14) 三宅眞理，淵岡 聡，細見亮太，久保田眞由美，増田俊介，梅村享司，西山利正：軽度認知症とフレイル対策．介護予防・健康づくり 5：82-85，2018 15) 介護予防のための生活機能評価に関するマニュアル分担研究班：介護予防のための生活機能評価に関するマニュアル（改訂版），https://www.mhlw.go.jp/topics/2009/05/dl/tp0501-1c_0001.pdf（アクセス2022年1月17日） 25) 佐々木敏：高齢者の低栄養予防と栄養からみたフレイル予防 : エビデンスと課題：概論．公衆衛生 85：502-512，2021 17) Kobayashi S, Honda S, Murakami K, Sasaki S, Okubo H, Hirota N, Notsu A, Fukui M, Date C : Both comprehensive and brief self-administered diet history questionnaires satisfactorily rank nutrient intakes in Japanese adults. J Epidemiol 22 : 151-159, 2012 22) Yamada M, Kimura Y, Ishiyama D, Nishio N, Otobe Y, Tanaka T, Ohji S, Koyama S, Sato A, Suzuki M, Ogawa H, Ichikawa T, Ito D, Arai H : Synergistic effect of bodyweight resistance exercise and protein supplementation on skeletal muscle in sarcopenic or dynapenic older adults. Geriatr Gerontol Int 19 : 429-437, 2019 |
| References_xml | – reference: 25) 佐々木敏：高齢者の低栄養予防と栄養からみたフレイル予防 : エビデンスと課題：概論．公衆衛生 85：502-512，2021 – reference: 3) 荒井秀典：フレイルの意義，日老医誌 51：497-501，2014 – reference: 2) 内閣府：平成30年版高齢社会白書（全体版）第2節 高齢期の暮らしの動向（2），https://www8.cao.go.jp/kourei/whitepaper/w-2018/html/zenbun/s1_2_2.html（アクセス2022年1月17日） – reference: 19) 文部科学省：食品成分データベース，https://fooddb.mext.go.jp/index.pl（アクセス2022年1月17日） – reference: 7) 荒木 厚：フレイルと認知機能障害．老年精医誌 27：497-503，2016 – reference: 26) Kobayashi S, Murakami K, Sasaki S, Okubo H, Hirota N, Notsu A, Fukui M, Date C : Comparison of relative validity of food group intakes estimated by comprehensive and brief-type self-administered diet history questionnaires against 16 d dietary records in Japanese adults. Public Health Nutr 14 : 1200-1211, 2011 – reference: 16) Satake S, Shimada H, Yamada M, Kim H, Yoshida H, Gondo Y, Matsubayashi K, Matsushita E, Kuzuya M, Kozaki K, Sugimoto K, Senda K, Sakuma M, Endo N, Arai H : Prevalence of frailty among community-dwellers and outpatients in Japan as defined by the Japanese version of the Cardiovascular Health Study criteria. Geriatr Gerontol Int 17 : 2629-2634, 2017 – reference: 21) Seino S, Sumi K, Narita M, Yokoyama Y, Ashida K, Kitamura A, Shinkai S : Effects of low-dose dairy protein plus micronutrient supplementation during resistance exercise on muscle mass and physical performance in older adults : A randomized, controlled trial. J Nutr Health Aging 22 : 59-67, 2018 – reference: 18) 運動器の機能向上マニュアル分担研究班：運動器の機能向上マニュアル（改訂版），https://www.mhlw.go.jp/topics/2009/05/dl/tp0501-1d.pdf（アクセス2022年1月17日） – reference: 20) Rosenberg IH : Sarcopenia : origins and clinical relevance. J Nutr 127 : 990S-991S, 1997 – reference: 9) サルコペニア診療ガイドライン作成委員会編：サルコペニア診療ガイドライン2017版一部改訂．84 pp，ライフサイエンス出版，東京，2020 – reference: 15) 介護予防のための生活機能評価に関するマニュアル分担研究班：介護予防のための生活機能評価に関するマニュアル（改訂版），https://www.mhlw.go.jp/topics/2009/05/dl/tp0501-1c_0001.pdf（アクセス2022年1月17日） – reference: 10) Walrand S, Short KR, Bigelow ML, Sweatt AJ, Hutson SM, Nair KS : Functional impact of high protein intake on healthy elderly people. Am J Physiol Endocrinol Metab 295 : E921-E928, 2008 – reference: 11) Liao CD, Lee PH, Hsiao DJ, Huang SW, Tsauo JY, Chen HC, Liou TH : Effects of Protein Supplementation Combined with Exercise Intervention on Frailty Indices, Body Composition, and Physical Function in Frail Older Adults. Nutrients 10 : 1916, 2018 – reference: 13) 厚生労働省：日本人の食事摂取基準［2020年版］，pp114-117，第一出版，東京，2019 – reference: 14) 三宅眞理，淵岡 聡，細見亮太，久保田眞由美，増田俊介，梅村享司，西山利正：軽度認知症とフレイル対策．介護予防・健康づくり 5：82-85，2018 – reference: 12) Park Y, Choi JE, Hwang HS : Protein supplementation improves muscle mass and physical performance in undernourished prefrail and frail elderly subjects : a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr 108 : 1026-1033, 2018 – reference: 29) Mamerow MM, Mettler JA, English KL, Casperson SL, Arentson-Lantz E, Sheffield-Moore M, Layman DK, Paddon-Jones D : Dietary protein distribution positively influences 24-h muscle protein synthesis in healthy adults. J Nutr 144 : 876-880, 2014 – reference: 8) Ahlskog JE, Geda YE, Graff-Radford NR, Petersen RC : Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. Mayo Clin Proc 86 : 876-884, 2011 – reference: 5) Fried LP, Tangen CM, Walston J, Newman AB, HirschC, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA, Cardiovascular Health Study Collaborative Research Group : Frailty in older adults: evidence fora phenotype. J Gerontol A Biol Sci Med Sci 56 : M146-156, 2001 – reference: 6) Shimada H, Makizako H, Doi T, Yoshida D, Tsutsumimoto K, Anan Y, Uemura K, Ito T, Lee S, Park H, Suzuki T : Combined prevalence of frailty and mild cognitive impairment in a population of elderly Japanese people. J Am Med Dir Assoc 14 : 518-524, 2013 – reference: 1) 内閣府：令和3年版高齢社会白書（全体版）第1章 高齢化の状況，https://www8.cao.go.jp/kourei/whitepaper/w-2021/zenbun/pdf/1s1s_01.pdf（アクセス2022年1月17日） – reference: 17) Kobayashi S, Honda S, Murakami K, Sasaki S, Okubo H, Hirota N, Notsu A, Fukui M, Date C : Both comprehensive and brief self-administered diet history questionnaires satisfactorily rank nutrient intakes in Japanese adults. J Epidemiol 22 : 151-159, 2012 – reference: 23) Mertz KH, Reitelseder S, Bechshoeft R, Bulow J, Højfeldt G, Jensen M, Schacht SR, Lind MV, Rasmussen MA, Mikkelsen UR, Tetens I, Engelsen SB, Nielsen DS, Jespersen AP, Holm L : The effect of daily protein supplementation, with or without resistance training for 1 year, on muscle size, strength, and function in healthy older adults : A randomized controlled trial. Am J Clin Nutr 113 : 790-800, 2021 – reference: 24) Ten Haaf DSM, Nuijten MAH, Maessen MFH, Horstman AMH, Eijsvogels TMH, Hopman MTE : Effects of protein supplementation on lean body mass, muscle strength, and physical performance in nonfrail community-dwelling older adults : a systematic review and meta-analysis. 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| Title | Combination Effect of Increased Amount of High Animal Protein Food Intake and Resistance Exercise on Frail Prevention : Intended for Elderly People Covered by Long-term Care Insurance in Japan |
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