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      Adaptation and validation of a protein intake screening tool for a UK adult population

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          Abstract

          Adequate dietary protein intake is important in human subjects for maintaining muscle turnover, determining the protein content of tissues and thus the preservation of muscle mass and function as we age. A screening tool to assess if an older individual is likely to have a lower dietary protein intake (predicted probability of protein intake ≤1⋅0 g/kg per d), has been developed for a Netherlands dietary profile, but this has not been validated in a UK population. This study aimed to adapt and then validate the protein screening tool for use in a UK population. Amendment of the tool was undertaken using data from UK BioBank and the UK National Diet and Nutrition Survey to reflect protein sources in the UK diet. Validation of the amended version of the protein screener screening tool was conducted using protein intake derived from a food frequency questionnaire (FFQ) in a sample of UK adults ( n = 184) (age range 18–91 years) as the reference standard. Using the FFQ, 40 % of respondents ( n = 74) reported a protein intake of ≤1⋅0 g per kg body mass. The discriminative accuracy of the amended screener was tested using receiver operating characteristic (ROC) curves. The area under the curve for the ROC was 0⋅731 (95 % CI 0⋅657, 0⋅805), indicating that the amended screener may be a valid tool to screen for individuals consuming ≤1⋅0 g/kg adjusted BM/d in an adult UK population. This protein screener tool is a potential method to screen individuals with a likelihood of habitually consuming protein intakes of ≤1⋅0 g/kg per d. Further validation is needed using a more robust dietary intake methodology and for specific groups, such as older adults. The screener may be applicable across healthcare, clinical and research applications.

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          Sarcopenia: revised European consensus on definition and diagnosis

          Abstract Background in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. Objectives to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. Recommendations sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. Conclusions EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems.
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            Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group.

            New evidence shows that older adults need more dietary protein than do younger adults to support good health, promote recovery from illness, and maintain functionality. Older people need to make up for age-related changes in protein metabolism, such as high splanchnic extraction and declining anabolic responses to ingested protein. They also need more protein to offset inflammatory and catabolic conditions associated with chronic and acute diseases that occur commonly with aging. With the goal of developing updated, evidence-based recommendations for optimal protein intake by older people, the European Union Geriatric Medicine Society (EUGMS), in cooperation with other scientific organizations, appointed an international study group to review dietary protein needs with aging (PROT-AGE Study Group). To help older people (>65 years) maintain and regain lean body mass and function, the PROT-AGE study group recommends average daily intake at least in the range of 1.0 to 1.2 g protein per kilogram of body weight per day. Both endurance- and resistance-type exercises are recommended at individualized levels that are safe and tolerated, and higher protein intake (ie, ≥ 1.2 g/kg body weight/d) is advised for those who are exercising and otherwise active. Most older adults who have acute or chronic diseases need even more dietary protein (ie, 1.2-1.5 g/kg body weight/d). Older people with severe kidney disease (ie, estimated GFR <30 mL/min/1.73 m(2)), but who are not on dialysis, are an exception to this rule; these individuals may need to limit protein intake. Protein quality, timing of ingestion, and intake of other nutritional supplements may be relevant, but evidence is not yet sufficient to support specific recommendations. Older people are vulnerable to losses in physical function capacity, and such losses predict loss of independence, falls, and even mortality. Thus, future studies aimed at pinpointing optimal protein intake in specific populations of older people need to include measures of physical function. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.
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              Dietary assessment methods in epidemiologic studies

              Diet is a major lifestyle-related risk factor of various chronic diseases. Dietary intake can be assessed by subjective report and objective observation. Subjective assessment is possible using open-ended surveys such as dietary recalls or records, or using closed-ended surveys including food frequency questionnaires. Each method has inherent strengths and limitations. Continued efforts to improve the accuracy of dietary intake assessment and enhance its feasibility in epidemiological studies have been made. This article reviews common dietary assessment methods and their feasibility in epidemiological studies.
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                Author and article information

                Journal
                J Nutr Sci
                J Nutr Sci
                JNS
                Journal of Nutritional Science
                Cambridge University Press (Cambridge, UK )
                2048-6790
                2022
                10 November 2022
                : 11
                : e100
                Affiliations
                [1 ]Department of Oncology and Metabolism, The Medical School, The University of Sheffield , Sheffield S10 2RX, UK
                [2 ]Sport and Physical Activity Research Centre, Sheffield Hallam University , Sheffield S10 2BP, UK
                [3 ]Department of Health Sciences, Faculty of Science, and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam , Amsterdam 1081 HV, The Netherlands
                [4 ]Human Nutrition Research Centre, Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University , Newcastle NE2 4HH, UK
                Author notes
                [* ] Corresponding author: Esme R. Tuttiett, email ertuttiett1@ 123456sheffield.ac.uk
                Author information
                https://orcid.org/0000-0002-7591-4099
                https://orcid.org/0000-0003-0449-2228
                https://orcid.org/0000-0002-1431-7549
                Article
                S2048679022000969
                10.1017/jns.2022.96
                9672832
                36405091
                d32e9dd6-93e5-4c9e-b87f-7d652e8d6107
                © The Author(s) 2022

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.

                History
                : 19 July 2022
                : 04 October 2022
                : 06 October 2022
                Page count
                Figures: 3, Tables: 2, References: 41, Pages: 7
                Funding
                Funded by: Medical Research Council, doi http://dx.doi.org/10.13039/501100000265;
                Award ID: MR/R502182/1
                Categories
                Research Article
                Human and Clinical Nutrition

                nutritional assessment,protein intake,rapid screening,validation

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