title: Treatment of metabolic syndrome by combination of physical activity and diet needs an optimal protein intake: a randomized controlled trial.
abstract: BACKGROUND
  The recommended dietary allowance (RDA) for protein intake has been set at 1.0-1.3 g/kg/day for senior. To date, no consensus exists on the lower threshold intake (LTI = RDA/1.3) for the protein intake (PI) needed in senior patients ongoing both combined caloric restriction and physical activity treatment for metabolic syndrome. Considering that age, caloric restriction and exercise are three increasing factors of protein need, this study was dedicated to determine the minimal PI in this situation, through the determination of albuminemia that is the blood marker of protein homeostasis.
  
  
  METHODS
  Twenty eight subjects (19 M, 9 F, 61.8 ± 6.5 years, BMI 33.4 ± 4.1 kg/m²) with metabolic syndrome completed a three-week residential programme (Day 0 to Day 21) controlled for nutrition (energy balance of -500 kcal/day) and physical activity (3.5 hours/day). Patients were randomly assigned in two groups: Normal-PI (NPI: 1.0 g/kg/day) and High-PI (HPI: 1.2 g/kg/day). Then, patients returned home and were followed for six months. Albuminemia was measured at D0, D21, D90 and D180.
  
  
  RESULTS
  At baseline, PI was spontaneously 1.0 g/kg/day for both groups. Albuminemia was 40.6 g/l for NPI and 40.8 g/l for HPI. A marginal protein under-nutrition appeared in NPI with a decreased albuminemia at D90 below 35 g/l (34.3 versus 41.5 g/l for HPI, p < 0.05), whereas albuminemia remained stable in HPI.
  
  
  CONCLUSIONS
  During the treatment based on restricted diet and exercise in senior people with metabolic syndrome, the lower threshold intake for protein must be set at 1.2 g/kg/day to maintain blood protein homeostasis.
authors.affiliation: Clermont University, Blaise Pascal University, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), BP 10448, F-63000, Clermont-Ferrand, France. fred_dutheil@yahoo.fr
authors.forename: Frédéric
authors.initials: F
authors.lastname: Dutheil
authors.forename: Gérard
authors.initials: G
authors.lastname: Lac
authors.forename: Daniel
authors.initials: D
authors.lastname: Courteix
authors.forename: Eric
authors.initials: E
authors.lastname: Doré
authors.forename: Robert
authors.initials: R
authors.lastname: Chapier
authors.forename: Laurence
authors.initials: L
authors.lastname: Roszyk
authors.forename: Vincent
authors.initials: V
authors.lastname: Sapin
authors.forename: Bruno
authors.initials: B
authors.lastname: Lesourd
mesh_terms: D000368:Aged; D000375:Aging; D015992:Body Mass Index; D031204:Caloric Restriction / Q000009:adverse effects; D003131:Combined Modality Therapy / Q000009:adverse effects; D004038:Diet, Reducing / Q000009:adverse effects*; D004044:Dietary Proteins / Q000008:administration & dosage* / Q000627:therapeutic use; D002149:Energy Intake; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000178:diet therapy / Q000628:therapy*; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000097:blood / Q000150:complications / Q000178:diet therapy / Q000628:therapy*; D050177:Overweight / Q000097:blood / Q000150:complications / Q000178:diet therapy / Q000628:therapy*; D011488:Protein Deficiency / Q000209:etiology / Q000517:prevention & control; D012709:Serum Albumin / Q000032:analysis; D000075462:Serum Albumin, Human
chemical_list: C422455:ALB protein, human; D004044:Dietary Proteins; D012709:Serum Albumin; D000075462:Serum Albumin, Human