title: Energy and protein intakes and their association with a decline in functional capacity among diabetic older adults from the NuAge cohort.
abstract: OBJECTIVE
  Diabetic older adults (OA) are at greater risk of muscle strength (MS) loss and functional capacity (FC) decline than non-diabetics. Protein and energy intakes are important determinants of muscle mass and MS maintenance and indirectly affect FC. The study sought to determine whether low protein and energy intakes were associated with FC decline and whether this association was mediated by MS in diabetic OA over a 3-year follow-up, in secondary analyses of the Quebec Longitudinal Study on Nutrition and Successful Aging.
  
  
  METHODS
  In 172 diabetic OA (62 % men, mean age = 75 years), FC decline was defined as the change between SMAF (Système de Mesure de l'Autonomie Fonctionnelle) scores at baseline (T1) and 3 years later (T4). Baseline adequate protein and energy intakes were set at ≥1 g/kg BW and ≥30 kcal/kg BW, respectively. Sex-stratified linear regressions were controlled for confounding variables.
  
  
  RESULTS
  Mean body weight (BW) was 85.42 ± 13.8 in men and 79.7 ± 11.5 in women (p ≤ .001). Adequate protein intake in women was associated with lesser FC decline (mean ± SE) (2.11 ± 0.81 vs. 4.91 ± 0.72; p = .029), while adequate energy intake was not associated with FC decline either in men or in women. In women, 1 g protein/kg BW helped maintain MS, hence minimizing FC decline.
  
  
  CONCLUSIONS
  These results demonstrate that protein intake is important in maintaining FC in diabetic OA, albeit with sex differences. This study provides further evidence that protein requirements may be greater than the 0.8 g/kg BW currently recommended for OA. Future research in larger samples over longer follow-up is needed to confirm these results.
authors.affiliation: Département de Nutrition, Université de Montréal, Montreal, Canada.
authors.forename: Berna
authors.initials: B
authors.lastname: Rahi
authors.affiliation: Division of Geriatric Medicine, McGill University, Montreal, Canada.
authors.forename: José A
authors.initials: JA
authors.lastname: Morais
authors.affiliation: Centre Hospitalier de l'Université de Montréal Research Centre, Montreal, Canada.|Département de Médecine, Université de Montréal, Montreal, Canada.
authors.forename: Pierrette
authors.initials: P
authors.lastname: Gaudreau
authors.affiliation: Centre de recherche sur le vieillissement, CSSS-IUGS, Sherbrooke, Canada.|Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Canada.
authors.forename: Hélène
authors.initials: H
authors.lastname: Payette
authors.affiliation: Département de Nutrition, Université de Montréal, Montreal, Canada. bryna.shatenstein@umontreal.ca.|Centre de recherche, Institut universitaire de gériatrie de Montréal, 4565 Queen Mary, Montreal, QC, H3W 1W5, Canada. bryna.shatenstein@umontreal.ca.
authors.forename: Bryna
authors.identifier: http://orcid.org/0000-0003-1821-4763
authors.initials: B
authors.lastname: Shatenstein
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D004032:Diet; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage*; D002149:Energy Intake; D005215:Fasting; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D011792:Quebec; D012737:Sex Factors
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins
keywords: Diabetic older adults; Energy intake; Functional capacity; Protein intake