title: Inadequacy of Body Weight-Based Recommendations for Individual Protein Intake-Lessons from Body Composition Analysis.
abstract: Current body weight-based protein recommendations are ignoring the large variability in body composition, particularly lean mass (LM), which drives protein requirements. We explored and highlighted the inter-individual variability of weight versus body composition-adjusted protein intakes by secondary analysis in three cohorts of (1) 574 healthy adults (mean ± SD age: 41.4 ± 15.2 years); (2) 403 cirrhotic patients (age: 44.7 ± 12.3 years) and (3) 547 patients with lung cancer (age: 61.3 ± 8.2 years). LM was assessed using different devices (magnetic resonance imaging, dual-energy X-ray absorptiometry, computer tomography, total body potassium and bioelectrical impedance), body weight-based protein intake, its ratio (per kg LM) and mean protein requirement were calculated. Variability in protein intake in all cohorts ranged from 0.83 to 1.77 g protein per kg LM per day using (theoretical protein intake of 60 g protein per day). Calculated mean protein requirement was 1.63 g protein per kg LM per day; consequently, 95.3% of healthy subjects, 100% of cirrhotic and 97.4% of cancer patients would present with a low protein intake per kg LM. Weight-adjusted recommendations are inadequate to address the LM specific differences in protein needs of healthy subjects or clinical populations. Absolute protein intake seems to be more relevant compared to the relative proportion of protein, which in turn changes with different energy needs.
authors.affiliation: Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel, Düsternbrooker Weg 17, D-24105 Kiel, Germany. cgeisler@nutrfoodsc.uni-kiel.de.
authors.forename: Corinna
authors.initials: C
authors.lastname: Geisler
authors.affiliation: Alberta Institute for Human Nutrition, Department of Agricultural, Food and Nutritional Science, University of Alberta, 4-002 Li Ka Shing Centre, Edmonton, AB T6G 2P5, Canada. carla.prado@ualberta.ca.
authors.forename: Carla M
authors.initials: CM
authors.lastname: Prado
authors.affiliation: Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel, Düsternbrooker Weg 17, D-24105 Kiel, Germany. mmueller@nutrfoodsc.uni-kiel.de.
authors.forename: Manfred J
authors.initials: MJ
authors.lastname: Müller
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D004044:Dietary Proteins / Q000008:administration & dosage* / Q000032:analysis; D017097:Electric Impedance; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000628:therapy; D008175:Lung Neoplasms / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D018482:Muscle, Skeletal / Q000378:metabolism; D009751:Nutritional Requirements; D011446:Prospective Studies; D055948:Sarcopenia / Q000628:therapy
chemical_list: D004044:Dietary Proteins
keywords: Caucasian; healthy and clinical populations; lean mass; protein intake-body composition relationship; protein needs