M.F. Engberink

A high whey protein–, leucine-, and vitamin D–enriched supplement preserves muscle mass during intentional weight loss in obese older adults: a double-blind randomized controlled trial

BACKGROUND Intentional weight loss in obese older adults is a risk factor for muscle loss and sarcopenia. OBJECTIVE The objective was to examine the effect of a high whey protein-, leucine-, and vitamin D-enriched supplement on muscle mass preservation during intentional weight loss in obese older adults. DESIGN We included 80 obese older adults in a double-blind randomized controlled trial. During a 13-wk weight loss program, all subjects followed a hypocaloric diet (-600 kcal/d) and performed resistance training 3×/wk. Subjects were randomly allocated to a high whey protein-, leucine-, and vitamin D-enriched supplement including a mix of other macro- and micronutrients (150 kcal, 21 g protein; 10×/wk, intervention group) or an isocaloric control. The primary outcome was change in appendicular muscle mass. The secondary outcomes were body composition, handgrip strength, and physical performance. Data were analyzed by using ANCOVA and mixed linear models with sex and baseline value as covariates. RESULTS At baseline, mean ± SD age was 63 ± 5.6 y, and body mass index (in kg/m(2)) was 33 ± 4.4. During the trial, protein intake was 1.11 ± 0.28 g · kg body weight(-1) · d(-1) in the intervention group compared with 0.85 ± 0.24 g · kg body weight(-1) · d(-1) in the control group (P < 0.001). Both intervention and control groups decreased in body weight (-3.4 ± 3.6 kg and -2.8 ± 2.8 kg; both P < 0.001) and fat mass (-3.2 ± 3.1 kg and -2.5 ± 2.4 kg; both P < 0.001), with no differences between groups. The 13-wk change in appendicular muscle mass, however, was different in the intervention and control groups [+0.4 ± 1.2 kg and -0.5 ± 2.1 kg, respectively; β = 0.95 kg (95% CI: 0.09, 1.81); P = 0.03]. Muscle strength and function improved over time without significant differences between groups. CONCLUSION A high whey protein-, leucine-, and vitamin D-enriched supplement compared with isocaloric control preserves appendicular muscle mass in obese older adults during a hypocaloric diet and resistance exercise program and might therefore reduce the risk of sarcopenia. This trial was registered at the Dutch Trial Register (http://www.trialregister.nl) as NTR2751.

Ethnicity and socioeconomic status are related to dietary patterns at age 5 in the Amsterdam born children and their development (ABCD) cohort

BackgroundHealth inequalities are already present at young age and tend to vary with ethnicity and socioeconomic status (SES). Diet is a major determinant of overweight, and studying dietary patterns as a whole in relation to overweight rather than single nutrients or foods has been suggested. We derived dietary patterns at age 5 and determined whether ethnicity and SES were both related to these dietary patterns.MethodsWe analysed 2769 validated Food Frequency Questionnaires filled in by mothers of children (5.7 ± 0.5y) in the Amsterdam Born Children and their Development (ABCD) cohort. Food items were reduced to 41 food groups. Energy adjusted intake per food group (g/d) was used to derive dietary patterns using Principal Component Analysis and children were given a pattern score for each dietary pattern. We defined 5 ethnic groups (Dutch, Surinamese, Turkish, Moroccan, other ethnicities) and 3 SES groups (low, middle, high, based on maternal education). Multivariate ANOVA, with adjustment for age, gender and maternal age, was used to test potential associations between ethnicity or SES and dietary pattern scores. Post-hoc analyses with Bonferroni adjustment were used to examine differences between groups.ResultsPrincipal Component Analysis identified 4 dietary patterns: a snacking, full-fat, meat and healthy dietary pattern, explaining 21% of the variation in dietary intake. Ethnicity was related to the dietary pattern scores (p < 0.01): non-Dutch children scored high on snacking and healthy pattern, whereas Turkish children scored high on full-fat and Surinamese children on the meat pattern. SES was related to the snacking, full-fat and meat patterns (p < 0.01): low SES children scored high on the snacking and meat pattern and low on the full-fat pattern.ConclusionsThis study indicates that both ethnicity and SES are relevant for dietary patterns at age 5 and may enable more specific nutrition education to specific ethnic and low socioeconomic status target groups.

Oral Communication III: Nutritional Assessment, Epidemiology and FormulationsOR25: Validity of Predictive Equations for Resting Energy Expenditure for Overweight Older Adults with and without Diabetes

Rationale: Predictive equations for resting energy expenditure (REE) are used in the treatment of overweight and obesity, but the validity of these equations in overweight older adults is unknown. This study evaluates which predictive REE equation is the best alternative to indirect calorimetry in overweight older adults with and without diabetes. Methods: In total 273 adults aged ≥55 years with a BMI of ≥25 kg/m2 were included. REE (by indirect calorimetry), body weight, body height, age, gender, and fat-free and fat mass (from air-displacement plethysmography) were measured. The measured REE was used as a reference and compared with 28 existing REE equations. The accuracy of the equations was evaluated by the percentage accurate predictions (within 10% of REE measured), the root mean squared error (RMSE), and the mean percentage difference (bias) between predicted and measured REE. Subgroup analyses were performed for type 2 diabetics (T2D) and non-T2D. Results: Mean age was 64 ± (SD 6) years, 42% had T2D (n = 116), and mean BMI was 32.8 ± (SD 4.5) with range 25–54 kg/m2. The adjusted Harris & Benedict (1984) provided the highest percentage accurate predictions in all adults (70%) and in T2D (74%), and second best in non-T2D (67%). RMSE was 184, 175 and 191 kcal/day, and bias −1.2%, −1.5% and −1.0% for all adults, T2D and non-T2D, respectively. Conclusion: For Dutch overweight older adults with and without diabetes the adjusted Harris–Benedict (1984) predictive equation for REE seems to be the best alternative to indirect calorimetry.

MON-PP260: Prevailing Dietary Patterns in 5–6 Year Old Children and Socio-Economic Status: The Abcd Cohort

Submission Identifier: ESPEN15-ABS-1348 PREVAILING DIETARY PATTERNS IN 5-6 YEAR OLD CHILDREN AND SOCIO-ECONOMIC STATUS: THE ABCD COHORT Viyan Rashid* 1, Marielle F. Engberink1, Tanja G. Vrijkotte2, Arnoud P. Verhoeff3, Peter Weijs4 1Department of Nutrition and Dietetics, School of Sports and Nutrition, Amsterdam University of Applied Sciences, 2 Department of Public Health, Academic Medical Center, University of Amsterdam, 3Department of Epidemiology, Public Health Service Amsterdam, 4Nutrition and Dietetics, Department of Internal Medicine, VU University Medical Center, Amsterdam, Netherlands If you think another topic than the one selected at first would suit your abstract, please choose below.: Nutritional epidemiology Presentation Method: Oral or Poster presentation Please indicate your professional occupation: Other The presenting author fulfills the above conditions and wants to apply for a travel award: No Rationale: Dietary patterns may be more predictive for weight development than individual foods or nutrients. We identified dietary patterns in children (aged 5-6y) in the multi-ethnic Amsterdam Born Children and their Development (ABCD) cohort. Methods: A validated FFQ was completed by parents of 2,769 children (5.7±0.5y, 51% boys). Energy-adjusted intake (g/d) of 41 predefined food groups was calculated and dietary patterns were derived using PCA. Children were categorized in three socio-economic status (SES) groups based on mother’s post-primary education (<6y=low, n=313; 610y=middle, n=980; >10y=high, n=1476) and related to tertiles of dietary pattern scores to describe its association. GLM and Post-hoc Bonferroni test were used to test interaction between dietary pattern score and SES. Results: PCA identified 4 major dietary patterns explaining 21% of the total variation of dietary intake. Pattern 1 “snacking” was defined by high component loadings on food groups snacks, biscuits, candy’s and refined grain products; pattern 2 “full-fat” by high loadings on full-fat spreads and full-fat cheese; pattern 3 by high loadings on meats, sauces, boiled potatoes and healthy warm meals; and pattern 4 “healthy” was defined by high loadings on fruits, vegetables, fish, water/tea and whole grain breakfast products. Dietary pattern score was significantly related to SES (p<0.001). Children with high pattern scores on the “snacking” pattern were more often from low SES group (23%, vs “full-fat”10%, “meats” 15% and “healthy” 14%). Children with high pattern scores on the “full-fat” pattern were more often from high SES group (56%, vs “snacking” 35%, “meats 46% and “healthy” 49%). Conclusion: In this multi-ethnic group where low SES was relatively underpresented, dietary pattern score was significantly related to SES. Further research investigating the consequences of dietary patterns on weight development

MON-PP209: Effect of a High Protein Diet and/or Resistance Exercise on Preservation of Fat Free Mass During Weight Loss in Overweight Older Adults: a Randomized Controlled Trial

Correspondence a.verreijen@hva.nl, Amely Verreijen, MSc., School of Sports and Nutrition, Amsterdam University of Applied Sciences, Dr. Meurerlaan 8, 1067 AM, Amsterdam, Netherlands Conclusion Although the targeted high protein diet was not completely achieved, the contrast of 23 gram protein per day had no effect on changes in FFM and FM during weight loss in older overweight subjects. Supervised resistance exercise increased the loss of relative FM but had no effect on FFM. However, in the group receiving the protein and exercise combination a significant increase in FFM was observed. Results At baseline, mean±SD BMI was 32±4 kg/m2. During intervention, protein intake was 1.15±0.27 g/kg in the protein groups vs. 0.93±0.19 g/kg in the non-protein groups, corresponding to a 23±5 g/day (p<0.001) higher protein intake. Mean adherence to the exercise program was 2.8±0.3 times/week. No interaction was observed between protein*exercise for all outcomes. Overall, subjects lost weight (-3.1±2.8 kg, p<0.01) without significant between-group effects, and had no significant change in FFM (+0.4±1.9 kg, p=0.12). Effects of protein and effects of exercise on body composition are displayed in the Table and Figure. Table: Outcome measures for protein vs. non-protein groups and for exercise vs. non-exercise groups in means ± SD. Protein (n=40) Non-protein (n=32) Protein effect