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To Get Middle-aged Women to Eat More Protein Consider Diet Coaching

Most adults don’t even get the minimum recommended dietary allowance (RDA) of 0.8 grams of protein per kilogram of body weight.

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Getting enough protein is vital to maintaining muscle health, especially as we age. Most adults don’t even get the minimum recommended dietary allowance (RDA) of 0.8 grams of protein per kilogram of body weight. Inadequate protein intake is especially problematic for middle-aged women because they typically have less muscle mass than men and are at greater risk of developing sarcopenia, the age-related loss in skeletal muscle.

Most studies to evaluate the effects of protein on muscle health have used powders that contain casein, whey, soy or free amino acids, while other studies have focused on increasing egg and protein consumption using herb/spice packets. Diet coaching for adults also has been examined, but only in adults with chronic diseases such as type 2 diabetes and cardiovascular disease.

A study led by 91����’s is the first to examine the impact of per-meal protein prescription and nutrition education with and without diet coaching to improve protein intake among middle-aged women. Since protein is the building block of muscles, researchers also investigated the impact of the changes in protein intake on muscle health. 

For the study, participants ages 45 to 64, all received nutrition education and per-meal protein prescription. Participants randomized to the coached group received 10 weeks of virtual diet coaching with a nurse practitioner, which focused on assisting them in increasing their protein-rich food selections at meals. Researchers assessed protein intake at baseline, week four and week 12. 

Results of the study, published in the journal , suggest that when nutrition education and a per-meal protein prescription were combined with diet coaching, more participants achieved the higher daily protein intake and a more even distribution of protein among meals (breakfast, lunch and dinner).

At baseline, 56 percent of the coached group participants met their per-meal protein prescription compared to 21 percent of the non-coached group participants. The effect of the coaching was clear at 12 weeks with 72 percent of the participants in the coached group meeting the protein prescription at breakfast compared to only 25 percent in the not-coached group. The participants who received diet coaching were 7.7 times more likely to meet their protein prescription at breakfast than those in the not-coached group. Moreover, at 12 weeks, 76 percent of participants in the coached group met the three-meal protein prescription compared to only 53 percent in the not-coach group. The coached participants were 2.7 times more likely to meet their protein prescription than the non-coached group participants.

“The overall pattern exhibited by the two groups in our study is noteworthy,” said Kelley Jackson, Ph.D., lead investigator and a Ph.D. graduate of the Christine E. Lynn College of Nursing. “The percentage of not-coached participants who met the protein prescription at each meal increased between baseline and week four but then declined again at week 12 and reverted back towards those exhibited at baseline. This pattern is in contrast to what we observed with continued improvements at each meal among participants in the coached group at baseline, week four, and week 12.” 

Findings from the study suggest that while nutrition education and a protein prescription may be valuable in initiating and maintaining behavior change over a four-week period, the effectiveness of behavior change without the coaching intervention wanes sometime between four and 12 weeks.

“Diet coaching should be considered in conjunction with nutrition education and a protein prescription to assist individuals in sustaining behavior change,” said , Ph.D., coinvestigator, registered dietitian/nutritionist and professor in the Christine E. Lynn College of Nursing. “Both the gained knowledge and the changed dietary behaviors adopted by participants, if sustained long term, are thought to be important to maintain muscle health and to help prevent age-related conditions such as sarcopenia and its associated adverse consequences that impact balance and gait, reduce strength and decrease quality of life.”

Other study co-authors are Dennis Hunt, Ed.D., an assistant professor, Florida Gulf Coast University; Deborah D’Avolio, Ph.D.; affiliate faculty; and David Newman, Ph.D., an associate professor and statistician; both within the Christine E. Lynn College of Nursing at 91����.  

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