Protein, Calcium, Vitamin D Intake and 25(OH)D Status in Normal Weight, Overweight, and Obese Older Adults: A Systematic Review and Meta-Analysis

Priya Dewansingh; Gerlof A R Reckman; Caspar F Mijlius; Wim P Krijnen; Cees P van der Schans; Harriët Jager-Wittenaar; Ellen G H M van den Heuvel

doi:10.3389/fnut.2021.718658

Protein, Calcium, Vitamin D Intake and 25(OH)D Status in Normal Weight, Overweight, and Obese Older Adults: A Systematic Review and Meta-Analysis

Front Nutr. 2021 Sep 10:8:718658. doi: 10.3389/fnut.2021.718658. eCollection 2021.

Authors

Priya Dewansingh¹, Gerlof A R Reckman^{1

2}, Caspar F Mijlius^{1

2}, Wim P Krijnen^{1

3}, Cees P van der Schans^{1

4

5

6}, Harriët Jager-Wittenaar^{1

7}, Ellen G H M van den Heuvel⁸

Affiliations

¹ Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, Netherlands.
² Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
³ Faculty of Mathematics and Natural Sciences, University of Groningen, Groningen, Netherlands.
⁴ Faculty of Medical Sciences, University Medical Center Groningen, Groningen, Netherlands.
⁵ Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
⁶ Department of Health Psychology Research, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
⁷ Department of Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
⁸ FrieslandCampina, Amersfoort, Netherlands.

Abstract

The aging process is often accompanied by increase in body weight. Older adults with overweight or obesity might have an overconsumption in energy that is accompanied by inadequate intake of protein, vitamin D, and calcium. It is unclear if intake of protein and vitamin D and calcium is sufficient in older adults with overweight/obesity, and whether it differs from older adults with normal weight, since a recent overview of the literature review is lacking. Therefore, we systematically analyzed the current evidence on differences in nutrient intake/status of protein, vitamin D and calcium between older adults with different body mass index (BMI) categories. Randomized controlled trials and prospective cohort studies were identified from PubMed and EMBASE. Studies reporting nutrient intake/status in older adults aged ≥50 years with overweight/obesity and studies comparing between overweight/obesity and normal weight were included. Nutrient intake/status baseline values were reviewed and when possible calculated for one BMI category (single-group meta-analysis), or compared between BMI categories (meta-analysis). Nutrient intake/status was compared with international recommendations. Mean protein (N = 8) and calcium intake (N = 5) was 0.98 gram/kilogram body weight/day (g/kg/d) [95% Confidence Interval (CI) 0.89-1.08] and 965 mg [95% CI: 704-1225] in overweight/obese. Vitamin D intake was insufficient in all BMI categories (N = 5). The pooled mean for vitamin D intake was 6 ug [95% CI 4-9]. For 25(OH)D, the pooled mean was 54 nmol/L [95% CI 45-62], 52 nmol/L [95% CI 46-58], and 48 nmol/l [95% CI 33-62] in normal (N = 7), combined overweight and obese (N = 12), and obese older adults (N = 4), respectively. In conclusion, older adults with overweight and obesity have a borderline sufficient protein and sufficient calcium intake, but insufficient vitamin D intake. The 25(OH)D concentration is deficient for the obese older adults.

Keywords: micronutrients; obesity; older adults; overweight; protein.

Publication types

Systematic Review