Effect of personalized dietary advice to increase protein intake on food consumption and the environmental impact of the diet in community-dwelling older adults: results from the PROMISS trial

Eur J Nutr. 2022 Dec;61(8):4015-4026. doi: 10.1007/s00394-022-02896-x. Epub 2022 Jul 5.

Abstract

Purpose: Diet modelling studies suggest that increasing protein intake with no consideration for sustainability results in a higher environmental impact on the diet. To better understand the impact in real life, the aim of this study was to assess the effect of dietary advice to increase protein intake on food consumption and the environmental impact of the diet in community-dwelling older adults.

Methods: Food consumption and environmental impact were analyzed among 124 Dutch older adults with lower habitual protein intake (< 1.0 g/kg adjusted body weight/day) participating in the six-month PROMISS trial. Dietary intake data from three 24-h dietary recalls, aided by food diaries, and results from life cycle assessments were used to examine the differences in changes in food consumption and environmental impact between those who received dietary advice to isocalorically increase protein intake to ≥ 1.2 g/kg aBW/d (Protein + ; n = 84) and those who did not receive dietary advice (Control; n = 40).

Results: Compared to the Control, Protein + increased protein intake from animal-based food products (11.0 g protein/d, 95% CI 6.6-15.4, p < 0.001), plant-based food products (2.1 g protein/d, 95% CI 0.2-4.0, p = 0.031) and protein-enriched food products provided during the trial (18 g protein/d, 95% CI 14.5-21.6, p < 0.001) at the 6-month follow-up. Diet-associated greenhouse gas emissions increased by 16% (p < 0.001), land use by 19% (p < 0.001), terrestrial acidification by 20% (p = 0.01), and marine eutrophication by 16% (p = 0.035) in Protein + compared to the Control.

Conclusion: This study found that dietary advice increased protein intake, favoring animal-based protein, and increased the environmental impact of the diet in older adults.

Trial registration: ClinicalTrials.gov. NCT03712306. October 2018.

Keywords: Diet; Older adults; Protein; RCT; Sustainability.

Publication types

  • Clinical Trial

MeSH terms

  • Diet
  • Environment
  • GTP-Binding Proteins
  • Greenhouse Gases*
  • Independent Living*

Substances

  • Greenhouse Gases
  • GTP-Binding Proteins

Associated data

  • ClinicalTrials.gov/NCT03712306

Grants and funding