Association of Low Hand Grip Strength with Protein Intake in Korean Female Elderly: based on the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII), 2016-2018

Won Jang; Ho Kyung Ryu

doi:10.5720/kjcn.2020.25.3.226

Articles

Page Path: HOME > Korean J Community Nutr > Volume 25(3); 2020 > Article

Research Article
Association of Low Hand Grip Strength with Protein Intake in Korean Female Elderly: based on the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII), 2016-2018: Won Jang, Ho Kyung Ryu; Korean Journal of Community Nutrition 2020;25(3):226-235.
DOI: https://doi.org/10.5720/kjcn.2020.25.3.226
Published online: June 30, 2020

¹Postdoctoral Researcher, Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Korea

²Professor, Department of Food Science and Nutrition, Pusan National University, Research Institute of Ecology, Busan, Korea

Corresponding author: Ho Kyung Ryu,
Email: hokryu@pusan.ac.kr

Received: 28 April 2020 • Revised: 18 June 2020 • Accepted: 19 June 2020

223 Views
7 Download
18 Crossref
0 Scopus

prev next

Full Article

Download PDF

Abstract

Objectives
Decreasing muscle strength in old age has become a significant health problem because it increases the risk of falls or fractures and transfers to other diseases. The precise role of dietary protein intake in preventing or reducing muscle weakness is unclear. This study examined the relationship between handgrip strength and protein intake in Korean female elderly.
Methods
This was a cross-sectional study that used data from the Seventh Korean National Health and Nutrition Examination Surveys (KNHANES) on female subjects aged 65 years and older. Low handgrip strength (LHGS) was defined as a handgrip strength below than 18 kg. Dietary intake data were obtained using the 1-day 24-hour recall method. Multiple regression was performed to test whether there is an independent relationship between the grip strength and protein intake, and the association between protein intake and LHGS was confirmed through multiple logistic regression.
Results
The mean age of the 2,083 elderly females was 73.3 ± 0.1 years, and the prevalence of LHGS was 35% (n=734). Elderly women with an LHGS consumed less energy, total protein, and animal-based protein than those in the normal group. A multiple regression analysis after adjusting for covariate revealed a significant positive association between the handgrip strength and energy, protein, and animal-based protein intake. Multiple logistic regression analysis showed that the odds ratio (OR) of LHGS in female elderly with the highest quartiles of consumption of energy [OR, 0.65; 95% confidence interval (CI), 0.43- 0.82; P for trend=0.004], and animal-based protein [OR, 0.59; CI, 0.40-0.87; P for trend= 0.037] were significantly lower than those in the lowest quartiles.
Conclusions
The energy intake and animal-based protein intake were negatively associated with the LHGS. These results suggest that adequate energy intake and protein intake, particularly those from animal-based sources, for elderly women in Korea are beneficial in lowering the risk of LHGS.

Keywords: handgrip strength; sarcopenia; protein intake; animal-based protein

Korean J Community Nutr. 2020 Jun;25(3):226-235. Korean.
Published online Jun 30, 2020.
https://doi.org/10.5720/kjcn.2020.25.3.226

Original Article

Association of Low Hand Grip Strength with Protein Intake in Korean Female Elderly: based on the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII), 2016–2018

Won Jang

,¹ and Ho Kyung Ryu

Author information

Author notes

- ¹Postdoctoral Researcher, Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Korea.
- ²Professor, Department of Food Science and Nutrition, Pusan National University, Research Institute of Ecology, Busan, Korea.
Corresponding author: Ho Kyung Ryu. Department of Food Science and Nutrition, Pusan National University, 2, Busandaehak-ro 63beon-gil, Geumjeong-gu, Busan 46241, Korea. Tel: (051) 510-7397, Fax: (051) 583-3648, Email: hokryu@pusan.ac.kr

Received April 28, 2020; Revised June 18, 2020; Accepted June 19, 2020.

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

Decreasing muscle strength in old age has become a significant health problem because it increases the risk of falls or fractures and transfers to other diseases. The precise role of dietary protein intake in preventing or reducing muscle weakness is unclear. This study examined the relationship between handgrip strength and protein intake in Korean female elderly.

Methods

This was a cross-sectional study that used data from the Seventh Korean National Health and Nutrition Examination Surveys (KNHANES) on female subjects aged 65 years and older. Low handgrip strength (LHGS) was defined as a handgrip strength below than 18 kg. Dietary intake data were obtained using the 1-day 24-hour recall method. Multiple regression was performed to test whether there is an independent relationship between the grip strength and protein intake, and the association between protein intake and LHGS was confirmed through multiple logistic regression.

Results

The mean age of the 2,083 elderly females was 73.3 ± 0.1 years, and the prevalence of LHGS was 35% (n=734). Elderly women with an LHGS consumed less energy, total protein, and animal-based protein than those in the normal group. A multiple regression analysis after adjusting for covariate revealed a significant positive association between the handgrip strength and energy, protein, and animal-based protein intake. Multiple logistic regression analysis showed that the odds ratio (OR) of LHGS in female elderly with the highest quartiles of consumption of energy [OR, 0.65; 95% confidence interval (CI), 0.43–0.82; P for trend=0.004], and animal-based protein [OR, 0.59; CI, 0.40–0.87; P for trend= 0.037] were significantly lower than those in the lowest quartiles.

Conclusions

The energy intake and animal-based protein intake were negatively associated with the LHGS. These results suggest that adequate energy intake and protein intake, particularly those from animal-based sources, for elderly women in Korea are beneficial in lowering the risk of LHGS.

Keywords

handgrip strength; sarcopenia; protein intake; animal-based protein

Tables

Table 1
General characteristics of the subjects

Download Table

Table 2
Dietary nutrient and food intakes of the subjects

Download Table

Table 3
Multiple regression analysis of dietary intakes and handgrip strength of the subjects

Download Table

Table 4
Risks for low handgrip strength according to quartiles of energy and protein intake

Download Table

References

1. JafariNasabian P, Inglis JE, Reilly W, Kelly OJ, Ilich JZ. Aging human body: changes in bone, muscle and body fat with consequent changes in nutrient intake. J Endocrinol 2017;234(1):R37–R51.
  PubMed
  
  CrossRef
1. Reinders I, Visser M, Schaap L. Body weight and body composition in old age and their relationship with frailty. Curr Opin Clin Nutr Metab Care 2017;20(1):11–15.
  PubMed
  
  CrossRef
1. Jura M, Kozak LP. Obesity and related consequences to ageing. Age 2016;38(1):23.
  PubMed
  
  CrossRef
1. Sacitharan PK. In: Ageing and osteoarthritis. Singapore: Springer; 2019. pp. 123-159.
1. Hassler N, Brozek W, Eriksen EF, Rauch F, Glorieux FH, Shane E, et al. Aging versus postmenopausal osteoporosis: Bone composition and maturation kinetics at actively-forming trabecular surfaces of female subjects aged 1 to 84 years. J Bone Miner Res 2016;31(2):347–357.
  PubMed
  
  CrossRef
1. Boskey AL, Imbert L. Bone quality changes associated with aging and disease: a review. Ann N Y Acad Sci 2017;1410(1):93–106.
  PubMed
  
  CrossRef
1. Abyad A, Boyer JT. Arthritis and aging. Curr Opin Rheumatol 1992;4(2):153–159.
  PubMed
  
  CrossRef
1. Rosenberg IH. Sarcopenia: origins and clinical relevance. J Nutr 1997;127(5 Suppl):990S–991S.
  PubMed
  
  CrossRef
1. Cao L, Morley JE. Sarcopenia is recognized as an independent condition by an international classification of disease, tenth revision, clinical modification (ICD-10-CM) code. J Am Med Dir Assoc 2016;17(8):675–677.
  PubMed
  
  CrossRef
1. Tournadre A, Vial G, Capel F, Soubrier M, Boirie Y. Sarcopenia. Joint Bone Spine 2019;86(3):309–314.
  PubMed
  
  CrossRef
1. Öztürk ZA, Türkbeyler İH, Abiyev A, Kul S, Edizer B, Yakaryılmaz FD, et al. Health-related quality of life and fall risk associated with age-related body composition changes; sarcopenia, obesity and sarcopenic obesity. Intern Med J 2018;48(8):973–981.
  CrossRef
1. Tolea MI, Galvin JE. Sarcopenia and impairment in cognitive and physical performance. Clin Interv Aging 2015;10:663–671.
  PubMed
  
  CrossRef
1. Tsekoura M, Kastrinis A, Katsoulaki M, Billis E, Gliatis J. Sarcopenia and its impact on quality of life. Adv Exp Med Biol 2017;987:213–218.
  PubMed
  
  CrossRef
1. Liu P, Hao Q, Hai S, Wang H, Cao L, Dong B. Sarcopenia as a predictor of all-cause mortality among community-dwelling older people: A systematic review and meta-analysis. Maturitas 2017;103:16–22.
  PubMed
  
  CrossRef
1. Bellanti F, Romano AD, Lo Buglio A, Castriotta V, Guglielmi G, Greco A, et al. Oxidative stress is increased in sarcopenia and associated with cardiovascular disease risk in sarcopenic obesity. Maturitas 2018;109:6–12.
  PubMed
  
  CrossRef
1. Zhang H, Lin S, Gao T, Zhong F, Cai J, Sun Y, et al. Association between sarcopenia and metabolic syndrome in middle-aged and older non-obese adults: A systematic review and meta-analysis. Nutrients 2018;10(3):364.
  CrossRef
1. Steffl M, Bohannon RW, Sontakova L, Tufano JJ, Shiells K, Holmerova I. Relationship between sarcopenia and physical activity in older people: a systematic review and meta-analysis. Clin Interv Aging 2017;12:835–845.
  PubMed
  
  CrossRef
1. Bloom I, Shand C, Cooper C, Robinson S, Baird J. Diet quality and sarcopenia in older adults: A systematic review. Nutrients 2018;10(3):308
  CrossRef
1. Morley JE, Malmstrom TK, Rodriguez-Mañas L, Sinclair AJ. Frailty, sarcopenia and diabetes. J Am Med Dir Assoc 2014;15(12):853–859.
  PubMed
  
  CrossRef
1. Landi F, Calvani R, Cesari M, Tosato M, Martone AM, Ortolani E, et al. Sarcopenia: An overview on current definitions, diagnosis and treatment. Curr Protein Pept Sci 2018;19(7):633–638.
  PubMed
  
  CrossRef
1. Chen LK, Lee WJ, Peng LN, Liu LK, Arai H, Akishita M, et al. Recent advances in sarcopenia research in Asia: 2016 update from the Asian working group for sarcopenia. J Am Med Dir Assoc 2016;17(8):767.e1–767.e7.
  CrossRef
1. Okamura T, Miki A, Hashimoto Y, Kaji A, Sakai R, Osaka T, et al. Shortage of energy intake rather than protein intake is associated with sarcopenia in elderly patients with type 2 diabetes: A cross-sectional study of the KAMOGAWA-DM cohort. J Diabetes 2019;11(6):477–483.
  PubMed
  
  CrossRef
1. Castaneda C, Charnley JM, Evans WJ, Crim MC. Elderly women accommodate to a low-protein diet with losses of body cell mass, muscle function, and immune response. Am J Clin Nutr 1995;62(1):30–39.
  PubMed
  
  CrossRef
1. Campbell WW, Trappe TA, Jozsi AC, Kruskall LJ, Wolfe RR, Evans WJ. Dietary protein adequacy and lower body versus whole body resistive training in older humans. J Physiol 2002;542(Pt 2):631–642.
  PubMed
  
  CrossRef
1. Beasley JM, LaCroix AZ, Neuhouser ML, Huang Y, Tinker L, Woods N, et al. Protein intake and incident frailty in the Women's Health Initiative observational study. J Am Geriatr Soc 2010;58(6):1063–1071.
  PubMed
  
  CrossRef
1. Houston DK, Nicklas BJ, Ding J, Harris TB, Tylavsky FA, Newman AB, et al. Dietary protein intake is associated with lean mass change in older, community-dwelling adults: the Health, Aging, and Body Composition (Health ABC) Study. Am J Clin Nutr 2008;87(1):150–155.
  PubMed
  
  CrossRef
1. Cholewa JM, Dardevet D, Lima-Soares F, de Araújo Pessôa K, Oliveira PH, Dos Santos Pinho JR, et al. Dietary proteins and amino acids in the control of the muscle mass during immobilization and aging: role of the MPS response. Amino Acids 2017;49(5):811–820.
  PubMed
  
  CrossRef
1. Sahni S, Mangano KM, Hannan MT, Kiel DP, McLean RR. Higher protein intake is associated with higher lean mass and quadriceps muscle strength in adult men and women. J Nutr 2015;145(7):1569–1575.
  PubMed
  
  CrossRef
1. Chan R, Leung J, Woo J, Kwok T. Associations of dietary protein intake on subsequent decline in muscle mass and physical functions over four years in ambulant older Chinese people. J Nutr Health Aging 2014;18(2):171–177.
  PubMed
  
  CrossRef
1. Ter Borg S, de Groot LC, Mijnarends DM, de Vries JH, Verlaan S, Meijboom S, et al. Differences in nutrient intake and biochemical nutrient status between sarcopenic and nonsarcopenic older adults-results from the Maastricht Sarcopenia Study. J Am Med Dir Assoc 2016;17(5):393–401.
  PubMed
  
  CrossRef
1. Kim HY, Kim CW, Park CH, Choi JY, Han K, Merchant AT, et al. Low skeletal muscle mass is associated with non-alcoholic fatty liver disease in Korean adults: the Fifth Korea National Health and Nutrition Examination Survey. Hepatobiliary Pancreat Dis Int 2016;15(1):39–47.
  PubMed
  
  CrossRef
1. Kim TN, Lee EJ, Hong JW, Kim JM, Won JC, Kim MK, et al. Relationship between sarcopenia and albuminuria: The 2011 Korea National Health and Nutrition Examination Survey. Medicine 2016;95(3):e2500
  PubMed
  
  CrossRef
1. Yoo JI, Ha YC, Kwon HB, Lee YK, Koo KH, Yoo MJ. High prevalence of sarcopenia in Korean patients after hip fracture: a case-control study. J Korean Med Sci 2016;31(9):1479–1484.
  PubMed
  
  CrossRef
1. Lim J, Park HS. Relationship between underweight, bone mineral density and skeletal muscle index in premenopausal Korean women. Int J Clin Pract 2016;70(6):462–468.
  PubMed
  
  CrossRef
1. Oh C, Jeon BH, Reid Storm SN, Jho S, No JK. The most effective factors to offset sarcopenia and obesity in the older Korean: Physical activity, vitamin D, and protein intake. Nutrition 2017;33:169–173.
  PubMed
  
  CrossRef
1. Jung JH, Lee JH, Kwon YJ. Difference of low skeletal muscle index according to recommended protein intake in Korean. Korean J Fam Pract 2019;9(6):539
  CrossRef
1. Kim CR, Jeon YJ, Jeong T. Risk factors associated with low handgrip strength in the older Korean population. PLoS One 2019;14(3):e0214612
  PubMed
  
  CrossRef
1. Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K, et al. Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc 2020;21(3):300–307.
  PubMed
  
  CrossRef
1. Ministry of Health and Welfare, The Korean Nutrition Society. Dietary reference intakes for Koreans 2015. Sejong: Ministry of Health and Welfare; 2015.
  Report No. 11-1352000-001537-14.
1. Lee K, Shin Y, Huh J, Sung YS, Lee IS, Yoon KH, et al. Recent issues on body composition imaging for sarcopenia evaluation. Korean J Radiol 2019;20(2):205–217.
  PubMed
  
  CrossRef
1. Janssen I, Heymsfield SB, Ross R. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc 2002;50(5):889–896.
  PubMed
  
  CrossRef
1. Lauretani F, Russo CR, Bandinelli S, Bartali B, Cavazzini C, Di Iorio A, et al. Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol 2003;95(5):1851–1860.
  PubMed
  
  CrossRef
1. Dupuy C, Lauwers-Cances V, Guyonnet S, Gentil C, Abellan Van Kan G, Beauchet O, et al. Searching for a relevant definition of sarcopenia: results from the cross-sectional EPIDOS study. J Cachexia Sarcopenia Muscle 2015;6(2):144–154.
  PubMed
  
  CrossRef
1. Shafiee G, Keshtkar A, Soltani A, Ahadi Z, Larijani B, Heshmat R. Prevalence of sarcopenia in the world: a systematic review and meta-analysis of general population studies. J Diabetes Metab Disord 2017;16:21
  PubMed
  
  CrossRef
1. Lee SK, Lee JA, Kim JY, Kim YZ, Park HS. The risk factors of sarcopenia among Korean elderly men: based on 2009 Korean National Health and Nutrition Examination Survey data. Korean J Obes 2014;23(1):23–31.
  CrossRef
1. Lorenzo-López L, Maseda A, de Labra C, Regueiro-Folgueira L, Rodríguez-Villamil JL, Millán-Calenti JC. Nutritional determinants of frailty in older adults: A systematic review. BMC Geriatr 2017;17(1):108
  CrossRef
1. Brzeszczyńska J, Meyer A, McGregor R, Schilb A, Degen S, Tadini V, et al. Alterations in the in vitro and in vivo regulation of muscle regeneration in healthy ageing and the influence of sarcopenia. J Cachexia Sarcopenia Muscle 2018;9(1):93–105.
  CrossRef
1. Kim HH, Kim JS, Yu JO. Factors contributing to sarcopenia among community-dwelling older Korean adults. J Korean Gerontol Nurs 2014;16(2):170–179.
  CrossRef
1. Park KB, Park HA, Kang JH, Kim K, Cho YG, Jang J, et al. Animal and plant protein intake and body mass index and waist circumference in a Korean elderly population. Nutrients 2018;10(5):577.
  CrossRef

Figure & Data

References

Citations

Citations to this article as recorded by

Development of Protein Enhanced Diet for Socially Vulnerable Elderly
Jihye Hong, Hyung-Geun Jeon, Seulgi Kim, Gitae Park
Journal of the East Asian Society of Dietary Life.2024; 34(1): 39. CrossRef
Association Between Dietary Fiber Intake and Low Muscle Strength Among Korean Adults
Sunhye Shin
Clinical Nutrition Research.2024; 13(1): 33. CrossRef
Health Outcome Comparison Based on Dietary Inflammatory Levels among Sample of Korean Elderly
Seul-Ki Koo, Hee-Sook Lim
Healthcare.2024; 12(10): 1003. CrossRef
Low dietary vitamin C intake is associated with low muscle strength among elderly Korean women
Chan Yoon Park, Sunhye Shin
Nutrition Research.2024; 127: 75. CrossRef
Macronutrients intake and physical frailty in Korean older adults: A cohort‐based cross‐sectional study
Narae Yang, Yunhwan Lee, Mi Kyung Kim, Kirang Kim
Geriatrics & Gerontology International.2023; 23(7): 478. CrossRef
The effect of combining nutrient intake and physical activity levels on central obesity, sarcopenia, and sarcopenic obesity: a population-based cross-sectional study in South Korea
Jong Eun Park, Seulgi Lee, Kirang Kim
BMC Geriatrics.2023;[Epub] CrossRef
Relationship between Anemia with Frailty and Nutritional Intake in Persons Age 65 and Older: The 2016–2018 Korea National Health and Nutrition Examination Survey
Heekyung Jeong, Chaeyoon Lee, So Yoon Han, Young-Jin Ko, Kyoung Jin Kim
Korean Journal of Family Practice.2023; 13(1): 15. CrossRef
Association between seafood intake and frailty according to gender in Korean elderly: data procured from the Seventh (2016–2018) Korea National Health and Nutrition Examination Survey
Won Jang, Yeji Choi, Jung Hee Cho, Donglim Lee, Yangha Kim
Journal of Nutrition and Health.2023; 56(2): 155. CrossRef
Association between plant protein intake and grip strength in Koreans aged 50 years or older: Korea National Health and Nutrition Examination Survey 2016–2018
Sook-Hyun Jun, Jung Woo Lee, Woo-Kyoung Shin, Seung-Yeon Lee, Yookyung Kim
Nutrition Research and Practice.2023; 17(5): 969. CrossRef
Trends in Seafood Consumption and Factors Influencing the Consumption of Seafood Among the Old Adults Based on the Korea National Health and Nutrition Examination Survey 2009~2019
Won Jang, Jung-Hee Cho, Donglim Lee, Yangha Kim
Journal of the Korean Society of Food Science and Nutrition.2022; 51(7): 651. CrossRef
Preparation of Mousse Type Pork Patties with Added Protaetia brevitarsis Larvae
Eunji Kim, Nami Joo
Journal of the East Asian Society of Dietary Life.2022; 32(1): 63. CrossRef
Dietary Essential Amino Acid Intake Is Associated with High Muscle Strength in Korean Older Adults
Jihyun Im, Hyoungsu Park, Kyong Park
Nutrients.2022; 14(15): 3104. CrossRef
Handgrip Strength Assessment and Its Associated Factors among Hospitalized Elderly in Klang Valley Hospitals
Khairunisar-E-Rashim Mohammed Yusufirashim, Noraida Omar, Shazli Illyani Mohamad Shafie, Siti Hazimah Nor’hisham
Malaysian Journal of Medicine and Health Sciences.2022; 18(6): 115. CrossRef
A study on the nutrient intake of the elderly in Korea based on activity limitations: data from the 2019 Korea National Health and Nutrition Examination Survey
Soyoung Kim, Youngmi Lee
Journal of Nutrition and Health.2022; 55(5): 543. CrossRef
Association between Sarcopenia and Energy and Protein Intakes in Community-dwelling Elderly
Woori Na, Dayoung Oh, Seohyeon Hwang, Bonghee Chung, Cheongmin Sohn
Korean Journal of Community Nutrition.2022; 27(4): 286. CrossRef
Dietary phytochemicals as a promising nutritional strategy for sarcopenia: a systematic review and meta-analysis of randomized controlled trials
Hye Yun Jeong, Oran Kwon
Applied Biological Chemistry.2021;[Epub] CrossRef
The Effect of Interaction between Obesity and Grip Strength on Health-Related Quality of Life in Elderly: Based on the Korea National Health and Nutrition Examination Survey (2016-2018)
Seungjae Hyun, Darae Woo, Sangshin Park
Journal of Health Informatics and Statistics.2021; 46(1): 28. CrossRef
Nutritional Status according to the Frailty Status of the Elderly at Home in Seo-gu, Gwangju, Korea
Ye Eun Kim, Young-Ran Heo
Korean Journal of Community Nutrition.2021; 26(5): 382. CrossRef

Cite

Related articles