Distribution of daily protein intake across meals and all-cause mortality in community-dwelling older adults

Recent findings suggest that the distribution of protein intake throughout the day has an impact on various health outcomes in older adults, independently of the amount consumed. We evaluated the association between the distribution of dietary protein intake across meals and all-cause mortality in community-dwelling older adults. Data from 3225 older adults aged >= 60 years from the Seniors-ENRICA-1 cohort were examined. Habitual dietary protein consumption was collected in 2008-2010 and in 2012 through a validated diet history. Protein distribution across meals was calculated for each participant as the coefficient of variation (CV) of protein intake per meal, in sex-specific tertiles. Vital status was obtained from the National Death Index up to 30 January 2020. Cox proportional hazards regression was performed to determine the hazard ratios (HR) and their 95 % CI for the association between the distribution of daily protein intake across meals and all-cause mortality. Over a median follow-up of 10 center dot 6 years, 591 deaths occurred. After adjustment for potential confounders, the CV of total protein intake was not associated with all-cause mortality (HR and 95 % CI in the second and third tertile v. the lowest tertile: 0 center dot 94 (0 center dot 77, 1 center dot 15) and 0 center dot 88 (0 center dot 72, 1 center dot 08); P-trend = 0 center dot 22). Similarly, the HR of all-cause mortality when comparing extreme tertiles of CV for types of protein were 0 center dot 89 (0 center dot 73, 1 center dot 10) for animal-protein intake and 1 center dot 02 (0 center dot 82, 1 center dot 25) for plant-protein intake. Dietary protein distribution across meals was not associated with all-cause mortality, regardless of protein source and amount, among older adults. Further studies should investigate whether this picture holds for specific causes of death.