Table 3

Multivariate adjusted odds ratios and 95% confidence intervals for frailty compared to no frailty by quintile of protein and amino acid intakes among 2108 elderly Japanese women
Q1 (Lowest) (n = 421) Q2 (n = 422) Q3 (n = 422) Q4 (n = 422) Q5 (Highest) (n = 421) P for trend
Protein*
Total protein, g/d ≤62.9 63.0-69.8 69.8-76.1 76.1-84.3 ≥84.3
   n of frailty/no frailty† 113/308 117/305 90/332 82/340 79/342
   Age adjusted OR (95% CI) 1.00 (reference) 1.07 (0.78, 1.48) 0.76 (0.54, 1.05) 0.70 (0.50, 0.98) 0.65 (0.46, 0.91) 0.0008
   Multivariate adjusted OR (95% CI)‡ 1.00 (reference) 1.02 (0.72, 1.45) 0.64 (0.45, 0.93) 0.62 (0.43, 0.90) 0.66 (0.46, 0.96) 0.001
Animal protein§, g/d ≤31.8 31.8-38.8 38.8-45.6 45.6-54.8 ≥54.8
   n of frailty/no frailty† 104/317 117/305 94/328 89/333 77/333
   Age adjusted OR (95% CI) 1.00 (reference) 1.20 (0.87, 1.66) 0.88 (0.63, 1.22) 0.86 (0.61, 1.20) 0.71 (0.50, 1.00) 0.008
   Multivariate adjusted OR (95% CI)‡ 1.00 (reference) 1.12 (0.79, 1.59) 0.76 (0.52, 1.09) 0.71 (0.49, 1.02) 0.73 (0.50, 1.06) 0.009
Plant protein||, g/d ≤27.1 27.1-29.4 29.4-31.2 31.2-33.9 ≥33.9
   n of frailty/no frailty† 117/304 102/320 82/340 98/324 82/339
   Age adjusted OR (95% CI) 1.00 (reference) 0.82 (0.59, 1.13) 0.60 (0.43, 0.84) 0.71 (0.51, 0.98) 0.62 (0.44, 0.87) 0.003
   Multivariate adjusted OR (95% CI)‡ 1.00 (reference) 0.73 (0.52, 1.04) 0.59 (0.41, 0.86) 0.72 (0.51, 1.04) 0.66 (0.45, 0.95) 0.04
Amino acids*
Essential amino acids, g/d ≤24.1 24.1-27.0 27.0-29.7 29.8-33.3 ≥33.3
   n of frailty/no frailty† 108/313 121/301 95/327 80/342 77/344
   Age adjusted OR (95% CI) 1.00 (reference) 1.17 (0.85, 1.61) 0.86 (0.62, 1.20) 0.74 (0.52, 1.04) 0.67 (0.47, 0.94) 0.001
   Multivariate adjusted OR (95% CI)‡ 1.00 (reference) 1.12 (0.79, 1.59) 0.72 (0.50, 1.05) 0.64 (0.44, 0.93) 0.69 (0.47, 1.00) 0.002
Branched chain amino acids, g/d ≤10.6 10.6-11.8 11.8-12.9 12.9-14.3 ≥14.3
   n of frailty/no frailty† 108/313 117/305 96/326 81/341 79/342
   Age adjusted OR (95% CI) 1.00 (reference) 1.12 (0.81, 1.54) 0.85 (0.61, 1.18) 0.74 (0.53, 1.04) 0.68 (0.48, 0.96) 0.003
   Multivariate adjusted OR (95% CI)‡ 1.00 (reference) 1.06 (0.75, 1.50) 0.75 (0.53, 1.08) 0.63 (0.43, 0.92) 0.70 (0.49, 1.02) 0.004
Leucine, g/d ≤4.78 4.78-5.31 5.31-5.82 5.82-6.44 ≥6.45
   n of frailty/no frailty† 110/311 116/306 94/328 82/340 79/342
   Age adjusted OR (95% CI) 1.00 (reference) 1.08 (0.78, 1.48) 0.81 (0.58, 1.23) 0.74 (0.53, 1.04) 0.67 (0.47, 0.94) 0.002
   Multivariate adjusted OR (95% CI)‡ 1.00 (reference) 1.02 (0.72, 1.45) 0.72 (0.50, 1.04) 0.63 (0.43, 0.92) 0.69 (0.48, 1.00) 0.004
Isoleucine, g/d ≤2.66 2.66-2.97 2.97-3.27 3.27-3.64 ≥3.64
   n of frailty/no frailty† 109/312 115/307 95/327 86/336 76/345
   Age adjusted OR (95% CI) 1.00 (reference) 1.09 (0.79, 1.50) 0.83 (0.60, 1.16) 0.80 (0.57, 1.12) 0.64 (0.46, 0.91) 0.002
   Multivariate adjusted OR (95% CI)‡ 1.00 (reference) 1.07 (0.75, 1.51) 0.74 (0.51, 1.06) 0.69 (0.47, 1.00) 0.68 (0.47, 0.98) 0.004
Valine, g/d ≤3.18 3.18-3.50 3.50-3.83 3.83-4.26 ≥4.26
   n of frailty/no frailty† 105/316 121/301 93/329 82/340 80/341
   Age adjusted OR (95% CI) 1.00 (reference) 1.18 (0.86, 1.63) 0.86 (0.62, 1.20) 0.76 (0.54, 1.08) 0.72 (0.51, 1.01) 0.004
   Multivariate adjusted OR (95% CI)‡ 1.00 (reference) 1.15 (0.81, 1.63) 0.76 (0.53, 1.10) 0.67 (0.46, 0.97) 0.74 (0.51, 1.08) 0.006
Sulfur amino acids, g/d ≤2.41 2.41-2.67 2.67-2.90 2.90-3.23 ≥3.24
   n of frailty/no frailty† 102/319 115/307 102/320 81/341 81/340
   Age adjusted OR (95% CI) 1.00 (reference) 1.14 (0.82, 1.58) 0.99 (0.71, 1.38) 0.77 (0.55, 1.08) 0.74 (0.53, 1.05) 0.01
   Multivariate adjusted OR (95% CI)‡ 1.00 (reference) 1.09 (0.77, 1.55) 0.86 (0.60, 1.23) 0.65 (0.45, 0.95) 0.73 (0.50, 1.06) 0.006
Methionine, g/d ≤1.45 1.45-1.64 1.64-1.81 1.81-2.04 ≥2.04
   n of frailty/no frailty† 100/321 119/303 100/322 84/338 78/343
   Age adjusted OR (95% CI) 1.00 (reference) 1.23 (0.89, 1.70) 1.02 (0.73, 1.41) 0.80 (0.57, 1.13) 0.74 (0.52, 1.04) 0.008
   Multivariate adjusted OR (95% CI)‡ 1.00 (reference) 1.14 (0.80, 1.62) 0.89 (0.62, 1.28) 0.67 (0.46, 0.97) 0.74 (0.51, 1.08) 0.006
Cysteine, g/d ≤0.97 0.97-1.04 1.04-1.11 1.11-1.20 ≥1.20
   n of frailty/no frailty† 104/317 120/302 90/332 95/327 72/349
   Age adjusted OR (95% CI) 1.00 (reference) 1.24 (0.90, 1.71) 0.85 (0.61, 1.19) 0.92 (0.66, 1.28) 0.65 (0.46, 0.92) 0.003
   Multivariate adjusted OR (95% CI)‡ 1.00 (reference) 1.26 (0.89, 1.78) 0.73 (0.50, 1.06) 0.85 (0.59, 1.23) 0.67 (0.46, 0.98) 0.005

CI, confidence interval; OR, odds ratio.

*Protein and amino acid intakes were energy-adjusted according to the residual method.

†Frailty score (0-5) was defined as the sum of poor physical function (two points), exhaustion (one point), low physical activity (one point), and unintentional weight loss (one point). A score ≥3 were classified as frailty.

‡Adjusted for age (y, continuous), body mass index (kg/m2, continuous), residential block (Hokkaido and Tohoku, Kanto, Hokuriku and Tokai, Kinki, Chugoku and Shikoku, and Kyushu), size of residential area (city with a population ≥1 million, city with a population <1 million, and town and village), living alone (yes or no), current smoking (yes or no), alcohol drinking (yes or no), dietary supplement use (yes or no), history of chronic disease (any of stroke, myocardial infarction, hypertension, diabetes, or chronic rheumatism; yes or no), depression symptoms (yes or no), and energy intake (kcal/d, continuous).

§Protein from the following four food groups were included in animal protein: fish and shellfish, meat, eggs, and dairy products.

||Protein from the following eight food groups were included in plant protein: cereals, pulses, potatoes, confectionaries, fruits, vegetables, alcoholic beverages, and non-alcoholic beverages.

Kobayashi et al.

Kobayashi et al. Nutrition Journal 2013 12:164   doi:10.1186/1475-2891-12-164

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