公衆衛生85巻8号

2021年08月発行

特集 高齢者の低栄養予防・フレイル予防

高齢者におけるたんぱく質必要量の考え方と課題

著者： 鳴海(百武)愛子¹

所属機関： ¹神戸学院大学栄養学部公衆栄養・衛生学部門

ページ範囲：P.526 - P.531

【ポイント】
◆高齢者におけるたんぱく質の必要量の考え方の理解には，食事摂取基準の推定平均必要量と目標量の両方の理解が必要である．
◆高齢者におけるたんぱく質の維持必要量は，成人と比べるとエビデンスが少ない，維持必要量検討のための方法に限界があるという課題がある．
◆習慣的なたんぱく質摂取量とフレイルについて，明確な結論は得られていない．目標量設定の背景について理解した上で数値を活用する必要がある．

参考文献

1)厚生労働省：日本人の食事摂取基準(2020年版)「日本人の食事摂取基準」策定検討会報告書．2019年12月　https://www.mhlw.go.jp/content/10904750/000586553.pdf

2)木戸康博：たんぱく質・アミノ酸の必要量に関する研究．栄養学雑誌69:285〜293，2011

3)Li M, et a:Protein requirements in healthy adults:a meta-analysis of nitrogen balance studies. Biomed Environ Sci 27:606-613, 2014

4)Bauer J, et al:Evidence-based recommendations for optimal dietary protein intake in older people:a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc 14:542-559, 2013

5)Australian Government Department of Health, New Zealand Ministry of Health:Nutrient Reference Values for Australia and New Zealand.　https://www.nrv.gov.au/

6)髙田和子：安定同位体を使用したヒトの栄養に関する研究．RADIOISOTOPES 64:475-488, 2015

7)Mao D, et al:Protein Requirements of Elderly Chinese Adults Are Higher than Current Recommendations. J Nutr 150:1208-1213, 2020

8)Lorenzo-López L, et al:Nutritional determinants of frailty in older adults:A systematic review. BMC Geriatr 17:108, 2017

9)Artaza-Artabe I, et al:The relationship between nutrition and frailty:Effects of protein intake, nutritional supplementation, vitamin D and exercise on muscle metabolism in the elderly. A systematic review. Maturitas 93:89-99, 2016

10)Beasley JM, et al:Protein intake and incident frailty in the Women's Health Initiative observational study. J Am Geriatr Soc 58:1063-1071, 2010

11)Sandoval-Insausti H, et al:Macronutrients Intake and Incident Frailty in Older Adults:A Prospective Cohort Study. J Gerontol A Biol Sci Med Sci 71:1329-34, 2016

12)Shikany JM, et al:Macronutrients, diet quality, and frailty in older men. J Gerontol A Biol Sci Med Sci 69:695-701, 2014

13)Bartali B, et al:Low nutrient intake is an essential component of frailty in older persons. J Gerontol A Biol Sci Med Sci 61:589-593, 2006

14)Bollwein J, et al:Distribution but not amount of protein intake is associated with frailty:a cross-sectional investigation in the region of Nürnberg. Nutr J 12:109, 2013

15)Kobayashi S, et al:High protein intake is associated with low prevalence of frailty among old Japanese women:a multicenter cross-sectional study. Nutr J 12:164, 2013

16)Kobayashi S, et al:Diet with a combination of high protein and high total antioxidant capacity is strongly associated with low prevalence of frailty among old Japanese women:a multicenter cross-sectional study. Nutr J 16:29, 2017

17)Rahi B, et al:Higher Protein but Not Energy Intake Is Associated With a Lower Prevalence of Frailty Among Community-Dwelling Older Adults in the French Three-City Cohort. J Am Med Dir Assoc 17:672. e7-672. e11, 2016

18)Coelho-Júnior HJ, et al:Low Protein Intake Is Associated with Frailty in Older Adults:A Systematic Review and Meta-Analysis of Observational Studies. Nutrients 10:E1334, 2018

19)Mendonça N, et al:Protein intake and transitions between frailty states and to death in very old adults:the Newcastle 85＋ study. Age Ageing 49:32-38, 2019

20)Isanejad M, et al:Higher protein intake is associated with a lower likelihood of frailty among older women, Kuopio OSTPRE-Fracture Prevention Study. Eur J Nutr 59:1181-1189, 2020

21)Verspoor E, et al:Macronutrient intake and frailty:the Rotterdam Study. Eur J Nutr 59:2919-2928, 2020

22)Schoufour JD, et al:The association between dietary protein intake, energy intake and physical frailty:results from the Rotterdam Study. Br J Nutr 121:393-401, 2019

23)Kaimoto K, et al:Association of Protein and Magnesium Intake with Prevalence of Prefrailty and Frailty in Community-Dwelling Older Japanese Women. J Nutr Sci Vitaminol(Tokyo)67:39-47, 2021