Low protein intake associated with poor diet and physical limitations in diabetics, says recent study

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A recent study published in Nutrients¹ and funded by Abbott Nutrition, found that low protein intake in people with diabetes was associated with physical limitations and poor diet quality. The study examined data from 23,487 non-institutionalized adults, 31 years and older, from the 2005–2016 National Health and Nutrition Examination Survey. Researchers used hemoglobin A1c (%) to classify subjects by glycemic control: non-diabetes (<5.7%); pre-diabetes (5.7–6.4%); diabetes (≥6.5%). Physical functioning was assessed through a questionnaire in which subjects self-reported physical limitations for 19 discrete tasks. The dietary data was collected from a single 24-hour dietary recall, and subjects were categorized as meeting or below the protein recommendation of 0.8 g/kg of body weight.

It was observed that the participants with diabetes that did not meet protein recommendations consumed significantly less energy of all the glycemic groups. Additionally, adults not meeting protein recommendations consumed significantly more total carbohydrates and added sugars across all glycemic groups. Adults across all glycemic groups that were below the protein intake recommendations also consumed significantly less total fat, saturated fat, monounsaturated fat, choline, vitamin B12, phosphorus, zinc, sodium, and selenium per 1000 kcal. Nor did many of these adults meet the Estimated Average Requirements (EAR) or Adequate Intakes (AI) for fiber, magnesium, choline, and vitamins C, D, E, and K across all glycemic groups.

Using the Healthy Eating Index (HEI)-2015, researchers assessed the subjects’ dietary quality. Results showed that adults across all glycemic groups below the protein intake recommendation had poor diet quality. HEI scores were below 70% of the ideal score for greens, beans, whole grains, dairy, seafood and plant proteins, fatty acids, refined grains, sodium, and saturated fat. Subjects with diabetes that met the protein recommendations has better HEI-2015 scores for total vegetables, whole grains, dairy, and added sugars than any other group, and in contrast, they had the poorest HEI-2015 score for sodium.

When it came to physical functioning limitations, adults with diabetes has a greater frequency of physical limitations compared to those without diabetes, regardless of protein intake. However, subjects that did not meet protein recommendations reported significantly more numbers of physical limitations than those that did meet protein recommendations across glycemic groups. The most common limitations across all the glycemic groups included stooping, crouching, and kneeling; standing for long periods; and pushing or pulling large objects. Fifty-two percent of the diabetes population below protein recommendations reported limitations with stooping, crouching, and kneeling.

"We've long studied the impact of sugar consumption in people living with diabetes, but new data shed light on the critical association between low protein intake and diabetes," said Christopher Taylor, PhD, RD, lead researcher, and professor of Medical Dietetics at The Ohio State University School of Health and Rehabilitation Sciences. "Diabetes is associated with a risk for developing low muscle mass, which can lead to falls and other injuries. That's why protein consumption—and awareness of the need for it—is critical to maintaining muscle mass and preserving functional mobility, which can help people living with diabetes live stronger overall lives."

"This study highlights the importance of the quality of foods in our diet as well as the quantity of nutrients we need daily—both of which have a significant impact on health and mobility, especially for people living with diabetes," said Sara Thomas, PhD, RDN, research scientist and dietitian at Abbott, in a press release. "Nutrition education will help people successfully manage a condition like diabetes, emphasizing the need to achieve a well-rounded diet with the right nutrients and avoid foods that are detrimental to optimal health."

Reference

1. Fanelli SM et al. “Low protein intakes and poor diet quality associate with functional Limitations in US adults with diabetes: A 2005–2016 NHANES analysis.” Nutrition, vol. 13, no. 8 (2021): 2582