nutrients
Article
Digitally Supported Dietary Protein Counseling Changes
Dietary Protein Intake, Sources, and Distribution in
Community-Dwelling Older Adults
Jantine van den Helder
1,
* , Sjors Verlaan
2,3
, Michael Tieland
1
, Jorinde Scholten
1
, Sumit Mehra
1,4
,
Bart Visser
1
, Ben J. A. Kröse
1,5
, Raoul H. H. Engelbert
1,6
and Peter J. M. Weijs
1,7,
*
Citation: van den Helder, J.; Verlaan,
S.; Tieland, M.; Scholten, J.; Mehra, S.;
Visser, B.; Kröse, B.J.A.; Engelbert,
R.H.H.; Weijs, P.J.M. Digitally
Supported Dietary Protein
Counseling Changes Dietary Protein
Intake, Sources, and Distribution in
Community-Dwelling Older Adults.
Nutrients 2021, 13, 502. https://
doi.org/10.3390/nu13020502
Academic Editor: Stéphane Walrand
Received: 17 December 2020
Accepted: 29 January 2021
Published: 3 February 2021
Publisher’s Note: MDPI stays neutral
with regard to jurisdictional claims in
published maps and institutional affil-
iations.
Copyright: © 2021 by the authors.
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
4.0/).
1
Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam,
The Netherlands; m.tieland@hva.nl (M.T.); jorindescholten@gmail.com (J.S.); s.mehra@hva.nl (S.M.);
b.visser2@hva.nl (B.V.); b.j.a.krose@hva.nl (B.J.A.K.); r.h.h.engelbert@hva.nl (R.H.H.E.)
2
FrieslandCampina, 3818 LE Amersfoort, The Netherlands; sjors.verlaan@frieslandcampina.com or
g.verlaan@amsterdamumc.nl
3
Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Vrije Universiteit,
1081 HV Amsterdam, The Netherlands
4
CREATE-IT Applied Research, Amsterdam University of Applied Sciences,
1091 GC Amsterdam, The Netherlands
5
Informatics Institute, University of Amsterdam, 1090 GH Amsterdam, The Netherlands
6
Department of Rehabilitation, Amsterdam University Medical Centers, University of Amsterdam,
1105 AZ Amsterdam, The Netherlands
7
Department of Nutrition and Dietetics, Amsterdam University Medical Centers, VU University,
1081 HV Amsterdam, The Netherlands
* Correspondence: j.e.m.van.den.helder@hva.nl (J.v.d.H.); p.j.m.weijs@hva.nl(P.J.M.W.);
Tel.: +31-(62)-1155919 (J.v.d.H.)
Abstract: Digitally supported dietary counselling may be helpful in increasing the protein intake
in combined exercise and nutritional interventions in community-dwelling older adults. To study
the effect of this approach, 212 older adults (72.2 ± 6.3 years) were randomised in three groups:
control, exercise, or exercise plus dietary counselling. The dietary counselling during the 6-month
intervention was a blended approach of face-to-face contacts and videoconferencing, and it was
discontinued for a 6-month follow-up. Dietary protein intake, sources, product groups, resulting
amino acid intake, and intake per eating occasion were assessed by a 3-day dietary record. The
dietary counselling group was able to increase the protein intake by 32% at 6 months, and the intake
remained 16% increased at 12 months. Protein intake mainly consisted of animal protein sources:
dairy products, followed by fish and meat. This resulted in significantly more intake of essential
amino acids, including leucine. The protein intake was distributed evenly over the day, resulting
in more meals that reached the protein and leucine targets. Digitally supported dietary counselling
was effective in increasing protein intake both per meal and per day in a lifestyle intervention in
community-dwelling older adults. This was predominantly achieved by consuming more animal
protein sources, particularly dairy products, and especially during breakfast and lunch.
Keywords: ageing; counselling; e-health; nutrition; protein; sarcopenia
1. Introduction
As the population is ageing worldwide, the preservation of mobility, vitality, and
independent living are of utmost importance for older adults. Effective exercise and
nutritional interventions are recommended to support healthy and active ageing [1]. The
combination of exercise training with optimal dietary protein intake has been intensively
studied in randomised controlled trials [2]. These trials in older adults showed that exercise
and dietary protein stimulated muscle mass gains and the effects on physical function are
promising [3,4]. Although these studies show relevant benefits of protein supplementation,
Nutrients 2021, 13, 502. https://doi.org/10.3390/nu13020502 https://www.mdpi.com/journal/nutrients