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 nutritional quality. The study examined data from 23,487 non-institutional adults aged 31 and over from the National Health and Nutrition Examination Survey 2005-2016. The researchers used hemoglobin A1c (%) to classify subjects based on glycemic control: non-diabetes (<5.7%); Prediabetes (5.7-6.4%); Diabetes (≥6.5%). The physical function was assessed by means of a questionnaire in which the test subjects themselves indicated physical limitations for 19 individual tasks. Nutritional data was collected from a single 24 hour nutritional reminder and subjects were categorized as meeting or below the protein recommendation of 0.8 g / kg body weight.
It was observed that participants with diabetes who did not meet protein recommendations consumed significantly less energy from all glycemic groups. In addition, adults who did not meet the protein recommendations consumed significantly more total carbohydrates and added sugars in all glycemic groups. Adults in all glycemic groups who 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. Many of these adults also failed to meet the Average Estimated Need (EAR) or Adequate Intake (AI) for fiber, magnesium, choline, and vitamins C, D, E, and K in all glycemic groups.
With the Healthy Eating Index (HEI) -2015, the researchers rated the nutritional quality of the test subjects. The results showed that adults in all glycemic groups had poor nutritional quality below the protein intake recommendation. HEI levels were below 70% of the ideal level for vegetables, beans, whole grains, dairy products, seafood and vegetable proteins, fatty acids, refined grains, sodium and saturated fat. Subjects with diabetes who met the protein recommendations had better HEI-2015 scores for whole vegetables, whole grains, dairy products, and added sugars than any other group, and in contrast, had the worst HEI-2015 scores for sodium.
When it comes to physical impairment, adults with diabetes are more likely to experience physical limitations than people without diabetes, regardless of protein intake. However, subjects who did not meet the protein recommendations reported significantly more physical limitations in all glycemic groups than those who met the protein recommendations. The most common restrictions for all glycemic groups included stooping, squatting, and kneeling; long standing; and pushing or pulling large objects. Fifty-two percent of the diabetic population who fell below the protein recommendations reported restrictions on bending, squatting, and kneeling.
“We’ve long studied the effects of sugar consumption in people with diabetes, but new data is shedding light on the critical link between low protein intake and diabetes,” said Christopher Taylor, PhD, RD, senior researcher and professor of medical dietetics at the Ohio State University School of Health and Rehabilitation Sciences. “Diabetes is associated with the risk of developing low muscle mass, which can lead to falls and other injuries. Because of this, protein consumption – and awareness of its need – is critical to maintaining muscle mass and maintaining functional mobility, which can help people living with diabetes lead an overall stronger life. “
“This study underscores the importance of the quality of food in our diet and the amount of nutrients we need each day – both of which have a significant impact on health and mobility, especially for people with diabetes,” said Sara Thomas, PhD, RDN, researcher and nutritionist at Abbott, in a press release. “Nutritional education will help people deal successfully with a condition like diabetes and emphasize the need to achieve a balanced diet containing the right nutrients and avoid foods that are harmful to optimal health.”
- Fanelli SM et al. “Low Protein Intakes and Poor Nutritional Quality Are Associated with Functional Limitations in US Adults with Diabetes: An NHANES Analysis 2005-2016.” Nutrition, Vol. 13, no. 8 (2021): 2582