Samenvatting

Background/purpose: For prevention of sarcopenia and functional decline in community-dwelling older adults, a higher daily protein intake is needed. A new e-health strategy for dietary counselling was used with the aim to increase total daily protein intake to optimal levels (minimal 1.2 g/kg/day, optimal 1.5 g/kg/day) through use of regular food products. Methods: The VITAMIN (VITal Amsterdam older adults IN the city) RCT included 245 community-dwelling older adults (age ≥ 55y): control, exercise, and exercise plus dietary counselling (protein) group. The dietary counselling intervention was based on behaviour change and personalization. Dietary intake was measured by a 3d dietary record at baseline, after 6-month intervention and 12-month follow-up. The primary outcome was average daily protein intake (g/kg/day). Sub-group analysis and secondary outcomes included daily protein distribution, sources, product groups. A Linear Mixed Models (LMM) of repeated measures was performed with STATA v13. Results: Mean age of the 224 subjects was 72.0(6.5) years, a BMI of 26.0(4.2). The LMM showed a significant effect of time and time*group (p<0.001). The dietary counselling group showed higher protein intake than either control (1.41 vs 1.13 g/kg/day; β +0.32; p<0.001) or exercise group (1.41 vs 1.11 g/kg/day; β +0.33; p<0.001) after 6-month intervention and 12-month follow-up. Conclusions and implications: This study shows digitally supported dietary counselling improves protein intake sufficiently in communitydwelling older adults with use of regular food products. Protein intake increase by personalised counselling with e-health is a promising strategy for dieticians.