Cosa sono le proteine e perché ne abbiamo bisogno?

Transcription

1 Cosa sono le proteine e perché ne abbiamo bisogno? Riccardo Calvani, PhD Dipartimento di Geriatria, Neuroscienze e Ortopedia Università Cattolica del Sacro Cuore

2 Man is what he eats Outline Nutrition, Protein and Hormesis Food protein role in frail life stages History of enthusiasm for protein Protein requirements

3 The doctrine of foods is of great ethical and political significance. Food becomes blood, blood becomes heart and brain, thoughts and mind stuff. Human fare is the foundation of human culture and thought. Would you improve a nation? Give it, instead of declamations against sin, better food. Man is what he eats [Der Mensch ist, was er isst]. Ludwig Andreas Feuerbach Lehre der Nahrungsmittel: Für das Volk(1850).

4 PLoS ONE 7(10): e doi: /journal.pone

5 PLoS ONE 7(4): e doi: /journal.pone

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8 Nutrizione, Proteine e Ormesi Mitridate VI del Ponto

9 PEM Protein Energy Malnutrition

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12 Modificazioni con l invecchiamento After age 40, healthy adults can lose 8% of muscle every 10 years Between 40 to 70 years old, healthy adults lose an average of 24% of muscle % loss from age % peak muscle mass % Loss each decade after age 70 Flakoll P, et al. Nutrition 2004 Baier S, et al. JPEN J Parenter Enteral Nutr 2009

13 Modificazioni con l invecchiamento For optimal maintenance with aging, it is important to build muscle when young, maintain it in mid-life, and minimize loss in older adulthood Build Maintain Minimize Loss Sayer AA, et al. J Nutr Health Aging 2008

14 Protein g/kg/d

15 Low protein intake increases risk of frailty Odds ratio (with 95% CI) Lower quintiles of protein intake are associated with higher risk of frailty 70.8 g/day g/day g/day g/day Q2 Q3 Q4 Q5 Risk of frailty by quintile of protein intake (% kcal) (n= 24,417) Increasing dietary protein intake, % of kcal Beasley JM, et al. J Am Geriatr Soc. 2010;58: TNT Geriatric 2.0 Session 2 15

16 J. Nutr. 116: Justus von Liebig Carl von Voit Wilbur Olin Atwater Protein was truly nutritive, whereas other organic compounds were only "respiratory. Voit recommended a dietary protein intake of 118 g/d for an adult human of average weight doing moderate muscular work. a general consensus of opinion that the protein element should amount to over 100 g a day, and the energy value should be over 3000 calories.

17 J. Nutr. 116: Russell Henry Chittenden one-half of the 118 g of protein food called for daily by the ordinary standards is quite sufficient to meet all the real physiologic need of the body, certainly under the ordinary conditions of life; and with most individuals, especially persons not leading an active out-of-door life, even smaller amounts of will suffice

18 Data for 235 individual subjects, each studied at 3 test protein intakes, were gathered from 19 studies. (WHO/FAO 2007) This meta-analysis provides new recommendations for dietary reference values, ie, an EAR (median) and RDA(97.5th percentile) for healthy adults of 105 and 132 mg N kg -1 d -1 (0.65 and 0.83 g good-quality protein kg -1 d -1 ), respectively

19 Protein Quality = protein digestibility * indispensable amino acids content FAO 2013 This Consultation recognises the inherent limitations in currently accepted values of protein and amino acid requirements identified in this report as amino acid scoring patterns. Further studies are clearly needed that include chronic disease related outcomes and functional studies as delineated in Figure 2 of this report. It is also noted that with very few exceptions, N-balance studies of the protein requirement have not included measures of specific physiological outcomes. It is recommended that future studies of the protein requirement incorporate where possible measures of specific physiological outcomes.

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21 Apporti di Proteine dagli alimenti nella popolazione italiana Numero soggetti Apporti con gli alimenti (g/die) (g/kg peso) (g/1000 Kcal) Maschi anni ,0 1,2 38,7 60 anni ,8 1,1 38,5 Femmine anni ,3 1,2 39,5 60 anni ,0 1,1 38,8 Dati INRAN-SCAI

22 Fonti alimentari di proteine per la popolazione italiana Gruppi alimentari Contributo% Cereali e derivati 29% Carne e derivati 28% Latte e derivati 21% Pesce e prodotti della pesca 9% Uova 3% Verdure e ortaggi 4% Frutta 2% Dati INRAN-SCAI Legumi 1,4%

23 Food vs you: How your dinner controls you By Mark Peplow "The 'right diet' isn't the same for everyone, 2

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25 The Journal of Frailty & Aging 03/2013; 2(1):

26 "I have had to eat my own words many times, and I have found it a very nourishing diet. Sir Winston Churchill