Thesis (M.A.) -- Mahidol University, 1979.

The loss of muscle (mass, strength, and function) occurs in many individuals in their 40’s and begins to accelerate after 50 years of age resulting from multiple understood mechanisms. While many factors are thought to contribute to the changes that are observed in muscle with aging, one significant, yet modifiable factor is dietary protein intake. This study proposed to improve dietary protein intake in a group of middle-aged women living in South Florida over a 12-week period using individualized per-meal protein prescriptions (1.2 g protein/kg body weight evenly distributed for all three meals) provided by a Registered Dietitian, followed by weekly diet coaching from a Nurse Practitioner (coach). Aims included: (1) An examination of the effect of diet coaching on protein intake, nutrition knowledge, muscle mass, strength, and function and (2) An understanding of how diet coaching sessions help in the process of making dietary changes. A parallel mixed methods research design allowed for a synthesis of inferences from each aim resulting in a meta-inference highlighting interdisciplinary collaboration. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2020. / FAU Electronic Theses and Dissertations Collection

Diss. (sammanfattning) Umeå : Umeå universitet, 2006. / Härtill 5 uppsatser.

Previous controlled studies have shown that severe daytime restriction of dietary protein improves the efficacy of L-dopa and reduces response fluctuations in some Parkinson's disease in-patients. The main purpose of the present study was to investigate the nutritional adequacy of the restricted protein diet. Other objectives were to assess the patients' acceptance of the diet and to identify the practical difficulties encountered in following the diet at home. The effect of the restricted protein diet on the subjects' response to levodopa was also examined. Subjects were 11 free-living, otherwise healthy Parkinson's disease patients who suffered from unpredictable response fluctuations to Sinemet (L-dopa containing medicine). This condition is also described as the "on-off" phenomenon. They were counselled to consume a daytime restricted protein diet for 6 weeks (mean ± s.d. protein intake before evening meal 12 ± 2 g for females and 14 ± 3 g for males). Food intake was unrestricted from dinner until bedtime, and subjects were encouraged to consume nutrient-dense foods during this period. The subjects were required to complete a series of three 6-day food records and "on-off" charts (pre-diet, diet week 2, diet week 6). The "on-off" charts indicated the daily number of hours spent in the "on" state (when medication is effective and parkinsonian symptoms are controlled) and in the "off" state (when medication is not effective and symptoms are not well controlled). Hemoglobin, plasma albumin, prealbumin and ferritin were measured before and after the 6-week diet period. Subjective evaluation questionnaires were completed by all participants and their spouses or caregivers. Results from dietary record analysis showed that the restricted protein diet was associated with significant decreases in total intakes of protein, calcium, iron, magnesium, phosphorus, niacin, riboflavin, vitamin B6 and pantothenate, in comparison to "usual" intakes. Intake of energy, carbohydrates, lipids, potassium, thiamin, folacin, and vitamins A, C and B12 did not change significantly. While on the restricted protein diet, only calcium intake was substantially less than the RNI. Biochemical measures of nutritional status were not significantly reduced. Mean body weight tended to decrease (p=.054) over the first 2 weeks and then stabilized until the end of the study period. The results of the "on-off" charts showed that three of the eleven subjects significantly increased their daily time "on" while on the restricted protein diet. Subjectively, six individuals noted an improvement in daytime mobility and indicated that they would maintain the diet for an indefinite period of time. Problems identified by the subjects included hunger prior-'to the evening meal and a lack of variety in food choices. These results show that otherwise healthy and motivated patients with Parkinson's disease can maintain an adequate intake of energy, protein, and most nutrients while on the daytime restricted protein diet. The diet appeared to be relatively well tolerated by patients who obtained a subjective benefit. It is suggested that in patients whose regular diets are marginally adequate, the restricted protein diet might compromise nutrient intakes. Counselling by a registered dietitian is recommended for all patients who undertake this type of diet. / Land and Food Systems, Faculty of / Graduate