Increasing Dietary Protein Requirements in Elderly People for Optimal Muscle and Bone Health

Allied Health Sciences, University of Connecticut, Storrs, Connecticut 06269, USA.
Journal of the American Geriatrics Society (Impact Factor: 4.57). 05/2009; 57(6):1073-9. DOI: 10.1111/j.1532-5415.2009.02285.x
Source: PubMed


Osteoporosis and sarcopenia are degenerative diseases frequently associated with aging. The loss of bone and muscle results in significant morbidity, so preventing or attenuating osteoporosis and sarcopenia is an important public health goal. Dietary protein is crucial for development of bone and muscle, and recent evidence suggests that increasing dietary protein above the current Recommended Dietary Allowance (RDA) may help maintain bone and muscle mass in older individuals. Several epidemiological and clinical studies point to a salutary effect of protein intakes above the current RDA (0.8 g/kg per day) for adults aged 19 and older. There is evidence that the anabolic response of muscle to dietary protein is attenuated in elderly people, and as a result, the amount of protein needed to achieve anabolism is greater. Dietary protein also increases circulating insulin-like growth factor, which has anabolic effects on muscle and bone. Furthermore, increasing dietary protein increases calcium absorption, which could be anabolic for bone. Available evidence supports a beneficial effect of short-term protein intakes up to 1.6 to 1.8 g/kg per day, although long-term studies are needed to show safety and efficacy. Future studies should employ functional measures indicative of protein adequacy, as well as measures of muscle protein synthesis and maintenance of muscle and bone tissue, to determine the optimal level of dietary protein. Given the available data, increasing the RDA for older individuals to 1.0 to 1.2 g/kg per day would maintain normal calcium metabolism and nitrogen balance without affecting renal function and may represent a compromise while longer-term protein supplement trials are pending.

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Available from: Erin Gaffney-Stomberg, Dec 03, 2015
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    • "g/kg/day. Furthermore, it is important to highlight that protein should be consumed in a pattern spread out through the day (approximately 30 g at each meal for a 70-kg person) in order optimize the muscular anabolic response[33,34]. Finally, Vitamin D supplementation (800 UI/day) increases the number and cross-sectional area of type II muscle fibers (which are typically lost in sarcopenic persons)[35]. "
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    ABSTRACT: Older people frequently fail to ingest adequate amount of food to meet their essential energy and nutrient requirements. Anorexia of aging, defined by decrease in appetite and/or food intake in old age, is a major contributing factor to under-nutrition and adverse health outcomes in the geriatric population. This disorder is indeed highly prevalent and is recognized as an independent predictor of morbidity and mortality in different clinical settings. Even though anorexia is not an unavoidable consequence of aging, advancing age often promotes its development through various mechanisms. Age-related changes in life-style, disease conditions, as well as social and environmental factors have the potential to directly affect dietary behaviors and nutritional status. In spite of their importance, problems related to food intake and, more generally, nutritional status are seldom attended to in clinical practice. While this may be the result of an “ageist” approach, it should be acknowledged that simple interventions, such as oral nutritional supplementation or modified diets, could meaningfully improve the health status and quality of life of older persons.
    Full-text · Article · Jan 2016 · Nutrients
    • "Unfortunately, many older adults are not meeting the Recommended Dietary Allowance (RDA) of 0.8 g/kg/d for protein intake (Food and Nutrition Information Center, 2012; Fulgoni, 2008). Furthermore, some research even suggest that increasing protein recommendations for older adults above the current RDA may be beneficial in preventing loss of lean body mass, frailty, and sarcopenia (Beasley et al., 2010; Gaffney-Stromberg et al., 2009; Houston et al., 2008). For instance, Houston et al. (2008) reported that older adults whose protein consumption comprised 18.2% (1.1 g/kg/d) of daily energy intake lost 40% less lean body mass than older adults whose protein consumption comprised 11.2% (0.7 g/kg/d) of daily energy intake. "
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    ABSTRACT: Abstract Protein-enhanced soups (PES) may improve protein intake among older adults. This study examined sensory attributes (aroma, texture, taste, and overall acceptability) and preferences of PES (chicken noodle and cheddar broccoli) compared with flavor-matched control soups (FCS) among older adults (≥65 years) and evaluated dietary profile changes of a standard menu based on the substitution of one PES serving/d for a standard soup. Modified paired preference tests and 5-point facial hedonic scales were administered to participants (n = 44). No significant differences in sensory attributes between either PES compared with FCS were identified, but significant gender- and age-related differences (p < 0.05) were observed. About Sixty-one percent of participants preferred protein-enhanced chicken noodle soup while only 38% preferred protein-enhanced cheddar broccoli soup to their respective FCS. Substituting one PES serving for one non-fortified soup serving per day resulted in significantly higher (p < 0.001) protein profile. Results suggest that all attributes of PES were consistent with sensory expectations and PES substitution could improve protein provision.
    No preview · Article · Sep 2014 · International Journal of Food Sciences and Nutrition
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    • "However, evidence continues to build in favor of increasing this recommendation for optimal protein intake to 1.0e1.2 g/kg body weight/day for adults older than 65 years [5] [7] [19] [20]. Taken together, evidence shows that when usual dietary protein intake does not meet increased protein needs of older adults, negative nitrogen balance results and protein levels decline, especially skeletal muscle proteins. "
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    ABSTRACT: The aging process is associated with gradual and progressive loss of muscle mass along with lowered strength and physical endurance. This condition, sarcopenia, has been widely observed with aging in sedentary adults. Regular aerobic and resistance exercise programs have been shown to counteract most aspects of sarcopenia. In addition, good nutrition, especially adequate protein and energy intake, can help limit and treat age-related declines in muscle mass, strength, and functional abilities. Protein nutrition in combination with exercise is considered optimal for maintaining muscle function. With the goal of providing recommendations for health care professionals to help older adults sustain muscle strength and function into older age, the European Society for Clinical Nutrition and Metabolism (ESPEN) hosted a Workshop on Protein Requirements in the Elderly, held in Dubrovnik on November 24 and 25, 2013. Based on the evidence presented and discussed, the following recommendations are made (a) for healthy older people, the diet should provide at least 1.0-1.2 g protein/kg body weight/day, (b) for older people who are malnourished or at risk of malnutrition because they have acute or chronic illness, the diet should provide 1.2-1.5 g protein/kg body weight/day, with even higher intake for individuals with severe illness or injury, and (c) daily physical activity or exercise (resistance training, aerobic exercise) should be undertaken by all older people, for as long as possible.
    Full-text · Article · Apr 2014 · Clinical nutrition (Edinburgh, Scotland)
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