Protein Needs For Older Adults

Written by Dr. Steve Chaney on . Posted in Exercise, Fitness and Health, Muscle Therapy and Health

How Much Protein Do We Need?

Author: Dr. Stephen Chaney

 

man lifts weightsWhat are the protein needs for older adults?  In previous “Health Tips From the Professor” I have covered the optimal amount of protein for weight loss diets in high protein diets and weight loss and following workouts . In this issue of “Health Tips From the Professor” I will review the latest information about protein needs as we age.

To put this in perspective, many Americans suffer from sarcopenia (loss of muscle mass) as they age.

Some of you may be saying “So what? I wasn’t planning on being a champion weight lifter in my golden years.” The “So what” is that loss of muscle mass leads to loss of mobility, a tendency to fall (which often leads to debilitating bone fractures) and a lower metabolic rate – which leads to obesity and all of the illnesses that go along with obesity.

How Can We Prevent Loss of Muscle Mass As We Age?

Fortunately, sarcopenia is not an inevitable consequence of aging. There are things that we can do to prevent it. The most important thing that we can do to prevent muscle loss as we age is to exercise – and I’m talking about resistance (weight) training, not just aerobic exercise.

But we also need to look at our protein intake and our leucine intake. Protein is important because our muscle fibers are made of protein.

Leucine is an essential amino acid. It is important because it stimulates the muscle’s ability to make new protein. Leucine and insulin act synergistically to stimulate muscle protein synthesis after exercise. I have covered the evidence behind leucine’s importance in maintaining and building muscle mass in a previous “Health Tips From the Professor”, Leucine Triggers Muscle Mass.

Do Our Protein Needs Increase As We Age?

protein shakeInterestingly, our protein needs actually increase as we age. Campbell et al (Journal of Gerontolgy: Medical Sciences 56A: M373-M380, 2001) showed several years ago that RDA levels of protein were not sufficient to maintain muscle mass in both men & women aged 55 to 77 years old.

Many experts recommend that those of us in our golden years should consume the amount of protein in grams that is equivalent to half our body weight in pounds every day.

When Should We Eat Our Protein?

When we consume the protein is also important. Forget that continental breakfast, salad for lunch and protein-rich dinner. As we age we increasingly need high quality protein at every meal.

In one study, young adults (average age = 31), experienced increased muscle protein synthesis when they consumed as little as 15 grams of protein at a meal, but older adults (average age = 68) experienced no increase in muscle protein synthesis in response to the same low protein meal (Katsanos et al, Am J Clin Nutr 82: 1065-1073).

However, when the amount of protein in a meal was increased to 30 grams (equivalent to a 4 oz piece of chicken or beef) both younger and older adults were able to use that protein to build muscle (Symons et al,Am J Clin Nutr 86: 451-456, 2007).

But, 30 grams seems to be about optimal. Protein intakes above 30 grams in a single meal resulted in no further increase in muscle protein synthesis (Symons et al, J Am Diet Assoc 109: 1582-1586, 2009), which means you can’t hope to get all of the muscle building benefits of protein in a single meal.

As a consequence of these studies most experts recommend that we “golden agers” aim for 20 to 30 grams of high quality protein with every meal.

How Much Leucine Do We Need?

leucine triggers muscle growthThe story with leucine is similar. 1.7 grams of leucine was not sufficient to increase muscle protein synthesis following exercise in older adults, while 2.7 grams was sufficient (Katsanos et al, Am J Physiol Endocrinol Metab 291: E381-E387, 2006). So the experts recommend that older adults get 3 grams of leucine in our diet following workouts to maximize the effect of the workout.

And, of course, if we want to maximize the effects of resistance training, both the protein and leucine need to be consumed after we exercise, not before (Fujita et al, J Appl Physiol 106: 1730-1736, 2009).

Where Do We Get the Protein and Leucine We Need?

So, where do we get the amount of protein and leucine that we are looking for?

If you want to get them from food alone, 4 oz servings of meat are a good starting place – with chicken being the best (35 grams of protein and 2.7 grams of leucine). Dairy, eggs and vegetable foods are much lower in leucine, protein or both.

Unfortunately, I keep running into seniors who are fully convinced that broccoli and tofu will meet their protein needs. I fully understand the rationale for choosing vegetarian protein sources, but you need a bit more than broccoli and tofu if you are going to meet your protein needs in your golden years.

For example, a 4 ounce serving of tofu provides only 10 grams of protein and 0.8 grams of leucine, and a 1.5 cup serving of broccoli provides only 4.2 grams of protein and a miserly 0.36 grams of leucine. That makes it very difficult to meet your target of 20-30 grams of protein and around 2.7 grams of leucine with each meal.

I’m not saying that you can’t get enough protein and leucine to maintain muscle mass on a vegetarian diet. However, you will need to plan that diet very carefully.

So, if you want to know what the old professor does, here it is:

I work out almost every day. On the days when I work out in the morning I rely on a protein shake immediately after the workout to meet my protein and leucine goals. On the days when I train at the gym in the late afternoon, I rely on 4 oz of chicken or fish with dinner to meet those goals.

Those of you who know me know that I will never be featured in muscle magazine, but at least I’m gaining muscle mass – not losing it.

 

The Bottom Line

  • As we age many Americans suffer from sarcopenia (loss of muscle mass). The loss of muscle mass leads to loss of mobility, a tendency to fall (and break things) and a lower metabolic rate – which leads to obesity and all of the illnesses that go along with obesity.
  • The most important thing that we can do to prevent muscle loss as we age is to exercise – especially resistance (weight) training exercise – at least 30 minutes every day. It is also important to make sure that we are getting adequate intake of protein and the essential amino acid leucine.
  • Our protein needs increase as we age. Recent studies suggest that the RDA levels of protein are not sufficient to maintain muscle mass in people over the age of 55. Many experts recommend that those of us in our golden years consume the amount of protein in grams that is equivalent to half our body weight in pounds every day.
  • Recent studies show that it is important to spread that protein out through the day rather than consume one protein rich meal at the end of the day. If we are over 50 we should be aiming at 20-30 grams of protein per meal. However, more than 30 grams of protein at a single serving appears to provide no additional benefit.
  • Seniors also appear to need more leucine in each meal than younger adults if they wish to preserve muscle mass. Young adults need only around 1.7 grams of leucine per serving to stimulate muscle protein synthesis, while mature adults may need as much as 2.7 grams per serving.
  • Well-designed protein shakes and 4 ounces of lean meats are the easiest way for seniors to meet their protein and leucine needs. Vegetarian diets can provide the protein and leucine needed to maintain muscle mass in seniors, but those diets need to be very well planned. Broccoli and tofu just don’t make the grade if you are serious about preserving muscle mass.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Latest Article

Can Plant-based Diets Be Unhealthy?

Posted September 10, 2019 by Dr. Steve Chaney

Do Plant-Based Diets Reduce Heart Disease Deaths?

Author: Dr. Stephen Chaney

 

plant-based diets vegetablesPlant-based diets have become the “Golden Boys” of the diet world. They are the diets most often recommended by knowledgeable health and nutrition professionals. I’m not talking about all the “Dr. Strangeloves” who pitch weird diets in books and the internet. I am talking legitimate experts who have spent their life studying the impact of nutrition on our health.

Certainly, there is an overwhelming body of evidence supporting the claim that plant-based diets are healthy. Going on a plant-based diet can help you lower blood pressure, inflammation, cholesterol and triglycerides. People who consume a plant-based diet for a lifetime weigh less and have decreased risk of heart disease, diabetes, and cancer.

But, can a plant-based diet be unhealthy? Some people consider a plant-based diet to simply be the absence of meat and other animal foods. Is just replacing animal foods with plant-based foods enough to make a diet healthy?

Maybe not. After all, sugar and white flour are plant-based food ingredients. Fake meats of all kinds abound in our grocery stores. Some are very wholesome, but others are little more than vegetarian junk food. If you replace animal foods with plant-based sweets, desserts, and junk food, is your diet really healthier?

While the answer to that question seems obvious, very few studies have asked that question. Most studies on the benefits of plant-based diets have compared population groups that eat a strictly plant-based diet (Seventh-Day Adventists, vegans, or vegetarians) with the general public. They have not looked at variations in plant food consumption within the general public. Nor have they compared people who consume healthy and unhealthy plant foods.

This study (H Kim et al, Journal of the American Heart Association, 8:e012865, 2019) was designed to fill that void.

 

How Was The Study Done?

plant-based diets studyThis study used data collected from 12,168 middle aged adults in the ARIC (Atherosclerosis Risk in Communities) study between 1987 and 2016.

The participant’s usual intake of foods and beverages was assessed by trained interviewers using a food frequency questionnaire at the time of entry into the study and again 6 years later.

Participants were asked to indicate the frequency with which they consumed 66 foods and beverages of a defined serving size in the previous year. Visual guides were provided to help participants estimate portion sizes.

The participant’s adherence to a plant-based diet was assessed using four different well-established plant-based diet scores. For the sake of simplicity, I will include 3 of them in this review.

  • The PDI (Plant-Based Diet Index) categorizes foods as either plant foods or animal foods. A high PDI score means that the participant’s diet contains more plant foods than animal foods. A low PDI score means the participant’s diet contains more animal foods than plant foods.
  • The hPDI (healthy plant-based diet index) is based on the PDI but emphasizes “healthy” plant foods. A high hPDI score means that the participant’s diet is high in healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) and low in animal foods.
  • The uPDI (unhealthy plant-based diet index) is based on the PDI but emphasizes “unhealthy” plant foods. A high uPDI score means that the participant’s diet is high in unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) and low in animal foods.

For statistical analysis the scores from the various plant-based diet indices were divided into 5 equal groups. In each case, the group with the highest score consumed the most plant foods and least animal foods. The group with the lowest score consumed the least plant foods and the most animal foods.

The health outcomes measured in this study were heart disease events, heart disease deaths, and all-cause deaths. Again, for the sake of simplicity, I will only include 2 of these outcomes (heart disease deaths and all-cause deaths) in this review. The data on deaths were obtained from state death records and the National Death Index. (Yes, your personal information is available on the web even after you die.)

 

Do Plant-Based Diets Reduce Heart Disease Deaths?

plant-based diets reduce heart deathsThe participants in this study were followed for an average of 25 years.

The investigators looked at heart disease deaths over the 25 years and compared people with the highest intake of plant foods to people with the highest intake of red meat and other animal foods. The results were:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

What Else Did The Study Show?

The investigators made a couple of other interesting observations:

  • The association of the overall diet with heart disease and all-cause deaths was stronger than the association of individual food components. This underscores the importance of looking at the effect of the whole diet on health outcomes rather than the “magic” foods you hear about on Dr. Strangelove’s Health Blog.
  • Diets with the highest amount of healthy plant foods were associated with higher intake of carbohydrates, plant protein, fiber, and micronutrients, including potassium, magnesium, iron, vitamin A, vitamin C, folate, and lower intake of saturated fat and cholesterol.
  • Diets with the highest amount of unhealthy plant foods were associated with higher intake of calories and carbohydrates and lower intake of fiber and micronutrients.

The last two observations may help explain some of the health benefits of plant-based diets.

 

Can Plant-Based Diets Be Unhealthy?

plant-based diets unhealthy cookiesNow, let’s return to the question I asked at the beginning of this article: “Can plant-based diets be unhealthy?” Although some previous studies have suggested that unhealthy plant-based diets might increase the risk of heart disease, this study did not show that.

What this study did show was that an unhealthy plant-based diet was no better for you than a diet containing lots of red meat and other animal foods.

If this were the only conclusion from this study, it might be considered a neutral result. However, this result clearly contrasts with the data from this study and many others showing that both plant-based diets in general and healthy plant-based diets reduce the risk of heart disease deaths and all-cause deaths compared to animal-based diets.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

There is one other subtle message from this study. This study did not compare vegans with the general public. Everyone in the study was the general public. Nobody in the study was consuming a 100% plant-based diet.

For example:

  • The group with the highest intake of plant foods consumed 9 servings per day of plant foods and 3.6 servings per day of animal foods.
  • The group with the lowest intake of plant foods consumed 5.4 servings per day of plant foods and 5.6 servings per day of animal foods.

In other words, you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet.

 

The Bottom Line

A recent study analyzed the effect of consuming plant foods on heart disease deaths and all-cause deaths over a 25-year period.

When the investigators looked at heart disease deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

A more subtle message from the study is that you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet. The people in this study were not following some special diet. The only difference was that some of the people in this study ate more plant foods and others more animal foods.

For more details on the study, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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