Older adults need to eat more protein-rich foods when losing weight, dealing with a chronic or acute illness, or facing a hospitalization, according to a growing consensus among scientists.
During these stressful periods, aging bodies process protein less efficiently and need more of it to maintain muscle mass and strength, bone health and other essential physiological functions.
Even healthy seniors need more protein than when they were younger to help preserve muscle mass, experts suggest. Yet don鈥檛 eat an adequate amount due to reduced appetite, dental issues, impaired taste, swallowing problems and limited financial resources. Combined with a tendency to become more sedentary, this puts them at risk of deteriorating muscles, compromised mobility, slower recovery from bouts of illness and the loss of independence.
Impact on functioning. Recent research suggests that older adults who consume more protein are less likely to lose 鈥渇unctioning鈥�: the ability to dress themselves, get out of bed, walk up a flight of stairs and more. In that followed more than 2,900 seniors over 23 years, researchers found that those who ate the most protein were 30 percent less likely to become functionally impaired than those who ate the least amount.
While not conclusive (older adults who eat more protein may be healthier to begin with), 鈥渙ur work suggests that older adults who consume more protein have better outcomes,鈥� said Paul Jacques, co-author of the study and director of the nutritional epidemiology program at Tufts University鈥檚 Jean Mayer USDA Human Nutrition Research Center on Aging.
In which was published in 2017 and followed nearly 2,000 older adults over six years, people who consumed the least amount of protein were almost twice as likely to have difficulty walking or climbing steps as those who ate the most, after adjusting for health behaviors, chronic conditions and other factors.
鈥淲hile eating an adequate amount of protein is not going to prevent age-associated loss of muscle altogether, not eating enough protein can be an exacerbating factor that causes older adults to lose muscle faster,鈥� said Wayne Campbell, a professor of nutrition science at Purdue University.
Recommended intake. So, how much protein should seniors eat? The most commonly cited standard is the Recommended Dietary Allowance (RDA): 0.8 grams of protein per kilogram (2.2 pounds) of body weight per day.
For a 150-pound woman, that translates into eating 55 grams of protein a day; for a 180-pound man, it calls for eating 65 grams.
To put that into perspective, a 6-ounce serving of Greek yogurt has 18 grams; a half-cup of cottage cheese, 14 grams; a 3-ounce serving of skinless chicken, 28 grams; a half-cup of lentils, 9 grams; and a cup of milk, 8 grams. (To check the protein content of other common foods, click .)
Older adults were rarely included in studies used to establish the RDAs, however, and experts caution that this standard might not adequately address health needs in the older population.
After reviewing additional evidence, of physicians and nutrition experts in 2013 recommended that healthy older adults consume 1 to 1.2 grams of protein per kilogram of body weight daily 鈥� a 25 to 50 percent increase over the RDA. (That鈥檚 69 to 81 grams for a 150-pound woman, and 81 to 98 grams for a 180-pound man.) Its recommendations were subsequently embraced by the .
When illness is an issue. For seniors with acute or chronic diseases, the group suggested protein intake of 1.2 to 1.5 grams per kilogram of body weight while noting that the precise amount needed 鈥渄epends on the disease, its severity鈥� and other factors. (At the 1.5 grams-per-kilogram level, a 150-pound woman would need to eat 102 grams of protein daily, while a 180-pound man would need to eat 123 grams.) Even higher levels, up to 2 grams per kilogram of body weight, could be needed, it noted, for older adults who are severely ill or malnourished.
(These recommendations don鈥檛 apply to seniors with kidney disease, who should not increase their protein intake unless they鈥檙e on dialysis, experts said.)
鈥淧rotein becomes much more important during events in an older adult鈥檚 life that force them into a situation of muscle disuse 鈥� a hip or knee replacement, for instance,鈥� said Stuart Phillips, director of McMaster University鈥檚 Centre for Nutrition, Exercise and Health Research in Canada.
鈥淗igher amounts of protein have value when something in an older adult鈥檚 body is changing,鈥� Campbell agreed. He co-authored a new study in that did not find benefits from raising protein intake for older men. This could be because the intervention period, six months, wasn鈥檛 long enough. Or it could have been because the study鈥檚 participants had adjusted to their diets and weren鈥檛 exposed to additional stress from illness, exercise or weight loss, Campbell said.
Per-meal amounts. Another recommendation calls for older adults to spread protein consumption evenly throughout the day. This arises from research showing that seniors are less efficient at processing protein in their diet and may need a larger 鈥減er-meal dose.鈥�
鈥淭he total dose that you eat may not matter as much as the dose you eat at a given meal,鈥� said Dr. Elena Volpi, a professor of geriatrics and cell biology at the University of Texas Medical Branch in Galveston, Texas. 鈥淚f I eat too little protein during a meal, I may not adequately stimulate the uptake of amino acids into skeletal muscle. If I eat too much, say from a large T-bone steak, I won鈥檛 be able to store all of it away.鈥�
Based on her research, Volpi suggests that older adults eat 25 to 30 grams of protein per meal. Practically, that means rethinking what people eat at breakfast, when protein intake tends to be lowest. 鈥淥atmeal or cereal with milk isn鈥檛 enough; people should think of adding a Greek yogurt, an egg or a turkey sausage,鈥� Volpi said.
Protein in all forms is fine. Animal protein contains all nine essential amino acids that our bodies need; plant protein doesn鈥檛. If you鈥檙e a vegetarian, 鈥渋t just takes more work to balance all the amino acids in your diet鈥� by eating a variety of foods, said Denise Houston, associate professor of gerontology and geriatric medicine at Wake Forest School of Medicine in North Carolina. Otherwise, 鈥淚 would typically recommend having some animal protein in your diet.鈥� As long as red meat is lean and you don鈥檛 eat it too often, 鈥渢hat鈥檚 OK,鈥� Houston said.
Supplements. What about powdered or liquid protein supplements? 鈥淭here鈥檚 generally no need for supplements unless someone is malnourished, sick or hospitalized,鈥� Volpi said.
In a new study, not yet published, she examined the feasibility of supplementing the diets of older adults discharged from the hospital with extra protein for a month. Preliminary data, yet to be confirmed in a larger clinical trial, shows that 鈥渢his can improve recovery from a hospitalization,鈥� Volpi said.
鈥淭he first line of defense should always be real food,鈥� said Samantha Gallo, assistant director of clinical nutrition at Mount Sinai Hospital in New York. 鈥淏ut if someone isn鈥檛 able to consume a turkey sandwich and would rather sip a protein shake during the day, we鈥檒l try that.鈥�
However, older adults should not routinely drink protein shakes instead of meals, Gallo cautioned, adding: 鈥淭hat鈥檚 a bad idea that can actually result in reduced protein and calorie intake over the long term.鈥�
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