How to Assess the Protein Needs of Older Adults

Protein needs become crucial for older adults, but many Americans over 50 don’t meet recommended intakes. Both insufficient and excessive protein consumption leads to health issues

Proteins, composed of amino acids, are essential for bodily functions. Your body requires 20 amino acids, including nine essential ones that must be obtained through diet

Studies show 31% to 50% of older adults don’t meet protein recommendations. This deficiency correlates with lower intake of essential nutrients and decreased physical functioning

Your ability to perform daily activities is closely tied to your protein intake. If you’re not meeting your protein needs, you’re more likely to experience limitations in activities of daily living such as standing for longer periods, walking upstairs, preparing meals and walking for a quarter mile

Protein should make up about 15% of your daily calories. More specifically, most adults need about 0.8 grams of protein per pound of ideal body weight. Quality, timing and distribution of protein consumption throughout the day are important factors in maintaining muscle health and overall vitality

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As you enter your golden years, your protein needs become increasingly important for maintaining health and functionality. A recent analysis of data from the National Health and Nutrition Examination Survey (NHANES) reveals, however, that many Americans over 50 are not meeting their recommended daily protein intake.1 This deficiency puts you at risk of a host of health issues, particularly as you age.

The study examined protein intakes, associated dietary patterns and physical functioning in adults aged 51 and older, shedding light on the importance of adequate protein consumption for healthy aging.

However, it’s important to optimize protein intake, as consuming either too much or too little is problematic. If you eat too much protein, it may harm your kidney health and homocysteine levels. But if you eat too little, there’s a risk of sarcopenia, an age-related condition characterized by the loss of muscle mass and function, and frailty.2

The Vital Role of Proteins in Your Body

You might not think about it often, but proteins are working tirelessly in your body every moment of the day. These remarkable molecules are essential for building and repairing your tissues, including your muscles and organs. They’re also important for the proper functioning of your enzymes, hormones and immune system components. But what exactly are proteins made of?

They’re composed of smaller units called amino acids, some of which your body can’t produce on its own. These “essential” amino acids must come from your diet, which is why it’s important to consume protein-rich foods like meat, eggs and dairy products. By ensuring a varied diet with these protein sources, you’re providing your body with the building blocks it needs to function optimally.

When you eat protein, your body doesn’t simply absorb it whole. Instead, it breaks down the protein into its individual amino acids. As explained by the educational platform Osmosis from Elsevier,3these amino acids are then reformed into new proteins in your body.

These newly formed proteins perform a vast array of functions, from fighting infections to helping your cells divide. At its most basic, a protein is like a string of beads, with each bead representing an amino acid. These strings then twist and fold into complex shapes, giving each protein its unique structure and function.

Most amino acids have a central carbon atom bonded to an amino group, a carboxylic acid group, a hydrogen atom and a unique sidechain. This structure is why they’re called amino acids.

The 20 Amino Acids Your Body Needs

While nature has produced hundreds of amino acids, your body only uses about 20 of them to create virtually every type of protein it needs. Those 20 proteins include:

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Each of these amino acids plays a role in your body’s functions. For example, leucine is important for muscle growth and repair. Not all amino acids are created equal when it comes to your dietary needs, however. Of the 20 amino acids your body uses, some are considered nonessential because your body produces them on its own. These include alanine, asparagine, aspartic acid, glutamic acid and serine.

However, don’t let the term “nonessential” fool you — these amino acids are still crucial for your health. They’re simply called nonessential because you don’t need to get them directly from your diet. On the other hand, there are nine essential amino acids that your body can’t produce — histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan and valine.

You must obtain these from the foods you eat, which is why a varied, protein-rich diet is so important.

There’s a third category of amino acids that falls between essential and nonessential: conditionally essential amino acids. These include arginine, cysteine, glutamine, glycine, proline and tyrosine. Under normal circumstances, your body produces these amino acids. However, during times of illness, stress or intense physical activity, your body’s ability to produce these amino acids may not be sufficient to meet your increased needs.

In these situations, it becomes necessary to consume these amino acids through your diet. This is why your protein needs change depending on your age, health status and activity level.

The Surprising Truth About Protein Intake in Older Adults

You might assume that most Americans easily meet or exceed their protein requirements, but the data tell a different story. A substantial proportion of older adults — between 31% and 50% — did not even meet the highly conservative recommended protein intake of 0.8 grams per kilogram of body weight per day.4

The problem becomes more pronounced with age, as the likelihood of meeting protein recommendations decreases in older age groups. This trend is particularly worrying because it coincides with the age range when sarcopenia becomes more prevalent. When you don’t meet your protein needs, it’s not just your muscles that suffer.

The study found that adults not meeting the protein recommendation were more likely to have lower intakes of several essential nutrients.5 These include fiber, various B vitamins, choline, vitamins C, A, D, E and K, as well as important minerals like zinc, calcium, phosphorus, magnesium and selenium. Many of these are considered nutrients of public health concern due to their widespread under-consumption. This nutrient shortfall has far-reaching effects on your health.

For instance, zinc insufficiency impairs your immune function and slows wound healing — issues that become increasingly problematic as you age. The combination of low protein and micronutrient deficiencies may increase your risk of common age-related issues such as falls, pressure sores, osteoporosis, muscle weakness and even premature mortality.

The Link Between Protein and Physical Functioning

Your ability to perform daily activities is also closely tied to your protein intake. The study found a positive association between achieving the recommended protein intake and self-reported physical functioning.

If you’re not meeting your protein needs, you’re more likely to experience limitations in activities of daily living such as stooping, crouching, kneeling, standing or sitting for longer periods, walking upstairs, preparing meals and walking for a quarter mile.6

These findings align with other research showing that higher protein diets improve physical functioning, particularly in activities like walking, climbing stairs and lifting heavy items.7 While the current study doesn’t prove causation, it suggests that ensuring adequate protein intake could play a role in maintaining your independence and quality of life as you age.

The Benefits of Increased Protein Intake for Older Adults

Epidemiological and experimental evidence supports the notion that in some cases older adults may benefit from protein intake higher than the current recommended dietary allowance (RDA).

A seminal study from the Health, Aging, and Body Composition Study revealed that older community-dwellers consuming around 1.2 grams of protein per kilogram of body weight daily lost 40% less lean muscle tissue in their arms and legs over a three-year follow-up compared to those ingesting 0.8 grams per kilogram.8

Similar findings were observed in two independent cohorts from the Women’s Health Initiative and the Framingham Offspring study, where protein intake of approximately 1.2 grams per kilogram of body weight was associated with better grip strength preservation.9 Several systematic reviews and meta-analyses have shown that protein intakes higher than the RDA are linked to improved physical function and reduced risk of sarcopenia in older adults.10

These findings have led several expert groups to issue updated nutritional recommendations for maintaining and improving lean body mass and function in old age, suggesting daily protein intakes of at least 1 to 1.2 grams per kilogram of body weight for healthy older individuals.11

Finding Your Protein Sweet Spot

So, how do you determine the right amount of protein for your body? The study suggests that both too little and too much protein can be detrimental to muscle health. While low protein intake (less than 0.8 grams per kilogram of body weight per day) was associated with a lower risk of low muscle mass, it didn’t provide significant protection against sarcopenia overall. The optimal range in this study was between 0.8 and 1.3 grams of protein per kilogram of body weight per day.

As a rule, protein should make up about 15% of your daily calories. Approximately one-third of this protein, or about 5%, should be collagen. More specifically, most adults need about 0.8 grams of protein per pound of ideal body weight (the weight you would ideally be, not necessarily the weight you are now), or for Europeans, approximately 1.76 grams of protein per kilogram.

So, while the conventional recommendation is 0.8 grams per KILO of TOTAL bodyweight, my recommendation is 0.8 grams per POUND of IDEAL bodyweight — including for seniors. This ends up being significantly higher than the conventional recommendation.

To determine your ideal bodyweight, you need to figure out your lean body mass. Take your current weight and subtract your body fat percentage. For example, if you weigh 160 pounds and have 20% body fat, your lean body mass is 128 pounds (160 x 0.8). Multiply that by 0.8, and you’ve got your daily protein target: 102.4 grams.

This might seem like a lot, but spread it out over your meals, and it’s totally doable. Aim for about 33 grams per meal if you’re eating three times a day. In another example, if your ideal weight is 135 pounds, your protein requirement would be 108 grams. Divided into two meals, that would be 54 grams per meal. For reference, there’s approximately 7 grams of protein in each ounce of steak, so a 5-ounce steak would give you 35 grams of high-quality protein.

For children, the average amount per meal is around 5 to 10 grams, while young adults typically can get away with 20 grams per meal. For most normal-weight adults, 30 grams per meal is the minimum you need to stimulate muscle protein synthesis. To find your personal protein sweet spot, consider factors such as your age, activity level and overall health status.

Quality and Timing Matter: Optimizing Protein Intake

When it comes to protein intake, quality and timing are just as important as quantity. Protein quality is sometimes expressed using the digestible indispensable amino acid score (DIAAS), which measures the systemic bioavailability of indispensable amino acids from specific foods, mixed meals or supplements.

Most animal food sources provide excellent quality protein (DIAAS ≥100), while whey falls into the high-quality category (DIAAS = 75–99). Leucine content is a key factor in protein quality, as it stimulates muscle protein synthesis through the activation of specific signaling pathways. To maximize muscle health, some experts recommend ingesting 25 to 30 grams of high-quality protein with at least 2.5 grams of leucine at each meal.12

Your eating pattern also matters, with current recommendations encouraging older individuals to distribute protein intake evenly across meals rather than concentrating it in a single sitting. Additionally, consuming protein-rich meals in close proximity to exercise routines, particularly resistance training, enhances muscle anabolic responses and supports overall muscle health.13

While optimizing your protein intake is important, it’s just one piece of the puzzle when it comes to maintaining muscle health and vitality as you age. Other factors are also associated with muscle strength and sarcopenia, including physical activity, overall diet quality and gut microbiome diversity. A holistic approach to healthy aging is best for preserving muscle mass and function.

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Notes

1, 4, 5, 6, 7 J Nutr Health Aging 23, 338–347 (2019)

2 Youtube, Dr. Mercola, The Importance of Exercise and Biological Youth for Longevity — Interview with Siim Land

3 YouTube, Osmosis from Elsevier, Proteins February 27, 2019

8, 9, 10, 11, 12, 13 Metabolism September 2023, Volume 146, 155637


Articles by: Dr. Joseph Mercola

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