Rethinking Protein Recommendations in Older Adults
Node Smith, ND
Many people wonder if they are getting enough protein, and it is commonly recommended that older adults increase daily protein intake to help maintain and promote muscle growth. However, few studies have actually flushed out this assumption – that older adults have greater protein needs. A recent study looked at this topic and found that increasing protein intake actually did not increase lean body mass, muscle performance, or physical function.1 The study was on older men and published in JAMA this April.
Recommended dietary allowance (RDA) for protein
The recommended dietary allowance (RDA) for protein is the same for male, female, young and old: 0.8-grams per kilogram of body-weight (g/kg/day).
Authors comment on the small amount of evidence leading to high amounts of protein recommendations
The authors of the study comment that “[it’s amazing how little evidence there is around how much protein we need in our diet, especially the value of high-protein intake, [and] [d]espite a lack of evidence, experts continue to recommend high-protein intake for older men.
Optimizing Protein Intake in Older Men (OPTIMen)
The clinical trial, called Optimizing Protein Intake in Older Men (OPTIMen), was a randomized, double-blind, placebo-controlled trial. Men aged 65 years or older were randomized to be administered one of two diets, a 0.8 g/kg/day protein diet or 1.3 g/kg/day protein diet. Each dietary category was further divided into two groups either being administered a weekly injection of testosterone or a placebo injection. Prepackaged meals with individualized protein and other macronutrients and supplements were utilized. In total, 78 participants finished the 6-month trial.
Conclusions of the study
The conclusions of the study were that a protein intake greater than the RDA amounts had no significant effect on lean body mass, fat mass, muscle mass (or performance), athletic function, fatigue, or other well-being measure. The authors’ comments are thus: “Our data highlight the need for re-evaluation of the protein recommended daily allowance in older adults, especially those with frailty and chronic disease.”
- Bhasin S, Apovian CM, Travison TG, et al. Effect of Protein Intake on Lean Body Mass in Functionally Limited Older Men: A Randomized Clinical Trial. JAMA Intern Med. 2018.
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Node Smith, ND, is a naturopathic physician in Portland, OR and associate editor for NDNR. He has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine among the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend camp-out where naturopathic medicine and medical philosophy are experienced in nature. Four years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision.