Sarcopenia — or a loss of muscle mass at a rate of about 5 percent per year after age 30 — affects one-third of individuals over 60 and more than half of seniors 80 years and older. The result is reduced physical strength, increased risk of falls and fractures, hindered tissue repair and a cascade of health problems that can dramatically increase healthcare costs. One factor of sarcopenia prevention may be adequate intake of dietary protein: at least 0.8 grams of high-quality protein daily per kilogram of body weight for healthy adults.
Does this amount increase in the elderly, for example to manage higher stress level from surgery, pressure ulcers, fractures, burns, uncontrolled diabetes or infection? The question is subject to scientific debate, according to a recent position paper from the Academy of Nutrition and Dietetics. “Although the role of dietary protein in the prevention of sarcopenia remains unclear, protein intake moderately greater than that amount may be beneficial to enhance muscle protein anabolism and reduce progressive loss of muscle mass with age,” writes the authors of Food and Nutrition for Older Adults: Promoting Health and Wellness. Because evidence suggests the most protein that can be used for muscle synthesis is 30 grams, “some experts now recommend that older adults aim to consume between 25 and 30 grams of high-quality protein with each meal.
For a population in which overall nutrient intake may be a challenge to begin with, serving foods with the most efficient delivery of protein is essential. Plant-based sources can provide adequate amounts of protein, but they must be consumed in a larger volume than animal proteins — which contain the essential amino acids to build muscle efficiently — and accommodate food preferences so they’re even eaten in the first place.
Thus a quandary: According to the 2010 Dietary Guidelines for Americans, less than 10 percent of total daily calories should come from saturated fat — making it challenging, but possible, to meet protein needs through lean meats, egg whites and non-fat dairy foods. While reducing saturated fat is a recommended guideline, RDs who work with elderly populations should first focus on dietary protein, then integrate best science to balance other nutritional needs and acceptance.
