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Written by Helen Chu, MS RDN, US Registered Dietitian
 
There is one word we must learn when we reach a certain age - Sarcopenia:  gradual loss of muscle mass, strength, and function. We start losing 3-5% muscle each decade after age 30.  Loss of muscle mass and strength can lead to poor balance, mobility issue, the risk of fall.  There is considerable scientific evidence that protein and exercise are the key components to prevent and manage sarcopenia.

Role of protein 

Our body uses protein to build and repair tissues. Protein is the building blocks of muscles, bones and skin.  Protein not only helps build muscle mass but also strength.  Strong muscles are important for daily activities such as walking, climbing stairs, shopping, carrying a grocery bag.  

How much protein seniors (age >65) need: 1-1.2gm/ kg (2.2lb) per day 

For adults, the current US Recommended Dietary Allowance is 0.8 protein /kg body weight.  However, this guideline is based on studies on younger adults. It may not be adequate to address the need of the older population.    New evidence suggests healthy seniors need more protein than younger adults to maintain muscle mass.   In 2013 the experts from the PROT- Age study group recommended increasing intake to 1-1.2 gm protein /kg body wt for age > 65. For example, for a person who weighs 60 kg  ( 132lb), the daily intake is like: the body weight  x1-1.2 gm = 60-72 gm protein. 

Protein needs are also based on individual health conditions.  An individual with chronic kidney disease may need to limit protein intake, so do consult Physician or Registered Dietitian for a specific recommendation.

Eat protein at every meal: 25-30 gm protein every meal  

When to eat protein is just as important as getting enough protein.  A few studies found that spreading protein intake over three meals, such as 25-30 gm per meal will be more helpful in the building of muscle mass.  The even distribution is to maximize the utilization of protein intake for the synthesis of muscle.

Studies also show eating too little protein e.g. 15 gm in a meal may not stimulate uptake of protein into skeletal muscle.  However, if consuming greater than 30 gm protein in a single meal does not appear to further enhance the building of muscle

Boost protein intake in the morning 

The recommendation of spreading protein intake throughout the day means a higher protein breakfast than most of us usually eat.  Breakfast tends to be lowest on protein and carbohydrate loaded meal as, for example, coffee, toast or sweet pastry, a bowl of noodle soup or congee provide less than 10 gm protein.  Lunch is slightly higher and dinner with the highest protein content of all.  One can change this eating pattern by replacing the high sugar content carbohydrate and adding protein food to breakfast and lunch, while maintaining moderate intake at dinner. To boost protein intake at breakfast, you may add an egg, a glass of cow or soy milk, peanut butter on toast. That will get you closer to target 25-30 gm protein per meal.

Choosing healthy protein food
  • Animal protein: poultry, fish are good choices.
  • Dairy – low or nonfat milk, cheese, yogurt
  • Eat less red meat (beef, pork, lamb) or eat smaller portions or only on special occasions     
  • Avoid processed meat- bacon, sausage, Ham, lunchmeat
  • Consume less meat; get your protein from plant-based produce when possible    
 
Protein is found in a variety of food, so It is not hard to meet the goal 25-30 gm/meal.   For vegetarians or those prefer to consume less animal protein, plant-based protein such as whole grains, legume-lentils, beans, nuts, soy products can provide adequate protein without the need for special supplements such as protein powder or drinks.

The protein content of common foods
 
Food Serving  size Protein (gm)
Chicken, turkey, 3ounces  (1 ounce = 85  gm) 26-28
Fish 3 ounces 22
Duck 3 ounces 19
Beef, pork, lamb 3 ounces 24-26
Cheese  1 ounce 8
tofu 3 ounces 9
Peanut butter  2 tablespoons 9
Walnuts,  almonds, peanuts ¼ cup 4-7
Black or red kidney beans ½ cup 6-7
Large egg 1 7
Lentils, quinoa ½ cup 9
Low-fat yogurt 8 oz 10-13
Nonfat milk 8 oz 8
Low fat Cottage cheese ½  cup 14
 
Strength training - prevent muscle loss 

If you are sedentary, no amount of protein intake by itself will give you strong muscles. Strength training is an exercise that uses some resistance to build and strengthen the muscle.   Resistance exercise also enables greater use of protein consumed for muscle synthesis. Some exercise may include using hand-held weights, weight machines, resistance bands. American College of Sports medicine recommends resistance training 2-3 times per week.

Check with your doctor before beginning any resistance exercise.  Work with a professional - physical therapist or trainer to develop an exercise plan.
       
In summary, lifestyle choices - healthy eating and regular exercise will help prevent age-related muscle loss. Adequate protein intake and strength exercise are important to help older adults to live an active and independent lifestyle   
 
Reference:

“Does nutrition play a role in the prevention and management of sarcopenia?” Clinical Nutrition August 2018 Evidence-based recommendations for optimal Dietary intake in older people (A position paper from PROT_AGE Study group JAMDA august 2013)


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