Effects of Dietary Protein on Muscle Mass and Frailty
Protein requirements are often discussed in the context of supporting muscle mass. Below is a great article on this topic. However, it is important to consider individual differences in body composition when determining ideal protein intake. Research indicates that protein needs can vary based on the amount of lean muscle mass an individual has in relation to their total body weight. A higher muscle mass may necessitate increased protein intake to support muscle growth and maintenance, while individuals with higher body fat levels may not require as much protein due to lower muscle mass. Understanding the relationship between protein requirements and body composition is crucial in optimizing dietary choices for overall health and well-being. For further insights on the effects of dietary protein on muscle mass and frailty, the article from Life Extension provides valuable information on this topic. If you are an athlete, prioritizing protein is key to success not just for better performance but for health, too. Watch out for overloading carbs, too, on an unsafe levels; this can actually raise your uric acid levels which stops your body's ability to actually use the glucose from the carbs, not good. Protein never will fail! Our two top protein products for your consideration should be: FundAminos (4x the power of protein amino acid blend) and PureClean Protein (the most complete dietary protein with collagen).
Many older adults don’t get enough protein. Increasing protein helps maintain muscle mass and bone density, preventing frailty, loss of function, and other problems.
Scientifically reviewed by: Amanda Martin, DC, in March 2024. Written by: Laurie Perkins.
Many older adults do not consume enough protein in their diet.1-3
Insufficient protein intake can cause loss of muscle and bone mass,4 which can lead to weakness and frailty.1,5-9
Diminished muscle can result in declines of physical functions and independence, along with increased risk of falls. It is also associated with early mortality.10
Increasing protein intake has been clinically shown to increase muscle strength, muscle mass, and physical performance in frail elderly people.3,11-13
Why We Need Protein
Many people associate protein powders and bars with athletes trying to build muscle. They may not realize that older adults also need abundant protein to maintain optimal health.1,5,6,14
Proteins are made of long chains of chemical units called amino acids. Cells can produce some of these protein building blocks, but others—termed essential amino acids—cannot be synthesized in the human body and must be acquired in the diet.15
Proteins serve many purposes. About 50%-70% of all proteins in the body are found in muscles.4,16
Studies show that after the age of 30, muscle is lost at a rate of about 3% to 5% per decade, and that accelerates with advancing age.17
Dangers of Low Protein Intake
Many older adults are at risk of suboptimal protein nutrition.3,18,19
The most profound impact of inadequate protein is on muscle and bone. With time, too little protein may eventually contribute to:
-
Sarcopenia, loss of muscle mass and strength,17,20 and
-
Osteopenia, loss of bone density and strength.4,7
Although loss of muscle mass may be the first thing that comes to mind regarding poor protein intake, bones are also profoundly affected.4
Bones require calcium and other nutrients for optimal mineralization, and the scaffolding of bone tissue requires protein as well. Maintenance of healthy bone structure requires adequate protein intake, and it suffers when protein availability is insufficient.
Both sarcopenia and osteopenia can occur without any symptoms in their early stages. But as they progress, they are a major contributor to declining health in older adults.
Loss of muscle and bone are closely associated with frailty and functional disability.4,7 Both these conditions are associated with an increased risk of falls, fractures, and other injuries, and increased risk of death.
How Much Do You Need?
Although the official Recommended Dietary Allowance (RDA) for protein intake is only 0.8 grams/kilogram per day, modern scientific, nutritional, and medical researchers generally agree that for elderly individuals and people with many medical conditions, a correct nutritional target is in the range of 1.0 to 1.5 grams/kilograms per day.3,13,21,22
A 180-pound older individual concerned about maintaining or building muscle and bone mass should aim for approximately 80 – 120 grams of protein per day from diet and protein supplements. Since two scrambled eggs provide only 12 grams of protein, and a serving of nonfat Greek yogurt delivers just 16 grams, it is apparent that protein supplementation may be crucial for some.
For instance, whey protein concentrate powders can deliver 20 grams of high-quality protein per scoop. This can make a big difference for those having trouble meeting their daily protein quotient.
WHAT YOU NEED TO KNOW
Increase Protein to Fight Frailty
-
Older adults require a good intake of protein to support healthy muscles, prevent frailty and functional decline, and support healthy aging.
-
Studies show that low protein intake is associated with frailty, risk for falls and other injuries, bone fractures, and other negative health outcomes in the elderly.
-
Increasing protein intake can help maintain muscle mass and bone density. That can prevent frailty, loss of function, and other age-related health problems.
Human Studies of Protein Intake
Observational and clinical studies confirm the impact that adequate protein intake has on overall health.
These studies have demonstrated benefits of consuming good amounts of protein – and many of these studies used protein supplementation to augment dietary intake.4-7,14,18,20,23-34
The Framingham Offspring study followed thousands of participants for an extended period of time. Over nine years of observation, individuals who consumed more protein were found to maintain a greater muscle mass. Moreover, in physically active subjects, higher protein intake was linked to an impressive 35% reduction in risk of functional decline.20
In a clinical trial, poorly nourished elderly individuals who were frail or prefrail were assigned to protein-supplement interventions that augmented diet to provide 1.2 or 1.5 grams/kg protein per day. Placebo recipients consumed 0.8 mg/kg/day, the usual RDA. After 12 weeks those in the 1.5 gram/kg group, compared to the 0.8 gram/kg group, had greater muscle mass in their arms, legs, and body overall, as well as improved walking speed.13
Multiple reviews and analyses of the scientific literature have concluded that protein consumption higher than the RDA, in the range of approximately 1.0 – 1.5 grams/kg of body weight, including through the use of whey protein supplementation, results in better muscle and physical function outcomes. Notably, several of these scientific papers concluded that better vitamin D status leads to better results with dietary protein optimization.3,11,12
BOOST YOUR PROTEIN INTAKE
Protein bars provide a convenient way to increase daily protein intake.
The problem is that many supposedly "healthy" bars are just candy with a protein serving added.
Some popular bars have as much as 12 grams of sugar per serving!
When choosing a protein bar, look for one with:
-
No added sugar and only 1-3 grams of total sugar,
-
A healthy serving of fiber, around 8 grams and,
-
At least 12 to 16 grams of protein.
Many people use whey protein or plant protein powder to increase their daily protein intake.
Look for a protein powder with no artificial sweeteners (stevia is ok) which provides between 18-20 grams of protein per scoop. These powders can be mixed into numerous recipes or used as basis for a healthy smoothie.
Summary
Many older adults consume inadequate amounts of protein in their diet.
Low protein intake is associated with loss of muscle mass and strength in the elderly, along with increased risk for weak bones, falls, and fractures.
Several age-related health issues are also more common with insufficient protein intake, including age-related muscle loss (sarcopenia) and frailty.
Increasing intake of protein in the diet as well as through supplementation has been shown to help support muscle mass and physical functioning. Some studies also suggest that proper vitamin D status is essential to reap the benefits of protein nutrition.
This can help ward off functional decline, frailty, and premature death.
References
-
Krok-Schoen JL, Archdeacon Price A, Luo M, et al. Low Dietary Protein Intakes and Associated Dietary Patterns and Functional Limitations in an Aging Population: A NHANES analysis. J Nutr Health Aging. 2019;23(4):338-47.
-
Buhl SF, Beck AM, Christensen B, et al. Prevalence of low protein intake in 80+-year-old community-dwelling adults and association with dietary patterns and modifiable risk factors: a cross-sectional study. Br J Nutr. 2022 Jan 28;127(2):266-77.
-
Weiler M, Hertzler SR, Dvoretskiy S. Is It Time to Reconsider the U.S. Recommendations for Dietary Protein and Amino Acid Intake? Nutrients. 2023 Feb 6;15(4).
-
Genaro Pde S, Martini LA. Effect of protein intake on bone and muscle mass in the elderly. Nutr Rev. 2010Oct;68(10):616-23.
-
Mendonca N, Hengeveld LM, Presse N, et al. Protein intake, physical activity and grip strength in European and North American community-dwelling older adults: a pooled analysis of individual participant data from four longitudinal ageing cohorts. Br J Nutr. 2022 Jul 6;129(7):1-26.
-
Mendonca N, Hengeveld LM, Visser M, et al. Low protein intake, physical activity, and physical function in European and North American community-dwelling older adults: a pooled analysis of four longitudinal aging cohorts. Am J Clin Nutr. 2021 Jul 1;114(1):29-41.
-
Paddon-Jones D, Campbell WW, Jacques PF, et al. Protein and healthy aging. Am J Clin Nutr. 2015 Jun;101(6):1339S-45S.
-
Coelho-Junior HJ, Rodrigues B, Uchida M, Marzetti E. Low Protein Intake Is Associated with Frailty in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients. 2018 Sep 19;10(9).
-
Bauer J, Biolo G, Cederholm T, et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc. 2013 Aug;14(8):542-59.
-
Larsson L, Degens H, Li M, et al. Sarcopenia: Aging-Related Loss of Muscle Mass and Function. Physiol Rev. 2019 Jan 1;99(1):427-511.
-
Lancha AH, Jr., Zanella R, Jr., Tanabe SG, et al. Dietary protein supplementation in the elderly for limiting muscle mass loss. Amino Acids. 2017 Jan;49(1):33-47.
-
Nasimi N, Sohrabi Z, Nunes EA, et al. Whey Protein Supplementation with or without Vitamin D on Sarcopenia-Related Measures: A Systematic Review and Meta-Analysis. Adv Nutr. 2023 Jul;14(4):762-73.
-
Park Y, Choi JE, Hwang HS. Protein supplementation improves muscle mass and physical performance in undernourished prefrail and frail elderly subjects: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr. 2018Nov 1;108(5):1026-33.
-
Wu G. Dietary protein intake and human health. Food Funct. 2016 Mar;7(3):1251-65.
-
Hou Y, Yin Y, Wu G. Dietary essentiality of "nutritionally non-essential amino acids" for animals and humans. Exp Biol Med (Maywood). 2015 Aug;240(8):997-1007.
-
Frontera WR, Ochala J. Skeletal muscle: a brief review of structure and function. Calcif Tissue Int. 2015 Mar;96(3):183-95.
-
Available at: https://www.health.harvard.edu/staying-healthy/preserve-your-muscle-mass. Accessed December 27, 2023.
-
Volpi E, Campbell WW, Dwyer JT, et al. Is the optimal level of protein intake for older adults greater than the recommended dietary allowance? J Gerontol A Biol Sci Med Sci. 2013 Jun;68(6):677-81.
-
Baum JI, Kim IY, Wolfe RR. Protein Consumption and the Elderly: What Is the Optimal Level of Intake? Nutrients. 2016 Jun 8;8(6).
-
Bradlee ML, Mustafa J, Singer MR, Moore LL. High-Protein Foods and Physical Activity Protect Against Age-Related Muscle Loss and Functional Decline. J Gerontol A Biol Sci Med Sci. 2017 Dec 12;73(1):88-94.
-
Lin CC, Shih MH, Chen CD, Yeh SL. Effects of adequate dietary protein with whey protein, leucine, and vitamin D supplementation on sarcopenia in older adults: An open-label, parallel-group study. Clin Nutr. 2021 Mar;40(3):1323-9.
-
Available at: https://kffhealthnews.org/news/why-older-adults-should-eat-more-protein-and-not-overdo-protein-shakes/. Accessed January 4, 2024.
-
Appel LJ. The effects of protein intake on blood pressure and cardiovascular disease. Curr Opin Lipidol. 2003Feb;14(1):55-9.
-
Hengeveld LM, Wijnhoven HAH, Olthof MR, et al. Prospective associations of poor diet quality with long-term incidence of protein-energy malnutrition in community-dwelling older adults: the Health, Aging, and Body Composition (Health ABC) Study. Am J Clin Nutr. 2018 Feb 1;107(2):155-64.
-
Naghshi S, Sadeghi O, Willett WC, Esmaillzadeh A. Dietary intake of total, animal, and plant proteins and risk of all cause, cardiovascular, and cancer mortality: systematic review and dose-response meta-analysis of prospective cohort studies. BMJ. 2020 Jul 22;370:m2412.
-
Qi XX, Shen P. Associations of dietary protein intake with all-cause, cardiovascular disease, and cancer mortality: A systematic review and meta-analysis of cohort studies. Nutr Metab Cardiovasc Dis. 2020 Jun 25;30(7):1094-105.
-
Tieland M, Dirks ML, van der Zwaluw N, et al. Protein supplementation increases muscle mass gain during prolonged resistance-type exercise training in frail elderly people: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc. 2012 Oct;13(8):713-9.
-
Tieland M, van de Rest O, Dirks ML, et al. Protein supplementation improves physical performance in frail elderly people: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc. 2012 Oct;13(8):720-6.
-
Wolfe RR. Perspective: Optimal protein intake in the elderly. J Am Med Dir Assoc. 2013 Jan;14(1):65-6.
-
Yuan M, Pickering RT, Bradlee ML, et al. Animal protein intake reduces risk of functional impairment and strength loss in older adults. Clin Nutr. 2021 Mar;40(3):919-27.
-
Elliott P. Protein intake and blood pressure in cardiovascular disease. Proc Nutr Soc. 2003 May;62(2):495-504.
-
Rahimi MH, Shab-Bidar S, Mollahosseini M, Djafarian K. Branched-chain amino acid supplementation and exercise-induced muscle damage in exercise recovery: A meta-analysis of randomized clinical trials. Nutrition. 2017 Oct;42:30-6.
-
Martinho DV, Nobari H, Faria A, et al. Oral Branched-Chain Amino Acids Supplementation in Athletes: A Systematic Review. Nutrients. 2022 Sep 27;14(19).
-
Zhang S, Zeng X, Ren M, et al. Novel metabolic and physiological functions of branched chain amino acids: a review. J Anim Sci Biotechnol. 2017;8:10.
Article Original Format here