Cited by 297Nutrition and Health in AgingMuscle metabolism and nutritionNutritional Studies and Diet

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Dietary protein intake in community-dwelling, frail, and institutionalized elderly people: scope for improvement

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Tieland, Michael, Borgonjen-Van den Berg, Karin J., van Loon, Luc J. C., de Groot, Lisette C. P. G. M.·2012·European Journal of Nutrition

DOI 10.1007/s00394-011-0203-6

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Abstract

Purpose Adequate dietary protein intake is required to postpone and treat sarcopenia in elderly people. Insight into dietary protein intake in this heterogeneous population segment is needed to locate dietary inadequacies and to identify target populations and feeding strategies for dietary interventions. Therefore, we assessed dietary protein intake, distribution of protein intake throughout the day, and the use of protein-containing food sources in community-dwelling, frail, and institutionalized elderly people in the Netherlands.Methods Secondary analyses were carried out using dietary data collected from studies among community-dwelling, frail, and institutionalized elderly people to evaluate protein intake characteristics.Results Dietary protein intake averaged 1.1 ± 0.3 g/kg-bw/day in community-dwelling, 1.0 ± 0.3 g/kg-bw/day in frail, and 0.8 ± 0.3 g/kg-bw/day in institutionalized elderly men. Similar protein intakes were found in women. Ten percent of the community-dwelling and frail elderly and 35% of the institutionalized elderly people showed a protein intake below the estimated average requirement (0.7 g/kg-bw/day). Protein intake was particularly low at breakfast in community-dwelling (10 ± 10 g), frail (8 ± 5 g), and institutionalized elderly people (12 ± 6 g) with bread and dairy products as predominant protein sources.Conclusions Whereas daily protein intake is generally well above the recommended dietary allowance in community-dwelling and frail elderly people, a significant proportion of institutionalized elderly showed an intake below the current protein requirement, making them an important target population for dietary interventions. Particularly at breakfast, there is scope for improving protein intake.

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Lochlainn, M. N., Nessa, A., Sheedy, A., Horsfall, R., García, M. P., Hart, D. J., Akdag, G., Yarand, D., Wadge, S., Baleanu, A.-F., et al. (2021) · BMC Geriatrics · doi:10.1186/s12877-021-02301-y · Cited by 17
“Many older people do not meet this, with fewer than 15 % meeting this recommendation in one UK study of 256 adults aged 65–89 years [8, 10].”
Background
Effect of Protein or Essential Amino Acid Supplementation During Prolonged Resistance Exercise Training in Older Adults on Body Composition, Muscle Strength, and Physical Performance Parameters: A Systematic Review
Gade, J., Pedersen, R. J., & Beck, A. M. (2018) · Rehabilitation Process and Outcome · doi:10.1177/1179572718765760 · Cited by 16
“In the 11 studies that provided a daily supplementation, the median intake was 27 (10-45) g/d.”
BackgroundInfluential
Peripheral Amino Acid Appearance Is Lower Following Plant Protein Fibre Products, Compared to Whey Protein and Fibre Ingestion, in Healthy Older Adults despite Optimised Amino Acid Profile
Castro, E. D. M., Valli, G., Buffière, C., Guillet, C., Mullen, B., Pratt, J., Horner, K. M., Gola, S., Bader‐Mittermaier, S., Paganini, M., et al. (2022) · Nutrients · doi:10.3390/nu15010035 · Cited by 21
Limited compensation at the following meal for protein and energy intake at a lunch meal in healthy free-living older adults.
Appleton, K. (2017) · Clinical Nutrition · doi:10.1016/j.clnu.2017.03.032 · Cited by 14
“2 g protein/kg body weight/day (as has been recommended by some) [5,7], an individual who weighs 71.”
Background
Protein supplementation with aging
Bauer, J. M., & Diekmann, R. (2014) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0000000000000124 · Cited by 16
Effect of meal size reduction and protein enrichment on intake and satiety in vital community-dwelling older adults
Ziylan, C., Kremer, S., Eerens, J., Haveman‐Nies, A., & de Groot, C. P. G. M. (2016) · Appetite · doi:10.1016/j.appet.2016.05.032 · Cited by 16
The Role of Nutrition in Attenuating Age-Related Skeletal Muscle Atrophy
Abiri, B., & Vafa, M. (2020) · Advances in experimental medicine and biology · doi:10.1007/978-3-030-42667-5_12 · Cited by 14
Nutrition and physical activity countermeasures for sarcopenia: Time to get personal?
Murphy, C. H., & Roche, H. M. (2018) · Nutrition Bulletin · doi:10.1111/nbu.12351 · Cited by 15
Analyzing and forecasting poultry meat production and export volumes in Thailand: a time series approach
Klaharn, K., Ngampak, R., Chudam, Y., Salvador, R. T., Jainonthee, C., & Punyapornwithaya, V. (2024) · Cogent Food & Agriculture · doi:10.1080/23311932.2024.2378173 · Cited by 14
“Meat, particularly from animal sources, is a vital component of the global diet, providing essential proteins, energy and specific nutrients (Paraskeuas et al., 2023; Tieland et al., 2012).”
Variation in Protein Origin and Utilization: Research and Clinical Application
Paddon‐Jones, D., Coss‐Bu, J. A., Morris, C. R., Phillips, S. M., & Wernerman, J. (2017) · Nutrition in Clinical Practice · doi:10.1177/0884533617691244 · Cited by 16
Enhancing Nutrition and Palatability: The Development of Cooked Sausages with Protein Hydrolysate from Secondary Raw Materials for the Elderly
Tultabayeva, T., Tokysheva, G., Zhakupova, G., Konysbayeva, D., Мухтарханова, Р. Б., Matibayeva, А., Мухаметов, А., Zamaratskaia, G., & Makangali, K. (2023) · Applied Sciences · doi:10.3390/app131810462 · Cited by 13
“At the same time, only 50–54% of each carcass reaches the end consumer in the form of meat [1,2].”
The effect of dose, frequency, and timing of protein supplementation on muscle mass in older adults: A systematic review and meta-analysis
Hettiarachchi, J., Reijnierse, E. M., Kew, N., Fetterplace, K., Tan, S., & Maier, A. B. (2024) · Ageing Research Reviews · doi:10.1016/j.arr.2024.102325 · Cited by 20
“However, observational data has shown that the average daily dietary protein intakes in community-dwelling, hospitalised and institutionalised older adults are 1.1, 0.65 and 0.8 g/kg of body weight respectively (Tieland et al., 2012a; Weijzen et al., 2020).”
BackgroundInfluential
Strategies to increase protein intake at mealtimes through a novel high-frequency food service in hospitalized patients
Dijxhoorn, D. N., IJmker-Hemink, V. E., Wanten, G. J. A., & van den Berg, M. G. A. (2018) · European Journal of Clinical Nutrition · doi:10.1038/s41430-018-0288-6 · Cited by 13
Nutrition for Master Athletes: Is There a Need for Specific Recommendations?
Louis, J. B., Vercruyssen, F., Dupuy, O., & Bernard, T. (2019) · Journal of Aging and Physical Activity · doi:10.1123/japa.2019-0190 · Cited by 15
Incorporating Milk Protein Isolate into an Energy-Restricted Western-Style Eating Pattern Augments Improvements in Blood Pressure and Triglycerides, but Not Body Composition Changes in Adults Classified as Overweight or Obese: A Randomized Controlled Trial
Hudson, J., Zhou, J., Kim, J. E., & Campbell, W. W. (2020) · Nutrients · doi:10.3390/nu12030851 · Cited by 19
“Only one trial out of the 37 utilized an isolate dairy protein source and this study was not a randomized controlled trial but a secondary analysis [43].”
Background
Low Physical Activity in Patients with Complicated Type 2 Diabetes Mellitus Is Associated with Low Muscle Mass and Low Protein Intake
Hagedoorn, I. J. M., den Braber, N., Oosterwijk, M. M., Gant, C. M., Navis, G. J., Vollenbroek-Hutten, M. M. R., van Beijnum, B.-J. F., Bakker, S. J. L., & Laverman, G. D. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9103104 · Cited by 14
“This has also been advocated in previous studies, which suggest that dietary protein should be prescribed together with physical exercise in order to optimize muscle health [12,16,17,36].”
Background
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
Buhl, S. F., Beck, A. M., Christensen, B., Kock, G., Boyle, E., & Caserotti, P. (2021) · British Journal Of Nutrition · doi:10.1017/s0007114521000799 · Cited by 12
“Two studies found that protein intake in community-dwelling older adults was low at breakfast(54,55) and was associated with low muscle mass(55).”
Background
Two dietary advice strategies to increase protein intake among community-dwelling older adults: A feasibility study
Reinders, I., Visser, M., & Wijnhoven, H. A. H. (2020) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2020.02.020 · Cited by 12
Effects of Diet Intervention on Body Composition in the Elderly with Chronic Kidney Disease
Hung, K.-Y., Chiou, T. T., Wu, C., Liao, Y.-C., Chen, C.-N., Yang, P.-H., Wang, H., & Lee, C. (2017) · International Journal of Medical Sciences · doi:10.7150/ijms.19816 · Cited by 12
Towards a Food-Based Intervention to Increase Protein Intakes in Older Adults: Challenges to and Facilitators of Egg Consumption
van den Heuvel, E., Murphy, J. L., & Appleton, K. (2018) · Nutrients · doi:10.3390/nu10101409 · Cited by 10
“Increased consumption of protein-rich foods by those of a younger age, within the older population, has previously been reported [4,30,32,35], and attributed to increased abilities or increased nutritional knowledge in younger individuals [30,32,35].”
Background
Dose, timing, and source of protein intake of young people with spastic cerebral palsy
der Wel, I. A.-V., Smorenburg, A. R. P., de Roos, N. M., & Verschuren, O. W. (2019) · Disability and Rehabilitation · doi:10.1080/09638288.2018.1558291 · Cited by 12
“Quality of the protein source is determined by the (essential) amino acid composition, digestibility and bioavailability of amino acids (absorption kinetics) [28,29].”
Background
Sarcopenia of Ageing: Does a Healthier Lifestyle Matter in Reversing the Trajectory? A Brief Narrative Review and a Call for Action in Saudi Arabia
Alghannam, A. F., Alharbi, D. S., & Al-Hazzaa, H. M. (2024) · Saudi Journal of Medicine and Medical Sciences · doi:10.4103/sjmms.sjmms_54_23 · Cited by 13
“Therefore, attention should be taken in this regard, [54] particularly when considering that protein intakes above EAR are recommended to counteract sarcopenia.”
Background
Could Eggs Help Increase Dietary Protein Intake in Older Adults? – Exploring Reasons for the Consumption and Non-Consumption of Eggs in People over 55 years old
van den Heuvel, E., Murphy, J. L., & Appleton, K. (2018) · Journal of Nutrition in Gerontology and Geriatrics · doi:10.1080/21551197.2018.1505577 · Cited by 9
“66g of protein per kg of body weight (15-17) , but it can be as high as 77% 38 when higher recommendations are used (18) .”
Background
Specific dairy foods and risk of frailty in older women: a prospective cohort study
Struijk, E. A., Fung, T. T., Rodríguez‐Artalejo, F., Bischoff-Ferrari, H. A., Willett, W. C., & López‐García, E. (2024) · BMC Medicine · doi:10.1186/s12916-024-03280-8 · Cited by 11
“Protein is thought to play an important role in the prevention of frailty because deficient intake adversely affects muscle mass and strength [5–7], a disorder known as sarcopenia [8], which is related to the frailty syndrome.”
Background
Association of major dietary patterns with muscle strength and muscle mass index in middle-aged men and women: Results from a cross-sectional study
Shahinfar, H., Safabakhsh, M., Babaei, N., Ebaditabar, M., Davarzani, S., Amini, M. R., & Shab‐Bidar, S. (2020) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2020.06.010 · Cited by 10
Dietary Protein Intake and Transition between Frailty States in Octogenarians Living in New Zealand
Teh, R., Mendonça, N., Muru‐Lanning, M., MacDonell, S. O., Robinson, L. A., & Kerse, N. M. (2021) · Nutrients · doi:10.3390/nu13082843 · Cited by 10
The provision of recipes and single-use herb/spice packets to increase egg and protein intake in community-dwelling older adults: a randomised controlled trial
van den Heuvel, E., Murphy, J., & Appleton, K. M. (2020) · Public Health Nutrition · doi:10.1017/s1368980020002712 · Cited by 10
“Protein intake over the day for most older adults, however, is generally skewed to the main meal (a hot meal for either lunch or dinner) and is typically low for breakfast and other non-main meals(11,12).”
Background
Co-spray drying whey protein isolate with polysaccharides provides additional lubrication impacting the sensory profile of model beverages
Giles, H., Bull, S. P., Lignou, S., Gallagher, J. A., Faka, M., Rodríguez‐García, J., & Methven, L. (2024) · Food Hydrocolloids · doi:10.1016/j.foodhyd.2024.110778 · Cited by 9
Reinforcement Effects of Social Network Intervention during Nutritional Supplementation in Frail Older Adults
Kim, C.-O., Jeong, Y.-H., Park, Y., Bae, J.-S., Kwon, Y., Cho, M. H., Yoo, C. H., & Lee, K. (2021) · Gerontology · doi:10.1159/000514676 · Cited by 9
Innovative plAnt Protein fibre and Physical activity solutions to address poor appEtite and prevenT undernutrITion in oldEr adults – APPETITE
Volkert, D., Corish, C. A., Dardevet, D. P., VITO, G. D., Guillet, C., Bader‐Mittermaier, S., Robinson, S. M., Roche, H. M., Sayer, A. A., & Visser, M. (2021) · Nutrition Bulletin · doi:10.1111/nbu.12529 · Cited by 10
Access to a pre-sleep protein snack increases daily energy and protein intake in surgical hospitalized patients
Weijzen, M. E. G., Kohlen, M. M. T. G., Monsegue, A. P., Houtvast, D. C. J., Nyakayiru, J., Beijer, S., Geerlings, P., Verdijk, L. B., & van Loon, L. J. C. (2024) · Clinical Nutrition · doi:10.1016/j.clnu.2024.03.016 · Cited by 9
Difference and Variance in Nutrient Intake by Age for Older Adults Living Alone in Japan: Comparison of Dietary Reference Intakes for the Japanese Population
Ishikawa, M., Yokomichi, H., & Yokoyama, T. (2021) · Nutrients · doi:10.3390/nu13051431 · Cited by 9
“A previous study proposed the association between aging, frailty, and protein intake, including total protein [21].”
Background
Protein Intake Throughout Life and Current Dietary Recommendations
Mariotti, F. (2016) · Elsevier eBooks · doi:10.1016/b978-0-12-802167-5.00002-5 · Cited by 12
Sarcopenia-A baby boomers dilemma for nurse practitioners to discover, diagnose, and treat
Jackson, K. L., Hunt, D., Chapa, D., & Gropper, S. (2018) · Journal of Nursing Education and Practice · doi:10.5430/jnep.v8n9p77 · Cited by 7
Resistance training increases myofibrillar protein synthesis in middle-to-older aged adults consuming a typical diet with no influence of protein source: a randomized controlled trial
Korzepa, M., Quinlan, J. I., Marshall, R. N., Rogers, L. M., Belfield, A. E., Elhassan, Y., Lawson, A., Ayre, C., Senden, J. M., Goessens, J. P. B., et al. (2025) · American Journal of Clinical Nutrition · doi:10.1016/j.ajcnut.2025.04.019 · Cited by 11
“…a total of ~1.0 g ⋅ kg BM (cid:2) 1 ⋅ d (cid:2) 1 of protein in line with the typical dietary protein intakes of middle-to-older aged adults [29,45], which are beyond the recommended dietary allowance of 0.8 g ⋅ kg BM (cid:2) 1 ⋅ d (cid:2) 1 but below alternative requirements to support…”
Influential
Personalized Protein Supplementation Improves Total Protein, Leucine, and Energy Intake in (Pre)Sarcopenic Community-Dwelling Older Adults in the ENHANce RCT
Dedeyne, L., Dupont, J., Verschueren, S., Koppo, K., Tournoy, J., Matthys, C., & Gielen, E. (2021) · Frontiers in Nutrition · doi:10.3389/fnut.2021.672971 · Cited by 10
Dairy and Dairy Alternative Supplementation Increase Integrated Myofibrillar Protein Synthesis Rates, and Are Further Increased when Combined with Walking in Healthy Older Women
Stokes, T., Mei, Y., Seo, F., McKendry, J., McGlory, C., & Phillips, S. M. (2021) · Journal of Nutrition · doi:10.1093/jn/nxab358 · Cited by 8
Guava Fruit and Acacia pennata Vegetable Intake Association with Frailty of Older Adults in Northern Thailand
Ruangsuriya, J., Wongpoomchai, R., Srichairatanakool, S., Sirikul, W., Buawangpong, N., & Siviroj, P. (2022) · Nutrients · doi:10.3390/nu14061192 · Cited by 8
Acute Quark Ingestion Increases Muscle Protein Synthesis Rates at Rest with a Further Increase after Exercise in Young and Older Adult Males in a Parallel-Group Intervention Trial
Hermans, W. J. H., Fuchs, C. J., Nyakayiru, J., Hendriks, F. K., Houben, L. H. P., Senden, J. M., van Loon, L. J. C., & Verdijk, L. B. (2022) · Journal of Nutrition · doi:10.1016/j.tjnut.2022.10.003 · Cited by 8
Postprandial plasma amino acid and appetite responses to a low protein breakfast supplemented with whey or pea protein in middle-to-older aged adults
Korzepa, M., Marshall, R. N., Rogers, L. M., Belfield, A. E., Quinlan, J. I., Huang, Y., Gritsas, A., Churchward‐Venne, T. A., Glover, E. I., van Loon, L. J. C., et al. (2025) · European Journal of Nutrition · doi:10.1007/s00394-025-03605-0 · Cited by 8
“Henceforth, protein intakes which maximise MPS are not commonly achieved in community-dwelling middle-to-older age adults and are further compromised during hospitalisation [20].”
Muscle Protein Synthesis and Muscle Mass in Healthy Older Men
Tomé, D. (2017) · Journal of Nutrition · doi:10.3945/jn.117.263491 · Cited by 8
Ernæringsstatus blant pasienter i sykehjem og i hjemmesykepleien kartlagt ved hjelp av Ernæringsjournalen
Landmark, B. T., Gran, S. V., & Grov, E. K. (2014) · Klinisk Sygepleje · doi:10.18261/issn1903-2285-2014-01-02 · Cited by 7
Changes in 24‐h energy expenditure, substrate oxidation, and body composition following resistance exercise and a high protein diet via whey protein supplementation in healthy older men
Griffen, C., Renshaw, D. W., Duncan, M. J., Weickert, M. O., & Hattersley, J. G. (2022) · Physiological Reports · doi:10.14814/phy2.15268 · Cited by 8
Association of Sociodemographic, Socioeconomic and Lifestyle Characteristics with Low Protein and Energy Intake in the Healthy Swiss Population
Wimmer, R., Audétat, A., Binggeli, J., Schüetz, P., & Kaegi-Braun, N. (2023) · Nutrients · doi:10.3390/nu15092200 · Cited by 8

Authors: Tieland, M., Borgonjen-Van den Berg, K. J., van Loon, L. J. C., & de Groot, L. C. P. G. M.
Affiliations: TiFN (NL)
Corresponding author: Tieland, Michael
ORCID: Tieland, Michael
Venue: European Journal of Nutrition
Publisher: Springer Science and Business Media LLC
Published: 2011-05-12
Volume: 51
Issue: 2
Pages: 173-179
ISSN: 1436-6207 (ISSN-L)
1436-6215
DOI: 10.1007/s00394-011-0203-6
OpenAlex: W2020203688
Cited by: 297
References: 47
Citations by year: 2026: 6 · 2025: 7 · 2024: 17 · 2023: 14 · 2022: 16 · 2021: 28 · 2020: 22 · 2019: 29 · 2018: 40 · 2017: 31 · 2016: 25 · 2015: 18 · 2014: 22 · 2013: 12 · 2012: 9
FWCI: 9.56
Type: journal article
Language: en
Open access: green
research.wur.nl
Licence: www.springer.com/tdm (tdm)
Locations: European Journal of Nutrition (publishedVersion)
PubMed (publishedVersion)
Socio-Environmental Systems Modeling (acceptedVersion)
Research Bank (Australian Catholic University) (submittedVersion)
Research Publications (Maastricht University) (submittedVersion)
Figshare (submittedVersion, cc-by)
Data Archiving and Networked Services (DANS) (submittedVersion)
Topics: Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
Health Sciences › Nursing › Nutrition and Dietetics › Muscle metabolism and nutrition
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Keywords: protein intake, older adults, sarcopenia, frail elderly, institutionalized elderly, community-dwelling older adults, protein sources, dietary intervention, protein requirements
MeSH terms: Aged, Aged, 80 and over, Bread, Energy Intake, Dairy Products, Diet, Dietary Proteins, Feeding Behavior, Female, Humans, Male, Netherlands, Residence Characteristics, Frail Elderly, Nutrition Policy

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Dietary protein intake in community-dwelling, frail, and institutionalized elderly people: scope for improvement

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