Increasing Dietary Protein Requirements in Elderly People for Optimal Muscle and Bone Health
Abstract
Osteoporosis and sarcopenia are degenerative diseases frequently associated with aging. The loss of bone and muscle results in significant morbidity, so preventing or attenuating osteoporosis and sarcopenia is an important public health goal. Dietary protein is crucial for development of bone and muscle, and recent evidence suggests that increasing dietary protein above the current Recommended Dietary Allowance (RDA) may help maintain bone and muscle mass in older individuals. Several epidemiological and clinical studies point to a salutary effect of protein intakes above the current RDA (0.8 g/kg per day) for adults aged 19 and older. There is evidence that the anabolic response of muscle to dietary protein is attenuated in elderly people, and as a result, the amount of protein needed to achieve anabolism is greater. Dietary protein also increases circulating insulin-like growth factor, which has anabolic effects on muscle and bone. Furthermore, increasing dietary protein increases calcium absorption, which could be anabolic for bone. Available evidence supports a beneficial effect of short-term protein intakes up to 1.6 to 1.8 g/kg per day, although long-term studies are needed to show safety and efficacy. Future studies should employ functional measures indicative of protein adequacy, as well as measures of muscle protein synthesis and maintenance of muscle and bone tissue, to determine the optimal level of dietary protein. Given the available data, increasing the RDA for older individuals to 1.0 to 1.2 g/kg per day would maintain normal calcium metabolism and nitrogen balance without affecting renal function and may represent a compromise while longer-term protein supplement trials are pending.
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A protein intake of 1.0 to 1.2 g/kg body weight per day is expected to help maintain nitrogen balance without affecting renal function.
“Given the available data, a recommendation of protein intake at 1.0 to 1.2 g/kg BW/d is expected to help maintain nitrogen balance without affecting renal function, especially until results of additional studies are available.6”
From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [6]
Reviews of research studies reveal little or no evidence that high-protein diets cause kidney damage in healthy individuals, including older persons.
“However, reviews of research studies reveal little or no evidence that high-protein diets cause kidney damage in healthy individuals, including those who are older.6,54,55”
From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [6]
Increasing the recommended dietary allowance to 1.0 to 1.2 g/kg per day would maintain normal calcium metabolism and nitrogen balance without affecting renal function and still be within the acceptable range according to the Institute of Medicine.
“Given the available data, increasing the RDA to 1.0 to 1.2 g/kg per day (or approximately 13%e16% of total calories) would maintain normal calcium metabolism and nitrogen balance without affecting renal function and still be well within the acceptable range according to the IOM. 2”
From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [6]
Physical activity during hospitalization and in posthospitalization rehabilitation sessions has reported benefits.
“There is no global standard or recommendation, but physical activity during hospitalization and in posthospitalization rehabilitation sessions has reported benefits.1e3,5e10, 69,70,149e152”
From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [6]
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BackgroundThe Rate of Protein Digestion affects Protein Gain Differently during Aging in Humans
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- Authors
- Gaffney‐Stomberg, E., Insogna, K. L., Rodriguez, N. R., & Kerstetter, J. E.
- Affiliations
- University of Connecticut (US)
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2009-05-29
- Volume
- 57
- Issue
- 6
- Pages
- 1073-1079
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- OpenAlex
- W1524604492
- Cited by
- 226
- References
- 6
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 3 · 2023: 11 · 2022: 9 · 2021: 16 · 2020: 15 · 2019: 15 · 2018: 18 · 2017: 21 · 2016: 21 · 2015: 12 · 2014: 28 · 2013: 15 · 2012: 9
- FWCI
- 7.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (AG070992)
- National Center for Research Resources (M01RR000125, RR00125)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Keywords
- dietary protein, older adults, sarcopenia, osteoporosis, muscle mass, bone health, protein requirements, RDA, muscle protein synthesis, insulin-like growth factor, calcium absorption, nitrogen balance, renal function, protein supplementation
- MeSH terms
- Calcium, Dietary Proteins, Humans, Metabolism, Muscular Diseases, Nutritional Requirements, Osteoporosis, Muscle, Skeletal, Nutrition Policy, History, 21st Century
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