Dietary Protein Requirement of Men >65 Years Old Determined by the Indicator Amino Acid Oxidation Technique Is Higher than the Current Estimated Average Requirement

Rafii, Mahroukh; Chapman, Karen; Elango, Rajavel; Campbell, Wayne W; Ball, Ronald O; Pencharz, Paul B; Courtney-Martin, Glenda

doi:10.3945/jn.115.225631

Cited by 87Muscle metabolism and nutritionNutrition and Health in AgingClinical Nutrition and Gastroenterology

Dietary Protein Requirement of Men >65 Years Old Determined by the Indicator Amino Acid Oxidation Technique Is Higher than the Current Estimated Average Requirement

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Rafii, Mahroukh, Chapman, Karen, Elango, Rajavel, Campbell, Wayne W, Ball, Ronald O, Pencharz, Paul B, Courtney-Martin, Glenda·2016·The Journal of Nutrition

DOI 10.3945/jn.115.225631

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Abstract

Background The current estimated average requirement (EAR) and RDA for protein of 0.66 and 0.8 g ⋅ kg-1 ⋅ d-1, respectively, for adults, including older men, are based on nitrogen balance data analyzed by monolinear regression. Recent studies in young men and older women that used the indicator amino acid oxidation (IAAO) technique suggest that those values may be too low. This observation is supported by 2-phase linear crossover analysis of the nitrogen balance data.Objective The main objective of this study was to determine the protein requirement for older men by using the IAAO technique.Methods Six men aged >65 y were studied; each individual was tested 7 times with protein intakes ranging from 0.2 to 2.0 g ⋅ kg-1 ⋅ d-1 in random order for a total of 42 studies. The diets provided energy at 1.5 times the resting energy expenditure and were isocaloric. Protein was consumed hourly for 8 h as an amino acid mixture with the composition of egg protein with L-[1-13C]phenylalanine as the indicator amino acid. The group mean protein requirement was determined by applying a mixed-effects change-point regression analysis to F13CO2 (label tracer oxidation in breath 13CO2), which identified a breakpoint in F13CO2 in response to graded intakes of protein.Results The estimated protein requirement and RDA for older men were 0.94 and 1.24 g ⋅ kg-1 ⋅ d-1, respectively, which are not different from values we published using the same method in young men and older women.Conclusions The current intake recommendations for older adults for dietary protein of 0.66 g ⋅ kg-1 ⋅ d-1 for the EAR and 0.8 g ⋅ kg-1 ⋅ d-1 for the RDA appear to be underestimated by ∼30%. Future longer-term studies should be conducted to validate these results. This trial was registered at clinicaltrials.gov as NCT01948492.

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Older adults require more protein per day.
“older adults require more protein per day,79–81”
From A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults (2018) · cites this paper as [79]
The Discussion (page not specified) estimates that men over 65 require about 30% more protein than current recommendations. But it also says their requirement per kilogram of body weight did not differ from that of younger men; a higher requirement was found only when measured per kilogram of fat-free mass. The unqualified claim that older adults require more protein therefore needs a comparator and a measure. (LLM, conf=0.85)
Experimental — accuracy not yet measured
The conclusion that protein at the RDA is insufficient is emphasised for older men and women wishing to obtain strength and gain lean mass with resistance exercise training and protein supplementation.
“This conclusion is emphasised for older men79 and women80 81 wishing to obtain strength and gain lean mass with RET and protein supplementation.”
From A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults (2018) · cites this paper as [79]
The Abstract reports that the estimated protein requirement for men over 65 exceeds the current RDA, and the Discussion says the estimate is similar to previously published results for older women. The study did not test resistance exercise training or whether protein supplementation helps older adults gain strength or lean mass. (LLM, conf=0.88)
Experimental — accuracy not yet measured

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Protein requirement of elderly women determined using the indicator amino acid oxidation technique
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Authors: Rafii, M., Chapman, K., Elango, R., Campbell, W. W., Ball, R. O., Pencharz, P. B., & Courtney-Martin, G.
Affiliations: Hospital for Sick Children (CA)
University of British Columbia (CA)
Purdue University West Lafayette (US)
University of Alberta (CA)
ORCID: Elango, Rajavel
Campbell, Wayne W
Venue: The Journal of Nutrition
Publisher: Elsevier BV
Published: 2016-04
Volume: 146
Issue: 4
Pages: 681-687
ISSN: 0022-3166 (ISSN-L)
DOI: 10.3945/jn.115.225631
OpenAlex: W2294814573
Cited by: 87
References: 49
Citations by year: 2026: 5 · 2025: 9 · 2024: 8 · 2023: 11 · 2022: 5 · 2021: 7 · 2020: 11 · 2019: 6 · 2018: 11 · 2017: 9 · 2016: 5
FWCI: 7.11
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 2502 d)
Locations: Journal of Nutrition (publishedVersion)
PubMed (publishedVersion)
Funders: Canadian Institute of Health Research (MT 10321)
Pfizer Consumer Healthcare
Topics: Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
Keywords: protein requirements, older men, indicator amino acid oxidation, estimated average requirement, RDA, nitrogen balance, change-point regression, protein intake recommendations, aging

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Dietary Protein Requirement of Men >65 Years Old Determined by the Indicator Amino Acid Oxidation Technique Is Higher than the Current Estimated Average Requirement

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