Food & Fitness After 50: Is There an Optimal Protein Intake for Older Adults?

A recent paper from three international protein gurus reviews the science behind the recommendations that older adults need more protein than young, healthy adults. The opening sentence of the paper sums up the current state of the science: “The optimum protein intake for adult health remains controversial.” How could that be?  The authors explain that why we know general requirements for protein we don’t know optimal intakes. Why there are limits to what we know about protein and aging?

  • Older adults, especially older women, are often not included as participants in research studies on protein needs.
  • Recommendations for protein are often derived from young, healthy adults. Healthy is a key word because we know that many older adults have chronic health conditions. Obesity, diabetes, high blood pressure, heart disease, and cancer affect 3 of 4 adults over the age of 65.
  • Research studies that look at protein intake and muscle mass in older adults are of short duration; most last less than 6 months. Since muscle loss is gradual, the short-term studies may not have time to show a positive effect of increasing protein.

While we may not have the definitive answer to the question posed in the title of this post, there is much we do know and here are some key points from the article:

  • The Recommended Dietary Allowance (RDA) for protein is inadequate for older adults due to something called the “anabolic resistance” of muscle. (Anabolic means building up and is the opposite of catabolic or breaking down.) Anabolic resistance means that the signals to build up muscle through strength training or eating protein is muted in older adults. This resistance can be overcome with an increased amount of strength training or a higher intake of protein.
  • When older adults experience a period of muscle disuse, which can occur during illness or injury, signals to muscle protein are blunted and a practical way to overcome this is through a higher protein intake, especially protein-rich foods that contain a key amino acid, leucine. Protein is made up of units called amino acids and 9 of the 22 amino acids are considered essential, meaning that we can’t make them in the body, so they must be consumed through diet. Leucine is one of the 9 essential amino acids and has been found to play a critical role in protein synthesis.
  • Sarcopenia, literally meaning vanishing flesh, is the progressive loss of muscle as we age. It doesn’t start when we are 60; it starts at about the age of 40 (even earlier in those who are inactive). Between the ages of 20 and 90, we can lose over 50% of our muscle mass due to sarcopenia and inactivity.

So, where does all of this leave us? The authors conclude that older adults should increase protein…both quality and quantity at meals. Consuming at least 30 grams of protein per meal, with 2.5 grams of leucine or more can overcome the anabolic resistance of aging muscle. While not all studies agree on meal timing, the authors also conclude that spreading the protein evenly across meals is better than backloading all the protein at one meal.

So, what does that mean for us? To recap to maintain muscle you need two things: progressive, resistance strength training and nutrition. Protein is a key nutrient for building and keeping muscle.  A few facts about protein:

  • High quality protein contains all 9 of the essential amino acids (EAAs) and includes:
    • Animal protein (beef, pork, poultry, fish, eggs, milk, cheese, cottage cheese, kefir, yogurt)
    • Soy protein (tofu, edamame, soy burgers, patties, crumbles, soymilk, cheese, yogurt)
  • The following foods do not contain all the EAAs, but they contribute to total protein intake:
    • Nuts (almonds, walnuts, etc.), almond butter, seeds (sunflower, chia, flax), legumes (peanuts, pinto, navy black beans, split peas, black-eyed peas, and other starchy beans and peas), peanut butter, pasta, rice, and whole grain bread.
  • Try and spread the protein evenly in 3-4 meals each day.

Examples of 30-gram protein meals

Sample meals and snacks with ~30 grams of protein

6 oz Greek yogurt (18)*

1 oz granola (4)

Small banana (1)

Skim milk latte (6)

2 scrambled eggs with 1 oz cheese and spinach (21)

8 oz soymilk (7)

½ slice whole grain toast (2)

Smoothie made with 1 ounce whey protein powder (20)**

6 oz Greek vanilla yogurt (18)

½ cup frozen berries (1)

Large green salad with veggies (2)

4 oz grilled chicken or salmon (28)

1 Tablespoon sunflower seeds (1)

1 Tablespoon chopped nuts (1)

3 oz tuna mixed with mayo (21)

2 slices of whole grain bread (7)

Lettuce, tomato, banana peppers or other veggies (2)

1 cup pasta (6)

3 oz turkey or beef meatballs (21)

Green salad with balsamic vinegar dressing (1)

1 cup cottage cheese (28)

1 Tablespoon chopped nuts (1)

3 slices fresh or canned peaches (1)

Stir fry with ½ cup tofu (10)

Carrots, broccoli, edamame (16)

1 cup brown rice (5)

3 oz cheddar cheese (21)

6 whole grain crackers (2)

8 ounces skim milk (8)

*grams protein in parentheses

 **most protein powders have ~20 grams protein per serving, but check labels

For those not used to thinking in terms of grams of protein (probably most of you), here are a few keys to understanding protein:

  • 1-ounce of beef, pork, fish, poultry, and cheese has about 7 grams of protein. Most of us don’t eat 1-ounce portions of these foods, so if you eat a 5-ounce portion of grilled salmon for dinner, you’ve eaten 35 grams of protein and that doesn’t count the other foods you have with the meal.
  • Dairy foods are rich in protein, the amino acid leucine, as well as other nutrients needed for muscle health such as vitamin D and calcium. 8-ounces (1 cup) of dairy milk has 8 grams of protein, but 8-ounces of ultra-filtered milk, such as Fairlife, has 13 grams of protein. Contrast that with Silk Almond milk that has only 1 gram of protein per serving. The point is that not all “milk” is a rich-protein source.
  • Foods carry a nutrition facts panel that tell you 2 important pieces of information: the serving size is of the food and how many grams of protein are in in one serving. That’s an important thing to keep in mind because you might be eating more than the stated serving size, meaning you are also getting more protein.

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  • I like to look for snacks that are nutrient-rich but not too high in calories. My recent favorite is kefir, a fermented milk drink with 11 grams of protein in 8-ounces, and is rich in probiotics, too.

I reached out the authors (aka, protein gurus) to ask them for a practical take-away from their article.

Meet the gurus

Dr. Stuart Phillips is a professor in the Department of Kinesiology at McMaster University, Hamilton, Canada (follow him on twitter @mackinprof).

“I’d recommend emphasizing the consumption of nutrient-dense sources of high-quality protein like dairy and eggs at meals that are traditionally lower protein: breakfast and lunch. My go-to protein food at breakfast (and sometimes lunch too) is Greek-style yogurt or Icelandic Skyr. Both are cultured dairy, rich in high quality protein, and many other necessary nutrients, and tasty and versatile as a base for berries and nuts.”

Dr. Doug Padden-Jones is a professor in the Department of Nutrition and Metabolism at The University of Texas Medical Branch, Galveston, Texas .

“For generally healthy adults, establish a dietary framework that includes a moderate amount of high-quality protein at each meal. Factors such as energy needs, physical activity, health status, body composition goals, and satiety should be weighed to determine protein needs. But, During periods of  physical disuse (injury, illness, inactivity) middle-age and older adults are at increased risk of muscle/function loss so just meeting the RDA for protein ( 0.8 g protein/kg/day)  is insufficient. Aggressive support with high quality protein (whey /leucine) and activity may help preserve muscle health.”

Dr. Donald Layman is a an emeritus professor in the Department of Food Science and Human Nutrition a the University of Illinois at Urbana-Champaign, Urbana, Illinois. (Follow him on twitter @donlayman).

 “A key for maintaining muscle health as we get older is dietary protein. Surprisingly, adults have higher protein needs than children because we have a continuous need to repair and replace proteins in our body but our efficiency of making new proteins declines with age. The best proteins are meats (including fish), eggs, and dairy. Vegetable proteins are popular, but they always have lower quality than animal proteins. You will need to consume 30% to 50% more total protein if you chose to use plant proteins. So, a 25 g whey protein shake would require at least 35 g of soy protein to be equivalent.” 

 

Dr. Christine Rosenbloom is a registered dietitian nutritionist and a nutrition professor emerita at Georgia State University in Atlanta. Along with Dr. Bob Murray, she is the author of Food & Fitness After 50.

Copyright © 2019 [Christine Rosenbloom]. All Rights Reserved

Food & Fitness After 50: Health Resources Available at Your Fingertips

If you are watching or reading the news about the coronavirus you’ve gotten no nonsense information  from Dr. Anthony Fauci, the Director of the National Institute of Allergy and Infectious Diseases or NIAID. What you might not know is that is that NIAID is one of 27 Institutes and Centers of the National Institutes of Health or NIH.

apple-blue-background-close-up-1353366The NIH is the world’s largest medical research agency and the website contains a vast amount of health information not just for scientists or researchers, but for everyday consumers, like us.

Many of my friends and neighbors know I am a registered dietitian and that I write about health and aging, so it is not unusual for me to get questions about diet and disease prevention or management. While I taught classes on medical nutrition therapy when I was on faculty at Georgia State, that was a while ago and I haven’t kept up with all the research on diet and disease management. Too often when people ask their doctor for nutrition advice, they get generic advice, such as “eat better and exercise more.” So, what do I tell people? I usually start by telling them that there is a lot of great, free information from reputable websites that they miss when they just google their specific concern. Enter the NIH websites.

What constitutes a reputable website? For me, it is one that provides information that is grounded in science and backed by evidence.  Another hallmark of a good health website is one that doesn’t rely on anecdotal testimonies from satisfied customers. Anecdotes make for compelling stories, but they don’t constitute evidence. I also stay away from websites that are trying to sell me something…the profit motive can bias the information.

That leads me to share some of my favorite NIH websites to learn more about the latest prevention and treatment strategies for various disease which affect many Americans. You won’t find flashy supplements that promise to cure you (and take money from your pocket) and you won’t find the magic, easy solution that many look for. You will find sound, credible information. So, when you have questions on (fill in the blank) check out these sites from the NIH:

  • When I was diagnosed with breast cancer in 2005 the first place I looked for information was the National Cancer Institute .From general information on cancer types, treatment and prognosis to specific cancers, this is a great place to start gathering information, including a list of questions to ask, before you talk to an oncologist.
  • For all things eye health, check out the National Eye Institute. As we age, we have more vision changes, from the normal age-related change presbyopia (the reason we need bifocals) to diseases like age-related macular degeneration. To learn about the symptoms, treatment, and latest research to prevent disease, start here. And, there is the good advice to get regular eye exams and give your eyes a break after 20 minutes of screen time.
  • The National Heart, Lung, and Blood Institute covers a variety of disease affecting the cardiovascular system and blood disorders. From A-Fib to Varicose Veins, this is the place to go. And, there is a lot of helpful information on medical devices like pacemakers and CPAP. heartHealth-1034500194-770x553-650x428
  • We’ve featured information on the National Institute on Aging in previous posts for information on healthy aging, but there is much more than nutrition on the site. Learn about the advances in geroscience, exploring the intersection of aging, biology, chronic disease, and health. Or get a free copy of Exercise & Physical Activity from Go4Life.
  • Arthritis is a common complaint of aging adults and you can learn about treatments at the National Institute of Arthritis and Musculoskeletal and Skin Diseases. You will also find information on bone health and osteoporosis in this Institute.
  • I’m often asked about diet for digestive issues and the National Institute of Diabetes, Digestive, and Kidney Diseases is a good place to start. I’m sharing the link for the diet and nutrition section because there is timely information on diet for irritable bowel syndrome, celiac disease, gallstones, and many other disorders.
  • While there are many for institutes within NIH, and I encourage you to browse the website, the last center I want to mention is the National Center for Complementary and Integrative Medicine . Many of you are interested in alternative treatments and this is good place to start learning about how various alternative treatments can complement traditional medical care. From herbs to acupuncture to Ayurvedic medicine, know the research that supports (or in some cases, refutes) what you think you know.

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Sadly, many people are rejecting science today. They complain that scientists are always changing their minds, so they are not trustworthy. But it is the nature of science to continue exploration which can lead to new information, especially with emerging and rapidly evolving diseases, such as COVID-19. The same is true for nutrition and health information, stay on solid ground and get good, unbiased information in your quest for good health.

Dr. Christine Rosenbloom is a registered dietitian nutritionist and a nutrition professor emerita at Georgia State University in Atlanta. Along with Dr. Bob Murray, she is the author of Food & Fitness After 50.

Copyright © 2019 [Christine Rosenbloom]. All Rights Reserved

Food & Fitness After 50: Nurturing Others…and, Yourself

Do you have a special friend who is a nurturer and a positive presence in your life? If not, I hope you find someone like my friend, Lisa, who elevates people by her outlook on life and being a champion and cheerleader for her friends and family.

In her early 60s, Lisa spent over 20 years in corporate America and now takes time to take care of her 89-year old mother, teach classes at a local college, and focus on nurturing her spirit by getting back into art and photography. Growing up the middle of three children, her mother tagged her as the “artistic” one. Lisa got her first Brownie camera as a child and took it everywhere, capturing people and places she loved. Art took a back seat to her career, but in 1991 when she moved to Chicago, she enrolled in a watercolor class at the Art Institute, where she met her husband, who was into oil painting. (At their wedding, the comparison to “oil and water” was raised!)
Lisa said she asked herself, “if art is my favorite thing to do, yet I don’t do it, how can I say it is my favorite thing?”

Lisa’s artistry and creativity are at their best at gatherings of friends. Many years ago, we met at a friend’s house in Pennsylvania. Hanging on her wall was a painting of a woman who she named “Shirley.” Lisa got the idea to have the five of us draw our version of “Shirley;” we were all pleasantly delighted when she compiled our drawings and framed the print for us. To this day, we call ourselves “The Shirleys,” thanks to Lisa!

The Shirleys

Lisa’s tips for healthy aging include sage advice for all of us. First, she says find your passion and act on it. Years ago, she heard Deepak Chopra  speak and one of the things he said has stayed with her. “Every day ask yourself three questions: Who am I? What do I want? How can I make a difference? The answers don’t have to come right away, but they will come to you.” For Lisa, she isn’t sure what the answers are, but she knows she wants the answers to be the same. Who she is will be someone who makes a difference.

She adds that a physically active life is also important for healthy aging. She enjoys running, walking, and cycling. But, she says, “don’t beat yourself up if you miss a day of exercise or don’t reach your goals.” She practices what she calls, “the power of now,” or living in the moment and being present for all of life’s experiences.

Lisa has always eaten well, but she admits she used to exercise so she could eat anything, but now she is more thoughtful about her food choices. Preferring local to support local farmers and protect the community, she shops at Farmer’s markets and grows veggies at home.

Lastly, Lisa doesn’t keep a “to do” list. Instead, she starts each day by thinking, “I’m going to feel great today if I do……” She also celebrates the little things in life and encourages us all to enjoy good news when it comes our way, instead of moving on to the next thing.
Lisa celebrates and elevates her family, her friends, and very importantly, herself.

Why this dietitian promotes healthful eating and exercise for those over 50

When talking about food and fitness for those over 50, it is the best of times, and sometimes the worst of times. Everyone want to know the ”best” exercise or food to eat to prevent aging. A quick Google search will provide you with many answers, unfortunately most of them are less than science-based and are usually trying to separate you from your money. Let’s be clear: there is no one superfood or exercise that will prevent aging.

That is why, I am excited to launch Food & Fitness After 50, with co-author, exercise book-front-pagephysiologist, Bob Murray. The book will be published later this year. While there might not be a “best” exercise or food, that doesn’t mean that food and fitness are unimportant as we age. You can be healthier at 65 than you were at 45 by eating well and starting (or increasing) your physical activity. This is important because so many of us are living longer. Baby boomers, those born between 1946 and 1964, began turning 65 in 2011 and by 2029 when all boomers will be 65, more than 20% of the population will be over 65. Why is 65 an important number? Because people reaching age 65 have an average life expectancy of 19.3 years (20.5 years for women and 18 years for men). How do you want to spend those 20 years? Do you want to travel, enjoy your favorite physical activities, and be a vibrant person in the lives of your grandchildren and great grandchildren? I am sure that we all want that, so being active and eating healthfully are steps you can take right now to increase your odds of being healthy into your later years.

Just this week, The Journal of the American College of Cardiology published an article on nutrition controversies in preventing heart and blood vessel disease. The article can be found here  http://www.onlinejacc.org/content/69/9/1172?_ga=1.183783078.1620905078.1488293025 and here is an easy to guide to see their recommendations.

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While their article focused on heart disease, our book covers many healthful eating patterns to keep your heart, bones, joints, blood sugar, blood pressure, and brain healthy. Remember there isn’t one “best” eating plan. So, we feature four plans that we think most older adults will find fit their lifestyle and their enjoyment of foods:

  • The DASH eating plan (DASH stands for Dietary Approaches to Stop Hypertension)
  • The Flexitarian plan
  • The Mediterranean Diet
  • The MIND diet (MIND stands for Mediterranean- ASH Intervention for Neurodegenerative Delay)

We also dive into exercise for endurance, strength, agility, balance, and functional fitness. Keeping our heart and lungs strong, halting muscle loss, and keeping agile all contributes to functional fitness….the ability to do the things you did when you were younger without a second thought. I want to be able to lift my suitcase in the overhead bin when I travel and pick up a 50-pound bag of dog food, all examples of functional fitness. Age-related muscle loss usually starts at about age 40. We can lose 10-15% of muscle mass and muscle strength every decade if we don’t engage in progressive, resistance exercise.

We hope that our book can help those over 50 learn to separate usual aging from the disuse of a sedentary lifestyle and sort out the fact from fiction about foods. Please visit our webpage to learn more about the book and leave us a question that you might see featured in an upcoming blog post. Web page for Food & Fitness After 50

 

 

 

 

How this Dietitian is Snacking on Super Bowl Sunday

I recently attended a conferchili_012610p10104141ence where both turkey (National Turkey Federation) and beans (Bush Brothers and Company) sponsored scientific sessions. I was not asked to write this post, do not serve as a consultant for either company, nor was I compensated for writing this article.

I am excited for the Atlanta Falcons playing in the big game on Sunday, and with the game comes parties and snacks, lots of snacks.  According to some sources, 49 million cases of beer, 100 million chicken wings, and 139 million avocados (for guacamole, of course) will be purchased in the days leading up to the Super Bowl. But, this year, I’m taking two of my favorite foods in that quintessential football dish to a Super Bowl party…chili. Not just any chili, but one with ground turkey and black beans.

Ground turkey breast is a great canvas for chili as it takes on the flavors from the tomatoes and spices and contributes to texture, taste, and nutrition. Turkey is a great source of lean protein without the excess saturated fat of other popular chili meats. Beans are also a good source of protein with the added benefit of containing soluble fiber. Bean have super powers: as part of a healthful diet, beans can lower blood sugar, blood pressure, blood lipids, and increase satiety (that means you might not look longingly at the platter of wings because you are full and satisfied after eating a bowl of my chili!) Associate professor of nutritional sciences and researcher on the health benefits of beans and peas at the University of Toronto, Dr. John Sievenpiper, is also a staff physician. He sees patients with diabetes and heart disease and those at high risk for developing chronic diseases. He writes prescriptions for his patients to eat a healthful diet (the “portfolio diet”) including beans and peas for the protein and fiber. I wish more doctors would write prescriptions for healthy diets! (For more information on the Portfolio Diet see http://portfoliodietplan.com/ )

Enjoy the chili and the game, and, of course, we will be hoping the Falcons come home with a victory.

Turkey Black Bean Chili (I’m not sure of the origins of this dish, but I’ve been making it for many years)

16-ounces of ground turkey breast

1 medium onion, chopped

2 Tablespoons of chili powder

Dash or red pepper flakes

½ teaspoon cumin

½ teaspoon salt

2 cans diced tomatoes (I like the diced tomatoes for chili)

1 can black beans, drained and rinsed

1 cup frozen or canned (drained) whole kernel corn

14-ounces unsalted chicken stock

Brown turkey over medium heat and separate into crumbles; cook and stir for about 7 minutes or until turkey is browned. Stir in onion and spices and continuing cooking for a few minutes. Add tomatoes, beans, corn, and stock and bring to a low boil. Transfer to chili to a crock pot and cook on low for several hours or until ready to serve at the Super Bowl party. Top with grated cheddar or jalapeno jack cheese, plain Greek yogurt, and a dash of hot sauce for those who like chili extra spicy.

Makes 6-8 servings

 

How this dietitian enjoys summertime grilling

Grilled Brussels Sprouts

Everyone loves to fire up the grill for a July 4th cookout. How you grill and what you cook on the grill can be tasty, healthy and can even reduce your risk of developing some cancers.  You may have heard that certain foods cooked on the grill at high temperatures aren’t good for you but you may ignore the risk because you love to grill. Well, no need to stop grilling, “just make some smart grill moves in what you cook and how you cook,” says Alice Bender, a registered dietitian and head of nutrition programs at the American Institute for Cancer Research (AICR).

First, let’s look at what is at the root of the health concern. The culprits include two chemicals produced when grilling meat. The first are chemicals called heterocyclic amines (HCAs) that are formed when meat is cooked at very high temperatures causing some the building blocks of protein (amino acids) to break down into HCAs. The other dangerous compound produced during grilling occurs when the fat from the meat hits the hot coals or gas grill lava rocks and causes flare-ups and smoke. The smoke contains polycyclic aromatic hydrocarbons (PAHs). Both of these compounds have the potential to alter DNA leading to increase cancer risk. The studies showing the changes are done in animals, and while the human research is only an association, not a cause, but why not make smart moves with grilling to reduce your risk?

What should you grill? The biggest culprit in forming HCAs comes from muscle meat, especially fatty cuts: steaks, burgers, chicken pieces with the skin, and ribs. So, consider leaner cuts of meat (flank steak, skinless chicken or turkey filets, and pork tenderloin) and try some new alternatives, like organic chicken sausages instead of the fatty brats. Other healthy grilling choices include fish, burgers made from soy or ground turkey or chicken breast, and kebabs made with smaller pieces of meat and plenty of vegetables.

The next strategy to reduce your risk is to change your grilling techniques.  All of the following will reduce the formation of HCAs and PAHs to reduce your exposure to harmful chemicals.

  • Pre-cook meat in the oven and finish it on the grill; that translates to less grilling time but still gives the meat the grilled flavor
  • Don’t eat the charred or blackened parts of grilled meat; cut those off and toss
  • Marinate meat before grilling; marinades seem to provide a barrier between the flames and the meat
  • Use lean cuts of meat and trim all fat
  • Keep the drips to a minimum by using tongs instead of a fork that pierces the meat and leads to more grill flare ups
  • Flip foods more often
  • Grill at lower heat to avoid flare-ups which lead to charring and smoke formation

Now for some good news; grilling vegetables doesn’t increase your risk of cancer; vegetables don’t contain a lot of protein and it is the protein in meat that interacts with the high heat and smoke to produce HCAs and PAHs. So, lighten up on the meat and load up the grill with veggies. Thick slices of veggies work well on the grill or toss smaller cuts of veggies in a grill basket and lightly baste with olive oil and fresh or dried herbs.  Try this Summer Grilled Balsamic Veggie recipe from AICR (and check out all of their healthy recipes) at http://www.aicr.org/health-e-recipes/2016/summer-grilled-balsamic-veggies.html

And, don’t forget that grilled fruit makes for a sweet ending to a meal. Grill slices of apple, pineapple, pears, or peaches and top with vanilla Greek yogurt and sprinkle of cinnamon and nutmeg.

For more information, take the AICR quiz on grilling and cancer risk.

http://www.aicr.org/enews/2015/05-may/enews-truth-about-grilling-and-cancer.html

 

Fit to Eat by Chris Rosenbloom, PhD, RD

Happy New Year! For five years I wrote a weekly column for the Atlanta Journal-Constitution titled “Fit to Eat.” As newspapers continue to shrink in size, scope, and importance, I will carry my column forward in this blog. As a nutrition professor and registered dietitian, I will write about food, nutrition, and fitness and hope my newspaper readers will find interest in my writing.

Now that it is 2010, here are my suggestions for the top 5 new year’s resolutions that you should not make.

  • Lose weight. This may be one of the most popular new year’s resolutions but it is also the easiest to break. This year aim for health, not weight loss. You might be surprised that by eating healthfully and making small changes to your activity patterns you might drop some pounds without even trying.
  • Join a gym in January. It is depressing to go the gym in January–the place is crowded, you have to wait for a treadmill, and the lines for the weight training machines are nuts. Wait until February when the crowds thin and the new year’s resolutions have faded.
  • Drink 8 glasses of water a day. Stop carrying around that gallon jug of water; there is nothing magical about drinking 8 glasses of water. All beverages count toward hydration–even caffeine-containing drinks, so stop counting water glasses.
  • Eat out less. Nothing wrong with eating out if you make the right choices. Start your meal with a broth-based soup and split an appetizer, salad, or entree to save money and calories.
  • Stop comparing your body to the models on the pages of health and fitness magazines–they are bad for your mental health. Every photo has been altered to show an image that is unattainable. Check out the DVD, “America the Beautiful” to get an insider’s look to our obession with beauty. This year learn to love your self.