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: Is There a Best Diet for Losing Weight?

dieting

Each week Obesity and Energetic Offerings arrives in my inbox. It is a weekly roundup of research from Indiana University School of Public Health and University of Alabama Birmingham Nutrition Obesity Research Center. One of my favorite features is called “Headline vs Study,” and a recent one on weight loss diets was intriguing.

The Headline: Study Reveals the Best Diet for Actually Losing Weight and Keeping It Off.

The Study: Exploratory, observational analysis: “Small differences in metabolic outcomes were apparent in participants following self-selected diets… However, results should be interpreted with caution given the exploratory nature of analyses.”

Being a nutrition nerd, I read the study titled “Intermittent fasting, Paleolithic, or Mediterranean diets in the real world: exploratory secondary analyses of a weight-loss trial that included choice of diet and exercise,” published in the American Journal of Clinical Nutrition. Here are the key takeways:

  • Conducted in New Zealand and Australia, the current study was a secondary analysis of data from a study on support strategies for three different diets and two different modes of exercise to understand different monitoring strategies that might encourage adherence to diets and exercise.
  • About 250 individuals who were healthy and had a body mass index that classified them as having overweight were selected and screened for height, weight, blood pressure, and blood sugar.
  • Individuals could choose one of three diets: Mediterranean, Paleo, or Intermittent Fasting (IF) and one of two exercise plans (recommended national guideline for exercise or high intensity intermittent training (HIIT). All participants were given detailed guidelines for the chosen diet and exercise plan.
  • The IF plan was the most popular, with 54% of participants choosing it, followed by Mediterranean diet (27%) and Paleo (18%).
  • Only half of the participants who choose the IF or Mediterranean diet were still following it at 12 months and one-third of the Paleo dieters were following the plan.
  • Adherence to any diet rapidly declines over time.
  • No matter which diet was followed, outcomes for weight loss, blood pressure, or blood sugar were modest.
  • There is difficulty following diet in a free-living environment without intensive ongoing support.

And, this is why it pays read beyond the headline and to dig deeper to get the real story.

All of this made me think of a recent presentation from Ted Kyle, founder of ConscienHealth and LeeAnn Kindness, of Tivity Health (Nutrisystem is one of their products) on the heterogeneity of obesity. According to Kindness, “77% of adults are actively trying to improve their health and more than 120 million are actively trying to lose weight.” Over the past 12 months, consumers have tried over 18 different dietary patterns to improve their health or lose weight. Yet, as was shown in the study on the three diet patterns, it is hard to stick with the plan.

So, what is “best?” Ted Kyle reminds us that the responses to diets vary. Study data usually report outcomes as averages of aggregate data, and we all know what an average is…that means that some people will lose weight on a specific plan while some people gain weight. He showed data from a study called DIETFITS on low carb vs low fat diets…. some people lost weight on both plans, but some people gained weight on both plans. “The same is true for any diet, drug regimen, or surgical intervention and the bottom line is one size doesn’t fit all,” says Kyle.

That is why programs like Nutrisystem are recognizing that “sustainable weight management requires a personalized approach, considering age, gender, food preferences, and goals,” says Kindness.

When choosing a plan for lifelong health, find something that works for you and seek the advice of a health professional who can help guide your choice and stick with the plan.

For more information on healthy food and exercise choices, check out Food & Fitness After 50, available at Amazon and other booksellers.

Disclosure: I attended a conference that paid for my travel expenses and the session mentioned was one of many over four days of education. I was not asked to write this post and was not compensated for it.

Copyright © 2019 [Christine Rosenbloom]. All Rights Reserved.

Food & Fitness After 50: It’s True! Good Things Come in Small Packages

“You can’t help getting older, but you don’t have to get old.” George Burns, Comedian

For 38 years, Bo worked in IT for IBM and then “retired” and worked for 3 years in the “best job I ever had.” That job was for the local Chamber of Commerce where “everyday was different, unpredictable, and fun.” But, being the people-person, she is, Bo says the best part was the people she worked with and the interactions with others in her community. Having just celebrated her 69th birthday, Bo is now fully retired, but she spends a good part of every day at the YMCA taking aerobic classes three days a week from Jean the Dancing Queen.”  She also plays pickelball for several hours 4 to 5 days a week.

Healthy Habits to Control Weight

Bo 2Bo has always been petite and the only time she gained weight was during her pregnancies with her 2 boys, but she quickly got back to her usual, healthy weight. While many adults gain weight as they age, Bo manages her weight by eating smaller portions, eating lots of fresh veggies, limiting sweets and sugar, and paying attention to how much and when she eats. “I’m lucky that I like the healthy stuff!” She often finds she doesn’t have much of an appetite, but eating breakfast and a mid-day meal around 2 pm (which she calls a cross between lunch and dinner as “linner”) keeps her fueled without being full. Her only dietary indulgence is a “real Coca-Cola” a couple of times a week. She also pays attention to hydration and is sure to drink plenty of water throughout the day to replenish water loss during activity.

Keep moving

As she has gotten older, Bo knows she needs to pay attention to her body and adjust as needed. “Know what you can do and what you can’t do.” TRX is all the rage at our local Y, but she knows that it isn’t for her. “Understand your body, but stay involved and active.” Her words of wisdom are “the more you use it, the better it gets.” Great advice for everyone!

Keep motivated

Many sedentary folks look at active people and think it is easy for them or that it comes naturally, but Bo makes exercise a priority in her life. Bo’s advice is “don’t be lazy; tell yourself you have to go to exercise class, an activity, or for that daily walk. “Feed your body right and use it every day!” Her words reminded me that while I often would prefer to skip morning exercise class and sleep in a bit longer or linger over a second cup of coffee, I have never once said, “I wish I hadn’t exercised today!” We all feel better, physically, mentally, and emotionally after a good workout!

 

Food & Fitness After 50: Good Genes + Good Health Habits = The Path to Healthy Aging

This guest blog post was written by Dr. Bob Murray

After high school, Linda stopped competing in gymnastics, but since then has led a physically active lifestyle, including 10-K road races and a handful of marathons. Now at age 56, road races are in her past, but her competitive instincts are still evident: she is fully engaged in a competition against Mother Nature. Linda’s over-arching goal is to look and feel younger than her age, although she knows Mother Nature may have other ideas. Blessed with the right genes and a lifelong commitment to eating well and staying physically active, Linda is happy with the way she looks and feels, but knows that she will have to double down on that commitment as she ages.

There is no doubt that genetics play an important role in how gracefully we age, but our genes are not the only determining factor. Our lifestyle habits also play a critical part in how we look and feel as we grow older. Fortunately, it’s never too late to eat well, move well, and be well, so even if we haven’t paid as close attention to our health and fitness during our first half-century of life, there is still plenty of time and room for improvement.

Linda D
Linda on a 12-mile day hike in Idaho backcountry

The three tips for aging well that have worked for Linda are: 1) get enough sleep every day, 2) eat and drink in moderation (no deprivation, no binging), and, 3) stay physically active.

On those occasions when Linda has gained unwanted fat weight, she sheds the pounds by increasing her daily physical activity—including the time she sets aside for exercise—eliminating snacks, reducing alcohol intake, and eating calorie-controlled meals. All of these changes are simple extensions of Linda’s usual routines, so losing weight never feels like a major life change.

 

Linda rarely sits or naps during the day and is constantly moving around her house, yard, and neighborhood, burning extra calories that aid in long-term weight control. She does not follow a set exercise schedule—although she knows that would be a plus—and she prefers to exercise on her own, opting for the occasional spin or body-pump class with friends. When it comes to exercise, Linda likes the familiarity of a set routine and doesn’t mind repeating the same workout multiple times.

Linda does cardio exercise for heart health and weight control, along with strength exercises to protect her muscle mass and stay toned. For cardio, she enjoys hill walking in the neighborhood or on the treadmill, interspersed with short jogs. When the weather permits, she and her husband like to ride their bikes in the country. Linda has done a 65-miler and would like to retain the stamina to do be able to cycle 20-30 miles without the effort being a major hardship. For strength training, Linda focuses on her arms, back, chest, and core, relying on 15-20 repetitions of relatively light weights (10-20 lb.), moving quickly from one exercise to the next in 20-minute sessions that she tries to accomplish four times each week. Whenever she’s able to keep that schedule, she quickly notices the changes in muscle size and tone.

“I’ve been fortunate to have good health and habits over the years,” Linda said. “Now that I’m in my 50s, it’s time for me to be even more diligent—but not crazily so—about getting enough exercise to keep my strength and muscle mass. I want to continue living an active life and staying strong is so important to that goal. I’m hoping that my understanding the benefits of good eating and exercise, combined with my vanity, will keep me on the right path!”

Dr. Bob Murray and Dr. Chris Rosenbloom are co-authors of Food & Fitness After 50, available in paperback on Kindle edition for E-readers at Amazon

 

Food & Fitness After 50: In my element with 12,000 dietitians

Greetings from Chicago, where I’m attending the annual meeting of the Academy of Nutrition and Dietetics. I’m with my peeps…. all 12,000 of them!

I’m often asked how I got interested in nutrition and why I became a dietitian. Like for many of us, parental influence was paramount.

I first became aware of the power of nutrition when I was a teenager. My father had kidney disease and was on dialysis for many years. Since I was the one kid (one of seven!) who liked to bake, I learned to make low protein bread for my dad, as protein was a nutrient that had to be controlled in his diet. My father died when I was a senior in high school and then my mother’s influence kicked in.

Chris HS 1969She was insistent that her daughters get a college education so we could always take care of ourselves. There was one catch; we had to have a useful college degree that would lead to real job. It was logical for me to choose nutrition and dietetics for my career path. In fact, my senior picture in the North Olmsted, Ohio yearbooks, says “future dietician.” (We prefer the spelling dietitian, but I didn’t know that in 1969 when I graduated from high school!).

So, I went to Kent State University to major in nutrition and it was the best choice for me because: (1) got a great foundation in nutrition science, and (2) I met my husband, Rob, at Kent State. After graduation I went to the University of Minnesota to complete a 12-month dietetic internship. I loved Minneapolis, but after growing up in Michigan, going to school in Ohio and spending a year in freezing Minnesota I was ready for a warmer climate. Georgia was it and has been for over 40 years.

Now that I am older and “retired” after 30 years university teaching, I am glad I became a dietitian and excited to put all the years of education, work experience, and personal insights into my new book Food & Fitness After 50. I still enjoy writing about nutrition, giving presentations, planning food influencer conferences, and talking to athletes, so that is why I say I am retired in quotes. I hope you get on a path to eat well, move well, and be well whatever your age.

Chris Rosenbloom and Bob Murray’s book Food & Fitness After 50 is available on Amazon

 

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.