Ageing, Protein and Muscle Loss

A New Study from Ireland 2021:

Ageing is not just a chronological process, but a biological one. Chronological age is measured in years, whereas biological age is all about assessing physical and mental function. Some people tend to age well, whereas others show their age quite early and much of this ‘premature ageing’ can be related to lack of exercise, poor nutrition (especially protein), low quality sleep and even stress.

Ireland tends to have a plethora of high-quality data from studies including the National Adult Nutrition Survey, the Trinity Ulster Study and also the Irish Longitudinal Study on Ageing. This can shine an accurate spotlight on the health of the nation as a whole and therefore make recommendations that much more precise going forward.

The Main Health Issues

Older adults in Ireland are more affected by obesity than any other age group. This can be due to lower metabolic rate combined with generally lower levels of activity. A poor diet high in ‘empty calories’ can also exacerbate this issue, where low protein intakes combined with low intakes of micronutrients becomes a recipe for poor health all round.

Older adults are more susceptible to chronic diseases too of course.

Over 50% of older adults have hypertension and this can be accompanied by additional problems such as arthrosclerosis, increasing arterial stiffness, increasing obesity and abdominal fat distribution.
This can in turn lead to other inflammatory diseases such as type 2 diabetes which can have a dramatic effect on one’s life, if not identified and treated early.

Also, early frailty due to ‘age related loss of muscle mass & strength’ (sarcopenia) can be brought on due to lack of exercise and also a low protein intake. Clearly this has negative connotations for the health and quality of life going forward.

There is also a recommendation from the Irish study suggesting or advising that older adults should not only have a higher protein dense diet, but also should engage in regular resistance exercise. This is more like weight training, or at least weight baring exercise, but can still be practiced at home to some degree with the right exercises. Together this is exactly what is needed to fight against frailty and ongoing loss of muscle function.

Hanging on to Muscle with Exercise and Protein

Muscle mass can decline between 1% and 3% after the ages of 40 and beyond. Just look at the mri scan across the upper legs of both these older and younger men. What a huge difference, yet both will have similar BMI.

But this can be inhibited to some degree by both exercising, preferably with resistance exercise and ensuring a protein intake of between 1.0-1.5g/ kilo per day. Loss of muscle mass has been associated with many negative health outcomes such as COPD, cardiovascular disease, general sarcopenia and even cancers. In addition, it is associated of course with an increased risk of falls and therefore fractures, the latter of which can be life changing and therefore should be avoided at all costs.

Ireland does clearly recognise that older adults actually need more protein than the general adult population. This is a surprise to most, but this has been clinically proven so many times and across different labs across the world.

Protein Quality and Source is Important too

Also, the higher the quality of protein, the better. For example, fish, meat, eggs, dairy and even whey protein itself represent top quality sources of healthy protein. It is also recognised by many scientists that these animal sources of protein are superior to plant based sources such as soy, pea , rice and others.

Plant protein sources are perfectly good however and just getting that crucial protein intake must be the priority, whatever the source. However, plant based proteins are still (based on many clinical trials) considered a lower quality protein, due to a less balanced EAA ( essential amino acids) content. These are the nine so called ‘essential amino acids’, which are the basic amino acid building blocks of protein and therefore muscle, enzymes and many other tissues within the body. The body cannot survive without protein.

Protein from animal sources such as meat poultry fish eggs and milk based products provide all these nine essential amino acids and have a higher content of the very important amino acid called leucine, which has been proven to be an absolutely key amino acid for the stimulation of muscle protein synthesis. This in turn helps maintain and even build muscle.

How Much Protein?

In fact, Ireland has recognised that the old WHO RDA (recommended daily target) of 0.8 g per kg/day (about 60gm) is out of date for older adults and this should be increased to at least 1.0 to 1.2 g/ kilo per day of protein to preserve muscle mass. Some scientists even suggest up to 2 g/kg/day!

The Irish Universities Nutrition Alliance indicated that one third of all the adults had protein intake is below the old WHO and EFSA recommendation of 0.8 g per kilo per day. Such low intakes will simply not maintain muscle mass and function which decline due to the ageing process.

Further research, has also indicated that spreading the protein intake across the day is a better way of maximising muscle protein synthesis, than ingesting a large bolus in the evening meal, which is quite typical in most households.
Typically most breakfasts are carbohydrate rich and low in protein, so ingesting a higher protein intake in the morning will be a healthy regime going forward to help fight against sarcopenia.

Having said this, getting enough protein during the day is actually quite challenging for most older adults and this is why supplementation can help enormously. This is what many nutritionists and dieticians forget, and that is the practicality of working out how to actually ensure how older adults ingest that amount of protein!

After all 100 g a day which is the average recommendation is the equivalent to four chicken breasts….or eighteen eggs! Not easy without help from some high quality supplementation.

Recommendations from Food Safety, Ireland

1. Frailty, sarcopenia and undernutrition should be identified in adults aged 65 years and older, as these conditions increase the risk of chronic disease, and mortality and reduce quality of life.
2. Older adults should consume adequate energy (calories) to prevent the development of frailty, sarcopenia and undernutrition.
3. Older adults at risk of frailty, sarcopenia and undernutrition are recommended to eat a minimum of 1.0–1.2 g/kg body weight of protein per day to preserve muscle mass. This is around 100g per day of protein.
4. Sufficient high-quality protein foods should be included in the diet and consumed at a minimum of two meals per day. Such foods include meat, poultry, fish, dairy products, and eggs, and, to a lesser extent, beans, peas, lentils and nuts.
5. Older adults should aim to complete physical activity daily and resistance exercise 2–3 times/week in order to maintain or improve physical function

Recommendations extracted from ‘Food Safety Authority of Ireland 2021’