Are your muscles melting away? Sounds pretty dire, but as we age, muscles do gradually lose mass and strength. It’s called sarcopenia, and it affects everyone to some degree. The Good News: you can take steps to minimize the effects. The Bad News: you can’t prevent it entirely.
According to current statistics, sarcopenia leads to:
- an average 0.8% loss of muscle mass per year
- an average 2-5% loss of strength per year
- these losses are greatly increased if you’re immobilized by illness or injury
- adding insult to injury, loss of muscle mass and strength puts you at higher risk for falling and bone fractures, which leads to more immobility. It can be a vicious circle.
Keep in mind, these numbers are estimates of averages. They’re worse for some people, less so for others. What can you do? There are two essential steps to take:
- adequate high quality protein intake
- adequate exercise — aerobic activities, resistance training (weights) and core strength
Neither one alone will address the problem. You must do both.
Determining adequate protein can be confusing, because the amount needed can vary according to the type of protein foods eaten. Meats, fish, dairy and eggs are high quality protein, so you can eat less quantity compared to plant protein foods like legumes, tofu, nuts and whole grains.
So how much protein should you eat? That seems like a simple question. Yet when it comes to protein recommendations for older adults, the answer is anything but clear these days. Until relatively recently, health professionals believed older adults did not need any more protein than a 35 year old — 0.8 grams protein per kilogram body weight per day (0.36 grams/lb body weight). Many people still do believe that. But others question this opinion, based on recent research on sarcopenia and muscle growth.
In fact there some nutrition researchers are calling for a recommendation of between 1.2 and 1.6 grams protein/kg body weight per day (0.54 – 0.72 grams protein/kg). In other words, from 50% more to 100% more than the standard one-size-fits-all-adults recommendation.
There’s a serious potential problem with these calculations (other than the fact that people don’t sit around with calculators at every meal): what number do you use for body weight? Women might be overweight, obese, normal weight or underweight. Look at what happens when you use actual weight for a hypothetical 5′ 6″ woman:
|5'6", wt in lbs (BMI)||0.8 gr/kg||1.2 gr/kg||1.6 gr/kg|
|130 normal weight||47||71||94|
|180 (BMI 29) overweight||65||98||130|
|215 (BMI 35) obese||78||117||156|
|110 (BMI 18) underweight||40||60||80|
As the woman becomes more overweight, the protein recommendation escalates, ending up at a potentially ridiculous 156 grams/day for the obese woman. On the other hand, the underweight woman ends up with far lower recommendations, even though she may need to recover weight and muscle mass after a debilitating illness. In her case, appropriate protein intake is especially critical.
Given that we eat less food in general as we age, eating close to 160 grams of protein per day when you only eat 1500 calories means close to half your calories must be from high protein foods like meat, fish, eggs, cheese. You’d need to eat a 5-egg omelet for breakfast, a half-pound of chicken for lunch, an 8 ounce steak for dinner and a few ounces of cheese or a big bowl of yogurt for a snack. This is crazy. Not much room or appetite left for other foods like vegetables, bread, cereal, fruit. Then there’s the expense of so much meat, because eating that much protein from plant foods or even dairy foods would be physically difficult. How many quarts of beans or blocks of tofu can you eat in a day?
Let’s get real
My preference is that the protein recommendations should be calculated based on a general estimate of ideal body weight, not actual weight. What’s ideal? One easy rule of thumb is that a woman who is 5 feet tall should weigh about 100 lbs. Add 5 lbs for every inch of height. Note: our 5′ 6″ woman in the example weighs 130 lbs. It’s an easy rule of thumb, and if you’re over or under by a few pounds, no big deal.
And in fact, forget doing calculations. Who sits around at a meal with a calculator? For argument’s sake, let’s say the ideal weight range for the vast majority of women goes from 100 lbs to 160. If you use 1.2 gram/kg, protein intake recommendations will range from 55 grams/day for petite women to 87 grams/day for a 6-foot tall woman.
Many of the articles on sarcopenia recommend that older adults eat 20-30 grams of protein at each meal, and perhaps spread it out more with a protein supplement drink as a snack. This protein-per-meal idea is a much easier way to think about this. Those aren’t outrageous amounts. Typical meat portions at the evening meal, such as chicken breast, pork chop or burger can easily weigh 4 or more ounces, which would be about 30 grams of protein at one meal.
Breakfast is more problematic. Breakfast foods like eggs, cheese, yogurt and milk, are good protein sources, but we rarely eat 3-4 cups of yogurt or drink 3 cups of milk at one meal. So breakfast and possibly lunch might have less protein. Another significant problem: vegetarian and especially vegan diets. Consuming large amounts of high quality protein every day when you avoid meat is difficult, because plant foods are bulky and filling.
A high protein protein supplement drink, used as a snack or as part of a meal like lunch, can help. Whey and soy protein powders are widely available. Both are high quality, but whey is particularly high in the amino acid leucine, which is known to boost muscle growth.
By the Whey…
… what is whey? Technically, it’s the liquid part of milk that’s drained away as cheese is made. Whey powder is prepared by evaporating the water; it’s sold in powder form for use in food and beverages. Because it’s a dairy food, it’s suitable for vegetarians but not vegans.
And of course if you drink milk or eat yogurt, you’re consuming the whey right in the food. Which brings up an important point: if you buy yogurt in large containers and scoop out servings, the whey will accumulate as liquid in the container. Don’t pour it out! Mix it back in to get the full protein benefit.
I’m not trying to push whey or soy supplements. Use them or not. Choose whey if you want to take advantage of the leucine benefit. You can certainly get plenty of quality protein from other food sources, from meat to tofu. The main point is to emphasize protein at all your meals and snacks, not just at the evening meal. And if your appetite is impaired due to illness or age or circumstances, a protein supplement can help with recovery.
And don’t forget: Aging muscles need exercise. Activity is just as important as protein intake. Muscles won’t grow and maintain mass if they aren’t challenged, no matter how much protein you eat.