Dietary protein supplementation in the elderly for limiting muscle mass loss

Abstract

Supplementation with whey and other dietary protein, mainly associated with exercise training, has been proposed to be beneficial for the elderly to gain and maintain lean body mass and improve health parameters. The main objective of this review is to examine the evidence provided by the scientific literature indicating benefit from such supplementation and to define the likely best strategy of protein uptake for optimal objectified results in the elderly. Overall, it appears that an intake of approximately 0.4 g protein/kg BW per meal thus representing 1.2-1.6 g protein/kg BW/day may be recommended taking into account potential anabolic resistance. The losses of the skeletal muscle mass contribute to lower the capacity to perform activities in daily living, emphasizing that an optimal protein consumption may represent an important parameter to preserve independence and contribute to health status. However, it is worth noting that the maximal intake of protein with no adverse effect is not known, and that high levels of protein intake is associated with increased transfer of protein to the colon with potential deleterious effects. Thus, it is important to examine in each individual case the benefit that can be expected from supplementation with whey protein, taking into account the usual protein dietary intake.

<p>The Favorable Effects of a High-Intensity Resistance Training on Sarcopenia in Older Community-Dwelling Men with Osteosarcopenia: The Randomized Controlled FrOST Study</p>

“…FranSO indicated a sole effect of protein supplementation, even when no exercise was performed. Having said that, it has to be taken into account that in respective trial, an amount above the recommended protein intake (1.7 versus 1.2-1.6 g/kg/day 25,58 ) had been prescribed and this amount of 1.7 g/kg/day was furthermore a much higher amount of consumed protein by the non-exercise CG than in FrOST, in which the non-exercise CG only received 1.2 kg/d. Looking at the positive effect of mere supplementation in the FranSO non-exercise CG as opposed to the lack of effect of supplementation in our trial's non-exercise CG raises the question, whether what is considered an adequate protein intake for the elderly, is actually sufficient.…”

“…A meta-analysis by Morton et al contradicts additional effects of higher protein consumption than 1,6 g/kg/day, 63 and discussions on general effectivity of protein supplementation continue, but there are strong arguments speaking for an increased intake, too. 58,[63][64][65][66][67][68] Nevertheless, the possible adverse effects of higher protein intake on kidney and colon health cannot be neglected. 58 Thus, an optimized balance between not too low, but safe enough has to be aimed for.…”

Αcute effects of essential amino acid gel-based and whey protein supplements on appetite and energy intake in older women

“…Notably, previous research suggests that protein intakes are significantly reduced at the breakfast meal with intakes of ~10 g (Tieland et al 2012a). These lower levels of protein are not considered optimum for maximisation of muscle protein synthesis for our study population, who should be receiving at least 25-30 g of protein per meal (Moore et al 2014;Phillips 2015;Lancha Jr et al 2016) based on their body mass. Thirty grams of high quality protein per meal would in turn provide approximately 15 g of EAAs (Hulmi et al 2010).…”

“…Indeed, evidence supports an increase in daily protein intake from the current RDA (0.8 g•kg -1 •d -1 ) to 1.0-1.6 g•kg -1 •d -1 (Bauer et al 2013;Deutz et al 2014;Loenneke et al 2016;Traylor et al 2018). Consumption of at least 0.4 g•kg -1 •BM of high quality protein per meal (Moore et al 2014;Phillips 2015;Lancha Jr et al 2016) is also recommended. This is primarily due to their high essential amino acid (EAA) content which optimises muscle protein synthesis (Breen et al 2011;Churchward-Venne et al 2014;Paddon-Jones et al 2014;Xu et al 2015;Murphy et al 2016;Phillips 2016;Hamarsland et al 2017).…”

Factors Associated with Poor Muscle Mass and Strength in A Community-Dwelling Elderly Population: A Cross-Sectional Study

“…Adequate calorie, protein and vitamin intake is essential to preserve muscle mass and strength during the ageing process [20]. Approximately 1.5 g protein/kg of body weight/day is recommended for the older population, considering potential anabolic resistance; however, maximum protein intake without adverse effects is not known, so recommendations must be individualized [21]. A meta-analysis of 15 controlled trials revealed that protein or essential amino acid supplementation did not significantly increase the effects of resistance exercise training on muscle mass, strength and functionality [22].…”