Protein intake in old age is an important topic at the moment, as we care about maintaining quality of life for older adults. Understanding osteoporosis, frailty sarcopenia and anorexia is important in keeping individuals independent. These diseases are all related to protein intake. There is a uni-sexual and uni-age recommendation for protein intake of 0.8g/kg body weight (BW) for adult over 19 years old, giving a wide range of daily energy intake between 10-35% of total daily energy intake from proteins. Women have higher rate of low protein intake than their male counterparts.
To overcome low protein and energy intake dietitian recommendation may be beneficial however, during treatment and nutritional recommendations, dietitians may sometimes fail to calculate the absolute requirement of protein per kg BW. It is quite usual to see the overall food intake decrease with age due to the decrease in activity, the absolute protein intake may not be adequate for older individuals.
Risk factors for inadequate protein intake includes reduced energy needs, physical dependence, anorexia, change in food preference and food insecurity. Studies have shown that nitrogen balance occurs around 1.1g/kg BW which is higher than the actual recommendations. As we grow older there is anabolic resistance that happens leading to less muscle protein synthesis. However, even though protein intake is important, it should not take precedence on meeting the daily energy intake.
The established RDA for protein of 0.8g/kg BW per day is inadequate for a majority of older persons. In this population and optimal protein intake of 1.0-1.2g/kg BW per day is recommended for healthy individuals. In older adults with acute and/or chronic diseases and intake of 1.2-1.5g/kg BW per day should be considered. Furthermore a more even distribution across the three meals is advised, if the threshold of 25-30g per meal can be reached.