New evidence shows that older adults need more
dietary protein than do younger adults to support good health, promote recovery from illness, and maintain functionality. Older people need to make up for age-related changes in
protein metabolism, such as high splanchnic extraction and declining anabolic responses to ingested
protein. They also need more
protein to offset inflammatory and catabolic conditions associated with chronic and
acute diseases that occur commonly with aging. With the goal of developing updated, evidence-based recommendations for optimal
protein intake by older people, the European Union Geriatric Medicine Society (EUGMS), in cooperation with other scientific organizations, appointed an international study group to review
dietary protein needs with aging (PROT-AGE Study Group). To help older people (>65 years) maintain and regain lean body mass and function, the PROT-AGE study group recommends average daily intake at least in the range of 1.0 to 1.2
g protein per kilogram of
body weight per day. Both endurance- and resistance-type exercises are recommended at individualized levels that are safe and tolerated, and higher
protein intake (ie, ≥ 1.2 g/kg
body weight/d) is advised for those who are exercising and otherwise active. Most older adults who have acute or
chronic diseases need even more
dietary protein (ie, 1.2-1.5 g/kg
body weight/d). Older people with severe
kidney disease (ie, estimated GFR <30 mL/min/1.73 m(2)), but who are not on dialysis, are an exception to this rule; these individuals may need to limit
protein intake.
Protein quality, timing of ingestion, and intake of other nutritional supplements may be relevant, but evidence is not yet sufficient to support specific recommendations. Older people are vulnerable to losses in physical function capacity, and such losses predict loss of independence, falls, and even mortality. Thus, future studies aimed at pinpointing optimal
protein intake in specific populations of older people need to include measures of physical function.