title: Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group.
abstract: 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.
authors.affiliation: Department of Geriatric Medicine, Klinikum Oldenburg, Geriatric Centre Oldenburg, Oldenburg, Germany. bauer.juergen@klinikum-oldenburg.de
authors.forename: Jürgen
authors.initials: J
authors.lastname: Bauer
authors.forename: Gianni
authors.initials: G
authors.lastname: Biolo
authors.forename: Tommy
authors.initials: T
authors.lastname: Cederholm
authors.forename: Matteo
authors.initials: M
authors.lastname: Cesari
authors.forename: Alfonso J
authors.initials: AJ
authors.lastname: Cruz-Jentoft
authors.forename: John E
authors.initials: JE
authors.lastname: Morley
authors.forename: Stuart
authors.initials: S
authors.lastname: Phillips
authors.forename: Cornel
authors.initials: C
authors.lastname: Sieber
authors.forename: Peter
authors.initials: P
authors.lastname: Stehle
authors.forename: Daniel
authors.initials: D
authors.lastname: Teta
authors.forename: Renuka
authors.initials: R
authors.lastname: Visvanathan
authors.forename: Elena
authors.initials: E
authors.lastname: Volpi
authors.forename: Yves
authors.initials: Y
authors.lastname: Boirie
mesh_terms: D000203:Activities of Daily Living; D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004044:Dietary Proteins / Q000378:metabolism; D015444:Exercise; D015577:Geriatric Assessment; D005853:Geriatrics; D006801:Humans; D009751:Nutritional Requirements; D017410:Practice Guidelines as Topic; D055948:Sarcopenia / Q000517:prevention & control*
chemical_list: D004044:Dietary Proteins
keywords: Older people; dietary protein; exercise; physical function; protein quality