THE BENEFITS OF PROTEIN IN YOUR DIET
Trenton Mackenzie-Armes has always been active and athletic but keeping strong and healthy became more of a challenge as he got older, particularly as he entered his 40s and 50s while working in a fast-paced job that required intense days, long nights, and rushed meals. Today, at 62 years old, he has changed his lifestyle, making sure that he is not only eating a protein-rich diet but also weightlifting, in order to set himself up as best as he can for his golden years.
“It’s amazing what happens to us – it happens so slowly, you can see it creep up on people,” he said. “In your early 60s, you really need to go out of your way to start to build those good habits. My dad’s 85 and he’s rapidly losing mobility. People don’t notice it until it’s too late and I don’t think I can change him. It will take a crisis where he can’t get out of his chair.”
Olivera Stojanovic was in her 20s when she decided that she wanted to take control of her health by learning more about fitness, the exercises that would keep her strong, and the food that would fuel her success. She too was motivated by watching her eastern-European relatives grow older and increasingly frail with a cultural diet that consisted primarily of high-fat and high-salt foods. Today in her 40s, Stojanovic believes that a proper diet is the key to healthy aging.
“Protein was previously viewed as a bodybuilder’s diet, but now it’s more widely accepted as the norm for a healthy lifestyle,” she said. “I have seen family members become frail because of the way they were eating. I knew that aging didn’t have to look like that or be like that. Being older can look different and that is my life’s mantra. I believe a good diet that includes a lot of protein, in combination with working out, is the only true key to anti-aging. I’m convinced there’s no cream or product you can buy that can compare or have the same impact.”
Stojanovic and Mackenzie-Armes are just two examples of how Canadians, both women and men, are increasingly becoming more health conscious about the foods that they consume and the impact that their diet will have on their lifestyle as they become older.
A recent survey conducted in March and April 2022 by Ipsos-Reid, entitled “A Profile of Canada’s Eating and Food Purchasing Habits,” found that the vast majority of respondents (73%) claimed to
eat a well-balanced, healthy diet. Additionally, similar to previous research, younger Canadians between the ages of 18 and 34 had less healthy diets compared to those over the age of 55.
When it came to protein intake, while almost half of respondents (46%) said that they were trying to increase their intake of red meat, it was younger Canadians (51%) who were actively trying to consume more of it. Researchers have noted, though, that it is the older generation that needs to be the most concerned about consuming enough protein in their diet, as it can help prevent or stave off sarcopenia (the loss of muscle tissue due to age-related changes to body composition, strength, and function). Sarcopenia can cause frailty, frequent falls, and fractures.
Several studies have identified protein as a key nutrient for elderly adults. A review conducted by Dr. Jamie I. Baum and colleagues – published in the June 2016 issue of Nutrients – concluded that “protein intake greater than the recommended amounts may improve muscle health, prevent sarcopenia, and help maintain energy balance, weight management, and cardiovascular function. Benefits of increased protein intake include improved muscle function and the prevention onset of chronic diseases, which can increase quality of life in healthy elderly adults.”
CANADA’S FOOD GUIDE QUESTIONED ON PROTEIN GUIDELINES
How much protein, though, is enough? Dr. Baum and his colleagues noted that experts in the field of protein and aging recommend a protein intake between 1.2 and 2.0 grams per kilogram of body weight per day or higher for elderly adults – an amount that falls short of the Recommended Dietary Allowance (RDA) of 0.8 grams per kilogram of body weight per day. It is estimated that approximately 38% of adult men and approximately 41% of adult women have dietary protein intakes below the RDA.
PART OF THE PROBLEM IS THAT THE GUIDELINES THAT HELP INFORM THE PUBLIC AND HEALTHCARE WORKERS USE A “ONE-SIZE-FITS-ALL” APPROACH FOR BOTH YOUNG AND OLDER ADULTS.
In 2018, researchers out of the University of Alberta released their assessment of Canada’s Food Guide and the guidelines that informit. In their literature review (published in the December 2018 issue of Applied Physiology, Nutrition, and Metabolism), Dr. Camila Oliveira and colleagues highlighted the latest evidence regarding protein intake and physical activity, and concluded that the current guidelines do not reflect recent knowledge on sarcopenia prevention.
Since the time of their analysis, the guide has been updated to recommend, amongst other things, an intake of more plant- based protein. However, some of the authors of the 2018 review recently told Mind Over Matter® that the guidelines still fall short of adequately advising older Canadians about their nutritional needs.
Dr. Oliveira, a postdoctoral research fellow in nutrition and metabolism at the University of Alberta, said key issues they identified were not addressed in the updated guide, including that:
- protein recommendations should be specific for distinct population groups (i.e., age, sex, health status, and phys- ical activity levels); and
- protein quality and distribution of intake should be addressed for older adults for the prevention of sarcopenia.
“The revised Canada’s Food Guide presents a plate showing that a quarter of the daily food intake should come from protein foods, which does not personalize it for different population groups, including older adults – which is understandable when simplicity is taken into account,” she said. “Therefore, the revised food guide also does not personalize protein recommendations for distinct population groups.”
Dr. Oliveira noted that an additional resource entitled “Canada’s Healthy Eating Pattern” was intended to be published in 2019 with the objective of providing more specific guidance on the recommended amounts and types of foods, as well as life stage guidance (for example, recommendations for young children and seniors).
“To my knowledge, this document has not been published yet, but when released, it has the potential to help healthcare professionals tailor protein intake recommendations for older adults,” she said.
Anissa Armet, a PhD candidate, registered dietician, and researcher who works with Dr. Oliveira, noted that the guide’s updated recommendation to “choose protein foods that come from plants more often” has advantages but may be problematic for some seniors struggling to meet their daily protein needs.
THE MAJORITY OF PLANT-BASED PROTEINS ARE INCOMPLETE PROTEINS.
Armet continued, “This means they are missing some indispensable amino acids (the building blocks of protein) that we need to get from our diet because our body can’t make these amino acids.
The exception is soy protein (tofu, tempeh, soy milk), which is the only plant-based protein that contains all of the indispensable amino acids. However, plant-based proteins have a lower anabolic potential, meaning they do not stimulate muscle protein synthesis as much as animal-based proteins.”
“With careful planning and working with a registered dietitian, it is possible for older adults to meet protein needs if they choose to only eat plant-based proteins. Otherwise, we would recommend eating a variety of both lean animal-based proteins and plant- based proteins to meet protein needs and prevent sarcopenia.”
A popular and easy method to increase protein intake is through protein shakes and supplements, but Dr. Oliveira warns that these are not an ideal substitute for the quality protein individuals receive from consuming unprocessed food.
“Overall, protein supplements should not substitute food, but they can help increase protein intake if people struggle to meet their needs through diet alone. However, before starting on a protein supplement, I would encourage the individual to see a registered dietitian and try to adjust the diet to increase its protein content. Food first, always!”
PHYSIOLOGICAL CHANGES, HEALTH & INFLATION PUT SENIORS’ NUTRITION AT RISK
Meeting the daily protein recommendations can be difficult, even for younger, healthy Canadians like Olivera Stojanovic and Trenton Mackenzie-Armes.
Stojanovic said that she relies on protein shakes to give her intake a boost on busy days where her diet is lacking.
Despite his best efforts to have protein at every meal, Mackenzie- Armes noted that his trainers at the gym insist that he requires more than he is consuming. “I find it hard to hit that daily intake. I usually succeed four out of seven days,” he said. “The last five or six years, I’ve drilled down even more to choose better and more protein. I’m not quite weighing my food but probably should be to get more energy.”
He has been trying to reduce the amount of red meat that he eats, but still balances his diet each week with lean cuts of beef, chicken, and fish, as well as plant-based proteins.
Dr. Chris Frank, former President of the Canadian Geriatrics Society and a Professor in the Department of Medicine at Queen’s University in Kingston, Ontario, advised that it is important to establish good nutritional habits early on because it becomes even more challenging to do so as you age, particularly for those older adults who are dealing with health conditions, reduced appetite, hospital stays, and a lack of support and/or resources.
Then there is the issue of balancing protein for elderly individuals suffering from kidney disease, he said, as too much animal protein can have an adverse effect.
Dr. Frank works with geriatric inpatients and believes that hospitals can do more to ensure that seniors in their care are getting adequate nutrition.
“There are a number of things in the hospital contributing to poor intake,” he said. “Most food has a certain degree of nutritional values, but there are so many barriers to people eating it. The patients could be eating, but then they need to talk to the physician and their food gets cold or they have a test scheduled at that time and they end up missing a meal.”
“Nutrition and exercise are the core of our health, along with social interactions,” he continued. “Particularly with those in the hospital, physicians need to do a better job of looking at poor nutrition and protein.”
Perhaps the biggest challenge has been the social isolation recently brought on by the response to the COVID-19 pandemic, along with inflation that has driven a steep spike in the price of food.
According to data from the United Nation’s Food and Agriculture Organization, global food prices have surged approximately 65% since the beginning of the pandemic in early 2020.
“One of the classic things that affect nutrition, particularly in frailer seniors, is access to food and the supports around food preparation,” said Dr. Frank. “Over the course of the pandemic, those that didn’t have family when we were all locked down probably had less adequate nutrition. And now, with rising prices, just knowing how close to the bone a lot of people already live, people are living a little bit more of a vulnerable existence, or on more of a fixed income and maybe can’t have that proactive interest in nutrition.”
NO DIFFERENCES BETWEEN THE SEXES FOR PROTEIN REQUIREMENTS
When it comes to protein intake, there are no dramatic differences between the sexes. While some experts believe that both sexes should have more protein than what is currently outlined in the RDA, there is no concrete evidence to suggest that women should consume more or less protein than their male counterparts.
CURRENTLY, THERE IS NO DISTINCTION BETWEEN PROTEIN REQUIREMENTS FOR WOMEN VERSUS MEN. ON A GRAM PER KILOGRAM PER DAY BASIS, ADULT WOMEN AND MEN REQUIRE THE SAME AMOUNT OF PROTEIN (0.8 G/KG/DAY).
“If a woman or a man is larger, then she or he would need more protein per day. Protein requirements may otherwise differ based on age, health condition, and/or activity levels.”
Furthermore, while women may crave more protein at different points in their menstrual cycle, there does not seem to be a connection between protein intake and an impact on their period.
A recent study conducted by Dr. Serena C. Houghton and colleagues, published in the June 2019 issue of Public Health Nutrition and involving women between the ages of 27 and 44 who were premenopausal, examined whether protein intake during the late luteal phase of the menstrual cycle helped develop pre-menstrual syndrome or “PMS” (characterized as physical and emotional symptoms in the first days of a woman’s period).
The researchers found that, overall, consuming protein was not associated with PMS nor was it associated with the risk of developing PMS.
“In logistic regression models adjusting for smoking, body mass index, B vitamins, and other factors, total protein intake was not associated with PMS development,” the authors of the study explained.
Armet (who was not involved in this particular study) noted that while protein intake may not influence a woman’s menstrual cycle, it does have an impact on aging.
TIPS FOR CHALLENGING TIMES
Dr. Frank cautioned that while seniors might be the most vulnerable to the effects of the pandemic and inflation, other members of the general public will also have to navigate this challenge carefully.
“Let’s face it, in the North American diet, meat is a fairly common source of protein and so I think the cost of food and even transportation is almost certainly going to put people’s general nutrition at risk,” he said.
Even for habitually active and successful professionals like Mackenzie-Armes and Stojanovic, the pandemic and rising food prices have taken a toll.
“During the pandemic, I couldn’t go to the gym. I tried to work out and when I turned 60, I noticed it was harder to maintain muscle mass,” Mackenzie-Armes said. “Time and experience have shown me that paying attention to food composition pays off and so I’m trying to eat more protein to help and to prepare food at home because, inflation aside, the economics of going out to eat is too painful to sustain.”
For Stojanovic, not having an outlet to release her stress during the pandemic had an impact on her mental health and consequently on her diet. Now, inflation is another challenge that she needs to navigate.
“It’s so much harder to get good quality meat for a reasonable price,” she said. “You have to be a really good shopper and constantly be price comparing.”
Armet provided a few tips for those struggling to buy protein at the current prices:
- Purchase meat when it is on sale and store it in the freezer for later;
- Purchase eggs, canned fish, and ground meat as they tend to be less expensive choices, as well as canned beans (which are a cheap, nutritious plant-based protein source and easy to prepare); and
- Make healthy and cost-effective substitutions to recipes – for example, replace sour cream with Greek yogurt, include cottage cheese in your smoothies, and add cracked eggs to stir-fries.
Just as importantly, Dr. Oliveira noted that social interaction remains a critical component of improved nutrition.
“The COVID-19 pandemic brought more social isolation to all of us, which negatively impacts appetite and hence nutritional status,” she said. “This is even more concerning for older adults, considering that social isolation was already a reality for them before the pandemic and now it became worse. Recognizing the nutritional impact of social interaction during mealtimes, the revised Canada’s Food Guide recommends that seniors eat meals with others.”
Mackenzie-Armes added that the most important piece of advice that he has ever received is to find balance and have fun with food.
“No one is going to eat properly if they can’t find joy in it.”
The Recommended Dietary Allowance (RDA) is the average daily dietary intake level that is sufficient average daily dietary intake level that is sufficient to meet the nutrient requirement of nearly all to meet the nutrient requirement of nearly all (97-98%) healthy individuals in a particular life-stage and gender group. The RDA is the goal for and gender group. The RDA is the goal for usual usual intake by an individual.
THE RIGHT KIND OF PROTEIN
While consuming enough protein is important to maintain optimal health and function, not all protein is created equal. Anissa Armet, a PhD candidate, registered dietitian, and researcher with the University of Alberta, noted that it is important to have both animal-based and plant-based proteins in your diet, particularly from sources that are unsweetened and that are low in fat and salt.
Optimal animal-based proteins include:
- Skinless chicken
- Turkey breast
- Lean cuts of red meat
- Unsweetened, low-fat Greek yogurt
- Unsweetened, low-fat milk
- Fish (such as tuna and salmon)
When it comes to plant-based proteins, Armet said that it is a bit more complicated. “The majority of plant-based proteins are incomplete proteins. This means they are missing some indispensable amino acids (the building blocks of protein) that we need to get from our diet because our body can’t make these amino acids.”
However, Armet pointed out that there are some great health benefits that make plant-based proteins an important part of a protein-rich diet.“Plant-based proteins are often low in fat, do not contain cholesterol, and are high in important nutrients like dietary fibre and potassium,” she said.
Soy protein (such as tofu, tempeh, and soy milk) is the only plant-based protein that contains all of the indispensable amino acids. Armet also encourages individuals to incorporate beans, lentils, and chickpeas in their diet.
“There is currently not enough evidence to suggest that women would need different types or amounts of protein based on their menstrual cycle or if they are postmenopausal or not,” she said. “What we do have evidence to support is that when a woman is 65 or older, her protein requirements increase to 1.2 to 1.5 grams of protein per kilogram of body weight.”
Click here to read the original article from Mind Over Matter magazine page 64.