Skip to content

Protein and Older Adults: What the Position Papers Say

Why some expert groups recommend higher protein intakes for older people, what the reference intakes actually cover, and where the evidence is still contested.

Reign Creative Team4 min read

Key takeaways

  • Reference intakes such as the RDA are set to prevent deficiency in most healthy people; several expert groups argue that is a different question from what supports function in older age.
  • The concept behind the higher recommendations is anabolic resistance: an older person's muscle appears less responsive to a given amount of protein.
  • Position papers from clinical groups have proposed higher intakes for older adults than the general reference intake, and those recommendations are not universal.
  • Kidney function and medication interact with protein intake, which is why this is a topic for a clinician rather than an article.
  • Nothing here is a recommendation about what any individual should eat.

This is a topic where general guidance and expert recommendations genuinely differ, and where the difference is not an error. They are answering different questions.

We are setting out what each says. We are not recommending an intake, because the appropriate amount for any individual depends on their health, their kidney function and their medication — and that is a clinician's assessment, not an article's.

Two different questions

Reference intakes such as the RDA, published in the Dietary Reference Intakes, are set to meet the requirements of most healthy people in a population. The design goal is preventing deficiency.

Clinical position papers may target a different outcome — maintaining muscle mass and physical function in later life — and arrive at a different number.

Neither is wrong. A figure sufficient to prevent deficiency is not necessarily the figure that best supports function, and those are separate questions with separate answers.

The mechanism usually cited

The reasoning behind higher recommendations for older adults is anabolic resistance: the observation that older muscle appears less responsive to a given amount of dietary protein than younger muscle.

If a given dose produces a smaller response, then achieving the same effect requires more. That is the argument, and it is the basis on which groups such as the PROT-AGE Study Group have proposed intakes above the general reference level — their position paper is published in the Journal of the American Medical Directors Association.

It is also the reasoning behind arguments that distribution across meals matters more with age, since anabolic resistance is a dose-response phenomenon. Protein per meal explained covers the distribution literature more generally.

Why we are not printing a number

Three reasons, all of which we think are good ones.

Recommendations differ between groups. Presenting one figure as the recommendation would misrepresent the state of the field.

They are conditional. The proposed intakes in the literature come with conditions — health status, activity level, presence or absence of illness — that a general article cannot assess for a reader.

Kidney function changes the answer. Protein intake interacts with renal function, and renal function changes with age and with several common conditions. This is the single clearest reason why "eat more protein" is not safe general advice for an older population.

If you want a number for yourself, the person to ask is a doctor or a registered dietitian who knows your medical history.

What is uncontroversial

A few things are not in dispute and are worth stating:

  • Adequate protein matters at every age. The debate is about how much, not whether.
  • Older adults frequently eat less overall, which makes hitting any protein target harder — appetite, dentition, cost and cooking for one all contribute.
  • Resistance exercise interacts with protein intake. Most of the literature on maintaining muscle in later life treats nutrition and activity together rather than separately.
  • Knowing what you actually eat is useful. Most people's estimate of their own protein intake is not accurate, which is the case for logging rather than guessing.

The practical problem: intake tends to fall

For many older adults the difficulty is not choosing a target but reaching any target, because total food intake has declined.

Practical factors that come up repeatedly: reduced appetite, difficulty chewing, the effort of cooking, and the cost of protein-dense foods. Those are real obstacles, and none of them is addressed by being told a higher number.

How to hit a protein goal covers practical approaches to raising a daily total, and protein sources compared covers which foods actually deliver protein efficiently. The National Institute on Aging publishes general healthy-eating information aimed specifically at older adults.

Where our app fits

Protein Diet Tracker makes your actual intake visible: log meals as you eat them, and see daily totals and a history you can look back over. Over weeks, that history is more informative than any single day.

You set the goals. The app does not calculate a target, does not recommend an intake for your age, and does not prescribe anything. If a clinician gives you a number, the app measures against it. That division of labour is deliberate.

It is free to download on Google Play, supported by ads, with optional in-app purchases, and entries stay on your device rather than on our servers.

This article is general information about a research area, not medical or dietary advice, and it has not been reviewed by a doctor or registered dietitian. Protein intake interacts with kidney function and with several medications. If you are over 65, managing a health condition, or taking regular medication, talk to a qualified healthcare professional before changing what you eat. How much protein per day covers the general reference intakes. The rest of our nutrition tools are under health and nutrition.

Good to know

Frequently asked questions

Do older adults need more protein?
Several expert groups have argued so, on the basis that the reference intakes were designed to prevent deficiency rather than to support muscle maintenance in later life. The recommendations are not universal, and the appropriate intake for any individual depends on their health status.
What is anabolic resistance?
The observation that older adults' muscle appears less responsive to a given amount of dietary protein than younger adults' muscle. It is the mechanism usually cited for suggesting higher intakes with age.
What is the difference between an RDA and a position paper recommendation?
A reference intake such as the RDA is set to meet the requirements of most healthy people in a population and is designed around preventing deficiency. A clinical position paper may set a different target aimed at a different outcome, such as maintaining function.
Are there reasons an older person should not increase protein?
Yes. Kidney function in particular changes what an appropriate intake looks like, and some medications and conditions interact with protein intake. This is exactly the situation where a clinician's input matters rather than general guidance.
Does distribution across meals matter more with age?
Some of the literature argues so, on the same anabolic-resistance reasoning. It is an active area rather than a settled one, and the general point that total intake matters most still applies.

Sources

  1. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group (Bauer et al., J Am Med Dir Assoc 2013) (opens in a new tab)PubMed, U.S. National Library of Medicine — accessed
  2. Healthy eating, nutrition, and diet (opens in a new tab)National Institute on Aging, National Institutes of Health — accessed
  3. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (opens in a new tab)National Academies Press — accessed

Keep reading