Skip to main content
Log in

Muscle Building and Maintenance in the Elderly: the Use of Protein

  • Nutrition and Aging (MC Serra, Section Editor)
  • Published:
Current Nutrition Reports Aims and scope Submit manuscript

Abstract

The involuntary loss of lean muscle mass that accompanies aging, or sarcopenia, necessitates identification of strategies that can blunt muscle protein breakdown and enhance muscle protein synthesis. This chapter focuses on the key factors impacting muscle protein synthesis in the elderly including adequacy of total caloric intake, a focus on the total daily quantity of high quality protein, a balanced pattern of protein ingestion per meal, characteristics regarding protein quality, anabolic resistance of aging, and achieving an adequacy of the essential amino acid, leucine, in each meal. A discussion is included regarding the existing limitations in current dietary protein recommendations for the elderly and the challenges of exaggerated muscle loss secondary to disuse.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Minor BD, Heusinger DE, Melanson EL, Hamilton KL. Energy balance changes the anabolic effect of post exercise feeding in older adults. J Geron Biol Sci Med. 2012;67:1161–9.

    Article  Google Scholar 

  2. Wolfe RR. The underappreciated role of muscle in health and disease. Am J Clin Nutr. 2006;84:475–82.

    CAS  PubMed  Google Scholar 

  3. Riddle ES, Stipanuk MH, Thalacker-Mercer AE. Amino acids in healthy aging. Front Biosci. 2016;1:326–50.

    Google Scholar 

  4. Cohn SH, Vartsky D, Yasumura S, et al. Compartmental body composition based on total-body nitrogen, potassium, and calcium. Am J Physiol. 1980;239:E524–30.

    CAS  PubMed  Google Scholar 

  5. Fielding RA, Vellas B, Evans WJ, Bhasin S, Morley JS. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International Working Group on Sarcopenia. J Am Med Dir Assoc. 2011;12:249–56.

    Article  PubMed  Google Scholar 

  6. Malafarina V, Uriz-Otano F, Iniesta R, Gil-Guerrero L. Effectiveness of nutritional supplementation on muscle mass in treatment of sarcopenia in old age: a systematic review. J Am Med Dir Assoc. 2013;14(1):10–7.

    Article  PubMed  Google Scholar 

  7. Roubenoff R, Hughes V. Sarcopenia: current concepts. J Geron. 2000;V55A(12):M710–24.

    Google Scholar 

  8. Nilwik R, Snijders T, Leenders M, Groen BB, van Kranenburgh H, et al. The decline in skeletal muscle mass with aging is mainly attributed to a reduction in type II muscle fiber size. Exp Gerontol. 2013;48(5):492–8.

    Article  PubMed  Google Scholar 

  9. Gariballa S, Alessa A. Sarcopenia: prevalence and prognostic significance in hospitalized patients. Clin Nutr. 2013;32(5):772–6.

    Article  PubMed  Google Scholar 

  10. Deutz N, Wolfe R. Is there a maximal anabolic response to protein intake with a meal? Clin Nutr. 2013;32(2):309–13. This article reviews the important role of suppressed muscle protein breakdown (MPB) secondary to higher dietary protein intakes in maximizing MPS. Contrary to the view that MPS stops after a certain quantity of dietary protein is ingested, they concluded there is no practical limit to an anabolic response when MPB is considered.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Nowson C, O’Connell S. Protein requirements and recommendations for older people: a review. Nutrients. 2015;7(8):6874–999. A good overview to initiate the reader on the main areas of importance and controversy in this area of study.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Wall B, van Loon L. Nutritional strategies to attenuate muscle disuse atrophy. Nutr Rev. 2013;71(4):195–208.

    Article  PubMed  Google Scholar 

  13. Layman DK, Anthony TG, Rasmussen BB, et al. Defining meal requirements for protein to optimize metabolic roles of amino acids. Am J Clin Nutr. 2015;101:1330S–8S. Exceptional discussion on the numerous metabolic signals that influence MPS secondary to protein meal provision. This background sets the stage for appreciating why protein quantity per meal is of emerging significance in MPS and maintenance.

    Article  CAS  Google Scholar 

  14. Deer RR, Volpi E. Protein intake and muscle function in older adults. Curr Opin Clin Nutr Metab Care. 2015;18(3):248–53.

    Article  CAS  PubMed  Google Scholar 

  15. Leenders M, Verdijk L, van der Hoeven L, van Kranenburg J, Nilwik R, van Loon L. Elderly benefit equally from prolonged resistance type exercise training. J. Gerontol A Biol Sci Med Sci. 2013;68(7):769–79.

    Article  Google Scholar 

  16. Pasiakos S, McClung H, McClung J, Margolis L, Anderson N, et al. Leucine enriched essential amino acid supplementation during moderate steady state exercise enhances post exercise muscle protein synthesis. Am J Clin Nutr. 2011;94:809–23.

    Article  CAS  PubMed  Google Scholar 

  17. Hảkkinen K, Kallinen M, Izquierdo M, et al. Changes in agonist-antagonist EMG, muscle CSA, and force during strength training in middle-aged and older people. J Appl Physiol. 1998;84:1341–9.

    PubMed  Google Scholar 

  18. Bamman MM, Hill VJ, Adams GR, et al. Gender differences in resistance-training-induced myofiber hypertrophy among older adults. J Gerontol A Biol Sci Med Sci. 2003;58:108–16.

    Article  PubMed  Google Scholar 

  19. Ivey FM, Rorh SM, Ferrell RE, et al. Effects of age, gender and myostatin genotype on the hypertrophic response to heavy resistance strength training. J Gerontol A Biol Sci Med Sci. 2000;55:M641–8.

    Article  CAS  PubMed  Google Scholar 

  20. Tracy BL, Ivey FM, Hurlbut D, et al. Muscle quality. Effects of strength training in 65- to 75-yr old men and women. J Appl Physiol. 1999;86:195–201.

    CAS  PubMed  Google Scholar 

  21. Ivey FM, Ttracy BL, Lemmer JT, NessAiver M, Metter EJ, Fozard JL, et al. Effects of strength training and detraining on muscle quality: age and gender comparisons. J Gerontol A Biol Sci Med Sci. 2000;55(3):B152–7.

    Article  CAS  PubMed  Google Scholar 

  22. Zampieri S, Pietrangelo L, Loefler S, Fruhmann H, Vogelauer M, et al. Lifelong physical exercise delays age associated skeletal muscle decline. J Gerontol A Biol Sci Med Sci. 2015;70(2):163–73.

    Article  CAS  PubMed  Google Scholar 

  23. Wroblewski AP, Amati F, Smiley MA, Goodpaster B, Wright V. Chronic exercise preserves lean muscle mass in masters athletes. Phys Sportsmed. 2011;39(3):172–8.

    Article  PubMed  Google Scholar 

  24. Kim IY, Schutzler S, Schrader A, Spencer HJ, Azhar G, Ferrando AA, et al. The anabolic response to a meal containing different amounts of protein is not limited by the maximal stimulation of protein synthesis in healthy young adults. Am J Physiol Endocrinol Metab. 2016;310(1):E73–80. Although this article focuses on young adults, the information discussed can also provide important core background concepts in the arena of protein for elderly.

    PubMed  Google Scholar 

  25. Paddon-Jones D, Campbell WW, Jacques PF, Kritchevsky SB, Moore L, Rodriquez NR et al. Protein and healthy aging. Am J Clin Nutr. doi: 10.3945/ajcn.114.084061.

  26. Bauer J, Biolo G, Cederholm T, et al. Evidence-based recommendations for optimal dietary protein in older people. JAMA. 2013;14:542–59.

    Google Scholar 

  27. Phillips SM. A brief review of critical processes in muscular hypertrophy. Sports Med. 2014;441 Suppl 1:S71–A77.

    Article  Google Scholar 

  28. Bohe J, Low J, Wolfe R, Rennie M. Latency and duration of stimulation of human muscle protein synthesis during continuous infusion of amino acids. J Phy. 2001;532:574–9.

    Google Scholar 

  29. Moore DR, Churchward-Veane TA, Witard O, Breene L, Burd NA, Tipton KD, et al. Protein ingestion to stimulate myofibrillar protein synthesis requires greater relative protein intake in healthy older vs younger men. J Gerontol A Biol Sci Med Sci. 2015;70(1):57–62. This is an intriguing paper because it observed the dose variability in leucine and total protein to stimulate MPS in healthy elderly.

    Article  PubMed  Google Scholar 

  30. Bohe J, Low A, Wolfe R. Human muscle protein synthesis is modulated by extracellular, not intramuscular amino acid availability: a dose response study. J Physiol. 2003;552:315–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Bohe J, Low A, Wolfe R. Latency and duration of stimulation of human muscle protein synthesis during continuous infusion of amino acids. J Physiol. 2001;532:575–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Reidy PT, Walker DK, Dickinson JM, Gundermann DM, Drummond MJ, et al. Soy-dairy protein blend and whey protein ingestion after resistance increases amino acid transport and transporter expression in human skeletal muscle. J Appl Physiol. 2014;116:1353–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Devries MC, Phillips SM. Supplemental protein in support of muscle mass and health: advantage whey. J Food Sci. 2015;80:S1-A8–A15. Important insights regarding how the chemical and metabolic properties of various protein sources, including whey, impact MPS are thoroughly reviewed in this article.

    Article  Google Scholar 

  34. Institute of Medicine, Food and Nutrition Board. Dietary reference intakes for energy, carbohydrates, fiber, fatty acids, cholesterol, protein and amino acids. Washington, DC: National Academies Press; 2002.

    Google Scholar 

  35. Dietary Guidelines Advisory Committee. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010, to the Secretary of Agriculture and the Secretary of Health and Human Services. Washington, DC: U.S. Department of Agriculture, Agriculture Research Service; 2010.

  36. Houston DK, Nicklas BJ, Ding J. Dietary protein intake is associated with lean mass change in older, community dwelling adults: the health, aging, body composition (Health ABC) study. Am J Clin Nutr. 2008;87:150–5.

    CAS  PubMed  Google Scholar 

  37. Fulgoni VL. Current protein intake in America: analysis of the National Health and Nutrition Examination Survey. Am J Clin Nutr. 2008;87(Suppl):S1554S–S1557.

    Google Scholar 

  38. Phillips SM, Fulgoni VL, Heaney RP, et al. Commonly consumed protein foods contribute to nutrient intake, diet quality and nutrient adequacy. Am J Clin Nutr. 2015;10:1346S–52S.

    Article  Google Scholar 

  39. Hector AJ, Marcotte GR, Churchward-Venne TA, et al. Whey protein supplementation preserves postprandial myofibrillar protein synthesis during short-term energy restriction. J Nutr. 2015;145:246–52.

    Article  PubMed  Google Scholar 

  40. Leidy HJ, Clifton PM, Astrup A, et al. The role of protein in weight loss and maintenance. Am J Clin Nutr. 2015;101:1320S–9S.

    Article  CAS  Google Scholar 

  41. Wolfe RJ, Miller SL. The recommended dietary allowance of protein: a misunderstood concept. JAMA. 2008;299:2891–3.

    Article  CAS  PubMed  Google Scholar 

  42. Fukagawa N. Protein requirements: methodologic controversy amid a call for change. Am J Clin Nutr. 2014;99:761–2. Article provides insightful background regarding the concerns related to use of nitrogen balance for determining long-term protein requirements in the elderly.

    Article  CAS  PubMed  Google Scholar 

  43. Coker RH, Wolfe RR. Bedrest and sarcopenia. Curr Op Clin Nutr Metab Care. 2012;15:7–11.

    Article  Google Scholar 

  44. Kortebein P, Symons TB, Ferrando A, Paddon-Jones D, Ronsen O. Functional impact of 10 day bed rest in healthy older adults. J Geront Biol Sci Med Sci. 2008;63(10):1076–81.

    Article  Google Scholar 

  45. Drummond MJ, Dickinson JM, Fry CS, Walker DK, Gundermann DM. Bed rest impairs skeletal muscle amino acid transporter expression, mTORC1 signaling, and protein synthesis in response to essential amino acids in older adults. Am J Physiol Endocrinol Metab. 2012;302:E1113–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Campbell WW, Tang M. Protein intake, weight loss and bone mineral density in postmenopausal women. J Gerontol A Biol Sci Med Sci. 2010;65A(10):1115–22.

    Article  CAS  PubMed Central  Google Scholar 

  47. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at http://health.gov/dietaryguidelines/2015/guidelines/.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hope Barkoukis.

Ethics declarations

Conflict of Interest

Hope Barkoukis declares that she has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Nutrition and Aging

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Barkoukis, H. Muscle Building and Maintenance in the Elderly: the Use of Protein. Curr Nutr Rep 5, 77–83 (2016). https://doi.org/10.1007/s13668-016-0163-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13668-016-0163-9

Keywords

Navigation