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Seniors and Ill People Need More Protein

People who are older, chronically inflamed, ill, and/or inactive need to eat more protein

Can you remember floppy disks?

Did you wear low rider pants the first time around?

If so, you need more protein.

Other factors besides age that cause anabolic resistance are chronic inflammation, physical inactivity, insulin resistance, nutrient deficiencies, metabolic stress, and inadequate protein intake.

As you age, your body processes protein less efficiently due to anabolic resistance. Anabolic resistance is when the body has a difficult time responding to muscle growing stimuli like exercise or protein. As a result, there is reduced muscle growth. Older people have as much as a 40% reduction in muscle protein synthesis efficiency compared to younger people.

Reduction in muscle mass and strength can cause age-related muscle attenuation, called sarcopenia. Sarcopenia is correlated with frailty. Frailty is when the body is weak and unable to handle or recover from illness or stress. Both sarcopenia and frailty can cause muscle weakness as well as impaired ability to function.

Not eating enough protein can reduce your strength. When looking at senior women and men (5362 people, age 50-70 years old); those with low handgrip strength had the lowest intake of all the protein groups (protein groups were dairy products; meat and fish; and eggs and legumes) (Eglseer et al. 2022). Adding supplemental protein increases muscle mass and function in adults over 65 years old (Kwon et al. 2023).

The Pensioners Story by Thomas Davidson 1883 oil on canvas.

Thomas Davidson, Public domain, via Wikimedia Commons

playing ball by Susan Fluegel

How much protein is needed for optimal health?

Healthy older adults need between 1.1 g and 1.3 g protein/kg/body weight (bw) to improve muscle protein synthesis (MPS) and maintain lean body mass. This is 0.5 g protein per pound of body weight (Nowson and O'Connell 2015, Harris et al. 2025).

Seniors who have chronic disease(s), malnutrition, acute illness, risks for frailty, and/or other inflammatory conditions, need to increase their dietary protein to between 1.2 and 1.5 g protein/kg/bw or 0.5-0.7 g protein/lb/bw.

People with severe illnesses or risk factors may need up to 2.0 g protein/kg/bw or 0.9 g protein/lb/bw, to support immune function. In this case, a 150 pound chronically ill senior would need 136 grams protein a day.

(According to recent research: see discussion Harris et al. 2025)

Seniors actually lose muscle mass when eating the current DRI recommendation for protein per day

In one study, adults (55–77 years) ate the current recommendation for protein, 0.8 g protein/kg/bw. People lost skeletal muscle mass, as measured by a decreased mid-thigh muscle area, and they had reduced urinary nitrogen excretion as the study progressed. Nitrogen is mostly found in protein; when people excrete less nitrogen it means their bodies are holding on to proteins). The decrease over time in urinary nitrogen excretion suggests that people did not achieve a metabolic steady state at 0.8 g protein and continued to lose muscle mass (Campbell et al. 2010).

This means older people need to eat more protein just to maintain their lean muscle.

Eat at least 20-35 grams protein for each meal

Recent research has suggested that people aim for a per meal protein requirement instead of a daily protein requirement (discussion Weiler et al. 2023).

Muscle protein breakdown and muscle protein synthesis (building) rates are highly responsive to both food intake, particularly protein intake, and to physical activity. How much protein per meal you need to eat to optimize postprandial MPS depends on age, the essential amino acid content of the protein (especially leucine which stimulates muscle protein synthesis), and whether or not you are doing strength training (resistance training).

People start losing skeletal muscle mass at around 50 years old. There is no difference in protein absorption between young and older women and men; but there is less muscle growth response to the protein intake. In other words, older people need to absorb more protein at a meal to jump start postprandial MPS. This failure of your muscles to respond to protein is called anabolic resistance (discussion Tian et al. 2016, Burd et al. 2019).

While muscle mass is lost at a rate of about 0.8% a year, strength loss occurs at a faster rate of 2-3% per year. This is due to a combination of aging, being less active, and diet. The best way to combat anabolic resistance is a combination of high quality protein meals and some form of strength training (discussion Nowson and O'Connell 2015, Burd et al. 2019).

Too many people neglect protein as they get older. Jules Jacques Veyrassat 1828-1893 - Interior with an Old Woman Eating Soup 1953 oil on canvas.

Jules Jacques Veyrassat, Public domain, via Wikimedia Commons

Want to build lean tissue? Eat 25-35 grams of protein 2-3 times a day

You need to maintain lean muscle if you want to age successfully. The average young adult (22 years old) has almost 48% lean muscle mass compared to 25% lean muscle mass in the average 78 years old. Muscle weakness is correlated with frailty, osteoporosis, risk of falling and reduced life expectancy. Stronger muscles equal stronger bones and more resilience to injury and illness (discussion Nowson and O'Connell 2015).

Meeting optimal per meal protein intakes (in most cases 25-35 grams protein) results in maximal postprandial muscle protein synthesis (MPS) in adults of all ages. MPS is when the body builds the proteins for muscles after a meal.

Healthy older men (48 men, average age 66 years old) consumed either 0, 15, 30, or 45 grams of milk protein concentrate after resistance exercise (leg press, leg extension, lat pulldowns, and chest press). Thirty grams of milk concentrate protein is around 1/3 cup. Ingestion of greater than 30 g milk protein after exercise increased muscle (myofibrillar) protein synthesis rates in the men (Holwerda et al. 2019).

In a similar line, 60 healthy older women and men (mean age 61 years old) either received a milk based protein supplement (0.165 g/kg body mass) or a maltodextrin control with the same caloric count at breakfast and lunch. Basically a 150 lb person would be given an extra 11 gram protein for breakfast and lunch. Consuming the protein supplement for 24 wk increased lean tissue mass by 0.6 kg compared to the maltodextrin control (Norton et al. 2016).

Frants Henningsen A man working near a farmhouse 1886 oil on panel.

Frants Henningsen, Public domain, via Wikimedia Commons

Want strong bones? Eat more protein and exercise

People over 65 years old who had a higher protein intakes (over the current DRI recommendation of of 0.8 g/kg body weight/day) had 11% less hip fractures than those with lower protein intake. People who ate more protein also had higher bone density in neck and hips (Groenendijk et al. 2019). A similar study with women over 65 years also saw an 11% decrease in hip fractures in those eating the most protein (Wu et al 2015).

Physical activity also significantly decreases your risk of bone fractures. People who are active have a 29% lower risk of all types of fracture when compared with people who don't perform physical activity. People who had more physical activity had a 39% less risk of hip fractures and a 28% lower risk of wrist fracture (Qu et al. 2019).

Protein intake is associated with less perceived cognitive decline

Women (49,493) who had a higher total, animal, and plant protein compared with total carbohydrates had a lower risk of subjective cognitive decline (Yeh et al. 2022).

Subjective cognitive decline is a person's perception of cognitive decline without standard tests showing cognitive impairments. Subjective cognitive decline is often an early indictor of mild cognitive impairment and dementia.  

Famous strongwoman Katie Sandwina in 1912. She was billed as 'Sandwina, Europe's Queen of Strength, Beauty and Dexterity.' 

Frederick Whitman Glasier, Public domain, via Wikimedia Commons

Strength (resistance) exercise plus protein increases muscle synthesis

Healthy older women (57 people, age 50-70 years) were given a supplemental milk protein powder to consume at breakfast and lunch. The supplement amount was adjusted for their weight; it added around 8.5-16 grams protein per meal. Half of the women also did 45-60 minutes of supervised strength training exercises 3-times a week.

In comparison to the protein group, women in the protein plus exercise group had an increase in upper leg lean tissue mass; an increase in knee extensor (KE) torque; and an increase in extended gait speed (Francis et al. 2016).

Essential amino acids prompt lean tissue gains

Total consumption of essential amino acids (EAA), at least in older adults, may be what prompts stimulation of muscle protein synthesis after eating (Jonker et al. 2017).

Protein powders high in EAA, such as whey or casein, are very effective at stimulating whole body protein anabolism (growth of muscles and lean tissue) in healthy and in non-healthy people. Researchers wondered if using a even more pure mix of EAA with some added leucine would result in even greater muscle gains.

Nineteen older adults that were healthy (64 +/- 2 years) were age matched with 23 people that had severe chronic obstructive pulmonary disease (COPD) (65 +/- 2 years). In a double blind cross-over study, the researchers looked at whether a free EAA mixture with a high proportion (40%) of leucine (called the EAA mixture) stimulated whole body net protein gain more than a very similar mixture containing balanced free EAAs and non-EAAs such as present in whey protein (called the TAA mixture).

They reported that the net protein gain was 49% higher in COPD patients and 42% higher in healthy controls after consuming the EAA mixture as compared to the TAA mixture (Jonker et al. 2017).

Add exercise for better results

In independent, healthy older women and men (age 71 +/- 1 year) a 24-week aerobic exercise training program (3 times per week) increased walking speed and aerobic fitness. When the fitness program was combined with EAA supplementation, it increased both muscle strength and EAA-stimulated muscle protein synthesis. Both the increase in strength and protein synthesis occurred without any improvements in muscle mass.

The EAA supplementation was given at 0.2g/kg body weight. The composition of the EAA mix was 40% L-leucine, 16.7% L-lysine, 11% L-valine, 10.7% L-isoleucine, 9.3% L-threonine, 6.7% L-phenylalanine, 3.3% L-methionine, 1.7% histidine, and 0.7% L-tryptophan (Markofski et al. 2019).

Science Bite: Leucine initiates muscle protein synthesis (MPS) after eating.

Leucine, an essential amino acid, activates the mammalian target rapamycin pathway (mTOR) pathway. The mTOR pathway helps maintain stable conditions in cells (cellular homeostasis) by controlling metabolism, immune responses, catabolism, autophagy, survival, proliferation, and migration.

Dysregulated mTOR signaling is linked with some diseases including aging, insulin resistance, osteoporosis, neurological disorders, and cancers  (discussion Panwar et al. 2023).

*Names and some minor identifying details in all stories in this website are changed to protect people's privacy

I'm not your doctor so this is not medical information. I'm just a person who would like to see you happy and healthy. If you have any questions or concerns about starting an exercise regiment, diet program, or supplements please consult a professional.

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