Annals of Long Term Care

Frailty—a common geriatric syndrome characterized by unintentional weight loss, weakness, fatigue, and low physical activity level—puts older adults at significantly greater risk of falls, fractures, disability, hospitalization, and death. Some research has suggested that increased protein intake can help protect against frailty in later life, but prospective observational studies investigating this relationship have been lacking. Filling a significant gap in the research, a three-year, prospective cohort study published in the June issue of Journal of the American Geriatrics Society finds that higher protein consumption, as a fraction of total caloric intake, is, in fact, associated with a strong, independent, and dose-responsive decline in risk of incident frailty among older adults.

The study, led by Jeannette M. Beasley, PhD, MPH, RD, of the Fred Hutchinson Cancer Research Center in Seattle, followed more than 24,000 women, age 65-79, participating in the Women’s Health Initiative Observational Study. All of the women were free of frailty at baseline and reported their food intake using the Food Frequency Questionnaire. After three years, Dr. Beasley and coauthors found that 13.5% of the women had become frail. Using a measure that corrects for error by calibrating self-reported protein and energy intake using recovery biomarkers, the researchers also found that higher protein intake was associated with lower risk of frailty.

While the Institute of Medicine’s Recommended Dietary Allowance for protein is 0.8 grams per kilogram of body weight per day, the study’s findings, like those of the 2008 Health, Aging and Body Composition Study, suggest that 1.5 grams per kilogram per day, or 20-25% of total calorie intake, may be more appropriate for older adults at risk of becoming frail, Dr. Beasley and colleagues report. However, the relationship between protein intake and other health conditions, such as kidney function, need to be examined before recommending changes to the dietary guidelines. Research suggests that eating protein throughout the day is preferable to eating it all at one meal, she adds, suggesting that older adults include three or four ounces of lean protein in every meal.

In light of these findings, ensuring that older adults are served meals that include a range of appealing high-protein foods and encouraging consumption of adequate protein seems prudent. To help older people and their caregivers understand the importance of ensuring adequate protein intake, the American Geriatrics Society’s Foundation for Health in Aging has posted an easy-to-read summary of the new study on its www.healthinaging.org public education website. The summary, and all other information on the site, can be downloaded and shared at no cost. We encourage you to share this information with your patients and their caregivers.