Eat Well to Be Well: Protein’s the power in preventing sarcopenia

Sarcopenia – a funny sounding word for a condition that affects 30 percent of people over the age of 60 and 50 percent of people age 80 and older. This word was coined in 1989 by a Dr. Irwin H. Rosenberg and is defined as the involuntary, gradual loss of muscle mass and strength as we age. All of us are at risk no matter our gender, ethnicity or where we live. The effects of sarcopenia can be devastating – increased falls and fractures, frailty, difficulty with walking, decrease in activities and a loss of physical function and independence.

This progressive condition can begin as early as age 30 and can reduce muscle tissue by 3 to 8 percent per decade. Between 50 and 60 years of age, muscle strength declines annually by 1.5 percent and by 3 percent after the age of 60. The muscle we lose as we age is slowly replaced with fat, even if body weight remains unchanged. That’s why even thin people can still have a high percent body fat content if they do little to maintain muscle mass leading to sarcopenia.

Think you can’t spot sarcopenia? It’s easy if you know what to look for. As the muscles weaken and get smaller, we have more difficulty in lifting heavy objects, walking far distances, reaching for something on a high shelf, bending over to pick objects up and a decline in stamina. And we just simply lose our muscle tone. Where we once enjoyed flexing muscles we could see, now they have gotten, well … flabby!

091714-sarcopeniaSo, is it inevitable we’re doomed to get sarcopenia? Thankfully the answer is no. Today, become proactive in preserving as much muscle mass as possible as you age. The earlier you start, the more likely you can maintain adequate muscle mass to be able to enjoy an active lifestyle well into old age.

There are two ways to do this. One is to exercise, primarily doing resistance training or lifting weights two to three times a week. Exercise is beneficial to help to slow down muscle loss and keeping you moving. If lifting weights is new to you, work with a trainer who can help you start with appropriate poundage of weights and movements. Weight training will help with weight management and improve bone health, reducing your risk of osteoporosis and reduce muscle wasting.

The second way is with protein.

“Protein is our best friend,” said Dr. David Samadi, chairman of urology and chief of robotic surgery at Lenox Hill Hospital in New York City. “Protein is how we stay fuller longer, therefore, protein enables us to stave off excessive and unnecessary cravings. It continues to be one of the most satisfying food groups you can eat and new research has revealed that eating plant-based protein may play a larger role in preventing sarcopenia.

“Protein helping prevent diseases like sarcopenia that can be so debilitating, especially on a gradual level, is exciting and people should take advantage,” Dr. Samadi said. “This leads us further down the path of understanding how food prepares us for the aging process and our physical being. What we eat is not just about gaining and losing weight. It’s largely connected to how our muscles and bones stay strong. This factor affects our older adult lives and is drastically undervalued, often until it’s too late.”

Obtaining adequate protein is key to preserving and maintaining our muscle mass the most. However, the vast majority of people in the United States are not protein deficient. Why then, are so many people vulnerable to developing sarcopenia? The reason is a couple of different factors – protein quality and protein distribution.

Protein quality

Protein comes from two sources, animal and plants. Animal sources include red meat (beef, pork, lamb), poultry, fish, eggs, and dairy foods. Plant sources include grains, beans, nuts, seeds and vegetables.

Amino acids are the building blocks of protein and there are a total of 20 amino acids necessary for the body to make protein. Out of the 20 amino acids, 9 of them are called “essential amino acids” as they cannot be made by the body and have to come from our food sources. The essential amino acids help stimulate and support muscle protein synthesis.

Animal sources of protein are called high-quality or complete proteins as they contain all of the 9 essential amino acids the body needs to build protein. Moderate amounts – 25 to 30 grams – of animal sources of protein should be included at each meal. The level of protein per meal has been shown through research to be what is necessary to stimulate skeletal muscle protein synthesis or to build muscle. This leads to less lean muscle mass being lost and a slower progression of sarcopenia.

Plant sources of protein are called low-quality or incomplete protein as they do not contain all of the 9 essential amino acids but they are still a very valuable supply of important nutrients and you can enjoy them as part of your daily diet. Combining incomplete proteins sources such as rice and beans will make a more complete protein.

“The Mediterranean Diet is my lifestyle and one of the best ways I believe anyone can eat and maintain a healthy weight,” said Dr. Samadi. “From this way of eating, there are hundreds of delicious and healthy protein sources. Some of my favorites include beets, beet greens, spinach, chia seeds, eggs, sun dried tomatoes and even pumpkin seeds. Notice how many of these foods are plant-based? That’s because eating increased amounts of plant-based protein has been shown to prevent weight gain and fight chronic diseases like diabetes. Nuts and grains continue to also be the protein kingdom. Think almonds, whole oats and your favorite nut butter like walnut butter. Incorporating these types of foods into not just meals but snacks can help those muscles stay strong while also fighting weight gain. Sounds like a good deal to me.”

A recent study showed that plant proteins may be associated with preserving muscle strength in older adults.

To obtain the 9 essential amino acids, animal protein is your best choice. It takes far less of an animal source of protein to achieve the amount of protein a plant source provides. The chart below shows the amount of a plant source of protein it would take to reach 25 grams of protein that just 3 ounces of lean beef provides.

081215-ewtbw-caloric-cost-p

Protein distribution

The second factor is distribution of protein. How you distribute your intake of protein throughout the day determines how well your body is able to utilize the protein to help build lean muscle mass.

Dr. Douglas Paddon-Jones, a researcher at the University of Texas, shows the difference between an adequate and inadequate protein distribution with the graph below. Part B is typical of how most of us tend to distribute our protein intake over the course of a day.

Breakfast usually consists of a little bit of protein, lunch slightly more, but dinner tends to be when we consume the majority of our protein. This uneven distribution of protein throughout the day is not as effective towards protein building or synthesis needed to maintain muscle mass.

091714-proteingraph

It is more effective to distribute protein intake evenly at each meal like it shows in part A on the graph. This even distribution of protein intake at around 25 to 30 grams per meal, is better for efficient muscle building and repair and 30 grams appears to be the optimal amount the body can use at one time. Consuming above 30 grams is more than what the body will use and any excess amount over that will end up being converted to fat or glucose and not towards muscle synthesis. Essentially, you’re wasting excess protein at a meal. To have adequate protein synthesis occurring in the body, you need to have available essential amino acids throughout the day and not just coming in all at once. Research has shown that when protein distribution is evenly distributed among each meal, muscle protein synthesis was about 25 percent greater than when protein distribution was skewed more toward the evening meal.

Here is an example of a one day meal plan containing 25 to 30 grams of protein at each meal:

Breakfast – Cooked oatmeal with 2 tablespoons of peanut butter, 1/2 cup blueberries, 1 scrambled egg, and 1 cup low-fat milk. (27 grams of protein)

Lunch – 3 ounces of salmon with a spinach salad and 1/2 cup black beans, 1 cup grapes and 1 cup baby carrots. (~30 grams of protein)

Dinner – 4 ounces of beef steak, 1 baked potato, 2 tablespoons of Greek yogurt and 1 cup steamed broccoli. (~30 grams of protein)

It doesn’t take huge amounts of protein to reach 25 to 30 grams at each meal. It just takes being more conscientious about planning meals to reach that 25 to 30-gram optimal amount.

Here are some ideas of high-quality protein sources from animals to include in your diet:

  • 1 egg 6 g protein
  • 3 oz tuna 19.5 g protein
  • 3 oz salmon 23 g protein
  • 1 cup milk 8 g protein
  • ½ cup 1 percent cottage cheese 14 g protein
  • ½ cup Greek yogurt 12 g protein
  • 1 cup low-fat milk 8 g protein
  • 1 scoop whey protein powder 20 g protein

To sum it up, sarcopenia doesn’t have to happen to you. Be proactive by:

  • Incorporating exercise and weight lifting to build muscle mass.
  • Consuming high-quality protein at each meal.
  • Distributing your protein intake to around 25to30 grams per meal – this would include both animal and plant protein sources.

Starting today, outsmart sarcopenia with every weight you lift and bite of protein you eat. Your strong, toned muscles will thank you for that.


Cheryl's-Headshot-2015-80x1Cheryl Mussatto MS, RD, LD, is a registered dietitian and an adjunct professor at Allen Community College, Burlingame, where she teaches Basic Nutrition, and at Butler County Community College, Council Grove, where she teaches Therapeutic Nutrition. She is also a certified health and wellness coach. She writes Eat Well to Be Well, a column about health and nutrition, is also a blog contributor for Dr. David Samadi at www.samadimd.com. Contact her at [email protected] or visit her website www.eatwell2bewellrd.com.


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