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  #1   ^
Old Sun, May-28-17, 04:15
teaser's Avatar
teaser teaser is offline
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Default Recommended daily protein intake too low for the elderly

https://www.sciencedaily.com/releas...70523095019.htm

Quote:
The minimum protein requirement for healthy adults has been set almost 15 years ago but there is a growing body of evidence that this recommended dietary allowance (RDA) is not sufficient for older persons.

You can find the recommended dietary allowance (RDA) on the nutrition labels of all your processed food. Food manufacturers are obliged to list the nutritional value of their products, and therefore must mention the percent daily value of the RDA their product meets for certain nutrients.

These RDA guidelines are put together by the Food and Nutrition Board of the National Academy of Sciences' Institute of Medicine. They inform you how much of a specific nutrient your body minimally needs every day. They are set to meet the requirements of 97.5% of the healthy individuals older than 19 years.

The RDA you will find on the nutrition labels on your food, however, were set in 1968, and the ones used by researchers and professionals were set in 2003. A recent review published in Frontiers in Nutrition points out that both these values do not do justice to the protein needs of the elderly and critically ill.

"A big disservice is being done. The prescribed 0.8 g/kg/day just isn't enough protein for the elderly and people with a clinical condition. This shouldn't be communicated as what is 'allowed' or even 'recommended' to eat.," author Stuart Phillips of McMaster University in Canada explains.

In his review, he points out that the quality of proteins should be considered when setting the RDA guidelines and recommending protein supplements. He argues that there should be a stronger focus on leucine; an indispensable amino acid and building block for proteins. The elderly have a higher need for leucine to build muscle proteins, and milk-based proteins (e.g. milk and whey) are a good source for this.

Moreover, it may be highly beneficial for the critically ill patients that rapidly lose lean body mass (i.e. the body weight minus body fat) to increase their protein intake. Again, elderly ill patients would benefit the most from this. "I think it's clear we need some longer-term clinical trials with older people on higher protein intakes. These trials need to consist of around 400 -- 500 people.," Phillips argues.

He is not the first researcher to challenge the current protein RDA, and hopes his message does not fall on deaf ears. That is also why he chose to publish Open Access: "I love to publish work that everyone can read. The days of publishing a paper that only people in academic institutions can read are over. I think it is essential that everyone and not only your scientific colleagues can read the work we do."

At his own dinner table, Phillips also puts the focus on proteins. "But not at the expense of other macronutrients. I enjoy a variety of foods, and the only thing I specifically focus on is limiting my intake of sugar and refined carbohydrates. But of course, given the benefits of proteins, they are a big part of what I think about when planning my meals."



http://journal.frontiersin.org/arti...2017.00013/full
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  #2   ^
Old Sun, May-28-17, 05:11
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WereBear WereBear is online now
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I see the "dark arts" of the vegan lobby, which demonizes protein. They are constantly claiming the body needs less than whatever the standard is, and they constantly clamor to lower those.

For me, I do better with more protein, from meat or fish. My vegetarian attempts, even with eggs and cheese, was a disaster.

My experience with elderly cats is that they need more nutrition, protein, and fat. Their digestive system is not as efficient as it used to be, and supplementation makes a huge difference to their quality of life.

Are people so different? I don't think so.
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  #3   ^
Old Wed, May-31-17, 10:32
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mike_d mike_d is offline
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Quote:
Originally Posted by WereBear
I see the "dark arts" of the vegan lobby, which demonizes protein. They are constantly claiming the body needs less than whatever the standard is, and they constantly clamor to lower those.

For me, I do better with more protein, from meat or fish. My vegetarian attempts, even with eggs and cheese, was a disaster.

My experience with elderly cats is that they need more nutrition, protein, and fat. Their digestive system is not as efficient as it used to be, and supplementation makes a huge difference to their quality of life.

Are people so different? I don't think so.
I think with age it's harder to digest many protein sources so I occasionally resort to low-carb protein shakes to provide a boost and that seems to be working. Haven't noticed they cause cravings. Usually have as part of a smaller meal. Yeah, I cringe at the 'healthy grains' for pets ads on TV these days.
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  #4   ^
Old Wed, May-31-17, 11:26
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GRB5111 GRB5111 is offline
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Protein balance is one we discuss quite frequently. The quote from the Science Daily stating there's a need for larger, longer term clinical trials with older subjects on varied amounts of protein intake:
Quote:
Moreover, it may be highly beneficial for the critically ill patients that rapidly lose lean body mass (i.e. the body weight minus body fat) to increase their protein intake. Again, elderly ill patients would benefit the most from this. "I think it's clear we need some longer-term clinical trials with older people on higher protein intakes. These trials need to consist of around 400 -- 500 people.," Phillips argues.

Note that the "varied amounts" is my adjustment to the proposed trial having subjects consuming from a range of low to high protein amounts. Yes, this is required to be able to really understand the dynamics of protein consumption as we age, and the cynic in me wonders if/when this will ever happen. My cynical self also suspects that "dietary experts" are still trying to find that "one optimized amount of protein for all" myth that likely doesn't exist other than very general guidelines tempered with caveats for many other variables in addition to age. This ultimately gets too hard to do and results in ineffective guidelines for all. Yeah, I'm really cynical about our ability to achieve this goal in today's chaotic nutritional climate.

I know from my own N=1 experiences, I can eat on the higher end of the Phinney/Volek recommendation for protein and do quite well. However, I also believe that negative impacts from too much protein (at least for me) could be mitigated by IF. My observations are that one of several reasons that periodic IF is healthy is due in large part to the absence of exogenous protein for periods of time. This enables the metabolism to clean out and re-balance. It may be in fact why I can eat more protein, very few carbs, and not have to resort to extensively increasing my fat consumption to achieve satiety when I'm not fasting.
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  #5   ^
Old Wed, May-31-17, 21:49
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Bintang Bintang is offline
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Quote:
Originally Posted by GRB5111
I know from my own N=1 experiences, I can eat on the higher end of the Phinney/Volek recommendation for protein and do quite well. However, I also believe that negative impacts from too much protein (at least for me) could be mitigated by IF. My observations are that one of several reasons that periodic IF is healthy is due in large part to the absence of exogenous protein for periods of time.

Rob, I'm interested by this. So how much protein do you actually consume in terms of g/kg body weight? And how exactly do you do the IF? Is it daily by restricting eating to within a 6 to 8 hour window or do you fast for whole days at regular intervals?
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  #6   ^
Old Thu, Jun-01-17, 16:35
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GRB5111 GRB5111 is offline
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Plan: Very LC, Higher Protein
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Quote:
Originally Posted by Bintang
Rob, I'm interested by this. So how much protein do you actually consume in terms of g/kg body weight? And how exactly do you do the IF? Is it daily by restricting eating to within a 6 to 8 hour window or do you fast for whole days at regular intervals?

Bintang - Here's how I approach g/kg or g/lb. of body weight using the Phinney/Volek recommended formula. I'm not precise and usually stay within a range of grams of protein based on my physical activity levels. I usually eat two meals per day with about a 5-6 hour eating window, some days I eat one meal with a 24 hour eating window. I also do a 3-4 day IF once a month on top of this. Here's the calculation method on which I base my protein intake in general terms (quoted from KetoDiet Buddy):

Quote:
According to Volek and Phinney (The Art and Science of Low Carbohydrate Performance), the multiplying factor should be between 0.6 - 1 grams per a pound (1.3 to 2.2 grams per a kilogram) of lean mass.

As an example, if your weight is 160 pounds and your body fat is 30%, your lean mass weight is calculated as follows:

160 lbs - 30% = 112 lbs

Therefore, your protein intake should be between:

112 x 0.6 = 67 g of protein (minimum amount)
112 x 1.0 = 112 g of protein (maximum amount)

Using your activity level will help you determine your protein intake more precisely. Based on the figures above, the ideal protein intake for different activity levels would be as follows:

Minimum protein intake for sedentary people = 0.6 x lean body mass in lbs
Lightly active = 0.7 x lean body mass in lbs
Moderately active = 0.8 x lean body mass in lbs
Very Active = 0.9 x lean body mass in lbs
Maximum protein intake = extremely active = 1 x lean body mass in lbs

So for me, (and I'll do the example using pounds) I weigh 186lbs. Estimating about 23% fat, that gives me around 143lbs. of lean mass. I multiply by 0.8 as a moderately active individual = 114.4g of protein, which to determine the overall weight of protein (use beef at 7 grams of protein per ounce) is around 16 ounces of protein sources (meat/fish/eggs) per day at the highest end. This is spread among two meals for me during the day typically; however, I often eat one meal per day and and I'm lower than 16 ounces of protein (114.4 protein grams) in a single meal. I often am lower in total protein per day than 16 ounces depending on my work schedule and the opportunity to do exercise (workouts). If I'm not working out, I'll lower my protein quantity, but I'm not weighing food or being very conscious of precision here. This approach seems to work for me.

So, my high end might occasionally touch a 16 ounces of eggs, meat or fish, my lower end might be 8-10 ounces or 56-70 protein grams, and my higher end is likely around 12-14 ounces. If I'm physically active, I'm going toward the higher end.

Note: edited to include eggs as a typical regular protein source and to clarify my low and high level of protein consumption.

Last edited by GRB5111 : Thu, Jun-01-17 at 19:44.
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  #7   ^
Old Sun, May-28-17, 05:45
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cotonpal cotonpal is offline
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Given all the advice lately to limit protein I tried, briefly, to follow Rosedale's advise but found it impossible. I could not limit my protein to the degree he recommends while keeping my carbs adequately low at the level where I seem to do best but still get sufficient micronutrients. It just didn't work for me. I would also have had to force feed myself more fat and my diet was already about 70%-75% fat and I have no interest in bullet proof coffee. I like mine black.

And also there was the problem of evidence. Do we really know that a mostly plant based limited protein diet confers benefits or is this just the latest enthusiasm? I'm going with the latter. I decided to simply eat the way that seems to work for me and which I constantly return to, my apparent "sweet spot". According to Cron-O-Meter over the last 7 days I have averaged 83.5 gms of protein without a whole lot of daily variation. That's where I have decided to stay.

I guess I fall into that "elderly" category at 68. Could it really be that I'm doing the right things for myself?

Jean
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  #8   ^
Old Sun, May-28-17, 05:47
teaser's Avatar
teaser teaser is offline
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I seem to do fine, even on a ketogenic diet, at the RDA. I reserve the right to not be typical. Or to increase protein if I stop seeming to do fine.

I might be okay with the RDA for protein if they'd call it the recommenday daily minimum instead, he's right that "allowance" makes it sound like a number you shouldn't go over, when it's intended to be a number you should meet or exceed.
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  #9   ^
Old Sun, May-28-17, 05:55
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cotonpal cotonpal is offline
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Quote:
Originally Posted by teaser
I seem to do fine, even on a ketogenic diet, at the RDA. I reserve the right to not be typical. Or to increase protein if I stop seeming to do fine.

I might be okay with the RDA for protein if they'd call it the recommenday daily minimum instead, he's right that "allowance" makes it sound like a number you shouldn't go over, when it's intended to be a number you should meet or exceed.


From what I understand all RDA's are considered the minimum necessary to prevent deficiency rather than what is optimal and, of course, there is that pesky problem of context. The necessary intake of any nutrient while eating the SAD may not be the same as the necessary intake while eating ketogenic. I tend to use them, logging my foods on Cron-O-Meter, just because they are the best we have but know that they are not some absolute etched in stone (and of course even stone erodes).
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  #10   ^
Old Sun, May-28-17, 06:27
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deirdra deirdra is offline
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I do fine on the RDA as long as I get all of it from animal protein. When I was a vegetarian, my nails & hair were constantly splitting, I lost lean body mass and was exhausted all the time. That and increased allergies, asthma symptoms, etc. turned me into a born-again near-carnivore.
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  #11   ^
Old Sun, May-28-17, 06:29
teaser's Avatar
teaser teaser is offline
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Requirements are highly individual and sort of subjective. If I ate 40 grams of protein a day for some period of time--eventually, I'd probably be in protein balance, likely after losing some amount of lean mass. Take 50 people just like me at that point, do a nitrogen balance study--you might find our protein requirement to be 40 grams a day. Another group of teaser clones eats 120 grams of protein a day for a similar period, and their protein requirement by nitrogen balance, after lean mass increases and plateaus, is 120 grams of protein a day. The whole exercise is a little meaningless, until you develop some sort of opinion about what level my lean mass should be at in the first place.
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  #12   ^
Old Thu, Jun-01-17, 14:22
M Levac M Levac is offline
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Euh, a simple logic. The Bellevue all-meat trial shows excess protein is impossible or with benign effects if at all, with some caveat specific to an all-meat diet (i.e. must eat enough fat, must be some fresh meat, etc). Conversely, kwashiorkor shows protein deficiency is possible and with severe and permanent effects. So, more protein is always better than less protein. And since RDA is a minimum to avoid deficiency but does not account for any unforseen situations that could require more protein, then more than RDA is always better than equal or less.
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  #13   ^
Old Thu, Jun-01-17, 15:16
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teaser teaser is offline
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Quote:
Originally Posted by M Levac
Euh, a simple logic. The Bellevue all-meat trial shows excess protein is impossible or with benign effects if at all, with some caveat specific to an all-meat diet (i.e. must eat enough fat, must be some fresh meat, etc). Conversely, kwashiorkor shows protein deficiency is possible and with severe and permanent effects. So, more protein is always better than less protein. And since RDA is a minimum to avoid deficiency but does not account for any unforseen situations that could require more protein, then more than RDA is always better than equal or less.


Gotta disagree here, anytime that a greater elevation of ketones is desirable. For my n=1, I get some benefits from restricting protein as well as from restricting carbohydrate. It's possible that being freed from binging, and reduced social anxiety/depression comes at a cost to lean mass or has some other cost to my well being, I don't know if this is true or not, I can't tell by performance or tape measure. But I don't know that we always have the option of optimizing for all things, either.

Also the Bellevue trial was pretty small. A study like that is powered enough to show that an all-meat diet will not universally cause deficiencies in humans--but it's not strong enough to conclude that this diet will be sufficient to meet the needs of all humans.
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Old Thu, Jun-01-17, 16:35
Zei Zei is offline
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mTOR. Higher protein intake upregulates our nutrient-sensing system mTOR, signalling there must be plenty of nutrients around so grow rapidly, reproduce and (as I understand it) sort of burn out quickly and drop dead? Not sure that's exactly the best way to describe it, but something like that. So then low protein downregulates mTOR. Hey, maybe there's a famine or something, thinks our body, so better hunker down and go into repair mode and preserve one's self to survive long-term in case things get better so we can then eat plenty and reproduce (and then drop dead?). So some low-protein advocates think we're better off not to be upregulating mTOR with lots of protein because not only we but things like cancer cells and stuff like to grow, so that we should keep it tamped down with low protein so we'll keep repairing ourselves, stay healthy and live a long time. Except then isn't there the potential problem of sarcopenia, muscle wasting, getting weaker and more frail as we age if we don't upregulate mTOR to do some muscle growth to prevent all that? On the one hand people like Dr. Rosedale and Dr. Gundry suggest fairly low protein targets to downregulate mTOR and stay healthy; on the other I heard a talk by another doctor say women of a certain age should be eating lots of protein several times each day to upregulate mTOR or the muscle wasting will occur. So kind of seem like opposites--do we want mTOR upregulated, downregulated or what as we age? Anyone who knows more about this have any thoughts? It seems to me like more than a trivial matter because who wants to be maybe really long-lived but weak and frail? There's got to be more to this.
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  #15   ^
Old Thu, Jun-01-17, 17:03
M Levac M Levac is offline
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Quote:
Originally Posted by Zei
mTOR. Higher protein intake upregulates our nutrient-sensing system mTOR, signalling there must be plenty of nutrients around so grow rapidly, reproduce and (as I understand it) sort of burn out quickly and drop dead? Not sure that's exactly the best way to describe it, but something like that. So then low protein downregulates mTOR. Hey, maybe there's a famine or something, thinks our body, so better hunker down and go into repair mode and preserve one's self to survive long-term in case things get better so we can then eat plenty and reproduce (and then drop dead?). So some low-protein advocates think we're better off not to be upregulating mTOR with lots of protein because not only we but things like cancer cells and stuff like to grow, so that we should keep it tamped down with low protein so we'll keep repairing ourselves, stay healthy and live a long time. Except then isn't there the potential problem of sarcopenia, muscle wasting, getting weaker and more frail as we age if we don't upregulate mTOR to do some muscle growth to prevent all that? On the one hand people like Dr. Rosedale and Dr. Gundry suggest fairly low protein targets to downregulate mTOR and stay healthy; on the other I heard a talk by another doctor say women of a certain age should be eating lots of protein several times each day to upregulate mTOR or the muscle wasting will occur. So kind of seem like opposites--do we want mTOR upregulated, downregulated or what as we age? Anyone who knows more about this have any thoughts? It seems to me like more than a trivial matter because who wants to be maybe really long-lived but weak and frail? There's got to be more to this.

Wow, ya, lots of stuff in there. I'm not familiar with mTOR, I just did a quick search to get an idea.

OK, so first, longevity. We got Cynthia Kenyon who worked with worms and showed that insulin was the driving agent. Less insulin, longer life. Don't know if it applies to humans, but there's a very high likelihood that it does.

So now, overall health. We got a bunch of stuff showing insulin is the primary agent here. More insulin, worse health. Basically, whatever makes us fat, also makes us sick. Not necessarily through the same mechanisms, but the association is too strong to ignore.

So now for protein. It stimulates insulin, so we're dealing with both longevity and health. But there's a trick - fat. Eat more fat, mitigates insulin. It's as simple as that.

On Wiki, there's mention of oxidative damage. In my opinion, the entire idea of oxydative damage (and that anti-oxydants are beneficial) is absolute BS. We have lungs. Our cells have tons of mitochondria for aerobic respiration. Everything our cells do requires oxygen. Oxydation is the de facto life-giving mechanism for us. How could it somehow flip 180 and begin to kill us as we grow older? Well, mTOR is blamed for oxydative damage, so it's about as much BS there too, in my opinion.

On the other hand, mTOR gets me thinking about a genetic kill-switch (like in the Blade Runner movie for the replicants) but that's way outside the scope of this forum and discussion.
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