Nourishing ourselves well in later life requires a thoughtful shift in focus, says renowned dietitian Brenda Davis, RD, because our metabolism, muscle mass, and nutrient absorption all change with age.

Speaking in an online interview with Dr Daisy Lund from UK Health Professionals, Davis explained in detail some of the critical nutrients that need to be monitored as people move into their 70s and beyond.

“We’re finding all kinds of interesting facts about older adults,” she said. “I would say the guidelines that recommend an increase in certain nutrients for older adults are based on a combination of precautionary principles and solid evidence from ageing research.

“The strength of the evidence varies for different nutrients. For example, the evidence is really strong for protein, B12, Calcium and vitamin D. It may be a little less robust for Omega 3, potassium and magnesium. But generally, older adults have some physiological changes that occur that can negatively affect their absorption and metabolism of nutrients.

Nutrient value

“In addition, increased intake of certain nutrients has actually been found to prevent or delay the onset of or progression of chronic diseases or conditions like sarcopenia associated with ageing.

“So, as the body undergoes age-related changes including reduced metabolic efficiency, diminished bone density, and slower muscle repair, there’s a question that specific nutrients become increasingly important in maintaining health and preventing chronic conditions.”

Dr Lund: But what are the main differences you would recommend for an older person?

“Let’s start with protein. In the UK, Canada, the US and the EFSA and in China, there are no separate recommendations for protein for older adults. The suggested intake for all adults ranges from .75g per kg in the UK to about 1g per kg in China.

“But, several countries including Australia, Germany, Austria, Switzerland, all the Nordic countries actually do have separate recommendations for older adults. They generally range from 1 to 1.5g per kilogram.

“I think current evidence strongly supports evidence of 1 to 1.2g per kilogram for older adults and possibly more for those with sarcopenia or acute or chronic illnesses. For people eating plant-exclusive or vegan diets, the digestibility of protein from whole plant foods is about 10 to 15 per cent lower than it is for lower fibre products or animal products.

“For these individuals, I think it is especially important to aim for a minimum of 1g per kilogram. It’s interesting that within the plant-based communities, the mantra has been that if you get enough calories from a variety of whole plant foods, you get enough protein. While this is almost always true, it may not be true for older adults, especially for women with low caloric requirements.

Protein shortfall

“I’ve worked with a number of older women who, I’ve found, fall short in their protein intakes.

“This lady, Trish, wrote to me and said she was frustrated by many symptoms after following a whole food plant-based diet for some time. She said she wondered if she was getting enough protein, but the plant-based doctors she was following told her protein wasn’t the issue.”

Davis said she suggested that Trish raise her protein intake from 35 to 40g a day to 60 or 70g a day. Trish’s response was:

“I look better, I feel better, my skin is vastly improved on increased protein. No band-aids no bleeding, my abdomen’s receding. These are issues I’ve dealt with since my mid-70s, and now at 83 years of age, they’re actually clearing up.”

Davis explained: “I want to tell you how simple it is to increase from 35-40g a day to 60 or 70 – you know I think I brought her to 72 with a simple swap.

“All we did was replace her low protein plant-milk which was soy milk. We added hemp seeds to her breakfast bowl we added about half a cup of tofu cubes to her salad, used, instead of a no-fat sugar-based dressing we used a tahini dressing and that was it. That was all we did.

Keeping protein intake up

“I think that says a lot. As you get older, you need to make sure you have a source of protein with your meals and even with your snacks if you have snacks. But you want to be focusing on beans, lentils, tofu, and edamame or whatever proteins you like to have.”

Dr Lund: “You’ve explained to us who are pretty experienced in the area how to get your protein values up, so, if you imagine yourself speaking to other dieticians who (and playing devil’s advocate here) are going to say it’s so much easier to get protein from animals as it’s easier to digest, it’s a more complete protein. You have to be thinking about different amino acids. How do you deal with those kinds of questions when they come from other dieticians?”

Davis: “Well, I just find it upsetting to be honest because the process of protein complementation came from work in the 1970s, and the lady who theorised that this was necessary actually, within the next decade said, ‘Whoops, I made a mistake.’ We’ve known for decades that we don’t need to do this. While it’s true that individual plant foods may have varying levels of essential amino acids, all plant foods contain all nine essential amino acids.

“The human body maintains a pool of free amino acids, which allows it to assemble proteins as needed. Even if some essential amino acids are contingent, say we lower amounts in a single meal, say, like you just have toast for breakfast and you’re a little low on lipene for that meal, you will draw out a lipene from the protein pool.

“As long as calorie and protein needs are met, and a variety of plant foods are consumed, we can easily get enough of all these essential amino acids.

“I think the selling of this myth of incomplete protein rarely helps people to adopt more sustainable dietary patterns without any unnecessary concerns. I find it really distressing that health professionals continue to perpetrate this kind of myth. We’ve known for way too long that this is unnecessary.”