AGING, PROTEIN-REQUIREMENTS, AND PROTEIN-TURNOVER

Current protein requirements for the elderly derive from 1985 FAO/WHO/ UNU recommendations of no change with age in adults: ie, 0.6 g/kg aver age and 0.75 g/kg safe allowance. Although concern has been expressed that protein requirements for the elderly may be greater, a review of nitrogen balance data, none of which are entirely satisfactory, indica tes little reason for any revision. Furthermore, the 1985 recommendati on is generally consistent with reports that the rate of whole-body pr otein turnover, a commonly assumed determinant of the protein requirem ent, exhibits minimal change with age per unit fat-free mass. Recent n ovel tracer studies aimed at evaluating protein requirements and turno ver in a systematic way also support the 1985 recommendations. [1-C-13 ]leucine balance studies have allowed measurement of metabolic demand from postabsorptive leucine oxidation and the efficiency of protein ut ilization from changes in leucine balance with feeding. The apparent p rotein requirement is metabolic demand divided by efficiency, an indic ation of protein needs and utilization during a standardized protocol at intakes similar to habitual ones. In healthy, mobile, elderly perso ns, metabolic demands are reduced by about one-third, with no signific ant impairment in efficiency of protein utilization. Thus, apparent pr otein requirements appear to fall with age from 0.98 +/- 0.17 to 0.69 +/- 0.22 g/kg. These changes with age reflect an improved restraint of proteolysis in the postabsorptive state, with little change with age in whole-body protein synthesis. The requirements of frail and immobil e elderly and the efficiency of protein utilization of meals as eaten by elderly people remain to be evaluated.