When it comes to understanding how to stimulate muscle growth, whey protein is well known as being ‘top of the heap’. It’s simply amongst the highest-quality, most bio-available proteins out there.
Over the last five years, however, my research has evolved to focus to mitigating muscle loss, mostly in the elderly, and mainly on those who in a sedentary state, such as people with chronic diseases or post-operative patients. Here, too, whey protein has much to offer. But in all too many instances, its acceptance into clinical practice is still being hampered by a legacy of misleading headlines and claims. Today’s science tells us, in fact, that older populations require more protein than they’re typically getting – and recent research (conducted in healthy subjects) has not been able to show any ill effects from long-term diets that are very high in protein.
Younger people who are sedentary for a limited period of time experience declines in muscle mass, however, they can regain lost muscle mass relatively quickly. So that’s not what motivates the research I lead at PACE (McMaster University’s Physical Activity Centre of Excellence). Instead, we’re talking about sarcopenia: The gradual loss of muscle mass and function that comes with aging. And my own interest centers on how to slow down sarcopenia.
Despite the fact that it is painfully obvious that people lose muscle, strength and mobility as they enter their twilight years, ‘sarcopenia’ is far less famous, as a term, than its rock star cousin osteopenia, which is the precursor to osteoporosis.
But it’s just as important to address the disease from an elderly care standpoint, mainly because muscle mass and function have implications for everything from metabolism to mobility. Perhaps it’s the fact that osteoporosis has a defined clinical end-point (debilitating fractures or breaks when bones become brittle) that leads to it getting so much attention? Sarcopenia, on the other hand, describes a gradual decline, with ultimately negative outcomes that are extremely varied and which can be hard to directly connect to the disease. But it’s seen as an inevitable consequence of aging where there’s very little you can do to slow it down.
Slowing down sarcopenia
So the question is how to slow the relentless downward advance of sarcopenia, maintaining mobility and giving people more independent years. And, importantly, I believe, with no or as few as possible pharmacological stimuli. Older persons are already over-medicated and I don’t think we need another ‘anti-muscle-loss’ pill, if there would ever be such a thing.
The two parameters we have to work with, to change the muscle loss trajectory, are physical activity and dietary protein. And there’s plenty of evidence to support the premise that higher levels of activity and protein intake are effective. But in which forms? And at what levels for different patient types and contexts?
Step reduction studies
At PACE, we have worked with various models of muscle disuse, introducing a period of ‘step reduction’, which requires study subjects to reduce their number of steps they take each day to, for example, just 1,000. This level reflects a highly sedentary pattern that might equate to a hospital stay or a prolonged sickness/recovery period.
Results have been useful. In one study, we compared the effect of feeding whey protein or collagen to older, sedentary subjects. Some degree of recovery was noted in the whey protein group, while no degree of recovery was observed in the collagen group. Overall, it appears that many older people simply don’t regain muscle mass or tone after sedentary periods – and that is very concerning.
While such models are indeed useful, more research is required into the effect of whey protein on subjects who combine a sedentary period with actual illness. Doing so allows researchers to incorporate the effect of inflammation and heightened intake of medications, for example, on study results.
For now, our message is for older populations to ensure they get a good protein serving of around 20-30 grams, irrespective of body weight, per meal. Most Western diets fall far short of this, particularly at breakfast and lunch. Here, protein supplements may be a useful addition. That may sound easy, but it’s not.
For some people and in some regions of the world, increasing the amount of dairy protein in the diet may go against what I like to call ‘protein mythology’ – long-standing, now debunked medical mantras that have convinced both laypeople and health professionals that too much protein is detrimental.
One such myth states that too much protein can reduce calcium in the bones. It’s an idea first proposed in the 1920s – and it’s not exactly a welcome message for those who have been diagnosed with osteoporosis! Another is that too much protein can damage your kidneys. But both of these persistent myths have long been laid to rest through multiple, recent investigations.
A 2017 meta-analysis, for example, conducted by the National Osteoporosis Foundation (Arlington, VA) showed no adverse effects of higher protein intakes on bone structure, and even evidence to suggest a moderately beneficial effect of a higher protein intake on lumbar spine bone mineral density compared with lower protein intake.
Similarly refuting evidence exists around the issue of kidney damage. A 2018 systematic review focusing on renal health in healthy individuals associated with protein intake above the US Recommended Dietary Allowance (RDA) pointed to increased protein intake having little or no effect on blood markers of kidney function. The evidence also suggested that protein intake above the US RDA has no adverse effect on blood pressure. At least in the short term (applicable longer term studies are generally lacking), it appears that higher protein within the range of recommended intakes is consistent with normal kidney function in healthy individuals.
So is it all good news with whey protein? It certainly seems that way, but we need more data to draw upon. I do believe, however, that the documented health benefits of higher protein-containing diets – definitely more than the RDA – are likely to far outweigh concerns.
For those who are approaching older age, it’s probably a good idea to find ways to increase the amount of high-quality protein in the diet, although the effectiveness of such an intervention may reduce at the far end of the aging scale.
This blog contains material and information intended for B2B customers, suppliers and distributors, and is not intended as information to the final consumers.