Sarcopenia: ‘Adhering to the RDA for protein would be like white water rafting without a paddle’

“If you put healthy people in their 70s in bed for 10 days, they can lose 10 percent of their total lean leg mass."

Aging populations and the growing threat of degenerative muscle loss (sarcopenia) will provide a lucrative category for brands to target, say industry experts, but the current recommended daily intakes for protein are simply nowhere near enough.

Muscle loss is a natural part of aging, and researchers have estimated that, after the age of 50, we lose 1-2% of our muscles each year. Strength declines as well, at a rate of 1.5% per year beginning at 50 years and accelerating to 3% after the age of 60.

According to a monograph from the US Dairy Export Council, the direct health care cost attributable to sarcopenia were estimated to be $18.5 billion in 2000 in the US, a number that represented about 1.5% of health care expenditures for that year.

 “Sarcopenia is just a fancy way of stating the obvious,” said Jose Antonio, PhD, CEO of the International Society of Sports Nutrition. “As we get older, we lose muscle mass. We become frail and our normal daily activities are often impaired. 

Duffy MacKay, ND, vice president of scientific and regulatory affairs for the Council for Responsible Nutrition (CRN), said, “What’s interesting for me is that muscle loss is a natural part of aging. Even if people don’t develop sarcopenia they will still experience some muscle loss. Bodybuilders who work out into their 80s will continue to look buffed but they will have less muscle mass. It’s the ‘use it or lose it’ situation.”

Dr Douglas Paddon Jones at the University of Texas medical branch told attendees at the IFT show in 2011 that a “horrifying” loss of muscle mass in older people after just a few days of inactivity should serve as a wake-up call for industry to put tackling sarcopenia higher up the priority list.

If you put healthy people in their 70s in bed for 10 days, they can lose 10 percent of their total lean leg mass. That’s a tremendous muscle loss.”

So has the industry heard these calls? Dr MacKay told us that he has heard more conversations within the nutrition industry about sarcopenia, but such conversations may still be limited to scientific circles. Marketing expert Jeff Hilton, partner and co-founder of BrandHive, said that, at this point, most companies see it as a focused, mass market opportunity that primarily revolves around protein.

“I don’t think there is a lot of innovative R&D going on in that segment with new ingredients being researched and cultivated that would have supplement applications,” he said.

Opportunities

While products like Ensure and Boost are already in the market place and positioned for the older consumer. CRN’s Dr MacKay said he could see “some really savvy marketer expand into functional foods, drinks and bars for active elderly people.”

Greg Miller, PhD, President of the Dairy Research Institute and Executive VP of the National Dairy Council, said that, while more protein products have been introduced in the last few years, they haven't been positioned against aging adults. “In fact, many aging adults are not even aware of their needs for increased protein. But if consumer awareness grows it will likely become a bigger opportunity and this could change.”

Any talk about muscle loss is certainly all about protein at this stage, added Hilton. “That said, this market opportunity with seniors is driving protein awareness and functionality to new heights.”

Dr Miller lamented that, although consumers are beginning to recognize the benefits of protein as it relates to a number of health benefits, including satiety and controlling appetite, body composition, sports performance, healthy aging and muscle health, they don’t recognize dairy as a source. 

“Protein is hot and seems to be getting hotter due to the benefits it offers.  Although dairy foods and ingredients such as whey protein are a source of high quality, easy to digest protein, people don’t associate them with protein or its benefits.”

Problems with the recommendations

Despite the increase in awareness of the benefits of protein, concerns have been raised about the current recommendations relating to age-related muscle loss. Indeed, ISSN’s Dr Antonio said that just adhering to the recommendations for protein is not enough. “It is about time that clinicians realized that consuming protein ABOVE the Recommended Dietary Allowance is needed to ameliorate the loss of muscle protein with age,” he said. “Adhering to the RDA for protein would be like white water rafting without a paddle.  It's just plain dumb."

Dr Miller explained that the RDI was established to provide a protein intake amount that meets the nutritional requirements of >97% of all healthy individuals.

“While the current RDI meets this standard, emerging evidence suggests that increasing dietary protein may be beneficial as we age by slowing the effects of sarcopenia or age-related muscle loss.   This is of interest to the consumer because as age-related muscle loss occurs the risk of injury and loss of independence is increased.”

The case for supplements

The RDI issue could also enhance the case for supplements, said CRN’s Dr MacKay. “A lot of the food sources of protein come with fat, so increasing protein in the diet will also lead to increased fat intakes. Supplements offer lean protein without the fat. And we now have all of these cool proteins in the market for all consumers, including dairy, soy, pea, hemp, and so on.”

Chuck Rutkowski, Sr. Marketing Manager, DSM Nutritional Products, told us that, “emerging science suggests that in addition to whole protein intake, specific amino acids such as the branched-chain amino acid leucine may have a role in stimulating muscle growth in the elderly.

“The emerging studies examining the specific role of leucine in muscle health have been very exciting, and we are awaiting the results of additional studies.”

ISSN’s Dr Antonio said that the shifting demographics (increased number of those 65 years plus) will provide a lucrative category for brands to target.  “The 65 year plus demo has plenty of disposable income and are more than willing to take supplements to improve their life's quality.

“HMB (beta-hydroxy-beta-methylbutyrate) is a supplement that has been shown to enhance LBM and may be particularly helpful for older individuals,” he added.

“Our understanding of sarcopenia is still limited,” cautioned DSM’s Rutkowski, “and at present we still don’t even have a widely accepted definition of this health condition. However, as our understanding of sarcopenia increases, it is very likely that public awareness of this condition will increase as well.

“Given the critical role of nutrition in the pathology of sarcopenia, the industry has an opportunity to develop products which focus on the specific dietary needs of those with sarcopenia in order to best support their health.”

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