Protein requirements and ageing: metabolic demand and efficiency of utilization

The protein requirements of the elderly were investigated with [13C]leucine balance studies of metabolic demand, the efficiency of postprandial protein utilization (PPU) and the consequent apparent protein requirement. Ten elderly subjects aged 68-91 years (five men and five women) and ten young adult subjects aged 21-31 years (five men and five women) were infused with L-[1-13C]leucine for 9 h commencing in the postabsorptive state (0-3 h), continuing during the half-hourly feeding of low-protein meals (LP; protein 3% energy, 3-6 h), and during similar feeding of isoenergetic higher protein meals (HP; protein 15% energy, 6-9 h). Leucine oxidation and balance were determined from plasma [1-13C]-alpha-ketoisocaproate enrichment and expired 13CO2 excretion measured during the 3rd hour of each 3 h period. The protein intake during the HP phase was similar to the habitual intake estimated in the subjects from 24 h urinary N excretion. Metabolic demand was defined as equal to twice the body-protein equivalent of measured postabsorptive leucine oxidation. The efficiency of PPU was calculated from the increased leucine oxidation observed during feeding, and the apparent protein requirement was defined as metabolic demand/PPU and calculated in relation to both body weight (BW) and fat-free mass (FFM) determined by densitometry or bioimpedance. Metabolic demand in the young adults was 0.83 g protein/kg per d; in both elderly groups it was 36% lower when expressed per kg BW and 30% lower when expressed per kg FFM. The apparent protein requirement calculated from metabolic demand and PPU was 0.99 g protein/kg per d in the young adults and this was also lower in the elderly, although this was only significant in the men (0.66 g per kg BW, P = 0.013; 0.79 g per kg FFM, P = 0.02). The results show that in this group of healthy elderly adults protein requirements as assessed from leucine balance studies were either similar to or less than those of younger adults.