Should We Increase Our Protein Intake After Age 65?

A study that purported to show that diets high in meat, eggs, and dairy could be as harmful to health as smoking supposedly suggested that “[p]eople under 65 who eat a lot of meat, eggs, and dairy are four times as likely to die from cancer or diabetes.” But if you look at the actual study, you’ll see that’s simply not true: Those eating a lot of animal protein didn’t have four times more risk of dying from diabetes—they had 73 times the risk. Even those in the moderate protein group, who got 10 to 19 percent of calories from protein, had about 23 times the risk of dying of diabetes compared to those consuming the recommended amount of protein, which comes out to be about 6 to 10 percent of calories from protein, around 50 grams a day.

So, the so-called low protein intake is actually the recommended protein intake, associated with a major reduction in cancer and overall mortality in middle age, under age 65, but not necessarily in older populations. When it comes to diabetes deaths, lower overall protein intake is associated with a longer life at all ages. However, for cancer, it seems to flip around age 65. I discuss this in my video Increasing Protein Intake After Age 65.

“These results suggest that low protein intake during middle age followed by moderate to high protein consumption in old adults may optimize healthspan and longevity.” Some have suggested that the standard daily allowance for protein, which is 0.8 grams of daily protein for every healthy kilogram of body weight, may be fine for most, but perhaps older people require more. The study upon which the recommended daily allowance (RDA) was based indicated that, though there was a suggestion that the “elderly may have a somewhat higher requirement, there is not enough evidence to make different recommendations.” The definitive study was published in 2008 and found no difference in protein requirements between young and old. The same RDA should be adequate for the elderly. However, adequate intake is not necessarily optimal intake. The protein requirement “studies have not addressed the possibility that protein intake well above the RDA could prove beneficial,” or so suggests a member of the Whey Protein Advisory Panel for the National Dairy Council and a consultant for the National Cattlemen’s Beef Association.

A study followed sedentary individuals over the age of 65 for 12 years and found they lose about one percent of their muscle mass every year. If you force people to lie in bed for days at a time, anyone would lose muscle mass, but older adults on bedrest may lose muscle mass six times faster than young people also on bedrest. So, it’s use it or lose it for everyone, but the elderly appear to lose muscle mass faster, so they better use it. The good news is that in contrast to the 12-year U.S. study, a similar study in Japan found that the “[a]ge-related decreases in muscle mass were trivial.” Why the difference? It turns out that in the Japanese study, “the participants were informed about the results of their muscle strength, [so] they often tried to improve it by training before the next examination.” This was especially true among the men , who got so competitive their muscle mass increased with age, which shows that the loss of muscle mass with age is not inevitable—you just have to put in some effort. And, research reveals that adding protein doesn’t seem to help. Indeed, adding more egg whites to the diet didn’t influence the muscle responses to resistance training, and that was based on studies funded by the American Egg Board itself. Even the National Dairy Council couldn’t spin it: Evidently, strength “training-induced improvements in body composition, muscle strength and size, and physical functioning are not enhanced when older people…increase their protein intake by either increasing the ingestion of higher-protein foods or consuming protein-enriched nutritional supplements.”

Is there anything we can do diet-wise to protect our aging muscles? Eat vegetables. Consuming recommended levels of vegetables was associated with basically cutting in half the odds of low muscle mass. Why? “[T]he alkalizing effects of vegetables may neutralize the mild metabolic acidosis” that occurs with age, when that little extra acid in our body facilitates the breakdown of muscle. I’ve discussed before how “[m]uscle wasting appears to be an adaptive response to acidosis.” (See my video Testing Your Diet with Pee and Purple Cabbage for more on this.) We appear to get a chronic low-grade acidosis with advancing age because our kidney function starts to decline and because we may be eating an acid-promoting diet, which means a diet high in fish, pork, chicken, and cheese, and low in fruits and vegetables. Beans and other legumes are the only major sources of protein that are alkaline instead of acid-forming. And indeed, a more plant-based diet—that is, a more alkaline diet—was found to be positively associated with muscle mass in women aged 18 to 79.

So, if we are going to increase our protein consumption after age 65, it would preferably be plant-based proteins to protect us from frailty. No matter how old we are, a diet that emphasizes plant-based nutrition “is likely to maximize health benefits in all age groups.”


What was that about a study that purported to show that diets high in meat, eggs, and dairy could be as harmful to health as smoking? See my video Animal Protein Compared to Cigarette Smoking.

Protein is so misunderstood. For more on the optimal amount of protein, see Do Vegetarians Get Enough Protein? and The Great Protein Fiasco.

Interested in learning more about the optimal source of protein? See:

What about the rumors that plant protein is incomplete? See The Protein Combining Myth.

For information on buffering the acid in our blood, see Testing Your Diet with Pee and Purple Cabbage.

And, for more on acid/base balance, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Dialing Down the Grim Reaper Gene

Only about 1 in 10,000 people live to be a 100 years old. What’s their secret? I discuss this in my video Animal Protein Compared to Cigarette Smoking.

In 1993, a major breakthrough in longevity research was published about a single genetic mutation that doubled the lifespan of a tiny roundworm. Instead of all worms being dead by 30 days, the mutants lived 60 days or longer. This lifespan extension was “the largest yet reported in any organism.” This methuselah worm, a “medical marvel,” is “the equivalent of a healthy 200-year-old human.” All because of a single mutation? That shouldn’t happen. Presumably, aging is caused by multiple processes, affected by many genes. How could knocking out a single gene double lifespan?

What is this aging gene—a gene that so speeds up aging that if it’s knocked out, the animals live twice as long? It’s been called the Grim Reaper gene and is the worm equivalent of the human insulin-like growth factor 1 (IGF-1) receptor. Mutations of that same receptor in humans may help explain why some people live to be a hundred and other people don’t.

So, is it just the luck of the draw whether we got good genes or bad ones? No, we can turn on and off the expression of these genes, depending on what we eat. Years ago I profiled a remarkable series of experiments about IGF-1, a cancer-promoting growth hormone released in excess amounts by our liver when we eat animal protein. Men and women who don’t eat meat, egg white, or dairy proteins have significantly lower levels of IGF-1 circulating within their bodies, and switching people to a plant-based diet can significantly lower IGF-1 levels within just 11 days, markedly improving the ability of women’s bloodstreams to suppress breast cancer cell growth and then kill off breast cancer cells.

Similarly, the blood serum of men on a plant-based diet suppresses prostate cancer cell growth about eight times better than before they changed their diet. However, this dramatic improvement in cancer defenses is abolished if just the amount of IGF-1 banished from their systems as a result of eating and living healthier is added back. This is one way to explain the low rates of cancer among plant-based populations: The drop in animal protein intake leads to a drop in IGF-1, which in turn leads to a drop in cancer growth. The effect is so powerful that Dr. Dean Ornish and colleagues appeared to be able to reverse the progression of early-stage prostate cancer without chemotherapy, surgery, or radiation—just a plant-based diet and lifestyle program.

When we’re kids, we need growth hormones to grow. There’s a rare genetic defect that causes severe IGF-1 deficiency, leading to a type of dwarfism. It also apparently makes you effectively cancer-proof. A study reported not a single death from cancer in about 100 individuals with IGF-1 deficiency. What about 200 individuals? None developed cancer. Most malignant tumors are covered in IGF-1 receptors, but if there’s no IGF-1 around, they may not be able to grow and spread.

This may help explain why lives appear to be cut short by eating low-carb diets. It’s not just any low-carb diet, though. Specifically, low-carb diets based on animal sources appear to be the problem, whereas vegetable-based low-carb diets were associated with a lower risk of death. But low-carb diets are high in animal fat as well as animal protein, so how do we know the saturated animal fat wasn’t killing off people and it had nothing to do with the protein? What we need is a study that follows a few thousand people and their protein intakes for 20 years or so, and sees who lives longest, who gets cancer, and who doesn’t. But, there had never been a study like that…until now.

Six thousand men and women over age 50 from across the United States were followed for 18 years, and those under age 65 with high protein intakes had a 75 percent increase in overall mortality and a fourfold increase in the risk of dying from cancer. Does it matter what type of protein? Yes. “These associations were either abolished or attenuated if the proteins were plant derived,” which makes sense given the higher IGF-1 levels in those eating excess protein.

The sponsoring university sent out a press release with a memorable opening line: “That chicken wing you’re eating could be as deadly as a cigarette.” It explained that “eating a diet rich in animal proteins during middle age makes you four times more likely to die of cancer than someone with a low-protein diet—a mortality risk factor comparable to smoking.” And when they say “low-protein diet,” what they actually mean is getting the recommended amount of protein.

“Almost everyone is going to have a cancer cell or pre-cancer cell in them at some point. The question is: Does it progress?” said one of the lead researchers. That may depend on what we eat.

“[T]he question is not whether a certain diet allows you to do well for three days,” a researcher noted, “but can it help you survive to be 100?” Excessive protein consumption isn’t only “linked to a dramatic rise in cancer mortality, but middle-aged people who eat lots of proteins from animal sources…are also more susceptible to early death in general.” Crucially, the same didn’t apply to plant proteins like beans, and it wasn’t the fat; the animal protein appeared to be the culprit.

What was the response to the revelation that diets high in meat, eggs, and dairy could be as harmful to health as smoking? One nutrition scientist replied that it was potentially dangerous because it could “damage the effectiveness of important public health messages.” Why? Because a smoker might think “why bother quitting smoking if my cheese and ham sandwich is just as bad for me?”

This reminds me of a famous Philip Morris cigarette ad that tried to downplay the risks of smoking by saying that if we think second-hand smoke is bad, increasing the risk of lung cancer 19 percent, drinking one or two glasses of milk every day may be three times as bad with a 62 percent higher risk of lung cancer. What’s more, doubling the risk is frequently cooking with oil, tripling our risk of heart disease is eating non-vegetarian, and multiplying our risk six-fold is eating lots of meat and dairy. So, they conclude, “Let’s keep a sense of perspective.” The ad goes on to say that the risk of cancer from second-hand smoke may be “well below the risk reported…for many everyday items and activities.” So, breathe deep!

That’s like saying we shouldn’t worry about getting stabbed because getting shot is so much worse. Or, if we don’t wear seatbelts, we might as well have unprotected sex. If we go bungee jumping, we might as well disconnect our smoke alarms at home. Two risks don’t make a right.

Of course, you’ll note Philip Morris stopped throwing dairy under the bus once they purchased Kraft Foods.


The IGF-1 story is so pivotal that it’s one of the first video series I ever produced for NutritionFacts.org. I’m so glad I was able to release this long-awaited update. If you want a blast from the past, watch the original series starting with Engineering a Cure.

For more parallels between the tobacco industry and the food industry, see:

What about the mobile phone industry? Does Cell Phone Radiation Cause Cancer?

For more on healthy aging and longevity, see:

It’s important to note the so-called low protein intake is actually the recommended protein intake, which is associated with a major reduction in cancer and overall mortality in middle age, under age 65. But did you notice that it says not among older individuals? All of this is covered in my video Increasing Protein Intake After Age 65.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Do You Have to Combine Plant Proteins at a Meal?

All nutrients come from the sun or the soil. Vitamin D, the “sunshine vitamin,” is created when skin is exposed to sunlight. Everything else comes from the ground. Minerals originate from the earth, and vitamins from the plants and micro-organisms that grow from it.

The calcium in a cow’s milk (and in her 200-pound skeleton) came from all the plants she ate, which drew it up from the soil. We can cut out the middle-moo, though, and get calcium directly from the plants.

Where do you get your protein? Protein contains essential amino acids, meaning our bodies can’t make them so they’re essential to get from our diet. But, other animals don’t make them either. All essential amino acids originate from plants and microbes, and all plant proteins have all of the essential amino acids. The only truly “incomplete” protein in the food supply is gelatin, which is missing the amino acid tryptophan, so the only protein source you couldn’t live on is Jell-O.

Those eating plant‑based diets average about twice the estimated average daily protein requirement. Those who don’t know where to get protein on a plant-based diet don’t know beans… (Get it? 🙂 That’s protein quantity, though—what about protein quality?

The concept that plant protein was inferior to animal protein arose from studies performed on rodents more than a century ago. Scientists found that infant rats don’t grow as well on plants. However, infant rats don’t grow as well on human breast milk either. Does that mean we shouldn’t breastfeed our babies? Ridiculous! They’re rats. Rat milk has ten times more protein than human milk because rats grow about ten times faster than human infants.

It is true that some plant proteins are relatively low in certain essential amino acids. So, about 40 years ago, the myth of “protein combining” came into vogue—literally, in the February ’75 issue of Vogue magazine, as I discuss in my video The Protein Combining Myth. The concept was that we needed to eat so-called complementary proteins together (for example, rice and beans) to make up for their relative shortfalls. However, this fallacy was refuted decades ago. The myths that plant proteins are incomplete, aren’t as good as animal proteins, or need to be combined with other proteins at meals have all been dismissed by the nutrition community decades ago, but many in medicine evidently didn’t get the memo. Dr. John McDougall called out the American Heart Association for a 2001 publication that questioned the completeness of plant proteins. Thankfully, they’ve changed and now that “[p]lant proteins can provide enough of the essential and non-essential amino acids” and that we “don’t need to consciously combine…complementary proteins…”

It turns out our body is not stupid.

Our body maintains pools of free amino acids that can be used to do all of the complementing for us, not to mention our body’s massive protein recycling program. Some 90 grams of protein are dumped into the digestive tract every day from our own body to get broken back down and reassembled, so our body can mix and match amino acids to whatever proportions we need, regardless of what we eat, making it practically impossible to even design a diet of whole plant foods that’s sufficient in calories but deficient in protein. Thus, plant-based “consumers do not need to be at all concerned about amino acid imbalances…from the plant-food proteins that make up our usual diets.”


How did all of these myths surrounding protein come to be? Learn about The Great Protein Fiasco.

I cover protein quantity in my Do Vegetarians Get Enough Protein? video.

For more detail on the benefits of protein from plants, see:

Plant protein also doesn’t have the same effect on the cancer-promoting growth hormone IGF-1 that I discuss in the cancer section of my Food as Medicine presentation. Meat-heavy maternal diets may even affect the obesity rates and stress responses of their children, as I explore in my videos Animal Protein, Pregnancy, & Childhood Obesity and Maternal Diet May Affect Stress Responses in Children.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: