Food and healthy aging: protein, Mediterranean eating and supplements

The PROT-AGE study group concluded that older adults need more dietary protein than younger adults to keep muscle and function and to recover from illness. For people over 65 it recommends at least 1.0 to 1.2 g of protein per kilogram of body weight a day, 1.2 g or more for those who exercise, and 1.2 to 1.5 g for most older adults with an acute or chronic illness. People with severe kidney disease who are not on dialysis are the exception and may need to limit protein Bauer 2013. For a 70 kg (154 lb) person, 1.0 to 1.2 g/kg works out to 70 to 84 g a day.

One ounce of meat, fish or poultry, one large egg, a quarter cup of tofu or half a cup of cooked beans or lentils each provide about 7 g of protein MedlinePlus. Spreading it across meals, with some at breakfast, is easier than one large portion at dinner. Beans and lentils, oily fish, eggs, dairy and nuts all count. To see where you are now, log a few typical days in Cronometer.

In PREDIMED, adults at high cardiovascular risk assigned to a Mediterranean diet with extra-virgin olive oil or nuts had fewer major cardiovascular events than those on a lower-fat control diet Estruch 2018. In a substudy of 447 cognitively healthy Barcelona participants (mean age 67), the Mediterranean groups did better on some memory and thinking composites after about four years, while the control group declined on all of them Valls 2015. Only 334 completed follow-up testing, so read the cognitive result as encouraging rather than settled.

COSMOS randomized 21,442 US adults (women 65 and over, men 60 and over) to cocoa extract with 500 mg of flavanols a day, a multivitamin, both or placebo. Cocoa extract did not significantly lower total cardiovascular events over a median 3.6 years, though cardiovascular deaths were lower, a secondary findingSesso 2022. In COSMOS-Mind (2,262 participants), cocoa extract had no effect on cognition over three years, while the daily multivitamin produced a small statistically significant benefit on global cognition Baker 2023. A meta-analysis of three COSMOS cognitive substudies confirmed a modest multivitamin benefit on global cognition and memory Vyas 2024.

So cocoa is fine as food, but the trial gives no reason to buy flavanol capsules for your brain. A daily multivitamin is worth discussing with your clinician; it is not a substitute for food.

In 2018 the USPSTF found adequate evidence that vitamin D supplements do not lower falls in community-dwelling adults 65 and older (without known osteoporosis or vitamin D deficiency) and recommended against them for that purpose Uspstf 2018. Its 2024 update recommends exercise interventions for older adults at higher risk of falling Uspstf 2024. The NIA adds balance and strength training, reviewing your medicines, getting your vision checked and making your home safer Nia. The recommended amount of vitamin D from age 71 is still 20 mcg (800 IU) a day; fortified foods supply most of it in US diets, and fatty fish are among the best natural sources NIH ODS.

Vitamin B12 is the other nutrient to watch: many older adults do not absorb B12 from food well, and the NIH advises people over 50 to get most of theirs from fortified foods or supplements NIH ODS. Thirst can change with age too, so see hydration.