Relationship between protein intake and sarcopenia in older adults: A systematic review

Authors

DOI:

https://doi.org/10.15359/ru.39-1.21

Keywords:

sarcopenia, muscle atrophy, muscle mass, muscle strength, aged

Abstract

[Objective] Assess whether low protein intake is related to the development of sarcopenia in older adults. [Methods] This paper included primary studies focused on the relationship between protein intake and sarcopenia or its individual components (low muscle mass and strength and lower physical performance) in adults older than 60 years. The following studies were excluded: projects with no research design, studies with other nutritional interventions, and studies in older individuals with a sarcopenia diagnosis different than the one defined by the European Working Group on Sarcopenia in the Older People, with other comorbidities, or with pharmacological treatment. A systematic search was conducted in four databases, utilizing keywords in combination with Boolean operators. [Results] Out of the 15 studies included, 6 cross-sectional studies and 1 cohort study identified a significant association between low protein intake and an increased risk of sarcopenia, while 3 studies reported no significant association. Furthermore, 3 randomized controlled trials (RCTs) found no significant improvements in the sarcopenia-related components for the protein-supplemented intervention group compared to the control group. Only one randomized controlled study and one secondary data analysis study demonstrated significant improvements in muscle mass within the intervention group. [Conclusions] Low protein intake was significantly associated with a greater development of sarcopenia and lower muscle mass. This association was not observed on individual sarcopenia-related components.

Downloads

Download data is not yet available.

References

Ackermans, L. L. G. C., Rabou, J., Basrai, M., Schweinlin, A., Bischoff, S. C., Cussenot, O., Cancel-Tassin, G., Renken, R. J., Gómez, E., Sánchez-González, P., Rainoldi, A., Boccia, G., Reisinger, K. W., Ten Bosch, J. A. y Blokhuis, T. J. (2022). Screening, diagnosis and monitoring of sarcopenia: When to use which tool? Clinical Nutrition ESPEN, 48, 36-44. https://doi.org/10.1016/j.clnesp.2022.01.027

Akehurst, E., Scott, D., Rodriguez, J. P., Gonzalez, C. A., Murphy, J., McCarthy, H., Dorgo, S. y Hayes, A. (2021). Associations of sarcopenia components with physical activity and nutrition in Australian older adults performing exercise training. BMC Geriatrics, 21(1). https://doi.org/10.1186/s12877-021-02212-y

Amasene, M., Besga, A., Echeverria, I., Urquiza, M., Ruiz, J. R., Rodriguez-Larrad, A., Aldamiz, M., Anaut, P., Irazusta, J. y Labayen, I. (2019). Effects of Leucine-Enriched Whey Protein Supplementation on Physical Function in Post-Hospitalized Older Adults Participating in 12-Weeks of Resistance Training Program: A Randomized Controlled Trial. Nutrients, 11(10), 2337. https://doi.org/10.3390/NU11102337

Aquiles, W., Loyola, S., Amafi, G., Corrales, L., Ganz, F., Caro, H. G. y Probst, V. S. (2020). Sarcopenia, definición y diagnóstico: ¿Necesitamos valores de referencia para adultos mayores de Latinoamérica? Revista Chilena de Terapia Ocupacional, 20(2), 259-267. https://doi.org/10.5354/0719-5346.2020.53583

Asamblea Médica Mundial. (2014). Declaración de Helsinki de la AMM: Principios éticos para las investigaciones médicas en seres humanos. Asociación Médica Mundial. https://www.wma.net/es/policies-post/declaracion-de-helsinki-de-la-amm-principios-eticos-para-las-investigaciones-medicas-en-seres-humanos/

Bauer, J., Biolo, G., Cederholm, T., Cesari, M., Cruz-Jentoft, A. J., Morley, J. E.,… y Boirie, Y. (2013). Evidence-based recommendations for optimal dietary protein intake in older people: A position paper from the prot-age study group. Journal of the American Medical Directors Association, 14(8). https://doi.org/10.1016/j.jamda.2013.05.021

Bauer, J., Morley, J. E., Schols, A. M. W. J., Ferrucci, L., Cruz-Jentoft, A. J., Dent, E.,… y Anker, S. D. (2019). Sarcopenia: A Time for Action. An SCWD Position Paper. Journal of Cachexia, Sarcopenia and Muscle, 10(5), 956-961. https://doi.org/10.1002/JCSM.12483

Camargo, J. B. B. De y Oliveira, A. F. de. (2022). Protein Supplementation for Strength and Functionality in Older Adults: Is There Still Any Doubt? A Brief Update Review. Journal of Aging and Physical Activity, 31(2), 311-318. https://doi.org/10.1123/JAPA.2022-0015

Cárdenas Quintana, H., Vidal, C. B., Parra, M. F. y Arancibia, E. H. (2004). Evaluación nutricional de un grupo de adultos mayores residentes en Perú. Revista Cubana de Salud Pública, 30(3). https://www.redalyc.org/articulo.oa?id=21430303

Coelho-Junior, H. J., Calvani, R., Azzolino, D., Picca, A., Tosato, M., Landi, F.,… y Marzetti, E. (2022). Protein Intake and Sarcopenia in Older Adults: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 19(14), 8718. https://doi.org/10.3390/IJERPH19148718/S1

Cruz-Jentoft, A. J., Bahat, G., Bauer, J., Boirie, Y., Bruyère, O., Cederholm, T.,… y Schols, J. (2019). Sarcopenia: Revised European consensus on definition and diagnosis. Age and Ageing, 48(1), 16-31. https://doi.org/10.1093/ageing/afy169

Cruz-Jentoft, A. J., Triana, F. C., Gómez-Cabrera, M. C., López-Soto, A., Masanés, F., Martín, P. M.,… y Formiga, F. (2011). La eclosión de la sarcopenia: Informe preliminar del Observatorio de la Sarcopenia de la Sociedad Española de Geriatría y Gerontología. Revista Española de Geriatría y Gerontología, 46(2), 100-110. https://doi.org/10.1016/J.REGG.2010.11.004

Deutz, N. E. P., Bauer, J. M., Barazzoni, R., Biolo, G., Boirie, Y., Bosy-Westphal, A.,… y Calder, P. C. (2014). Protein intake and exercise for optimal muscle function with aging: Recommendations from the ESPEN Expert Group. Clinical Nutrition, 33(6), 929-936. https://doi.org/10.1016/J.CLNU.2014.04.007

Dorhout, B. G., Overdevest, E., Tieland, M., Nicolaou, M., Weijs, P. J. M., Snijder, M. B.,… y De Groot, L. C. (2020). Sarcopenia and its relation to protein intake across older ethnic populations in the Netherlands: the HELIUS study, Ethnicity & Health, 27(3), 705-720. https://doi.org/10.1080/13557858.2020.1814207

Granic, A., Mendonça, N., Sayer, A. A., Hill, T. R., Davies, K., Siervo, M., Mathers, J. C., y Jagger, C. (2020). Effects of dietary patterns and low protein intake on sarcopenia risk in the very old: The Newcastle 85+ study. Clinical Nutrition, 39(1), 166-173. https://doi.org/10.1016/j.clnu.2019.01.009

Griffen, C., Duncan, M., Hattersley, J., Weickert, M. O., Dallaway, A. y Renshaw, D. (2022). Effects of resistance exercise and whey protein supplementation on skeletal muscle strength, mass, physical function, and hormonal and inflammatory biomarkers in healthy active older men: a randomised, double-blind, placebo-controlled trial. Experimental Gerontology, 158, 111651. https://doi.org/10.1016/J.EXGER.2021.111651

Guillamón Escudero, C., Soriano, J. M., Diago Galmés, Á., Tenías Burillo, J. M. y Fernández Garrido, J. (2021). Ingesta proteica en mujeres posmenopáusicas residentes en la comunidad y su relación con la sarcopenia. Nutrición Hospitalaria, 38(6), 1209-1216. https://doi.org/10.20960/NH.03690

Hengeveld, L. M., Boer, J. M. A., Gaudreau, P., Heymans, M. W., Jagger, C., Mendonça, N., Ocké, M. C.,… y Visser, M. (2020). Prevalence of protein intake below recommended in community-dwelling older adults: a meta-analysis across cohorts from the PROMISS consortium. Journal of Cachexia, Sarcopenia and Muscle, 11(5). https://doi.org/10.1002/jcsm.12580

Højfeldt, G., Nishimura, Y., Mertz, K., Schacht, S. R., Lindberg, J., Jensen, M.,… y Holm, L. (2020). Daily protein and energy intake are not associated with muscle mass and physical function in healthy older individuals—a cross-sectional study. Nutrients, 12(9), 1-16. https://doi.org/10.3390/nu12092794

Ingestas Dietéticas de Referencia (IDR) para la Población Española. (2010). Actividad Dietética, 14(4). https://doi.org/10.1016/S1138-0322(10)70039-0

Instituto Nacional de Estadística e informática (INEI). (2023). Situación de la población adulta mayor. Informe técnico, Lima, Perú. https://m.inei.gob.pe/media/MenuRecursivo/boletines/01-informe-tecnico-poblacion-adulta-mayor-oct-nov-dic-2022.pdf

Joint FAO/WHO/UNU Expert Consultation. (2002). Protein and amino acid requirements in human nutrition. WHO Library Cataloguing-in Publication Data, 935. https://iris.who.int/bitstream/handle/10665/43411/WHO_TRS_935_eng.pdf

Kamińska, M. S., Rachubińska, K., Grochans, S., Skonieczna-Żydecka, K., Cybulska, A. M., Grochans, E. y Karakiewicz, B. (2023). The Impact of Whey Protein Supplementation on Sarcopenia Progression among the Elderly: A Systematic Review and Meta-Analysis. Nutrients, 15(9), 2039. https://iris.who.int/bitstream/handle/10665/43411/WHO_TRS_935_eng.pdf

Kim, D. y Park, Y. (2020). Amount of Protein Required to Improve Muscle Mass in Older Adults. Nutrients, 12(6), 1700. https://doi.org/10.3390/NU12061700

Kirk, B., Mooney, K., Amirabdollahian, F. y Khaiyat, O. (2019). Exercise and dietary-protein as a countermeasure to skeletal muscle weakness: Liverpool Hope University - Sarcopenia aging trial (LHU-SAT). Frontiers in Physiology, 10, 445. https://doi.org/10.3389/fphys.2019.00445

Krok-Schoen, J. L., Archdeacon Price, A., Luo, M., Kelly, O. J. y Taylor, C. A. (2019). Low Dietary Protein Intakes and Associated Dietary Patterns and Functional Limitations in an Aging Population: A NHANES Analysis. The Journal of Nutrition, Health & Aging, 23(4), 338. https://doi.org/10.1007/S12603-019-1174-1

Mendonça, N., Granic, A., Mathers, J. C., Hill, T. R., Siervo, M., Adamson, A. J.y Jagger, C. (2018). Prevalence and determinants of low protein intake in very old adults: insights from the Newcastle 85+ Study. European Journal of Nutrition, 57(8), 2713-2722. https://doi.org/10.1007/s00394-017-1537-5

Moher, D., Liberati, A., Tetzlaff, J. y Altman, D. G. (2009). Preferred Reporting items for systematic reviews and meta-analyses: The PRISMA statement. BMJ (clinical Research Ed.), 339, b2535. https://doi.org/10.1136/bmj.b2535

Montiel-Rojas, D., Nilsson, A., Santoro, A., Bazzocchi, A., de Groot, L. C. P. G. M., Feskens, E. J.,… y Kadi, F. (2020). Fighting sarcopenia in ageing european adults: The importance of the amount and source of dietary proteins. Nutrients, 12(12), 1-11. https://doi.org/10.3390/nu12123601

Murillo Noa, J. (2020). Relación entre la sarcopenia e ingesta de proteínas en adultos mayores de la “Casa del Adulto Mayor Aeropuerto”, Callao [Tesis de licenciatura, Universidad Nacional Mayor de San Marcos]. Repositorio Institucional UNMSM. https://cybertesis.unmsm.edu.pe/handle/20.500.12672/14204

Nikolov, J., Norman, K., Buchmann, N., Spranger, J., Demuth, I., Steinhagen-Thiessen, E., Spira, D. y Mai, K. (2021). Association between meal-specific daily protein intake and lean mass in older adults: results of the cross-sectional BASE-II study. American Journal of Clinical Nutrition, 114(3), 1141-1147. https://doi.org/10.1093/ajcn/nqab144

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D.,… y Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372 (71). https://doi.org/10.1136/bmj.n71

Papaioannou, K. G., Nilsson, A., Nilsson, L. M. y Kadi, F. (2021). Healthy eating is associated with sarcopenia risk in physically active older adults. Nutrients, 13(8). https://doi.org/10.3390/nu13082813

Park, Y. J., Chung, S., Hwang, J. T., Shon, J. y Kim, E. (2022). A review of recent evidence of dietary protein intake and health. Nutrition Research and Practice, 16(1), 37-46. https://doi.org/10.4162/nrp.2022.16.S1.S37

Pereyra-Mosquera, M., Revilla-Merino, A., Falvy-Bockos, I., Gutierrez, M., Ibañez, A., Gutierrez, E. L. y Runzer-Colmenares, F. M. (2023). Asociación entre sarcopenia e índice de masa corporal en adultos mayores. Anales de La Facultad de Medicina, 84(2). https://doi.org/10.15381/anales.v84i2.25153

Petermann-Rocha, F., Balntzi, V., Gray, S. R., Lara, J., Ho, F. K., Pell, J. P. y Celis-Morales, C. (2022). Global prevalence of sarcopenia and severe sarcopenia: a systematic review and meta-analysis. Journal of Cachexia, Sarcopenia and Muscle, 13(1), 86-99. https://doi.org/10.1002/jcsm.12783

Ramos-Ramirez, K. E., Soto, A., Ramos-Ramírez, K. E. y Soto, A. (2020). Sarcopenia, mortalidad intrahospitalaria y estancia hospitalaria prolongada en adultos mayores internados en un hospital de referencia peruano. Acta Médica Peruana, 37(4), 447-454. https://doi.org/10.35663/AMP.2020.374.1071

Rendón-Rodríguez, R. y Osuna-Padilla, A. (2018). El papel de la nutrición en la prevención y manejo de la sarcopenia en el adulto mayor. Nutrición Clínica en Medicina, 1, 23-36. https://doi.org/10.7400/NCM.2018.12.1.5060

Rethlefsen, M. L., Kirtley, S., Waffenschmidt, S., Ayala, A. P., Moher, D., Page, M. J. y Koffel, J. B. (2021). PRISMA-S: An extension to the PRISMA statement for reporting literature searches in systematic reviews. Systematic reviews, 10, 1-19. https://doi.org/10.1186/s13643-020-01542-z

Rodríguez, J. H., Domínguez, Y. A. y Licea Puig, M. E. (2019). Sarcopenia and some of its most important features. Revista Cubana de Medicina General Integral, 35(3), 1-19. http://scielo.sld.cu/scielo.php?pid=S0864-21252019000300009&script=sci_arttext&tlng=en

Rodríguez-Rejón, A. I., Ruiz-López, M. D. y Artacho, R. (2019). Diagnosis and prevalence of sarcopenia in long-term care homes: Ewgsop2 versus ewgsop1. Nutrición Hospitalaria, 36(5), 1074-1080. https://doi.org/10.20960/nh.02573

Rojas Bermúdez, C., Buckcanan Vargas, A. y Benavides Jiménez, G. (2019). Sarcopenia: abordaje integral del adulto mayor. Revista Médica Sinergia, 4(5), 24-34. https://doi.org/10.31434/rms.v4i5.194

Shafiee, G., Heshmat, R., Ostovar, A., Khatami, F., Fahimfar, N., Arzaghi, S. M., Gharibzadeh, S., Hanaei, S., Nabipour, I. y Larijani, B. (2020). Comparison of EWGSOP-1and EWGSOP-2 diagnostic criteria on prevalence of and risk factors for sarcopenia among Iranian older people: the Bushehr Elderly Health (BEH) program. Journal of Diabetes and Metabolic Disorders, 19(2). https://doi.org/10.1007/s40200-020-00553-w

So, E. y Joung, H. (2020). Effect of Dairy Protein Intake on Muscle Mass among Korean Adults: A Prospective Cohort Study. Nutrients, 12(9), 2537. https://doi.org/10.3390/NU12092537

Tagliafico, A. S., Bignotti, B., Torri, L. y Rossi, F. (2022). Sarcopenia: how to measure, when and why. La Radiologia Médica, 127 (3),228-237. https://doi.org/10.1007/s11547-022-01450-3

Ten Haaf, D. S. M., Eijsvogels, T. M. H., Bongers, C. C. W. G., Horstman, A. M. H., Timmers, S., de Groot, L. C. P. G. M. y Hopman, M. T. E. (2019). Protein supplementation improves lean body mass in physically active older adults: a randomized placebo-controlled trial. Journal of Cachexia, Sarcopenia and Muscle, 10(2), 298-310. https://doi.org/10.1002/JCSM.12394

Valent, D., Peball, M., Krismer, F., Lanbach, A., Zemann, S., Horlings, C., Poewe, W. y Seppi, K. (2022). Different assessment tools to detect sarcopenia in patients with Parkinson’s disease. Frontiers in Neurology, 13. https://doi.org/10.3389/fneur.2022.1014102

Vidal Cuéllar, C. L., Mas Ubillús, G. y Tello Rodríguez, T. (2021). Screening de sarcopenia y factores relacionados en adultos mayores de un hospital general en Lima, Perú. Universidad Peruana Cayetano Heredia. https://hdl.handle.net/20.500.12866/10129

Vinson, J., Wang, W., Voulgaridou, G., Papadopoulou, S. D., Spanoudaki, M., Kondyli, F. S., Alexandropoulou, I., Michailidou, S., Zarogoulidis, P., Matthaios, D., Giannakidis, D., Romanidou, M. y Papadopoulou, S. K. (2023). Increasing Muscle Mass in Elders through Diet and Exercise: A Literature Review of Recent RCTs. Foods, 12(6), 1218. https://doi.org/10.3390/FOODS12061218

Yeung, S. S. Y., Trappenburg, M. C., Meskers, C. G. M., Maier, A. B. y Reijnierse, E. M. (2020). Inadequate energy and protein intake in geriatric outpatients with mobility problems. Nutrition Research, 84, 33-41. https://doi.org/10.1016/j.nutres.2020.09.007

Yuan, S. y Larsson, S. C. (2023). Epidemiology of sarcopenia: Prevalence, risk factors, and consequences. Metabolism, 144. https://doi.org/10.1016/j.metabol.2023.155533

Zanini, B., Simonetto, A., Zubani, M., Castellano, M. y Gilioli, G. (2020). The Effects of Cow-Milk Protein Supplementation in Elderly Population: Systematic Review and Narrative Synthesis. Nutrients, 12(9), 1-26. https://doi.org/10.3390/NU12092548

Published

2025-11-30

Issue

Section

Original scientific papers (evaluated by academic peers)

How to Cite

Pérez-Cruz, P. J., Peña-Lévano, J. J., Obregón-La Rosa, A. J., & Paca-Palao, A. Y. (2025). Relationship between protein intake and sarcopenia in older adults: A systematic review. Uniciencia, 39(1), 1-18. https://doi.org/10.15359/ru.39-1.21