The importance of protein for Aged Care residents

Protein is an essential macronutrient required in the diet to build and repair tissues ⁵ in addition to providing a source of energy.

The amount of protein we require in our diets depends on age, body weight, level of physical activity and health status. Evidence shows that older adults need more dietary protein than do younger adults to support good health, promote recovery from illness, and maintain functionality ⁴

According to the National Health & Medical Research Council which provides guidance on meeting nutritional requirements, the recommended daily intake for protein in older persons ² is detailed in the below table.

Current advice for healthy older adults is to consume 25-30g of protein per meal to help meet daily requirements ^4. However, more research is needed to help better fine tune protein intake recommendations in older adults including those in aged care settings ⁴.

Aged care residents should be consuming a variety of nutrient dense foods which contain a good source of protein to help meet their daily protein requirements. According to Food Standards Australia New Zealand (FSANZ), a source of protein must contain at least 5g of protein per serve, and a good source must contain at least 10g of protein per serve. Dietary protein can be obtained from animal and/or plant sources. See some examples below;

• Animal based – chicken, beef, pork, eggs, fish, dairy products (cheese, yoghurt, milk)

• Plant based– soy-based foods, grains such as quinoa, legumes such as chickpeas and lentils

It is important that vegetarian residents are encouraged to choose additional protein containing meals and snacks to ensure they meet their requirements.

To help older persons meet their daily protein requirements, the Australian Guide to Healthy Eating (AGHE, 2013) ³ recommends the following serves of the below protein contributing food groups;

For further information on what constitutes a ‘serve’ of the above food groups, please visit the Eat for Health website below;

https://www.eatforhealth.gov.au/food-essentials/how-much-do-we-need-each-day/serve-sizes

The Australian Institute of Health and Welfare (AIWH) 2018 reported that the majority (99%) of older persons (71 years plus), do not meet the recommended serves of the AGHE dairy products and alternatives food group, on average only consuming 1 serve/day. Only 1 in 10 women (over 71 years) met the recommended serves for meat and meat alternatives daily. If older persons, including those in aged care residents are not meeting the recommended serves of AGHE dairy and dairy alternatives and meat and meat alternatives food groups for older persons, then it proves very difficult for them to consume adequate protein over the day.

Below are some tips for chefs to help aged care residents meet protein requirements by consuming enough protein containing foods throughout the day;

1. Include protein containing foods at each meal time (e.g. beef, fish, egg, cheese, milk, nuts or legumes) ⁷
2. A dairy desert providing ½ AGHE serve included at least once a day ⁸
3. Add protein containing foods to soups where possible (shredded chicken, fish, legumes such as lentils, milk, milk powder) ⁸
4. Add protein containing foods to salads, for example cheese and meat and meat alternatives (legumes) food group⁸
5. Try to include protein containing foods at breakfast, such as ½ to 1 AGHE meat and alternatives serve at breakfast ⁸
6. For vegetarian meals, such as pastas, soups, and salads, add at least 1 AGHE serve of meat alternatives ⁸
7. Consider offering a soup with a higher meat/meat alternative/dairy content on the days that the main item has a lower protein content ⁸

References

1. Protein Requirements and Recommendations for Older People: A Review Caryl Nowson and Stella O’Connell. Nutrients 2015, &, 6874-6899
2. Nutrient Reference Values (NRV’s) for Australia and New Zealand 2006 (Protein). National Health and Medical Research Council
   Source: https://www.nrv.gov.au/nutrients/protein
3. Australian Dietary Guidelines, 2013
4. Bauer J et al. Evidence-based recommendations for optimal dietary protein in older people: a position paper from the PROT-AGE Study Group. Am J Med Dir Assoc, 2013 Aug;14(8):542-59
5. Best Practice Food and Nutrition Manual for Aged Care Edition 2. NSW Government Central Coast, Local Health District
6. Australian Institute of Health and Welfare (AIWH). Nutrition across the life stages (71 years and older)
7. National Meal Guidelines, a guide for service providers, caterers, health professionals providing home delivered and centre based meal programs for older Australians (2016)
8. DAA Menu Audit tool for Aged Care Homes 2016 (Anne Schneyder and Julie Dundon, Nutrition Professional Australia).