Protein Recommendations Are Too Low For Older Adults Having Type II Diabetes Mellitus
A randomised pilot study.
The study investigated how increased dietary protein intake affects muscle mass, strength, physical performance, and diabetes progression in middle-aged and older adults with type 2 diabetes mellitus (T2DM).
PMID: 39751920
Key Points
Aim
The study aimed to assess whether a higher protein intake could improve muscle-related outcomes and physical performance in adults over 55 years with T2DM who also had low muscle mass, strength, or poor physical performance.
Methods
Design: 12-week randomised, controlled, parallel pilot study.
Participants: 26 adults with T2DM, aged over 55, exhibiting sarcopenic features.
Intervention: Two groups were compared:
Control group: protein intake of 0.8-1.0 g/kg/day (current recommended intake).
Intervention group: protein intake of 1.2-1.5 g/kg/day.
Measurements: Body composition (skeletal muscle index [SMI], appendicular lean mass [ALM]), muscle strength (hand grip strength [HGS]), physical performance (gait speed [GS], standing balance [SB], timed-up-and-go test), and metabolic markers were assessed before and after the intervention.
Results
The intervention group (1.2-1.5 g/kg/day protein) showed significant improvements in hand grip strength (p < 0.001) and physical performance measures including timed-up-and-go (p < 0.001), gait speed (p = 0.011), and standing balance (p = 0.022).
The control group (0.8-1.0 g/kg/day protein) experienced significant declines in appendicular lean mass (p = 0.014), skeletal muscle index (p = 0.011), and hand grip strength (p = 0.011).
Both groups showed similar changes in metabolic markers related to diabetes progression, indicating that increased protein intake did not alter the course of T2DM within the study period.
Related
Practical Takeaways
The current protein intake recommendations (0.8-1.0 g/kg/day) are insufficient to prevent muscle loss in middle-aged and older adults with T2DM.
Increasing protein intake to 1.2-1.5 g/kg/day can improve muscle strength and physical performance, which are critical for maintaining independence and reducing sarcopenia risk in this population.
Despite these musculoskeletal benefits, higher protein intake alone does not appear to affect the progression of T2DM over 12 weeks.
For individuals with T2DM concerned about muscle loss, adjusting dietary protein upwards within this range could be a beneficial strategy alongside other diabetes management approaches.
Key Takeaways
Higher protein intake (1.2-1.5 g/kg/day) improves muscle strength and physical function in older adults with T2DM.
Standard protein recommendations (0.8-1.0 g/kg/day) may not be adequate to prevent sarcopenia in this group.
Increased protein intake does not significantly impact diabetes metabolic markers or progression in the short term.
Nutritional strategies for T2DM should consider protein intake as a component of musculoskeletal health but not as a standalone intervention for glycemic control.
This study provides evidence supporting a revision of protein intake guidelines for older adults with T2DM to better maintain muscle health and physical performance, which are vital for quality of life and functional independence.
Reference
Argyropoulou D, Nomikos T, Terzis G, Tataki S, Geladas ND, Paschalis V. The effects of dietary protein on physical performance and body composition in middle age and older people having type II diabetes mellitus: a randomised pilot study. Eur J Nutr. 2025 Jan 3;64(1):63. doi: 10.1007/s00394-024-03575-9. PMID: 39751920.