Benefits of Beef for Older Adults

Written by Maria-Paula Carrillo, MS, RDN, LD

As a society, we now understand that the evolution of medicine, access to public healthcare, and an increased focus on healthy lifestyles, are great avenues that allow us to improve the length and the quality of our life. The World Health Organization (WHO) defines healthy aging as developing and maintaining the functional ability that enables well-being in older age (1). Unfortunately, for many, aging is usually seen as a process in which the loss of physical and cognitive functions are expected to occur over time. Healthy aging therefore refers to an individual’s ability to meet their basic needs and perform their activities of daily living from a social, physical, and cognitive perspective (2).

As human beings age, it is natural for our bodies to experience a breakdown of muscle and bone. Sarcopenia is a condition characterized by the loss of skeletal muscle mass and function – it is strictly correlated with physical disability, poor quality of life and death (3). Fortunately, this does not have to be our path. The amazing work of the late Dr. Paddon-Jones, has repeatedly shown us the benefit of optimal protein intake alongside physical activity (specifically resistance and aerobic exercise), on not only maintaining muscle mass while controlling body fat, but as well as appetite control and satiety (4). As health care professionals, it is essential that we familiarize ourselves with this and similar research, in order to be able to educate our patients and provide recommendations that can allow them to continue to live an independent, active and healthy life.

For the past 15-20 years, studies have found that eating sufficient protein-rich foods will help to preserve lean body mass and prevent sarcopenia. The research was focused however on a daily requirement to prevent a deficiency. More recent research suggests that a better way to advise our aging patients regarding protein intake is to consume about 30 grams of high-quality protein per meal (3 times per day), to prevent sarcopenic muscle loss (4). Unfortunately without guidance, this is not what our aging population and even other age groups, naturally consume. There are a variety of factors that may cause older adults to decrease their protein intake. Some of the most common ones include the following: reduced acuity of taste and smell, reduced appetite and chewing efficiency, acute/chronic illness and medication side effects (5). It has also been suggested that lack of variety in the diet plays an important role in decreased intake in older adults (6). It is essential that during our healthcare visits, we take the time to discuss these known obstacles with our patients. We can provide practical recommendations that can allow them to work towards specific goals.

To strengthen the importance of these guidelines, we now have a variety of studies that support that the same recommended intake of about 30 grams of protein per meal is not only valuable for muscle synthesis, but also good for calcium economy and potentially beneficial to bone health (7). For example, in a case-control study, increased protein intake was associated with a decrease in risk of hip fracture in men and women 50-69 years of age (8). We know bone health and muscle mass maintenance are prime areas of concern in aging adults. We now have great research that allows us to understand how we can help this population maintain and achieve improved overall health and independence. Educating our older patients about adequate protein intake and its equal distribution across meals, can have an impactful role in their health and quality of life.

Another area of significant importance is the concern for micronutrient deficiencies like zinc, selenium, B vitamins, and iron. As mentioned before and cited by Inzitari, et al (2011), aging Americans often limit their intake due to decreased appetite, difficulty in food preparation, or loneliness. These factors can lead to lack of variety in the diet or inadequate intake of several key nutrients. Deficiencies in micronutrients can lead to a higher loss of long-term independence – a highly desired function in those aging. Even more critical, these nutritional gaps can even affect the longevity of older Americans. These declines are mostly due to the adverse functional outcomes that these deficiencies cause(9).

A recent study by Vega-Cabello et al, found that a higher zinc intake was prospectively associated with a lower risk of impaired lower-extremity function and frailty among older adults (10). This suggests that a balanced diet providing adequate zinc, may help preserve physical function and reduce the progression to frailty. Zinc deficiency may lead to loss of appetite, impaired immune function, weight loss, delayed healing of wounds, eye and skin lesions, and smell and taste disturbances (11). Older adults are already highly prone to many of these clinical findings. Promoting a diet that includes zinc-rich foods can help prevent the progression of these ailments.

Moreover, a review in the Molecules Journal points out that insufficient dietary intake of selenium is known to cause cognitive dysfunctions and heart failure in aged persons (12). Data analysis from cross-sectional and longitudinal studies found that selenium concentrations in whole blood were inversely associated with physical function limitations: weakness, lower-extremity performance, mobility and agility (13). Selenium is involved in improving antioxidant defense, immune functions, and metabolic homeostasis. Selenium from food is considered an efficient source of supporting human health.

It is also known that with aging, the prevalence of iron deficiency anemia increases. More than 10% of people ≥65 years have iron deficiency anemia, and this rate doubles in people ≥85 years . The concern is the high frequency of its occurrence, as well as the severity of its consequences. These include fatigue, heart palpitations, pale skin, breathlessness, and more significantly, cognitive impairment and decrease in physical activity(14). The benefits of iron can often go unnoticed until health concerns indicate an individual is not meeting his or her needs.

Additionally, risks regarding deficiencies in B vitamins are also important to note. In older adults, Vitamin B6 (pyridoxine) deficiencies have been associated with a decline in cognitive function, impaired immune function, as well as depression (15). Vitamin B12 (cobalamin) is also a problem in the aging population. This is commonly due to its decreased absorption with the lowered stomach acidity that is present in this age group. On top of that, regularly prescribed and over-the-counter acid blocking medications also block the ability to absorb vitamin B12. The risk of B12 deficiency in older adults can lead to a variety of serious nerve-related effects. These include peripheral neuropathy, balance disturbances, cognitive disturbances, and ultimately physical disability (16). Other findings also show an association between lower vitamin B12 concentrations and greater loss of bone density (8).

Knowing that proper nutrition can prevent most of these detrimental side effects, should be the key that guides our conversations with our patients. It is our professional duty to provide adequate information and practical education to the aging population. Our nutrition recommendations can help older adults address these health concerns or possibly even prevent them. The research is vast and the benefit of a healthy and balanced diet is well known. Encouraging our patients to consume nutrient-rich foods should be at the forefront of our recommendations.

Beef is not only nutritious, but also well-liked by most due to its adaptability and strong flavor profile. Beef contains several essential nutrients, including protein with all essential amino acids, iron, zinc, selenium, riboflavin, niacin, vitamin B6, vitamin B12, phosphorus, pantothenate, magnesium, and potassium (17). For example, a 3-oz serving of cooked lean beef accounts for only a fraction of the daily calorie requirements (8.2%), ~25 grams of dietary protein, ~6.0 mg of zinc (40% daily value) 2.2 μg of B12 (37% daily value), 0.4 mg of B6 (18% daily value), and 2.7 mg of iron (15% daily value)(18). The concern that exists regarding many of these micronutrients being inadequate in the diets of older adults, could be easily alleviated by the consumption of only a few ounces of beef per week.

It is also beneficial to review and understand the results of the BOLD (Beef in an Optimal Lean Diet) study. This controlled- consumption study led by Rousell et al, looked at cholesterol lowering diets with various amounts of lean beef and their effects on low density lipoprotein (LDL) cholesterol. Researchers concluded that the inclusion of lean beef (113 grams per day) or the partial replacement of carbohydrates with protein (including lean beef) in a low-saturated fatty acid (</=7%), DASH-like (Dietary approaches to Stopping Hypertension) diet significantly decreased total cholesterol, and LDL cholesterol compared with a healthy American diet. The results of the BOLD study provide convincing evidence that lean beef can be included in a heart-healthy diet that meets current dietary recommendations and supports a heart healthy diet and lifestyle(19).

There is plenty of research to support the consumption of 3 portions (113 grams per portion) of lean beef a week as part of a healthy diet. The United States Department of Agriculture (USDA), defines acut of cooked fresh meat as “lean” when it contains less than 10 grams of total fat, 4.5 grams or less of saturated fat and less than 95 mg of cholesterol per 100 grams (3½ oz) and per RACC (Reference Amount Customarily Consumed), which is 85 grams (3 oz). containing less than 10 grams of fat and 4.5 grams of saturated fat in a 3.5 ounce serving (~100 grams) (20). Extra-lean cuts of beef contain less than 2 grams of saturated fat and 5 grams of total fat per serving. Extra lean cuts include but are not limited to a 3 ounce cooked serving of: eye of round roast and steak, sirloin tip side steak, top round roast and steak, bottom round roast and steak, top sirloin steak. Other lean cuts include a 3oz cooked serving of: tenderloin, T-Bone, top sirloin, tri-tip, and flat-half brisket(18). For older adults, using ground beef can often be beneficial because of its ease in preparation, variability of uses, as well as its flavor and texture. To be lean, ground beef must have a lean point of 92% lean/8% fat or higher. Extra lean ground beef must have a lean point of 96% lean/4% fat or higher.

As we work with this continuously growing population of aging Americans, we ought to remember to encourage proper nutrition by recommending not only the obvious. Proper hydration, avoiding empty calories and balancing meals should not be forgotten recommendations. We should make a conscious effort to guide them through the importance of variety in their food choices, the power of evenly distributed and adequate protein intake (about 30 grams per meal), as well as the benefit of including nutrient-rich foods like lean beef in their weekly options. Together, we can help improve the quality of life and increase the longevity of older adults.

References

1. World Health Organization. (n.d.). Health Topics: Aging. https://www.who.int/health-topics/ageing#tab=tab_1
2. Ramnath U, Rauch L, Lambert EV, Kolbe-Alexander TL. The relationship between functional status, physical fitness and cognitive performance in physically active older adults: A pilot study. PLoS One. 2018 Apr;13(4).
3. Santilli V, Bernetti A, Mangone M, Paoloni M. Clinical definition of sarcopenia. Clin Cases Miner Bone Metab. 2014 Sep;11(3):177-80.
4. Paddon-Jones D, Leidy H. Dietary protein and muscle in older persons. Curr Opin Clin Nutr Metab Care. 2014 Jan;17(1):5-11.
5. Ni Lochlainn M, Bowyer RCE, Steves CJ. Dietary Protein and Muscle in Aging People: The Potential Role of the Gut Microbiome. Nutrients. 2018 Jul;10(7):929.
6. Hollis JH, Henry CJ. Dietary variety and its effect on food intake of elderly adults. J Hum Nutr Diet. 2007 Aug;20(4):345-51.
7. Surdykowski AK, Kenny AM, Insogna KL, Kerstetter JE. Optimizing bone health in older adults: the importance of dietary protein. Aging health. 2010 Jun;6(3): 345-357.
8. Wengreen HJ, Munger RG, West NA, Cutler DR, Corcoran CD, Zhang J, Sassano NE. Dietary protein intake and risk of osteoporotic hip fracture in elderly residents of Utah. J Bone Miner Res. 2004 Apr;19(4):537-45.
9. Inzitari M, Doets E, Bartali B, Benetou V, Di Bari M, Visser M, Volpato S, Gambassi G, Topinkova E, De Groot L, Salva A; International Association Of Gerontology And Geriatrics (IAGG) Task Force For Nutrition In The Elderly. Nutrition in the age-related disablement process. J Nutr Health Aging. 2011 Aug;15(8):599-604.
10. Vega-Cabello V, et al. Association of Zinc Intake With Risk of Impaired Physical Function and Frailty Among Older Adults. The Journals of Gerontology: Series A, 2022 Oct;77(10):2015-2022.
11. Pisano M, Hilas O; Zinc and Taste Disturbances in Older Adults: A Review of the Literature. The Consultant Pharmacist. 2016 May;31(5):267-270(4).
12. Bjørklund G, Shanaida M, Lysiuk R, Antonyak H, Klishch I, Shanaida V, Peana M. Selenium: An Antioxidant with a Critical Role in Anti-Aging. Molecules. 2022 Oct;27(19):6613.
13. García-Esquinas E, Carrasco-Rios M, Ortolá R, Sotos Prieto M, Pérez-Gómez B, Gutiérrez-González E, Banegas JR, Queipo R, Olmedo P, Gil F, Tellez-Plaza M, Navas-Acien A, Pastor-Barriuso R, Rodríguez-Artalejo F. Selenium and impaired physical function in US and Spanish older adults. Redox Biol. 2021 Jan;38: 101819.
14. Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood. 2004 Oct;104(8):2263-2268.
15. Tucker KL., Qiao N, Scott T, Rosenberg I, and Spiro III A. High homocysteine and low B vitamins predict cognitive decline in aging men: The Veterans Affairs Normative Aging Study. American Journal of Clinical Nutrition. 2005 Sept;82(3):627-635.
16. Healton, EB, Savage DG, Brust JCM, Garrett TJ, and Lindenbaum J. Neurologic aspects of cobalamin deficiency. Medicine. 1991 July;70(4):229-245.
17. Hawley A, Liang X, Børsheim E, Wolfe R, Salisbury L, Hendy E, Wu H, Walker S, Tacinelli A, Baum JI. The potential role of beef and nutrients found in beef on outcomes of wellbeing in healthy adults 50 years of age and older: A systematic review of randomized controlled trials. Meat Science. 2022 Jul:189:108830.
18. U.S. Department of Agriculture, Agricultural Research Service, Nutrient Data Laboratory. USDA National Nutrient Database for Standard Reference, Release 28 (Slightly revised). Version Current: May 2016. Available at http://www.ars.usda.gov/ba/bhnrc/ndl
19. Roussell MA, Hill AM, Gaugler TL, West SG, Heuvel JP, Alaupovic P, Gillies PJ, Kris-Etherton PM. Beef in an Optimal Lean Diet study: effects on lipids, lipoproteins, and apolipoproteins. Am J Clin Nutr. 2012 Jan;95(1):9-16.
20. United States Department of Agriculture. (2023 Mar). AskUSDA.