“But where do you get your protein from?” This is a common question of vegetarians, perpetuated by a long-standing myth that if you don’t eat your meat you will become weak and emaciated.
This myth has been well and truly busted – but it doesn’t mean that people who eschew meat can rest on their laurels. Like all older adults, vegetarians need to be mindful of meeting their protein needs.
It is true that we need protein, even more so with aging. While Australian guidelines spout 0.75g/kg bodyweight per day, this falls short of international guidelines stipulating 1.2g/kg for older adults – and recent evidence putting it as high as 1.5g/kg.
These levels help counteract diminishing lean muscle mass and strength that occurs with aging, reducing risk of sarcopenia and associated falls, fractures, hospital admissions, declining independence and mortality.
And it’s not just muscles that need protein. These industrious amino acid assemblages support wound healing, bone density, immunity, lung function and cognition.
So how do vegetarians get theirs?
Unravelling plant protein
When combined with exercise, research shows it doesn’t matter which type of protein people eat – plant, animal or otherwise – to boost muscle health.
But while plant sources comprise 40% of the world’s protein intake, Australians get 60% of theirs from animal origins.
And although the Australian Guide to Health Eating recommends legumes as a primary protein source for vegetarians, a review found that legumes constitute a meagre 0.44% of diets in aged care facilities – served with meat.
Even for non-vegetarians, legumes are a no-brainer – they are cheap, versatile, packed with nutrients and fibre and one of the best solutions to soft-textured diets for older adults with swallowing or chewing difficulties.
The scrumptious, wholesome meals that can be cooked with legumes are only limited by the imagination, ranging from a vast range of soups and vegetable patties to dals, dips and casseroles.
Other non-meat sources of protein abound too, including eggs, milk, cheese, nuts, wholegrains, seeds and hemp.
For older adults with higher protein needs due to poor appetite, declining muscle mass and strength or illness, eggs and dairy (cream or milk powder) can be used to fortify meals and make a great base for snacks.
Beyond protein, evidence suggests that a good quality diet is most important for preventing frailty and fragility, providing all the nutrients, polyphenols and fibre essential for good health.
After addressing dietary needs, some nutrition supplements might be advisable. Vegetarians and vegans would benefit from an algal source of the long chain omega-3 fatty acid DHA that is consumed directly through deep-sea fish.
Vegans may need supplementation to meet requirements for Vitamins D and B12. Pea protein can be used as a concentrated protein source where needed. Contrary to popular opinion, there is plenty of iron in plant foods – including legumes.
What it means for residential aged care
With a growing population embracing various diets without animal-sourced food – for health, ethical or environmental reasons – aged care facilities need to step up and leave the antiquated “meat and three veg” behind.
Special diets aside, the variety and quality of food provided in residential care is in dire need of an overhaul to address nutritional, cultural and personal needs and preferences in a way that enhances appetite and the social bonding that can only come from sharing a tasty meal in a pleasant environment.
Cost of Malnutrition
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