Tag Archive for: recovery

Vitamin D: Benefits, Sources, Deficiency

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By Maya Shetty, BS

This blog is part of our Supplements newsletter. If you like this content, sign up to receive our monthly newsletter!

Key Takeaways: 

  • Vitamin D affects the health of bones and also plays a role in our muscles, immunity, and prevention of some diseases.
  • The most common form of vitamin D is synthesized in the skin after exposure to sunshine. Vitamin D can also be found in some foods naturally as well as supplements and fortified foods.
  • Vitamin D insufficiency is defined as less than 30 ng per mL of blood. Strive to maintain sufficient vitamin D levels through a balanced diet, sensible sun exposure, and supplementation as needed. 
  • When choosing a vitamin D supplement, D3 is recommended over D2, and should be combined with a fat (such as a handful of almonds or an Omega-3 supplement). You should not take more than 4,000 IU (100 mcg) per day due to the potential for toxicity unless recommended by a medical professional.

In a nation saturated with supplements, vitamin D commands the spotlight as one of the most widely taken across all age groups, second only to multivitamins. 

“Ever since vitamin D deficiency was found to be the root cause of rickets, we have long recognized its role in bone health. Now research is looking at this vitamin as a panacea for numerous ailments, from the common cold, to even cancer,” states Robert Oh, MD, MPH, Chief Wellness Officer of the VA Palo Alto Healthcare System. 

As ongoing research peels back the layers of complexity surrounding this vitamin, the scientific landscape becomes dynamic and subject to rigorous debate.

Where Does Vitamin D Come From?

Vitamin D distinguishes itself from other vitamins due to its unique ability to exist as both a dietary nutrient and as a hormone. Sourced from sunlight exposure, food, and supplements, this fat-soluble vitamin accumulates in the body’s fatty tissues and liver, available to be released as needed.

Sunlight

The primary source of vitamin D is the production that occurs in our skin from cholesterol precursors when exposed to the sun’s ultraviolet-B (UVB) rays, earning its nickname “the sunshine vitamin.” Considering the pivotal role sunlight plays in vitamin D production, daily exposure is beneficial.

Some plants and animals also possess the ability to synthesize vitamin D, contributing to the vitamin’s content in various foods and supplements. In plants, vitamin D is in the form D2 (ergocalciferol), while in animals, including humans, it is in the form D3 (cholecalciferol). Both forms are absorbable by humans; however, there is evidence suggesting that D3 has a more substantial and prolonged impact.

Food

High amounts of vitamin D3 are found in oily fishes such as salmon, mackerel, and sardines, whereas small amounts are found in eggs, red meat, and liver. 

Vitamin D2 is found in specific mushrooms, but its concentrations vary significantly based on exposure to light. Mushrooms, much like our skin, require sunlight for vitamin D production. “Since commercially available mushrooms are typically grown in dark conditions, they contain minimal amounts of vitamin D and organic mushrooms will contain almost none. Exposure to UV light through irradiation, which is not allowed in organic food production, will substantially increase conventional mushroom vitamin D content,” said Rachele Pojednic, PhD, Stanford University nutrition and exercise scientist.

Due to the limited natural food sources of vitamin D, many products, including breakfast cereals, dairy items, and plant-based milks, are fortified with vitamin D2 and D3. For a comprehensive list of vitamin D content in specific foods, refer to the U.S. Department of Agriculture (USDA) list categorized by nutrient content and food name.

Supplements

Vitamin D2 and D3 can be found in supplement form. Due to the potentially higher bioavailability, D3 supplements are typically recommended over D2. 

Dr. Pojednic emphasizes the importance of considering the fat-soluble nature of vitamin D when taking a supplement. “Vitamin D absorption, especially when consumed in concentrated doses, will be significantly enhanced when taken in conjunction with dietary fat, such as a handful of almonds or an omega-3 supplement,” she says.

When determining the appropriate vitamin D supplementation dosage, keep in mind that higher is not better. Toxic levels of vitamin D can arise from excessive supplement intake, a risk not associated with sunlight exposure due to the skin’s ability to self-regulate production. Therefore, Dr. Oh advises consulting with a physician or dietitian before taking high-dosage supplements. “Too much vitamin D can cause health issues, such as too high calcium levels or even kidney damage, so work with your care team if you are taking high doses of vitamin D,” he says.

Health Benefits of Vitamin D

Vitamin D is crucial for human health. While primarily recognized for its role in building strong bones, new findings suggest that this fat-soluble vitamin may exert a broader influence throughout the body. 

“We now know that the majority of organs and tissues in the body possess vitamin D receptors,” states Dr. Pojednic. “This finding suggests vitamin D has effects beyond the skeletal system, sparking considerable research in the potential benefits of vitamin D for multiple health conditions.”

A substantial portion of this research focuses on the effects of vitamin D supplements, rather than dietary and sunlight sources. However, this by no way means the benefits of vitamin D are found solely through supplementation. Additionally, it should be noted that many studies have not compared outcomes in individuals with sufficient versus deficient vitamin D blood levels, which make conclusions from many supplementation studies difficult to interpret.

Bone Health

Vitamin D stands as a key player in sustaining the structural integrity of our skeletal system by facilitating the absorption of calcium and phosphorus—the building blocks of our bones. Through the process of mineralization, these minerals are incorporated into our bones to maintain normal bone density. Inadequate vitamin D levels can result in insufficient mineralization, which can lead to weakened bones and conditions such as osteoporosis, as well as more severe disorders like rickets and osteomalacia. 

While the adverse effects of inadequate vitamin D on bone health are well-established, the evidence concerning the impacts of supplemental vitamin D over-and-above sufficient levels remains inconsistent.

In 2007, the US Agency for Healthcare Research and Quality synthesized the research on vitamin D and determined daily supplementation of vitamin D (≤ 800 IU) with calcium (≥ 500 mg) resulted in small increases in bone mineral density in older adults. 

There is additional evidence that suggests that vitamin D supplementation lowers the risk of fractures in institutionalized older adults (700-800 IU vitamin D) and female navy recruits (800 IU vitamin D and 2000 mg calcium). However, both groups were initially at a high risk of vitamin D deficiency, and their levels were likely insufficient to begin with.

 On the contrary, the largest vitamin D study to date, Vitamin D and Omega-3 Trial (VITAL), showed that daily supplementation of 2000 IU vitamin D did not reduce fracture risk in more than twenty-five thousand midlife and older adults who had sufficient vitamin D levels on average.

The current body of evidence indicates that vitamin D supplementation offers the most significant benefits for individuals with deficiencies. However, for those already meeting their vitamin D requirements, the benefits of additional supplementation are less clear. This suggests the need to approach vitamin D supplementation for bone health as a targeted strategy—aimed at maintaining sufficient levels rather than striving for excessively high, or supramaximal, levels. Such a focused approach ensures supplementation benefits those who need it, without unnecessary excess in those already meeting their vitamin D requirements.

Dr. Pojednic underscores the importance of a proactive approach, stating, “Ensuring sufficient intake of vitamin D and calcium serves as a foundational preventive measure to mitigate bone mineral loss and reduce the risk of osteoporosis later in life.” This strategy is particularly crucial early in life, as the foundation for peak bone mass, particularly for women, is established in our twenties. By achieving and maintaining optimal levels of vitamin D and calcium from a young age, individuals can maximize their bone strength and preserve it as they age.

Muscle Health

Our muscles need vitamin D to function and develop properly. Studies have established a correlation between deficient vitamin D levels and muscle weakness, pain, and atrophy. While the precise molecular mechanisms of vitamin D’s influence on skeletal muscle necessitate further investigation, cell culture studies indicate that vitamin D administration can alter cell pathways related to muscle contraction, cell proliferation, differentiation, growth, and inflammation.

An increasing body of research suggests a positive impact of high and low vitamin D supplementation on physical performance and injury prevention, particularly in vitamin D deficient adults and athletes. Research has identified a negative correlation between blood levels of vitamin D and biomarkers of muscle damage and inflammation, as well as number of injuries. 

“These findings indicate the potential of vitamin D as a supplement for aiding recovery in injured or overtrained athletes,” states Dr. Pojednic. “However, further research is required to determine the optimal dosages and interventions for effective recovery.”

It has also been hypothesized that vitamin D may reduce the risk of falls in older adults by enhancing muscle strength and coordination, thus improving balance and postural sway. An analysis of multiple studies indicates that daily vitamin D supplementation may decrease the risk of falls in older adults with low vitamin D levels. However, this protective effect was not observed in individuals with sufficient vitamin D levels, a conclusion supported by the VITAL trial, which administered 2,000 IU of vitamin D daily.

The current evidence regarding vitamin D and muscle health suggests that the benefits of supplemental vitamin D are, again, primarily observed in individuals deficient in the vitamin, mirroring patterns observed in bone health. However, it may also have some benefit for athletes and others struggling with muscle damage and recovery. Overall, more research is needed to understand the optimal level of vitamin D for muscle health and determine whether these levels exceed what is required for bone health.

Immune Function

Vitamin D plays a crucial role in immune health, demonstrating various effects on inflammation, autoimmune diseases, and infection rates. The VITAL study revealed that healthy individuals taking vitamin D (2,000 IU per day) were less likely to develop autoimmune diseases such as rheumatoid arthritis and psoriasis, with a 22 percent reduction in incidence over the five-year supplementation period. However, these protective effects were no longer evident after participants discontinued the vitamin D supplement. This implies that vitamin D needs to be consistently taken for long-term prevention.

In the context of respiratory health, a comprehensive meta-analysis demonstrated that daily or weekly vitamin D supplementation lowers the risk of upper respiratory tract infections, especially in very deficient individuals. During the COVID-19 pandemic, studies revealed that low serum levels are associated with a higher risk of COVID-19 infection.

These findings underscore the importance of maintaining optimal vitamin D levels for immune health and the long-term prevention of autoimmune and respiratory diseases. “Similar to muscle and bone health, supplemental vitamin D has the most consistent benefits among those with deficient levels at baseline,” states Dr. Oh. “However, the new findings suggest supplemental vitamin D may reduce autoimmune disease risk even in individuals with already sufficient vitamin D levels.” Therefore, further research is warranted to identify the optimal vitamin D level for sustaining long-term immune health.

Diabetes

Research has consistently found an inverse relationship between vitamin D blood levels and diabetes risk. Vitamin D deficiency may influence key biochemical pathways involved in the development of prediabetes and diabetes, impacting beta cell function in the pancreas and contributing to inflammation.

In a noteworthy observation from the Nurses Health study, women who regularly consumed higher daily doses of vitamin D (>800 IU) and calcium supplements (>1,200 mg) experienced a remarkable 33 percent lower risk of Type 2 Diabetes compared to those with lower doses (400 IU vitamin D, <600 mg Calcium).

Further evidence comes from randomized control trials, which have shown that the benefits of vitamin D supplementation are most pronounced in individuals with low levels of this nutrient. In a randomized clinical trial involving 2,000 adults with prediabetes, participants received daily high doses of vitamin D (4,000 IU) over two years. The study discovered a significant risk reduction for diabetes among those with severely low vitamin D levels. However, this beneficial effect was not observed in participants who already had sufficient levels of vitamin D.

Cancer and All-Cause Mortality

Epidemiological studies have revealed a connection between insufficient vitamin D levels and an increased risk of cancer and all-cause mortality, prompting significant research into the potential role of vitamin D in cancer prevention and overall longevity.

Laboratory studies showcase vitamin D’s ability to inhibit cancer cell growth, while epidemiologic investigations suggest that inadequate vitamin D levels correlate with a 30 to 50 percent increased risk of incident colon, prostate, and breast cancer, along with elevated mortality from these cancers. Despite these findings, clinical evidence remains mixed. The large-scale VITAL study reported a reduction in cancer-related deaths over five years of daily vitamin D supplementation (2,000 IU), but not a decrease in the risk of developing cancer. However, a recently published secondary analysis of the trial data revealed that participants taking the vitamin D supplement had a 20 percent lower likelihood of developing advanced cancer, defined as metastatic or fatal.

A review of several clinical trials further substantiated the link between low vitamin D levels and risk of mortality, more broadly showing a seven percent reduction in all-cause mortality with daily vitamin D supplementation (median dose 800 IU).

Many unknowns continue to surround vitamin D and its relation to cancer risk and overall mortality. “Significantly more research is needed to determine if low vitamin D levels are a risk factor for cancer and whether supplementation can impact overall longevity,” states Dr. Oh. “Nevertheless, the present data does suggest that individuals at risk for cancer may consider supplementing with vitamin D.”

How Much Vitamin D Do I Need?

There is controversy over the levels of vitamin D considered to be sufficient; however, it is widely acknowledged that 25-OH vitamin D levels below 30 ng per mL of blood (50 nmol/L) are insufficient to maintain bone health. 

Optimal levels of vitamin D vary among individuals based on factors such as age, race, metabolic differences, and physiological condition. Adding complexity to this understanding, Dr. Pojednic emphasizes that most vitamin D recommendations are based solely on bone health, and levels required to support other tissues may vary. As such, there is no universally accepted optimal vitamin D level for overall health.

Dr. Oh recommends optimizing natural sources of vitamin D first, such as averaging about 30 minutes in the sun most days, and including a few servings of vitamin D-rich foods in their diet. 

Dr. Pojednic adds that achieving these levels does not need to be a daily practice. “Since vitamin D is a fat-soluble vitamin, our fat cells can store excess for weeks. Therefore, it is more important to consider average sunlight exposure and vitamin D consumption rather than focusing on daily intakes,” she says.

Because vitamin D is stored in fat cells, excessive doses can build up to toxic levels, therefore taking high doses of vitamin D (i.e. more than 4,000 IU per day)  can be dangerous and should be avoided. Symptoms of vitamin D toxicity include weight loss, irregular heart beat, hardening of blood vessels and tissues due to increased blood levels of calcium, potentially leading to damage of the heart and kidneys.

Common Risk Factors for Vitamin D Deficiency

Although it seems easy to absorb 30 minutes of sunlight per day , vitamin D deficiency is common in the US. There are many factors to explain this, including limited geographical location, time outdoors, age-related changes, skin color, restrictive diets, and certain medical conditions. Those affected by these factors may need supplementation to ensure they meet their body’s vitamin D requirements.

1. Sun exposure

During the winter months, people who live in areas above 37 degrees north latitude, which includes cities such as San Francisco, Seattle, Denver, St. Louis, Philadelphia, New York, Boston, and Chicago, do not receive sufficient UVB exposure to produce the necessary amount of vitamin D.

“Vitamin D synthesis in our bodies occurs only at specific wavelengths,” explains Dr. Pojednic. “Thus, geographical location is an essential factor in determining the best way to maintain your vitamin D levels.”

Even people living in sunny areas can experience deficiency related to sun exposure. By spending significant time indoors or consistently wearing clothing that covers most of the body, our skin will not receive necessary exposure for optimal vitamin D synthesis. Moreover, while many believe they get sufficient sunlight through car or office windows, most windows filter out the UVB rays necessary for synthesis. 

Of course, there are many concerns surrounding direct sun exposure, most notably skin cancer. Using sunscreen and limiting sun exposure are still very important measures to protect the skin. While the role of sunscreen in contributing to low vitamin D levels is subject to debate, evidence indicates that the typical use of sunscreen does not significantly impact the body’s ability to produce vitamin D. This means that for most individuals, wearing sunscreen during exposure to sunlight still allows for the synthesis of vitamin D.

2. Age

The skin’s ability to produce vitamin D diminishes significantly with age, declining at an estimated rate of 13 percent per decade of life. Additionally, as we age, our body becomes less efficient in absorbing and utilizing vitamin D.

3. Skin color

Individuals with darker skin often exhibit lower blood levels of vitamin D likely due to the pigment melanin acting as a natural shade, reducing the production of vitamin D. Consequently, low vitamin D levels are particularly prevalent among Americans with darker skin tones. 

4. Diet

Individuals who cannot tolerate or choose not to consume milk, eggs, and fish, such as those with lactose intolerance or those adhering to a vegan diet, face an elevated risk of vitamin D deficiency. “The exclusion of these food sources, which are rich in vitamin D, makes it challenging for individuals in these groups to obtain sufficient levels of this nutrient from food alone,” states Dr. Pojednic.

5. Certain medical conditions

Individuals with inflammatory bowel diseases, such as ulcerative colitis, Crohn’s disease, celiac disease, and chronic pancreatitis may encounter difficulties in maintaining optimal vitamin D levels. This is because the absorption of vitamin D, a fat-soluble vitamin, is contingent on the digestive tract’s ability to absorb dietary fat, and inflammatory conditions within the tract can impede this process. Additionally, certain liver and kidney conditions may impair the metabolism and utilization of vitamin D within the body.

“Signs that your body may need more vitamin D than it is currently getting include bone pain, especially of your chest, shins and even overall chronic pain. For athletes, any bone stress injury like shin splints and poor healing stress fractures may indicate a vitamin D deficiency,” states Dr. Oh. “Finally if you have muscular weakness or pain, especially of your upper legs it would be reasonable to check your vitamin D levels with a blood test.”

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Supplements for Elite Athletic Recovery

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By Caitlin Aguirre, Adrian Vallejo, Matthew Kaufman, MD

This blog is part of our Supplements newsletter. If you like this content, sign up to receive our monthly newsletter!

Key Takeaways:

  • It is recommended to consult with a medical professional before taking the supplements listed in this blog.
  • Branched Chain Amino Acids stand out as a well-supported supplement for athletic recovery, aiding in faster physical recovery, decreased fatigue perception, and maintenance of lean mass. Recommended dosages range from 10 – 30 grams per day.
  • L-theanine shows promise in mental recovery post-exercise, with suggested doses ranging from 50 – 200 mg per day. 
  • N-acetylcysteine’s role in reducing perceived muscle soreness remains uncertain, with doses of 1200 – 1800 mg per day utilized for supplementation within existing studies.
  • Turmeric shows promise in alleviating muscle soreness at doses ranging from 1.5 – 5 grams of turmeric extract daily, although research is conflicting. Supplementing with piperine (black pepper) may enhance its effectiveness.
  • Ashwagandha holds the potential to reduce muscle soreness and improve athletic and mental recovery at a dose of 600 mg daily. While research on its effects is limited, current evidence suggests it’s generally safe for supplementation.

For high-performance athletes, achieving peak performance is not solely a result of pushing one’s physical limits. Even the best competitors experience fatigue, musculoskeletal pains, exercise-induced muscle dysfunction (EIMD), and delayed-onset muscle soreness (DOMS) that may impact their ability to sustain maximal training efforts and combat injury. In response to these physical ailments, often a sign of our bodies adapting to higher training loads, high-performance athletes have mastered the practice of athletic recovery.

The principles of athletic recovery can be thought of as a pyramid having a base of quality sleep, balanced nutrition, and hydration. These elements are the foundation upon which adapting to the demands of intense training is built. However, as committed athletes refine their sleep hygiene, prepare macro-friendly meals, and hydrate appropriately, they often look to ascend this metaphorical “athletic recovery pyramid” by utilizing nutritional supplements to gain an edge over their competitors. Previous literature has estimated that 40 – 100 percent of trained athletes have employed nutrient supplementation, depending on the definitions of trained athletes and supplementation.

In this blog post, we’ll explore the role of popular anti-inflammatory and antioxidant nutritional supplements, including BCAA’s, L-theanine (LTE), N-acetylcysteine (NAC), Turmeric, and Ashwagandha, and what role they may play in athletic recovery.

What are Branched Chain Amino Acids (BCAAs)?

BCAAs are a specific class of amino acids that have branched side chains. These include amino acids like leucine, isoleucine, and valine. Studies suggest that BCAAs are among the most commonly used supplements in trained athletes. These essential amino acids are broken down for fuel during exercise, and supplementation has been thought to provide substrate for anabolic (muscle-building) processes to prolong energy sources and protect against muscle damage and fatigue. Rather than a supplement, you may also consume BCAAs by eating foods high in leucine, such as salmon, chicken, cottage cheese, eggs, nuts, lentils, and beans.

Potential Benefits of BCAAs for Athletic Recovery

Our Recommendations

BCAAs are a supplement well supported by scientific literature that can shorten recovery time and decrease perceptions of fatigue. As an athlete, this may maximize athletic results by supporting the ability to continue long training sessions and return to sport quicker!

Dosing

Studies have shown positive outcomes with BCAA supplementation ranging from 0.087 – 0.22 grams per kg of body weight per day for at least eight days. Positive effects were also shown when the athlete took 20 grams one hour prior to exercise. While there’s no apparent consensus on the optimal dosing strategy, studies show that taking between 10 – 30 grams per day had no noted ill effects.

What is L-theanine (LTE)?

LTE is a non-proteinogenic amino acid that is structurally similar to glutamate. It is a primary component of the Camellia Sinensis plant, which is used to make green tea, and can also be found in smaller quantities in other foods, such as mushrooms, apples, and red wine.

Potential Benefits of LTE for Athletic Recovery

Our Recommendations

Since mental restoration following strenuous training or competition is vital for preventing burnout and enabling athletes to maintain a consistent level of high-intensity training, we recommend a supplement that provides mental recovery. Current evidence shows that LTE has the potential to aid mental recovery, however, further studies on larger sample sizes of athletes may be necessary for a comprehensive recommendation. 

Dosing

Although there is no clear agreement regarding the best dosing strategy for LTE, the studies examined in this review have demonstrated physiologic benefits with doses ranging from 50 – 200 mg per day. Within this range, LTE is considered safe for consumption and has demonstrated no toxic effects in both human and rodent studies.

What is N-acetylcysteine (NAC)?

NAC is a synthetic derivative of the naturally occurring amino acid L-cysteine. In the body, L-cysteine and NAC have direct antioxidative properties and serve as precursors to glutathione (GSH), another powerful antioxidant that prevents excessive molecular damage.

Potential Benefits of NAC for Athletic Recovery

  • May reduce perceived muscle soreness – Numerous studies evaluating the effects of NAC supplementation have shown mixed outcomes regarding the benefits of its antioxidative properties and ability to reduce muscle soreness.

Our Recommendations

Further investigations are necessary before clear conclusions can be drawn about whether NAC supplementation improves athletic recovery by decreasing perceived muscle soreness. 

Dosing

While there is no standardized dosing strategy for NAC supplementation, existing studies evaluated doses between 1200 – 1800 mg per day, with a loading period of at least three days. It’s important to note that exceeding 70 mg per kg of body weight may lead to negative side effects, including gastrointestinal upset, so it’s essential to monitor dosage and potential reactions carefully.

What is Turmeric?

Turmeric, Curcuma longa, is a commonly used medicinal herb that contains curcuminoids, including curcumin. Curcumin has been shown to have antioxidant effects and is associated with pain reduction, anti-inflammation, and chronic disease prevention and treatment.

Potential Benefits of Turmeric for  Athletic Recovery

  • May reduce perception of muscle soreness – Despite conflicting literature, numerous studies evaluating the effect of turmeric on whole and lower-body soreness and single-leg squat pain scores have found that its supplementation significantly reduced measures of muscle soreness. However, one recent meta-analysis found no significant effects on exercise-induced muscle damage or delayed onset muscle soreness. 
  • Taking piperine (black pepper) along with turmeric has been shown to potentially increase its bioavailability and may increase the efficacy of this supplement.

Our Recommendations

According to the literature, turmeric, or curcumin, seems to be a safe supplement for potentially reducing perceived muscle soreness following exercise. However, further study is needed to confirm the extent of turmeric’s efficacy due to the presence of conflicting research. It’s worth noting that simultaneously supplementing with piperine (black pepper) may positively influence its effectiveness.

Dosing

There is no standardized dosing strategy, however, doses ranging from 1.5 – 5 grams of turmeric extract daily, perhaps with piperine (black pepper), may be helpful in exercise recovery. Higher doses of 10 mg and above have been shown to produce mild negative side effects, including headache, diarrhea, yellow stool, and rash. Take caution when consuming higher doses is warranted as the literature on safety and side effects is limited. 

What is Ashwagandha?

Ashwagandha, or Withania somnifera, is an adaptogenic herb commonly used in Ayurvedic medicine. It has gained traction within the fitness community due to some preliminary studies showing an association between the supplement and enhancing muscle strength, muscle endurance, and cardiorespiratory fitness while counteracting chronic fatigue, weakness, nervous exhaustion, and premature aging. The mechanisms by which ashwagandha may improve physical recovery in humans are not well understood but are hypothesized to be at least partially due to antioxidant properties and endocrine effects.

Potential Benefits of Ashwagandha for Athletic Recovery

  • May reduce perception of muscle soreness – Supplementation has been found to decrease one’s perception of muscle soreness after exercise. This effect on muscle soreness is attributed to its antioxidant properties and its hypothesized ability to be converted into testosterone and DHEA, however, further study is needed to elucidate the exact mechanism.
  • May reduce recovery time – While evidence for this effect is minimal, two studies found significant improvement in participants’ perceived athletic recovery experiences. 
  • May promote mental recovery – One study found that supplementation lowered participants’ perception of general stress, fatigue, and lack of energy and improved general well-being scores compared to placebo.

Our Recommendations

The literature on the effects of ashwagandha on athletic recovery is minimal, however, current studies suggest that it is a safe supplement that may reduce one’s perception of muscle soreness and improve athletic and mental recovery following exercise. 

Dosing

There is no standardized dosing strategy, however, studies show that 600 mg of ashwagandha daily may be helpful in exercise recovery. Common side effects may include drowsiness, epigastric discomfort, and loose stools. Less common effects include mild CNS depression, increased thyroxine levels, hallucinations, blurred vision, vertigo, nausea, decreased appetite, constipation, hyperacidity, nasal congestion, dry mouth, hyperactivity, nocturnal cramping, skin rash, and weight gain.

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Protein Needs for Adults 50+

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By Sharon Brock, MEd, MS

This blog is part of our Nutrition newsletter. If you like this content, sign up to receive our monthly newsletter!

Key Takeaways: 

  • For adults aged 50+, we recommend consuming 1.2  – 1.6 grams of protein/kg of body weight per day (0.54 – 0.72 grams/pound body weight per day). For a 165-pound adult, this translates to roughly 90 – 120 grams of protein per day.
  • To build muscle past the age of 50, we need to eat enough protein AND do weight training, and consume 30 – 35 grams of protein within two hours of the workout.
  • Due to anabolic resistance, which increases as we age, it’s recommended to increase protein intake per meal to roughly 30 – 35 grams.
  • Here is a detailed list of the protein content of various foods.

While looking at the menu at your favorite café and deciding whether to add salmon to your salad, it’s important to remember that we should strive to eat protein with every meal for optimal health. Protein is found in animal products, such as meat, fish, eggs, and dairy, as well as beans, tofu, nuts, and many vegetables. In your daily life, protein is the milk in your coffee, the eggs and cheese in your omelet, the chicken and beans in your burrito, and the handful of almonds as your afternoon snack.

Protein is essential for a multitude of functions in the body. Not only does protein support the building of our muscle mass, it helps the body repair tissues and cells, makes immunoglobulins and antibodies to fight infection, and drives metabolic reactions like digestion for energy production. It also makes up hormones, like insulin, provides structure in the body, such as bone and collagen, balances fluids and pH, as well as transports nutrients throughout the body, like blood sugar and cholesterol.

“It’s important to learn about protein and make sure we are eating enough because it’s a major building block of our bodies,” said Marily Oppezzo, PhD, MS, RDN, DipACLM, Nutrition Scientist and Head of the Stanford Lifestyle Medicine Nutrition Pillar. “We need to eat enough protein every single day to get the essential nutrients necessary for optimal health and functioning.”

How Much Protein Do You Need Every Day?

The federal guideline for individuals aged 19 and older is 0.8 grams of protein per kilogram of body weight. For a 165-pound adult, this translates to roughly 60 grams of protein per day (equivalent to consuming an 8oz salmon fillet and a handful of almonds). Many nutrition experts, however, believe this amount is too low, especially for those over 50.

“There is a growing body of evidence, particularly by researcher Stuart Phillips, that shows health benefits of consuming higher amounts of protein as we age, including slowing down age-related loss of muscle mass,” says Dr. Oppezzo. “There’s a difference between just surviving and thriving. For those over 50, I’d recommend between 1.2 grams / kg of body weight to 1.6 grams / kg of body weight, which is roughly double the federal recommendation.”

A recent study recommended that adults aged 18 to 30 consume 0.8 – 0.93 grams of protein per kilogram of body weight, with an increase of 0.85 to 0.96 grams / kg after the age of 30. For those over 65, another study recommended 1.2 – 2.0 grams / kg of body weight per day.

Dr. Oppezzo says that eating protein is not sufficient for building muscle—we must also strength train as we age. Researchers from this study recommend a protein intake higher than 1.6 grams / kg of body weight per day combined with resistance training to improve muscle strength. “Protein is important, but strength training is THE most important way to prevent age-related muscle loss, and it’s important to consume around 30 grams of protein within a couple of hours after working out,” she says. “First, give your body a reason to get stronger and build muscle (lifting weights), then give it enough materials (consuming protein) to build.”

Why Do We Need More Protein as We Age?

Starting around age 30, our body goes into maintenance mode, and our muscle mass starts to decline roughly one to two percent per year. And, as we age, the rate of decline increases by three to 10 percent per decade. Once we reach our 60s and beyond, the accumulated decline of muscle mass can increase the risk of falling, bone fractures, hospitalization, and earlier death, making the topic of protein consumption relevant to longevity.

“As we get older, we move less, and we eat less, and if we are not paying attention to our activity level and protein consumption, we can become frail,” says Dr. Oppezzo. “This becomes more important as we age because we become more anabolic resistant. Anabolic resistance is basically a reduced stimulation of muscle protein synthesis to a given dose of protein—it’s like you need to speak louder (more protein) for your muscles to hear (grow).”

Over the last ten years, there have been many studies on anabolic resistance. One study measured the amount of muscle synthesis between men aged ~22 and men aged ~71. The researchers gave each group a meal containing 20 grams of protein and then tested the degree of muscle synthesis. In the same sitting, both groups ate an additional 20 grams of protein, followed by a second test of muscle synthesis.

For the ~22 aged men, there was no difference in muscle synthesis between eating 20 or 40 grams of protein in one sitting. But for the ~71 aged men, their muscles were unresponsive to 20 grams of protein; they needed 40 grams. Specifically, the ~71-year-old group needed 0.4 grams / kg of body weight per meal, whereas the ~22  year-old-group only needed 0.2 grams / kg of body weight.

“The men in their 70s needed more than 20 grams of protein at a time to get their muscles to listen,” says Dr. Oppezzo. “Though they didn’t do this same elegant study in women, I imagine it is the same.”

Since protein consumption supports just about every function in the body, the body will utilize the amino acids where they are needed, such as the functioning of the brain, liver, immune system, or gastrointestinal tract. Unfortunately, maintaining muscle strength can be last on that list. Therefore, individuals over 50 need to consume enough protein to maintain the healthy functioning of their organs and keep their muscles strong.

“Within a meal, we must eat enough protein to wake up our muscles and say, ‘you have enough protein and calories to build,’ but in older adults, maybe the body is instead going to use that protein for energy or to support another function,” says Dr. Oppezzo. “I think muscle growth is a bit like remodeling your kitchen. You don’t remodel your kitchen if you can’t afford your utility bill. And, I think—as we age—the remodelers require more up-front cash.”

How Much Protein Do We Need Per Meal?

One study shows that there is no “upper limit” to the amount of protein we should eat in terms of our muscles’ ability to utilize it. However, Dr. Oppezzo suggests that we still spread out our protein throughout three meals a day.

Eating 20 grams of protein per meal might be enough if you’re 25 years old, but for those aged 50 or above, Dr. Oppezzo recommends 0.4 grams / kg of body weight per meal (which translates to 30 grams of protein per meal for a person who is 165 pounds).

Dr. Oppezzo says there are occasions when individuals may need to eat more towards the 1.6 grams / kg of body weight end of the range, such as competitive athletes or those recovering from an infection, hospitalization, or surgery. She also urges people who are intermittent fasting or on a very low-calorie or restrictive diet to make sure they are still consuming adequate protein.

“If we don’t eat enough protein during the day, where do we get our amino acids from? From our muscles!” exclaims Dr. Oppezzo. “I wouldn’t panic about a single day, but it’s not a great long-term plan.”

What are the Best Sources of Protein?

Luckily, every food has some protein in it! And most would agree that getting protein from a whole food source is always better than getting it from a powder. Whole foods have many other nutrients that are part of the package, and since we chew, swallow, and digest whole food at a specific rate, protein-rich foods enter the body more naturally than powders.

If you need to supplement with a protein powder, Dr. Oppezzo recommends whey protein or pea protein (vegan option). The most important amino acid needed to build muscle is leucine, which is found in high quantities in whey and milk. Researchers from this study found that leucine enhanced muscle protein synthesis in women aged 65 to 75, suggesting that older women should ensure that leucine is part of their protein intake.

“Although my mom, who is in her 70s, exercises every day, I’ve tried to supplement her activity by emphasizing eating enough protein every day and lifting weights weekly to keep her strong,” says Dr. Oppezzo. “I’m passionate about getting this information out there. It can help many people in their 50s and beyond maintain optimal health and live their best lives as they age.”

 

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