Protein—a word that has long carried the reputation of being the “good for you” nutrient – usually doesn’t need an explanation about its importance. However, the noise and chatter about “how much” protein we need seems to demand some clarification.
It’s worth remembering that protein’s primary role is to supply the building blocks—amino acids—for body tissues and nearly every human biological process. This may be a reason why protein has often been positioned in popular culture as more important than other nutrients, like carbohydrates and fats. However, the “health halo” surrounding protein often reflects a deeper cultural obsession with weight control, leading to its exaggerated status in today’s nutritionally sensationalized world.
Protein is important for women as they transition into menopause and beyond because it helps preserve muscle mass and strength, supports bone health, and overall physical function, all of which naturally decline with age. However, protein has been rebranded by some researchers and influencers as the “menopause nutrient,” reinforcing the idea that women in midlife should consume even more of it. Hormonal changes during menopause – particularly the drop in estrogen – can accelerate muscle and bone loss, increasing the risk of osteoporosis and fractures. Therefore, getting enough protein may help counter these effects while supporting wound healing, skin, hair, and immune function, and promoting better recovery from exercise – but still, how much do women really need?
The Great Protein Debate
This question is a source of a lively, ongoing debate that has persisted for centuries. If you have time, an elegant walk down the halls of the “protein history museum” can be found in this summary by Rachel Pham.
Despite a long history of questioning adult protein needs, the mixed messaging about how much protein midlifewomen need remains an elusive problem, given the lack of rigorous, convincing research in this population. Furthermore, questions persist about how protein needs, or the RDA, are determined – all of which has resulted in a tangled web of confusion.
The RDA (Recommended Dietary Allowance) for protein was originally established in 1941 at 1.0 g/kg/day by the US National Research Council to serve as a basis for food relief efforts due to malnutrition and starvation from the war or economic depression. It was decreased to the current recommendation of 0.8 g/kg/day in the 80s, based on the principle that adult protein allowances should be based on nitrogen balance studies, despite admitting to having little information on which to base recommendations for protein intake in the elderly.
Beginning in the early 2000s, however, researchers began to challenge the simplistic thinking about protein turnover and aging, and whether the current dietary guidelines for protein were adequate for adults over age 65 to support muscle and bone health. As a result, research shifted to a focus on the effect of protein on muscle mass, bone health, and physical functioning when estimating protein needs in older adults (including factors such as illness, injury, chronic disease, or malnutrition). Furthermore, many factors can affect an individual’s dietary requirements for protein and need to be accounted for, such as:
Dietary factors (i.e., type and amount of protein consumed, overall energy intake, presence or absence of other nutrients, such as carbs or fat)
Disease state (i.e., digestive issues, infection, stress, diabetes, cardiovascular disease)
Type and amount of physical activity, including frequency and intensity
Scientists have also questioned whether protein recommendations should be based on a person’s daily needs or “per meal” requirements. Consequently, these questions have stirred a great debate about protein requirements for aging adults – which has not been settled yet.
Current Protein Recommendations
A review of the current expert consensus is that needs vary based on all these factors. On average, a healthy adult needs 1.0 to 1.2 g/kg/d (or 0.45 to 0.55 grams per pound of body weight per day) to preserve muscle mass and strength and higher intakes (1.2 to 1.5 g/kg/d) are suggested for those with acute or chronic disease. Yet, some researchers suggest that data support an ideal target of 1.2–1.6 g/kg/day, especially for older adults to stimulate muscle protein synthesis.
In 2023, the French Rheumatology Society and the Osteoporosis Research and Information Group published recommendations for the prevention and treatment of osteoporosis. In menopausal women, individuals with osteoporosis, and the elderly, the recommended daily protein intake is at least 1–1.2 g/kg/day as part of a balanced diet with adequate calorie, calcium and vitamin D intake.
Recommendations get even more confusing when we consider the position among sports nutrition researchers. In 2007, the International Society of Sports Nutrition recommended that athletes should aim for 1.0 to 1.6 g/kg/d to support endurance activities, such as running, cycling, and swimming, and 1.6 to 2.0 g/kg/d to support muscle building and strength training with no distinction regarding male vs female, age, or stage of menopause.
In 2016, a joint position paper from the Academy of Nutrition and Dietetics (AND), Dietitians of Canada, and American College of Sports Medicine (ACSM) recommended that “dietary protein intake of 1.2 to 2.0 g/kg/d is necessary necessary to support metabolic adaptation, repair, remodeling, and for protein turnover” without specifics for female athletes or peri- or postmenopausal women. This group suggested that athletes focus on consuming 0.3 g/kg per meal or 15 to 25 g protein across the typical range of athlete body sizes, and that “higher doses (i.e., >40 g dietary protein per meal) have not yet been shown to improve muscle protein synthesis.”
In 2021, Dr. Bryan Holtzman from the Perlman School of Medicine and Dr. Kathryn Ackerman from Harvard Medical School and Director of the Female Athlete Program in Boston co-authored “Recommendations and Nutritional Considerations for Female Athletes: Health and Performance,” and cited the recommendations from the 2016 joint position paper. But remember, this paper did not provide specific direction based on research for female athletes of any age. Nevertheless, the recommendation was that female athletes need to consume “1.2 to 2.0 g/kg/d evenly spread throughout the day.” The authors emphasize that female athletes also should establish adequate energy availability by consuming at least 45 calories per kilogram of fat-free mass per day; and, for women exercising 90 minutes a day, their “protein intake should be at least 1.6 g/kg/d during the follicular phase” (so, not specific to postmenopausal athletes).
To further complicate the messaging about protein recommendations for midlife and older women, a 2023 position stand from the International Society of Sports Nutrition stated that peri and post-menopausal athletes, regardless of sport, need to consume daily protein intake in the range of 1.8 to 2.2 g/kg/day in doses of approximately 0.3 g/kg every 3 hours. The author’s rationale was that this is necessary “due to the decline of estradiol and the ensuing insulin and anabolic resistance coupled with the demands of physical activity.” Given that perimenopause can be a time of hyperestrogenism and many peri- and postmenopausal women do not have insulin resistance, this sweeping recommendation could be without merit for many women. Furthermore, it’s unclear from the references cited in this paper where the evidence is for the higher protein dosing for this population.
Are today’s protein recommendations realistic?
Despite the range of protein recommendations from various reputable sources, for some reason, the 2.2 g/kg/day (or 1 gram per pound of body weight) cited seems to be the number many women hear as a solution to their weight and aging concerns. I haven’t been convinced that anyone has confirmed that a higher amount is necessary – even for muscle building at this age. But, more importantly, I have a few concerns about the high doses of protein recommended in the 2023 ISSN paper, especially related to the potential downsides of unnecessary overconsumption for older women.
For example, consider a scenario of a 150-pound woman who exercises regularly and enjoys consistent, balanced meals resulting in roughly 80+ grams of protein per day – let’s say about 20 to 30 grams of protein at 3-4 meals/snack daily or approximately 1.2 g/kg/day. Let’s say she’s instructed to eat “more” protein to achieve the “one gram per pound” goal. This would mean adding another 70 grams of protein somewhere in her day. Should this be at the expense of other macronutrients, such as carbohydrates? What if she’s not that hungry – should she disregard her internal cues of fullness? Does the research suggest that there is harm, such as muscle or bone loss, if she doesn’t “eat more”?
Also, researchers say these guidelines are based on “ideal body weight,” which could be challenging to pinpoint, especially as women’s weight tends to naturally increase during the menopause transition. So, which weight do we base the guidelines on? If she gains 20 pounds during the menopause transition, despite a healthy diet and regular exercise, is she supposed to add another 20 grams of protein? If she “eats more,” will this help her lose the 20 pounds (which is what most women are hearing)? Maybe it’s just me, but I’m not convinced that adding more protein for the sake of a food rule, such as this, is going to improve her current or long-term health status – or her weight concerns.
Also, consider this example. Let’s say that a woman weighs around 200 pounds. If she is an active individual who lifts weights three to four times per week, should she try to eat 200 grams of protein per day (based on the advice for active older adults to consume 2.2 g/kg/d or 1 g/lb/day)? Let’s say that she eats three meals and a couple of snacks. So, should she be aiming for roughly 50 grams of protein at each meal and the rest in snacks? How is she really going to achieve this? In many cases, people are unknowingly consuming this amount of protein at some meals, given that a typical portion today—like 6 ounces of steak or turkey, or 7 ounces of salmon—can easily provide around 50 grams of protein. However, reaching these higher protein targets at a typical breakfast or lunch would require something like 7 eggs, 2 cups of cottage cheese, or 2 cans of tuna—an amount that’s often unrealistic. For this reason, a skewed eating pattern where most of the protein is consumed at one meal or toward the end of the day is often recognized as the more likely problem for meeting protein and overall nutritional requirements.
Finally, consider that a single nutrient approach to health and nutrition misses the benefit of the additive and synergistic effects of a balanced eating plan. If excess consumption of protein foods displaces other foods, like wholesome carbohydrate foods (fruit, vegetables, whole grains, etc.), nutritional deficiencies can become a problem. And don’t forget that saturated fat comes along with some protein foods, so is there a risk of contributing to excess saturated fat intake, which could harm heart health? Of course, we could prioritize plant-based protein, but for the woman in the previous example aiming for 200 grams of daily protein, she’d be looking at consuming the equivalent of 1 ½ blocks of tofu, 2 ½ cups of lentils, or 4 cups of quinoa per meal.
Then, there’s all the anxiety from the mixed messaging about protein recommendations. Let’s be clear – women are stressed about this issue! Just consider the following image that provides a snapshot of these different recommendations. It’s not surprising that women are confused and distressed when they are simply trying to care for their health and nourish their bodies at this stage of life.
Translating protein science into the real world
Although these recommendations provide interesting perspectives for nutrition science and guidance in women’s health, remember that research studies are only ONE resource for determining nutritional needs. For many important reasons, it’s beneficial for women to tune into and respectfully respond to their body’s natural cues of hunger and fullness. Plus, life is stressful enough at this age. Why are we complicating food and eating with a bunch of protein math and giving a false sense of “good nutrition” by mixing potions and powders into coffee and other random diet tricks? Frankly, this only adds unnecessary stress, worry, and anxiety when there isn’t great research to prove a particular benefit.
But, what about those stories of women who “lose weight by eating more protein?” In these cases, was eating more protein the “magic metabolic switch” for weight loss? Not necessarily. Maybe her typical eating pattern consisted of “skipping breakfast, skimping on lunch, and blowing it later in the day.” Correcting this skewed pattern by eating protein at breakfast and eating a better protein-rich lunch may have helped decrease compulsive overeating later in the day. Perhaps a focus on protein in her meals and snacks provided more satiety so that she decreased grazing or mindlessly eating highly palatable goodies. There are many versions of this story that I’ve seen firsthand with my clients. One person was binging on donuts, but when she chose to cut out sugar and eat more protein, she magically lost weight – so her story is that “eating more protein and less carbs/no sugar” resulted in weight loss (rather than recognizing the problem with a cycle of restricting and binge eating). It’s hard to say, but the idea that “more protein” = weight loss is often without context.
So, the next time you hear someone say that women need to “eat more protein,” consider what that means. Eat more than what? Do you have a protein deficiency? Studies have shown that the reasons for inadequate protein intake among older adults include skipping meals, low appetite, difficulties acquiring and preparing food, changes in food preference, dental issues, food insecurity, and swallowing difficulties. In a study of more than 11,000 Americans, aged 51 and older, 40 to 43% of the participants were eating fewer than three meals a day.
More recently, in a study of women, ages 41 to 59 years, only 3 out of 10 peri- and postmenopausal women said that they ate three meals a day. Most women in the study (87.8%) reported occasionally or consistently skipping meals, with the most frequently missed meals being lunch and the midmorning meal. In fact, this study highlighted the relationship between a disordered eating pattern (such as skipping meals and night eating) and suffering from menopausal symptoms.
So the question is: Are you skipping meals, restricting your intake, or simply not eating enough for whatever reason? Then, that is the issue that we need to address!
In my practice, most women are not deficient in protein. Instead, the most common reason I see for inadequate protein intake is due to restrictive eating (undereating and/or skipping meals), vegetarian and vegan eaters, and simply not eating enough due to appetite (more common in women over age 70). Therefore, by addressing these issues with personalized meal planning and simplifying meals and snacks (as illustrated below), we’ve improved their protein intake – even for those whose preference is vegan, vegetarian, or plant-forward.
It’s always a bit tricky to provide “sample meal plans” because there is so much nuance and individualization to people’s eating patterns, so please keep in mind that I’m not encouraging anyone to fixate on this as the “right” food or way to eat. Nevertheless, many people find illustrations of meals and snacks helpful for visualizing how they may be able to use these ideas to simplify their nutrition planning for nourishing their family and themselves. Also, notice that these are not large portions of food (in fact, many women may feel hungrier or need more than this) – and there’s nothing wrong with having a larger portion of protein. What I hope to illustrate is that you don’t need to push past fullness to achieve crazy amounts of protein at meals or snacks.
Vegan | Plant-Based Protein Example:
A final note
My final takeaway for you is that instead of focusing on meals being “perfect, correct, and right,” take it one meal at a time, trying to include enjoyable sources of protein on a regular basis. Experiment with new recipes. Explore different types of protein-containing foods in your meals and snacks – but not at the expense of other nutrients or pleasure with food and eating. With this approach, meals and snacks can be simple, pleasurable, and nourishing for your body in midlife and beyond.
With nearly two decades of experience as a registered dietitian, I’ve gained a deep understanding of the unique health challenges faced by women as they age, particularly during menopause. I hope to help you embrace midlife with confidence and vitality, and to show you that with the right mindset and approach, aging can be a time of great empowerment and joy.
Ready to prioritize your midlife health and wellness? The Four Pillars of Midlife Wellness will provide you with a fresh perspective on food, nutrition, health, and your body, enabling you to embrace your full potential and cultivate a robust sense of well-being throughout midlife and beyond!
