Dietary protein is an essential nutrient for many functions, such as building and repairing muscle tissue, supporting the immune system, and metabolic function. There’s a lot of discussion and hype about protein, said AMA President Bobby Mukkamala, MD, who hosted an AMA webinar about counseling patients on protein intake.
Many products at the grocery are advertised as having “high protein” content. “Patients are curious about how much protein they should be eating” and what to consider when choosing different protein sources, said Dr. Mukkamala, an otolaryngologist who is board certified in lifestyle medicine.
During the webinar, several experts discussed how protein needs change with age and how physicians can best approach this topic with patients.
In 2024, the International Food Information Council Food and Health Survey found that 71% of Americans were trying to increase their protein and fiber intake and limiting saturated fat. “Patients' instincts are pointing in the right direction,” said webinar speaker Shirley K. Kalwaney, MD, director of graduate medical education and nutrition in medical education at Inova Health System in Virginia. She’s also an internist who specializes in lifestyle medicine.
When a clinical opportunity exists to guide patients, “We should not chase single super foods or single nutrients,” Kalwaney advised. Nutrition counseling should foster eating patterns that patients can realistically maintain over time, using motivational interviewing to support behavioral changes, she said.
The webinar, "Helping Your Patients Navigate Protein," is available to watch on demand at the AMA Ed Hub™. The AMA has designated this blended live and enduring material for a maximum of 1 AMA PRA Category 1 Credit™.
How much protein are Americans consuming?
The new Dietary Guidelines for Americans, 2025–2030, recommends modestly raising protein intake to 1.2–1.6 g/kg per day. While most Americans already meet that threshold, you have to consider the bell curve of that statistic, said Donald K. Layman, PhD, professor emeritus in the Department of Food Science and Human Nutrition at the University of Illinois at Urbana-Champaign.
Roughly half of Americans already fall within this range, while the other half—disproportionately women—do not, he emphasized.
Data from the National Health and Nutrition Examination Survey (NHANES) shows that about 20% of women over 60 and 20% of women aged 18–22 consume less than the recommended daily allowance (RDA), highlighting a substantial shortfall in key subgroups. That said, RDA for protein should not be mistaken for an ideal target, he advised. The previous RDA of 0.8 grams per kilogram of body weight per day was designed as a minimum intake to prevent deficiency based on nitrogen-balance studies—not as an optimal intake for long-term health.
Another misconception is that protein consumed above the RDA is simply “wasted” or converted directly into fat. Revisiting older lysine-oxidation studies, Layman showed that even after amino acid oxidation begins to rise, less than 20% of the extra intake is oxidized. In other words, most additional amino acids are still being used by the body for other purposes.
Amino acids do far more than build muscle. They help regulate blood sugar, support neurotransmitter production, maintain immune and gut function, and participate in antioxidant defenses, he said in the AMA webinar.
This is the third of four AMA Ed Hub “Healthy Diet and Dietary Patterns” webinars, all of which are hosted by Dr. Mukkamala. The last in the series, “Reducing Risk of Chronic Disease Through Diet,” airs June 23, 2 p.m. CDT. Learn more and register now.
Older adults should pair protein intake with exercise
Protein requirements vary substantially depending on age, physical activity level, and lean body mass. There’s also the question of quality—“are you using high quality protein or lower quality,” said Layman.
Research has shown that aging reduces the ability to produce protein. Younger adults can stimulate muscle protein synthesis with about 15 grams of high-quality protein per meal, while older adults generally require closer to 30 grams to achieve a similar response.
Certain habits can help offset this age-related decline. “If we think about adult protein needs, it's very important to recognize that as we age the efficiency of protein use goes down. We can buffer against that by adding in more essential amino acids, increasing the quality and the synergistic effect with exercise,” he said.
But protein requirements aren’t one size fits all, particularly in medically vulnerable populations.
Frail older adults, during pregnancy, and other illnesses are situations where protein needs “can be individualized and should be,” said Kalwaney. In clinical practice, especially in hospitalized patients, nutritional recommendations often need to be tailored to a person’s overall health status and medical condition.
The relationship between aging and protein intake isn’t that straightforward, she continued. “Protein intake and aging is real, but it’s nuanced and it’s usually multifactorial,” she explained. Many factors can contribute to inadequate nutrition in older adults, including depression, loneliness and reduced appetite.
Could a high protein breakfast help teens?
With younger people, there are other specific problems. “What's really happening in teenagers specifically, but we also see this in kids as well is they're under consuming nutrient dense foods,” said Heather Leidy, PhD. She’s a nutritional psychologist and an associate professor at the University of Texas at Austin, where she has a joint appointment in the nutritional sciences and pediatrics departments with Dell Medical School.
NHANES data shows that many adolescents fail to meet estimated average requirements and food-based guidelines, with low intakes of vegetables, fruits, whole grains, dairy, and most protein food groups, aside from nuts and seeds.
This shortfall coexists with overconsumption of energy-dense options. This contributes to high rates of obesity, related chronic conditions, poor mental health, physical inactivity, and inadequate sleep, she summarized.
One possible solution is a high protein breakfast, said Leidy. Intervention trials in breakfast-skipping adolescents show that a high-protein breakfast (about 24–30 grams) enhances satiety and reduces food cravings, leading to voluntary reductions of roughly 400 calories per day. “Usually, snacking behavior is lower when a higher protein breakfast is consumed. And then we do see some benefits with weight management,” she said.
Breakfast eaters also had improved 24-hour glycemic control, compared with those who skipped breakfast, she added.
How to approach the plant-based narrative
The conversation around protein should not simply be about increasing intake indiscriminately, said Kalwaney. In her view, “it’s not just simply about more protein, but it’s really about the better protein and within a healthier diet.”
Updated American Heart Association guidance recommends shifting from meat to plant-based sources such as legumes and nuts, regularly consuming fatty fish and select low-fat dairy, choosing lean cuts of red meat when used, avoiding processed meat, and emphasizing high-fiber patterns with saturated fat under 10% of total energy, said Kalwaney.
Layman cautioned that plant-based reliance could drive down both the essential amino acid and the amount of protein in the diet. “One has to be careful with that as to who's going to be affected, who's listening to that narrative and what's the ultimate outcome going to be.”
Plant foods can meet protein needs, Kalwaney emphasized. “If people want to swap out some of the animal products, it's very doable” and affordable, if people choose low-cost choices such as dried beans and other legumes. All the presenters agreed that a diet more focused on whole foods and less on highly processed foods was ideal for a healthier America.
