Medicine, Nursing: Nutrition – Protein Intake for Seniors

Diabetes can negatively be affected by excess protein intake. The variation of the protein content in the diet can affect glucose homeostasis as amino acids are modulators of insulin action. The branch-chain amino acids leucine, isoleucine, valine are essential amino acids as they are only received into the body through dietary intake. High dietary consumption of BCAA is associated with an increased risk of type 2 diabetes.1
Elevated circulating concentration levels of the amino acids leucine and proline act upon metabolism (to CoA and malonyl-CoA). Specifically, these amino acids act on the hypothalamus which then sends a signal to the liver to decrease glucose output by lowering the rate of glycogenolysis and gluconeogenesis which decreases glucose production and reduces the concentration of circulating glucose. Proline acts upon astrocytes in the central nervous system for the central regulation of glycaemia. Consumption of fat-rich diets can interfere with gluco-regulatory mechanisms, if they are low in proline and leucine, which may lead to the development of hyperglycemia and ultimately type 
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Diabetes occurs when there is too much glucose present in the blood and not enough insulin to remove it or when the body is unable to sue the insulin that is made. Prolonged consumption of a high protein diet increases the amino acids in the blood and this ultimately affects glucose equilibrium. Long term consumption of a high-protein diet can cause high glucose stimulated insulin secretion and unsuppressed glucose output by the liver. In diabetics excess protein decreases insulin sensitivity and increased liver production of insulin.3 
The average American adult consumes over 100g of protein each day. The recommended daily intake is 46-53g of protein per day.4 I would recommend that a client eat a variety of protein to include meat, fish, dairy, and vegetable protein. I would have them focus on lowering their consumption of meat and dairy and replace those proteins with the increased consumption of fish, leafy green vegetables (spinach, kale, broccoli, romaine, Swiss chard), black beans and rice, kidney beans, peas, lentils, garbanzo beans, quinoa, and peanuts/peanut butter. Soy is a complete protein, but with the issues surrounding soy consumption, I would advise them to limit soy intake in their diets.5