The targets · Decision 6 of 15
Why your targets change at 65
From age 65, the app changes three numbers. Protein is 1.2 g per kilogram whatever you do, the calorie deficit is smaller, and the lowest goal weight is higher. If you choose to lose weight, it may first suggest keeping your weight, and it asks you to talk to your doctor.
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- What the app does
- From 65, protein is 1.2 g per kilogram for every goal, with or without strength training. The extra protein for strength training goes down slowly from age 50, so it does not drop on a birthday. The deficit is at most 500 kcal a day. The lowest goal weight is a BMI of 23, not 18.5. If you choose to lose weight with a BMI under 30, or at 80 or older, setup first suggests keeping your weight. You can still choose to lose. Before weight loss, setup shows a warning.
- How sure we are Fair , Real, but small, indirect, or thinly measured.
- Guidelines and a large review of older people point the same way on all of these. But most of this is expert advice and studies that observe people, not trials. 65, 80 and the slope from 50 are cut-offs we chose, not changes in the body. And you can still choose weight loss against the advice.
Why the numbers change
Three findings from different sources. They describe groups of older people, not you.
The rules for everybody under 65 are on how we calculate your calorie target and how fast the app will let you lose weight. This page covers what changes as you get older.
Protein: 1.2 g per kilogram for everybody
Under 65, the app asks for 1.2 g of protein per kilogram if you do not do strength training. If you do it at least twice a week, it asks for 1.6 g when you keep or gain weight, and 2.0 g when you lose weight (why those numbers). The higher numbers rest mostly on trials in younger adults. From 65, every goal gets 1.2 g, with or without strength training. So if you do not train, nothing changes at 65. The weight it multiplies is still capped at a BMI of 27.5, as it is for everybody. The grams that leave protein go to carbohydrate and fat.
A slope from 50, not a step at 65
Every guideline we read gives one protein number for all adults, and another one from 65. None of them gives a slope. With a step, the woman below would go from 140 g on the day before her 65th birthday to 85 g on the day after. That is about 40% less overnight, and nothing in her body changed that day. So from 50, the strength-training numbers go down in a straight line, to 1.2 g at 65.
This slope is our own choice. It joins two ends that each have a source. We start at 50 because kidney disease gets more common in middle age. The CDC found it in 6% of US adults aged 18 to 44, 13% at 45 to 64, and 34% at 65 or older.
| Age | Protein per kg | Protein a day | Calories a day |
|---|---|---|---|
| 50 | 2.0 g | 140 g | 1,550 kcal |
| 55 | 1.73 g | 120 g | 1,500 kcal |
| 60 | 1.47 g | 105 g | 1,450 kcal |
| 64 | 1.25 g | 90 g | 1,450 kcal |
| 65 | 1.2 g | 85 g | 1,450 kcal |
| 68 | 1.2 g | 85 g | 1,400 kcal |
Three expert groups name a range for healthy older people. PROT-AGE (Bauer et al., 2013) says “at least in the range of 1.0 to 1.2 g protein per kilogram of body weight per day” for people over 65. It advises 1.2 g or more for people who exercise, and 1.2 to 1.5 g for most people with an acute or chronic disease. The ESPEN expert group (Deutz et al., 2014) says the same: at least 1.0 to 1.2 g for healthy older people, 1.2 to 1.5 g for older people who are underfed, or at risk of it, because of an illness. The ESPEN guideline for older people (Volkert et al., 2022) asks for at least 1 g, also during weight loss.
Why not more: kidneys
The KDIGO 2024 kidney guideline says: “Avoid high protein intake (>1.3 g/kg body weight/d) in adults with CKD at risk of progression.” CKD is chronic kidney disease. For stages 3 to 5 it suggests 0.8 g. PROT-AGE also says people with severe kidney disease who are not on dialysis may need to eat less protein.
Kidney disease is common at this age, and mostly hidden. In the US, the CDC found it in 34% of people aged 65 or older, against 13% at 45 to 64. About 9 in 10 adults with kidney disease (87%), at any age, did not know they had it. We do not ask about your kidneys. So the app cannot know who is in that third. The 1.6 g and 2.0 g for strength training are above the 1.3 g limit. 1.2 g is under it.
In healthy people, more protein does not seem to harm the kidneys. Devries et al. (2018) pooled 28 trials with 1,358 adults. They found that “HP intakes do not adversely influence kidney function on GFR in healthy adults”. HP means high protein. But those trials left out people with kidney disease, and that is the group the 1.3 g limit is for. The authors also rated the quality of the evidence “low to very low”.
A deficit of 500 kcal a day at most
From 65, the app takes at most 500 kcal a day off what we estimate you burn. With 7,700 kcal per kilogram, that is about 0.45 kg a week. The other limits still apply: 0.8% of your weight a week, and 35% of what you burn. Whichever is smallest wins.
This follows the ESPEN guideline. For obese older people who do lose weight, it advises “a maximally moderate caloric restriction (~500 kcal/d less than estimated needs and maintaining a minimum intake of 1000–1200 kcal/d)”. It aims at 0.25 to 1 kg a week, with at least 1 g of protein per kilogram. Our calorie minimum stays at 1,200 kcal for women and 1,500 for men, which is at or above that floor.
ESPEN also says the diet should be combined with exercise whenever possible, to keep muscle. That advice has its highest grade, A. In its trials, diet plus exercise often kept lean mass better than diet alone. The app cannot make you exercise. It can say so, and the warning does.
Not everything supports this. Most people in those trials were 60 to 70, ESPEN notes, not very old or frail people. And ESPEN wrote this advice for obese older people. For people who are only overweight, it says something else. That is next.
Below a BMI of 30, and from 80, we suggest keeping your weight
When somebody aged 65 or older with a BMI under 30 chooses to lose weight, setup does not show the pace choice straight away. It says that we suggest keeping your weight, and why. Then it offers two buttons: “Keep my weight” and “Lose weight anyway”. From 80, it does this at every BMI. “Lose weight anyway” gives a normal loss plan, with every limit on this page.
| Age | BMI | What setup does |
|---|---|---|
| Under 65 | 18.5 or less | No weight-loss plan: plans keeping weight |
| Under 65 | Over 18.5 | Shows the pace choice |
| 65 or older | 23 or less | No weight-loss plan: plans keeping weight |
| 65 to 79 | Over 23, under 30 | Suggests keeping weight first |
| 65 to 79 | 30 or more | Shows the pace choice |
| 80 or older | Over 23 | Suggests keeping weight first |
Under a BMI of 30, this follows the ESPEN guideline. Its recommendation 79 says: “In overweight older persons, weight-reducing diets shall be avoided in order to prevent loss of muscle mass and accompanying functional decline.” Overweight is a BMI of 25 to 30. Below 25, the case for losing weight is weaker still.
From 80, BMI does not change the advice. Most people in the trials ESPEN relies on for obese older people were much younger. It writes that their participants “were mostly ‘young-old’ (60–70 years) not representing a typical geriatric population”. And: “As very old and frail persons are more vulnerable to any kind of stress, decisions for or against weight loss require particular care in this population”. In those trials, diet plus exercise often kept muscle better than diet alone. But few people this old move much. Westerterp (2003) reviewed measurements of daily activity and found: “Most subjects > 80 years have an activity level well below the level defined for sedentary middle-aged adults.” So the exercise that protects muscle during a diet is least likely to happen at this age.
The lowest goal weight is a BMI of 23
Under 65, no goal weight goes below a BMI of 18.5. That is the WHO line for underweight. From 65, the lowest goal is a BMI of 23. For somebody 160 cm tall, that is about 59 kg instead of 47 kg.
Winter et al. (2014) pooled 32 studies of 197,940 people aged 65 and over, followed for 12 years on average. Risk of dying went up below a BMI of 23. It only began to go up above a BMI of 33. In their words: “For older populations, being overweight was not found to be associated with an increased risk of mortality.”
Thin older people may be thin because they are already ill. That can make low weight look worse than it is. The authors left out early deaths and people with disease at the start, and the result did not change much. Even so, studies that watch people cannot prove that weight causes the risk.
The warning before weight loss
When somebody aged 65 or older goes ahead with losing weight, setup shows a warning. It says to talk to your doctor before you start. It says that losing weight can cost muscle and bone. It says to ask most of all if you have kidney problems. And it says strength exercise helps keep muscle.
Each line comes from the sources above. ESPEN writes that weight loss, “whether intentional or not”, speeds up the loss of muscle with age. That raises the risk of frailty, loss of function, fractures and malnutrition. Weight that comes back after a diet is mostly fat, not muscle.
Where we go against the advice, and what we do not know
ESPEN says overweight older people should not diet. We suggest that, but you can still choose to
ESPEN’s recommendation 79 says: “In overweight older persons, weight-reducing diets shall be avoided in order to prevent loss of muscle mass and accompanying functional decline.” 95% of its experts agreed. Its grade is GPP, a good practice point, not grade A or B. It adds that “maintaining stable BW is considered desirable for overweight older adults”. BW is body weight. Even for obese older people, it says to weigh up the risks for each person first.
The app follows it as a suggestion, not a block. A person of 65 or older with a BMI of 25 to 30 can tap “Lose weight anyway”. Then they get a loss plan with the limits on this page, and the warning. The 2013 US obesity guideline (AHA/ACC/TOS) says weight loss treatment is right for overweight people with one sign of heart risk, such as diabetes, high blood pressure or a large waist. That guideline is for adults in general, not written for older people. We do not ask about any of those conditions. So we cannot tell which guideline fits you. Your doctor can. That is why we suggest, the warning sends you to your doctor, and the choice stays yours.
Some experts would set protein higher
Kim et al. (2016) pooled 20 trials in adults older than 50 who lost weight. Higher protein meant 25% of calories or more, or 1.0 g per kilogram. “Older adults retained more lean mass and lost more fat mass during weight loss when consuming higher protein diets.” That supports eating more than the minimum. It does not show that 2.0 g is better than 1.2 g. And PROT-AGE asks for 1.2 to 1.5 g for most older people with a disease, so 1.2 g may be low for some.
The slope from 50 is ours, and some evidence points the other way
No guideline lowers protein between 50 and 65. We do, for people who train, so the number does not fall by 40% on one birthday. Morton et al. (2018) found that extra protein added less muscle as age went up. The authors think older people who train may need more protein to gain muscle, not less. Their review had few older people who ate that much, so it could not test the idea. A 60-year-old who trains hard may get less protein from us than some experts would advise.
And some would set it lower
The Dutch Health Council (Gezondheidsraad, 2021) found “onvoldoende aanleiding om een aparte, hogere voedingsnorm voor eiwit vast te stellen voor volwassenen van 60 jaar en ouder”: not enough reason for a separate, higher protein norm for adults of 60 and over. It found that extra protein probably does not help muscle strength unless people also move more. EFSA sets 0.83 g for all adults. So 1.2 g is already well above what two European bodies think older people need.
65 is a cut-off, not biology
Nothing changes in the body on your 65th birthday. PROT-AGE and the ESPEN expert group write their advice for people over 65, and the Dutch Health Council uses 60. We picked 65 because the protein advice uses it. 80 is a cut-off too: ESPEN calls the very old more vulnerable, but names no age. A fit 66-year-old and a frail 79-year-old get the same rules.
We do not know your kidneys, and BMI is crude
The app does not ask about kidney function, and most people with kidney disease do not know they have it. If you do have it, your doctor’s number beats ours. BMI only uses height and weight. It cannot tell muscle from fat, so two people with the same BMI can be in very different health. The goal-weight floor uses it because it is the measure the mortality studies used.