Gerontologists have emphasised that older adults are not only recipients of support but also important support providers. Using data from the first wave of the Netherlands Kinship Panel Study of 727 middle-generation adults aged 45 to 79 years, we examined the associations between loneliness and giving support up, across and down family lineages. Overall, the findings were consistent more with an altruism perspective, that giving brings rewards, than with an exchange perspective, which emphasises the costs of giving support. The results showed an inverse relationship between the number of generations supported and loneliness, and that those engaged in balanced exchanges with family members in three generations (parents, siblings and children) were generally the least lonely. As regards the direction of support giving, the findings showed that the association between giving support and loneliness was insignificant if the support was for parents, negative for support to siblings, and positive for support to children. Imbalanced support exchanges were differentially associated with loneliness, and depended on the type of family relationship involved. Non-reciprocated support made parents more vulnerable to loneliness, whereas non-reciprocated giving in sibling ties was associated with low levels of loneliness. Imbalanced support giving in relationships with parents was not associated with loneliness.