Buongiorno!!

Yes, yes, it’s true! In less than a week, this ND will be heading to beautiful Italy for the first time!! I’m excited. Just think of all the geeky things I’ll learn!

So, before I go roaming (pun intended), I have scheduled a 3-part series on protein. I just kept digging in on these building blocks of life, and couldn’t stop until I made it to the top of the Cathedral! (Ok, will stop with the Italy references now).

Let me tell you how this undercover investigation and borderline protein obsession started…

highproteinI was a doc-blogger on a mission! My assignment was to set out and search the studies to substantiate if the recent literature would prove the latest trend of higher protein diets for weight loss and satiety. It seems reasonable to ensure that the “building block of life” would be a key component in the regulation of metabolism.

Therefore, the million dollar question is, “What is the optimal amount of protein for health, vitality, and optimizing weight?” So my goal was to really “dig in” on this (pun intended). Uh-oh, rabbit hole! I saw it, I was cautioned, but still, I jumped down it! Oh, why? Hours later, I was still staring at a list of references and had 20-30 tabs open on my computer. (As a side note, my computer unexpectedly went wonky the next day, I’m convinced as a protest.)

As quoted by one of my esteemed colleagues, “Do you really want to go there? You can get 70 experts in the same room, all right, with 70 different opinions. It’s the most controversial subject in nutrition.” A good warning I failed to heed.

Even in the midst of digging through the research and speaking with my supervisor, who is an expert physiologist, I knew it would be a task, perhaps too enormous for a blog. However, this is important for all health devotees, so, once again, my blog will be divided into a series.

In Part I, I will begin by introducing you to the concept and discuss the pitfalls of “the required amounts of protein.”

I visited the low-cal, low-carb, low-fat controversy topic back in 2014, spurred by a study that reported on the different weight and cardiovascular effects of a low-carbohydrate diet compared with a low-fat diet. When this trial hit headlines, it sparked the polarized-sides of the “dietary gurus” everywhere to take out their (fluffy-non-concussion forming) boxing gloves, the smug versus the infuriated. I began to then wade through various opinions.1-2

This trial specifically compared the cardiovascular and weight-loss outcomes of 60 subjects assigned a low-carbohydrate diet (<40 g/d) to 59 participants randomized to a low-fat diet (<30% of daily energy intake from total fat [<7% saturated fat]). The researchers took measurements on weight, cardiovascular health, and dietary composition at baseline and every 3 months for one year. In the end, the low carbohydrate diet won out.

Here were some of the caveats as reported by the Huffington Post.3 However, in my opinion regarding protein, I’m wondering….are they really caveats or support for my conclusion? I’ll get to that.

Now yes, these “limitations” are not good science, but they may be good evidence. Here are the reported “biases”:

  1. Low carb dieters were reported to eat higher amounts of carbohydrates than assigned AND tended to add more protein for “appetite regulation.”
  2. Both groups supplemented with meal replacement bars or shakes. The authors say this makes the study not applicable to the general population!?! Hmm, my clients drink shakes and eat bars to manage their metabolism. In fact, the weight loss market is flooded with supplemental meals and snacks.4
  3. There wasn’t a measurement of BMI. This could be an issue, though this wasn’t an end point and BMI has its own caveats5 (underestimating fat in elderly with low muscle mass, overestimating body fat in athletes).

Score one for the low carb side, right? In the form of sugary carbs, at least this issue isn’t strongly debated in integrative and functional medicine circles and most doctors agree to decrease these “bad carbohydrates.” Most of my colleagues will agree that our population is consuming too much sugar, sugary drinks,6-7 and processed foods. Even the World Health Organization was underwhelmed by people’s ability to regulate consumption and this urged them to recommend to reduce sugar intake to less than 10% of total energy, with a further reduction to less than 5% as a conditional recommendation to reduce the risk of dental caries.8

This brings us back to the subject of the blog. Arguably, the most popular dietary trend9-10 has been to increase dietary protein content while decreasing carbohydrates and virtually eliminate all these obesity-promoting and health-degenerating sugars.8  The popularity9-10of Paleo9 and protein diets may be one reason to explain why the updated Advisory Report of the 2015 Dietary Guidelines11  for Americans reported, “Protein was not identified as a shortfall nutrient for the overall older adult population but it should be noted that 6 percent of men older than 80 years and 11 percent of women older than 80 years old had protein intakes that were below the protein EAR (g/kg/body weight)”(By the way, another good pearl of wisdom in these recommendations included the “cholesterol comeback.” Yup, butter (and eggs) is back!)12

The 2005 recommendations by the Institute of Medicine recommended approximately 10-35% of daily calories from protein or .8g/kg of body weight a day.   Just how was this calculated? The “adequacy of requirements is defined as the lowest daily intake value for a nutrient that will meet the need, as defined by the specified indicator or criterion of adequacy, of apparently healthy individuals.”

Hmmm, in the next blog I’ll dig into some of the science (flaws) in calculating protein content. After we establish a baseline understanding of protein requirements, it may provide a reason why the controversy of “high protein” or “low protein” may be a matter of terminology verses adequate nutrient repletion and the whole “satiation” issue.

PODCAST TIME!

As your waiting eagerly for part II, want to hear me on a podcast??

This podcast is intended for docs and functional medicine practitioners who are supporting their patients with weight loss goals. You can listen here.

Want to hear me on another podcast for everyone?

Stay tuned….I’m going to be hosting an amazing monthly podcast with some of the most renowned experts in integrative medicine, health, nutrition, and functional medicine.

First guest is…it’s a surprise!

Here’s a hint, I call him “the thyroid master!”

References

  1. Bazzano LA, Hu T, Reynolds K, Yao L, Bunol C, Liu Y, et al. Effects of Low-Carbohydrate and Low-Fat Diets: A Randomized Trial. Annals of Internal Medicine. September 2, 2014.
  2. Physicians Committee for Responsible Medicine. Clinical Research. Notable Physicians Committee Publications. http://www.pcrm.org/clinical/publications/
  3. Penner E. Is Low-Carb Really King of Weight Loss? HuffingtonPost. September 6, 2014. http://www.huffingtonpost.com/elle-penner/is-lowcarb-really-king-of_b_5773800.html
  4. Meal Replacement Product Manufacturing in the US: Market Research Report. IBIS World. http://www.ibisworld.com/industry/meal-replacement-product-manufacturing.html
  5. NIH. Assessing Your Weight and Health Risk. Department of Health and Human Services, National Institute of Health. https://www.nhlbi.nih.gov/health/educational/lose_wt/risk.htm
  6. Bushak L.These Are The Countries That Consume The Most Sugar: 6 Times As Much As The Recommended Amount. Medical Daily. September 12, 2014. http://www.medicaldaily.com/these-are-countries-consume-most-sugar-6-times-much-recommended-amount-302916
  7. Yang Q, Zhang Z, Gregg EW, Flanders D, Merritt, Hu F.  JAMA Intern Med. 2014;174(4):516-524. doi:10.1001/jamainternmed.2013.13563.
  8. World Health Organization. WHO calls on countries to reduce sugars intake among adults and children. March 4, 2015.
  9. Fry L. Caveman Diet goes mainstream: how to be ‘paleo-ish’. March 6, 2015.
  10. NPR. Was 2013 Really the Year of the Paleo Diet? NPR.og. December 30, 2013.
  11. U.S. Department of Health and Human Services. Scientific Report of the 2015 Dietary Guidelines Advisory Committee. Part D. Chapter 1: Foods and Nutrient Intakes, and Health: Current Status and Trends. Office of Disease Prevention and Health Promotion. Health.gov. Updated 6/10/2015.
  12. Bittman, M. Butter is Back. The New York Times. March 25, 2014.
  13. 10 Protein and Amino Acids.” Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients) . Washington, DC: The National Academies Press, 2005 . http://books.nap.edu/openbook.php?record_id=10490&page=612
  14. Center for Disease Control and Prevention. Nutrition for Everyone: Protein. CDC.gov. October 4, 2012.