Make the Right Decision about Protein

Many people are becoming enamored with protein and eating more protein that some should eat. Because of the misinformation put out by many doctors, registered dietitians, and nutritionists, about avoiding fat and overloading us with carbohydrates, more people are moving toward more protein and away from fats and carbohydrates. This is often to their own detriment and is causing some people additional health problems.

First, excess protein can be converted to fat by many people. This is because your body can only use a certain amount of protein each day. If you take in too much protein, you may gain weight. Each gram of protein has 4 calories. If you take in 100 grams of protein, but your body can only use 50 grams of it, your body will store the extra 200 calories' worth of protein as fat. Doing this daily can cause you to take in 1,400 extra calories per week, resulting in a weight gain of almost 2 pounds per month.

Second, too much protein can damage your liver. An excessive protein intake can be harmful to your liver, brain and nervous system. When you eat protein, your body produces ammonia, a toxin that your liver normally makes harmless. Eating too much protein over a long period of time can cause your liver to become overworked, allowing ammonia and other toxic substances to build up in your bloodstream. This can lead to hepatic encephalopathy, a condition marked by a decline in brain and nervous system function.

Third, protein can increase your levels of cholesterol. Many high-protein foods, particularly from animal sources, contain an abundance of cholesterol. The National Heart, Lung and Blood Institute recommends limiting your cholesterol intake to no more than 200 milligrams per day, but a 6-ounce broiled porterhouse steak has 126 milligrams of cholesterol and half a roasted chicken breast has 83 milligrams of cholesterol. Eating too much animal protein can cause you to exceed the National Heart, Lung and Blood Institute's guidelines, putting you at risk for dangerous conditions.

Fourth and the final problem is protein in your urine. Protein in your urine may be an early sign of kidney disease. Proteinuria means protein in your urine. Your kidneys make urine by cleaning extra fluid from your blood. Your kidneys also help prevent the loss of things that your body needs, like protein. Proteinuria happens when your kidneys let protein leak into your urine. Protein in your urine may also be called albuminuria or microalbuminuria.

A very tiny amount of protein in your urine may be common from time to time, but a larger amount of protein in your urine may be an early sign of kidney disease. If proteinuria is not controlled, the increased amount of protein in your urine can lead to more kidney damage. Over time, this can cause your kidneys to fail, and you may need dialysis or a kidney transplant. If you find and treat the problem that is causing your proteinuria, you may be able to stop or slow down the damage. Testing is the only way to determine if you have this.

The Institute of Medicine recommends that protein-rich foods represent 10 to 35 percent of the calories you take in. The average woman should get about 46 grams of protein a day and men should get about 56 grams of protein daily. Active people need more protein than sedentary people, so if you engage in moderate to vigorous exercise on a regular basis, talk to your doctor to see if you should increase your protein intake.

Is the Protein Bandwagon for You?

I have blogged about carbohydrates (and that is natural for those of us with type 2 diabetes) because we need to reduce the number of carbohydrates we consume. I have also blogged about fat because we now know that fat is not bad for us like many doctors want us to believe that follow the teaching of Ancel Keys who has been proven wrong. Many are having better test result for cholesterol when eating more fat.

Now we are hearing about the third macronutrient, protein. Yes, most grocery stores have more foods advertised as being high protein. Although protein has, until recently, kept a low profile compared to fat and carbohydrates, it’s always been a major player in the body. Present in every cell, proteins act as building blocks for all types of tissue. Foods naturally high in protein, such as meat, poultry, fish, beans, eggs, nuts, and seeds, also tend to be high in other important nutrients.

Some writers want to label high protein a fad, and others are saying protein is needed for the building blocks in our body. While the latter is true, high quantities of protein can have adverse effects on our body, especially for those that have renal weakness. When a writer says there are a lot of perceived health benefits to consuming more protein, remember that the meaning of perceived means - to recognize, discern, envision, or understand.

Three-quarters of U.S. consumers agree that protein contributes to a healthy diet, and more than half say they want to eat more of it. The study found that nearly half of the primary grocery shoppers in a household have bought protein-enriched foods. Americans are looking for protein to aid in satiety, weight management, boost muscle recovery, and build muscle after a workout

The U.S. is by far the world’s biggest market for high-protein products. Introductions of foods and drinks making a high-protein claim in 2012 were almost triple that of any other country. And yet, according to the most recent available data, Americans aren’t exactly pigging out on protein.

They really don’t have to, according to the government’s 2010 Dietary Guidelines, to be updated late next year. The guidelines, issued jointly by the U.S. Department of Agriculture and the Department of Health and Human Services, give plenty of leeway when it comes to protein, recommending that adults over age 18 get 10% to 35% of their daily calories from the nutrient. Nobody’s anywhere near the 35%, says Trish Britten, PhD, a USDA nutritionist. As a population, we are at 15.5%. And the top 5% of protein-eaters get only 19.6% of their calories from the nutrient, Britten says.

The USDA recently began calculating Americans’ usual intake of protein, so information about trends over time isn’t yet available. But if saturated fat consumption is any indication, change occurs very slowly. The USDA has been tracking saturated fat as a percent of calories forever. So despite the growing popularity of protein-added products, it’s doubtful that Americans are eating much more than they were before it was all the rage.

Frank Hu, MD, PhD, MPH, a professor of nutrition and epidemiology at Harvard says, “The current American diet contains too much refined carbohydrates. I think it’s a good idea to replace at least some of the refined carbs and added sugars with healthy sources of proteins, such as nuts, legumes, no-fat dairy products. In other words, trading a nutty chocolate bar for a handful of nuts might not be a bad idea.”

Dr. Hu continues, “If you’re engaged in a high level of physical activity, particularly resistance training, you probably need more protein than the average individual, perhaps as much as 20% to 25% of your calories.” Dr. Hu concludes by saying, “We don’t know how high is too high, although, given the USDA data, few Americans are anywhere near the upper limit of the government’s Dietary Guidelines. If you want to increase your protein, cut back on less-nutritious foods such as simple carbs.”

Yoni Freedhoff, MD, an assistant professor of family medicine at the University of Ottawa, made this statement, "Unless you have pre-existing kidney problems I have no concerns about people eating large amounts of protein.”

The last statement is the concern you should have before jumping on the protein bandwagon. If necessary, have a talk with your doctor and find out if there are problems or if he needs to do some tests. Let the doctor know that you are interested in increasing the amount of protein in your diet. This will let the doctor know that he needs to make sure that you will not have problems with increased protein.

How Much Protein?

Because there are different guidelines for protein needed I will show the chart first, which is from the Institute of Medicine (IOM).

Exactly how much protein you need changes with age:

1. Babies need about 10 grams a day.
2. School-age kids need 19-34 grams a day.
3. Teenage boys need up to 52 grams a day.
4. Teenage girls need 46 grams a day.
5. Adult men need about 56 grams a day.
6. Adult women need about 46 grams a day (71 grams, if pregnant or breastfeeding)

You should get at least 10% of your daily calories, but not more than 35%, from protein, according to the Institute of Medicine.

The key measure is the Dietary Reference Intake (DRI), a system of nutrition recommendations from the Institute of Medicine of the U.S. National Academy of Sciences. Used by both the United States and Canada, the DRI supersedes the Recommended Dietary Allowances (RDAs), which is still used in food labeling.

Protein from animal sources such as meat, poultry, fish, eggs, milk, cheese, and yogurt provide all nine indispensable amino acids, and for this reason are referred to as ‘complete protein.'

Doctors still want you to limit saturated fat and select leaner cuts of meat. I would only agree on limiting processed meats like hot dogs and sausage. According to researchers at the Harvard School of Public Health, to help lower the chance of heart disease, it's a good idea to limit the amount of red meat, especially processed red meat, and eat more fish, poultry, and beans.

Other researchers say if you are trying to get more omega-3s, you might choose salmon, tuna, or eggs enriched with omega-3s, and if you need more fiber, look to beans, vegetables, nuts, and legumes.

Some of us with type 2 diabetes can have real problems with protein, especially if they have kidney disease and need to limit their amount of protein. Without kidney disease and following a vegan diet, then the problem becomes consuming enough protein. That is why I listed the table for protein consumption at the beginning.

Most of the studies proclaiming low-carb diets are good also have the diet as a low fat and were replacing the carbohydrates eliminated with protein. Some said this was good and others make no comments. The reason for the low fat is that many do not recognize the fallacy of Ancel Keys and that his conclusions have been debunked.

I do not agree to the low fat argument and think fat needs to be the macronutrient added as long as protein is at the level needed providing kidney disease is not a problem. A good discussion with a nutritionist may be necessary as well as the doctor if there is a kidney disease. No, I did not say a dietitian, as they generally want the carbohydrates to stay up and especially the whole grains. Gallbladder issues may also limit the amount of fat you can tolerate.

Please read this blog by David Mendosa about protein. He covers the many sides of protein that I do not.

More on Nutrition for People with Diabetes

In the last blog, I covered eating patterns and started the macronutrients as covered in the October ADA dietary guidelines. Now I will write about protein and fat.

The macronutrient, protein. People with diabetes that don't have kidney disease might be surprised by this. There is no 'ideal' amount of protein that helps to improve blood glucose management, or even lowers the risk of heart disease. There are studies on both sides of this issue for both diseases and most are approached with a bias or what the author or funding agency is trying to prove.

The good news for those that have kidney disease do not have to follow a very low protein diet. More is the concern about malnourishment and the protein does not seem to affect the rate of progression of kidney disease. Even with all the hoop-la about red meat causing heart disease, it is more the highly processed meats that have an effect on the heart.

The macronutrient, fat. This section is more difficult and they are still trying to limit fat to a low fat diet. They of course want monounsaturated fats like olive oil and push vegetable oils. They are unanimous in eliminating trans fat as they should, but to curtail saturated fats with the evidence having been disproved still concerns me. I could agree if they had asked for moderation in the consuming of saturated fat.

The guidelines do say that there is no optimal mix of macronutrients. The statement is just made that evidence suggests that there is not an ideal percentage of calories from carbohydrate, protein, and fat for all people with diabetes; therefore, macronutrient distribution should be based on individualized assessment of current eating patterns, preferences, and metabolic goals.

Yet, they continue by saying it has been observed that people with diabetes eat about 45% of their calories from carbohydrate, 36–40% of calories from fat, and the remainder (16–18%) from protein. All this means is that the authors could care less about assessing people with diabetes and allowing them to have individualized eating plans. They are going to push for high carbohydrates.

They do cover omega 3 fatty acids and advise not to be taking fish oil supplements as there is no evidence that these help protect you from heart disease. The guidelines push the importance of getting your fish oils from food sources and that people eat at least two fish meals per week. This the guidelines say will help lower the risk of heart disease.

The dietary guidelines recommend that people who are 51 years of age, those who are African-American, or those that have high blood pressure, diabetes, or chronic kidney disease limit their sodium (salt) intake to 1500 milligrams (mg) per day. Restricting salt to this level is difficult and can make food unpalatable. Evidence does not support lowering salt level to this amount and the guidelines recommend capping salt intake at 2300 mg per day or the same recommendation as for the general public.

The guidelines do advise limiting alcohol as this can mask hypoglycemic symptoms and lead to problems for those on insulin. The guidelines also recommend high dietary fiber and liberal quantities of whole grains. Big Food is speaking here and for those on low-carbohydrate diets need to limit or eliminate wheat from their diets.

In rereading the guidelines for these two blogs, it has been interesting the conflicts in the advice given and how the leanings are still high-carbohydrate low-fat in nature.