How Much Protein Do You Need?

Written by Dr. Steve Chaney on . Posted in How Much Protein Do You Need

Are You Getting Too Much Protein?

Author: Dr. Stephen Chaney

 

breaking newsHow much protein do you need?  In a recent article entitled “Can You Get Too Much Protein?” the New York Times asserted that most Americans were getting too much protein in their diet. They went on to imply that protein supplements were useless at best and might be downright harmful at worst.

If you happened to read this article, you are probably wondering whether it is true or just another example of media bias. If you have read other articles about supplementation in the New York Times, you may have already suspected that they are biased against the use of supplements.

However, the problem goes way beyond media bias. In today’s online world everyone is a writer and everyone is an editor. More importantly, news is instant. Newspapers and journalists no longer have the time and resources to fully research a topic before they publish it. When a story comes along that fits their bias, the temptation is strong to publish it immediately.

In this issue of “Health Tips From the Professor” I will try to give you a more balanced perspective. If you would like other examples of a more balanced perspective, you might want to read articles from Harvard Medical School’s Health Publications newsletter  or WebMD .

 

What Did The New York Times Get Right?

The New York Times didn’t completely miss the mark. Here are a few things that they got right:

  • Most Americans are getting more than the RDA for protein in their daily diets. They imply that is too much. However, the prevailing view among nutrition experts today is that the RDA is too low for some groups, and many Americans are getting too little protein, not too much.
  • They do acknowledge that there are groups who aren’t getting enough protein, for example – teenage girls, pregnant and lactating women, people over 60, and professional athletes. I would add, based on recent studies, that any adult who is engaged in a weight loss program and/or couch potatoregular, vigorous workouts will also benefit from extra protein, especially after their workout. If you combine all those categories, we are talking about the majority of Americans not getting enough protein. The only exception is the otherwise healthy adults who are “couch potatoes”.
  • They are correct in saying that the average “couch potato” adult in the US doesn’t need more protein. However, even the “couch potatoes” among us would benefit from a healthy protein supplement in place of some of the high fat, high cholesterol animal protein they are eating. They don’t need more protein. They just need better protein.
  • Finally, they are correct in saying many protein supplements are either unsafe or suffer from poor quality control, topics I have covered in previous issues of “Health Tips From the Professor”. My advice is simple. Avoid those protein supplements making extravagant claims about “exploding” your muscles and giving you boundless energy. Also, choose protein supplements made by reputable companies that employ rigorous quality controls.

 

What Did The New York Times Get Wrong?

  • The main theme of their article was that most Americans were getting too much protein. They acknowledged that some nutritionists advocated consuming more protein but implied that most experts did not agree. That paradigm is 20 years old. The evidence has shifted. Most experts today feel that many Americans aren’t getting enough protein.
  • They warned high protein intake could be harmful. It could lead to increased risk of cancer, heart disease, diabetes and kidney disease. Let’s put how much protein do you needthose claims into perspective.
    • Increased risk of cancer is linked to high intake of animal protein, especially red meat and processed meats.
    • Increased risk of heart disease and diabetes is linked to high intake of fat and cholesterol rich animal proteins.
    • In short, for these diseases it’s the kind of protein, not the amount, that is the problem.
    • As for kidney disease, it is clear that protein intake should be restricted when you have kidney disease. It is not clear that high protein intake can cause kidney disease in healthy adults.
  • Finally, they assumed that most people just added protein supplements to the protein they were already eating. If that were true, it might be a problem. However, most people use protein supplements in place of some of the high fat animal protein in their diet. They aren’t necessarily eating more protein. They are eating healthier protein.

 

What Do Recent Studies Show?

If we look at recent publications on the subject, it is clear the New York Times article did not accurately report what current studies show about protein needs of Americans. Here are just a few examples:

High protein diets improve physical function and weight loss in older adults. In this study participants on the high protein diet:

  • Lost 15% more weight than those on the low protein diet. More importantly, the high protein group had:
    • 60% better retention of lean body mass (muscle).
    • 25% better loss of fat mass.
  • They also performed substantially better on physical function tests than the low protein group. There was no exercise component to this study. The improvement in physical function was solely related to the better retention of muscle mass and the greater loss of fat mass in the high protein group.

protein shakeHigh protein diets improve fat mass loss and muscle mass gain in young adults on a weight loss diet(American Journal of Clinical Nutrition, 103: 738-746, 2016). In this study the high protein group:

  • Had 33% greater loss of fat mass than the low protein group.
  • Increased muscle mass by an average of 2.6 pounds compared to no change in the low protein group.

High protein diets improve satiety (The Journal of Nutrition, 146: 637-645, 2016). In this study the high protein group:

  • Reported greater satiety and less hunger between breakfast and lunch.
  • Consumed 12% fewer calories at lunch.

These are just a few recent studies. There are dozens of other studies that come to the same conclusions about how much protein you need. This is the new paradigm.

 

Why do some studies still come up with negative results?

The problem may be in the experimental design of those studies. Here are two recent papers that give some hints as to why some studies might fail to see the benefit of protein supplementation.

Protein quality matters (Nutrition & Metabolism, doi: 10.1186/s12986-016-0124-8).  This review concluded that protein quality, particularly the leucine content of the protein, was important in determining the effectiveness of that protein supplement in enhancing muscle mass increases following resistance training,

Spread protein throughout the day(American Journal of Physiology, endocrinology & Metabolism, 308: E734-E743, 2015 ). This study concluded that high protein intake is most effective at promoting muscle gain and weight loss when protein intake is spread evenly throughout the day.

In short, these studies suggest that good quality protein and good experimental design are essential if you wish to evaluate the role of additional protein on things like muscle mass and weight loss.

 

How Much Protein Do You Need?

What Do RDAs and Dietary Guidelines Say? Let’s start by looking at the RDA and how it has changed over the years. You probably have heard protein dietshakes for proteinthat the RDA is 46 grams of protein a day for women and 56 grams a day for men. However, that is misleading. The RDA for protein is based on body weight. The conversion is 0.36 grams of protein for every pound of body weight.

A simple calculation will tell you that 46 grams per day for women assumes they weigh 127 pounds, and 56 grams for men assumes they weigh 155 pounds. We haven’t seen those weights since the 50’s. Today the average weight for a 50-year-old woman is 170 pounds. The average weight for a 50-year-old man is 201 pounds. That translates into an RDA of 61 grams for the average woman and 72 grams for the average man.

You may have also heard that 10% of our calories from protein would meet our RDA requirements, and most Americans are currently getting around 16% of their calories from protein. The New York Times article implied that 16% of calories from protein was too much. Anything above that would be excessive, perhaps even dangerous.

What do the guidelines say? The current Dietary Guidelines for Americans  recognizes individual variations in protein needs and recommends we get between 10% and 35% of our daily calories from protein. For a 2,000 calorie diet that represents between 50 and 175 grams of protein/day.

 

What Are The Experts Saying? Experts are not just recommending more protein for some groups. They are making specific recommendations for how much protein people in those groups should be getting. How much protein do you need?

 

  • If you are an inactive, otherwise healthy, middle-aged adult, 10% of your calories from protein or 0.36 grams of protein a day per pound of body weight is sufficient. However, you would probably benefit from healthier protein choices.
  • If you are a teenage girl, your protein requirements are only slightly higher than a woman in your 20s. However, teenage diets are often not what they should be. You may not be getting the protein you need. Aim for around 0.38 grams of protein per pound of body weight per day.
  • If you are pregnant or lactating, your protein requirements are between 0.47 and 0.56 grams per pound of body weight per day. That represents a 30-55% increase in protein requirements. Your developing baby needs the extra protein. Be sure you are getting enough.
  • If you are over 50, you are probably losing a little muscle mass every day (a condition referred to as sarcopenia). To offset that muscle loss, most experts on aging recommend seniors increase their protein intake to around 0.5 grams of protein per pound of body weight per day. Ideally, that protein should be spread evenly throughout the day with about 25-30 grams of protein per meal. Leucine needs are increased as well, so leucine-rich protein sources are best. I’ve covered this topic in detail in a previous issue Protein Needs of Older Adults of “Health Tips From the Professor.”
  • If you are not an athlete, but work out on a regular basis, you will achieve better muscle gain from your workouts if you consume leucine-rich protein after each workout. If you are a young adult, 15-20 grams will suffice. If you are an older adult 20-25 grams is a better target. I’ve also covered this topic in a previous issue Leucine Trigger Muscle Growth of “Health Tips From the Professor.”
  • If you are trying to lose weight, diets providing about 0.72 grams of leucine-rich protein per pound (~ 2X the RDA or 28% of the total calories) appear to be more effective than RDA levels of protein at preserving muscle mass and reducing fat mass. Again, this topic is covered in a previous issue High Protein Diets and Weight Loss of “Health Tips From the Professor.”
  • Higher protein intake is most effective when coupled with resistance (weight bearing) exercise.
  • Higher protein intake is also most effective when spread throughout the day rather concentrated in a post-workout supplement or at a single meal.

 

The Bottom Line

  • A recent New York Times article asserted that most Americans were already getting too much protein in their diets and that dietary protein supplements were either unnecessary or dangerous.
  • That paradigm is at least 20 years out of date. Today, most experts agree that many Americans are getting too little protein in their diet.
  • Groups most likely to need additional protein are teenage girls, pregnant and lactating women, adults over 50, elite athletes, people who work out regularly, and people on weight loss diets.
  • The only group routinely getting more than enough protein from their diets are otherwise healthy, adult “couch potatoes,” and most of them would benefit from healthier protein choices in their diet.
  • Increased protein intake is best utilized when coupled with resistance (weight-bearing) exercise. It is also best utilized when spread out evenly throughout the day rather than being concentrated in a single post-workout supplement or a single meal.
  • The most current guidelines for protein needs of various groups are given in the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Comments (1)

  • coach Mike Walker BS,MA

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    As always Dr Chaney teaches and preaches great info for all us fans of his…keep it up Doc ….coach Walker

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Latest Article

Should We Use Supplements For Cardiovascular Health?

Posted July 10, 2018 by Dr. Steve Chaney

Are You Just Wasting Your Money On Supplements?

Author: Dr. Stephen Chaney

 

supplements for cardiovascular health wast moneyYou’ve seen the headlines. “Recent Study Finds Vitamin and Mineral Supplements Don’t Lower Heart Disease Risk.”  You are being told that supplements are of no benefit to you. They are a waste of money. You should follow a healthy diet instead. Is all of this true?

If I were like most bloggers, I would give you a simple yes or no answer that would be only partially correct. Instead, I am going to put the study behind these headlines into perspective. I am going to give you a deeper understanding of supplementation, so you can make better choices for your health.

 Should we use supplements for cardiovascular health?

In today’s article I will give you a brief overview of the subject. Here are the topics I will cover today:

  • Is this fake news?
  • Did the study ask the right questions?
  • Is this a question of “Garbage In – Garbage Out?
  • Reducing Heart Disease Risk. What you need to know.

All these topics are covered in much more detail (with references) in my book “Slaying The Supplement Myths”, which will be published this fall.

 

How Was This Study Done?

supplements for cardiovascular healthThis study (D.J.A. Jenkins et al, Journal of the American College Of Cardiology, 71: 2540-2584, 2018 ) was a meta-analysis. Simply put, that means the authors combined the results of many previous studies into a single database to increase the statistical power of their conclusions. This study included 127 randomized control trials published between 2012 and December 2017. These were all studies that included supplementation and looked at cardiovascular end points, cancer end points or overall mortality.

Before looking at the results, it is instructive to look at the strengths and weaknesses of the study. Rather than giving you my interpretation, let me summarize what the authors said about strengths and weaknesses of their own study.

The strengths are obvious. Randomized control trials are considered the gold standard of evidence-based medicine, but they have their weaknesses. Here is what the authors said about the limitations of their study:

  • “Randomized control trials are of shorter duration, whereas longer duration studies might be required to fully capture chronic disease risk.”
  • “Dose-response data were not usually available [from the randomized control studies included in their analysis]. However, larger studies would allow the effect of dose to be assessed.”

There are some other limitations of this study, which I will point out below.

Is This Fake News?

supplements for cardiovascular health fake newsWhen I talk about “fake news” I am referring to the headlines, not to the study behind the headlines. The headlines were definitive: “Vitamin and Mineral Supplements Don’t Lower Heart Disease Risk.” However, when you read the study the reality is quite different:

  • In contrast to the negative headlines, the study reported:
    • Folic acid supplementation decreased stroke risk by 20% and overall heart disease risk by 17%.
    • B complex supplements containing folic acid, B6, and B12 decreased stroke risk by 10%.
    • That’s a big deal, but somehow the headlines forgot to mention it.
  • The supplements that had no significant effect on heart disease risk (multivitamins, vitamin D, calcium, and vitamin C) were ones that would not be expected to lower heart disease risk. There was little evidence from previous studies of decreased risk. Furthermore, there is no plausible mechanism for supposing they might decrease heart disease risk.
  • The study did not include vitamin E or omega-3 supplements, which are the ones most likely to prove effective in decreasing heart disease risk when the studies are done properly (see below).

Did The Study Ask The Right Question?

Most of the studies included in this meta-analysis were asking whether a supplement decreased heart disease risk or mortality for everyone. Simply put, the studies started with a group of generally healthy Americans and asked whether supplementation had a significant effect on disease risk for everyone in that population.

That is the wrong question. We should not expect supplementation to benefit everyone equally. Instead, we should be asking who is most likely to benefit from supplementation and design our clinical studies to test whether those people benefit from supplementation.

supplements for cardiovascular health diagramI have created the graphic on the right as a guide to help answer the question of “Who is most likely to benefit from supplementation?”. Let me summarize each of the points using folic acid as the example.

 

Poor Diet: It only makes sense that those people who are deficient in folate from foods are the most likely to benefit from folic acid supplementation. Think about it for a minute. Would you really expect people who are already getting plenty of folate from their diet to obtain additional benefits from folic acid supplementation?

The NIH estimates that around 20% of US women of childbearing age are deficient in folic acid. For other segments of our population, dietary folate insufficiency ranges from 5-10%. Yet, most studies of folic acid supplementation lump everyone together – even though 80-95% of the US population is already getting enough folate through foods, food fortification, and supplementation. It is no wonder most studies fail to find a beneficial effect of folic acid supplementation.

The authors of the meta-analysis I discussed above said that the beneficial effects of folic acid they saw might have been influenced by a very large Chinese study, because a much higher percentage of Chinese are deficient in folic acid. They went on to say that the Chinese study needed to be repeated in this country.

In fact, the US study has already been done. A large study called “The Heart Outcomes Prevention Evaluation (HOPE)” study reported that folic acid supplementation did not reduce heart disease risk in the whole population. However, when the study focused on the subgroup of subjects who were folate-deficient at the beginning of the study, folic acid supplementation significantly decreased their risk of heart attack and cardiovascular death.  This would seem to suggest using supplements for cardiovascular health is a good idea.

Increased Need: There are many factors that increase the need for certain nutrients. However, for the sake of simplicity, let’s only focus on medications. Medications that interfere with folic acid metabolism include anticonvulsants, metformin (used to treat diabetes), methotrexate and sulfasalazine (used to treat severe inflammation), birth control pills, and some diuretics. Use of these medications is not a concern when the diet is adequate. However, when you combine medication use with a folate-deficient diet, health risks are increased and supplementation with folic acid is more likely to be beneficial.

Genetic Predisposition: The best known genetic defect affecting folic acid metabolism is MTHFR. MTHFR deficiency does not mean you have a specific need for methylfolate. However, it does increase your need for folic acid. Again, this is not a concern when the diet is adequate. However, when you combine MTHFR deficiency with a folate-deficient diet, health risks are increased and supplementation with folic acid is more likely to be beneficial. I cover this topic in great detail in my upcoming book, “Slaying The Supplement Myths”. In the meantime, you might wish to view my video, “The Truth About Methyl Folate.”

Diseases: An underlying disease or predisposition to disease often increases the need for one or more nutrients that help reduce disease risk. The best examples of this are two major studies on the effect of vitamin E on heart disease risk in women. Both studies found no effect of vitamin E on heart disease risk in the whole population. However, one study reported that vitamin E reduced heart disease risk in the subgroup of women who were post-menopausal (when the risk of heart disease skyrockets). The other study found that vitamin E reduced heart attack risk in the subgroup of women who had pre-existing heart disease at the beginning of the study.

Finally, if you look at the diagram closely, you will notice a red circle in the middle. When two or three of these factors overlap, that is the “sweet spot” where supplementation is almost certain to make a difference and it may be a good idea to use supplements for cardiovascular health.

Is This A Question Of “Garbage In, Garbage Out”?

supplements for cardiovascular health garbage in outUnfortunately, most clinical studies focus on the “Does everyone benefit from supplementation question?” rather than the “Who benefits from supplementation?” question.

In addition, most clinical studies of supplementation are based on the drug model. They are studying supplementation with a single vitamin or mineral, as if it were a drug. That’s unfortunate, because vitamins and minerals work together synergistically. What we need are more studies of holistic supplementation approaches.

Until these two things change, most supplement studies are doomed to failure. They are doomed to give negative results. In addition, meta-analyses based on these faulty supplement studies will fall victim to what computer programmers refer to as “Garbage In, Garbage Out”. If the data going into the analysis is faulty, the data coming out of the study will be equally faulty. It won’t be worth the paper it is written on. If you are looking for personal guidance on supplementation, this study falls into that category.

 

Should We Use Supplements For Cardiovascular Health?

 

If you want to know whether supplements decrease heart disease risk for everyone, this meta-analysis is clear. Folic acid may decrease the risk of stroke and heart disease. A B complex supplement may decrease the risk of stroke. All the other supplements they included in their analysis did not decrease heart disease risk, but the analysis did not include vitamin E and/or omega-3s.

However, if you want to know whether supplements decrease heart disease risk for you, this study provides no guidance. It did not ask the right questions.

I would be remiss, however, if I failed to point out that we know healthy diets can decrease heart disease risk. In the words of the authors: “The recent science-based report of the U.S. Dietary Guidelines Advisory Committee, also concerned with [heart disease] risk reduction, recommended 3 dietary patterns: 1) a healthy American diet low in saturated fat, trans fat, and meat, but high in fruits and vegetables; 2) a Mediterranean diet; and 3) a vegetarian diet. These diets, with their accompanying recommendations, continue the move towards more plant-based diets…” I cover the effect of diet on heart disease risk in detail in my book, “Slaying The Food Myths”.

 

The Bottom Line

 

You have probably seen the recent headlines proclaiming: “Vitamin and Mineral Supplements Don’t Lower Heart Disease Risk.” The study behind the headlines was a meta-analysis of 127 randomized control trials looking at the effect of supplementation on heart disease risk and mortality.

  • The headlines qualify as “fake news” because:
    • The study found that folic acid decreased stroke and heart disease risk, and B vitamins decreased stroke risk. Somehow the headlines forgot to mention that.
    • The study found that multivitamins, vitamin D, calcium, and vitamin C had no effect on heart disease risk. These are nutrients that were unlikely to decrease heart disease risk to begin with.
    • The study did not include vitamin E and omega-3s. These are nutrients that are likely to decrease heart disease risk when the studies are done properly.
  • The authors of the study stated that a major weakness of their study was that that randomized control studies included in their analysis were short term, whereas longer duration studies might be required to fully capture chronic disease risk.
  • The study behind the headlines is of little use for you as an individual because it asked the wrong question.
  • Most clinical studies focus on the “Does everyone benefit from supplementation question?” That is the wrong question. Instead we need more clinical studies focused on the “Who benefits from supplementation?” question. I discuss that question in more detail in the article above.
  • In addition, most clinical studies of supplementation are based on the drug model. They are studying supplementation with a single vitamin or mineral, as if it were a drug. That’s unfortunate, because vitamins and minerals work together synergistically. What we need are more studies of holistic supplementation approaches.
  • Until these two things change, most supplement studies are doomed to failure. They are doomed to give negative results. In addition, meta-analyses based on these faulty supplement studies will fall victim to what computer programmers refer to as “Garbage In, Garbage Out”. If the data going into the analysis is faulty, the data coming out of the study will be equally faulty. It won’t be worth the paper it is written on. If you are looking for personal guidance on supplementation, this study falls into that category.
  • If you want to know whether supplements decrease heart disease risk for everyone, this study is clear. Folic acid may decrease the risk of stroke and heart disease. A B-complex supplement may decrease the risk of stroke. All the other supplements they included in their analysis did not decrease heart disease risk, but they did not include vitamin E and/or omega-3s in their analysis.
  • If you want to know whether supplements decrease heart disease risk for you, this study provides no guidance. It did not ask the right questions.
  • However, we do know that healthy, plant-based diets can decrease heart disease risk. I cover heart healthy diets in detail in my book, “Slaying The Food Myths.”

 

For more details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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