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.

Trackback from your site.

Comments (1)

  • coach Mike Walker BS,MA

    |

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

    Reply

Leave a comment

Recent Videos From Dr. Steve Chaney

READ THE ARTICLE
READ THE ARTICLE

Latest Article

A Low Carb Diet and Weight Loss

Posted January 15, 2019 by Dr. Steve Chaney

Do Low-Carb Diets Help Maintain Weight Loss?

Author: Dr. Stephen Chaney

 

low carb dietTraditional diets have been based on counting calories, but are all calories equal? Low-carb enthusiasts have long claimed that diets high in sugar and refined carbs cause obesity. Their hypothesis is based on the fact that high blood sugar levels cause a spike in insulin levels, and insulin promotes fat storage.

The problem is that there has been scant evidence to support that hypothesis. In fact, a recent meta-analysis of 32 published clinical studies (KD Hall and J Guo, Gastroenterology, 152: 1718-1727, 2017 ) concluded that low-fat diets resulted in a higher metabolic rate and greater fat loss than isocaloric low-carbohydrate diets.

However, low-carb enthusiasts persisted. They argued that the studies included in the meta-analysis were too short to adequately measure the metabolic effects of a low-carb diet. Recently, a study has been published in the British Medical Journal (CB Ebbeling et al, BMJ 2018, 363:k4583 ) that appears to vindicate their position.

Are low carb diets best for long term weight loss?

Low-carb enthusiasts claim the study conclusively shows that low-carb diets are best for losing weight and for keeping it off once you have lost it. They are saying that it is time to shift away from counting calories and from promoting low-fat diets and focus on low-carb diets instead if we wish to solve the obesity epidemic. In this article I will focus on three issues:

  • How good was the study?
  • What were its limitations?
  • Are the claims justified?

 

How Was The Study Designed?

low carb diet studyThe investigators started with 234 overweight adults (30% male, 78% white, average age 40, BMI 32) recruited from the campus of Framingham State University in Massachusetts. All participants were put on a diet that restricted calories to 60% of estimated needs for 10 weeks. The diet consisted of 45% of calories from carbohydrate, 30% from fat, and 25% from protein. [So much for the claim that the study showed low-carb diets were more effective for weight loss. The diet used for the weight loss portion of the diet was not low-carb.]

During the initial phase of the study 161 of the participants achieved 10% weight loss. These participants were randomly divided into 3 groups for the weight maintenance phase of the study.

  • The diet composition of the high-carb group was 60% carbohydrate, 20% fat, and 20% protein.
  • The diet composition of the moderate-carb group was 40% carbohydrate, 40% fat, and 20% protein.
  • The diet composition of the low-carb group was 20% carbohydrate, 60% fat, and 20% protein.

Other important characteristics of the study were:

  • The weight maintenance portion of the study lasted 5 months – much longer than any previous study.
  • All meals were designed by dietitians and prepared by a commercial food service. The meals were either served in a cafeteria or packaged to be taken home by the participants.
  • The caloric content of the meals was individually adjusted on a weekly basis so that weight was kept within a ± 4-pound range during the 5-month maintenance phase.
  • Sugar, saturated fat, and sodium were limited and kept relatively constant among the 3 diets.

120 participants made it through the 5-month maintenance phase.

 

Do Low-Carb Diets Help Maintain Weight Loss?

low carb diet maintain weight lossThe results were striking:

  • The low-carb group burned an additional 278 calories/day compared to the high-carb group and 131 calories/day more than the moderate-carbohydrate group.
  • These differences were even higher for those individuals with higher insulin secretion at the beginning of the maintenance phase of the study.
  • These differences lead the authors to hypothesize that low-carb diets might be more effective for weight maintenance than other diets.

 

What Are The Pros And Cons Of This Study?

low carb diet pros and consThis was a very well-done study. In fact, it is the most ambitious and well-controlled study of its kind. However, like any other clinical study, it has its limitations. It also needs to be repeated.

The pros of the study are obvious. It was a long study and the dietary intake of the participants was tightly controlled.

As for cons, here are the three limitations of the study listed by the authors:

#1: Potential Measurement Error: This section of the paper was a highly technical consideration of the method used to measure energy expenditure. Suffice it to say that the method they used to measure calories burned per day may overestimate calories burned in the low-carb group. That, of course, would invalidate the major findings of the study. It is unlikely, but it is why the study needs to be repeated using a different measure of energy expenditure.

#2: Compliance: Although the participants were provided with all their meals, there was no way of being sure they ate them. There was also no way of knowing whether they may have eaten other foods in addition to the food they were provided. Again, this is unlikely, but cannot be eliminated from consideration.

#3: Generalizability: This is simply an acknowledgement that the greatest strength of this study is also its greatest weakness. The authors acknowledged that their study was conducted in such a tightly controlled manner it is difficult to translate their findings to the real world. For example:

  • Sugar and saturated fat were restricted and were at very similar levels in all 3 diets. In the real world, people consuming a high-carb diet are likely to consume more sugar than people in the other diet groups. Similarly, people consuming the low-carb diet are likely to consume more saturated fat than people in the other diet groups.
  • Weight was kept constant in the weight maintenance phase by constantly adjusting caloric intake. Unfortunately, this seldom happens in the real world. Most people gain weight once they go off their diet – and this is just as true with low-carb diets as with other diets.
  • The participants had access to dietitian-designed prepared meals 3 times a day for 5 months. This almost never happens in the real world. The authors said “…these results [their data] must be reconciled with the long-term weight loss trials relying on nutrition education and behavioral counseling that find only a small advantage for low carbohydrate compared with low fat diets according to several recent meta-analyses.” [I would add that in the real world, people do not even have access to nutritional education and behavioral modification.]

 

low carb diet and youWhat Does This Study Mean For You?

  • This study shows that under very tightly controlled conditions (dietitian-prepared meals, sugar and saturated fat limited to healthy levels, calories continually adjusted so that weight remains constant) a low-carb diet burns more calories per day than a moderate-carb or high-carb diet. These findings show that it is theoretically possible to increase your metabolic weight and successfully maintain a healthy weight on a low-carb diet. These are the headlines you probably saw. However, a careful reading of the study provides a much more nuanced viewpoint. For example, the fact that the study conditions were so tightly controlled makes it difficult to translate these findings to the real world.
  • In fact, the authors of the study acknowledged that multiple clinical studies show this almost never happens in the real world. These studies show that most people regain the weight they have lost on low-carb diets. More importantly, the rate of weight regain is virtually identical on low-carb and low-fat diets. Consequently, the authors of the current study concluded “…translation [of their results to the real world] requires exploration in future mechanistic oriented research.” Simply put, the authors are saying that more research is needed to provide a mechanistic explanation for this discrepancy before one can make recommendations that are relevant to weight loss and weight maintenance in the real world.
  • The authors also discussed the results of their study in light of a recent, well-designed 12-month study (CD Gardener et al, JAMA, 319: 667-669, 2018 ) that showed no difference in weight change between a healthy low-fat versus a healthy low-carbohydrate diet. That study also reported that the results were unaffected by insulin secretion at baseline. The authors of the current study noted that “…[in the previous study] participants were instructed to minimize or eliminate refined grains and added sugars and maximize intake of vegetables. Probably for this reason, the reported glycemic load [effect of the diet on blood sugar levels] of the low-fat diet was very low…and similar to [the low-carb diet].” In short, the authors of the current study were acknowledging that diets which focus on healthy, plant-based carbohydrates and eliminate sugar, refined grains, and processed foods may be as effective as low-carb diets for helping maintain a healthy weight.
  • This would also be consistent with previous studies showing that primarily plant-based, low-carb diets are more effective at maintaining a healthy weight and better health outcomes long-term than the typical American version of the low-fat diet, which is high in sugar and refined grains. In contrast, meat-based, low-carb diets are no more effective than the American version of the low-fat diet at preventing weight gain and poor health outcomes. I have covered these studies in detail in my book “Slaying The Food Myths.”

Consequently, the lead author of the most recent study has said: “The findings [of this study] do not impugn whole fruits, beans and other unprocessed carbohydrates. Rather, the study suggests that reducing foods with added sugar, flour, and other refined carbohydrates could help people maintain weight loss….” This is something we all can agree on, but strangely this is not reflected in the headlines you may have seen in the media.

The Bottom Line

 

  • A recent study compared the calories burned per day on a low-carb, moderate-carb, and high-carb diet. The study concluded that the low-carb diet burned significantly more calories per day than the other two diets and might be suitable for long-term weight control. If confirmed by subsequent studies, this would be the first real evidence that low-carb diets are superior for maintaining a healthy weight.
  • However, the study has some major limitations. For example, it used a methodology that may overestimate the benefits of a low-carb diet, and it was performed under tightly controlled conditions that can never be duplicated in the real world. As acknowledged by the authors, this study is also contradicted by multiple previous studies. Further studies will be required to confirm the results of this study and show how it can be applied in the real world.
  • In addition, the kind of carbohydrate in the diet is every bit as important as the amount of carbohydrate. The authors acknowledge that the differences seen in their study apply mainly to carbohydrates from sugar, refined grains, and processed foods. They advocate diets with low glycemic load (small effects on blood sugar and insulin levels) and acknowledge this can also be achieved by incorporating low-glycemic load, plant-based carbohydrates into your diet. This is something we all can agree on, but strangely this is not reflected in the headlines you may have seen in the media.
  • Finally, clinical studies report averages, but none of us are average. When you examine the data from the current study, it is evident that some participants burned more calories per hour on the high-carb diet than other participants did on the low carb diet. That reinforces the observation that some people lose weight more effectively on low-carb diets while others lose weight more effectively on low-fat diets. If you are someone who does better on a low-carb diet, the best available evidence suggests you will have better long-term health outcomes on a primarily plant-based, low-carb diet such as the low-carb version of the Mediterranean diet.

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.

UA-43257393-1