Do some of us need more protein?

Nutrition orthodoxy holds that we all get enough protein, frequently too much protein. The idea that certain groups of people may in fact need to eat more protein flies in the face of that conventional wisdom.

I started seriously questioning this orthodoxy while writing Food Wisdom for Women. Muscles mass decreases with age, leading to increasing frailty, weakness, falls, broken bones and disability. This muscle loss, known as sarcopenia, is a very serious and poorly recognized problem. Do you know any doctors who routinely measure an older person’s lean body mass? Neither do I.

Turns out we can fight back with a combination of higher protein intake and consistent physical activity to challenge muscles to stay strong. And it’s not just older adults who would benefit. Higher protein intake is also good for dieters. Cutting calories can lead to weight loss regardless of the type of diet you choose, but if your lower calorie diet is high protein, you lose more fat weight while preserving your muscles mass.

How Much Protein?

The standard recommendation for protein intake is 0.8 grams dietary protein per kilogram body weight per day. Or 0.36 grams per pound body weight. Anyone who challenges that orthodoxy is a nutrition heretic. “You don’t need that much protein!” is the common criticism. “Science says so!”

News Flash: “Science” is not something set in stone. This is particularly true for nutrition. Information changes all the time. If nutrition “science” were set in stone, we’d be stuck thinking eggs caused heart attacks and vitamin D really isn’t very important.

The studies that look at sarcopenia and weight loss found benefits at modestly higher intakes: 1.0 – 1.5 grams protein per kilogram body weight (0.45 – 0.68 grams per pound body weight). In fact, plenty of people eat that much protein, or more, on a regular basis. But many older adults do not even get 0.8 grams/kg, let along 1.0 – 1.5. And when someone cuts back food intake to lose weight, protein intake can be reduced as well. A 150 lb woman on a 1400 calorie diet might only get 45-50 grams of protein per day; the higher recommendation would be 68-102 grams. To achieve that level of protein, her meals and snacks would have to shift more towards protein foods.

Ok, enough math. What does this look like in food? An ounce of cooked meat/fish/chicken has on average 7 grams of high quality protein. An egg from 6-7. A glass of milk 8-10, same for 8 oz yogurt. Greek style yogurt has more, but there’s a catch, discussed below. An ounce of cheese typically has 7 grams, although higher fat cheeses (Brie…) have less. If our 150 lb woman is going for a higher protein intake, she would include eat 10-14 of these protein equivalents a day.

  • 2 eggs
  • one 8 oz yogurt and/or an ounce of cheese
  • 3-4 oz tuna
  • 4-6 oz chicken breast

Plant-sourced protein foods are fine, but you may have to eat more volume and/or more calories to get the same amount of protein. You’d have to eat 2 TB of peanut butter (200 calories), 2/3 cup cooked beans (120 calories) or 3 oz plain tofu (about 80 calories) to get the same amount of protein as 1 egg (80 calories).

Our sample woman can have the eggs at breakfast, the yogurt or cheese as a snack, tuna at lunch and chicken for dinner. This food accounts for roughly 400-600 calories out of a 1400 calorie weight loss diet.

Choosing the higher protein goal (1.5g/kg/day) on a restricted calorie diet makes for a very protein-heavy diet. This emphasis on protein foods might not be agreeable to everyone. I’d suggest that a lower protein goal (1 – 1.2 g/kg/day) is a reasonable option.

my latest breakfast

Breakfast and snacks may be our biggest hurdles to increasing protein intake. Lots of people ignore protein at breakfast: it’s too much trouble, those foods don’t sound appetizing in the morning, you’d rather have a pastry or toast and jam. I know; I’m in the same boat. Lately I’ve been making a concerted effort to add an egg, by preparing an egg sandwich on homemade sourdough. It’s actually quite yummy and easy. Use a soft boiled, over-easy, poached or scrambled egg. Put it on the toast; put a second piece of toast on top. Done. If you use scrambled egg, it’s easy to use 2 eggs (not as messy). But other foods are also easy at breakfast: yogurt, cheese melted on toast, nut butter, refried beans on a burrito, milk on cereal.

Snacks have even more options: an ounce of cheese with fruit slices, hard cooked egg, tuna salad, smoked salmon, yogurt, hummus, nuts, sliced deli meat or leftover cooked turkey or chicken. You don’t need a lot, just 1-2 ounces. Add some vegetables or soup. I’m fond of a chopped cooked egg with a dash of olive oil and minced celery. Or sliced turkey or tuna salad rolled into lettuce leaves.

The key is to make these choices a daly habit. Instead of grabbing high carb foods like crackers or cookies, plan a high protein snack. You can also make smoothies for breakfast or lunch, using yogurt, whey powder, soy powder or milk for protein.

Some amino acids are more equal than others

Emerging evidence suggests that older people and dieters can benefit from increased intake of so-called Branched Chain Amino Acids. These are a specific type of amino acid, the building blocks of protein. BCAAs uniquely stimulate muscles to increase mass. In one study, muscle mass and strength improved in elderly subjects given modest supplements of a BCAA. However, those improvements reversed after the supplements were discontinued.

Another recent study of older adults used a more concentrated BCAA mix, including a metabolite of leucine, one of the BCAAs thought to have particularly potent effects on muscle growth. Results indicated that muscle mass and strength improved significantly, even for people who did not exercise. This effect would be especially beneficial for elderly people who are immobilized by illness or injury and are losing muscle mass and strength at an accelerated rate.

Finally data from another study reported at a recent nutrition conference showed that higher protein weight loss diets preserved muscle mass and led to more fat loss. You can certainly lose weight on a low calorie higher carbohydrate/moderate protein diet, but if a lot of that loss is muscle mass instead of fat tissue, you aren’t doing yourself any favors.

Where do we get these BCAAs? The studies used supplement powders to boost intake of these specific amino acids. Of course, you also consume all amino acids from protein foods. Animal-sourced foods are especially high in leucine. Swiss cheese is particularly high. Pork, dark meat poultry, beef, lamb, bison and other hard cheese are very good sources. Tofu isn’t bad either.

The supplements used in studies are typically made from whey powder, which is a byproduct of cheese production. Once milk is coagulated to make cheese, the liquid whey is poured off. You can see the same effect if you buy large containers of yogurt and scoop some out. You’ll see the liquid whey collecting in the container. Some people drain this liquid off before scooping another serving of yogurt out of the container. If you’re trying to build or maintain muscle, STOP! Mix that leucine-rich liquid back into the yogurt.

Should you use protein powder? It’s not necessary, but some people might find it helpful. For example, an elderly person with a poor appetite, who can’t chew very well might benefit from a protein-rich drink. A dieter might use a protein smoothie as a meal replacement. It’s an option, not a necessity.

More protein is not for everyone

People with kidney disease or other metabolic problems impacted by protein digestion and metabolism shouldn’t be boosting intake of amino acids from food or supplements without consulting a qualified registered dietitian. And people who already over-do protein don’t need even more. You know who you are: 3 egg omelets with cheese for breakfast, double cheeseburgers at lunch, 8 oz steaks for dinner. More protein isn’t going to be helpful.

I’m talking to people who eat very little, either because they’re on a weight loss diet or because their appetites are reduced by age or illness. The evidence is most promising for elderly people who want to combat the detrimental effects of sarcopenia. Muscle loss is part of aging, but it diet and exercise can reduce the impact, so you can maintain good quality of life for years.

Copyright: All content © 2020 Nutrition Strategy Advisors LLC. Photographs © Donna P Feldman, unless otherwise attributed. Reproduction or use without permission is prohibited.