Category Archives: Protein

Which Macronutrient Helps the Most With Appetite Control and Weight Management?

You can make a good case for protein. Julianne Taylor has the sciencey details in a fine post at her blog. She talks about insulin, glycogen, digestion, glycemic index, and the benefits of vegetable and fruit carbohydrates over grains.

Read the whole enchilada.

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Filed under Overweight and Obesity, Protein, Weight Loss

Large Breakfast Rich in Protein and Fat Beats a Small Breakfast Strategy in Type 2 Diabetes

…according to research reported at MedPageToday.  This was a relatively small study with about 30 participants in each treatment arm. A snippet:

Patients in the big-breakfast group were instructed to consume 33% of their daily calories in their morning meal — that included up to 30% protein, up to 37% fat, and the rest in carbohydrates. Patients in the small-breakfast group were instructed to consume 12.5% of their daily calories at breakfast — with up to 70% in the form of carbohydrates.

Average fasting glucose decreased 14.51 mg/dL in the big breakfast group and decreased 4.91 mg/dL in the small breakfast group (P=0.011), she said at the annual meeting of the European Association for the Study of Diabetes.

The big breakfast group also saw a significant drop in systolic blood pressure (almost 10 mmHg), although probably not to the point it created a problem.

Read the whole enchilada.

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Filed under Fat in Diet, Protein

Do You Worry About Eating Too Much Meat?

If so, read the interesting essay by Dr. Georgia Ede on the health of traditional heavy meat-eating cultures such as the Masai and Inuits.

Of the Canadian Eskimos of a century ago, Dr. Ede writes:

Their diets were therefore extremely low in fiber most of the time, and very high in animal protein and animal fat.  These traditional ways of eating would terrify the USDA, the American Heart Association, the American Cancer Society, not to mention the Harvard School of Public Health, which remains a staunchly anti-meat, anti-saturated fat, anti-cholesterol institution.  How in the world did these uninformed fringe types manage to get all their vitamins and minerals without the heaping helpings of colorful fruits, vegetables, and whole grains without which we are told we shall surely perish?

Weren’t they cancer-riddled, heart-clenching, constipated, fat slobs who died young from scary deficiency diseases like rickets and scurvy?

[Apparently not.]

This post was not designed to provide an airtight argument for meat and health, but I do hope that it has at least prompted those of you who remain skeptical about meat to rethink what you’ve been led to believe. If you’ve got a hankerin’ for more information about meat and health, take a look at my meat page.

Check it out.

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Is Low-Carb Killing Swedish Women?

MPj04384870000[1]A recent Swedish study suggests that low-carbohydrate/high protein diets increase the risk of cardiovascular disease in women.  I’m not convinced, but will keep an eye on future developments.  This is a critical issue since many women eat low-carb/high protein for weight loss and management.

Researchers followed 43,000 women, 30-49 years of age at enrollment, over the course of 16 years.  In that span, they had 1270 cardiovascular events: ischemic heart disease (heart attacks and blocked heart arteries), strokes, subarachnoid hemorrhages,  and peripheral arterial disease.  Food consumption was estimated from a questionnaire filled out by study participants at the time of enrollment (and never repeated).

In practical terms, … a 20 gram decrease in daily carbohydrate intake and a 5 gram increase in daily protein intake would correspond to a 5% increase in the overall risk of cardiovascular disease.

So What?

To their credit, the researchers note that a similar analysis of the Women’s Health Study in the U.S. found no such linkage between cardiovascular disease and low-carb/high protein eating.

The results are questionably reliable since diet was only assessed once during the entire 16-year span.

I’m certain the investigators had access to overall death rates.  Why didn’t they bother to report those?  Your guess is as good as mine.  Even if low-carb/high protein eating increases the rate of cardiovascular events, it’s entirely possible that overall deaths could be lower, the same, or higher than average.  That’s important information.

I don’t want to get too far into the weeds here, but must point out that the type of carbohydrate consumed is probably important.  For instance, easily digested carbs that raise blood sugar higher than other carbs are associated with increased heart disease in women.  “Bad carbs” in this respect would be simple sugars and refined grains.

In a 2004 study, higher carbohydrate consumption was linked to progression of blocked heart arteries in postmenopausal women.

It’s complicated.

Steve Parker, M.D.

PS: I figure Swedish diet doctor Andreas Eenfeldt would have some great comments on this study, but can’t find them at his blog.

Reference: Lagiou, Pagona, et al.  Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women: prospective cohort study.  British Medical Journal, June 26, 2012.  doi: 10.1136/bmj.e4026

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Filed under Carbohydrate, coronary heart disease, Heart Disease, Protein

Does Dietary Protein Affect Blood Sugars?

The protein in this can raise your blood sugar

I’m considering whether I should advise my patients with diabetes to pay careful attention to the protein content of their diet, assuming they’re not malnourished.  It’s an important issue to Dr. Richard K. Bernstein, who definitely says it has to be taken into account.

Protein can undoubtedly raise blood sugar levels.  But is the effect clinically significant?  Most  dietitians and physicians pay little attention to it as a source of hyperglycemia.  Here are some of Dr. Bernstein’s ideas pulled from the current edition of Diabetes Solution:

  • The liver (and the kidneys and intestines to a lesser extent) can convert protein to glucose, although it’s a slow and inefficient process.
  • Since the conversion process—called gluconeogenesis—is slow and inefficient, diabetics don’t see the high blood sugar spikes they would see from many ingested carbohydrates.
  • For example, 3 ounces (85 g) of hamburger patty could be converted to 6.5 g of glucose under the right circumstances.
  • Protein foods from animals (e.g., meat, fish, chicken, eggs) are about 20% protein by weight.
  • Dr. B recommends keeping protein portions in a particular meal consistent day-to-day (for example 6 ounces with each lunch).
  • He recommends at least 1–1.2 g of protein per kilogram of ideal body weight for non-athletic adults.  That’s more than the usual 0.8 g per kilogram.
  • The minimum protein he recommends for a 155-lb non-athletic adult is 11.7–14 ounces daily.
  • Growing children and athletes need more protein.
  • Each uncooked ounce of the foods on his “protein foods” list (page 181) provides about 6 g of protein.
  • On his eating plan, you choose the amount of protein in a meal that would satisfy you, which might be 3 ounces or 6–9 ounces.
  • If you have gastroparesis, however, you should limit your evening meal protein to 2 ounces of eggs, cheese, fish, or ground meat, while eating more protein at the two earlier meals in the day.

“In many respects—and going against the grain of a number of the medical establishment’s accepted notions about diabetics and protein—protein will become the most important part of our diet if you are going to control blood sugars just as it was for our hunter-getherer ancestors.”

Conclusions

I haven’t changed my thinking on this issue yet, but will let you know if and when I do.  I don’t talk much about protein in Conquer Diabetes and Prediabetes in part because I wanted to keep the program simpler than Dr. Bernstein’s.  Albert Einstein reportedly said, “Everything should be made as simple as possible, but not simpler.”

As with most aspects of diabetes, your mileage may vary.  The effect of dietary protein on blood sugars will depend on type 1 versus type 2 diabetes, and will vary from one person to another.  So it may be impossible to set rigid guidelines.

If interested, you can determine how much protein is in various foods at NutritionData.

Steve Parker, M.D.

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Which Of Three Low-Carb Diets Reduces Future Risk of Diabetes?

Men eating low-carb diets featuring protein and fats from sources other than red and processed meats may reduce risk of developing type 2 diabetes later, compared to other types of low-carb diets.  The same Boston-based researchers previously looked for a similar association in women and found none.

The article in American Journal of Clinical Nutrition seems to me unusually complicated, like the first sentence of this post.  It was frustrating to read, searching for but not finding much useful for clinical practice.  How low-carb were these diets?  Thirty-seven to 43% of energy from carbs in the most dedicated dieters, compared to 50-60% in the standard American diet.

After wading through most of this article, I came away with the impression the authors were just data-mining a huge database, to add one more item to their CVs (curriculum vitae).  This article is a confusing mess, or maybe I’m just stupid. I regret wasting an hour on it.

Steve Parker, M.D.

Reference: De Konig, Lawrence, et al.  Low-carbohydrate diet scores and risk of type 2 diabetes in menAmercan Journal of Clinical Nutrition, 2011. doi: 10.3945/ajcn.110.004333

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Filed under Causes of Diabetes, Fat in Diet, Protein

High-Protein Diets Harmful to Bones? Nah!

Contrary to accepted wisdom, high  protein intake does not seem to be harmful to mineralization of bone, according to Seattle-based researchers reporting in the American Journal of Clinical Nutriton.  Mineralization of bone is important because higher bone mineral content generally translates to lower risk of fractures.

A consistent criticism of low-carbohydrate diets in the past is that they are detrimental to bone health.  How so?  If you reduce carb consumption, you have to replace at least some of the calories with either fat or protein.  Some low-carb diets lean towards higher protein content, others towards higher fat, still others increase both fat and protein.  The building blocks of proteins are amino acids, and some amino acids are acidic.  Acid-rich biochemical states may promote removal of calcium from bone and, ultimately, loss of that calcium in urine.  The calcium-poor bones are more prone to fracture.

If that theory is correct, women eating greater amounts of protein should demonstrate lower bone mineralization.  [The primary bone minerals are calcium and phosphorus.] 

ResearchBlogging.orgInvestigators tested the theory in 560 women aged 14 to 40 by measuring bone mineral density (via DEXA scans) over two or three years and monitoring food consumption via yearly questionnaires.  This was an observational study, not interventional.

They found that bone mineral density had nothing to do with protein consumption.  Higher protein intake was not associated with lower bone density.

Women in the low-protein group ate 52 g of protein daily, compared to 63 g in the medium group and 77 g in the high-protein tertile.  As best I can tell, the low-protein third of participants ate 12% of total calories as protein, compared to 20% in the high-protein third.  [Study authors could have put this in the appropriate table, but, mysteriously, opted against that.]

Caveats

We can’t tell from this study whether these findings apply to protein intakes outside this range, to men, or to women older than 40.  To their credit, the study authors review much of the pertinent literature and note that research in this area produces results all over the map.  To me, this suggests that the association between dietary protein and bone mineralization in the general population is weak, if not nonexistent.

Bottom Line

Looks like you can stop worrying so much about hurting your bones if you’re on a low-carb, high-protein diet.

Steve Parker, M.D.

Reference: Beasley, J., Ichikawa, L., Ange, B., Spangler, L., LaCroix, A., Ott, S., & Scholes, D. (2010). Is protein intake associated with bone mineral density in young women? American Journal of Clinical Nutrition, 91 (5), 1311-1316 DOI: 10.3945/ajcn.2009.28728

 

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