Thursday 14 November 2019

What effect is our protein obsession having on our health?

It's a vital nutrient in our everyday diet, but with a wealth of protein products available on the supermarket shelves today, could we be overdoing it?

Food high in protein

Áilín Quinlan

A courier arrived at my front door recently, requesting my signature for the delivery of some large boxes.

The cartons, which were addressed to my 20-year-old son, held, I discovered on investigation, two giant containers of protein powder.

I expressed my disapproval and concern to my son, a college student who plays a lot of sports, when he came home for the weekend.

He'd ordered them, he argued, because he was doing a lot of training and he needed extra protein.

He knew what he was doing, he said. Yeah, he understood how to use them - and yeah, yeah, yeah; he'd be careful about how much he took. Defeated, I was left with little option but to let it go.

There's no getting past the fact that the push is on to eat more protein - an avalanche of protein bars, shakes, snacks and powders are readily available; these days you can even buy ice-cream with added protein. But could we be in danger of overdoing it?

A scientific review of research published in a recent edition of the British Journal of Sports Medicine showed eating more protein can significantly augment the effects of lifting weights, for example. However, the review concluded, any form of protein, for example beef, chicken, yoghurt or even peas, not just high-protein shakes and supplements, are likely to be effective in helping to build larger, stronger muscles.

"It has become de rigueur to take protein," observes family doctor and expert in lifestyle medicine, Dr Mark Rowe, who has noticed growing public interest in the reported benefits of increased protein consumption.

"It's not just about whether you're having a protein shake now, it's about which one you're having," he says.

While protein is a very important macro- nutrient and an essential part of a healthy diet, Dr Rowe acknowledges, we may not need quite as much of it as we might assume. In fact, he says: "A lot of people are taking too much of it. But just because something's good for you doesn't mean that more of it is better."

In fact, very few of us are protein-deficient, says dietitian Paula Mee, but she advises, just as important as the quantity of protein we consume is the timing of our protein intake over the day.

At breakfast for example, Mee suggests eating an egg, or having some Greek yoghurt with your porridge - you could also make it with milk or add seeds and nuts.

For lunch, she suggests a bean salad, a cheese or boiled egg sandwich or an egg omelette, all of which will help you on your way to reaching your daily protein requirement. Also she says, it's important to eat two servings of fish a week - one oily and one white.

"Both contain very good protein sources but the oily fish also contains Vitamin A and D and anti-inflammatory fats - one thing I would urge people to eat more of is fish, particularly oily fish," she recommends.

Meanwhile, Mee points out, nuts and seeds are excellent protein-containing snacks, compared to many commercial options which, she warns, can be high in bad fats and refined sugars.

Individual protein intake requirements will naturally vary, depending on the amount of physical activity undertaken, she explains, adding that athletes, for example, would need more protein than the average couch-potato.

"There are some circumstances where athletes cannot get the right amount of food into their day because they are doing excessive training," she says.

"However there's a blanket marketing of protein to everyone, and the message is that if you're not taking some sort of protein food you won't excel at your sport. In fact it's about balance."

Most strength trainers, she observes, are under the illusion of "the more protein the better" - which is not true, she adds.

"Ideally bodybuilders might need to consume between 1.5 and 1.7 grams of protein per kilogram of body weight, assuming that adequate energy is consumed from carbohydrates. Any excess protein that we take in is simply burned as fuel or could be stored as fat."

The current avalanche of protein supplements in the form of shakes, bars and powders is the result of a strong marketing push by the fitness industry, says nutritionist Gaye Godkin.

"I know of young guys who are buying tubs of protein powder and shakes and at the same time not eating natural foods - their diets are not balanced," she says, adding that she's also aware of young adults who buy amino acids in supplement form (protein is broken down into amino acids in the body) in the belief that it's good for them.

In fact, Godkin observes, a good healthy diet featuring a diversity of protein sources - red meat, chicken, eggs, cheese, yoghurt, fish and vegetables as well as peas, beans and lentils - will fulfil most protein needs. There's no need to consume these shakes and bars even if you do play a lot of sports or work out regularly, she emphasises.

One should remember, cautions Dr Rowe, that there's a downside to eating too much protein.

"Too much protein can have damaging effects on your kidneys. It can cause dehydration and put a strain on your liver," he explains, adding that some people increase their protein intake in a bid to make progress on their weight reduction goals.

While they will lose weight in the short-term, after about six months or so, he says, the body's metabolism adapts to the increased protein intake and the weight reduction can drop off. Another downside to a high protein diet can, he warns, result in people eating more processed meat, which he points out, may contain large amounts of additives.

On top of that, cautions Dr Rowe, eating too much red meat means your intake of saturated fats and artery-clogging cholesterol also increases.

"The bottom line is that taking too much protein is not necessarily a good idea," he advises.

So what's a good guiding rule?

We're getting enough protein but we need to examine the quality of protein we are eating, says Mee. "We're eating too many processed meats and not enough fish, nuts, seeds, peas, beans," she declares. For Godkin, the big message is that people need to learn more about the diversity of good protein sources available to them.

"People in Ireland eat too much chicken because of fears around saturated fat in red meat. You shouldn't eat meat twice a day and you shouldn't eat meat every day," she says, adding that people in general need to "upskill" in terms of understanding how to get protein from a variety of sources other than the old standbys of red meat or chicken.

However, all experts agree, there is one sector of the population which is highly vulnerable to protein malnutrition - the elderly.

The reasons are simple, says Professor Dermot Power, consultant in Geriatric Medicine at the Mater Hospital, who, in his capacity as President of the Royal Academy of Medicine in Ireland, is heading up a new social media campaign, #dinnertime, expected to launch next month. The campaign highlights the need for elderly people to eat properly and to be given both the time and the support they require to eat a proper, well-balanced dinner.

Older people, who need just as much protein as other adults, can be at risk of cutting back their intake for a variety of age-related reasons from lack of appetite to inability to chew food or even eat quickly enough.

He warns: "Getting older means you may lack teeth or have ill-fitting dentures and it may not be easy to chew meat, which can disappear from the diet.

"Older people can end up eating a lot of 'soft' foods like toast, soup or biscuits. Also, because the ageing taste-buds may not work so well anymore, older people may seek sweeter foods and eat more pastries and biscuits and less food which requires more energy to eat, such as red meat."

On top of that, he explains, both the ageing gut and the appetite may be upset by medication, resulting in a reduced desire or capacity for food.

"In hospital quite frequently I see meals put in front of an elderly person and by the time they are able to chew and swallow the food, it can be cold," he says. The food is given to these older people, he explains, but under-pressure nursing staff and care attendants can be challenged to find the time to feed an elderly patient.

All of these things conspire against older people, he says, yet they need the resilience that protein gives them in order to fight off ailments such as 'flu.

"They can be more vulnerable to infection and at the same time not have the capacity to deal with the infection when it occurs," says Professor Power.

"Older people need protein. Protein malnutrition is a major issue for many old people in the community, particularly those who end up in hospital, because in that context they need even more protein to feed their recovery," he says.

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