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Rethinking Protein Supplementation in your Practice

Posted August 20, 2018

By: Dr. Colin O’Brien ND, Medical Doctor, Cyto-Matrix

It’s easy to think of protein supplementation when patients are concerned about athletic performance and muscle recovery. Of course, protein is extremely useful in these circumstances, yet the many other clinical indications often get overlooked. Protein is a macronutrient that should be considered as a foundational item in all of our treatment protocols.

Improving dietary protein intake is key. But many times, a high-quality protein supplement is useful adjunctively. The purpose of this article is not to say that everyone should be supplementing with protein, more so, to say that there are likely other circumstances that you could be considering its impact. Here is a brief refresher on when to consider a high-quality protein with your patients:

 

  • Liver Health: Whey protein is a rich source of cysteine, making it a viable option to increase glutathione production and, therefore, liver detoxification. Research has confirmed this and also shown that protein supplementation improves outcomes in individuals with liver cirrhosis and those with non-alcoholic steatohepatitis (NASH).[1] [2]
  • Blood Sugar Regulation: Protein, unlike carbohydrates, does not significantly raise blood sugars in individuals with adequate insulin levels.[3] In fact, substituting protein in for carbohydrates or other macronutrients may lead to better blood sugar regulation in both diabetics[4] and non-diabetics.[5]  
  • Pre-eclampsia: Weak evidence suggests that the edema and protein spilling in pre-eclampsia is as a result of low protein intake, breaking down tissues to provide the fetus with needed amino acids. Although research appears to be far from conclusive, extra protein is a simple and safe intervention.[6]
  • Weight Management: High protein meals, especially at breakfast, have been shown to increase satiety and reduce snacking, making protein supplementation a staple for those trying to lose weight or manage dietary cravings.[7] [8]
  • Post-surgery Recovery: Regardless of the complexity or invasiveness of the procedure, surgery is a significant stress and physical trauma to the body. This means that protein is required for recovery. Evidence shows that protein is beneficial not only on the days after surgery but also in preparation for the operation.[9] [10]
  • Hair Loss: Yes, thyroid function, iron, biotin, medication side effects and other factors need to be considered for hair loss, but protein is a core component of collagen and a core component of hair. Most women trying to solve hair loss on their own likely don’t consider protein levels as a key first step.[11]
  • Sports Performance: It is still worth mentioning that protein supplementation added to a resistance training or endurance program has the ability to stimulate anabolism in muscles with increased hypertrophy, improved strength and reduced recovery time.[12] [13]
  • Bone Health: Protein is necessary for building collagen in the bone matrix. Multiple studies have shown that protein supplementation improves fracture healing, bone mineral density and overall recovery from injury.[14] [15]
  • Mood Balancing: Protein contains all the amino acid building blocks for our key neurotransmitters like dopamine, GABA and serotonin. Moreover, anecdotal and preliminary evidence shows that specific amino acids, like taurine, can be beneficial for balancing mood.[16] A common concern in poorly managed vegan or vegetarian patients is low mood, and suboptimal protein intake can be a part of this problem in conjunction with low iron and B12.

 

Certainly, this is not an all-encompassing list of reasons to consider protein supplementation with your patients, but it should serve as a reminder, at the very least, to assess macronutrient intake and be cognizant of the tremendous impact that suboptimal protein intake can have on the body long-term!


References:

[1] Hirsch S et al. Nutritional support in alcoholic cirrhotic patients improves host defenses. J Am Coll Nutr. 1999 Oct;18(5):434-41.

[2] Chitapanarux T et al. Open-labeled pilot study of cysteine-rich whey protein isolate supplementation for nonalcoholic steatohepatitis patients. J Gastroenterol Hepatol. 2009 Jun;24(6):1045-50. doi: 10.1111/j.1440-1746.2009.05865.x.

[3] Franz MJ. Protein: metabolism and effect on blood glucose levels. Diabetes Educ. 1997 Nov-Dec;23(6):643-6, 648, 650-1.

[4] Mary C Gannon, Frank Q Nuttall, Asad Saeed, Kelly Jordan, Heidi Hoover; An increase in dietary protein improves the blood glucose response in persons with type 2 diabetes, The American Journal of Clinical Nutrition, Volume 78, Issue 4, 1 October 2003, Pages 734–741, https://doi.org/10.1093/ajcn/78.4.734

[5] Rains TM et al. A randomized, controlled, crossover trial to assess the acute appetitive and metabolic effects of sausage and egg-based convenience breakfast meals in overweight premenopausal women. Nutr J. 2015 Feb 10;14:17. doi: 10.1186/s12937-015-0002-7.

[6] James M. Roberts, Judith L. Balk, Lisa M. Bodnar, José M. Belizán, Eduardo Bergel, Anibal Martinez; Nutrient Involvement in Preeclampsia, The Journal of Nutrition, Volume 133, Issue 5, 1 May 2003, Pages 1684S–1692S, https://doi.org/10.1093/jn/133.5.1684S

[7] Heather J Leidy, Laura C Ortinau, Steve M Douglas, Heather A Hoertel; Beneficial effects of a higher-protein breakfast on the appetitive, hormonal, and neural signals controlling energy intake regulation in overweight/obese, “breakfast-skipping,” late-adolescent girls, The American Journal of Clinical Nutrition, Volume 97, Issue 4, 1 April 2013, Pages 677–688, https://doi.org/10.3945/ajcn.112.053116

[8] Skov AR et al. Randomized trial on protein vs carbohydrate ad libitum fat reduced diet for the treatment of obesity. Int J Obes 1999; 23:528-536

[9] Herbert Freund et al. Infusion of the Branched Chain Amino Acids in Postoperative Patients: Anticatabolic Properties. Ann Surg. 1979 Jul; 190(1): 18–23.

[10] Klein JD et al. Perioperative nutrition and postoperative complications in patients undergoing spinal surgery. Spine (Phila Pa 1976). 1996 Nov 15;21(22):2676-82.

[11] Rushton DH. Nutritional factors and hair loss. Clin Exp Dermatol. 2002 Jul;27(5):396-404.

[12] Cooke et al. Whey protein isolate attenuates strength decline after eccentrically-induced muscle damage in healthy individuals. J Int Soc Sports Nutr. 2010 Sep 22;7:30. doi: 10.1186/1550-2783-7-30.

[13] Cermak et al. Protein supplementation augments the adaptive response of skeletal muscle to resistance-type exercise training: a meta-analysis. Am J Clin Nutr. 2012 Dec;96(6):1454-64. doi: 10.3945/ajcn.112.037556. Epub 2012 Nov 7.

[14] Chiu JF, Lan SJ, Yang CY, Wang PW, Yao WJ, Su LH, Hsieh CC. Long-term vegetarian diet and bone mineral density in postmenopausal Taiwanese women. Calcif Tissue Int. 1997 Mar;60(3):245-9.

[15] Tengstrand B et al. Effects of protein-rich supplementation and nandrolone on bone tissue after a hip fracture. Clin Nutr. 2007 Aug;26(4):460-5. Epub 2007 May 11.

[16] Gao-Feng Wu et al. Antidepressant effect of taurine in chronic unpredictable mild stress-induced depressive rats. Sci Rep. 2017; 7: 4989. Published online 2017 Jul 10.