Morning everyone!

Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. This week I want to talk about PROTEIN and how vital it is to your body’s overall function. I know that I focus a lot on carbs and fats (when talking about diet and nutrition), but PROTEIN is just as important!  


The Importance of Protein 


Protein is essential. You could live without carbs, but not without protein or fats. When most people think about protein, they think about muscles, but protein is also for the skin, hair, tendons, cartilage, hormones and enzymes. Protein is for your immune system and your neurotransmitters. It’s so much more than just muscles! ALL of these factors need protein. 

Amino acids are the basic building blocks of protein. Your body can make all but 9 (of the 22 total amino acids). The nine essential amino acids you need to get from your diet or supplementation are: histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine. Three of these are branched-chain amino acids: leucine, isoleucine, and valine. 

Note: You may have heard of body builders taking branched-chain amino acids before they workout, along with L-Glutamine. 

These branched-chain amino acids make up one third of your muscle’s protein. Branched-chain amino acids are broken down directly in your muscles rather than having to go through the liver. So they directly release energy into the muscles, which means muscle growth, and also muscle recovery. Recovery is as important as growth, remember that! 

Note: I think you should take your branched-chain amino acids 15-30 minutes before a workout for best results. The same thing with L-Glutamine. 


Protein Deficiencies  


As we get older we break down (sad but true). Our muscles get weaker. Our tendons and ligaments break down a little bit. I’m going through this now as a 67 year old man, which is why I’m sharing my thoughts on the process with you guys. My goal is to do everything I can to prevent muscle decline. 

With protein you need to lift weights. You want to build those muscles! And remember muscle health equals bone health. Your bones are going to be weak if your muscles are weak. Same for your brain. As you get older your ability to digest protein decreases, which leads to weak muscles, weak bones, weak heart, and weak brain.

If you don’t get enough protein in your body it also can lead to decreased neurotransmitters. This can mean more depression, poor memory, and sleep problems. These things could be because of poor protein intake. Also, your body’s detoxification system needs proteins. Lower hormone levels can occur when you have a protein deficiency. It inhibits the creation of hormones like testosterone, growth hormone, thyroid, and insulin. 

Note: Many people are on acid blockers (PPIs). This in fact can affect absorption of proteins


Protein Utilization 


Proteins have different forms. Where do you get your protein from? You can get protein from steak, all meats, eggs, fish, and nuts. When you eat steak it’s broken down (digested) into the amino acids. It then has to be put back together. Some of it is utilized as protein and some of it is wasted. Some of it is converted into sugar and fat. 

When I talk about protein waste I’m talking about nitrogen balance. Protein waste affects your nitrogen balance. Have you heard of nitrogen balance? For example, this is something we take very seriously for patients in the ICU. Nitrogen is an element that is essential for all living things. It’s what makes them organic. Nitrogen is required for plants to make chlorophyll and then make DNA, RNA, and amino acids. It’s a requirement for life. Think of organic plants. 

Nitrogen balance is something we can measure in critically ill patients when it’s necessary. You need to know they’re getting enough protein. Nitrogen is mostly in protein. Every 6 grams of protein has 1 gram of nitrogen in it. Nitrogen balance represents the net result of protein anabolism (build up or growth) and protein catabolism (the breakdown or loss of protein). This is affected by the quality of the dietary protein and the energy balance that you’re trying to maintain. 

Note: Protein synthesis is affected by the anabolic hormones: think insulin, growth hormone (IGF-1), and testosterone. 

Growing kids in adolescence accumulate nitrogen and thus they are in a positive nitrogen balance. Starving, immobilized, and severely ill people are in a negative nitrogen balance. They’re breaking down their tissue proteins, and unlike fats and carbs, your body doesn’t have a mechanism for long term storage of free amino acids. Instead it liberates them from skeletal muscle. Again, this is complex, but important, because how much protein you accumulate and actually absorb depends on how much is utilized and how much is wasted. So you have a spectrum of how much gets utilized and how much is wasted. 

At the low end – whey protein, nuts, and soy (about 80% wasted) 

Slightly better – meats, fish and poultry (slightly better at 68% wasted) 

Best – eggs are the winners (only 52% wasted)

Note: The problem with getting your protein from eggs is a lot of people are allergic to them. 


My Favorite Protein Supplement 


Even the branched-chain amino acid supplements can be mostly wasted. You want to get the right mix. The one I’ve been taking is called Perfect Aminos, which comes in powdered form or capsules. It kind of bypasses the digestive system (about 99% of it is absorbed). For me this is the best way (but you still need to eat healthy!). In my opinion, Perfect Aminos are really good for you, especially if you’re exercising, breaking down, or getting older. 


Daily Protein Intake 


Most experts say to take .8 gm/kg of protein for baseline longevity, and if you’re very active 1.5 to 2.5 gm/kg. For example, if you’re a 170 pound man, baseline you need 77gm of protein per day. But if you’re active you need at least 150gm per day. 

Could you take too much protein? Yes, you could. Remember it gets stored as fat. And if you have compromised kidney function (think hypertension, diabetes, or obesity), then too much protein can further damage your kidneys. That’s why as an adult you should get regular blood tests (and even urine tests) to make sure what your kidneys are doing. This is especially true if you have hypertension, diabetes, or are obese. 

Note: It’s normal to have a small amount of protein in your urine, so don’t freak out about that. 

I’m a big proponent of routine lab testing. Most older adults (like me) should have a Cleveland Heart Panel twice a year.


And The Best Diet Goes To… 


Protein is important. You have to have it. As a macronutrient in my diet, my protein intake is about 30%, but everyone is different. Some people do better with a little more carbs than other people. Same with protein. I think most everyone should have a diet of high healthy fats, moderate amounts of protein, and then lower carbohydrates. 

Note: It’s all individual. See how you feel and how your body responds to these things. 

Don’t just think about low carbs and high healthy fats. Think about good quality protein and how it’s affecting your energy levels, muscle growth, and recovery from workouts. All of this affects your daily life. I always say the best diet is the one you’ll stick to and feel great on!