How Much Protein Does Your Body Need to Function Properly?

To function properly, all living cells in our body need protein. Protein also supplies fuel for meeting the body’s energy needs. Proteins are essential in the diet of animals for the growth and repair of tissue and can be obtained from foods such as meat, fish, eggs, milk, nuts, grains and legumes.

Proteins, like carbohydrates, contain four calories per gram as opposed to lipids which contain nine calories and alcohols contain seven calories.

There are about 20 amino acids used by humans in protein synthesis. There are 11 “nonessential” amino acids – that means our body can synthesize these amino acids in sufficient quantities. We do not have to rely on our food for these amino acids.

The nine essential amino acids cannot be synthesized by the body and must come from dietary sources. If you eat a balanced diet then you should be able to get all the essential amino acids your body needs.

The Recommended Dietary Allowance (RDA) is 0.8 grams of protein per kilogram (2.2 pounds) of body weight per day for an average size healthy person. Protein should provide about 15 per cent of a healthy person’s daily calories.

About eight ounces of chicken or six ounces of canned tuna should be enough. A vegetarian can get enough proteins from grains, nuts and legumes. Some vegetarians eat dairy products (lactovegetarians), egg products (ovovegetarians) or both (ovolactovegetarians).

What happens if you eat too much protein?

Studies have shown that excess dietary protein increases calcium loss in the urine, raising the risk for osteoporosis and kidney stones. Your weight goes up because you consume more calories than you need. You also increase the risk of cardiovascular disease if you consume protein high in saturated fats.

From time to time our body needs extra protein. For example: the RDA is higher during childhood, pregnancy, lactation and recovery from a serious illness, trauma, or major surgery. Very active people and athletes in training probably need more protein as well, but no special RDAs have been established for such individuals as there is no general agreement on this subject.

An article in a sports medicine journal by Tipton and Witard (Clinics in Sports Medicine – January 2007) discusses the subject of protein requirements and recommendations for athletes.

The authors say that protein nutrition for athletes has long been a topic of interest. From the legendary Greek wrestler Milo – purported to eat copious amounts of beef during his five successive Olympic titles – to modern athletes consuming huge amounts of supplements including protein.

The subject is controversial. In general, scientific opinion on this controversy seems to divide itself into two camps – those who believe participation in exercise and sport increases the nutritional requirement for protein and those who believe protein requirements for athletes and exercising individuals are no different from the requirements for sedentary individuals.

The authors say that there seems to be evidence for both arguments but from a practical perspective, the requirement for protein may not be applicable to most athletes who consume a varied diet that contains complete protein foods and meets energy needs.

An athlete’s protein needs should be carefully assessed by the coach, physician and nutritionist. Risks and benefits of high protein diet and supplements should be discussed with the athlete. There is no reason to recommend protein supplements per se because there is no evidence that supplements work better than foods, say the authors.

Steak is a great source of protein but it is also a source of saturated fat.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Fingers and Toes Sensitive to Cold can Lead to Ulcers and Gangrene

Raynaud's Phenomenon

There are many individuals whose hands and feet are very sensitive to cold or emotions resulting in blanching, pain and numbness of the fingers and toes. The condition is episodic and is known as Raynaud’s phenomenon. In severe cases this can progress to local ulcers and gangrene. This condition can also cause nails to become brittle with longitudinal ridges.

Primary or idiopathic Raynaud’s phenomenon (Raynaud’s disease) occurs without an underlying disease. In this situation the blood vessels of the fingers and toes are excessively sensitive to cold or emotional stimuli without any good reason. Raynaud’s disease accounts for 60 per cent of cases.

Secondary Raynaud’s phenomenon (Raynaud’s syndrome) occurs in association with an underlying disease. Most patients with scleroderma and about 30 per cent of patients with systemic lupus erythematosus have secondary Raynaud phenomenon. There are many other medical conditions which can cause Raynaud’s syndrome. Forty per cent of cases are secondary to other medical conditions.

The condition was first described in 1862 by Maurice Raynaud (1834-1881), a physician and professor in Paris. The onset is typically between the ages of 20 and 40 years, and it is more common in women than men.

In a general population it is difficult to estimate how many people suffer from this condition. But people who live in cool damp climates seem to have higher incidence (20-25 per cent). About 40 to 90 per cent of chainsaw operators and miners using vibrating equipment have Raynaud’s syndrome. Food workers who work in cold areas have about 50 per cent incidence of this disease. Raynaud’s has also occurred in breastfeeding mothers, causing nipples to turn white and become extremely painful. This may cause painful breast feeding.

In 2002, the New England Journal of Medicine described a case of a 54-year-old man who had an acute primary episode of Raynaud’s disease involving only the ring finger after surfing for 80 minutes in water that was 21°C. The episode persisted for 40 minutes. Medical evaluation subsequently revealed no disorder known to cause secondary Raynaud’s phenomenon.

Most patients with Raynaud’s syndrome have only mild symptoms, which respond well to simple conservative treatment, including wearing of warm clothes and gloves. Avoid cold environment and stress. Do not smoke. Avoid blood vessel constricting agents.

About 10 per cent of patients have sufficiently severe and frequent episodes to require drug therapy. Vasodilators are most frequently used. Many medications have been studied including vasodilators, platelet inhibitors, serotonin antagonists and fibrinolytics.

Here are some examples: sustained-release nifedipine (Adalat) reduces attack rate compared to placebo, losartan (Cozaar) 50 mg/day may be more effective than nifedipine 40 mg/day, sildenafil (Viagra) 50 mg twice daily reduces frequency of Raynaud attacks and topical nitroglycerin may be effective for treatment of Raynaud’s phenomenon.

Recently, another erectile dysfunction drug tadalafil (Cialis) 20 mg has been tried. Compared to Viagra, Cialis has a longer half-life of 17.5 hours. The conclusion was that Cialis, in combination with other vasodilators, help reduce the severity of attacks but also helps heal digital ulcers.

Surgical treatment in the form of sympathectomy (division of autonomic nervous system) causes dramatic improvement in occasional patient but can be unpredictable and disappointing.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Scientific Evidence and the Role of Dietary Fats and Carbohydrates in Heart Disease

Dear Dr. B: In your Feb 1, 2011 article, you say that data indicate dietary cholesterol has little effect on blood serum cholesterol levels. I wonder if you could send me references for this. I’m having a debate with a friend and mentioned this, but he doesn’t believe it.

Answer: Finding a reference is not difficult these days. You just have to Google your question and you will find thousands of references. The difficult part is to know which reference is reliable. When I do my research, I generally look at several articles and find reliable scientific information from different sources.

You can find an excellent article on this subject in the American Journal of Clinical Nutrition (April 2011 vol. 93 no. 4 684-688) titled: The role of reducing intakes of saturated fat in the prevention of cardiovascular disease: where does the evidence stand in 2010?

The old hypothesis was that dietary fat raises blood cholesterol which eventually leads to atherosclerosis (hardening of the arteries) and coronary artery disease. This hypothesis was based on research done before we knew anything about the dangers of trans fats.

Now the research has confirmed that heart disease risk rises if there is a high concentration of bad cholesterol (LDL) in our blood and the risk is reduced if there is a high concentration of good cholesterol (HDL) in our blood. But what is poorly understood is the link between dietary fat and high blood cholesterol level.

What do we know about the role of dietary fats and carbohydrates?

-Eating saturated fats – SFs – (found in beef, pork, lamb, dairy products and tropical oils such as palm oil, palm kernel oil, and coconut oil) raises bad cholesterol (LDL) but also raises good cholesterol (HDL). One negative effect, one positive effect.

-Eating unsaturated fats – UFs – (MUFAs – monounsaturated fats – found in plant oils such as olive, canola, and peanut oil; PUFAs – polyunsaturated fats – found in plant oils such as safflower, sunflower, corn or soybean oil, fish with omega-3 fat) lowers the bad cholesterol (LDL) and lowers the good cholesterol (HDL). One positive effect, one negative effect.

-Eating industrially produced trans fats – TFs – (vegetables oils that have been chemically changed by a process called hydrogenation to make them solid at room temperature found in margarine, many fast foods, snack foods and fried or baked goods) is highly dangerous because it does two bad things – raises bad cholesterol (LDL) and lowers good cholesterol (HDL).

-Replacing saturated fats with carbohydrates (CHO) may actually increase cardiovascular risk unless carbohydrates come from whole-grain fibre-rich sources. Studies have shown that carbohydrates with high glycemic index –GI – (a measure of the effects of foods on blood-sugar levels) increase cardiovascular risk by 33 per cent.

Do you find all this confusing? You are not alone.

Next time you go to a grocery store, tell the helper (if you can find one) to give you some SFAs, PUFAs, MUFAs, no TFs, no LDL, lots of HDL, healthy CHOs and some low GI food. See what you get and surprise your family. Happy eating.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!