With all the protein powders on the market, it can be extremely challenging to know what to take or recommend for our patients. Any product taken orally that contains a dietary ingredient is intended to supplement the diet, rather than completely replace it. One of the most common reasons to utilize protein supplementing is to support muscle mass growth. Those that contain more carbs (70-90%) than protein, creatine, essential amino acids and branched chain amino acids help stimulate protein synthesis and are most commonly taken up to 30 minutes post- exercise sometime in the morning.
The International Society of Sports Nutrition recommends the following for protein supplementation:
Resistance exercise and protein ingestion that either precedes or follow the exercise.Protein intake of 1.4-2.0 g/kg of body weight to build and maintain muscle mass.If utilizing resistance training on a low-calorie diet, you may need 2.3-3.1 g/kg of body weight per day.The optimal protein per served is .25 g/kg or 20-40 g at a time.A protein dose should contain between 700-3000 mg of leucine and balanced essential amino acids.The true optimal time to ingest may be altered, due to individual tolerance.Powder is practical to ensure intake while minimizing total caloric intake.
When supplementing with protein powder, it is important to realize that an increase of over 35% of daily caloric intake of protein may cause nausea, cramps, headaches, bloating, and fatigue in some patients. If the kidneys have to work harder, there can be an increase in calcium excretion, which can also contribute to bone loss over time. Dehydration is also a potential risk factor if protein intake becomes too high.
Protein powders come in many forms, and the differences are important when deciding which to implement in a protocol for your patient. There are 3 common forms to become familiar with: protein concentrates, in which the protein is extracted from a whole food, using heat and acid or enzymes. This supplies a 60-80% protein, with the rest being fat and carbohydrates. Protein isolates occur when filtering removes more fat and carbohydrates than in the concentrate. This will contain 80-95% protein. Protein hydrolysates incorporate further heating, breaking the bond between amino acids and allowing it to be absorbed more quickly than the other two forms. It may also raise insulin levels more quickly, so physicians should be conscious of whether or not blood sugar and insulin levels are normal to begin with or if there are any signs of diabetes, hypoglycemia, metabolic syndrome or insulin resistance when prescribing protein powders.
Whey protein is one of the most common types of protein. It comes from the watery part of milk and contains lactose. The isolate version contains less lactose, but for those sensitive it may cause gastrointestinal disturbances and discomfort. It digests very quickly and is rich in branched chain amino acids. Whey protein helps with recovery from heavy exercise, can help to increase strength, and reduces appetite. One negative to whey is that it can cause an allergic reaction for those sensitive to milk. It also may cause abnormal heart rhythms, changes in cholesterol levels, headaches, increases risk for diabetes, fracture and osteoporosis, lead to kidney dysfunction, liver damage, acid reflux, bloating, constipation, cramps, gas, lower blood sugar levels, low blood pressure and drowsiness. It also can interfere with drugs using the cytochrome P450 enzyme system.
Casein is found in milk and is slowly absorbed and digested. Casein forms a gel with stomach acid and delays absorption of amino acids. It is more effective at increasing strength than soy protein, but less than whey. A benefit of casein is that it promotes fat loss during calorie restriction.
Egg protein is an extremely high-quality protein which is easily digested and can help decrease appetite, allowing your patients to say fuller longer. It is usually made from egg whites and provides all 9 essential amino acids. It has the second highest source of leucine needed for muscle health, and it a great alternative for those with dairy sensitivities.
Pea protein is the perfect solution for vegetarians, vegans or those with an allergy or sensitivity to egg and dairy. Pea is a high fiber legume and has 8 essential amino acids. This protein promotes fullness and can help increase muscle growth.
Another good plant-based protein that is well digested is hemp. This typically contains trace amounts of THC and is rich in Omega 3 fatty acids. The downfall of hemp protein is that is has low levels of lysine and leucine, so it is not considered a complete protein source.
Brown rice protein, although containing all 9 essential amino acids, is considered inferior for building muscle. It is also too low in lysine to be considered complete.
Mixed proteins are common and incorporate two or more of the following types: brown rice, pea, hemp, alfalfa, chia seeds, flax seeds, artichoke and quinoa. The mixed protein digests at a slower rate and limits the amino acids the body can utilize right after exercise, so additional enzymes to increase absorption and digestion may be added.
One great resource to check on protein powders and their quality is at ConsumerLab.com. Here they rate common products on the market, giving you an idea of what is good and what is potentially a waste of money. A lot of these products do not contain the proper amount of carbs, cholesterol and sugar that is claimed on the label, resulting in over consumption of these items. Quite a few also contain sweeteners that are unhealthy, as well as “natural flavors,” gums, and additives. Some common ingredients that would be good to avoid include high fructose corn syrup and other added sugars, artificial sweeteners, food dyes, maltodextrin, soy lecithin, and industrial oils such as soybean, palm and canola oil.
Purchasing from a reputable company also help to eliminate the exposure of over 130 toxins that Consumer Reports has found to be in some of the protein powers, including heavy metals, bisphenol-A and pesticides. Reports have shown that up to 1/3 of protein supplements failed their quality assurance tests, and some had potentially risky amounts of lead in them.
When picking a protein power, it is good to look for real, whole food ingredients, preferably a quality protein with no extra added ingredients, and, if necessary, natural unrefined sugars. Stocking a few of the better products you find can help your patients by making the choice easier, allowing them the ability to have confidence in what they are consuming and for you to take the best care of them that you can. Knowing the different types of protein and how to best meet everyone’s needs can make a big difference.
References
Kreider RB, Wilborn CD, Taylor L, Campbell B, Almanda AL, COllins R. et al. ISSN exercise & sport nutrition review: research & recommendations . J Internat Soc Sports Nutr. 2010;7:7-49Koop,am R, Pennemans DLE, Jeukendrup AE, et al. Combined ingestion of protein and carbohydrate improves protein balance during ultra-endurance exercise. Am J Physiol Endo Metab 2004;287:E712-E720. AbstractManninen AH. Protein hydrolysates in sports nutrition. Nutr Metab. 2009;6:38-42Petroczi A, Naughton DP, Mazanov J, Holloway A, Bingham J. Performance enhancement with supplements: incongruence between rationale and practice. J Internat Soc Sports Nutr. 2007;4:19-26Phillips SM. Protein requirements and supplementation in strength sports. Nutrition. 2004;20:689-95 #muscle #knowledge #proteinpowder
