Background

One of the most common questions I get in the clinic or during lectures is:

 How do I get more protein into my diet?

Today we’ll talk about the science of protein in your diet and some of the risks and benefits. Our dietitian, Prerna Uppal, will end the post with some practical tips on getting more protein in the diet, including an easy and delicious recipe.

By the way, vegetarians have no fear.  Here is a dedicated post for protein intake in vegetarians which has good information for meat eaters too who can benefit from more plant-based protein.

I’m not a big fan of specifically measuring calories or macro and micro nutrients, except for carbohydrate intake in my patients with obesity and insulin resistance.  Once patients clean up their diet and understand the essential concepts, I would rather have them follow their own natural instincts to liberate them from the chore of measuring the amounts of nutrients they are consuming.  We’ll talk about this later in the post.

Having said this, the reality is that I take care of a lot of scientists, engineers, and entrepreneurs who want exact granular details on how much protein they should eat. They often come into my clinic with detailed spreadsheets, so telling them to eat based on instincts is not initially acceptable. I get it.  I like metrics too and they have been a powerful motivator in my patients.  So let’s dig into some of the science and then I’ll provide some numbers to keep you satisfied.

Protein problems in our modern world

Protein is a macronutrient composed of chains of amino acids which the cells in our bodies need to function properly. Muscles, skin, bones, and vital organs are made up of a significant amount of protein, while enzymes, hormones, and the antibodies essential to our immune system are actually proteins themselves.

Inadequate dietary protein intake or excessive protein breakdown (aka “catabolism”) can be linked to a variety of different health issues like obesity, insulin resistance, and impaired immune function.

In our ancestors inadequate protein intake was due to famine or limited access to food, while protein catabolism was due to events like trauma, infection, and periods of intense physical exertion.

Here in Silicon Valley I see patients suffer from inadequate protein intake due to a diet full of empty, processed calories which trigger obesity and chronic disease.  I also see a significant number of vegetarians, predominantly of South Asian ancestry, who are eating an extraordinarily insufficient amount of protein.  Read this post for vegetarian sources of protein to help with diabetes and weigh tloss.

My Western vegetarian patients generally do a much better job of consuming plant-based proteins compared to my Indian patients who are eating predominantly carbohydrate-rich foods like flatbreads, grains and lentils.

What about protein catabolism in modern society where we’re not facing famine, trauma and severe infections on a regular basis, except in underprivileged parts of the world?

In my clinic, where I mostly see Silicon Valley type A overachievers who can’t slow down, excess catabolism of proteins is coming from chronic stress, disrupted sleep, inappropriate calorically-restricted diets, and intensive workout regimens without adequate rest periods between.  That’s right…stress hormones like cortisol break protein while sufficient sleep builds it back up.

In fact, many of the hormones that trigger muscle and overall growth (aka “anabolism”-opposite of catabolism) start pulsing out between 10p-2a.  If your bedtime is well past 10p, you are missing out on a significant anabolic window.   This may also be a reason why your child is not hitting his or her growth landmarks.

Famine and trauma broke down our ancestor’s protein stores. Late night Netflix sessions and your addiction to your smartphone and devices might be breaking down yours.

Go here to read some of my posts on sleep.

The health benefits of protein

Why are we making a big deal about protein?  Studies show that adequate protein intake in the range of 25-30% of your calories can help with weight loss and is more effective in helping you continue to burn calories even a couple of hours after your meal (aka “postprandial thermogenesis”) as shown in this study.

Aside from the thermogenic effect of protein, the other key reason it helps with weight loss is through satiety, which suppresses cravings for the sugar, junk food and excess carbohydrates which are the central culprit behind those extra pounds.

For those of you following my work, you might know that I’m a bit obsessed with insulin resistance, which is the root cause for most of the major chronic health conditions society faces today like diabetes and heart disease.

As I’ve explained in past posts, the primary target site of insulin resistance is muscle, and a key way to overcome insulin resistance is to build and preserve muscle through exercise and the intake of sufficient protein, which is the major building block for muscle.  We’ll discuss specific ranges for protein intake in the next section.

As we age, sufficient protein in the diet helps combat sarcopenia (gradual muscle wasting from aging), osteoporosis (thinning bones), helps preserve our immune system function, and overall helps us function more independently and disease-free during our golden years.  If you want to find out how to prevent accelerated aging, read this post.

How much protein should you eat?

Your individual protein intake depends on a number of personal variables including your current body composition, your age, your activity level, your sex, your health status, and your goals, to name a few. The standard dietary recommendations for protein are inadequate based on more updated science.

I generally recommend most individuals aim for ~1.5 g of protein/kg body weight which is around 100 grams of protein daily.  For more specifics based on activity levels, read the basic categories below.

Chronic Sitters

If you spend most of your day sitting in a car and sitting in your office, then  dietary standards recommend you consume 0.8 g of protein per kilogram body weight or 0.36 g of protein per pound bodyweight.

In our experience, this falls on the lower side for most patients since we want to ensure adequate protein to control appetite and prevent cravings for excessive sugars, carbohydrates and inflammatory junk foods.  We also want to get those thermogenic benefits from increasing protein intake so you’re burning at least a few more calories at the desk after lunch.

Assuming you are eating good quality proteins in your diet and not fast food burgers or processed meats, you can easily and safely push up your protein intake to closer to 0.5 or 0.6 grams protein per pound bodyweight (1.1-1.3 grams per kg), but please make it a goal to gradually increase your physical activity levels.  Optimal health cannot be reached through diet and protein intake alone.

If you are in otherwise excellent health with a good body composition, you don’t need to force yourself into this protein range unless you are planning to get more active, which is a good idea.

Non-sitters

These aren’t athletic folks, but they at least move around and if they were to track their walking steps they are getting at least 8000 steps a day. The folks above routinely get less than 5000 steps a day.

If you are trying to lose weight or overcome insulin resistance, I think it’s reasonable to aim for a minimum of 0.5 grams protein per pound bodyweight (1.1 grams per kg) and you can push that even towards 1 gram protein per pound bodyweight (2.2 grams per kg), especially if you are trying to lose weight and/or overcome insulin resistance.

Athletes and the Very Active

Athletes is a broad category and I’m not just referring to individuals training for the Olympics. These are my patients who stay relatively active at baseline and also include at least 2 to 3 more intensive workouts per week which can be any combination of aerobic and resistance training.

In this situation I recommend you consume closer to 1- 1.5 grams of protein per pound of body weight (2.2-3.3 grams per kg)

Weight Loss

If you are trying to lose weight and have been unsuccessful with your current approach, then instead of obsessing about the exact protein ranges listed above, just start adding more protein to each of your meals and snacks.  Maybe an extra egg for breakfast, a little more fish, meat or organic non-GMO tofu for lunch, some greek yogurt for your snack, etc.  More tips at the end.

The Plate Approach  

I generally recommend a more visual approach based on your plate rather than grams of kilograms. In almost all cases we need to strive for a plate that is at least half covered with vegetables.  For sedentary and lightly active folks, around a quarter of the plate can be your protein portion and the other quarter can be a healthy starch.  Be sure to use healthy fats to prepare these foods and include plenty of herbs and spices.

If you did a major exercise session before this meal, you can allow yourself to dial-up the protein first since you broke down muscle, and you can up the carb a little as well which will mostly flow towards your recently exercised muscles, instead of those dreaded fat and liver cells.  If this doesn’t make sense, read my post on carb trafficking here.

If the heaviest object you lifted during the day was your smart phone or a cup of coffee, then you should prioritize increasing your vegetables first, your protein next, and try to avoid dialing up the carbs, especially if you are someone struggling with excess weight or insulin resistance.  You especially want to make sure that you used adequate healthy fat in preparing your meal to keep you satiated.

Hands On Approach

Another great visual for portion sizes can be achieved with your hands.  Your palm can estimate your protein portion, your cupped hand can be your carb portion, your fist can represent your vegetable serving, and typically the thumb is a serving of fat.  Go here for a great infographic on this “hands on” approach.

My modified approach using this method with each of my meals is 2-3 fists of vegetables, about a palm of protein, and a cupped hand of carb.  I don’t specifically limit healthy fat intake, but make sure there is some fat with each of these meals and my snacks.  After an intense workout or a vigorously active day, my protein portion is increased to about 2 palms, vegetables still at 2-3 fists, and carbs may go up 2 handfuls or sometimes even more.

However, I am no longer insulin resistant and I no longer carry around much extra body fat.  I also walk at least 10,000 steps daily and get at least 2 hard exercise sessions in each week, so I can afford to be more liberal with my post-exercise carb intake and my protein portions.  You may not have that luxury right now, but may develop it later.  It’s something worth striving for.

Hand protein
Credit to http://achievehb.com/what-works-better-then-counting-calories/

This is my average approach.  Some days my protein may be just one half to 1 palm since I know my body doesn’t need it.  Some meals have virtually no carbs at all since I still have carbs in my muscle (aka muscle glycogen) from the day before, or I know I’m going to be especially sedentary due to a long commute followed by meetings.

If you’re a woman who doesn’t carry much muscle and who doesn’t lift heavy things for exercise, you don’t need as much protein or carbohydrate, so you can dial your amounts down compared to me.

Rely on Instincts…Eventually

Over time as you continue to eat cleaner foods, exercise more, and manage your stress or sleep, you will start relying on your natural hunger instincts more than any other cue.  There will be some days where you have little to no craving for protein, which correlates with your body’s needs.  On these days I put aside the extra protein I don’t want to eat and add it to a future meal or snack.  For example, chicken from dinner last night may end up in my omelette for breakfast or salad for lunch.

There will be other days where you feel like you can eat a few pounds of animal flesh or a load of vegetarian protein.  This might come after some catabolic stressor like an intense workout or a period of illness.  Our body is incredibly intuitive, which is why our ancestors didn’t need weigh scales, apps or blog posts written by doctors like me to tell them how much protein to eat each day.

Unfortunately this intuitive sense is completely blunted if you are continuing to eat excessive sugars, unhealthy fats, and inflammatory, processed junk foods which are characteristic of today’s modern diet.

Add on top of that chronic stress and inadequate sleep and it is virtually guaranteed that your hunger signals are disrupted and will guide you towards extra body fat and chronic disease rather than optimal health.

This is when your modern diet might initially need a modern solution like a health app or a more specific quantitative approach to override aberrant and misleading hunger signals which will inevitably lead you into the pantry, desperately reaching for those crispy snacks and sweets.

Are there risks to eating too much protein?

Some of my patients think eating more and more protein is the answer to all their health problems once they realize the health benefits of protein we just discussed, and especially when they start cutting back on the excess carbs. Many of these patients are still a bit fat-phobic and are wary about increasing healthy fats, so all their energy goes into boosting protein.  Let me summarize a few problems with this approach:

Protein Quality

The early days of low carb dieting resulted in ecstatic individuals gorging on low quality steak, bacon and processed meats, watching their pounds magically melt away.  Food quality was not part of the conversation.  This is when I started seeing patients lose weight, while raising their risk of cancer and heart disease since they were consuming artificial chemicals and hormones that raised inflammation in their body.

Our goal of increasing protein intake must be aligned with making sure that protein is coming from natural sources.  Organic and grass-fed in the case of meat and dairy, and wild over farmed for seafood.

If you reside in an area where you just can’t get regular access to high quality protein or if your budget doesn’t allow it, then I would not recommend pushing your protein intake up too vigorously.

Also be sure you surround these proteins with other nutrients like vegetables, herbs and spices which can help counteract some of the inflammatory effects of these proteins.  Read this post for more information on nutrient quality and interactions.

Kidney Disease

If you have impaired kidney function, especially evidenced by an elevated blood creatinine level or similar marker (talk to your doctor about this), then you may need to curtail your protein intake.

Keep in mind that diabetes and high blood pressure are top causes for chronic kidney disease, and increasing protein intake while lowering sugar and processed foods can help prevent diabetes and hypertension-related kidney disease from developing in the first place. 

Insulin Resistance and Glucose Issues (Prediabetes, Diabetes, Metabolic Syndrome, etc.)

Cutting back on sugar, artificial fructose and excess carbs are the nutritional staple to managing these conditions since these foods directly raise blood glucose and insulin levels.  However, keep in mind that excess protein can be converted to glucose by our liver through a process called gluconeogenesis, so unrestrained protein intake may be stalling your efforts to get your blood glucose or hemoglobin A1c (long-term marker for glucose control) into goal range.

Again, think more plants, more healthy fats, more activity/exercise, more sleep and better stress management before piling on more and more protein.  Need help with these?  Read my book and my prior blog posts which focus on all these areas.

Constipation and Digestive Issues

Animal protein in particular can be tough to digest if you are not secreting sufficient stomach acid and digestive enzymes, which is a common problem in our patients resulting from poor eating habits and chronic stress.  Read my free fatigue e-book where I talk about gut health in more detail.

Once you improve your gut health, you may be able to tolerate digesting animal protein better, but until then focus on vegetables, plant based proteins, seafood, high quality dairy and eggs, and smaller portions of animal meat.

mTOR Pathway and Longevity

As we’ve discussed, protein is a building block for muscle growth and actually overall growth. A special enzyme called mTOR is a nutrient sensor that increases growth especially in response to protein intake.  The problem is that excessive protein intake over time can cause excess growth, which is also associated with the development of cancer, a state of unrestrained tumor cell growth, and other chronic health conditions.

Keeping the mTOR pathway restrained is a critical path to increasing longevity.  Healthy sources of dietary fat do not trigger mTOR activity.  So if you are lowering excess carbs in the diet, it is important to make sure you are increasing healthy fat along with protein to avoid an abundance of just protein, which can accelerate aging and its associated diseases via mTOR overactivation.

The message once again is about balance.  A pure low carb, high protein diet may satisfy some immediate goals like weight loss and glucose control, but over time it may trigger other less desirable and unnecessary growth pathways that impede lifespan.

Excess carbohydrates also trigger excess growth due to increased insulin and IGF-1 (insulin-like growth factor) levels which may be another reason how abundant carb intake is related to cancer risk as we discuss here.

Out of our major macronutrients (carbs, fat and protein), healthy sources of dietary fat have little to no effects on activating mTOR or insulin and IGF-1.  

This is why I repeatedly stress an abundance of vegetables and including healthy fats in the diet alongside your high quality protein and healthy carbs.  This is also how the healthiest populations in the world have always eaten.  Diversify your nutritional portfolio to protect you over the long haul.

Now I’d like to turn it over to our nutrition expert, Prerna Uppal, on some practical tips on boosting protein in the diet.

Prerna’s Tips on How to Boost Protein

So, what is the most powerful way to pack your protein punch?  I am listing some of the healthiest protein-packed foods and in particular, am emphasizing vegetarian sources so you can include more of the healthier plant-based proteins.

We know that animal foods supply high quality proteins, meaning they contain all 9 “essential” amino acids. Essential amino acids cannot be made by the body and must be obtained through food. Meat, fish, poultry, eggs and dairy are all animal sources of protein.

Vegetarian sources of protein on the other hand, usually pack only a fraction of the essential amino acids. It is therefore important to eat a variety of plant foods to get the full array of amino acids. These include lentils, legumes, nuts, seeds, certain grains, soybean and vegetables.

Here are my protein picks:

1. Nuts/nut butters– great way to get protein.  Watch out for unhealthy (and unneeded) ingredients such as added sugars and hydrogenated fats.  Nut butter spread on fruits like apple wedges or vegetables like celery makes a great snack.  Read more about nuts here.

2. Greek yogurt– has twice the protein of regular yogurt and half the carbs (can’t beat that!).  Choose organic, grassfed, full fat dairy and if you’re worried about dairy fat, read this.

3. Eggs– get the organic, pastured variety and include the yolks, especially for vegetarians who can eat eggs.  The yolk has nutrients that cannot be obtained from plant-based foods.  Read this if you’re still nervous about egg yolks.

4. Legumes/lentils– great source of protein but be sure to keep an eye on their carb content

5. Quinoa– It is considered a grain, but in reality is a seed. It is one of the few plant-based proteins that contains all 9 essential amino acids. I love its versatility as it can be added to salads, soups and used as a rice replacer (does contain carbs, so be sure to take that into account)

6. Paneer– preferably made at home with organic, grass-fed milk

7. Soy– we recommend organic, non-GMO tofu and choose fermented soy products like miso, natto, or tempeh (great stand-in for meat!).  Edamame is as close to a natural state and therefore the least processed

8. Seeds– hemp and chia in particular are good sources of protein and healthy fats and are easy to sprinkle onto your yogurt, salads or add to your smoothies

9. Fish– cold water fatty fish like salmon, tuna, mackerel and sardines of the wild variety

10. Vegetables– as Dr. Ron mentioned, we often overlook the protein power of vegetables. We advise our patients to eat a lot of vegetables as they can add up to make a significant contribution to our daily protein intake. Often we might blend veggies into a green smoothie.

Speaking of smoothies and shakes, are these an acceptable way to get more protein in the diet?  This is a common question from our muscle builders and protein-deficient vegetarians, trying desperately to boost protein intake.

Most of our vegetarian, non-bodybuilding patients can easily hit their protein range with the foods mentioned above.  If they are very physically active and looking to pack on some muscle, then adding on a high quality grass-fed whey protein without artificial sweeteners or chemicals like the Jarrow brand (many others can be found online) should be fine.

Here’s a recipe to get you started:

Prerna’s Protein Packed Parfait
This is a favorite of mine as it is extremely versatile- works for breakfast, as a snack or even for dessert!
Ingredients*
Greek yogurt, plain: 6 oz
Chia seeds: 2 Tbsp
Almond milk: 2 oz (4 Tbsp)
Berries: 1/2 cup
Almonds: 1/2  oz (12 almonds) crushed
Method
In a mason jar,
1. Stir in the chia seeds and almond milk
2. Let the mixture soak for 5-10 min
3. Layer on the greek yogurt
4. Next layer on the blueberries
5. Top with the crushed almonds
* Use organic ingredients whenever possible
How’s this for a whopping 26g of protein with only 10 g of net carbs?