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High Protein Diet

Many people in society have fallen for the high protein diet. Majority of those individuals tend to contain a high protein diet and a low carbohydrate diet. A very popular low carbohydrate diet is known as the Atkins diet. In recent years these types of diets have been promoted as an effective way to lose weight regardless of the many side effects that are associated with a high protein intake. Proteins have been classified in performing five main functions which include: maintenance of body tissues. Protein maintenance involves replacing blood cells every 120 days, replaces the cells that line the intestine and replacing the proteins that have been lost through perspiration, urine and feces. Proteins are also involved in the formation of new tissues from infancy to adulthood. It also is involved in regulation that are found in the cells and blood fluids. For example, the protein of the blood plasma helps regulate water balance and osmotic pressure, these proteins act as a buffer controlling the acid-base balance in our bodies. Protein is also involved in milk production. Each liter of human milk contains about 12g of protein. The last important function that protein plays a role in is the production of energy. The break down of amino acids yields energy (Ensminger et al, 1995). Despite all the functions that protein plays if an individual exceeds the Recommended Daily Allowance of 0.8grams per kilogram of body weight there are many side effects associated with a high intake of protein.

As previously stated the RDA for protein is 0.8g/kg of body weight, with the exception of high performance athletes. Long distance runners and triathletes need close to double the amount of protein for endurance events and training, whereas strength athletes like weightlifters can benefit from double the RDA for the average individual. (Thompson et al. 2007) This excess protein helps in the restoration of body tissue damage and tissue growth, caused by strenuous exercise. “Regular exercise increases the transport of oxygen to body tissues, requiring changes in the oxygen-carrying capacity of the blood.”(Thompson et al, 2007) To enhance the amount of oxygen carried, more hemoglobin, a protein, must be produced. It is also important for athletes and those on high-protein diets, as outlined in Harris’s A Passion for Protein, to exercise regularly as it aids the kidneys in flushing out harmful waste and substances more effectively from the body.
In an average Canadian diet we consume about ten to fifteen percent of our daily caloric intake from protein, twenty-five to thirty percent from fats and the remaining fifty percent from carbohydrates. A high protein diet consists of about twenty-five to thirty-five percent protein, therefore it is very common that our carbohydrate intake declines. This is why high-protein and low-carbohydrate diets like the Atkins and Zone diet are used interchangeably. With the increase in protein consumption our body uses less carbohydrates for energy and more protein and fat for fuel, creating an acidic blood pH known as ketosis. Researchers suggest that a diet high in protein causes blood pH to become overly acidic increasing potential health risks caused by ketoacidosis. Doctor Heather Hatfield stated that “eating only protein forces our body into starvation mode because most tissues, including the brain, typically prefer to run on glucose or blood sugar, which is supplied by carbohydrates.” When carbohydrates are not sufficient in the diet the body is forced to break down fatty acids as a fuel source. Many low carbohydrate diets force the body to break down fatty acids to use as a primary energy source, known as ketosis. In Health “Ketosis” is described as a state brought on when the bodies main source of fuel, carbohydrates, are severely restricted from the diet. Ketosis produces an energy known as ketones which supply the brain with sufficient energy when carbohydrates are absent. If ketones are produced for an extended period of time blood will become acidic resulting in “ketoacidosis”. Donatelle et al. warns that and extended period of “ketosis interferes with basic bodily functions resulting in a loss of lean body mass and damage to many of the body’s tissues” (176). In other words, weight loss is not necessarily due to total fat loss. Wilmore et al. in Physiology of Sport and Exercise, refers to these diets as “crash diets” which insufficiently supply the body with proper carbohydrate stores, eventually becoming depleted. Wilmore et al. explains a cause and affect relationship between water and carbohydrate stores, and as carbohydrate stores deplete so do water stores (326-327). We can then conclude that high protein, low carbohydrate diets are not effective in losing body fat but rather a loss in bodily fluids and lean body mass caused by ketoacidosis. As ketoacidosis continues the body is at risk for potentially life threatening conditions.

For extended periods of time low grade acidosis disrupts the body’s acid-alkaline homeostasis. Minich, PhD, and Clinical Nutritionist at the Functional Medicine Centre in Gig Harbor Washington believes that current trends in high protein, low carbohydrate diets can result in “chronic low grade level of metabolic acidosis” , which can result in osteoporosis, kidney disease and muscle wasting (62). Minch et al. explained the inner workings of the body’s acid-alkaline homeostasis as “compartmentalized organ systems operating within specific pH ranges” (63). Each system has specific pH levels tightly controlled by the body and when one system becomes too acidic or alkaline resources are borrowed from other systems to restore acid-alkaline homeostasis. Blood for example, is tightly regulated between pH of “7.35-7.45” whereas urine has a pH range of “4.5-8”.

In the field of medicine it is common practice to use pH values to determine common disease and potential risk. This technique was used by Minch’s et al. in the research conducted for Acid-Alkaline Balance: Role in Chronic Disease and Detoxification to show the correlation between taxation on other systems to maintain acid-alkaline homeostasis. Research demonstrated by Minich held that those who ate a high protein, low carbohydrate diets had blood pH levels which became acidic. When this occurs, calcium and magnesium cations are drawn upon from bone matrix to provide alkalinity in the event of insufficient buffering capacity in the blood (Minich et al. 62). If persisted over time Minich et al says, “calcium stores become depleted which may lead to metabolic bone disease and calcium nephrolithiasis” (Minich et al. , 2007). Calcium nephorlithiasis is an accumulation of calcium deposits which build up to form kidney stones.
Much of the research up until now has been against high protein diets, but lets take a look at what some have to say who are in favour of high protein diets. In an article in Alive: Canadian Journal of Health & Nutrition, Schanfarber provides unbiased opinion by recognizing the dangers of a high protein diet. Schanfarber doesn’t disagree with the fact that high protein diets can be harmful to ones health but rather attributes the problem to what may be lacking in a high protein diet. Schanfarber explains that many high protein diets consist primarily of animal source proteins and “limit important leafy green and colourful vegetables, whole grains, nuts, seeds, and fresh foods ,which, if avoided can be costly to one’s overall health”. This can lead to an overly acidic system, frequent urination , and risk of dehydration. Schanfarber recommends anyone who plans on using a high protein diet should increase their intake of fruits and vegetables to properly balance high acidity levels with the alkaline obtained from fruits and vegetables (2004).

Interestingly, some researchers have taken a whole different approach using Ketosis to treat type II diabetes and childhood epilepsy. In the journal Nutrition and Wellness an article published by Pérez-Guisado from the University of Spain, department of Genetics believes that ketosis can “correct glucose metabolism, as revealed by a decrease in glucose and insulin circulating in the blood” (par. 23, 2007). In a study Guisado refers to:
“… of 58 epilepsy patients with histories of approximately 20 seizures per day, refractory to over 6 drugs, a KD was effective in two thirds of the cases. In one third, it produced the cessation of seizures and in another third a significant reduction in frequency” (par. 28, 2007).

It appears whether you agree or disagree with a high protein diets, there is supporting evidence to suggest that a diet high in protein can have potentially severe consequences in developing chronic illnesses. As we’ve seen with both sides of the argument proteins are still an important part of the puzzle to a balanced intake and help satiate one’s cravings.

Protein is digested slower than fats and carbohydrates, leaving the stomach feeling ‘more full’ for a longer period of time, evidently resulting in decreased hunger and quick weight loss. Unfortunately, this decrease in weight is primarily water loss, as Gilbert’s report states. Increased protein intake raises uric acid and urea blood volumes, toxic by-products from protein metabolism. “The body eliminates this uric acid and urea by pumping lots of water into the kidneys and urinary tract to help it flush out. However, a detrimental side effect of this diuretic response is the loss of essential minerals from the body, including calcium.”(Gilbert, 2009) Calcium excretion and its side effects are explained in more detail in the later portion of this report.

High sources of protein are red meats, eggs, fish, milk, chicken, seeds, nuts and legumes. If the goal of an individual is weight loss, then he or she should eat leaner cuts of meat such as chicken and fish.

The majority of the population that has fallen for the high protein diet is actually blinded by the many side effects that are associated with it. One of the main drawbacks of a high protein diet is associated with kidney failure. Consuming an excess amount of protein that is higher than the RDA puts added stress on the kidneys and can be related to kidney failure. With the consumption of red meats and animal sources of protein, higher blood cholesterol levels come into play. Although these high protein and high fat foods will give an individual a full stomach feeling, they are loaded with saturated fat, which eventually leads to heart complications and coronary disease with the clogging of arteries. Bone loss is also another factor of a high-protein diet, due to excess calcium excretion and extraction.

Osteoporosis and kidney stones are negative factors related to a high caloric intake of protein. High protein diets have been associated with individuals to excrete more calcium through their urine. Over a prolonged period of time this may cause an individual to associated to having osteoporosis or kidney stones. Research over the years has shown that typically people tend to lose 1.75 milligrams of calcium for every 1 gram of protein that in ingested through the urine. “As calcium and other minerals are leached from our bones, they are deposited in the kidneys and can form into painful kidney stones. If a kidney stone becomes large enough to cause a blockage, it stops the flow of urine from the kidney and must be removed by surgery or other methods” (Gilbert, 2009)
With low levels of blood calcium, it is withdrawn from our bones, leaving our bones brittle and weak and eventually leading to osteoperosis.

Body Weight, Body Composition and Health

Body composition varies from individual to individual. Body weight is a combination of fat and lean tissue (water, muscle and bone). It is not possible to take direct measures of body composition of live individuals so assessments are made indirectly “Weight” loss or gain itself says nothing about the composition changes in the body. Weight measures are inexpensive, easy and accurate. Being overweight is not necessarily the same as being over fat. Lean body mass is denser than body fat.

What is a Healthy Weight?

Here are some important aspects of a healthy weight
• a weight that is appropriate for a person’s age and physical development
• a weight that a person can achieve and maintain without excessive diet restrictions or constant “dieting”
• a weight that a person feels satisfied with
• a weight that is congruent with a person’s genetic makeup and family history or body shape and weight
• a weight that promotes healthy eating habits and allows for participation in regular physical activity

A person is considered underweight when he/she has insufficient amounts of body fat to maintain health. In this state. he/she has a weight that is below an acceptably defined weight for a given height.
A person is considered overweight is when he/she has a moderate amount of excess body fat. In this state, he/she has a weight that is greater than some accepted standard for a given height but is not considered obese.

A person is considered obese when he/she has excess body fat to the extent that it is adversely affecting his/her health. In this situation, a person has a weight that is substantially greater than some accepted standard for a given height.

How “Healthy” Body Weights Are Determined

How much should a person weigh?

Is a person’s weight, jeopardizing his/her health? These are not easy questions to answer. Generally, healthy weights have been established by looking at weights associated with lowest mortality rates and establishing criteria for healthy weights. These include:
1. A weight within a health BMI range
2. Fat distribution associated with low risk of illness or death
3. No medical condition present that suggests a need for weigh loss
For many people, body image and weight is a more important issue than health and weight.

Body Mass Index (BMI)
BMI compares weight for height and is calculated using the following formula:
BMI = Weight in kg/Ht in m2
BMI Interpretation is as follows:
<18.5- underweight – at risk for health problems 18.5 - 24.9 - healthy weight range - least risk for devloping health problems 25 - 29.9 -overweight- at risk for health problems 30 -34.9 -obese- high risk for health problems 35-39.9 obese- very high risk for health problems >40 obese- extremely high risk for health problems
Note: BMI has limited value when used for people who have very large muscle mass for a given height. BMI is also not intended for us on children younger than 18 yrs old or on pregnant or lactating women. BMI is also not accurate for adults who are naturally very lean or seniors over 65 yrs old and certain ethinc groups.

Is Distribution of Body Fat Related to Health?

For the average man a reasonable body fat range is10-25%. The average woman has a reasonable body fat range of 18 – 32%. Athletes have a lower body fat that is advantageous for performance. Female athletes have a fat range of 15 -20% (some are even lower) while male athletes are 5-10%.
People living in cold climates may benefit from higher body fat percentages and pregnancy needs higher fat stores.
Low body fat is associated with hormonal abnormalities, infertility, depression, abnormal hunger regulation and the inability to maintain normal body temperature.

What is the Ideal?

The media strongly influences our perceived body image and people often turn to fashion or culture rather than health. The body shapes that society values have changed over time. When food was scarce, fashion dictated being overweight was a sign of prosperity and well-being. When food was plentiful, being slimmer is usually favoured. Our culture holds high value on thinness
There is a movement towards the acceptance of a wider range of body shapes. Thin does not necessarily equate with health. A person should have enough fat for their needs but not too much so as to be at increased health risk. Fat distribution may be more important and than total fat in determining health.

Apple vs Pear shape

Central obesity or the storage of fat around the abdomen (apple) is associated with increased risk of diabetes, heart disease, stroke and hypertension. Fat around the thighs and hips (lower body fat-pear shape), is more common in women and seems to pose less of a health risk. Two measures the Waist to Hip Ratio and Waist Circumference can be used to assess fat patterning.

Waist to Hip Ratio and Waist Circumference

The ratio is an indicator of fat distribution and is calculated by dividing the waist circumference by hip circumference. Women with a waist to hip ratio of > .80 are at high risk as are men with a ratio of >1.0. For the waist circumference, a man’s risk is increased when his waist circumference is greater than 102 cm (40 inches) and for women increase risk is associated with measures greater than 88 cm (35 inches).
A recent study* demonstrated the waist to hip ratio was the best indicator of risk for heart attacks. This study also found that BMI was not a good predictor for heart attack risk. When obesity was considered using the waist to hip ratio rather than the BMI, the number of people at risked tripled. The link between increased waist to hip ratio and increased risk of heart attack was a consistent finding in all 52 countries involved in the study.

The reason increased abdominal fat increases the risk of heart disease, stroke, hypertension and diabetes may be that abdominal fats seem to be more active than hip/thigh fat. When mobilized, abdominal fat goes directly to the liver rather than into the general circulation which other fat does. The liver takes abdominal fat and converts it to VLDL and then LDL.

As lipids rise, hormones are released that result in increased heart rate and increased blood pressure. Fat metabolism interferes with insulin metabolism and insulin levels and blood glucose levels tend to rise too.
*Yusuf, S et al. Effect of Potentially Modifiable Risk Factors Associated with Myocardial Infaction in 52 Countries( the INTERHEART study): Case control study. Lancet 2004:364:937-52.

Measuring Body Fat

Calipers are used to measure body fat by fat folds (skin folds). Measurements are taken as several sites including the triceps, biceps, subscapular and suprailiac. The thickness of skin fold reflects the amount of body fat (almost half of fat is under the skin). Measures are taken and compared to standards. Fat folds give a good estimate of body fat and a fair assessment of the location of the fat. It is best used to monitor changes in an individual over time. If there is a gain in body fat, there is a corresponding increase is the skin fold measure. If a person loses body fat, there is a decrease in skin fold measure.

One limitation of this method is that the calipers are too small to measure the skin folds on obese people. To be accurate, this method also relies on well trained technicians. Fat fold measures correlate directly with heart disease.

BIA – Bioelectrical Impedance Analysis involves sending a very low level of electrical current through a person’s body. Lean body mass is mostly made up of water. Water is a good conductor of electricity so the rate at which an electrical current is conducted provides an indication of a person’s body composition. The leaner person is less resistant to the current. There are limitations with this method but under ideal conditions BIA can estimate body fat with an error of 3-4%.

Hydrodensitometry or underwater weighing measures a person’s weight on land and underwater.-not the most convenient thing to do! This method is primarily used in research settings. It is considered on of the most accurate methods of determining body composition. Body fat can be estimated within 2-3%.
Near Infrared Reactance is base on the priciples of light absorption and reflection. A probe is attached to the biceps. Then an infraed beam penetrates the arm and is reflected back into the probe. This method is widely used in health clubs but the accuracy is very poor and the value of any result have to be questioned.
Pod Bod is a machine the uses air displacement to measure body composition. This technology is expensive and is used primarily in research settings. The results seem to be accurate for caucasians but overestimates body fat in some other ethnic groups.

Health Risks Associated with Body Weight and Body Fat

Too little or too much body fat is associated with health risks. People who are underweight or extremely overweight have a high risk of illness and early death.

Underweight
A person with minimal nutrient and energy reserves has difficulty dealing with physical stress such as surgery or illnesses. Underweight women also tend to be infertile.

Overweight
There are multiple health risks associated with being overweight including diabetes, hypertension, cardiovascular disease, sleep apnea, gout, gallbladder disease, liver malfunction, complications after during pregnancy and after surgery.
People who are overweight place a high cost on the health care system.

Cardiovascular Disease
There is a strong association between overweight and increased risk of heart disease and high blood pressure. With weight loss these people see better control of blood lipids and decreased blood pressure.

Diabetes
Type II diabetes is much more likely to develop in an obese than non-obese person. Insulin resistance associated with central obesity. Weight loss contributes to better blood glucose control.

Cancer
There is an increased risk of cancer with increased body weight. It is believed this is because the elevated levels of hormones could influence cancer development.