Ask the Experts - High-Protein Diets
Ask the Experts - High-Protein Diets
Recently in my clinical practice, I have come across a lot of patients going for chemical dieting with excess of protein intake and deficient intake of cholesterol and fats, both saturated and unsaturated. How does it affect the overall milieu of the body? It is claimed to reduce weight quite effectively. Also, please advise regarding its side effects if appropriate.
Habib Ahmad, MBBS, MD
What is the evidence behind the low-carbohydrate/high-protein diet currently available as "the Atkins Answer?"
Paul Cronin, MB ChB, BSc, DA
The Role of High-Protein Diets for Weight Loss
Recently, there has been a resurgence in the popularity of high-protein diets for weight, partially due to the growing epidemic of obesity and limitations of traditional treatment programs. These diets are attractive, because they offer liberality in food choices containing protein. However, they are generally restrictive in foods containing carbohydrates and as such often become monotonous over the long-term. The role of these diets in weight loss is limited because initial weight losses are usually difficult to maintain over the long-term.
There are currently no long-term, randomly assigned studies that demonstrate the safety and efficacy of high-protein diets over the long-term. Individuals who follow this diet, however, often experience significant initial weight losses due to the change in eating patterns and limitations in total intake of kilocalories. The corresponding switch from a high to low carbohydrate diet, which causes substantial water loss, is partially responsible for this weight loss.
It is important to note that high-protein diets promote a dramatic departure from normal eating patterns and can be self-limiting due to the foods they "allow." Most Americans already consume too much protein. Individuals who follow a high-protein diet tend to compensate their intake by dramatically decreasing their carbohydrates and increasing their fat intakes. The percentage of protein in the typical diet is generally stable and averages approximately 15% kcal/day. Very-high-protein diets, on the other hand, provide twice this amount.
High-protein diets are generally associated with higher intakes of total fat, saturated fat, and cholesterol compared with the average diet. Because food choices are limited, nutrient inadequacy can also become a problem. Individuals who follow these diets for a long period of time are at risk for compromised intakes of vitamins as well as potential cardiac, renal, bone, and liver abnormalities.
Indications for High-Protein Diets
High-protein diets are generally self-prescribed, following the advice of friends and popular books. Most professionals do not consider high-protein diets efficacious, safe, or palatable over the long-term. Instead, the majority promote a "balanced" eating pattern, which can support health maintenance overall.
High-protein foods are high in purines and as a source of uric acid may cause or exacerbate gout. A high-protein diet is especially risky for patients with diabetes as it may speed the progression of diabetic renal disease. Furthermore, high-protein diets limit intake of fruits, vegetables, nonfat dairy products, and whole grains, which have been associated with the balance of vitamins, mineral, fiber, and phytochemicals recommended for the treatment and prevention of conditions such as hypertension and osteoporosis. Protein is also the most expensive source of calories in the diet. High-protein diets may not be harmful for "healthy" individuals in the short-term, but they do promote unhealthy eating patterns and, therefore, may increase disease risk over the longer term.
Note: The Statement by the American Heart Association Nutrition Committee that provides the background for these answers is currently under review. Additionally, there are numerous ongoing studies and efforts at implementing long-term clinical trials to address the many questions surrounding high-protein diets.
Recently in my clinical practice, I have come across a lot of patients going for chemical dieting with excess of protein intake and deficient intake of cholesterol and fats, both saturated and unsaturated. How does it affect the overall milieu of the body? It is claimed to reduce weight quite effectively. Also, please advise regarding its side effects if appropriate.
Habib Ahmad, MBBS, MD
What is the evidence behind the low-carbohydrate/high-protein diet currently available as "the Atkins Answer?"
Paul Cronin, MB ChB, BSc, DA
The Role of High-Protein Diets for Weight Loss
Recently, there has been a resurgence in the popularity of high-protein diets for weight, partially due to the growing epidemic of obesity and limitations of traditional treatment programs. These diets are attractive, because they offer liberality in food choices containing protein. However, they are generally restrictive in foods containing carbohydrates and as such often become monotonous over the long-term. The role of these diets in weight loss is limited because initial weight losses are usually difficult to maintain over the long-term.
There are currently no long-term, randomly assigned studies that demonstrate the safety and efficacy of high-protein diets over the long-term. Individuals who follow this diet, however, often experience significant initial weight losses due to the change in eating patterns and limitations in total intake of kilocalories. The corresponding switch from a high to low carbohydrate diet, which causes substantial water loss, is partially responsible for this weight loss.
It is important to note that high-protein diets promote a dramatic departure from normal eating patterns and can be self-limiting due to the foods they "allow." Most Americans already consume too much protein. Individuals who follow a high-protein diet tend to compensate their intake by dramatically decreasing their carbohydrates and increasing their fat intakes. The percentage of protein in the typical diet is generally stable and averages approximately 15% kcal/day. Very-high-protein diets, on the other hand, provide twice this amount.
High-protein diets are generally associated with higher intakes of total fat, saturated fat, and cholesterol compared with the average diet. Because food choices are limited, nutrient inadequacy can also become a problem. Individuals who follow these diets for a long period of time are at risk for compromised intakes of vitamins as well as potential cardiac, renal, bone, and liver abnormalities.
Indications for High-Protein Diets
High-protein diets are generally self-prescribed, following the advice of friends and popular books. Most professionals do not consider high-protein diets efficacious, safe, or palatable over the long-term. Instead, the majority promote a "balanced" eating pattern, which can support health maintenance overall.
High-protein foods are high in purines and as a source of uric acid may cause or exacerbate gout. A high-protein diet is especially risky for patients with diabetes as it may speed the progression of diabetic renal disease. Furthermore, high-protein diets limit intake of fruits, vegetables, nonfat dairy products, and whole grains, which have been associated with the balance of vitamins, mineral, fiber, and phytochemicals recommended for the treatment and prevention of conditions such as hypertension and osteoporosis. Protein is also the most expensive source of calories in the diet. High-protein diets may not be harmful for "healthy" individuals in the short-term, but they do promote unhealthy eating patterns and, therefore, may increase disease risk over the longer term.
Note: The Statement by the American Heart Association Nutrition Committee that provides the background for these answers is currently under review. Additionally, there are numerous ongoing studies and efforts at implementing long-term clinical trials to address the many questions surrounding high-protein diets.