CIA-Harvard Menus of Change National Leadership Summit. Protein 101
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1 CIA-Harvard Menus of Change National Leadership Summit June 10, 2014 Cambridge, MA General Session III Protein 101 Christopher Gardner, PhD, Professor of Medicine, Stanford Prevention Research Center, Stanford University
2 Protein 101
3 Outline Standard Recommendations Minimum / Optimal / Maximum CONFUSION? Quality Impact of Shifting from Animal to Plant-Based Proteins
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5 Dietary Reference Intakes (DRI) Dietary Guidelines for Americans
6 PROTEIN: Estimated Average Requirement (EAR) Grams / kg body weight Age Group 7-12 months 1-3 years 4-8 years 9-13 years years >18 years Girls/Women Boys/Men
7 PROTEIN: Estimated Average Requirement (EAR) > 18 years 0.66 Grams / kg body weight Weight (lbs) EAR 30 g 45 g 60 g 75 g
8 Distribution of Requirement Protein Requirement 25 grams/day 54 grams/day
9 Recommended Daily Allowance (RDA) Population Approach: Add 2 Standard deviations to EAR Protein Requirement 25 grams/day 54 grams/day
10 PROTEIN: Recommended Daily Allowance (RDA) Grams / kg body weight Age Group 7-12 months 1-3 years 4-8 years 9-13 years years >18 years Girls/Women Boys/Men
11 PROTEIN: Recommended Daily Allowance (RDA) > 18 years 0.8 Grams / kg body weight Weight (lbs) RDA 36 g 55 g 73 g 91 g
12 Recommended vs. Actual Intake in U.S. RDA for protein for adults >18 years Women: 46 g/day Men: 58 g/day Daily estimated intake of protein by Americans 85% from animal sources 111 g/day Does not account for the cumulative amounts of protein from minor protein sources The data are from (e.g., 2006, potatoes, based on data published vegetables) in 2011, and accessed April 28, (
13 grams PROTEIN Intake Stanford Students Range: grams Mean (+/- SD) = 99 +/- 39 grams Average requirement?? RDA for men ~55 grams RDA for women ~45 grams
14 Class Exercise: Protein and Energy (Kcal) intake PROTEIN Intake Stanford Med Students Protein (grams) Kcals
15 Class Exercise: Protein and Energy (Kcal) intake Protein (grams) PROTEIN Intake Stanford Med Students Likely under-reporting average intake for typical day, unless actively losing weight Kcals
16 Class Exercise: Protein and Energy (Kcal) intake PROTEIN Intake Stanford Med Students Protein (grams) EAR Kcals
17 Class Exercise: Protein and Energy (Kcal) intake PROTEIN Intake Stanford Med Students Protein (grams) RDA EAR Kcals
18 % Protein Class Exercise: Protein and Energy (Kcal) intake 40% 35% PROTEIN Intake Stanford Med Students 30% 25% 20% 15% 10-25% 10% 5% 0% Kcal
19 Outline Standard Recommendations Minimum / Optimal / Maximum CONFUSION? Protein Quality Impact of Shifting from Animal to Plant-Based Proteins
20 JAMA, June 25, 2008 Vol 299, No. 24 pp
21 JAMA, June 25, 2008 Vol 299, No. 24 pp The recommended dietary allowance (RDA) is an estimate of the minimum daily average dietary intake level that meets the nutrient requirements of nearly all (97 to 98 percent) healthy individuals.
22 JAMA, June 25, 2008 Vol 299, No. 24 pp The recommended dietary allowance (RDA) is an estimate of the minimum daily average dietary intake level that meets the nutrient requirements of nearly all (97 to 98 percent) healthy individuals. the minimum protein intake necessary to avoid a progressive loss of lean body mass as reflected by nitrogen balance.
23 Acceptable macronutrient distribution ranges (AMDR) Percentages of daily calories from carbohydrate, fat and protein sufficient to provide adequate total energy intake and nutrients while reducing the risk of chronic disease % Protein 45-65% Carbohydrate 20-35% Fat IOM Dietary Reference Intakes
24 Acceptable macronutrient distribution ranges (AMDR) Percentages of daily calories from carbohydrate, fat and protein sufficient to provide adequate total energy intake and nutrients while reducing the risk of chronic disease % Protein 10% of a typical caloric intake translates to 0.95 g/kg/d and 35% of energy intake translates to 3.3 g/kg/d. IOM Dietary Reference Intakes
25 Athletes and active individuals may benefit from protein intakes of 1.2 to 1.7 g/kg/d, an amount higher than the recommended daily allowance of 0.8 g/kg/d.
26 Health (%) OPTIMAL intake is typically a wide range Bounded by marginal deficiency and toxicity
27 Outline Standard Recommendations Minimum / Optimal / Maximum CONFUSION? Protein Quality Impact of Shifting from Animal to Plant-Based Proteins
28 Amino Acids Essential Histidine Isoleucine Leucine Lysine Methionine Phenylalanine Threonine Tryptophan Valine Nonessential Alanine Arginine Asparagine Aspartic acid Cysteine Glutamic acid Glutamine Glycine Proline Serine Tyrosine
29 How Many Amino Acids? Insulin: ~50 amino acids Lipoprotein lipase (LPL): ~450 amino acids Hemoglobin: ~600 amino acids Thyroglobulin: ~2,700 amino acids Titin: largest known protein ~34,350 amino acids
30 Food Proteins: Quality, Use, and Need Limiting Amino Acid Protein Quality The essential amino acid that is present in dietary protein in the lowest amount proportional to its requirement
31 Just as each letter that is part of a word must be present when forming that word, each amino acid that is part of a protein must be present when building that protein.
32 His Iso Leu Lys Met Phe Thr Trp Val Ala Arg Asp/ine Cys Glut/ine Gly Pro Ser Tyr grams Amino Acid Distribution (per 40 grams protein): EGG Essential Non-Essential
33 His Iso Leu Lys Met Phe Thr Trp Val Ala Arg Asp/ine Cys Glut/ine Gly Pro Ser Tyr grams Amino Acid Distribution (per 40 grams protein): EGG fold difference fold difference 0.0 Essential Non-Essential
34 His Iso Leu Lys Met Phe Thr Trp Val Ala Arg Asp/ine Cys Glut/ine Gly Pro Ser Tyr grams Amino Acid Distribution (per 40 grams protein) Whole Egg White Rice Essential Non-Essential
35 His Iso Leu Lys Met Phe Thr Trp Val Ala Arg Asp/ine Cys Glut/ine Gly Pro Ser Tyr grams Amino Acid Distribution (per 40 grams protein) Limiting amino acid Whole Egg White Rice Essential Non-Essential
36 His Iso Leu Lys Met Phe Thr Trp Val Ala Arg Asp/ine Cys Glut/ine Gly Pro Ser Tyr grams Amino Acid Distribution (per 40 grams protein) Limiting amino acid Whole Egg Pinto Beans Essential Non-Essential
37 His Iso Leu Lys Met Phe Thr Trp Val Ala Arg Asp/ine Cys Glut/ine Gly Pro Ser Tyr grams Amino Acid Distribution (per 40 grams protein) Limiting amino acid Whole Egg Beans and Rice Essential Non-Essential
38 Outline Standard Recommendations Minimum / Optimal / Maximum CONFUSION? Protein Quality Impact of Shifting from Animal to Plant-Based Proteins
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42 the source of protein (90 percent animal, 90 percent vegetable, or mixed) did not significantly affect the median nitrogen requirement, slope, or intercept. It should be noted that almost all of the studies included as 90 percent vegetable were based on complementary proteins.
43 Food Proteins: Quality, Use, and Need Concern about the quality of individual food proteins is of only theoretical interest in settings where food is abundant. Most people in the US and Canada eat a variety of nutritious foods to meet their energy needs not just say, cookies, potato chips or alcoholic beverages. They would find it next to impossible not to meet their protein requirements, even if they were to eat no meat, fish, poultry, eggs, cheese or soy products. Sizer and Whitney, Nutrition Concepts and Controversies
44 One of my vegan days Breakfast 1 c Steel cut oats ¼ c Unswtnd soy milk ⅓ c Walnuts ¾ c Mango ⅓ c Unswtnd soy milk 4 oz coffee Snack ¼ c Trail Mix Lunch SALAD Mixed lettuce, edamame, pinto beans, garbanzo beans, tofu, carrots, jicama, sunflower seeds, beets, potatoes, slivered almonds, olive oil, balsamic vinegar Snack Apple 1 oz Dark Chocolate 12 oz Soy chai Dinner 2 c Gypsy Soup (Sweet potatoes, chickpeas, veggies, turmeric) 1/8 c Cashews 1 slice Whole grain bread 6 spears Asparagus Snack 1 oz Dark Chocolate ⅓ c Unswtnd soy milk 4 oz coffee
45 One of my vegan days Item 2 c Gypsy Soup 1.75 c Soy milk 2 Tblsp Edamame ¼ c Trail Mix 1/3 c Walnuts 1 c Steel cut oats 2 Tblsp Pinto beans 2 Tblsp Garbanzo beans 1 slice Whole grain bread 2 Tblsp Slivered almonds Kcal Protein (g) Subtotal 61 g 2 oz Dark Chocolate 1/8 c Cashews 6 spears Asparagus 1 Tblsp Sunflower Seeds 3 c Mixed greens 1/16 c tofu g Mango, apple, beets potato, chai tea, carrots, jicama, balsamic vinegar, olive oil = 78 g
46 Protein Use
47 Protein Use 1. Functional Protein
48 Protein Use 1. Functional No Storage Protein
49 Protein Use 1. Functional No Storage Protein 2. Carbohydrate (for immediate need, or conversion to glycogen)
50 Protein Use 1. Functional No Storage Protein 2. Carbohydrate (for immediate need, or conversion to glycogen) 3. Fat (conversion for energy storage)
51 Protein Use 1. Functional No Storage Protein Nitrogen 2. Carbohydrate (for immediate need, or conversion to glycogen) 3. Fat (conversion for energy storage)
52 Protein Use 1. Functional No Storage Protein Nitrogen NH3 (Ammonia) 2. Carbohydrate (for immediate need, or conversion to glycogen) 3. Fat (conversion for energy storage)
53 Protein Use 1. Functional No Storage Protein Nitrogen NH3 (Ammonia) 2. Carbohydrate (for immediate need, or conversion to glycogen) 3. Fat (conversion for energy storage)
54 Take Home Points Standard Recommendations Minimum / Optimal / Maximum CONFUSION? Quality Impact of Shifting from Animal to Plant-Based Proteins
55 Take Home Points Standard Recommendations Minimum / Optimal / Maximum CONFUSION? Quality Impact of Shifting from Animal to Plant-Based Proteins Americans (justifiably) confused about HOW MUCH protein they need, and from WHAT SOURCES to get it
56 Take Home Points Standard Recommendations Minimum / Optimal / Maximum CONFUSION? Quality Impact of Shifting from Animal to Plant-Based Proteins Americans (justifiably) confused about HOW MUCH protein they need, and from WHAT SOURCES to get it In general, they get a LOT, and with some qualifiers, a LOT MORE THAN THEY NEED
57 Take Home Points Standard Recommendations Minimum / Optimal / Maximum CONFUSION? Quality Impact of Shifting from Animal to Plant-Based Proteins Americans (justifiably) confused about HOW MUCH protein they need, and from WHAT SOURCES to get it In general, they get a LOT, and with some qualifiers, a LOT MORE THAN THEY NEED Tremendous room for substantial shift from animal to plant protein
58 Measuring Protein Quality Protein digestibility - corrected amino acid score: PDCAAS (100=perfect/best) Egg white Ground beef Chicken products Fat free milk Tuna fish 100 Soybean 94 Most legumes 50 s and 60 s Gluten (wheat protein) 25 Pea flour (67) + whole wheat flour (40) - 82
59 Protein requirement and recommendations How much protein do people really need? PROTEIN RECOMMENDATIONS (Table 6.2, page 197) DRI: 0.8 g / kg / day (women ~46 g/day, men ~56 g/day) Dietary Guidelines: Every day 5 to 6-1/2 oz equivalents of legumes, nuts, seeds, eggs, lean poultry without skin, or lean meat. Every day 3 cups fat-free or low-fat milk or yogurt, or fortified soy beverage Eat a variety of foods to provide protein from other sources Daily Value (for 2,000 calories/day): 50 grams/day World Health Organization: 10-15% of daily calories DRI AMDR (2002): 10-35% of daily calories
60 4 oz Tenderloin Beef Calories Protein (g) Fat (g) Saturated fat (g) Carbs (g) Added sugar (g) Fiber (g) ~
61 4 oz Hamburger patty Calories Protein (g) Fat (g) Saturated fat (g) Carbs (g) Added sugar (g) Fiber (g) ~ ~
62 4 oz Chicken Breast Calories Protein (g) Fat (g) Saturated fat (g) Carbs (g) Added sugar (g) Fiber (g) ~
63 4 oz Salmon Calories Protein (g) Fat (g) Omega-3 fat (g) Carbs (g) Added sugar (g) Fiber (g) ~ ~
64 Two eggs Calories Protein (g) Fat (g) Sat fat (g) Carbs (g) Added sugar (g) Fiber (g) ~ <1 0 0
65 What is in 8 oz of the different types of milk? Calories Fat Carbs Protein g 11 g 9 g 2% g 14 g 10 g g 14 g 10 g 100 <1 g 14 g 10 g
66 Plain (Low-Fat) Yogurt Calories Protein (g) Fat (g) Sat fat (g) Carbs (g) Added sugar (g) Fiber (g) ~
67 What is in 8 oz of different types of SOY milk? Calories Fat Carbs Protein g 10 g 6 g g 8 g 7 g 80 4 g 4 g 7 g
68 1/2 cup Edamame Calories Protein (g) Fat (g) Sat fat (g) Carbs (g) Added sugar (g) Fiber (g) ~
69 Beans ½ cup cooked Kcal Protein Carb Fiber Fat Sat Fat Lentils Garbanzos Kidney Pinto g 20 g 8 g 0.4 g 0.1 g g 22 g 6 g 2 g 0.4 g g 20 g 6 g 0.4 g 0 g g 22 g 7 g 0.5 g 0 g
70 Nuts 1 ounce Kcal Protein Carb Fiber PUFA MUFA Sat Fat Almonds Cashews Walnuts Pistachios g 5.7g 3.5g 3.3g 9.0g g 8.5g 0.9g 2.2g 6.8g g 2.8g 1.9g 9.9g 4.2g g 7.9g 2.9g 3.8g 6.6g 1.5
71 1 slice Whole Grain Bread Calories Protein (g) Fat (g) Sat fat (g) Carbs (g) Added sugar (g) Fiber (g) ~ varies 1-4
72 1 cup Broccoli Calories Protein (g) Fat (g) Sat fat (g) Carbs (g) Added sugar (g) Fiber (g) ~
73 1 cup Romaine Calories Protein (g) Fat (g) Sat fat (g) Carbs (g) Added sugar (g) Fiber (g) ~ <1 0 1
74 Protein Requirement (g/kg/day) FIGURE 10-5 Distribution of the estimated protein requirement for 225 individuals (Rand et al., 2003) in a trimmed data set showing the skewness of protein requirement. SOURCE: William Rand, personal communication, 2002.
75 The advantages of legumes (beans) Soy protein quality and quantity is high Legumes (beans) are excellent sources of: Fiber B-vitamins Iron Calcium And other minerals Legumes (beans) are not good sources of: Vitamins A, C or B12
76 2011
77 2011 MyPlate.gov
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87 The USDA Food Guide Pyramid
88 The USDA Food Guide Pyramid
89 Beans, Nuts, Fish, Eggs, Poultry, Meat CONTRIBUTE: Protein, fiber B6, B12, niacin, thiamin, folate, Vitamin E Potassium, zinc, magnesium, iron
90 Beans, Nuts, Fish, Eggs, Poultry, Meat CONTRIBUTE: Protein, fiber B6, B12, niacin, thiamin, folate, Vitamin E Potassium, zinc, magnesium, iron 2-3 servings/day
91 Beans, Nuts, Fish, Eggs, Poultry, Meat 2-3 servings/day CONTRIBUTE: Protein, fiber B6, B12, niacin, thiamin, folate, Vitamin E Potassium, zinc, magnesium, iron 1 Serving equals 1/2 cup cooked beans 1/3 cup nuts 2 tbs peanut butter 2-3 oz lean fish poultry meat (5-7 oz/day)
92 Beans, Nuts, Fish, Eggs, Poultry, Meat 2-3 servings/day CONTRIBUTE: Protein, fiber B6, B12, niacin, thiamin, folate, Vitamin E Potassium, zinc, magnesium, iron 1 Serving equals 1/2 cup cooked beans 1/3 cup nuts 2 tbs peanut butter 2-3 oz lean fish poultry meat (5-7 oz/day)
93 Beans, Nuts, Fish, Eggs, Poultry, Meat Fish, legumes, tempeh, peanut butter, nuts, seeds, eggs, poultry (no skin), lean meat Bacon, ground beef, hot dogs, sausages, spare ribs, luncheon meats, marbled steaks Make lean or low-fat choices
94 Milk, Yogurt and Cheese CONTRIBUTE: Protein Riboflavin & B12 (Vitamins A & D when fortified) Calcium, magnesium, potassium
95 Milk, Yogurt and Cheese CONTRIBUTE: Protein Riboflavin & B12 (Vitamins A & D when fortified) Calcium, magnesium, potassium 2-4* servings/day
96 Milk, Yogurt and Cheese 2-4* servings/day CONTRIBUTE: Protein Riboflavin & B12 (Vitamins A & D when fortified) Calcium, magnesium, potassium * 3 servings/day for: Teenagers Young adults Pregnant/lactating Postmenopausal women 4 servings/day for: Pregnant or lactating teenagers
97 Milk, Yogurt and Cheese 2-4* servings/day CONTRIBUTE: Protein Riboflavin & B12 (Vitamins A & D when fortified) Calcium, magnesium, potassium 1 Serving equals 1 cup milk or yogurt 1-1/2 oz cheese 2 oz processed cheese food
98 Milk, Yogurt and Cheese Fat-free milk, fat-free milk products (e.g., buttermilk, cheeses, cottage cheese, yogurt), fat free fortified soy milk Ice cream, whole milk, milk shakes, milk products with added sugar Make fat-free or low-fat choices
99 His Iso Leu Lys Met Phe Thr Trp Val Ala Arg Asp/ine Cys Glut/ine Gly Pro Ser Tyr grams Amino Acid Distribution Whole Egg: 40 g protein White Rice: 80 g protein Limiting amino acid Essential Non-Essential
100 Protein Content Amount Protein (g) Kcal Egg White Rice 1 cup Pinto Beans 1 cup Soy Beans 1 cup
101 Protein Content (cooked) Eggs White Rice Pinto Beans Soy Beans Amount providing 40 g protein 7.2 eggs 9 cups 2.6 cup 1.2 cups Kcal ~470 ~2,200 ~635 ~450
Outline. Ø Standard Recommendations. Ø Minimum / Optimal / Maximum CONFUSION? Ø Quality Ø Impact of Shifting from Animal to Plant-Based Proteins
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