Optimizing Protein in a Carbohydrate World
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1 Optimizing Protein in a Carbohydrate World Donald K. Layman, Ph.D. Professor Emeritus Department of Food Science & Human Nutrition University of Illinois at Urbana Champaign The confused consumer 1
2 Myth: Adults eat more protein than they need Myth: Adults eat more protein than they need Recommended Dietary Allowance (RDA) The lowest level of dietary protein intake that will balance the losses of nitrogen from the body in persons at energy balance with modest levels of physical activity Minimum intake to prevent deficiencies versus Optimum intake for health 2
3 Dietary Reference Intake Acceptable Macronutrient Distribution Range RDA = Recommended Dietary Allowance Safe Range of Dietary Protein (DRI) Dietary Reference Intake (for protein) Acceptable Macronutrient Distribution Range P P 0.8 g/kg ~56 g/d 10% En > 3.0 g/kg ~225 g/d 35% En 3
4 The paradigm shift from Pyramids to Plates 2010 avoid fat eat grains daily net servings vegetables protein (and dairy) balanced meals What s new in protein research: health of skeletal muscle critical for long term health age related sacropenia functional mobility metabolic health aging reduces efficiency of protein use meal distribution of protein 4
5 A Muscle centric View of Nutrition Am J Clin Nutr 2006; 84:475 Metabolic Advantage of Protein (with reduced carbohydrate intakes) improves body composition protects skeletal muscle; targets fat loss increases metabolic rate enhances satiety reduces snacking reverses the Metabolic Syndrome TG, HDL, LDL size FBG, post prandial insulin, BP 5
6 Minimum versus Optimum? what are the critical health outcomes? Growth versus Aging Protein RDA = ? g/kg Meal effects on muscle protein balance 6
7 Muscle protein synthesis after a meal in young versus older adults muscle protein synthesis Meal containing: 15 grams of protein (7 g essential amino acids) Katsanos et at AJCN 82: 1065, 2005 Aging reduces the Efficiency of protein use Cause (?) reduced capillary blood flow reduced membrane transport reduced metabolic signaling*** 7
8 Why do we need protein = Amino Acids Non essential Amino Acids Arg Ala Asn Asp Cys Glu Gln Gly Pro Tyr Essential Amino Acids Lys Met Trp Limiting AA s Thr Leu Phe His Val Ile building blocks for new proteins multiple other metabolic roles Why do we need protein = Amino Acids Non essential Amino Acids Arg Ala Asn Asp Cys Glu Gln Gly Pro Tyr Essential Amino Acids Lys Met Trp Thr Leu Phe His Val Ile = leucine = valine = isoleucine BCAAs Branched chain amino acids 8
9 Metabolic signals from amino acids Neurotransmitters (mood, appetite) gut hormones (GLP1, CCK, PYY) GCN2 (integrated stress response) amino acids Leucine mtorc1 (protein synthesis muscle health) SIRT 1, PGC1 (mitochondria biogenesis) vascular health (nitric oxide) Aging reduces the efficiency of protein use but does not impair the capacity to respond muscle protein synthesis Katsanos et at AJCN 82: 1065, 2005 Symons et al AJCN 86:451, oz of beef ~15 g protein ~ 7 g EAA ~32 g protein ~ 15 g EAA specifically Leucine 9
10 Regulation of Muscle Protein Synthesis Amino acids (leucine) Growth hormones (insulin) Energy (glucose) Stress (exercise) Sestrin2 GATOR2 Akt AMPK GATOR1 TSC1 TSC2 REDD1 AMPK GTP Rag A/B Ragulator Raptor Rag C/D GDP S6K1 eef2k rps6 mtorc1 Rheb eif4e BP1 eif4f eef2 Muscle protein synthesis GTP inhibitor activator regulator Diet Controls Muscle Metabolism insulin leucine mtor protein synthesis 10
11 Plateau of muscle protein synthesis (22 yr old subjects) Moore et al. Am J Clin Nutr 2009; 89:161 Meal response for adult muscle protein synthesis: Response to leucine content of meal protein synthesis Leucine (g) meal threshold Protein (g)
12 1/18/2018 Meal Patterns: Unbalanced Protein Distribution Balanced Protein Distribution Maximum Protein Synthesis Breakfast Lunch Dinner Breakfast Lunch Dinner ~10 g protein ~20 g protein ~60 g protein ~30 g protein ~30 g protein ~30 g protein Balanced Unbalanced Mamerow et al. J Nutr 144: 876, 2014 Recommendations: 30 g of protein per meal 2.5 g of leucine per meal g protein/kg/day JAMDA 14:542,
13 Protein Quality: Leucine content of proteins Protein source Leucine (%) whey isolate milk protein 9.5 egg white 8.8 meats 8.6 * soy protein 7.8 oat protein 7.8 wheat gluten 6.8 *meats = 8 g protein/oz fish = 5 g protein/oz Metabolic Roles of Leucine and BCAAs stimulates mtor and muscle protein synthesis stabilizes blood glucose with recycling of alanine enhances fatty acid oxidation thru CPT 1 anaplerotic maintenance of TCA cycle enhances innate immunity thru glutamine production enhances vascular function thru arginine production 13
14 Leucine Metabolism in Skeletal Muscle leucine BCAT mtor alpha KIC BCKAD Protein synthesis CPT 1 acyl CoA Fatty acids glucose alanine pyruvate PDH acetyl CoA TCA cycle alpha KG glutamate glutamine mitochondria succinyl CoA Val & Ile Asp arginine Leucine Metabolism in Skeletal Muscle [Leucine] mtor Protein synthesis BCAT alpha KIC BCKAD acetyl CoA TCA cycle [ATP] mitochondria 14
15 Leucine Metabolism in Skeletal Muscle leucine mtor Protein synthesis BCAT alpha KIC BCKAD glucose pyruvate PDH acetyl CoA alanine TCA cycle mitochondria Leucine Metabolism in Skeletal Muscle leucine mtor Protein synthesis BCAT alpha KIC CPT 1 Fatty acids BCKAD acyl CoA glucose pyruvate PDH acetyl CoA alanine TCA cycle mitochondria 15
16 Leucine Metabolism in Skeletal Muscle leucine BCAT mtor alpha KIC BCKAD Protein synthesis CPT 1 acyl CoA Fatty acids glucose alanine pyruvate PDH acetyl CoA TCA NH cycle alpha KG 3 glutamate glutamine Asp mitochondria arginine Leucine Metabolism in Skeletal Muscle leucine BCAT mtor alpha KIC BCKAD Protein synthesis CPT 1 acyl CoA Fatty acids glucose alanine pyruvate PDH acetyl CoA TCA cycle alpha KG glutamate glutamine mitochondria succinyl CoA Val & Ile Asp arginine 16
17 Dietary Reference Intake (Leucine: minimum vs optimum) Acceptable Macronutrient Distribution Range 2 g 8 9 g > 35 g Protein and Exercise (athletes) Exercise improves efficiency Protein for athletes 1.2 up to 2.0 g/kg body weight 17
18 The Western Diet Is Protein Safe? 18
19 2009;9:311 Nature Reviews Endocrin 2014;10:723 Safety of Dietary Protein Isn t protein bad for your kidneys? Protein enhances kidney function and efficiency. 19
20 Isn t protein bad for you bones? Solid Bone Matrix Protein is the foundation of bone matrix and essential for bone repair and remodeling. Weakened Bone Matrix Doesn t protein cause cancer? 20
21 Why is there so much Fake News about Nutrition? IJO 39: 1109, 2015 Surveys in error by ~800 kcal/day Epidemiology: provides statistical correlations Correlations do not equal Causation Carbohydrates: The Good, the Bad, and the Ugly! sugar fructose whole grains lactose fiber starch VLCD Glucose (sugar) is an essential fuel but glucose can be toxic to cells (diabetes) 21
22 Dietary Reference Intake (carbohydrates) Acceptable range C >300 g/d 130 g/day 65% kcal RDA = 5 servings of vegetables 2 3 servings of fruit 3 servings of grains (15 g each) Carbohydrate needs or tolerance RDA = 130 g/day average U.S. intake ~ 300 g/day 22
23 Glucose as a fuel for muscle: exercise Factors are: intensity duration training Carbohydrate Tolerance (designing diets) RDA = 130 g/day RDA meets all nutrition needs (veggies, fruit, fiber, whole grains) Carbs > 130 g/day are earned with exercise ~60 g/hr intense Ex; HR > 100 Meal threshold < 40 g/meal; minimizes insulin response Meals > 40 g associated with exercise recovery 23
24 Designing Diets: Designing Diets: Diets with higher protein & reduced Carbs are beneficial Optimal protein to protect muscle & stimulate metabolism should be 1.2 to 1.5 g/kg (100 to 140 g/day) Evidence supports meal distribution with ~30 g/meal The first meal is important for muscle response 24
25 Designing Diets: carbohydrates? Balance protein and carbohydrates at every meal approximately 1:1 ratio Meal with more than 40 g of Carbs have large insulin response (restrict early meals to < 40 g of Carbs) dlayman@illinois.edu 25
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