Laura Hernandez, MBA RD LD Registered Dietitian KC Bariatric Shawnee, KS

Transcription

1 Laura Hernandez, MBA RD LD Registered Dietitian KC Bariatric Shawnee, KS

2 Protein: What Is It? The word protein is derived from the Greek word prōteios which means primary or of prime importance. Proteins are essentially bio-molecules that are made up of smaller units called amino acids that are linked together. Amino acids are molecules that are composed of carbon, hydrogen, oxygen, nitrogen, and sometimes sulfur.

3 Primary Functions Growth Tissue repair, speeds healing and recovery Immune system function Hormone and Enzyme production Lean muscle mass and tone maintenance Regulation of metabolism Maintaining acid balance (ph) in body Since proteins supports all these functions, they are called the building blocks of our body.

4 Protein Categories Structural proteins are used for support such as connective tissue and keratin that forms hair and finger nails. Transport proteins transport many substances throughout the body such as hemoglobin which transports oxygen from the lungs to the other parts of the body. Hormone proteins coordinate body activities such as insulin which regulates the amount of sugar in the blood. Contractile proteins help control movement such as proteins in the muscles which help control contraction. Enzymatic proteins accelerate the speed of chemical reactions such as digestive enzymes which break down food in the digestive tract.

5 Protein: A Secondary Function Amino acids may be used by the body as a source of energy, but first they must be converted by the body to carbohydrates. It happens only if there is a shortage of carbohydrates or lipids through diet. As a source of energy, proteins have the same caloric value per gram as carbohydrates: 4 cal/g.

6 Let s Take a Closer Look Protein Carbohydrate

7 Amino Acids Essential Conditionally Essential Non-Essential Histidine Arginine Alanine Isoleucine Asparagine Asparatate Leucine Glutamine Cysteine Methionine Glycine Glutamate Phenylalanine Threonine Tryptophan Proline Serine Tyrosine Valine Lysine

8 Protein Digestion

9 Causes of Protein Malnutrition for Post-Bariatric Patients Factors of restriction, maldigestion, intolerance Increased protein needs: surgery/infection Chronic inadequate intake: anorexia, poor food choices Post-op complications: loss of blood

10 Protein Digestibility Use meat preparation procedures that tenderizes tough cuts of meat, soften connective tissue, and release muscle proteins from their attachments. Goal: make proteins more available to digestive enzymes and improve tolerance. Tip: Use acid, salt, and heat. Mixing/agitation help breaking attachments. Example: wine or vinegar, salt, moist heat. Scrambled eggs vs hard boiled eggs.

11 Protein Deficiencies: Symptoms Muscle Wasting Weight loss plateau or weight loss if severe Fatigue and Weakness Frequent Infections Hair loss Severe Edema

12 Diagnosis of Protein Malnutrition Serum Albumin half life is 21 days Normal levels: g/dl Serum Pre-Albumin half life is 1.9 days Normal levels: mg/dl Moderate depletion: mg/dl Severe depletion: < 10 mg/dl

13 Protein Recommendations Most recommend using a calculation of grams of protein per kg of adjusted body weight ABW=current weight-ideal weight x 25% + ideal weight A range of g/day for all procedures depending on age, physical activity, medical diagnosis, etc.

14 Protein Sources

15 Animal sources Food Sources : Complete Beef, poultry, pork, eggs, milk/milk products, fish and shellfish. These provide the highest quality ratings. Choose lean or very lean to minimize fat intake. Vegetable sources: Incomplete Consumption of a variety of vegetables, fruits, grains, nuts, soy products, and legumes are required to ensure all essential amino acids are adequate.

16 Wait! Did you say fruits?!? 1 medium apple has all essential amino acids in very small amounts 1%of your protein needs Coconut: Tree of Life. Coconut milk has ~5g protein Others: Avocado, pineapple, watermelon, grapes Helps supplement but not considered of high biological value

17 Regular Diet Sample Menu Breakfast Lunch Dinner 2 scrambled eggs 3oz tuna salad 3 oz pot roast 1 oz shredded cheese 2-3 baby carrots 1/3c steamed vegetables ½ multigrain toast 2-3 crackers 1/3c mashed potatoes

18 Too Much Protein Meal Breakfast Snack Snack Lunch Snack Snack Dinner Snack Food Eaten 3/4c Oatmeal Protein shake 2 handful almonds ½ sandwich ½ sandwich Protein shake 4oz pot roast 3/4c Mashed potatoes

19 Supplement Sources Why Supplements? Cannot consume enough through foods Difficulty tolerating certain foods Vegetarian Pregnant Sources Powders- flavored/unflavored. total carbs: 4-7g, 20g PRO Bars contains high amounts of protein and carbohydrates Shakes- Pre-made with total carbs:4-12g. Ex: Premier Protein Puddings MHP Power Pak Pudding (30g PRO/serving) Drinks Zero Carb Isopure Drink, Protein Ice (40g PRO) Soups

20 Common Supplements Milk By-Products: Both are Lactose Free 100% Whey 100% Casein Liquid by-product of cheese production Rapidly-digesting protein Stimulates protein synthesis High levels of Leucine May cause gassiness, diarrhea 80% of true protein in milk is casein. Has all essential a.a It digest slowly. It takes 5-7 hrs to fully digest Slow gastric emptying, useful appetite suppressor Has rich Calcium content

21 Isolate versus Hydrolyzed Isolate Fat and lactose are removed Higher percentage of protein by weight Usually mixes better Hydrolyzed Predigested Undergone partial hydrolysis, most of what the stomach does, it has already been done Does not require as much digestion

22 Branched-Chain Amino Acids (BCAA) What About Them? Leucine, Isoleucine, Valine. They are unique: can be broken down in the skeletal muscle for fuel. Key stimulators of muscle building and recovery. Role in prevention of muscle breakdown. Limit immune suppression resulting from exercise.

23 In Summary, Protein Support weight loss Improve metabolism Improve body composition Increase lean muscle mass Help to manage appetite Prevent hair loss Is a macronutrient Add variety of food sources Too much leads to stalled weight or weight gain Supplements are a meal replacement

24 Open Discussion, Let s Talk!