Clinical Issues in Protein Nutrition

As Arne Astrup’s editorial in the American Journal of Clinical Nutrition points out, protein increases satiety even if the effect is not explained by changes in the hunger hormone ghrelin or the satiety hormone leptin [54]. The high-protein diets of Atkins, the Zone, and the South Beach Diet seem to point in the direction of increasing protein recommendations by 30%-40% of the calorie content, at the expense of carbohydrates. The protein needs for bariatric surgery patients should have top priority in research with adequate testing done by laboratories specializing in amino acid profiles.

Dietary protein needs for a moderately fasting bariatric surgery patient are currently calculated as 1.2—1.4 g protein per kg ideal body weight based on approximately, 250 g protein turnover in a day for the average adult [38, p. 46]. Muscle protein turnover equals approximately, 65 g/day or around one-fourth of the total turnover according to Shills et al. A 300 lb. bariatric patient whose ideal body weight or weight loss goal is 180 lb. would need 98 g (82 kg x 1.2 g) to 115 g (82 kg x 1.4 g) protein daily. Faria et al. conclude that care should be taken to ensure that bariatric patients consume not only high-quality protein supplements (60-120 g/day) but that it includes good quality proteins like meat, eggs, and cheese [55]. An example of meal plan to provide adequate amino acids, based on USDA database analysis, follows [56]. It emphasizes the importance of small frequent meals and high-quality protein at each snack/meal for use during the first months postsurgery.

  • 8 am smoothie: 4 scoops amino acid powder[1] + 1/4 cup plain yogurt, 1/2 banana, 1/2 cup mixed berries, 1/2 cup water
  • 10 am 2 oz. yogurt with 1 scoop amino acid powder[1]

Noon 2 oz. cottage Cheese and pureed peaches

  • 2 pm 2 oz. tuna fish salad + 1 scoop amino acid powder[1] mixed in
  • 4 pm smoothie with 4 scoops amino acid powder[1] + 1/2 banana, 1/2 tablespoon cocoa powder, 1/4 cup plain yogurt, 1/2 cup water
  • 6 pm 2 oz. cream cheese or goat cheese with 1 scoop amino acid powder,[1] one small baked potato or 1/4 cup mashed potato
  • 8 pm 1/2 cup ice cream or fruit ice with 1 scoop amino acid powder[1]

Cold-processed whey protein concentrate is an alternative to amino acid capsules or powder. Whey protein isolate products are not recommended because they are stripped of nutrition cofactors in the production of the powder and primarily provide only calories.

Look for labels that read “free of genetically modified organisms (GMO) ingredients,” pesticides and chemicals. Cows fed GMO corn and soy have glyphosphates in the milk and whey. The World Health Organization has indicated glyphosphate is a probable carcinogen.

  • [1] Pure Encapsulations Amino Replete (2 scoops/4 teaspoons = 1/4 cup cottage cheeseor 1 egg)
  • [2] Pure Encapsulations Amino Replete (2 scoops/4 teaspoons = 1/4 cup cottage cheeseor 1 egg)
  • [3] Pure Encapsulations Amino Replete (2 scoops/4 teaspoons = 1/4 cup cottage cheeseor 1 egg)
  • [4] Pure Encapsulations Amino Replete (2 scoops/4 teaspoons = 1/4 cup cottage cheeseor 1 egg)
  • [5] Pure Encapsulations Amino Replete (2 scoops/4 teaspoons = 1/4 cup cottage cheeseor 1 egg)
  • [6] Pure Encapsulations Amino Replete (2 scoops/4 teaspoons = 1/4 cup cottage cheeseor 1 egg)
 
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