Diabetes Diet

How Much Protein Do You Need?

One of the most important diet questions for people with diabetes is to decide how much protein you need to eat each day. Yet it’s something that few people consider.

While the debate still rages over how many grams of carbohydrates and fats that we should eat, people with diabetes tend to ignore the key role that this third macronutrient plays. Your body uses protein to build and repair bones, muscles, cartilage, skin, and blood as well as to make key chemicals in our bodies, including enzymes and hormones.

Not until a couple of years ago did I pay much attention to how much protein my body needs. Only when I adopted a vegetarian diet in addition to the low-carb lifestyle that I have followed for years to manage my Type 2 diabetes, did I realize I would need to get more protein now that I don’t eat fish or meat.

If you are a vegetarian, like me, or a vegan, you are a part of a large group of people who need to make a special effort to get enough protein.  The people who are trying to lose weight also need to give attention to how much protein they consume. But if you have kidney disease, one of the potentially most serious complications of diabetes, the amount of protein you eat can be even more important.

How much protein is enough for you depends in part on whether you have one of these three concerns. But if not, how much you need is simple and straightforward. Adult men need 56 grams of complete protein per day, according to the National Academy of Medicine, or NAM, formerly the Institute of Medicine. Most adult women need only 46 grams, but pregnant women and nursing mothers need a lot more, 71 grams.

While other organizations provide different advice, we have two good reasons to accept the NAM recommendations. First, the U.S. Congress set up this non-profit to operate under a formal peer-review system to give us unbiased, evidence-based, and authoritative guidance for our health. Second, while other organizations, like the UK’s Food Standards Agency, just tell us what they recommend, the NAM tells us exactly how they arrived at the levels.

Vegetarian and vegan adjustments

Adjusting to a vegetarian diet is pretty easy, as I discovered. The biggest change I needed to make in order to continue getting enough protein was to replace my beloved smoked salmon breakfast with a protein shake that I enjoy equally well. I also bumped up how many eggs and servings of plain Greek yogurt I eat.

But vegans, who not only abstain from meat, fish, and seafood and don’t eat eggs or dairy products either, have a harder time satisfying their protein requirements. While most Americans get more than enough protein, most vegans probably don’t.

Good plant-based protein shakes are available, and they partly fill the gap. Tofu, in its many forms, has a good amount of protein as do legumes, nuts, and seeds. But even the best of these may have many carbs, which will spike your blood.

Protein increases satiety

If you want to lose weight  to manage your diabetes better, you are well advised to consider increasing how much protein you eat. Some people find that boosting their protein intake satisfies their hunger better than either carbohydrates or fats. One of my early articles about diabetes, “What Really Satisfies,” which I wrote for Diabetes Interview magazine in 1998, shows that protein-rich foods are some of the most satisfying.

A meta-analysis that the Journal of the Academy of Nutrition and Dietetics published just a few months ago offers more evidence in support of the concept that eating more protein might make you feel full. Of course, a high protein diet isn’t a magic bullet for weight loss — nor is anything else.

Kidney disease differences

Unlike these vegetarians, vegans, and dieters who might need more protein another large group of people with diabetes need less. These are people with diabetic kidney disease. The Joslin Diabetes Center states that “Up to 40 percent of people with type 1 diabetes and 20 to 30 percent of those with type 2 diabetes have some form of kidney disease.”

The National Kidney Foundation’s guidelines are clear that people with chronic kidney disease, stages 1 to 4, must follow a diet that is low or moderate in protein, 0.8 grams per kilogram of your weight per day. If you are in stage 5, kidney failure, your doctor may recommend that you eat even less. But this has led many people to incorrectly conclude that we should avoid eating a lot of protein because it might stress healthy kidneys.

It doesn’t. “The literature lacks significant research demonstrating a link between protein intake and the initiation or progression of renal [kidney] disease in healthy individuals,” a review in the journal Nutrition & Metabolism concludes.

You may be a vegetarian or a vegan, need to lose weight, have chronic kidney disease, or have none of these challenges. In any case, you need to eat the right amount of protein if you want to maximize your health.

This article is based on an earlier version of my article published by HealthCentral.

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