Weighing In: Protein for Weight Management

Transcription

1 Weighing In: Protein for Weight Management

2 Welcome Matthew Pikosky, PhD, RD Vice President Nutrition Marketing and Affairs National Dairy Council 2

3 Continuing Education This webinar has been approved by the Commission on Dietetic Registration for 1 CPEU. 3

4 Overview Translate the latest science examining the role of protein on weight management and its related benefits (satiety, fat loss and/or muscle preservation). Educate peers and the public on the importance of protein timing and distribution as well as high quality, higher protein diets for maintaining a healthy weight and an active lifestyle over time. Identify and apply practical solutions to help patients/clients determine appropriate protein quantity and methods for optimizing timing of protein intake. Advise patients/clients on how the integration of protein can help support the benefits of regular physical activity. Build patient tips and menu plans focused on improving satiety between meals and throughout the day, recommending quantities and optimal timing for protein consumption. 4

5 Weighing In: High Quality Protein for Weight Management Heather Leidy, PhD Assistant Professor, University of Missouri Leslie Bonci, MPH, RD, LDN, CSSD Sports Nutri+on Consultant for Pi2sburgh Pirates, Toronto Blue Jays, Kansas City Chiefs, WNBA, and U.S. Figure Ska+ng 5

6 The Science

7 Assembling the Pieces of Healthy Living Proposed Benefits Improve: - Weight Management Fat Loss Higher Protein Diets Weight Loss - Fitness/Performance Reduce risk of: - Sarcopenia Lean Mass Reten+on - Type 2 Diabetes - Cardiovascular Disease - Obesity - Metabolic Syndrome 7

8 Higher Protein Diets Improve Weight Management over the Short-term 8 Modified from: Wycherley TP, 2012; AJCN; 96:

9 Higher Protein Diets Improve Weight Management over the Long-term Modified from: Clifton, PM (2014); NMCD; 24:

10 Higher Protein Diets Prevent Weight Re-gain Modified from: Larsen TM, (2010); NEJM; 363: ; Damsgaard CT (2013); JN; 143(6): ;Aller EEJG; IJO; 2014; 38(12):

11 Assembling the Pieces of Healthy Living kcal/d Reduced Intake Protein Synthesis * Fat Loss Higher Protein Diets Weight Loss Protein Synthesis Lean Mass Reten+on g protein kg-1 d kcal/d Modified from: Wycherley TP, et al., 2012; AJCN; 96: ; Skov et al Int J Obesity; ; Weigle 2005; AJCN; 41-48; Symons et al., 2007; AJCN 86: ; Clifton, PM (2014); NMCD; 24:

12 Ingestive (Eating) Behavior Homeostatic Hunger Homeostatic Satiety Hedonic Hunger Hedonic Satisfaction 12

13 Protein Improves Appetite Control & Satiety *HP vs. NP; p<0.01 AUC* AUC* Modified from: Leidy et al Obesity; ; Leidy et al. 2010; Obesity; 18(9):

14 Protein Improves Appetite Control & Satiety *HP vs. NP; p<0.01 AUC* AUC* Modified from: Leidy et al Obesity; ; Leidy et al. 2010; Obesity; 18(9):

15 Food Cravings Food Stimuli 15

16 Protein Reduces Food Cravings Post-meal Activation (NP > HP) Insula (food cravings) Pre-frontal (executive control) Modified from: Leidy, 2011 Obesity 19(10):

17 Assembling the Pieces of Healthy Living Appe+te Reduced Intake Sa+ety Fat Loss Higher Protein Diets Weight Loss Key Protein-related Factors Quantity (how much?) Quality (what type?) Protein Synthesis Lean Mass Reten+on Timing of Consumption (when?) g protein kg-1 d-1 17

18 Modified from: Paddon-Jones Curr Opin Clin Nutr Metab Care; : 5-11; Witard O C et al. Am J Clin Nutr 2013;99:86-95; Symons et al., 2007; AJCN 86: ; Symons et al, 2009; JADA Meal-specific Protein Quantity Protein synthesis following meals containing 0-90 g protein Fullness following meals containing g protein b b b b a a a *all 18

19 Protein Quality Protein Synthesis following Whey, Soy or CHO Supplementation (of ~26 g/supplement 2 x/d) before and after a 14-d energy-restriction (Pre & Post Study) Whey vs. Soy & CHO, p<0.01 * (Pre & Post Study) Soy vs. CHO, p<0.01 Modified from Hector et al., JN; 2015; 145:

20 Protein Timing of Consumption 50g *all Protein Intake (g) 20g 30g 10g 5g Breakfast Snack Lunch Snack Dinner Modified from: Leidy; British J Nutrition; 2009; 101: ; Rains TM; FASEB j; 2013; 27:

21 Protein Timing of Consumption *all Protein Intake (g) Even Distribution? Breakfast Lunch Dinner Modified from: Leidy; British J Nutrition; 2009; 101: ; Rains TM; FASEB j; 2013; 27:

22 Protein Distribution Protein synthesis after 7-d skewed protein (g): 10/15/65 (B/L/D) even protein (g): 30/30/30 (B/L/D) in healthy adults Protein synthesis after 4-wks energy restriction + resistance exercise skewed protein (%): 7/17/72/4 (B/L/D/S) even protein (%): 25/25/25/25 (B/L/D/S) in overweight older adults * *Skewed vs. Even, p<0.05 EB vs. ER & ER+RT (only Skewed), p<0.05 NS (p>0.05) * * Modified from: Mamerow M; JN 2014; 144(6):876-80; Murphy AJPEM; 2015 EPUB 22

23 Protein Timing of Consumption 50g *all Protein Intake (g) 20g 30g 10g 5g Breakfast Snack Lunch Snack Dinner Modified from: Leidy; British J Nutrition; 2009; 101: ; Rains TM; FASEB j; 2013; 27:

24 Protein Distribution Compared to Skipping Breakfast or a NP breakfast, HP led to: Increased daily satiety Decreased evening food cravings Decreased unhealthy evening snacking on high fat and high sugar foods Leidy, HJ, 2013; AJCN 97(4): ; Leidy HJ; Obesity Aug; 2015 EPUB 24

25 Benefits of a High Protein Breakfast Daily Intake Fat Loss Modified from: Leidy, HJ, 2013; AJCN 97(4): ; Leidy HJ; Obesity Aug; 2015 EPUB 25

26 Summary A modest increase in dietary protein appears to be a excellent strategy to improve weight management. Quantities that elicit these responses: ~30 g protein/meal (high quality) Unique benefits re: the consumption of a proteinrich breakfast, suggesting a re-distribution of protein (from dinner)

27 The Solution

28 Four out of five Americans are trying to lose weight or maintain their current weight Which of the following best describes what you are currently doing regarding your weight? 2015 n=1,007; 2014 n=1,005; 2013 n=1,006 Arrows indicate significant (.95 level) differences vs. prior years Source: IFIC The 2015 Food & Health Survey: Consumer Attitudes toward Food Safety, Nutrition & Health 28

29 Most Americans agree that it s important to consume enough protein in their diet, and that protein can be part of a heart healthy diet. Nearly as many agree that protein can help maintain muscle during aging. To what extent do you agree or disagree with the following statements about protein? Agree strongly Agree somewhat Disagree somewhat Disagree strongly Not sure It is important to get enough protein in the diet Protein helps people feel full High protein diets can help with weight loss % 22% 35% 34% 59% 60% 40% 41% 38% 38% 8% 31% 31% 5% 11% 2% 7% 1% 2% 8% 21% 26% 2% 5% 19% 24% 2015 Net: Agree 89% 86% Groups more likely to agree: Women, College grads Women, College grads 81% College grads 77% 73% 72% 65% Younger, College grads Women, In better health Women, Higher income Women, College grads, Higher income, In better health 2015 n=1,007; 2014 n=1,005. Percentages under 2% are not labeled. 50% Source: IFIC The 2015 Food & Health Survey: Consumer Attitudes toward Food Safety, Nutrition & Health 29

30 The most common perceived barrier to increasing protein intake is the belief that they already get enough, followed by cost and lack of knowledge about which foods contain protein. Which of the following are reasons why you do not consume more protein than you do now? I already get enough protein Foods with protein are sometimes more expensive I don t know which foods contain protein Foods with protein spoil if not used quickly It takes too much time to prepare foods with protein Higher protein foods often have a lot of unhealthful components 2015 n=1,007; 2014 n=1,005. In 2014, the question allowed respondents to specify which of the items were major reasons and minor reasons. Shown above is the netted result of major and minor. Arrows indicate significant (.95 level) differences vs Source: IFIC The 2015 Food & Health Survey: Consumer Attitudes toward Food Safety, Nutrition & Health Groups more likely to select Yes : Higher income, College grads Younger, Lower income, Women, Higher BMI Lower income Younger, Lower income Younger, Lower income Younger 30

31 Proportion of calories from protein is similar for gender and age groups 35 Males % total daily kcal Females 30 % kcal AMDR Average 5 0 Age NHANES

32 Protein Quantity and Quality

33 Protein Recommendations RDA: 0.8 g/kg BW/d for adults estimate of the minimum daily average dietary intake level that meets the nutrient requirements of nearly all (97 to 98%) healthy individuals 55 grams of protein per day for 150 lb person Acceptable Macronutrient Distribution Range (AMDR): 10-35% total calories a range of intakes for a particular energy source that is associated with reduced risk of chronic diseases while providing adequate intakes of essential nutrients 2,000 calorie diet: grams of protein/day Research supports some may benefit from protein intakes greater than the RDA Athletes / highly active adults Older adults Rodriguez NR and Miller SL. Am J Clin Nutr

34 Protein intake pattern is similar in males and females Percent of daily protein Males gm / ea+ng occasion Females Breakfast: 16% Lunch: 28% Dinner: 42% Snacks: 14% Protein, grams Breakfast Lunch Dinner Snacks Daily total: 93.7 g Breakfast Lunch Dinner Snacks Daily total: 66.5 g NHANES

35 Protein Quality is Critical Protein quality is determined by its specific amino acid composition and digestibility Animal sources of protein are considered the highest sources of quality protein due to amino acid composition However, plant based sources of protein can also be valuable sources to reach protein needs There are a variety of protein sources available to fit all diets, preferences, tastes and budgets. 35

36 Protein Quality Servings of Protein Foods Energy (kcal) Protein (g) Leucine (g) 4 oz. skinless chicken breast oz. hamburger (93% lean) scoop (36 g) whey protein isolate cup co2age cheese (1% ) cup black beans oz. firm tofu oz. canned tuna cup skim milk Tbsp. peanut bu2er cup quinoa large egg cup oatmeal oz. (23) almonds

37 Protein Distribution is Key 1. Determine total daily calories (RMR + activity factor + exercise calories + calorie change for weight gain/loss) 2. Determine protein needs(0.5 to 0.9 grams protein/# body weight for most athletes and active people and to boost satiety) 30 g Even out the intake throughout the day* Example: 120 grams of protein per day = Breakfast 30 g 30 g 30 g 30 g 30 g Lunch grams protein/meal with minimum of 2.5 grams leucine Dinner 30 g 30 g Snack Animal and plant based sources can contribute to the protein content of meals. *If Pre- and Post-Workout = consider dividing evenly by 5 meals (1/5 calories and protein between the two eating occasions) 37

38 Muscle Protein Synthesis Skeletal muscle growth occurs when Muscle Protein Synthesis (MPS)>Muscle Protein breakdown 38

39 Protein Dose for Muscle Synthesis 8 grams EAA maximally stimulates MPS Young Adults: 20 grams of high-quality protein- will provide ~8 grams of essential amino acids Ø Ø Ø Ø 24 oz (2.5 cups) skim milk 3 large eggs 3 oz lean meat/fish 8 oz (1 cup) yogurt Older Adults: grams Witard OC et al. Am J Clin Nutr Moore DR et al. Am J Clin Nutr Yang et al. Br J Nutr Pennings et al. Am J Physiol Endocrinol Metab

40 Leucine Assists in protein synthesis acting as a dietary trigger to support an anabolic response in muscle tissue Meal plan adequate in leucineé Muscle Protein Meal plan inadequate in leucine è block Muscle Protein Synthesis Vegetarians will need to eat more total protein to get adequate leucine 40

41 #140 Fitness Enthusiast Calorie / Protein needs to reach 130 # = 1,800 calories / 135 grams protein per day (30% of calories) Typical Plan = Eat very little during the day, workout at 2 pm, overeat from 5pm throughout the night Concern: Eating too many times during the day will increase hunger Ø Ø Ø Ø Ø Breakfast = 360 calories and g protein Lunch = 360 calories and g protein Dinner = 360 calories and g protein Snacks = 360 calories and g protein Pre-/Post-Workout = 360 calories and g protein 41

42 #140 Fitness Enthusiast Breakfast: 3 egg whites, scrambled with ½ cup mushrooms + 1 slice whole grain toast/butter + 1 cup 1% milk + 1 orange (400 calories / 30 grams protein) Lunch: 3 oz lean ground turkey patty on a whole grain bun + 1 cheese stick + 1 cup grapes + 1 cup baby carrots (450 calories / 30 grams protein) Pre-workout: 1 protein bar + 1 plum (200 calories / 15 grams protein) Post-workout: 1 scoop whey protein powder + 16 oz sports drink (200 calories / 20 grams protein) Dinner: 1 big salad/veggies with 3 oz sliced ham + ½ cup quinoa + 2 cups watermelon (400 calories / 30 grams protein) Snack: 1 light yogurt cup + ½ cup high-protein whole grain cereal (150 calories / 15 grams protein) TOTAL = 1,800 calories / 140 grams protein 42

43 Quality and Quantity Matter PROTEIN (1-2 servings) CARBS (1-2 servings) FRUITS/VEGS (1-2 servings) FAT (1-2 servings) iphone size chicken 1 slice bread 1 tennis ball size fruit 1 tsp/pat bu2er iphone size meat 1 tor+lla ½ cup chopped fruit 1 tsp oil iphone size fish 1 small potato ½ cup berries 1 TBSP nut bu2er 8 oz Greek yogurt ½ cup rice ½ cup cooked vegs 2 TBSP nuts 6 oz tofu ½ cup pasta 1 cup raw vegs 1/8 avocado 1 cup beans ½ cup quinoa/ barley 6 oz juice 2 TBSP guacamole 3 eggs ¾ cup cold cereal 8 oz veg juice 2 TBSP hummus 1 cup co2age cheese ½ cup oatmeal ½ cup dried fruit 1 TBSP salad dressing 3 oz cheese 1 svg crackers ½ cup beans 1 TBSP mayo 43

44 Providing Guidance on Protein Intake to Clients

45 30 gram Protein Breakfasts Breakfast #1: 2 slices of whole wheat toast with 2 tablespoons of peanut butter mixed with 1 TBSP whey protein isolate + 1 banana + 1 cup low-fat chocolate milk Breakfast #2: 2-egg omelet with 1 oz low-fat cheese and 1 oz chopped ham wrapped in 1 medium whole grain tortilla Breakfast #3: Smoothie with ½ cup low-fat vanilla Greek yogurt + ½ cup grape juice + ½ cup frozen berries + 1 scoop vanilla whey protein isolate + ice Breakfast #4: Oatmeal made with 2 TBSP Whey protein isolate, skim milk, chopped apple, walnuts and cinnamon Breakfast #5: 1 Canadian bacon, egg and cheese bagel + 1 low-fat milk (McDonald s) 45

46 30 gram Protein Lunches Lunch #1: 3 oz can tuna, lettuce, tomato, mayo on whole wheat with ½ cup baby carrots Lunch #2: Salad with grilled chicken breast, kidney beans, whole grain crackers & an apple Lunch #3: Peanut butter/banana/honey on a high protein wrap with a 6 oz Greek yogurt Lunch #4: Cheese pizza, 2 slices, a salad and a 12 oz glass of skim milk Lunch #5: Vegetarian chili, 1.5 cups with Texturized Vegetable Protein, beans, tomatoes, served with brown rice 46

47 30 gram Protein Dinners Dinner #1-3 oz ( palm size) roasted chicken, 1 c broccoli, 1 c of rice pilaf Dinner #2-6 oz tofu, with 2 c Asian vegetables, served with 1 c soba noodles Dinner #3- Fish taco with 3 ounces, fish, ½ cup black beans, salsa, guacamole in a corn tortilla Dinner #4 1.5 c pasta & marinara sauce with 1 c veggie crumbles & ½ c garbanzo beans Dinner #5: Omelet with 3 eggs, ¼ cup feta, spinach, tomatoes, mushrooms and a small baked potato 47

48 10 gram Protein Boosters ½ scoop whey protein powder ½ cup Greek yogurt or ½ cup yogurt with ¼ cup high protein granola 2 eggs or 1/3 cup egg substitute 2 slices cheese prop -sicles A 10 gram protein bar 10 oz low-fat milk (white or chocolate) ½ sandwich with 1 ½ oz lean meat 1 TBSP almond butter and 1 TBSP whey protein isolate 2 tablespoons peanut butter ¼ cup hummus or 2 strips beef/ chicken jerky Commercial yogurt smoothies 48

49 ACSM Exercise Recommendations Prevent weight gain minutes/week of moderate-intensity physical activity is associated with prevention of weight gain. More than 150 minutes/ week of moderate-intensity physical activity is associated with modest weight loss. Weight loss minutes/week of moderate-intensity physical activity provides only modest weight loss. Greater amounts (ie. >250) provide clinically significant weight loss. For weight maintenance after weight loss -- There is some evidence that >250 minutes/week of moderate-intensity physical activity will prevent weight re-gain. Energy/diet restriction combined with physical activity will increase weight loss as compared to diet alone. 49

50 Bottom Line Protein adequacy is a critical component of weight management to optimize body composition and achieve goals The combination of physical exercise (output) and hand to mouth exercise (intake) is the key to successful weight management Food is an excellent way to meet protein needs and protein supplements can augment an inadequate protein intake

51 THANK YOU! QUESTIONS?