Conquer Your Weight

Dr. Sarah Stombaugh: This is Dr. Sarah Stombaugh and you are listening to the Conquer Your Weight Podcast, episode number 70. Announcer: Welcome to the Conquer Your Weight podcast, where you will learn to understand your mind and body so you can achieve long-term weight loss. Here's your host, obesity medicine physician and life coach, Dr. Sarah Stombaugh. Dr. Sarah Stombaugh: Hello everyone. Thank you so much for joining me today. I am excited to talk to you about protein because you hear it all over the place. Protein, protein, protein, make sure you get enough, make sure you are hitting those protein goals. What does that mean? Why should you do it? What are easy ways that you can do that? And how can that be supportive of your weight loss journey? And if this episode and some of the others make you think, oh gosh, I wish I had more support in this, I would love to invite you to join my email list. I send out weekly recipes that are easy, healthy, meet a lot of your health and nutrition goals, so you can look for those. You can look for podcast updates, other updates from the practice or updates in the obesity medicine world. And so if you are looking for a good source of information, knowing how you can best support your weight and health goals, come on over to my website. I would love to support you in that by just signing up for my email list when you visit my website, www.sarahstombaughmd.com. It's S-A-R-A-H-T-O-M-B-A-U-G-H-M-D.com. You will automatically be prompted to join that mailing list. You can go ahead and fill out your name and your email address. We do not sell your information or send it, so don't worry about getting lots of spam. If you decide that it's annoying, you can opt out at any time. But we would love to share some of those easy recipes and great updates with you all. So I so appreciate you taking the time to do that. And today we are going to be talking about protein. So it's interesting because last week we talked about why I do not recommend calorie counting and some of the food logging that is done so frequently in the weight loss realm. But that does not mean that calories and macronutrients don't matter. And the way that I reconcile these two things is that it's important to be cognizant of the foods that we're eating, the choices that we make, see how those are best serving our body in terms of what is fueling our body, what is providing satiety, what is supporting our health goals. And so it matters. We have to be really intentional about the foods that we choose for the body, for our body. So those are supporting our goals. So thinking about that, there are three macronutrient categories. They are carbohydrates, fats, and proteins. Technically, there's actually even a fourth of macronutrient category, which is alcohol. Alcohol. It's funny we haven't talked about terribly much in the podcast. I do have an upcoming episode dedicated to alcohol, how our body processes that, that plays a role in our weight loss journey and why we choose that. But for right now we are talking about protein and sort of the main macronutrients, which are the carbs, the fats, and the proteins. And those are the macronutrients that our body needs to survive. It needs really all three of these macronutrients. And while alcohol does have its own category, it is certainly not needed for human survival. So among carbs, among fats, among proteins, you'll hear people talk about emphasizing different aspects of these. And you'll hear in ketogenic diets for example, or in certain plans where there's really high protein diets and we get a lot of really conflicting advice. So I want to talk about what is that role of protein, why you may be having higher versus lower goals, and how do you know am I getting enough protein in my diet? So first we are going to start and answer the question, what is protein and what is the role that it plays in our body? So protein is broken down to amino acids. So you can think of amino acids as the building blocks that make up proteins. And those amino acids are really important and a handful of different functions in our body. We think about them the most when we think about muscle mass. So when we think about maintaining our muscle mass, or especially in building our muscle mass, it is important to have amino acids or proteins in order to do that. They also play an important role in our hormones, in the enzymes in our body and then in giving us energy. So proteins are also digested and used for fuel for our body. So we need them to some extent for the enzymes, hormones for building our muscles and we can utilize those for energy. So in weight loss though, protein becomes even more important. And the reason why is that one, it really is important to make sure that while we're losing weight, we are emphasizing fat mass loss. And anytime I say this, people are like, well, of course when we're losing weight, we don't really care about weight loss, we care about fat mass loss. And that seems very obvious and every single person I've ever had a conversation with agrees that they want to lose fat mass and not overall muscle mass. But the reality is that a lot of times we do not take appropriate measures to make sure that as we're losing weight that are we predominantly losing that from our fat stores. So one of the most important things and as we're losing weight is to make sure that we have plenty of protein in order to support our muscles. So there is often a slight decrease in our muscle mass when we are losing weight that is common and that is to be expected, as you've probably heard me say before, if you imagine a 300 pound body, for example, and you imagine the amount of energy that it takes, the amount of muscle that it takes to move that 300 pound body throughout its daily activities and you compare that to a 200 pound body and the muscle required to move that same 200 pound body throughout all of its daily activities, there is simply less muscle required to move that 200 pound body as opposed to moving that 300 pound body. So I say that to say there might be some slight decrease in muscle mass as we're losing weight, and that's okay. But what we don't want to happen is that there is a predominant decrease in muscle mass because what actually happens is that our body fat percentage, so the amount of fat in our body that as we're losing muscle, more of our body is composed of fat. And so even though the number on this scale may be lower, our health outcomes and our health metrics may not be any better. So we think about the risk of insulin resistance and associated conditions like prediabetes, diabetes, polycystic ovarian syndrome. When we think about fatty liver and high blood pressure, all of those improving are dependent upon our body fat mass decreasing. And so we need to be really intentional in our weight loss journey that that is the predominant weight that they're losing. And the way to do that is to make sure that we are supporting muscles. So we are making sure in weight loss to get plenty of protein and not only does it support our muscle mass, but it helps to keep our metabolic rate high. It provides really great satiety protein is really dense. It provides this satiety that sort of sticks with us for many hours after eating. When we eat certain foods that are processed quickly, particularly simple carbohydrates, but even some complex carbohydrates, if there is not protein associated with those, we often feel hungry pretty soon after a meal. Now a lot of things contribute to satiety. We know we can get satiety from protein. Fat plays an important role in satiety. Fiber plays an important role in satiety, but that protein piece is certainly important. There's a really interesting hypothesis called the protein leverage hypothesis. And in the protein leverage hypothesis, they hypothesize that humans prioritize the consumption of protein and food over our other dietary components and we will continue to eat until our protein goals have been met regardless of the energy content leading to an overconsumption when the protein content of our food is low. So to give some examples of what that means, so it's saying that our body really needs this pretty set amount of protein and that we know we are driven to eat that amount of protein regardless of the types of food that we're eating. And so if you look at foods that are really carbohydrate forward or really fat forward but do not have a lot of protein, we are driven to consume those in greater quantity because we are trying to hit our protein goals. And so if you imagine trying to hit your protein goals with a diet that has lots of chicken or lots of eggs or dairy or soy or fish or other things that are very protein forward, and we'll talk about lots of those protein options in a minute, but if you imagine someone who has a diet that is very protein forward, they may be able to eat less food because their body has already hit those protein goals as opposed to someone who is eating foods that may contain processed foods like chips or pastry products or like ice cream, dairy certainly has some protein in it, but if you're trying to get your dairy exclusively from protein, it's going to take a lot of dairy in order to do that. If you're having a lot of fruits, those are very low in protein. So even sometimes healthy foods that aren't high in protein, we're sort of being driven to eat more and more of these things in order for us to hit our protein goals. And so it's easy to imagine that our body is needing and requiring some protein that we are going to be driven to eat more and more of foods that are low in protein just so that we can hit those protein goals and make sure that at the very least we are not losing our muscle even if we're not in a weight loss journey. Our bodies really like to maintain homeostasis, which is the state of being sort of even that our body is not expending too much energy or burning too much energy that we are just in this fairly stable place. And so our bodies will do a lot of things in order to cause that to happen. So when we think about our protein needs, if you Google this, how much protein do I need? You are going to get recommendations all over the board. And the reason why is that there's many factors that will determine how much protein your body needs. Age is a really big factor in general as we're younger, we need more protein as opposed to when we're older. But in general, we need lots of protein throughout the ages. Our gender will determine, men may need slightly more protein in their diet compared to women. Our body size and weight will determine how much protein that we need. So people who are in larger bodies will need more protein compared to people who are in smaller bodies. Our activity level determines our protein needs. So people who are much more active, particularly if they're doing resistance training, trying to build their muscle mass, that resistance training is breaking down the muscles. And so we're building that back up by emphasizing protein in the diet. And then what is our muscle mass? So if you have less muscle mass, it requires less protein in order to support that. If you have more muscle mass, it requires more protein in order to support that. So there's a lot of general guidelines and a lot of them are written in grams per kilogram. So how many grams of protein do you need to eat per kilogram of body weight? And this is going to be really pretty variable. On the lower ends, we hear recommendations like 0.8 grams per kilogram. So what that means, if you imagine a 100 kilogram body that is someone who weighs 220 pounds, so the difference between a kilogram and a pound, there are 2.2 pounds in one kilogram. And so a person who weighs a hundred kilograms or 220 pounds and is hitting that sort of lower threshold of 0.8 grams per kilogram is going to be getting about 80 grams of protein per day. Another way that we hear it talked about is in terms of the percent of calories and how many percent of our calories are coming from different macronutrients. So the lower end of those goals are about 10%, and the higher end are typically about 30 to 35%. So this person who's eating 0.8 grams per kilogram, the 100 kilogram person, 220 pound person, they are getting 80 grams per day. If they were on a 2000 calorie diet, that's about 15% of their total calories are coming from protein. So that is on the lower end as you can see where some of the upper recommendations for someone who is more moderately active are about 1.2 grams per kilogram. And so in a 100 kilogram person, that 220 pound body that is about 120 grams of protein that they're getting. So that's going to bump up that protein content even more in the diet. Another way is if you think about how many calories that you're getting, you can sort of calculate backwards how many of those are coming from protein. A good rule of thumb, I usually will ask people to aim for about 30% or a third of their calories coming from protein when they're actively trying to lose weight and build muscle. So what that looks like in a 2000 calorie per day diet, you're looking at about 660 calories coming from protein to do some math here. For those of y'all that don't like math, there are four s, excuse me, there are four calories in a gram of protein. And so in 660 calories of protein, that is 166 grams. So that would be what we're looking for if we're trying to get about a third of our calories coming from protein. Now, if you're on a lower calorie diet, like 1500 calories per example, that's 500 calories coming from protein, meaning that about 125 grams of protein that you're getting per day. So you can see how this is going to be really pretty variable. So honestly, the best thing that I recommend for you to do is talk with your physician, ask them what your protein goals will be and start to aim to make sure that you are getting enough protein to support your body's needs. You can do things like body composition readings to see what your fat mass is, what your muscle mass is, and then utilize that to help understand what is your basal metabolic rate, how much energy is your body burning? That is a good way to, you can do some basic basal metabolic rate calculators online, get a recommendation of how many calories your body is burning at baseline and then make sure at least a third of those are coming from protein. And that calculation, again, is basically taking the calories and dividing it by four because there's four calories in a gram of protein. So if the recommendation is I need 500 calories of protein, that means 125 grams of protein. If you need 400 calories of protein, you're getting divided by four, a hundred grams of protein. So that's a really simple way to do that calculation. So you might be thinking, oh my gosh, am I getting that much? I have no idea. This is where doing food logging for a period of time, spending a little bit of time paying attention to where do some of these different things come from? How is my body feeling in terms of satiety? How is my body feeling in terms of energy? So when we think about common sources of protein, most times people are thinking about meat. So meat and poultry are really energy dense sources of protein, and those are excellent. There are lots of other sources of protein as well that should not be discounted. So thinking about dairy, thinking about grains in their whole form. So thinking about whole grains, not like whole grain bread, but actually like quinoa or bran or bulgar, wheat, that type of thing. And then nuts. We know that nuts, legumes, beans, that whole category is a really excellent source of protein. Thinking about soy, so soy in the form of tofu in the form of edamame, fish and shellfish are also excellent forms. Veggies, believe it or not, vegetables have protein in them as well. And so that is an excellent way, especially if you're having a large volume of vegetables. And then there are protein shakes and supplements that can be considered as well. And so this may be things that are coming in powdered form or in premixed forms. Protein shakes are an excellent way to get sort of that extra protein. You do want to be cognizant of the sugar content of those. Most of the protein shakes that are designed for people who are losing weight are going to be very low in sugar. They're going to be sweetened with artificial or non-nutritive sweeteners. So just being cognizant of how those feel in your body, if you have any sensitivities to the non-nutritive or artificial sweeteners. And then just making sure that there's not too many calories coming from sugar because some of them that are designed for, particularly for muscle growth and may have some carbohydrates in them, may actually be unnecessarily sweet even if they're helping you to hit your protein goals. If there is added real sugar, you may be also getting a lot of energy that you don't necessarily need when you're trying to lose weight. So I recommend talking to your doctor, talking to a healthcare provider that you trust to ask What are my protein goals? Doing that basal metabolic rate calculator is a really good sort of rough place to start. A third of those calories coming from protein. So you'll take whatever number you get out of that, divide it by three, so a third of them are coming from protein, and then you'll divide that by four to get the grams of protein that you should be having. If you have any questions about that, I would love to support you. Go ahead and reach out to me on my website at www.sarahstombaughmd.com. If you're interested in working with me as a patient, you can fill out the form on the individual visits page. If you just have questions or you'd like to be pointed in the right direction, maybe you're located elsewhere in the country that I'm not licensed to practice medicine, reach out on the Contact Me page. I'm happy to answer any questions that you have. Thank you all so much for joining me today. Hopefully this helps to bring a little bit of clarity to hitting those protein goals. I'll see you all next week. Bye-Bye.