I received this information from the company that provides the bariatric protein supplement that I use. I found the information interesting so I thought I would pass it on to all of you.
The Role of Protein for Effective Weight Loss
BACK GROUND INFORMATION AND TERMS
Conversion of Energy: It is well known that all foods consumed are broken down (converted) by the body into energy. Foods are made up of either carbohydrates, fats, or protein. The converted energy from the consumed foods is called calories. Carbohydrates provide 4 calories per gram, proteins provide 4 calories per gram, and fats provide 9 calories per gram.
Energy Requirements: The energy (calorie) requirement for any given person can generally be described as the amount calories needed to maintain that person’s body weight. Calorie requirements for a healthy female are approximately 9 to 10 calories per pound per day, and 10 to 12 calories per day for a healthy male (Example: 2,000 calories per day for a 200 pound man).
Calorie Expenditure: Calories expended each day by the body are divided into three areas:
Resting Metabolic Rate (RMR): The Resting Metabolic Rate is defined as the amount of calories required by the body to maintain organ function (brain, lungs, etc.) as well as muscle function. Since a male generally has more muscles than a female, a man’s RMR (and subsequent calories used) is generally higher than a woman’s. The RMR accounts for 60-65% of daily calories used by the body.
Activity of Daily Living (ADL): These are the calories a person uses through normal daily activities. It accounts for approximately for 25 to 35% of the calories used daily. It obviously varies greatly between those persons who are active and those who are relatively sedentary. ADL calories do not include exercise calories.
Thermogenesis: This describes the process of converting the foods we eat into energy. It accounts for 5- 10% of the calories we use (basically, it takes energy to make energy). PLEASE NOTE: While it is generally recognized that simple carbohydrates are easily converted by the body into energy, one must realize that it requires much more calories by the body (up to 30% more) to convert protein into energy.
Protein Requirements in General: For muscle repair, muscle growth and/or maintenance (preservation of lean body mass), the consumption of protein in adequate amounts is required. Generally, the daily protein requirements are 15-20% of total daily calories, which translates into a minimum of 55 grams for women and 70-75 grams for men (based on 2,000 – 2,500 calories per day). The type of protein is also very important. The protein ingested must have adequate amounts of essential and non-essential amino acids to be effective for the preservation of lean body mass.
WEIGHT LOSS IN GENERAL
Weight loss for any individual can only occur through a reduction of calories. The general rule to follow is 1 gram of weight loss for every reduction of 7 calories needed to maintain existing weight. This means that a person with a daily calorie requirement of 2,000 calories will be expected to lose approximately 72 grams (2.5 ounces) of overall body weight if he (or she) reduces their caloric intake by 500 calories, and ingests only 1,500 calories. This equates to about a pound of weight loss a week.
PLEASE NOTE: If a person takes in less calories a day than is needed to maintain his or her existing weight, and does not take in adequate protein, the overall weight loss does not mean that only fat is being lost. On the contrary, the body will first lose retained water (about half the total weight lost the first 3 weeks is water), and then the body will lose muscle. Fat loss will be last.
Basically, the body will compensate for the reduction of calories by first taking energy from stored carbohydrates (1,500 to 2,000 calories), and will then convert muscle or Lean Body Mass into needed energy. Even though fat is eventually lost, the body tries to store fat reserves, and draws on other available energy sources first.
This type of weight loss from simple calorie reduction is ineffective. The end result is that people who lose weight through simple reduction of calories actually end up increasing their total body fat percentage because of the loss of lean body mass. This is further compromised if the original weight is gained back. Studies have shown that those individuals who gain their weight back after dieting by simple calorie reduction gain their weight back as fat. If the cycle is repeated several times (as is often the case), the overall body composition of those individuals changes dramatically. In addition to being overweight, they now have a much higher percentage of fat than normal, and have a much lower percentage of lean body mass. This leads to strength loss, as well as to possible health risks.
PROTEIN REQUIREMENTS FOR REDUCED CALORIE DIETS
The most important fact to realize is that the reduction of calories does not mean that the body requires less protein. The reality is that the protein requirements on reduced calorie diets to preserve lean body mass while promoting effective weight loss (i.e., fat loss) dramatically increases. In general, on low calorie diets (700 – 1,000 calories per day), the minimum protein requirements are 80-90 grams per day for women, and 100-120 grams per day for men. This is calculated by assigning roughly .6 grams of protein for every pound of “ideal” body weight. The added protein acts to preserve the lean body mass, while the body draws the energy it needs from the fat stores to offset the daily caloric reduction.
CASE STUDY
In order to highlight the importance of protein in preserving lean body mass for patients on low calorie diets, Dr. Frank Johnson, currently medical director for SmartForme, took 57 of his own patients (27 BMI or greater) from his private practice, and measured their initial body fat using state of the art body composition machines before they started weight loss. Body fat percentages were usually above 45% and frequently in the 50-70% range. The low lean body mass for all patients was attributed to prior frequent attempts at weight loss without adequate protein intake.
Each patient was put on a weight management program (VLCD or LCD) with a range of 700-1,000 calories total per day. All were given 95-115 grams of protein daily. After weight loss was achieved, lean body mass was again evaluated using the same body composition machines.
Out of 57 patients, 31 patients maintained their initial lean body mass, while 24 patients actually increased their lean body mass an average of 14 pounds (the range was 5-46 pounds) during the weight loss phase. Only 2 patients lost lean body mass during the study. Even more remarkable was the fact that exercise did not seem to be necessary for an increase in lean body mass to occur.
Dr. Johnson, during his 20 plus years as a bariatric physician, also became aware that low calorie diets with adequate amounts of protein seemed to offset the high insulin levels commonly found in his obese patients, and, more importantly, the symptoms normally associated with high insulin levels (rapid fall of blood sugar levels after carbohydrate intake, strong cravings, and fatigue). He found that patients in general on low calorie diets with adequate amounts of protein, and especially those patients who avoided all carbohydrates in the earlier part of their day, had an immediate increase in energy and sense of “well being,” especially where feelings of satiety were concerned.
WEIGHT LOSS AND PROTEIN REQUIREMENTS FOR BARIATRIC SURGERY PATIENTS
There are three very important things to consider when reviewing our recommendation for protein intake for bariatric surgery patients (post surgery): First, there is the fact that the initial body mass of the bariatric patient is quite high (along with the assumption that total body fat percentage is above normal, and lean body mass is low). This means that the energy (calorie) requirement to maintain this body mass is also very high.
Second, there is the fact that the subsequent drop in caloric intake after surgery is obviously dramatic, and will result in significant weight loss, especially during the first year. As discussed above, however, the significant weight loss that occurs will be the result primarily of the loss of lean body mass, not fat loss, because of the body’s natural reaction to use lean body mass as a source of energy to compensate for the calorie depletion. Unless adequate amounts of protein are taken, overall fat percentage will remain high, resulting in ineffective weight loss.
Third, the weight loss phase following surgery is the most critical time for patients with respect to maintaining lean body mass, and to ensure fat loss. It is truly their “window of opportunity” given to them as a result of the surgery. Weight loss during this time is inevitable. The goal, however, is to make sure that the weight loss during this time is effective by ensuring adequate amounts of protein are taken by surgery patients to preserve lean body mass. This goal cannot be achieved if proper eating habits are not learned and implemented by the patients immediately following surgery.
Based on the three facts above, and based on clinical experience that adequate protein amounts for those on low calorie diets actually helps curb hunger and promotes energy and well being, it is our recommendation that the minimum amount of daily protein to preserve existing lean body mass during the weight loss phase for post surgery patients is 90 grams, and that this minimum should be increased for larger patients. This is especially true for male bariatric patients, who start out usually with a larger lean body mass profile than females. If this minimum is not met, then weight loss becomes ineffective in that lean body mass and fat will both be lost, resulting in loss of strength, as well as possible health risks.
The Role of Protein for Effective Weight Loss
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