Of all the questions and concerns I hear over the years, the top one is always, "How will I get enough protein?"

It's the elephant in the room, so let's show it the door!

Speaking of which, what do all the following beings have in common?

Of course- they're all vegan!

 "Humans do not need to eat meat. Not to build muscle, not to get adequate protein, not for any reason at all. A human diet can be optimal and complete without meat." 

 That's from Dr. David Katz MD., PhD. of Yale, world-renowned nutritionist par excellence, founder and former director of Yale University's Yale-Griffin Prevention Research Center, and author of nutrition books used by medical schools nationwide. (For his most recent publication, see this.) He is one of the world's leading authorities on lifestyle medicine, health promotion, and chronic disease prevention. He is also the author of my favorite self-imposed food label - "vegan wannabe"!

He goes on.

"Passions about meat and the mythology of its role in building strong muscle should be tempered by common observation. Animals routinely build much more powerful muscle than any ever owned by any human out of meat or plants. Human beings are constitutionally omnivorous, meaning we are adapted to eat both plant and animal (meat) foods. There is no requirement to eat meat to grow big muscles. The conversion of food to muscle depends on a given animal's adaptations, not the food. Herbivores, like horses, grow muscle entirely from plants; carnivores, like lions, grow muscle exclusively from meat. Omnivores like humans may grow their muscle from either." 

Proteins are made up of 22 building blocks called amino acids. Our body can make 14 of them from scratch, but there are nine we cannot. They are considered 'essential'; we obtain them only through food. Both animals and plants provide them.

For a wonderful summary of protein, visit this Harvard article.

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 From another world recognized authority, see Dr. Gregers Nutrition Facts.org:

"It is true that some plant proteins are relatively low in certain essential amino acids. So, about 40 years ago, the myth of "protein combining" came into vogue—literally, the February '75 issue of Vogue magazine. The concept was that we needed to eat "complementary proteins" together, for example, rice and beans, to make up for their relative shortfalls. This fallacy was refuted decades ago. The myth that plant proteins are incomplete, that plant proteins aren't as good, that one has to combine proteins at meals—these have all been dismissed by the nutrition community as myths decades ago...It turns out our body maintains pools of free amino acids that it can use to do all the complementing for us, not to mention the massive protein recycling program our body has. Some 90 grams of protein are dumped into the digestive tract every day from our own body to get broken back down and reassembled, and so our body can mix and match amino acids to whatever proportions we need, whatever we eat, making it practically impossible to even design a diet of whole plant foods that's sufficient in calories, but deficient in protein. Thus, plant-based consumers do not need to be at all concerned about amino acid imbalances from the plant proteins that make up our usual diets." He further discusses the origins of our preoccupation with getting enough protein in this article. 

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Some plants are sources of complete proteins, the main ones being soy (think soy milk, edamame, tofu), chickpeas (hummus), and quinoa (also buckwheat and oyster mushrooms).

 Certain vegetables contain more protein than others, as shown below. 

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This 2013 study of 73,000 participants showed that strict vegetarians ate the same amount of protein as omnivores, and all diets got almost twice the average daily protein requirement. 

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So the question really becomes, ? As with carbs or fats, what we don't use is turned into fat. Significantly, since most animal protein comes packaged with the meat's saturated fats, it often increases blood lipids and heart disease.

Recent studies show animal protein is less healthy for us compared to plant protein (especially red meat). Check out this article and see my video for a discussion of very large and very impressive scientific studies comparing outcomes of substituting plant for animal protein.  Dr. Greger references it:

"And in 2016, a landmark study was published out of Harvard, involving more than 100,000 men and women, that found that replacing 3% of your animal protein with plant protein was associated with lower risk of dying prematurely. If you don’t think 100,000 people are enough, how about 400,000 people? The NIH-AARP study is the largest diet cohort study in history. And again, simply swapping 3 percent of calories from various animal protein sources with plant protein was associated with 10 percent decreased overall mortality. And you get even twice that benefit if you get rid of eggs, too. That’s not a surprise, since egg consumption is associated with a higher risk of developing cardiovascular disease."

 Sometimes it's not the animal protein itself that is the concern, but the company it keeps: cholesterol, saturated fat, and lack of fiber, phytonutrients and antioxidants. When you consume animals, you eat what they ate- toxins, pesticides, and herbicides.  Another compound, TOR,  is a natural enzyme in our bodies that stimulates growth, a good thing when you are young, not so much when you get old as it promotes aging and also the growth of cancer cells. It’s being studied in anti-aging research. The amino acid leucine, which is found in higher concentrations in animal vs plant proteins, stimulates TOR. Another compound called TMAO from carnitine in red meat may be as harmful for our cardiac health as cholesterol.

Katz: "The dietary patterns consistently strongly associated with the best health outcomes based on every kind of study, and people around the world–emphasize whole, wholesome plant foods. They are rich in vegetables and fruits every time; beans and lentils almost every time; nuts and seeds much of the time; and whole grains most of the time. The world's healthiest, most vital and disease-free people rely on plain water to quench their thirst and often drink tea or coffee, and perhaps some wine–but never (or hardly ever) soda. They eat little meat, and very little if any processed meat, but also eat very little added sugar. In other words their diets are good not because of any one thing, but because of everything–and their health is generally good for the same reason...." 

What you DO need if you become more plant-focused is Vitamin B12 1000 mcg daily. Most nutrition specialists also recommend increasing omega 3s, but from algae sources. There's no need to eat the middleman or kill the krill. 

 Here's the bottom line from Katz:

"The fact is that only vegan and near-vegan diets have been shown to shrink atherosclerotic plaque; reduce LDL as effectively as statins; and modify gene expression in a manner suggesting the potential to prevent the development and progression of cancer. Maybe other diets can do all this- but the burden is on them to prove it."

He continues to say, however, no studies prove adding small amounts of fish or meat is harmful. (See my video discussing the largest study to date addressing this question.) He eats this way because of environmental and humanitarian reasons.

According to the nation's top researchers and scientists, the quality of plant protein is superior to that of animal protein. The rub is in the quantity, especially since recent studies suggest we need more as we age. I cannot disagree that this takes more planning. Great sources are beans, lentils, legumes , peas, soy products (tofu, soy milk, edamame), mushrooms, spinach, broccoli, quinoa, whole wheat, greens, nuts, seeds and veggie burgers and patties.

"None of us asked to be born into a global human population nearing 8 billion. None of us asked to be born into a time of mass extinction, resource depletion, and accelerating climate change –but here we are. The world, all too literally, is on our plates now. We are all invited, if not obligated, to dine accordingly. We may even choose to view the likely benefits to our cardiovascular systems, telomeres, longevity, and vitality as merely incidental to being conscious citizens in a modern world" Dr Katz.

And what of the current concern that we need more protein as we age to maintain adequate muscle strength and function?

My first question was, where did this concern originate? And next, what studies support this hypothesis. Spoiler alert- there is no scientific data to support increasing protein intake as we age. In fact, this may do more harm than good.

I turned to my guru, Dr. Michael Greger and his new publication "How Not to Age" to, as he famously states, "put it to the test". Here are excerpts from his book p. 404-410.

• "A loss in muscle mass is characteristic of aging found in every species. This is not just because people tend to become less active with age. Even among master athletes, like marathon runners and weightlifters who remain fit throughout their lives, performance tends to decline after about 40, dropping in half by age 80. The heritability of muscle mass and strength may be as high as 50-60%.
• Excessive age-related loss of muscle mass, strength, and function is termed sarcopenia. Sarcopenia is associated with not only an increased risk of falls, but an overall shorter lifespan. The loss of muscle strength may be even  more important, though, as it is tied to mortality, regardless of muscle mass.
• Resistance exercise is considered the most effective strategy to prevent age-related muscle weakness, treat muscle loss, and improve physical function.
• The recommended dietary allowance is .8 g of protein per kilogram of (your ideal) body weight per day for all adults regardless of age, which is about your ideal weight in pounds multiplied by four and then divided by 10.
• Some advocate for protein intake for older individuals in excess of the official recommendations. Among them, not surprisingly, are consultants for the National Cattleman's Beef Association and members of the Whey Protein Advisory Panel for the National Dairy Council. Indeed, the most comprehensive study on the protein needs of healthy adults found no difference in protein requirements with age, and authorities in the United States, the EU, and globally agree...the elderly don't require more protein. But would they benefit from more, and what about unhealthy adults already suffering from frailty or sarcopenia?
• When all studies on protein or amino acid supplementation for older men and women were put together, overall, there was no significant improvement and lean body mass or upper or lower body muscle strength. In non-frail, older adults, extra protein, or essential amino acid supplementation appears to have little or no effect on muscle mass, strength, or performance, when taken alone, or added to an exercise regimen.
• What about those who really need it- sarcopenic, pre-frail or frail individuals? One of the first things doled out by doctors is a nutrition shake like Ensure... showed no discernible benefit for any measured outcomes – muscle mass, muscle, strength, muscle function, frailty, status, cognitive function, or mortality.
• Researchers have been trying to find effective ways to treat sarcopenia for decades, and so far, only resistance exercise has consistently yielded benefits. One of the largest and most rigorous studies to treat pre-frail and frail adults was published in 2021. Hundreds were enrolled to test the effects of leucin, whey protein, soy protein, creatine, and a combination of creatine and whey versus placebo control, in the context of 16 week resistance training program. The strength training itself worked, increasing muscle mass and function, but everything else flopped. No added benefit to frail or pre-frail individuals taking any of those supplements (was seen) compared to taking the cornstarch placebo.
• Of all proteins, the milk protein whey stimulates the greatest response in terms of short term muscle protein synthesis, likely due to its high concentration of leucine, the amino acid that triggers mTOR. ( In our childhood, mTOR is an engine of growth, but, in adulthood, it can be thought of as the engine of aging.(See p. 101-108.) Straight leucine supplements also fail to add muscle. If leucine stimulates muscle protein synthesis, why doesn't this translate into greater muscle mass? Surprisingly,...there is little correlation between these acute (short term) changes in muscle protein  creation and long-term changes in muscle mass, as verified by MRI screens.
• This also explains why plant proteins can accrue muscle on par with animal proteins. For example, even though the acute muscle protein synthesis to whey protein is greater than soy protein in the immediate hours after consumption, the accretion of muscle mass and strength is the same. So, in the end, whey protein may just leave one to suffer the added mTOR activation side effects. mTOR is a growth enzyme that is good when you're young, not so much when you're old. It stimulates growth of muscle, yes, but also stimulates cancer growth, Alzheimers, coronary disease. In a bid to slow muscle wasting in cancer, for example, researchers tried giving leucine to cancer ridden mice, but only ended up doubling the growth of their tumors.
• Food is a package deal. If you go to the Harvard School of Public Health webpage on protein, you'll see that it emphasizes the source rather than the amount of protein as being most consequential for health. This is because foods present of protein package, which can contains saturated, fat and sodium on one hand (from animal products), or antioxidants and fiber (from plant sources) on the other. This is why it's number one tip for making the best protein choice is 'Get your protein from plants when possible.' "

For a more entertaining discussion of this topic, enjoy The Game Changers!