Protein and Your Health
How would you answer this question:
Which one of the following three essential macronutrients is most important: carbohydrate, fat or protein?
Due to the popularity of various low-carbohydrate, high-protein diets (Keto, Paleo, Atkins, etc), many might answer - protein. The correct answer: none of them are most important. All of them are equally important.
Let’s take a deeper dive into the world of protein and health by exploring the following:
- How do protein packages impact our health?
- Impact on the planet
- Which protein packages are healthiest?
- What about other protein packages?
- Do protein packages impact our longevity?
What is Protein?
Proteins are large, complex molecules made up of 20+ amino acids, called the building blocks of protein. The body assembles these amino acids in a certain order to build each specific protein, much like letters of the alphabet are put together in a certain order to make words.
Proteins make up about 15% of the total body mass of healthy adults1, and play many important roles. They have major structural roles in muscles, tendons, ligaments, skin, hair, nails, for example. Proteins play important functional roles in vision and blood clotting, as enzymes, hormone messengers and antibodies, to name a few. They also regulate the fluid and acid-base balance of the body.
As a last resort, protein can provide energy, but glucose is the primary, clean-burning fuel for all the cells of the brain and body.
Note: Carbohydrates are efficiently metabolized to glucose, and the body maintains some glucose reserves. Therefore, the greatest proportion of our daily calories should come from health-promoting, whole, unprocessed carbohydrate foods, not protein. Conversion of protein to glucose is not energy efficient and the body does not have protein stores.
How much protein do we need?
The Institute of Medicine (IOM) recommends that adults get a minimum of 0.8 grams of protein for every kilogram of body weight per day2. You can arrive at the same answer by simply multiplying your weight in pounds by 0.36. That means a 150-pound person would need 54 grams of protein a day, while a 200-pound person 72 grams daily.
150lbs X 0.36 = 54 grams of protein/day
200lbs X 0.36 = 72 grams of protein/day
The IOM has recommended a wide range of protein intake as a percentage of daily calories: 10-35%.3 This range provides flexibility and diversity in dietary planning, allowing people to make healthy choices based on their personal food preferences.
Some groups such as women who are postmenopausal may need to aim higher (1-1.2 grams / kilogram of bodyweight per day) in order to maintain lean muscle mass and bone health. To meet these needs, aim to include 75% protein sources like beans, lentils, and soy foods at every meal. Excess protein above your needs is not beneficial - it will simply be stored as fat or excreted as waste.
It is understood that people with specific conditions or diseases will get nutritional advice by qualified health professionals to meet their special needs. So if you are under medical supervision for any reason, please consult with your doctor or nutrition professional before following any of these recommendations.
How are we doing?
While it’s true that millions of people worldwide, especially young children, do not have adequate protein intakes due to food scarcity, this is not typically the case in America. There is very little risk of protein deficiency because 97% of Americans meet or exceed minimum daily protein recommendations.4
National data suggests the average American male gets about 102 grams of protein a day, while the average American female gets 70 grams.5 That’s 82% and 52% more protein than IOM general protein recommendations for adult males and females.
So, as a nation, we don’t have an issue with adequate protein intake. However, we do have an issue with the quality of our protein intake. That’s because not all protein foods are created equal in terms of their immediate and long-term effects on health.
Two sources of protein
It is often surprising to people to learn there are actually two sources of protein — animal and plant.
Most Americans think protein means animal foods. About 70% of our protein consumption comes from animal sources: meat, eggs, dairy products, fish and seafood.5 Meat constitutes the majority of intake from the different protein food groups, and red and processed meat constitute the majority of total meat intake.4
Protein is also found in all whole, unprocessed plant foods, the richest sources being beans/legumes, whole grains, nuts, seeds and some vegetables, especially cooked broccoli, cooked leafy greens, green peas, sweet potatoes and winter squash.6
The protein package is key
When we eat protein foods we’re not just eating protein. The protein comes packaged with other things: different fats, cholesterol, carbs, fiber, sodium, vitamins, minerals, phytochemicals and other substances. Different protein foods have different protein packages.
The table below illustrates the concept of different protein packages by looking at two quality protein choices: salmon (animal) and black beans (plant).6
**The amount of cooked beans to substitute for a 3-oz serving of meat or fish
- The cup of cooked black beans has 31 more calories than the serving of fish.
- The fish has about 6.6 grams more protein.
- The fish does not contain carbohydrates, whereas the beans have about 41 grams.
- The black beans have very little fat, including saturated fat, whereas the fish has a significant amount of fat, including more saturated fat.
- Fish has no fiber, while the cup of cooked black beans has 15 grams.
- Fish does not contain phytochemicals because these are only found in plant foods, while the beans contain many.
- Fish contains cholesterol, whereas beans are cholesterol-free.
→It’s important to consider what kinds of protein packages you eat on a regular basis because that’s going to impact your present health and your long-term health outcomes. In other words, the protein packages you regularly eat are a determinant of how healthy you are now and in the future.
So, for example, if you have high blood pressure, you might want to choose a different animal protein package than ham. While a 4-oz serving of ham does provide a generous 22 grams of protein with only 1.6 grams of saturated fat, it’s loaded with 1500 mg of sodium. According to the American Heart Association, that’s the maximum amount of sodium a person with high blood pressure should have for an entire day!7 If you don’t have high blood pressure, that’s 65% of the daily recommended amount of sodium. A better animal protein choice would be a 3-ounce serving of grilled salmon, which contains only 51 mg of sodium while providing the same amount of protein and only one more gram of saturated fat.6
How do protein packages impact our health?
Research studies published in peer-reviewed journals have shown that higher intakes of animal protein, especially red and processed meat, are associated with increased risk of coronary heart disease8-13, type 2 diabetes14-18, colorectal cancer19-23, chronic kidney disease, stroke and gout.24-28, while increasing plant protein intake is associated with a decreased risk of these same diseases.9,11-28
It’s not surprising then, that several recent papers published in peer-reviewed journals29-33 have found high animal protein intake to be associated with an increased risk of mortality, while plant protein intake was associated with decreased risk of dying. The researchers found that replacing just 3% of calories from animal protein with 3% of calories from plant protein was associated with lower mortality.
Impact on the planet
Just as different protein packages have different effects on human health, they also have differing effects on our environment.
As illustrated in the graph below, plant-based proteins are less resource-intensive and have much lower greenhouse gas emissions, the major driver of climate change.34
Good strategies for having a more positive impact on our environment are: 1) choosing poultry, fish or dairy in place of beef and processed meat, and 2) eating largely plant protein foods, like beans, whole grains, nuts and veggies.
That means, when you’re eating the whole foods, plant-predominant Full Plate Approach, you’ll be helping the planet at the same time you’re helping yourself.
Which protein packages are healthiest?
Here are our recommendations for both plant and animal protein choices.
Focus on these healthiest plant protein choices:
- Beans & legumes – black, kidney, pinto beans, cannellinis, lentils, chickpeas, edamame, split peas
- Whole grains – oats, brown rice, quinoa, kamut, amaranth
- Vegetables – particularly cooked broccoli and cooked dark leafy greens, green peas, sweet potatoes and winter squash
- Nuts & seeds – almonds, pecans, walnuts, peanuts, pistachios, chia, flax and hemp seeds
Focus on these healthiest animal protein choices:
- Skinless poultry – chicken, turkey, duck
- Cold-water, fatty fish – salmon, arctic char, Atlantic mackerel, sardines, sablefish/black cod, anchovies, rainbow trout, albacore tuna
- Fat-free or low-fat dairy products
- Egg whites
What about other protein packages?
Because red meat is associated with increased risk of coronary heart disease, type 2 diabetes, colorectal cancer, chronic kidney disease, stroke, gout, mortality and is a probable carcinogen,35 we have not included it as one of the healthiest animal protein choices and recommend limiting intake to one 3-oz serving (size of a deck of cards) per week.36
Because processed meat is associated with increased risk of coronary heart disease, type 2 diabetes, colorectal cancer, chronic kidney disease, stroke, gout, mortality and has been determined to cause cancer,35 we are not making any recommendations for processed meat.
Plant-based meat and dairy substitutes are typically highly processed foods, often with high fat and/or sodium levels. Therefore, we recommend limiting their use to one serving a week. Avoid non-dairy products made with coconut milk, coconut oil or coconut cream, as well as plant milks made with added sugars, both of which can contribute to increasing risk of heart disease by increasing LDL cholesterol. Learn how to make the best non-dairy cheese choices in Are Non-Dairy Cheeses Really Healthier?
Protein powders are heavily processed, concentrated sources of protein that come from plants, eggs or milk. They are considered a supplement and, therefore, are not regulated by the FDA for safety. They can contain added sugars, calories, heavy metals, BPA, pesticides and other contaminants.37 For these reasons, we recommend you meet your protein needs from the healthiest plant and animal choices mentioned above.
Do protein packages impact our longevity?
The famous Blue Zones Project has described five people groups with the highest percentages of healthy, active, engaged centenarians (100-year olds).38 From their in-depth study of these diverse groups they learned that diet is one lifestyle factor they have in common: 90-95% of all of their diets are primarily composed of unprocessed plant foods. These healthy centenarians are thriving on a diet composed largely of plant proteins, which includes a daily cup of cooked beans.
The real-world examples of longevity from the Blue Zones are supported by a recent study where researchers developed a model for predicting how dietary choices affect life expectancy.39 Sustained change from the typical Western diet to an optimal diet abundant in beans, whole grains and nuts, with decreased amounts of red and processed meat, is associated with an increased life expectancy of 10.7 years in females and 13 years in males if started at age 20, and more than 8 years of increased life expectancy when started at age 60.
The news from this study is really good—health gains can be had for people of all ages when they develop the habit of choosing healthy protein foods. The plant-predominant Full Plate Approach can help you do just that.
- ZiMian Wang, Wei Shen, Donald P Kotler, Stanley Heshka, Lucian Wielopolski, John F Aloia, Miriam E Nelson, Richard N Pierson, Jr, Steven B Heymsfield, Total body protein: a new cellular level mass and distribution prediction model, The American Journal of Clinical Nutrition, Volume 78, Issue 5, November 2003, Pages 979–984, https://doi.org/10.1093/ajcn/78.5.979
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- Fehrenbach KS, Righter AC, Santo RE. A critical examination of the available data sources for estimating meat and protein consumption in the USA. Public Health Nutr. 2016 Jun;19(8):1358-67. doi: 10.1017/S1368980015003055. Epub 2015 Nov 17. PMID: 26573136.
- All nutrition data from: https://fdc.nal.usda.gov/
- Zhong VW, Van Horn L, Greenland P, et al. Associations of Processed Meat, Unprocessed Red Meat, Poultry, or Fish Intake With Incident Cardiovascular Disease and All-Cause Mortality. JAMA Intern Med. Published online February 03, 2020. doi:10.1001/jamainternmed.2019.6969
- Bernstein, A. M., Sun, Q., Hu, F. B., Stampfer, M. J., Manson, J. E., & Willett, W. C. (2010). Major dietary protein sources and risk of coronary heart disease in women. Circulation, 122(9), 876–883. https://doi.org/10.1161/CIRCULATIONAHA.109.915165
- Micha, R., Wallace, S. K., & Mozaffarian, D. (2010). Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. Circulation, 121(21), 2271–2283. https://doi.org/10.1161/CIRCULATIONAHA.109.924977
- J Nutr. 2017 Mar;147(3):281-292. doi: 10.3945/jn.116.239574. Epub 2017 Jan 25. A Systematic Review of the Effects of Plant Compared with Animal Protein Sources on Features of Metabolic Syndrome. Chalvon-Demersay T1, Azzout-Marniche D1, Arfsten J2, Egli L2, Gaudichon C1, Karagounis LG2, Tomé D3.
- Tharrey, M., Mariotti, F., Mashchak, A., Barbillon, P., Delattre, M., & Fraser, G. E. (2018). Patterns of plant and animal protein intake are strongly associated with cardiovascular mortality: the Adventist Health Study-2 cohort. International journal of epidemiology, 47(5), 1603–1612. https://doi.org/10.1093/ije/dyy0
- Curr Atheroscler Rep. 2011 Dec;13(6):493-8. doi: 10.1007/s11883-011-0208-x.Protein and coronary heart disease: the role of different protein sources. Clifton PM1.
- Dietary Intake of Total, Animal, and Vegetable Protein and Risk of Type 2 Diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)-NL Study. Ivonne Sluijs, Joline W.J. Beulens, Daphne L. van der A, Annemieke M.W. Spijkerman, Diederick E. Grobbee, Yvonne T. van der Schouw. Diabetes Care Jan 2010, 33 (1) 43-48; DOI: 10.2337/dc09-1321
- Malik V.S., Li Y., Tobias D.K., Pan A., Hu F.B. Dietary Protein Intake and Risk of Type 2 Diabetes in US Men and Women. Am. J. Epidemiol. 2016 doi: 10.1093/aje/kwv268.
- Virtanen, H., Koskinen, T., Voutilainen, S., Mursu, J., Tuomainen, T., Kokko, P., & Virtanen, J. (2017). Intake of different dietary proteins and risk of type 2 diabetes in men: The Kuopio Ischaemic Heart Disease Risk Factor Study. British Journal of Nutrition, 117(6), 882-893. doi:10.1017/S0007114517000745
- Comerford, K. B., & Pasin, G. (2016). Emerging Evidence for the Importance of Dietary Protein Source on Glucoregulatory Markers and Type 2 Diabetes: Different Effects of Dairy, Meat, Fish, Egg, and Plant Protein Foods. Nutrients, 8(8), 446. https://doi.org/10.3390/nu8080446
- Schwingshackl, L., Hoffmann, G., Lampousi, A. M., Knüppel, S., Iqbal, K., Schwedhelm, C., Bechthold, A., Schlesinger, S., & Boeing, H. (2017). Food groups and risk of type 2 diabetes mellitus: a systematic review and meta-analysis of prospective studies. European journal of epidemiology, 32(5), 363–375. https://doi.org/10.1007/s10654-017-0246-y
- Liao, L.M., Loftfield, E., Etemadi, A. et al. Substitution of dietary protein sources in relation to colorectal cancer risk in the NIH-AARP cohort study. Cancer Causes Control 30, 1127–1135 (2019). https://doi.org/10.1007/s10552-019-01210-1
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- Ko, G. J., Obi, Y., Tortorici, A. R., & Kalantar-Zadeh, K. (2017). Dietary protein intake and chronic kidney disease. Current opinion in clinical nutrition and metabolic care, 20(1), 77–85. https://doi.org/10.1097/MCO.0000000000000342
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