Vegans eat the least protein.
That doesn't mean they don't eat enough protein.
The RDA does not reflect individual requirement.

Here is a brief RDA tweetorial.

>50 years ago, individual protein requirements were assessed in rigorous studies.
Requirements ranged...
The estimated average requirement (EAR) was determined to be 0.66 g protein per kg body weight.

Hypothetical question: What if 100 individuals were provided with a day of food that contained EXACTLY the EAR....how many of them would NOT meet their individual requirement?
By definition, half the individuals would meet their requirement.

But there is also another subtle point to be made here, technically, 50% would meet OR EXCEED their requirement.

Get it, the range tends to be a normal distribution. Most people are either above or below ave.
The RDA's for protein, vitamins and minerals are calculated as being 2 std dev's above the EAR.
Why?
It's a population approach, not an individual approach

If the EAR were recommended, & everyone achieved ONLY that, then by definition half of the population would be deficient.
From a public health perspective, the RDA's are set to meet and/or exceed the individual requirements of the population.

Hypothetical question: What if 100 individuals were provided with a day of food that contained EXACTLY the RDA....how many of them EXCEED their requirement?
As intended, by definition, ~97% of those meeting the RDA exactly would be EXCEEDING their individual requirement (and 2.5% of them would fall short).

This means getting 70-90% of the RDA (i.e., <100%) would still meet and exceed individual requirements for most individuals.
You might be in that 2.5% that needs > RDA. To be safe, you might want to eat a bit more than the RDA...you'd probably need just a little more.

Interestingly, in the US, people eat a LOT MORE than the RDA, according to the National Health And Nutrition Examination Survey
Vegetarians should have no trouble meeting and exceeding their individual requirement.

Vegans need to be more conscious, but should not have a problem provided they have access to a reasonably diverse diet.

Even vegan body builders?
Ask @NimaiDelgado

vegnews.com/2017/6/vegan-b…
There is an important follow-up question.

When the RDA was established, what metric was being used for "requirement"?

Longevity?
Prevention of cancer or heart disease?
Nope.
Maintaining lean muscle mass.

Is that minimal, or optimal?

That will have to wait for another day.

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More from @GardnerPhD

Mar 27
PROTEIN MATH GAME

I believe most people who have access to a reasonably diverse diet get ⬆️⬆️ protein than the RDA, especially athletes.

Do you?

Simple math

How much do you weigh?
Doubly-labeled water
% Protein in diet

@mackinprof – please check my math

Wanna play?
Let's start with the % of protein in your diet.
Do you have any idea what that might be?
You don't need to know to play.
If you know great,
If not, have some fun and guess.
Yesterday @ScepticalDoctor provided screen shot below (source?)
Meat eaters ~16%
Vegetarians ~13%
Vegans ~12.5%

@MrBigNoodle noted this:
pubmed.ncbi.nlm.nih.gov/23988511/
with higher amounts (although, in grams).

I find few examples in published lit. of ave’s outside the 15-20% range Image
Read 13 tweets
Mar 26
High vs. Low Protein

A few wks ago, @ScepticalDoctor & @theproof brought up this ??. I was too busy @ the time, & it's a tough topic - limited base of quality evidence to draw from.

Got more time now.

Time for a protein tweetorial?

For starters, how high is "high"?

g? %?
And how low is "low"?
There aren't correct answers. There is no consensus on grams or % of what qualifies as "low" or "high".

And there is the important consideration of plant vs. animal protein, and translating "protein" into "food". But I'll save that topic for another day.
Read 12 tweets
Mar 19
It Depends - Coffee vs Tea

I'm working on a book. One of the chapters will be Coffee vs Tea.

Thought it would be fun to preview some of the content. I'll try turning this into a Tweetorial. (17 in 🧵)

Several polls, several fun facts.

Are you a coffee or a tea drinker?
Coffee vs Tea and health

Which do you think is a HEALTHIER choice?

2/17
How many of you paused in trying to answer the previous question thinking.....it depends?

Doesn't it depend on what you add?
Maybe even what type of coffee or tea?

Most common additions, sweetener & dairy

Start with sweetener, do you add:

3/17
Read 16 tweets
Mar 13, 2021
#KetoMedStudy
Week #5
1/5

For past 4 wks, we've been sharing study design details of forthcoming Keto vs Mediterranean Study

This week, we want to share the 36-wk time point & get your thoughts.

Poll on next post in thread - vote on time point you think is most interesting 🤔
2/5
Which is most interesting?

Adherence best at Wk #4 of each phase (food delivered)
⬆️rigor (efficacy)

Wk #12 of each phase
⬆️generalizabilty

36 wk - reality check (effectiveness)
Who is following what?
3/5

Caveat

Primary outcome=HbA1c (ct.gov)
12wk Keto vs 12wk Med, relative to baseline

HbA1c not appropriate for assessing 4 wk change

We have Hba1c @ wks 0, 12, 24 & 36
We have CGM glucose @ wks 0, 4, 12, 16, 24

(Not enuf $$ to get CGM @ wk 36) 🙁
Read 5 tweets
Feb 13, 2021
1/9
Just completed trial
Keto vs Mediterranean

Just submitted Design & Adherence paper PRIOR to main results paper

While waiting for reviews & decision…
 ~10 weekly mini-threads - #KetoMedStudy

⬆️design understanding &
⬆️twitter civility?🙏
 
Week #1
Main study question Image
2/9
US calories: 1999-2016
pubmed.ncbi.nlm.nih.gov/31550032/

Low quality carbs
Added sugars, refined grains: ~40%

High quality carbs (whole grains, legumes, fruits): ~10%

3 types fat: ~10% each

Protein: Animal ~10%; plant ~5%

***Biggest impact potential - ⬇️ low quality carbs Image
3/9
Most/all healthy diet patterns recommend avoiding/minimizing added sugars & refined grains, while including non-starchy vegetables

Is there additional overall health benefit to also eliminating:
*Legumes/beans
*Whole intact grains
*Fruits

Poll next tweet Image
Read 9 tweets
Sep 30, 2019
Series of 6 papers published today in Ann Int Med from “NutriRECS” group.

They recommend people continue to consume unprocessed & processed red meat at current rates

I disagree, in USA

My perspective - in 17 tweets
#ReduceRedMeat in USA

n.pr/2mkxWN7
2 of 17

I seek to dispute it
As does @TrueHealthINIT & @HSPHnutrition

It isn’t hard
3 of 17

The recommendations are stated to be “weak, with low-certainty evidence”.
I agree.

Beyond weak, they are reckless.
They will confuse the public & undermine scientific credibility.
Potential to harm public health & environment.
Read 17 tweets

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