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
Next, please estimate what you to believe your daily caloric intake to be....
....in terms of percent of energy or calories
In the field of nutrition, it is well known that study participants tend to under-report their caloric intake.
Ask @KevinH_PhD

Gold standard for assessing this is doubly-labeled water.

See below for what are considered actual energy intakes for adults maintaining their weight
In general, I assume the ave adult consumes ~2,500 kcal day (< for women, > for men), & gets ~16% protein.

16% of 2,500 kcal is 100 g protein, or ~double the RDA

And now I'm broadening to include athletes who focus more on protein, and eat ⬆️ calories.

Find yourself below.
Now let's add in weight.
Obviously larger people eat more calories and have higher total needs.

I got that for you. Try to find yourself below.

Now, who is below the RDA in this map?
The only cell below the RDA is the 225 lb person who only gets 75g protein/day.

75 g protein X 4 Kcal/g = 300 Kcal

That would be
10% protein in a 3,000 Kcal day
12% protein for 2,500 Kcal
15% protein for 2,000 Kcal

I assume very few 225lb people get <75g protein/day
The only group getting "just" the RDA are those weighing in at 200 lbs who "only" eat 75 g.

That person would have to be eating less than 2,000 kcal/day & maintaining their weight, or getting <15% protein in their diet, to be below 75 g protein.

I'm skeptical that can be done.
Let's move on to the athletes. I believe one of the recommendations for athletes is 1.2-1.6 g/day.

Here are the cells achieving that range (green).
This would be without supplements, and without protein bars and shakes, just food.
And beyond....

I'll call on @mackinprof for guidance on concerns for protein intakes >2.0 g/kg/day. I believe there are some data suggesting reason for concern about impaired performance above this level. Correct?

Here they are, in gray. I would suggest this is easy to achieve.
Example of elite/extreme athletes, caloric intake, & protein intake.

@TRotto53 was the TA for my Human Nutrition class at Stanford back in 2015 and 2016. He was also on the Stanford football team that went to the Rose Bowl in 2016.

At that Kcal level, easy to go >2.0 g/kg/day
Back to @ScepticalDoctor & vegans.

Let's say they only get 12.5% protein (I assume higher, but let's go with that).

& they are maintaining weight, at least 2,000 kcal (doubly-labeled water)

2,000 X 12.5% = 62.5 g protein

~150 lbs (68 kg)

=0.92 g/kg
>RDA
>>EAR

Protein math

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More from @GardnerPhD

Mar 26
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.
Read 9 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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