Protein Intake for Athletes

If you skim through a body building magazine, talk to someone in the gym, or conduct an online search for protein you will be inundated with information. Some if not most may be inaccurate but how do you decipher what is true? This article will outline protein sources to include the recommended quantity, timing and quality. 

First let’s discuss some background information on protein. Protein is the building blocks for the bones, muscles, cartilage and skin and is also essential for maintaining cellular integrity and function (1). Protein is made up twenty amino acids, nine of which are considered essential. Essential amino acids are ones the body cannot make so they must be acquired through food sources which can be found in animal food sources such as meat, fish, eggs and milk or vegetarian food sources such as grains, legumes, seeds and beans. Different types of protein have shown to provide a faster recovery response post workout that I’ll discuss later in the article. 

According to the Institute of Medicine Food and Nutrition Board, the recommended daily allowance (RDA) for protein for both men and women is 0.8 grams per kilogram body weight per day (1). The 2010 Dietary Guideline for Americans* state the daily recommended intake (DRI) for protein to be 10 to 35 percent of total calorie intake. In my opinion the RDA is excessively low when considering athletes and the DRI is too broad of a range especially if you are trying to dial in on your macronutrient needs, i.e. macronutrients are your carbohydrates, protein and fat. So how do you know how much you need? Digging deeper and coming to a more accurate response, in a 2009 Position Stand of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance, the recommended protein intake for athletes is 1.2 to 1.7 grams per kilogram body weight per day (2).  The position stand notes the RDA and DRI do not take into account the specific needs of athletes which I completely agree with. The following is their recommendation for different types of athletes:

  • Endurance athletes: 1.2 to 1.4 grams per kilogram body weight per day
  • Strength Training: 1.2 to 1.7 grams per kilogram body weight per day

For example: A 165 pound (75 kilogram) endurance athlete would need 90 to 105 grams of protein per day OR the same weight athlete who was strength training would need 90 to 127 grams of protein per day. Both of these instances are well over the RDA of a calculated 60 grams per day (0.8 grams X 75 kilograms = 60 grams).  

Quantity and Timing of Protein Intake

This is all great information but what about specific timing of protein intake? I get this question a lot… how much post workout or how much during the day at each meal should I consume? I recommend a minimum of 20 grams of protein post workout. Research has shown that this amount illicits the leucine response and stimulates muscle protein synthesis (3). More specifically, protein intake for athletes includes (3):

  • Four equally spaced meals containing protein,
  • Three meals should be 0.25 to 0.3 grams per kilogram per body weight
  • A larger pre-sleep meal with protein intake at 0.6 grams per kilogram body weight

For example, let’s take a look at the 165 pound (75 kilogram) athlete. The protein intake would be to 18 to 22 grams at three meals with a larger intake of 45 grams of protein before bed. Total protein intake for the day would be 99 to 111 grams. This falls in the range of the 1.2 to 1.7 grams per kilogram per day in the example shown above. One minor exception, as stated above, I would recommend at least 20 grams of protein within 30 minutes after each workout because of the leucine response. For those who need more, the same leucine response has been found when consuming up to 40 grams of protein post workout. It has been shown that in elderly men, 40 grams of protein post workout is essential for muscle synthesis (3). The consumption of a minimum of 20 grams post workout recommendation would be across the board for any athlete, regardless of weight and gender. 

Phillips, Stuart. (2012). Leucine Trigger. The Importance of Dietary Protein in Resistance Exercise-Induced Adaptation: All Proteins Are Not Created Equal. Retrieved from http://scan-dpg.s3.amazonaws.com/resources/DOCS/webinars/2012_The_Importance_of_Dietary_Protein_in_Resistance_Exercise_Induced_Adaptation_webinar.pdf.

Phillips, Stuart. (2012). Maximal rate of muscle protein synthesis at 20g of complete protein. The Importance of Dietary Protein in Resistance Exercise-Induced Adaptation: All Proteins Are Not Created Equal.  Retrieved from http://scan-dpg.s3.amazonaws.com/resources/DOCS/webinars/2012_The_Importance_of_Dietary_Protein_in_Resistance_Exercise_Induced_Adaptation_webinar.pdf.

Phillips, Stuart. (2012). Maximal rate of muscle protein synthesis at 20g of complete protein. The Importance of Dietary Protein in Resistance Exercise-Induced Adaptation: All Proteins Are Not Created Equal.  Retrieved from http://scan-dpg.s3.amazonaws.com/resources/DOCS/webinars/2012_The_Importance_of_Dietary_Protein_in_Resistance_Exercise_Induced_Adaptation_webinar.pdf.

Quality of Protein Intake

I’ve discussed timing and quantity of protein intake but now let’s take a look at quality. Not all protein is created equal especially for athletes and their recovery. Specifically whey protein produces a greater increase of muscle protein synthesis. Whey protein contains all 20 amino acids including the three branch chain amino acids leucine, isoleucine and valine which can be oxidized by muscled during exercise. The term “branch-chain” is the chemical structure of these amino acids. During recovery, due to the leucine content of whey, protein muscle synthesis is increased. Whey is more effective than soy which is more effective than casein protein sources (3). Lean body mass gains are seen with the ingestion of whey protein due to the leucine response. Whey is higher in leucine and is absorbed more quickly post workout. The ideal protein dose post workout to elicit the leucine response is 20 grams (3). The best whey protein source comes from diary. An inexpensive source of 20 grams of protein is 20 ounces of chocolate milk and a banana. While food sources of protein are best, protein powders can work but you have to be careful of the type of protein powder and what other "junk" is added to the product.

Phillips, Stuart. (2012). The rise in AA is more rapid with whey ingestion. The Importance of Dietary Protein in Resistance Exercise-Induced Adaptation: All Proteins Are Not Created Equal. Retrieved from http://scan-dpg.s3.amazonaws.com/resources/DOCS/webinars/2012_The_Importance_of_Dietary_Protein_in_Resistance_Exercise_Induced_Adaptation_webinar.pdf.

Phillips, Stuart. (2012). The rise in AA is more rapid with whey ingestion. The Importance of Dietary Protein in Resistance Exercise-Induced Adaptation: All Proteins Are Not Created Equal. Retrieved from http://scan-dpg.s3.amazonaws.com/resources/DOCS/webinars/2012_The_Importance_of_Dietary_Protein_in_Resistance_Exercise_Induced_Adaptation_webinar.pdf.

I’ve seen many athletes who are trying to achieve a specific weight especially in endurance events. I myself know that I can run faster and with less pain if I am even 5 pounds lighter come race day. Based on personal experience I’ve cut back on food intake but lost lean muscle in the process. I came across a study looking at protein intake in women who are trying to lose weight. Research has found that increased protein intake, specifically through dairy during weight loss spares lean muscle mass while decreasing fat mass (4,5). When I work with athletes looking lose weight, I stick to the equally spaced protein at each meal and a bolus before bed as discussed earlier in the article. 

Overall, the main things to keep in mind with protein intake:

  1. Consistent timing and quantity is important for athletes and in weight loss.
  2. Post workout consumption of at least 20 grams of whey protein will stimulate a leucine response and protein muscle synthesis.

While this article focuses on protein intake, athletes still need adequate carbohydrate intake for performance and recovery. I’ll look more into carbohydrate intake and research on timing and quantity in the near future. 

*The 2015 Dietary Guidelines Americans will be released this fall


References: 

  1. Institute of Medicine, Food and Nutrition Board. (2005). Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). Retrieved June 15, 2015, from http://www.nap.edu/catalog/10490/dietary-reference-intakes-for-energy-carbohydrate-fiber-fat-fatty-acids-cholesterol-protein-and-amino-acids-macronutrients.
  2. Position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and athletic performance. J Am Diet Assoc.2009; 109(3):509-527.
  3. Phillips, Stuart. (2012). The Importance of Dietary Protein in Resistance Exercise-Induced Adaptation: All Proteins Are Not Created Equal. [PowerPoint slides].  Retrieved from http://scan-dpg.s3.amazonaws.com/resources/DOCS/webinars/2012_The_Importance_of_Dietary_Protein_in_Resistance_Exercise_Induced_Adaptation_webinar.pdf.
  4. Josse AR, Atkinson SA, Tarnopolsky MA, Phillips SM. Diets higher in dairy foods and dietary protein support bone health during diet- and exercise-induced weight loss in overweight and obese premenopausal women. J Clin Endocrinol Metab. 2012 Jan;97(1):251-60. doi: 10.1210/jc.2011-2165. Epub 2011 Nov 2.
  5. Josse AR, Atkinson SA, Tarnopolsky MA, Phillips SM. Increased consumption of dairy foods and protein during diet- and exercise-induced weight loss promotes fat mass loss and lean mass gain in overweight and obese premenopausal women. J Nutr. 2011 Sep;141(9):1626-34. doi: 10.3945/jn.111.141028. Epub 2011 Jul 20.

Dietary Supplements Mini Series: Part 1 Calcium

I've been asked on numerous occasions whether or not multivitamins or supplements are needed during training. My response is two-fold. If you have no malabsorption or food allergy/intolerance issues then I feel you can get all nutrients through food. However, if you have and medical issues such as dysmenhorrea or any food allergy/intolerance where absorption of certain nutrients is impaired, then a supplement may be needed. Individuals who are lactose intolerant most likely need a calcium supplement while those with dysmennhorea may need an iron supplement. But what are the food sources of calcium and iron and how do you know what type of supplement to buy? This mini-series will answer those questions and inform you of how much you should be taking in each day.

Part 1: Calcium

Calcium intake is important for athletes for maintaining proper bone health and preventing stress fractures. We reach our peak calcium content by age 30 and after that slowly begin to lose calcium stores. This can be mitigated in two ways, through proper dietary calcium intake and also through exercise, specifically running or walking and weight training. When not meeting the dietary calcium needs, while in the short term, too little calcium intake will not cause harm, a long term deficiency can put you at risk for osteoporosis and stress fractures. But how much calcium do you need? The chart below is the recommended daily amounts of dietary calcium intake.

Life Stage Recommended Amount

  • Teens 14–18 years 1,300 mg
  • Adults 19–50 years 1,000 mg
  • Adult men 51–70 years 1,000 mg
  • Adult women 51–70 years 1,200 mg
  • Adults 71 years and older 1,200 mg

You can meet your calcium needs through food sources and that is always the best option however certain groups of people are at risk for not meeting the daily recommended needs. Those groups include a food allergy to dairy or lactose intolerance, postmenopausal women and women who have amenorrhea (absence of the menstrual period because of heavy exercise, restricting food intake or both). Other factors affecting absorption include too little Vitamin D intake and vegetarians with high intakes of oxalic acid (dark leafy greens, rhubarb, soy and cocoa) and phytic acid (in whole grains and wheat bran) can reduce calcium absorption.

Calcium decreases the absorption of certain drugs (bisphophonates, thyroid, some antibiotics). Other drugs can increase calcium needs (corticosteroids, some diuretics). It’s best to check with your doctor to determine if any of your medication interferes with any supplement use.

Fortunately for those who are lactose intolerant, there are also alternative dairy products that can help meet calcium needs. This includes Lactaid milk and soy, rice or almond milk. Also, Greek yogurt is typically well tolerated in those with lactose intolerance. When it comes to comparing cow’s milk or soy or almond milk products, cow’s milk contains 300 milligrams of calcium per 8-ounce cup whereas soy or almond milk contains 450 milligrams of calcium per 8-ounce cup. While milk, yogurt and cheese are the main sources of calcium in the typical diet, other sources include vegetables such as kale and broccoli or fish with soft bones such as canned sardines and canned salmon. Calcium has also been fortified in many of the foods we eat so looking at the food label to determine the amount is important.

But do you need a calcium supplement? Ask yourself the following:

  1. Are you lactose intolerant?
  2. Are you an ovo-vegetarian?
  3. Do you consume less than the recommended 3 servings of dairy each day?

If you answered yes to any of these questions, a calcium supplement may be right for you. But then the next question is which one to choose? Calcium supplements come in many forms to include calcium carbonate, citrate, citrate malate, phosphate, gluconate and lactate. The two most common forms are calcium carbonate and citrate. Avoid supplements made of dolomite, oyster shell and bone meal as they may contain metals and lead. Calcium phosphate, calcium lactate and calcium gluconate are not generally recommended because they contain very small amounts of calcium.

The upper limit should not exceed 2,500 milligrams per day. A risk factor of excess intake is kidney stones. Note if you are meeting the daily recommended intake needs, you do not need to increase intake if training. These supplements provide 250 to 1,000 milligrams of calcium often added with Vitamin D and magnesium to increase absorption. When reading a supplement label, the amount of calcium to pay attention to is the elemental calcium. This is because during digestion, the elemental calcium is released from the compound (carbonate, citrate) and is what becomes available for absorption. The number that is part of the brand name (such as Caltrate 600, Os-Cal 500 and TUMS 500 Extra Strength) usually indicates the amount of elemental calcium in each tablet. However, make it a habit of reading the label to be certain. If the label does not state elemental calcium, assume the elemental calcium is 40 percent from carbonate and 21 percent from citrate. This means if the label states it provides 1,000 milligrams calcium carbonate; it actually contains 400 milligrams elemental calcium.

The two most common types of calcium supplements on the market are calcium carbonate and calcium citrate. Calcium carbonate is cheaper and best absorbed when taken with food because it requires stomach acid to dissolve and be absorbed. This type, since it contains the most elemental calcium per tablet (40 percent), fewer tablets are needed. However, a side effect of calcium carbonate is constipation. Common types of over-the-counter calcium carbonate supplements include Viactiv Soft Calcium Chews with vitamins D & K, Tums 500, Caltrate 600 and Os-Cal 500.

Calcium citrate is well absorbed on an empty stomach and does not cause constipation, however it typically is more expensive. This option may be a better choice for older adults who have a lower stomach acid level. The downside is it contains less elemental calcium per pill (20 percent). Common types of calcium citrate include Citracal, Citracal with vitamin D (315 mg), TwinLab Calcium Citrate Caps (300 mg), some calcium-fortified orange juice (but not all), Solgar Calcium Citrate (250 mg) and Citrical Ultradense Calcium Citrate Tablets (200 mg).

If you have do not have any issues with stomach acid and digesting calcium carbonate, I’d recommend this type of calcium supplement due to its increased amount of elemental calcium and lower cost. However if it causes constipation, switching to a calcium citrate supplement may be a better option for comfort on a personal level. When taking any calcium supplement, it is best absorbed 500 milligrams at a time so space out the pills or tablets. Vitamin D also enhances calcium absorption, so make sure to get 400 to 800 international units (IU) of vitamin D per day. Most calcium supplements contain Vitamin D to enhance its absorption.

When taking any dietary supplements check for a USP (United States Pharmacopeia) symbol on the label which means the calcium supplement is free of lead and other metals. It also meets standards for quantity of elemental calcium in the tablet and how well it dissolves. The application for this symbol is voluntary, so a product may be acceptable even if it does not display this symbol. This is because dietary supplements are not regulated by the Food and Drug Administration (FDA) and third party companies such as USP provide standards for these supplements.

Key points to keep in mind when looking for calcium supplements:

  1. Is it necessary – are you taking in enough calcium through your diet?
  2. When looking at supplements, calcium carbonate contains more elemental calcium and therefore will be better absorbed by the body, usually taken with food and cheaper to purchase, however causes constipation and harder for people with low stomach acid to tolerate.
  3. Calcium citrate contains a lower amount of calcium your body will absorb and is typically more expensive but can be taken on an empty stomach.
  4. Check with your doctor if you are taking medications that can cause problems if taking a calcium supplement.
  5. Take the supplement in 500 milligram increments at a time to increase its absorption.
  6. Calcium is better absorbed when taken with vitamin D; most supplements contain this for optimal absorption.

Exercise to include walking or running and strength training will also help with preserving bone density loss. For an exercise program check out a respected friend and phenomenal athlete Dennis Welch Coaching and Consulting on Facebook!

References:

Office of Dietary Supplements, National Institute of Health (http://ods.od.nih.gov/)

Sarubin-Fragakis A. The Health Professional’s Guide to Popular Dietary Supplements, 3rd ed. Chicago, IL: American Dietetic Association, 2007. ISBN: 9780880913638

Juicing vs. Blending.. the latest craze

Are you trying to find quick and easy ways to increase your fruit and vegetable intake? You’re not alone. Most Americans do not meet the minimum requirement of at least five servings daily. The health benefits of a diet high in fruits and vegetables, low in saturated fat, sodium and processed sugar has been shown to reduce the risk for certain chronic diseases and help maintain (or lose) weight. Fruits and vegetables provide variety of vitamins, minerals and phytochemicals essential for good health. They also contain fiber, a component that can help keep you full longer. What’s a quick and easy way to obtain all of these nutrients for good health? This is where blending and juicing comes in, but what’s the difference?

In juicing, you discard the pulp and end up losing fiber and other vitamins and minerals from produce whereas blending retains the pulp, and in turn more of the fiber and nutrients; the extent retained depends on how much is blended. If you are dead set on blending or juicing your fruits and vegetables I’d say choose blending over juicing. However keep in mind if you are trying to watch your caloric intake, drinking your calories in general can lead to excess intake.

When trying to maintain or lose weight, caloric intake is very important. When drinking your calories, you are more likely to over consume. For example, a 20-ounce bottle of 100% orange juice contains around 275 calories. The good news with this juice has no added sugar; the bad news is this is one way to effortlessly over consume your intake. Reason being, you can easily drink these 275 calories within a short period of time, it will not fill you up and most likely you will eat the same amount you normally would -- without the juice -- throughout the day. The end result is excess calorie intake for the day. Even if you are consuming your calorie needs to maintain your weight and you add just 100 extra calories everyday for an entire year, you can gain 10 to 12 pounds in that year.

Also, unless you are making your smoothies at home and have control over what you are adding, you can end up taking in even more calories from fruit juices containing added sugar. Often popular chain smoothies are riddled with added sugar and in turn contain excess empty calories. For example a 20-ounce smoothie from a popular chain can top 400 to 500 calories. When it comes to blending, for those who are very active and not necessarily concerned with weight loss due to the extensive training, it may be included but make at home to have control over the ingredients added.

I personally do not agree with either method of juicing or blending when trying to add more fruits and vegetables to your diet. Juicing lacks fiber along with vitamins and minerals and can easily add excess calories, not ideal if you are trying to watch your weight. While blending can retain some of those nutrients and fiber, I still believe the best source of eating fruits and vegetables in their whole form. Nothing beats the taste of deep red juicy strawberries or crisp sugar snap peas so delicious you won’t want to share!

My go-to breakfast is plain greek yogurt mixed with a cup of sweet red cherries topped with 1/2 to 3/4 cup of bran cereal. My favorite snacks are a mix of fruits and vegetables to include juicy blood oranges, fresh strawberries, or cherry tomatoes so sweet they taste like candy. I walk to my corner market for fresh produce almost daily, this way I can incorporate vegetables easily into my meals… I’m not picky and usually choose produce in season for the best taste! If you are not close to a fresh market, keep frozen fruit and vegetables on hand to always have an option for incorporating into meals and snacks.

Tips to increase fruit and vegetable intake:

  • Add to breakfast – egg white omelet with onions, bell peppers, arugula, and tomatoes; add bananas or fresh berries to a bran cereal; mix fresh fruit in yogurt or in a low fat or fat free cottage cheese.
  • At mealtimes – add vegetables to sandwiches: lettuce, tomato, avocado, sprouts, cucumber, peppers, onion or olives; make half of your plate vegetables at mealtimes; choose a variety and incorporate many colors.
  • Incorporate as snacks – bell peppers, carrots, cucumber, broccoli or cauliflower dipped in hummus; apple and peanut butter or cheese sticks; celery and peanut butter.
  • During the summer, bring a refreshing fruit salad to a BBQ.
  • Always keep frozen fruit and vegetables on hand in case you run out of fresh.

Running for Weight Loss: What You Eat Counts

If your goal for lacing up your shoes and hitting the pavement is weight loss, the right foods and proper timing is very important. Skimping on meals or snacks to save calories will not only make you hungrier, but it will sabotage your weight loss efforts. It is important to create the calorie deficit and the right timing of meals and snacks will help avoid the cravings for junk food. Studies have shown skipping meals will cause you to eat more throughout the day. When your blood sugar drops, you start craving anything sweet. If you cave into the cravings, you can end up eating several hundred empty calories, i.e. foods that provide no nutrition benefit. Eating three meals with snacks throughout the day will help keep your blood sugar stable and reduce these unhealthy cravings.

The plate method to portion control is a favorite for setting up lunch and dinner in the right portions. What would you normally put in the largest area of a three-sectioned plate? Ninety percent of the time the answer is the meat or carbohydrate which is where the excess calorie intake occurs. The largest section, or half of your plate, should be non-starchy vegetables (starchy vegetables are potatoes, beans and corn); a quarter of your plate should be carbohydrate while the other quarter should be your protein. Setting up your plate this way, you are still eating volume from the vegetables, but eliminating excess calories. The vegetables provide vitamins, minerals and antioxidants your body needs along with fiber to help keep you full longer. If you are consuming a casserole or a pasta dish, always think of the vegetable. I recommend adding the vegetable to your plate instead of using a separate dish. This still gives the illusion of having a full plate while saving calories at the same time.

Fluid intake is also important not only in exercise but also in weight loss. If you are not consuming enough water you are hindering your exercise performance and you can also end up over eating – our bodies can confuse dehydration with hunger. When you think you may be hungry, think of how much water you’ve had for the day. The goal is to aim for 2 to 3 liters per day.

My favorite saying is “you can have all foods in moderation.” The key word being moderation; when you restrict yourself to the point of being miserable, your plan will not last. Diet and exercise come hand in hand in successful weight loss. You are already starting with the exercise piece by hitting the road, so complete the lifestyle change and incorporate a healthy diet at the same time! As you become more comfortable running and able to increase your mileage, your diet becomes even more important as the fuel for your training.

Healthy Breakfast Ideas (200 to 250 calories):

Fat Free Plain Greek Yogurt + ½ cup frozen fruit + ½ cup bran flakes

Mini whole wheat bagel + 1 tablespoon natural peanut butter (Substitute 1 tablespoon of PB2 in place of the peanut butter to save 60 calories)

3 egg white omelet (tomatoes, onion, spinach and 1-ounce of goat cheese) with ½ of an whole wheat English muffin and 1 tablespoon of jam

Snack Ideas (100 to 150 calories): Pair a carbohydrate and protein for a well rounded snack!

Apple + one low fat cheese stick (140 calories, 8 grams of protein)

Celery sticks + 1 Tbsp peanut butter (120 calories, 4 grams of protein)

Vegetables (sliced bell pepper, carrots, cucumber) + 2-oz hummus (130 calories, 6 grams of protein)

Homemade trail mix (raw nuts, dried fruit and bran cereal = 1 oz or the size of the palm of your hand)

Fat Free Greek Yogurt (100-140 calories, 15-18 grams of protein)