Jacqui Lewis - BHSc Nutritional and Dietetic Medicine
Spotting Protein Deficiency & What to Do About Prevention
Protein is an essential part of our daily food intake. Whether you had a gastric sleeve or gastric bypass, you will definitely find that the buzzword will be protein following these restrictive procedures. You'll need to start thinking about food in a different way than you might ever have done before.
Protein is an essential part of so many crucial functions in the human body:
Muscle maintenance, making hormones, making neurotransmitters for your brain and muscles to function well, as well as protecting immunity, to name just a few.
- Red Meat
- Dairy Foods
- Beans and Legumes
There are two types of protein; complete and incomplete - complete proteins come from animals, and incomplete almost always come from plants. These need to be considered when you map out your food plan to meet your needs for all amino acids (smaller units derived from protein).
Whilst collagen powder is a trendy protein supplement in the WLS community - it's an incomplete protein. It's pertinent to note that collagen powder should be considered - a top-up - not a replacement for good food.
What is Protein Deficiency?
It’s when your intake of protein does not meet your needs every day. Protein has many vital roles in the body. A range of health issues can arise when there is a deficiency, such as loss of muscle tissue, weakness and feeling unstable on your feet, and impaired immune function (critical at this point).
Severe impacts of protein deficiency can result in a condition known as Sarcopenia - or loss of function and strength and displacement of muscle tissue with fat. It can lead to physical disability, poor quality of life and death.
Protein malnutrition can become visible as it starts to slow the growth of hair, skin and nails. In obese patients with malabsorption and malnutrition, hair loss, splitting or thin nails, and legs and arms are "skinny" whilst the abdominal area is still plump.
Weight loss surgery is implemented to decrease some absorption of nutrients and calories from food to support weight loss. However, bariatric patients need to be aware that the requirements for protein and some vitamins and minerals are increased.
So how much Protein do you Need Every Day?
The standard recommendation for those who have had bariatric procedures is 60-80g / day.
However, the research continuing into best outcomes for obese patients is slowly showing that this is an underestimate.
During the rapid weight loss phase, it is critical to meet your needs for protein to ensure you are losing fat, not muscle tissue, and along the WLS journey. It will be your daily protein intake that helps protect you from weight regain. Your protein target also depends on your level of activity - so those who are lifting weights, looking to build muscle would be looking more toward 1.2g - 1.4g protein per kilo of your ideal weight every day.
Fitting this much protein can be a juggle with a tiny tummy, so working out your meals in advance is the key to your success. Remember that protein plays a huge part in fat loss and muscle gain when you are looking to change your body composition.
Signs of Protein Deficiency
Thinning hair, brittle nails and skin conditions,
as mentioned above, protein is an essential building block of our "integumentary system".
When these signs are present, other systems have struggled for a while due to protein deficiency. Therefore, action should be taken swiftly in bariatric patients. Some patients will need to rely on protein supplementation to help accommodate the amount of protein required after restrictive surgery.
A lack of protein can become evident when we feel extra "saggy" and "floppy". After such malabsorptive procedures, some patients can feel like they're just saggy skin and bone if there is not enough muscle tissue retained to keep them feeling strong and healthy. As a result, some people feel unsteady on their feet or experience falls, increasing the risk of falls and fractures.
Protein also plays a massive role in appetite control and increases certain hormones that tell your brain you have had enough to eat.
Research has shown that eating protein at breakfast can reduce the number of calories consumed for the rest of the day by up to 80%!!!
Getting the protein-rich breakfast habit manages hunger and sweet cravings in the afternoon and evening. If you are suddenly feeling hungry between meals, or overall unsatisfied, it is likely your carbs have snuck back in and are promoting snacking and hunger throughout the day.
Trouble falling asleep and staying that way could mean protein deficiency; research has shown that protein intake lower than 20% of calories impacts sleep quality and difficulty falling asleep.
Loss of precious muscle tissue will leave you feeling weak and tired as your strength diminishes.
This is a risk anytime but is exacerbated in the rapid loss phase.
It’s mainly a low activity level, and food can be hard to accommodate as you recover from the weight loss surgery.
What is the Effect on Health Overall?
When you continually lack the correct protein level in your diet after surgery, you can expect to see:
- Decreased Metabolism, which can result in weight regain over time.
- Compromised Immune System Frequent colds, cold sores, coughs, and other infections such as regular Urinary Tract Infection, Candida, or yeast overgrowth and itching skin rashes become hard to heal.
- Mood Swings Many of the neurotransmitters that maintain a healthy mood, such as Serotonin, GABA, and Dopamine, are made from the single units of protein called amino acids. So a regular lack of protein in your diet after Sleeve Gastrectomy, or Gastric Bypass, can make you feel relatively low and depressed if left unchecked.
What Can Be Done?
- Familiarise yourself with protein-rich foods and include them at every meal and snack to keep you fighting fit after any bariatric procedure
- Exercise regularly and include resistance training to help build muscle.
- If you are having trouble meeting your needs with food, add a protein supplement or meal replacement to ensure you are reaching 2-25g protein at each mealtime and about 10-15g at each snack.
BHSc Nutritional and Dietetic Medicine