High-Protein Diets

The high-protein diet has become the corner stone of dietetics, both for its efficiency and for its ability to correct metabolic disorders.

The high-protein diet is aimed at reducing the ingestion of lipids and glucides, maintaining protein intake which keeps the nitrogenous balance stable. This compels the organism to consume its own reserves, first glucides and then lipids, resulting in specific weight loss in the accumulated fatty tissue deposits.

The high-protein diet requires the following of a strict nutritional plan where dos basic rules must be adhered to:

• The sole base of the diet is made up of high quality proteins.
• All sugars and fats should be excluded.

The reason for following these guidelines are:

We must be certain that we are losing fatty mass and not lean mass (muscle). In order to avoid protein consumption, a minimum intake of 1.2 to 1.5 gr. / kg of body weight, depending on sex, must be assured. This is why the proteins must be of the highest quality, with an excellent PER (Protein Efficiency Rating) and a chemical index above 100.

The human organism requires energy to perform its duties. A spontaneous source of energy is glycolysis, which goes through the Krebs cycle (citric acid cycle) and metabolises glucose to obtain energy. But our metabolism can only store a few hundred grams of glucose for an half a day of activity. If the ingestion of carbohydrates is omitted and the entire organism’s glucose consumed, no sugars remain to be burnt for energy. Therefore, the organism activates another form of obtaining energy, known as Beta oxidation: the body obtains energy from the accumulated fat in the organism.

Beta oxidation generates energy from the accumulated fat, but leaves a residue: ketone bodies that produce a state of ketosis: acetone or ketone bodies are the only substances in the organism with a “hunger-stopping” effect. 72 hours after starting the diet, the concentration of ketone bodies in the blood is high enough to obstruct hunger. Ketone bodies also have a psychostimulant effect that maximises the feeling of well-being.

Once Beta oxidation is initiated, accumulated energy is obtained from the accumulated fat provided that we are not including them simultaneously in the diet. To assure the burning of accumulated fat we must not take in carbohydrates or fats. Otherwise, the slimming process would be interrupted.

Stages of a high-protein diet

The high-protein diet is divided into three stages that include the association of a protein fast with an eating behaviour adjustment therapy to insure greater, long-term weight loss.

The high-protein diet consists of nutrition based on purified protein preparations, high in biological value with the progressive addition in time of vegetables, fruit and starches after phase 1 and with the additional help of micronutrients (minerals, essential fatty acids, vitamins and trace elements) to avoid diet-related deficiencies. The high-protein preparations are usually presented in a variety of formats and flavours made to satisfy the tastes and needs of each patient at all times throughout the day. These can be cold or hot chocolate, strawberry or vanilla flavoured drinks, high-protein bars, purées, soups and stews, bread, puddings, mousses, yoghurts, etc.

Stage 1: Corresponds to the catabolism of triglycerides (fats), begun by the fast.

A target weight loss is set and 80% of the loss will be programmed for this initial stage. The physician should prescribe the type of high-quality protein satchels to be taken by the patient as well as the exact intake of salt, calcium, potassium, vitamins and trace elements according to a preliminary clinical study.

Within the first stage, in the first weeks, the laboratory-based protein diet is complemented solely with vegetables. In the following weeks, two protein preparation-based meals a day are substituted by compound nutrients almost exclusively of meats, fowls or fish: 200 gr per meal.

This stage requires the patient to drink at least 2 litres of water per day.

In order to increase the basal metabolic rate, the patient must exercise every day (for example: a 30 minute walk).

Stage 2: Progressive reintroduction of the various food groups.

In this stage, weight loss continues by learning to eat better and by introducing nutrients such as fruit, bread and starches into the diet. It is normally structured in five levels that include the progressive inclusion of nutrients and the substitution of the protein preparations.

It is vital to follow the medical indications for the intake of nutrients and to progressively increase daily exercise.

This is the nutritional diversification stage. New foods will be consumed by the patient (fruit, bread, starches, etc.) whilst they continue to lose weight until a ponderal balance is reached.

Stage 3: Stabilisation, this is the most important stage to avoid recovering all the lost weight.

The intake of optimum quality high protein products should be in the mid-morning and afternoon tea. The physician should maintain contact with the patient to reinforce the most important dietary rules, such as:

• Starch intake only in one of the two main meals, which would greatly reduce the risk of snacking.
• Never skip a meal or the prescribed protein snack.
• Drink liquids that hydrate the body and avoid soft drinks such as cola and sugary juices.
• Get into the habit of eating with company, structuring meals in a traditional manner and not improvising. Always include a dish of raw or cooked vegetables, eat a little at a time, slowly, small spoonfuls and chew every mouthful thoroughly.

This is the moment to continue with the body’s reshaping by exercising, as its advantages are important both in the short and in the long term. Exercise aids in weight loss and maintains it, because:

In the short term:

• Increases the burning of calories through muscle movement.
• Increases the feeling of well-being.
• Diminishes mental tension and aids in improving sleep.
• Activates circulation.

In the long term:

• Increases the muscle mass that consumes energy even when resting.
• Aids in the prevention or improvement of metabolic disorders (cholesterol, diabetes, etc.).
• Aids cardiovascular protection and the development of breathing capacity.
• Provides a harmoniously aesthetic figure.
• Aids in “reconciling” with one’s body imaga.

The high-protein diet will always be successful if the rules are followed. The average weight loss for a male on a high protein diet in a period of 28 days is 10 kg and between 7 and 9 for a female.

The advantages of a high protein diet versus other diets are:

• Fast weight loss, 3 to 4.5 kg in the first week and 2 kg on average in the following weeks of the first stage or the Active Stage.
• Through fat loss and not muscle.
• No sensation of hunger.
• No sensation of depression, weakness or lack of vitality.
• Skin tone is protected due to conservation of muscle mass.
• It is a safe method as it must always be carried out under medical supervision.

The physician may need to run tests to measure the percentages of water, fat and muscle in the body throughout all the stages. Other more precise diagnostic techniques may also be needed such as tomographs or magnetic resonance.

The metabolic benefits of a high-protein diet are:

• Adjustment of pancreas functioning. An alteration in insulin secretion is always present with weight gain. The ingestion of carbohydrates (glucides) makes the pancreas produce insulin that carries glucose to the cells to produce energy. But this causes burning of glucose and not accumulated fat, aiding the build up of fat and therefore causing weight gain.
• Reduction of blood-sugar levels in the first week of treatment.
• Reduction of insulin-resistance problems and improvement of diabetes control parameters (blood-sugar and glycosylated haemoglobin).
• Extreme reduction of total cholesterol levels between 5 and 25% and lowering of the LDL and triglycerides of 15 to 50%. Thus increasing the “good” HDL cholesterol.
• Blood pressure in obese hypertense people is lowered by 8 to 13% in the first week of dieting. In order to reduce the risk of heart disease, approximately 5% of the initial weight must be lost.
• Reduction of sleep apena.
• Improvement of breathing pathologies, osteoarticular disorders and lypodistrophy.

The side effects that can be corrected by the physician are:

• Halitosis from a state of ketosis that produces a peculiar bad breath due to oxidation of free fatty acids in the liver it can be concealed with sprays.
• Constipation, which the physician can regulate with a suitable fibre intake.
• Hypotension, due to dehydration that can be controlled by the physician with an appropriate supply of sodium.
• Muscle cramp due to a lack of potassium that can be corrected by the physician.
• Hair loss that the physician can control with an appropriate supply of trace elements.
• Migraines, associated to the increase of ketone bodies and which usually subsides 48 to 72 hours after starting the diet.
• Orthostatis hypotension that can be caused by:
  • Sodium loss.
  • Glycogen degradation, a hyperhydrated substance.
  • Urine el elimination of ketone bodies that consume positive ions such as sodium.
  • An adrenergic response from the slowed down sympathetic nervous system.

Orthostatic hypotension can be controlled by and adequate balance of sodium that is fundamental to patient comfort in high-protein diets.

Menstrual disorders may occur due to the alteration of oestrogen synthesis shared by the ovaries and the fat. When considerable weight loss takes place in any type of diet, there is always an adjustment period where the ovaries adapt and increase oestrogen production to accommodate and organism with a lower rate of adipose tissue.

Contraindications of a high-protein diet:

• Kidney failure, high protein intake is not recommended.
• Liver disorders, 60% of the free fatty acids are metabolised in the liver during a high-protein diet.
• Hyperuricemia, this is only partially contraindicated as it decreases the elimination of uric acid in the renal tube through rivalry with ketone bodies. Nevertheless, this is spontaneously regulated in the 3rd week.
• Psychiatric Disorders.
• The use of diuretics that involve a loss of potassium (hydrochlorothiazide, furosemide, spironolactone and triamterene).
• Minors under the age of 18 (the metabolic needs at this age is too high and growth could be affected) and people over 65 (ketone diets accelerate the habitual proteolysis suffered at that age).
• Neoplasic disorders, as they greatly increase proteolysis.
• Heart failure, the hypovolemia caused by dehydration could trigger cardiovascular incidents.
• Addison’s disease.
• Cerebrovascular accidents, the hypovolemia could trigger a new stroke through the decrease in perfusion.

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