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Protein
Principles for Diabetes |
by:
Protica
Research |
Dietary
considerations can present a Hobson’s choice
in diabetes. Even when the intake is nutritious,
assimilating it can be another matter. Then
there is the problem of progression of diabetic
complications if one ends up with excess
glucose or fat in the system. Excess carbohydrates
in a meal, and the resulting uncontrolled
blood sugar levels can be detrimental to
any number of tissues, from the lens of
the eye, to the neurons, small blood vessels
and the kidneys. Fat is also a problem with
increase incidences of atherosclerosis,
large vessel disease and cardiac complications.
What, then is the appropriate macronutrient
for the diabetic population? Enough medical
literature exists to suggest that in diabetes,
proteins are probably the best bet.
Proteins are the natural choice of the body
when faced with diabetes. In uncontrolled
diabetes, muscle protein is broken down
into amino acids to be converted into glucose
by the liver. If left to fend for itself,
this can create a commotion within the body.
Since proteins have to supply enough energy
to substitute for carbohydrates, proteins
are broken down faster than they are made.
The body ends up with a protein deficit,
a situation with subtle, yet far-reaching
effects on normal body functions. Importantly,
for diabetics, a protein deficit has been
shown to impair resistance to infections
(Ganong WF). Replenishing the depleting
protein stores is a vital requirement of
all diabetic diets.
Importance of proteins in a diabetic has
been well documented. The American Associations
of Clinical Endocrinologists have made it
clear that not much evidence exists to indicate
that the patients with diabetes need to
reduce their intake of dietary proteins.
The AACE recommends that 10-20% of the calorie
intake in diabetes should come from proteins
(AACE Diabetes Guidelines). It is in fact
believed that this is one nutrient that
does not increase blood glucose levels in
both diabetics and healthy subjects (Gannon
et al).
Nutrition therapy for diabetes has progressed
from prevention of obesity or weight gain
to improving insulin’s effectiveness and
contributing to improved metabolic control
(Franz MJ). In this new role, a high protein
diet (30% of total food energy) forms a
very pertinent part of nutrition therapy.
One of the most important causes for type
II diabetes is obesity. Excess body fat
raises insulin resistance and higher levels
of insulin are required to bring down blood
sugars as the weight increases (Ganong WF).
Another problem with excess fat is the clogging
of arteries with atherosclerotic plaques
that is responsible for a wide range of
diabetic complications. Any mechanism that
reduces body fat decreases insulin resistance
and improves blood glucose control. Parker
et al have also shown that a high protein
diet decreased abdominal and total fat mass
in women with type II diabetes. Other studies
by Gannon et al. and Nuttall et al have
verified that blood glucose levels and glycosylated
hemoglobin (a marker of long term diabetic
control) reduce after 5 weeks on a diet
containing 30% of the total food energy
in the form of proteins and low carbohydrate
content. It is speculated that a high protein
diet has a favorable effect in diabetes
due to the ability of proteins and amino
acids to stimulate insulin release from
the pancreas. Thus, a high protein diet
is not only safe in diabetes, but can also
be therapeutic, resulting in improved glycemic
control, and decreased risk of complications
related to diabetes.
The benefits of a high protein diet do not
end here. Individual protein components
of such a diet, when aptly chosen, can have
other advantages as well. Dietary supplements
containing proteins like whey and casein
come highly recommended. Casein is a milk
protein and has the ability to form a gel
or clot in the stomach. The ability to form
this clot makes it very efficient in nutrient
supply. The clot is able to provide a sustained,
slow release of amino acids into the blood
stream, sometimes lasting for several hours
(Boirie et al. 1997). A slow sustained release
of nutrients matches well with the limited
amount of insulin that can be produced by
the pancreas in diabetes. A protein supplement
containing casein can thus increase the
amount of energy assimilated from every
meal and, at the same time, reduce the need
for pharmacological interventions to control
blood sugar.
Whey proteins and caseins also contain “casokinins”
and “lactokinins’, (FitzGerald) which have
been found to decrease both systolic and
diastolic blood pressure in hypertensive
humans (Seppo). In addition, whey protein
forms bioactive amine in the gut that promotes
immunity. Whey protein contains an ample
supply of the amino acid cysteine. Cysteine
appears to enhance glutathione levels, which
has been shown to have strong antioxidant
properties -- antioxidants mop up free radicals
that induce cell death and play a role in
aging.
Thus, development of a protein supplement
containing casein and whey can provide an
apt high protein diet and its health benefits
to individuals suffering from diabetes,
obesity and hypercholesterolemia.
ABOUT PROTICA
Founded in 2001, Protica, Inc. is a nutritional
research firm with offices in Lafayette
Hill and Conshohocken, Pennsylvania. Protica
manufactures capsulized foods, including
Profect, a compact, hypoallergenic, ready-to-drink
protein beverage containing zero carbohydrates
and zero fat. Information on Protica is
available at http://www.protica.com
You can also learn about Profect at http://www.profect.com
Copyright - Protica Research - http://www.protica.com
REFERENCES
The American Association of Clinical Endocrinologists.
Medical guidelines for the management of
diabetes. AACE Diabetes Guidelines, Endocr
Pract. 2002; 8(Suppl 1).
Boirie, Y., Dangin, M., Gachon, P., Vasson,
M.P., Maubois, J.L. and Beaufrere, B. (1997)
Slow and fast dietary proteins differently
modulate postprandial protein accretion.
Proclamations of National Academy of Sciences
94, 14930-14935.
Counous, G. Whey protein concentrates (WPC)
and glutathione modulation in cancer treatment.
Anticancer Research 2000; 20, 4785-4792
FitzGerald RJ, Murray BA, Walsh D J. Hypotensive
Peptides from Milk Proteins. J. Nutr. 134:
980S–988S, 2004.
Franz MJ. Prioritizing diabetes nutrition
recommendations based on evidence. Minerva
Med. 2004; 95(2):115-23.
Gannon et al An increase in dietary protein
improves the blood glucose response in persons
with type 2 diabetes. Am J Clin Nutr 2003;
78:734– 41.
Gannon MC, Nuttall J A, Damberg G. Effect
of protein ingestion on the glucose appearance
rate in people with type II diabetes. J
Clin Endocrinol Metab 86: 1040–1047, 2001
Ganong W F. Review of Medical Physiology,
21st Ed. Lange Publications 2003
Ha, E. and Zemel, M.B. Functional properties
of whey, whey components, and essential
amino acids: mechanisms underlying health
benefits for active people. Journal of Nutritional
Biochemistry 2003; 14, 251-258.
Kent KD, Harper WJ, Bomser JA. Effect of
whey protein isolate on intracellular glutathione
and oxidant-induced cell death in human
prostate epithelial cells. Toxicol in Vitro.
2003; 17(1):27-33.
Nuttall et al. The Metabolic Response of
Subjects with Type II Diabetes to a High-Protein,
Weight-Maintenance. J Clin Endocrinol Metab
88: 3577–3583, 2003
Parker et al. Effect of a High-Protein,
High–Monounsaturated Fat Weight Loss Diet
on glycemic Control and Lipid Levels in
Type 2 Diabetes. Diabetes Care 25:425–430,
2002.
Seppo, L., Jauhiainen, T., Poussa, T. &
Korpela, R. () A fermented milk high in
bioactive peptides has a blood pressure-lowering
effect in hypertensive subjects. Am. J.
Clin. Nutr. 2003; 77: 326–330.
Unger RH. Glucagon physiology and pathophysiology.
N Engl J Med. 1971; 285:443– 449.
About the author:
About Protica
Founded in 2001, Protica, Inc. is a nutritional
research firm with offices in Lafayette
Hill and Conshohocken, Pennsylvania. Protica
manufactures capsulized foods, including
Profect, a compact, hypoallergenic, ready-to-drink
protein beverage containing zero carbohydrates
and zero fat. Information on Protica is
available at http://www.protica.com
You can also learn about Profect at http://www.profect.com
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