Your Protein Prescription with Courtney Kozischek, RD

Know When You're Consuming Too Much, Too Little and the Best Sources

Based on data spanning 2021 to 2023 from the Centers for Disease Control and Prevention (CDC), obesity affects an estimated 40.3 percent of adults in the United States — a figure representing over 100 million individuals.

That in mind, a ton of people are on the weight loss bandwagon. Weight loss, especially when rapid (often seen with the increasing use of GLP-1 medications), can lead to muscle loss, which may indicate insufficient protein intake. On the other hand, diets excessively high in animal protein — common among meat lovers — lead to high cholesterol and even strain the kidneys (if a known kidney condition exists). 

To better understand the role of protein, we spoke with WakeMed dietitian Courtney Kozischek, RD, about the benefits of adequate protein consumption, the signs of both deficiency and excess and the best sources for optimal health.

Protein builds and repairs tissue. 

Protein boiled down to its simplest form is amino acids. Amino acids make up our proteins and are used beneficially throughout the body, including for tissue repair and tissue development. When we are injured or have a tear, amino acids will rebuild that tissue.

Protein supports muscle growth and strength. 

Protein also helps with muscle growth. When we work out, especially when weightlifting, we're creating microscopic muscle tears. Following a workout, protein helps to repair these tears and promote muscle growth. If we are not consuming enough protein, while trying to build muscle mass, it's more difficult to build it in a significant way.

Protein helps regulate metabolism. 

Protein can help increase our caloric expenditure, helping our metabolism. Protein takes a lot of energy for the body to break down compared to carbohydrates and fat. Since our bodies are putting in more work, revving the engine harder to break down the proteins we're consuming, it boosts our caloric expenditure, boosting our metabolism as well.

Protein helps with satiety and appetite control. 

When we consume a high protein meal or snack, our hunger hormones decrease, and our satiety hormones increase. This happens each time we eat, but more significantly with high protein meals. It helps with that feeling of fullness. This, in turn, helps with feeling full and not overeating at mealtime. Protein also keeps us fuller longer, minimizing excessive snacking during the day.

Protein supports immune function. 

Amino acids are the building blocks of proteins, which perform a wide range of vital functions in the body, including fighting infections. Antibodies, which are proteins produced by the body to protect against illness, also play a crucial role in combating disease.

Protein promotes blood sugar control. 

Protein slows digestion helping to prevent a blood sugar spike after a meal or snack. Most of us have protein with our meals but find it more difficult to incorporate protein with snacks. Having a protein-rich snack can help with blood sugar stability. Power combo snacks incorporate a protein source with a carbohydrate source. Example power combos include apples (carbohydrates) with peanut butter (protein/fat) or raw veggies (carbohydrate) with hummus (protein). The options are endless! 

Protein maintains fluid balance. 

Protein plays a crucial role in maintaining fluid balance within our bodies. Circulating in the bloodstream, proteins act as sponges, attracting and holding water. This helps to keep the right amount of fluid in our blood vessels and tissues. Without enough protein, fluid can leak out of the blood vessels and into the surrounding tissues, leading to swelling, particularly in the ankles and feet. Therefore, adequate protein intake is essential for helping to prevent edema and ensuring proper fluid distribution throughout the body.

Protein provides energy. 

Proteins can be broken down for energy. If there's not enough carbohydrates in our system, then we can use proteins for fuel. While our bodies don't prefer protein for energy, proteins are very filling, and they keep us full longer throughout the day, giving us sustained energy.

Animal proteins are healthy in moderation. 

To maintain a delicate balance, lean animal proteins are best:

• Chicken breast
• Skinless chicken thighs
• Pork tenderloin, boneless thin pork chops
• 93/7 or 97/3 percent ground meat (turkey, chicken, beef, pork)
• Fish and seafood (non-fried)
• Lean cuts of red meat (eye of round/top round steaks, sirloin steak)
• Game meat – venison, bison, etc.  
• Low-fat dairy products (one to two percent milk, Greek yogurt, cottage cheese)
• Eggs and egg whites  
   

Some animal proteins should be limited. 

Occasionally consuming a high-fat cut of meat is fine, but we should generally be mindful of how often we eat these:

• Steak
• Roast (beef and pork)
• Heavy cuts of pork
• Fried meats 

Numerous plant-based proteins are available. 

Easily accessible, high-quality proteins are found in plant-based foods.

Here are some options:

• Beans, lentils, peas.
• Tofu, tempeh, edamame (soy based)
• Nuts and seeds
• Some whole grains (Quinoa, oatmeal, kamut, amaranth, farro, buckwheat, etc.)

Numerous options are available for those who prefer to consume vegetarian or vegan proteins.

Commercial protein is an option. 

Protein powders, bars and shakes can be a great tool, especially if we have a high protein need. These might include bariatric patients, patients using weight loss medications and those with low appetites.

Yet, natural protein sources, whether from lean meats, low-fat dairy or plant-based are preferable since they have a lot of other good nutrition in them. That said, it's fine to use powders, bars and shakes as tools, but it's great to consume natural protein sources for the added benefits as well.

Adequate protein consumption is critical. 

The basic recommended dietary allowance (RDA) for protein is 0.8 grams per kilogram of body weight.

For those who are 18 years or older, generally healthy and not trying to gain muscle or lose weight, hitting that 0.8 gram per kilogram goal should be fine. Essentially, a quarter of our plate should be proteins. 

For those seeking to gain muscle or lose fat, protein needs increase dramatically. For weight loss, protein needs can rise as high as 1.8 grams per kilogram of ideal body weight.

For weight gain and muscle growth, protein needs can range from 1.6 to 2.2 grams per kilogram of ideal body weight. For all of these conditions — weight loss, muscle gain or weight gain — people may require higher protein. 

Different medical conditions, such as injury, illness and burns also require higher protein. Pregnancy and lactation require more protein. Also, children need more protein on average for growth and development.

Inadequate protein has clear signs.

Muscle loss is one of the main signs of inadequate protein intake and can be evidenced by reduced strength, general weakness, and notable decrease in muscle size. With weight loss clients, it is important to have adequate protein in the diet.

Brittle nails and hair loss are another sign. Nails and hair are made of a lot of proteins. When not intaking enough, nails can become very brittle. Hair can start falling out or thinning. 

Overconsumption of protein can have negative consequences. 

Sometimes when we begin to fill our bodies with high amounts of protein, we develop constipation. In this case, it can be helpful to cut back on animal-based proteins, i.e., meats and heavy dairy products like butter or heavy cream. Opting for more plant-based proteins can help with constipation since they have more fiber. Of course, if constipation is driven by another condition, it is always good to talk to your doctor or gastroenterologist for further guidance. 

High cholesterol can be genetic, but it can also be driven by a diet high in high fat animal-based proteins. In this case, choosing leaner animal proteins and plant-based options may help lower cholesterol levels over time. 

Remember these protein takeaways.

Protein plays a vital role in numerous bodily functions, from building and repairing tissues to producing enzymes and hormones. Incorporating sufficient protein into our daily diet is crucial for maintaining optimal health. It's not just about consuming protein, but also about consuming the right amount and types. We need to be proactive in ensuring we meet our individual protein requirements, considering factors, such as age, activity level and overall health status. This involves understanding our own protein needs and strategically planning meals to fulfill them. Also, it's essential to be mindful of potential imbalances. Consuming too little protein can lead to muscle loss, weakened immunity and fatigue, while excessive intake may strain the kidneys and contribute to other health problems. Paying close attention to how our body reacts to different protein levels and sources is key to safeguarding our overall well-being.

Schedule an appointment with WakeMed Nutrition Services to learn more.

About Courtney Kozischek, RD

Courtney Kozischek is a CPR-certified, registered dietitian with clinical interests in diabetes, healthy eating, sports nutrition and weight-inclusive nutrition care. She earned her bachelor's degree from Appalachian State University in Boone, NC. She went on to complete a master's degree at Meredith College in Raleigh, NC.

Kozischek believes food is very personal and that nutrition should be individualized to meet each person's specific needs. Healthy eating and exercising navigate people on lifelong journeys best traveled one step at time employing small, attainable goals. She also believes it is important to establish a positive relationship with food and understand that food is not only fuel for the body, but it is also tradition, culture, comfort and natural medicine.

When not working, Kozischek enjoys rollerblading, weightlifting, spending time with friends and family and baking cookies.