Diabetes Spectrum. The number of people worldwide with type 2 diabetes is expected to double by 2. In the United States, diabetes affects ~ 2. Despite the availability of a wide range of pharmacological treatments and the best efforts of diabetes educators and other health care professionals, good control of diabetes and its comorbidities remains elusive for much of the population, as evidenced by rates of cardiovascular morbidity and mortality that are two to four times higher than those of people who do not have diabetes. Although dietary habits and body weight play undisputed roles in type 2 diabetes, the question of what eating pattern best addresses glycemia, cardiovascular risk factors, and weight control remains controversial. The uniform, calorie- controlled diabetic diet plans of the past have been replaced by individualized meal- planning approaches, and in more recent years, nutrition guidance has focused on carbohydrate counting and minimizing saturated and trans fats. With the release of the U. S. Department of Agriculture's 2. Dietary Guidelines for Americans. Individuals following a plant- based eating pattern typically consume fewer calories and less fat, saturated fat, and cholesterol and have lower BMIs than nonvegetarians. They also consume more fiber, potassium, and vitamin C. In prospective studies of adults, compared to nonvegetarian eating patterns, vegetarian eating patterns have been associated with lower prevalence rates of type 2 diabetes,4 cardiovascular disease (CVD),5 hypertension,6 and obesity. Both the American Academy of Nutrition and Dietetics and the American Diabetes Association (ADA) now include well- planned, plant- based eating patterns (vegetarian and vegan) as a meal- planning option in their nutrition recommendations for people with diabetes. This article provides a brief discussion of research on plant- based eating patterns, relevant nutrition issues, and practical applications for clinicians. Prevention of Type 2 Diabetes. Diabetes prevalence in the United States is lower among vegetarians than nonvegetarians. Most vegetarian diets are low in or devoid of animal products. Treatment of Type 2 Diabetes. Plant-based eating patterns combined with exercise have been found to improve diabetes control and reduce the need for medication in. Get your career in nursing started with an online nursing degree. Find out what nursing schools in your area offer online courses and what programs will provide you. In two large Adventist cohort studies (n = 2. Part of the difference is attributable to higher body weight among nonvegetarians, but much of the difference persists after adjustment for body weight. A 2. 00. 9 study. Data from the Harvard Women's Health Study, the Nurses' Health Study, the Health Professionals Follow- Up Study, and other trials were part of a systematic review. Intake levels of red meat, processed meat, and fish were all associated with risk of type 2 diabetes. These studies suggest that the total amount of meat consumed may be more important than the type of meat. Treatment of Type 2 Diabetes. Plant- based eating patterns combined with exercise have been found to improve diabetes control and reduce the need for medication in intervention trials as far back as 1. A more recent study. National Institutes of Health set out to examine the effect of a plant- based eating pattern isolated from the effect of exercise on type 2 diabetes. This prospective, randomized study compared 4. GI), vegan (legumes, fruits, vegetables, and whole grains) diet to a control group of 5. ADA's 2. 00. 2 nutrition principles and recommendations. Those recommendations included the following energy intake distribution and cholesterol levels: carbohydrate and monounsaturated fat together should provide 6. All participants were instructed not to modify their exercise habits during the intervention period. Both groups experienced improvements at 2. However, among medication- stable participants after 2. P < 0. 0. 01) and a greater reduction in A1. C (1. 2. 3 vs. 0.
P = 0. 0. 1). Medication- stable participants in the vegan group lowered their LDL cholesterol levels by an average of 2. P = 0. 0. 2). Although medication changes were not a goal of the study, requirements for medication also dropped; 4. After 7. 4 weeks, improvements in glycemia and plasma lipid concentrations remained greater in the vegan group. An assessment was conducted of the nutrient intake and dietary quality of participants in the two arms of the study described above. Using Harvard School of Public Health's Alternative Healthy Eating Index (AHEI), a nine- component dietary quality index that predicts the risk of cardiovascular and other major diseases,2. Turner- Mc. Grievy et al. The vegan group increased intake of fruits and vegetables, soluble and insoluble fiber, and several micronutrients and demonstrated improvements in AHEI score in all categories. The AHEI score for those in the conventional diet group remained unchanged. The study found that those in the vegan arm consumed adequate vitamin B1. The authors concluded that both groups had difficulty meeting the recommended intake levels for vitamins D and E, calcium, and potassium and consumed excessive sodium, although less than at baseline. CVD Prevention and Treatment. Low- fat, plant- based eating patterns have shown efficacy in reducing LDL cholesterol concentrations and result in significant reductions in CVD risk and cardiovascular events. Appleby et al. 6 studied hypertension across a range of eating patterns and found that blood pressure control was inversely proportional to the amount of animal products consumed, with those abstaining from all animal products achieving the most significant improvements. In a review of 2. Ferdowsian et al. LDL cholesterol by 2. Ornish et al. 2. 6 effectively used a low- fat (1. Multicenter Lifestyle Demonstration Project (MLDP) clinical trial demonstrating reversal of heart disease. The MLDP included a subset of people with diabetes (n = 5. Long- Term Weight Loss. In observational studies, vegetarians and vegans are slimmer than nonvegetarians. When vegetarian and vegan eating patterns are used in clinical trials, they elicit significant weight loss. Importantly, weight loss occurs in the absence of intentional calorie restriction (providing an obvious benefit with regard to facilitating adherence), even when exercise regimens remain constant. Clinical trials show that weight loss achieved in short- term interventions is partially sustained over the longer term. In a study. 8 of overweight postmenopausal women who began a low- fat, vegan diet without added exercise as part of a 1. Median net weight reduction was 4. National Cholesterol Education Program (NCEP) guidelines. Among individuals with CVD, a lifestyle program including a low- fat, vegetarian diet and mild exercise was associated with a net weight loss of 1. Mechanisms: Why Does It Work? Three biological factors may explain why a low- fat, plant- based eating pattern is effective for glycemic control. First, foods from plants contain less total and saturated fat, resulting in reduced caloric intake, weight loss, and improved A1. C levels. 2. 1 Second, independent of weight loss, a low- fat, plant- based diet improves insulin sensitivity,3. As insulin sensitivity improves, carbohydrate tolerance increases. Third, participants in the diabetes studies by Barnard et al. GI carbohydrates and limited high- GI foods, which has been shown to be beneficial in other studies. Translating Research into Practice. Clinicians may agree that plant- based eating patterns are effective for weight loss, glycemic control, and reduced cardiovascular risk but believe that this approach is too difficult for their patients to follow. Indeed, meat and dairy are now commonly consumed for breakfast, lunch, and dinner in the United States across a wide range of ethnic and socioeconomic groups, and a shift to plant- based food choices from current eating patterns represents a significant dietary change for many. This section will review research on the acceptability of a plant- based eating pattern and present ideas on how to effectively incorporate instructions for following it into clinical practice. Acceptability research. Nutrition researcher Neal Barnard, MD, has extensively studied adherence to and acceptability of plant- based eating patterns compared to other therapeutic eating patterns. In quantitative comparisons in which individuals beginning vegan eating patterns rate several parameters of acceptability (e. NCEP3. 6 and ADA3. Furthermore, beneficial outcomes were achieved without requiring participants to limit unrefined or minimally refined carbohydrates or to adhere to a fixed daily caloric intake, which may have improved adherence. A University of Pittsburgh survey. Practical applications for clinicians. After assessing a patient's current eating pattern and readiness for change, a clinician could state, “Studies have shown there are many health benefits when individuals eat fewer meat and dairy products.” If true, it is also helpful to say, “I have seen people in this practice improve their diabetes control by avoiding. Follow with the question, “Would you like to know more about this meal- planning approach?”Figure 1: The Power Plate. The Power Plate is a useful plant- based nutrition educational tool. This diagram consists of four food groups: fruits, vegetables, legumes, and grains. It was created by the Physicians Committee for Responsible Medicine in 2. Additional information is available online at www. The. Power. Plate. A visual aid, such as The Power Plate (Figure 1; available online from www. The. Power. Plate. Diet and Diabetes: Recipes for Success” (available online for download at http: //www. Table 3. Principles of a Low- Fat, Plant- Based Eating Pattern. In the authors' experience, it is not unusual to find that patients have some familiarity with this eating pattern, perhaps through hearing about famous vegan athletes, celebrities, or politicians, or they may have a son or daughter who has been encouraging them to try it, or they have tried it themselves in the past. Sometimes, just validation from a health care professional that plant- based eating is effective, along with useful educational resources, provides the impetus to give it a try. Table 1 provides a sample 3- day menu. Table 2 provides a grocery list. Veganism - Wikipedia. As per The Vegan Society, which coined the term, . Likewise, it rejects the commodity status of animals. A vegan (pronounced. VEE- g. Likewise, those who follow a plant- based diet only for environmental reasons are not vegan; veganism entails concern for animals. In addition to this essential basis, vegans can also have other reasons besides opposing animal cruelty, such as health and/or environmental concerns. However, new terms have been created in recent years in an attempt to include non- vegan lifestyles in the definition of . Dietary vegans (or strict vegetarians) refrain from consuming animal products, not only meat but also eggs, dairy products and other animal- derived substances. At first he used it to mean . More vegan stores opened, and vegan options became increasingly available in supermarkets and restaurants in many countries. In Massachusetts Amos Bronson Alcott, father of the novelist Louisa May Alcott, opened the Temple School in 1. Fruitlands in 1. 84. The Vegetarian Society .. Wheldon's No Animal Food: Two Essays and 1. Recipes, was published in London in 1. There were regular discussions about it in the Vegetarian Messenger; it appears from the correspondence pages that many opponents of veganism came from within the vegetarian community. This lent support to the vegan position, although Gandhi himself drank goat's milk. This became the predominant view of the Vegetarian Society, which in 1. When the request was turned down, Donald Watson, secretary of the Leicester branch, set up a new quarterly newsletter in November 1. They suggested allvega, neo- vegetarian, dairyban, vitan, benevore, sanivores and beaumangeur. Those in attendance were Donald Watson, Elsie B. Henderson, Alfred Hy Haffenden, Paul Spencer and Bernard Drake, with Mme Pataleewa (Barbara Moore, a Russian- British engineer) observing. Henderson, and Aids to a Vegan Diet for Children by Kathleen V. In 1. 94. 7 Watson wrote: . Jay Dinshah founded the American Vegan Society (AVS), linking veganism to the concept of ahimsa, . Mc. Dougall, Michael Greger and biochemist T. Colin Campbell, argued that diets based on animal fat and animal protein, such as the Western pattern diet, were detrimental to health. Dean Ornish's Program for Reversing Heart Disease (1. Articles on veganism were viewed more during this period than articles on vegetarianism in the English, French, German, Portuguese, Russian and Spanish Wikipedias.! Food declared that it had become . According to the latter, 7. Dietary vegans might use animal products in clothing (as leather, wool, and silk), toiletries and similar. Vegans reject the commodification of animals. Some of these are chemical compounds that can be derived from animal products, plants, or petrochemicals. Allantoin, lactic acid, retinol and squalene, for example, can be vegan. These products and their origins are not always included in the list of ingredients. They avoid certain vaccines; the flu vaccine, for example, is usually grown in hens' eggs, although an effective alternative, Flublok, is widely available in the United States. Non- vegan items acquired before they became vegan might be donated to charity or used until worn out. Some vegan clothes, in particular leather alternatives, are made of petroleum- based products, which has triggered criticism because of the environmental damage involved in their production. Ethical vegans avoid them on the premise that their production causes animal suffering and premature death. In egg production, most male chicks are culled because they do not lay eggs. Female calves are separated from their mothers within 2. Male calves are slaughtered at birth, sent for veal production, or reared for beef. Tofu comes in a variety of textures, depending on water content, from firm, medium firm, and extra firm for stews and stir- fries; to soft or silken for salad dressings, desserts, and shakes. Soy is also eaten in the form of tempeh and texturized vegetable protein (TVP); also known as textured soy protein (TSP), the latter is often used in pasta sauces. Almond milk is lower in dietary energy, carbohydrates and protein. Babies who are not breastfed may be fed commercial infant formula, normally based on cows' milk or soy. The latter is known as soy- based infant formula or SBIF. The recommendation is three or more servings a day of fruit (one of them high in vitamin C, such as citrus fruit, melon or strawberries); two or more of protein- rich legumes (such as soybeans, which can be consumed as soy milk, tofu or tempeh); five or more of whole grains (corn, barley, rice and wheat in products such as bread or cereal); and four or more of vegetables. My. Plate is divided into five groups: grains, vegetables, fruits, dairy products (or calcium- fortified soymilk), and protein. The protein includes meat, poultry, seafood, beans and peas, eggs, processed soy products, nuts and seeds. A raw vegan diet includes vegetables, fruits, nuts, grain and legume sprouts, seeds and sea vegetables. There are many variations of the diet, including fruitarianism. Vegans obtain all their protein from plants, omnivores usually a third, and ovo- lacto vegetarians half. Combinations that contain high amounts of all the essential amino acids include rice and beans, corn and beans, and hummus and whole- wheat pita. A deficiency can lead to megaloblastic anaemia and nerve damage. Vegetarians should thus take preventive measures to ensure adequate intake of this vitamin, including regular consumption of supplements containing B1. Plants not washed properly may contain B1. Animals obtain it by eating contaminated plants, other animals, or their own faeces, and become sources of B1. The mouth is another source, but in small amounts and possibly analogue (not biologically active). Tempeh, a fermented soybean food, is cited as another source, perhaps because of contamination during production. Ninety- nine percent of the body's calcium is stored in the bones and teeth. Plant sources include broccoli, turnip, bok choy and kale; the bioavailability of calcium in spinach is poor. The study found that vegans consuming at least 5. Without it bones can become thin and brittle; together with calcium it offers protection against osteoporosis. Vitamin D is produced in the body when ultraviolet rays from the sun hit the skin; outdoor exposure is needed because UVB radiation does not penetrate glass. It is present in salmon, tuna, mackerel and cod liver oil, with small amounts in cheese, egg yolks and beef liver, and in some mushrooms. People with little sun exposure may need supplements. The extent to which sun exposure is sufficient depends on the season, time of day, cloud and smog cover, skin melanin content, and whether sunscreen is worn. According to the National Institutes of Health, most people can obtain and store sufficient vitamin D from sunlight in the spring, summer and fall, even in the far north. They report that some researchers recommend 5. Tanning beds emitting 2. Cholecalciferol (D3) is synthesized in the skin after exposure to the sun, or consumed in the form of animal products; when produced industrially it is taken from lanolin in sheep's wool. Ergocalciferol (D2) is derived from ergosterol from UV- exposed mushrooms or yeast and is suitable for vegans. Conflicting studies have suggested that the two forms may or may not be bioequivalent. This is particularly true of anyone with hemochromatosis, a relatively common condition that can remain undiagnosed. Coffee and some herbal teas can inhibit iron absorption, as can spices that contain tannins (turmeric, coriander, chillies, and tamarind). The study concluded that there was no effect of vegan diets overall on all- cause mortality, cancer mortality, cerebrovascular disease or cardiovascular- disease- related mortality. The effects also disappeared when specific cancers were analysed. Vegans tend to be thinner, with lower serum cholesterol and lower blood pressure. Vegans might be at risk of low bone mineral density without supplements. They indicate that vegetarian diets may be more common among adolescents with eating disorders, but that its adoption may serve to camouflage a disorder rather than cause one. The Australian National Health and Medical Research Council similarly recognizes a well- planned vegan diet as viable for any age. Attention should be given to nutrient intake, particularly protein, vitamins B1. D, essential fatty acids, iron, zinc and calcium. Animal ingredients are ubiquitous because they are cheap. After animals are slaughtered for meat, the leftovers are put through the rendering process, and some of that material, particularly the fat, ends up in toiletries. Common ingredients include tallow in soap, and collagen- derived glycerine, used as a lubricant and humectant in many haircare products, moisturizers, shaving foams, soaps and toothpastes. Stearic acid is a common ingredient in face creams, shaving foam and shampoos; as with glycerine, it can be plant- based but is usually animal- derived. Lactic acid, an alpha- hydroxy acid derived from animal milk, is used in moisturizers, as is allantoin, from the comfrey plant or cows' urine, in shampoos, moisturizers and toothpaste. The British Vegan Society's sunflower logo and PETA's bunny logo mean the product is certified vegan, which includes no animal testing. The leaping- bunny logo signals no animal testing, but it might not be vegan. Its website contains a list of certified products. Most leather clothing is made from cows' and calves' skins, but the skin of sheep, goats, horses and pigs is also used. Less common skins include those from kangaroos, elephants, zebras, seals, crocodile and deer. Vegans regard the purchase of leather, particularly from cows, as financial support for the meat industry. Divisions within animal rights theory include the utilitarian, protectionist approach, which pursues improved conditions for animals, and rights- based abolitionism, which seeks to end human ownership of non- humans. The Benefits of Protein. High- protein, low- carbohydrate diets are the hottest thing since sliced flank steak, and every food marketer in the known universe appears to want a piece of the protein pie. Body builders are snatching, grabbing, and gulping down protein shakes. Dieters are gobbling down protein bars (and shunning pasta) in hopes of quick weight loss. The Power of Protein. It's easy to understand the excitement. Protein is an important component of every cell in the body. Hair and nails are mostly made of protein. Your body uses protein to build and repair tissues. You also use protein to make enzymes, hormones, and other body chemicals. Protein is an important building block of bones, muscles, cartilage, skin, and blood. Along with fat and carbohydrates, protein is a . Vitamins and minerals, which are needed in only small quantities, are called . Not so fast, say nutritionists. The truth is, we need less total protein that you might think. But we could all benefit from getting more protein from better food sources. How Much Protein Is Enough? We've all heard the myth that extra protein builds more muscle. In fact, the only way to build muscle is through exercise. Bodies need a modest amount of protein to function well. Extra protein doesn't give you extra strength. Department of Health and Human Services: Teenage boys and active men can get all the protein they need from three daily servingsfor a total of seven ounces. For children age 2 to 6, most women, and some older people, the government recommends two daily servings for a total of five ounces. For older children, teen girls, active women, and most men, the guidelines give the nod to two daily servings for a total of six ounces. Everyone who eats an eight- ounce steak typically served in restaurants is getting more protein that their bodies need. Plus they're getting a hefty amount of artery- clogging saturated fat as well. Continued. The Drawbacks of High- Protein Diets. Many people who have jumped on the high- protein/low- carb bandwagon think that they can pack away as much protein as they like. But nutrition experts urge caution. The reasons why have to do with how high- protein/low- carb diets are thought to lead to weight loss. When people eat lots of protein but few carbohydrates, their metabolisms change into a state called ketosis. Ketosis means the body converts from burning carbs for fuel to burning its own fat. When fat is broken down, small bits of carbon called ketones are released into the bloodstream as energy sources. Ketosis, which also occurs in diabetes, tends to suppress appetite, causing people to eat less, and it also increases the body's elimination of fluids through urine, resulting in a loss of water weight. Christopher D. Gardner, Ph. D, assistant professor of medicine at Stanford University in Palo Alto, Calif., tells Web. MD that high- protein diets like the Atkins regimen may trade short- term benefits for long- term health consequences. Among the risks: The body produces ammonia when it breaks down protein. No one knows the long- term risks of higher levels of ammonia in the body. Also, there is evidence to suggest that people who eat high- protein diets typically excrete excess calcium in their urine, says Deborah Sellmeyer, MD, assistant professor of medicine and director of the Center for Osteoporosis at the University of California at San Francisco. This suggests that the body is releasing stores of calcium into the bloodstream to counteract an increase in acids caused by protein consumption (calcium buffers, or neutralizes, acids). Too much calcium loss could lead to osteoporosis down the road, Sellmeyer says. Lastly, there are the obvious concerns. Carbohydrate foods shunned by some people on low- carb diets include fruits and vegetables, which are the best sources for vitamins, fiber, and antioxidants - - nutrients that help prevent disease. By contrast, animal foods that are high in protein are usually also high in saturated fats, which increase the risk for heart disease, stroke, diabetes, and several types of cancer. The American Heart Association warns: . This raises cholesterol levels even more and increases cardiovascular risk. The extra effort translates into fewer calories available, Hu said at a recent symposium on the science of obesityobesity. When it comes to feeling full, the clinical studies consistently showed that high- protein diets increase satiety and decrease hunger compared with high- fat or high- carbohydrate diets. In addition, most, but not all of the studies reviewed showed that most people on high- protein diets took in about 1. On average, high- protein diets produced an average weight loss that was about 4. You'll have a harder time maintaining weight loss if you eat these proteins often, and you may be damaging your body. Hu and other nutrition experts recommend getting dietary proteins from the following sources: Fish: Fish offers heart- healthy omega- 3 fatty acids and, in general, less fat than meat. Poultry: You can eliminate most of the saturated fat by removing the skin. Beans: Beans contain more protein than any other vegetable protein. Plus, they're loaded with fiber that helps you feel full for hours. Nuts: One ounce of almonds gives you 6 grams of protein, nearly as much protein as one ounce of broiled ribeye steak. Whole grains: A slice of whole wheat bread gives you 3 grams of protein, plus valuable fiber. I have nuts for breakfast every day, because they not only give you a lot of protein, but they're healthy sources of fat. Nutrition and Your Health: Dietary Guidelines for. Americans (5th ed., 2. Plant Proteins - Today's Dietitian Magazine. February 2. 01. 7 Issue. Plant Proteins. By Sharon Palmer, RDNToday's Dietitian. Vol. 2. 6As more people choose plants for their sources of proteins, RDs will need to become better acquainted with the issues surrounding their quality. Powering up on plant proteins—beans, lentils, peas, soyfoods, nuts, seeds, and whole grains—has been one of the hottest food and nutrition trends over the past few years. And these trendy protein sources are continuing along the same trajectory this year, appearing on many of the 2. The 2. 01. 7 Innova Market Insights report predicts that plant proteins will move into a ? You can thank the growing body of research backing the replacement of animal proteins with plant proteins for health benefits. Research has linked plant- based diets with lower risks of heart disease, obesity, hypertension, type 2 diabetes, and certain types of cancer. In addition, studies consistently show that plant- based diets are better for the environment. Diets high in meat increase greenhouse gas emissions from food production and global land clearing, as well as rate of species extinction. Many people also are concerned about the treatment of farm animals and are interested in replacing meat, dairy, and eggs with plant proteins. For example, the Chinese government announced efforts to curb meat consumption by 5. And the Netherlands' new dietary guidelines issued a recommendation that people eat no more than two servings of meat per week. According to research conducted by Midan Marketing and Meatingplace, 7. United States are substituting a nonprotein meal at least once per week, and 2. Going Mainstream. A couple of decades ago, you'd be hard pressed to find tofu, veggie burgers, or plant- based milk in mainstream supermarkets, restaurants, or foodservice establishments. Now these products are everywhere. Target has a plant- based protein section in its stores. It seems that every day you hear about a new plant- based product hitting the market. The Impossible Burger uses heme to make their plant burger . On the other end of the spectrum, Hilary's offers delicious, culinary- inspired veggie burgers with minimally processed ingredients, such as millet, quinoa, sweet potatoes, greens, beets, and dandelions. MALK makes organic cold- pressed nut milks made with sprouted, organic nuts. Ripple is a higher- protein plant- based milk made from pea protein. Even Tyson—one of the largest meat processors in the world—recently announced that it's embracing plant proteins. They've invested in Beyond Meat, a company that makes plant- based meat alternatives designed to taste like the real thing. Enter Plant Protein Quality With so much interest in highlighting plant proteins at the center of the plate, there's more interest in understanding the quality of plant proteins. Yet there's confusion among consumers, as well as nutrition professionals, on this issue. Do we need to combine these proteins with other protein sources to make a ? Indeed, a recent cross- sectional study led by Glenna Hughes, MS, a consultant and previously a research scientist for Du. Pont Nutrition and Health who works predominantly in the field of plant protein quality, assessed dietitians' perceptions of plant- based protein quality via an online survey. Those not produced by the body are called essential amino acids, of which there are nine: histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine. Proteins in the human body tend to exist in consistent amounts of the essential amino acids—these levels also may be found in soy products and animal foods, according to Jack Norris, RD, plant- based expert and coauthor, with Virginia Messina, of Vegan for Life. These proteins found in soy products and animal foods are considered . All plant foods contain at least some of every essential amino acid, but in general, legumes are lower in methionine, and most other plant foods are lower in lysine. So, as long as one consumes a variety of foods throughout the day—even if they're exclusively vegan—they can generally get an adequate amount of amino acids. This nullifies the concept made popular in the 1. However, the current thinking, per the Academy's position statement on vegetarian diets, is that the liver stores the various essential amino acids over the course of a day to ensure adequate nitrogen retention and use in healthy adults. You don't have to eat them at the same meal; you can get the amino acids over the course of a day. She also says there are no definitions by the FDA or other regulatory agencies for ? Hughes explains that though specific needs might be different, such as for performance athletes or those with sarcopenia, both quality and quantity of protein are important. For example, there has been a great deal of research on soy protein and muscle synthesis showing that it's comparable to whey protein, which is considered the gold standard for athletes. Thus, a well- planned diet based on plant proteins can meet nutrient needs. Limiting Amino Acids. Lysine is the limiting amino acid (the amino acid in shortest supply) in vegan diets. If you're eating a plant- based diet, the amino acid lysine is more important than total protein, according to Norris, because if you eat enough lysine, chances are you're getting enough total protein. Quinoa, amaranth, pistachios, and pumpkin seeds also are decent sources. Norris has collected an impressive amount of information on protein and amino acid levels of plant foods at the following webpage: http: //veganhealth. Virginia Messina suggests that, for the most part, quality isn't something RDs need to be concerned about. Enough Protein? It's completely possible to obtain an adequate amount of protein on an exclusively plant- based diet. However, very little research has been done on nitrogen balance among those eating plant- based diets. The little research available seems to support nitrogen balance for vegans who consume at least one- third of their protein as legumes (or quinoa or seitan) within a diet that provides about 1 to 1. Norris. A 2. 01. 5 study based on data from EPIC- Oxford found that vegan men met the recommended dietary allowance (RDA) for all essential amino acids, and the vegan women had lysine intakes that were at 9. RDA. 8. So, what about the data that suggest older adults may need more protein than the RDA? Mark Messina, Ph. D, expert on soy and coauthor of The Simple Soybean and Your Health, says, . The protein intake of most Americans exceeds the current RDA. It may impact recommendations for older adults, however. And since plant foods provide fiber and are low in saturated fat, they certainly can be healthful choices for helping to meet the protein needs of older adults. Legumes in particular are 3. Mark Messina says, . Older adults tend to get most of their protein in the latter part of the day. Once the leucine threshold is met, the source of protein doesn't appear to matter. However, it may take higher amounts of plant protein compared with whey protein, for example, since whey is extremely rich in leucine. Plant Protein Digestibility. Vegans may require a slightly higher protein intake due to the slight decrease in digestibility of plant proteins. Protein in whole plant foods is digested slightly less well compared with isolated proteins or animal proteins, says Virginia Messina, who suggests aiming for a protein intake that's about 1. RDA as a good idea for people who are getting most of their protein from whole plants. As mentioned earlier, many plant- based experts recommend about 1 to 1. Mark Messina adds that the RDA is based on a mix of high- and low- quality proteins, so for those consuming a plant- based diet it's reasonable to recommend consuming at least 1. RDA. For example, whole beans contain factors that inhibit protein digestion, whereas in proteins extracted from whole beans some of these factors are eliminated. To this point, isolated soy protein is very well digested (> 9. Plant Protein Scoring. If you really want to get to the bottom of plant protein quality, you have to talk about PDCAAS, a method of evaluating protein quality based on the amino acid requirements of humans and their ability to digest them. The score is based on the ratio of the amount of the first- limiting essential amino acid in the protein source to the amino acid requirement of a 1- to 2- year- old child, corrected for protein digestibility based on true fecal nitrogen digestibility, and using the growing rat as a model for the adult human. Values at higher than 1. Hughes explains that PDCAAS has been in use since the Food and Agriculture Organization and World Health Organization of the United Nations first published it in 1. The beauty of the method is that it allows you to look at combinations and how they complement one another with a score. She reports that PDCAAS was first used by the FDA for nutrition labeling in 1. May 2. 01. 6, which included revised Nutrition Facts labeling, confirmed that they will still be using PDCAAS for nutrition labeling. Digestible Indispensable Amino Acid Score (DIAAS), a newer method of scoring protein quality, has been introduced. Hughes explains that DIAAS has a similar basis as PDCAAS; you compare the amino acid profile with a reference pattern and correct for digestibility. However, a different method is used to evaluate digestibility, and the digestibility of each amino acid is considered instead of the overall protein. Some protein experts believe DIAAS is the best method for several reasons, including that the scoring system uses ileal rather than fecal estimates of protein digestibility, which some say are more accurate. But Hughes says, . When the FDA recently updated its nutrition labeling, their response on DIAAS was that it isn't far enough along yet, and that we need more data generated in order to make this scoring method more widely accepted.?
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