==AMDR for protein==: 10% - 35%
- provides the essential amino acids
Protein Quality
Protein Quality: a measure of a dietary proteins’ ability to provide the essential amino acids (EAA) required for tissue maintenance
Protein Digestibility-corrected amino acid score (PDCAAS): the standard adopted to evaluate protein quality, based upon the profile of essential amino acids and digestibility of protein.
- highest score: 1.00
- provides a method to balances intakes of poorer-quality proteins with high-quality proteins
<<Proteins from animal sources:<<
- meat poultry, milk and fish
- high quality (contain all the EAA and are more readily digested)
- Gelatin is an exception, it has low biological value
<<Proteins from plant sources:<<
- lower quality than animal proteins
- proteins from different plant sources may be combined to form high biological value
- e.g. wheat (lysine deficient but methionine rich) may be combined with kidney beans (methionine poor but lysine rich)
Nitrogen Balance
Nitrogen balance: amount of nitrogen consumed equals that of the nitrogen excreted.
- most normal healthy adults are normally in nitrogen balance
Positive Nitrogen Balance
Positive nitrogen balance: nitrogen intake exceeds nitrogen excretion
Occurs in situations in which tissue growth is observed:
- childhood
- pregnancy
- convalescing
Negative Nitrogen Balance
Negative nitrogen balance: nitrogen loss is greater than nitrogen intake.
Associated with:
- inadequate dietary protein
- lack of an essential amino acid
- during physiological stress
Protein Requirements
amount of dietary protein required varies with its biological value
disease states influence protein needs
- protein %%restriction%% may be needed in %%kidney disease%%
- %%burns%% require %%increased%% protein intake
recommended intake: @@0.8g/kg/day@@
people who exercise strenuously on a regular basis may benefit from extra protein to maintain muscle mass
- daily intake of: @@~1g/kg/day@@
pregnant or lactating women require up to @@30g/kg@@ in addition to their basal requirements
infants should consume @@2 g/kg/day@@
Consumption of excess protein:
- no physiological advantage to the consumption of more protein than the RDA
- protein consumed in excess of the body’s needs is %%deaminated%%
- the resulting carbon skeletons are metabolized to provide %%energy%% or %%acetyl CoA%% for fatty acid synthesis
- when excess is eliminated from the body as urinary nitrogen, it is often accompanied by @@increased urinary calcium@@, increasing the risk of @@nephrolithiasis (kidney stones)@@ and @@osteoporosis@@
The protein-sparing effect of carbohydrates:
- dietary protein requirement is influenced by the carbohydrate content of the diet
- if carbohydrate intake is %%low%% amino acids are %%deaminated%% to provide carbon skeletons for the synthesis of %%glucose%% that is needed as %%fuel for the central nervous system%%
- if carbohydrate intake is @@less than 130 g/day@@ sustainable amounts of protein are metabolized to provide @@precursors@@ for @@gluconeogenesis@@
- carbohydrate allows amino acids to be used for repair and maintenance of tissue protein rather than for gluconeogenesis
Protein-energy (calorie) malnutrition (PEM)
also known as protein-energy undernutrition (PEU)
in developed countriess it is mostly seen in patients with @@medical conditions@@ that:
- decrease appetite
- alter how nutrients are digested or absorbed
- in hospitalized patients with major trauma or infections
- often require intravenous or tube-based administration of nutrients
may be seen in children or elderly who are @@malnourished@@
@@inadequate intake@@ of protein and/or energy is the primary cause of PEM in developing countries
symptoms include %%depressed immune system%%, reduced ability to resist infection
secondary infections can lead to death
Two extreme forms of PEM:
Kwashiorkor
- protein deprivation is relatively greater than the reduction in total calories
- associated with severely %%decreased synthesis of visceral protein%%
- commonly seen in developing countries in children after weaning at about the %%age of 1 year%%
Typical symptoms:
- stunted growth
- skin lesions
- depigmented hair
- anorexia
- edema (results from the lack of adequate blood proteins to maintain the distribution of water between blood and tissues)
- fatty liver
- @@decreased serum albumin concentration@@
Marasmus
- calorie deprivation is relatively greater than the reduction in protein
- usually occurs in children younger than 1 year of age
- when the mother’s breast milk is supplemented with thin watery gruels of native cereals, which are usually deficient in protein and calories
Typical symptoms:
- arrested growth
- extreme muscle wasting and depletion of subcutaneous fat (emaciatation)
- weakness
- anemia