How Much Is Too Much?

Patients ask me frequently about protein intake for building muscle, weight loss, general health, etc.  I talk to a lot of people about weight loss and about a good healthy balanced diet all the time (it IS my job, after all, LOL!) but I am NOT a dietitian or nutrition expert.

My concern about patients, especially fitness aficionados, is that they will overdo the protein intake trying to build muscle faster and hurt themselves.  I had talked to my friend and colleague Ron Flauto, DO, some time ago about this topic, and I asked him if he would be kind enough to revisit the subject for the blog.  Recently I got an email from him and wanted to share his advice.

Dr. Flauto is a nephrologist (medical kidney specialist).  The kidneys function to get rid of stuff the body DOESN’T need and to hang on to the stuff the body DOES need.  Healthy kidneys let little or no protein escape into the urine.  Sometimes damaged kidneys give a clue by “leaking” protein through the filter into the urine, which can be seen on a routine urine test in the office or the lab.

I try to be sure to do a urine test regularly on those who have high blood pressure or diabetes.  These folks have a higher risk of kidney damage and protein in the urine can be an early hint.  Sometimes patients come in with urinary problems like those that would signal a urine infection or seeing blood when urinating, and the urine test also shows protein.  If it doesn’t go away on repeat testing, we have to dig a little more.

My go-to guy for kidney puzzles is Dr. Flauto.  More than once, somebody with persistent protein in the urine has turned out to be a bodybuilder who is taking megadoses of protein supplements in the hopes of looking like Arnold Schwarzeneggar in “Conan, The Barbarian.”  I always get a very nice letter back from Dr. Flauto with pointers like that, and I’ve learned to ask about high protein intake BEFORE referring patients.  (I think he’ll agree I haven’t sent him anybody like that recently.  Yes, she CAN be taught!)

So how much protein is too much?  From talking with Dr. Flauto and my own research, it seems that’s a tricky question.  Obviously if you’re taking so much your kidneys can’t handle it, that’s way too much.  We don’t want to get there.  It looks like it depends on your size and your activity level.  Dr. Flauto was kind enough to check with his practice’s dietitian, who is a high-level athlete as well.  Here is his guidance on carbohydrate and protein intake:

light to moderate training:
carbohydrate needs:  2.3-3.2 gms/pound
protein needs:  .55 – .8 gms/pound
heavy training and high intensity:
carbohydrate needs:  4.5 – 5.5 gms/pound
protein needs:  0.7 to 0.9 gms/pound
It is worth noting that protein needs are debated (even in the nephrology world).  They are a considered a minor fuel for endurance exercise.  Regarding fat intake, it is reasonable to recommend sticking to “healthy fats” including fish, nuts, olives, avocados, veg oils etc.  If fat is being consumed via dairy, I’d recommend the low fat versions such as low fat milk or low fat cheeses.  Finally, I would also recommend avoiding saturated fats.

Those of you who are very fitness conscious, trying to lose weight, or just trying to improve your diet in general, I hope this helps you stay within a range that is safe for your body and sensible for you as an individual.

PS – If you or anyone you know needs a great kidney doctor, please call Dr. Flauto.  He sees patients in Parma Hts and Middleburg Hts.  The Parma Hts office number is (440) 292-0226.


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