Give me name of some vegetarian food rich in protein ..

2

Replies

  • neanderthin
    neanderthin Posts: 9,549 Member
    Traditionally, protein recommendations have been based on studies that estimate the minimum protein intake necessary to maintain nitrogen balance [3,8]. However, the problem with relying on these results is that they do not measure any physiological endpoints relevant to healthy aging, such as muscle function.

    https://ncbi.nlm.nih.gov/pmc/articles/PMC4924200/#:~:text=Experts%20in%20the%20field%20of%20protein%20and%20aging,value%20at%20the%20lowest%20end%20of%20the%20AMDR.

    This suggests that the lack of muscle responsiveness to lower doses of protein in older adults can be overcome with a higher level of protein intake. The requirement for a larger dose of protein to generate responses in elderly adults similar to the responses in younger adults provides the support for a beneficial effect of increased protein in elderly populations [8]. The consumption of dietary protein consistent with the upper end of the AMDRs (as much as 30%–35% of total caloric intake)
  • BartBVanBockstaele
    BartBVanBockstaele Posts: 623 Member
    edited October 2022
    https://hindawi.com/journals/jbe/2015/357627/

    Most US medical schools (86/121, 71%) fail to provide the recommended minimum 25 hours of nutrition education; 43 (36%) provide less than half that much. Nutrition instruction is still largely confined to preclinical courses, with an average of 14.3 hours occurring in this context.

    It cannot be a realistic expectation for physicians to effectively address obesity, diabetes, metabolic syndrome, hospital malnutrition, and many other conditions as long as they are not taught during medical school and residency training how to recognize and treat the nutritional root causes.
    Thank you for the link. I read the article, and it seems largely (but certainly not entirely) consistent with what I described, especially this part:
    In fact, there are few areas of medical practice that are completely isolated from nutritional links or influences.

    My main question is, and has always been since I first heard the claim, that I wonder what a "nutrition course" would add to the knowledge that so permeates almost all courses (there are a few very logical exceptions to that claim).

    One of the problems related to nutrition is that, while we know quite a bit, there is a lot more that we don't know and can't know, due to ethical concerns. Ethical concerns are probably the biggest problem in research and they are all too often insurmountable. We can't teach what we don't know, after all.

    As a result, a course in nutrition is bound to be problematic at best, and I would argue that one can easily see that when one looks at many claims made by dietitians that don't seem to be well thought out or just plain wrong. For example, when a dietitian tells me there are no carbs in Greek yoghurt or that mangoes are full of fibre, I am highly motivated to run away, except that running is not something I do well or even badly.

  • lynn_glenmont
    lynn_glenmont Posts: 9,910 Member
    vivmom2014 wrote: »
    @33gail33 I totally agree about the being obsessed aspect. How did it happen? Protein was never a concern in my (fairly) recent past, but you start reading some nutrition boards and protein is the holy grail, not to be trifled with. I'm glad to read your post that 60-75g is enough. I'd like to stop worrying about it as well.

    The best thing you can do is ask a doctor. A real one, i.e. an MD, he/she should be able to put your mind at ease. You can also find the information online, but it will take you much more time and effort to learn to distinguish between information and disinformation and to put it all together in a coherent understanding.

    While there are some genuine reasons to up protein intake, the vast majority of people do not need it and while, if they are in good health, it is not very likely to do them harm, it is also not going to do them any good.

    Please do not do what I do (or anyone else does), just because I do it, but I just looked at my numbers for the time I have been of MFP (since 25 September). Most of my intake is between 60 g and 65 g. There are a few outliers as well: the lowest one was 40 g. That is clearly not enough, but nothing to worry about, since it was exactly that, an outlier, the only case in fact. I also had an outlier of 104 g. Again, nothing to worry about, as it was the only time.

    My main message remains unchanged: ask an MD. These people study this stuff in depth. They know what they are recommending. Once you have done that, you could go to a dietitian to get advice on how to achieve the recommended goals, but do not skip the doctor. He/she is your most reliable source of information even if you are studying medicine yourself (because you do not know yet what he/she knows already ^_^)

    No, they really don't.
  • neanderthin
    neanderthin Posts: 9,549 Member
    edited October 2022
    https://hindawi.com/journals/jbe/2015/357627/

    Most US medical schools (86/121, 71%) fail to provide the recommended minimum 25 hours of nutrition education; 43 (36%) provide less than half that much. Nutrition instruction is still largely confined to preclinical courses, with an average of 14.3 hours occurring in this context.

    It cannot be a realistic expectation for physicians to effectively address obesity, diabetes, metabolic syndrome, hospital malnutrition, and many other conditions as long as they are not taught during medical school and residency training how to recognize and treat the nutritional root causes.
    Thank you for the link. I read the article, and it seems largely (but certainly not entirely) consistent with what I described, especially this part:
    In fact, there are few areas of medical practice that are completely isolated from nutritional links or influences.

    My main question is, and has always been since I first heard the claim, that I wonder what a "nutrition course" would add to the knowledge that so permeates almost all courses (there are a few very logical exceptions to that claim).

    One of the problems related to nutrition is that, while we know quite a bit, there is a lot more that we don't know and can't know, due to ethical concerns. Ethical concerns are probably the biggest problem in research and they are all too often insurmountable. We can't teach what we don't know, after all.

    As a result, a course in nutrition is bound to be problematic at best, and I would argue that one can easily see that when one looks at many claims made by dietitians that don't seem to be well thought out or just plain wrong. For example, when a dietitian tells me there are no carbs in Greek yoghurt or that mangoes are full of fibre, I am highly motivated to run away, except that running is not something I do well or even badly.
    https://hindawi.com/journals/jbe/2015/357627/

    Most US medical schools (86/121, 71%) fail to provide the recommended minimum 25 hours of nutrition education; 43 (36%) provide less than half that much. Nutrition instruction is still largely confined to preclinical courses, with an average of 14.3 hours occurring in this context.

    It cannot be a realistic expectation for physicians to effectively address obesity, diabetes, metabolic syndrome, hospital malnutrition, and many other conditions as long as they are not taught during medical school and residency training how to recognize and treat the nutritional root causes.
    Thank you for the link. I read the article, and it seems largely (but certainly not entirely) consistent with what I described, especially this part:
    In fact, there are few areas of medical practice that are completely isolated from nutritional links or influences.

    My main question is, and has always been since I first heard the claim, that I wonder what a "nutrition course" would add to the knowledge that so permeates almost all courses (there are a few very logical exceptions to that claim).

    One of the problems related to nutrition is that, while we know quite a bit, there is a lot more that we don't know and can't know, due to ethical concerns. Ethical concerns are probably the biggest problem in research and they are all too often insurmountable. We can't teach what we don't know, after all.

    As a result, a course in nutrition is bound to be problematic at best, and I would argue that one can easily see that when one looks at many claims made by dietitians that don't seem to be well thought out or just plain wrong. For example, when a dietitian tells me there are no carbs in Greek yoghurt or that mangoes are full of fibre, I am highly motivated to run away, except that running is not something I do well or even badly.

    This is just my opinion on this.

    1st bolded statement

    I seriously don't understand this line of thinking at all. The basics in nutrition are not something that can be tosses around in general medical conversation and then assume we're good to go, it doesn't work that way. First of all, nutrition is a daunting field. There are scientists with PhD's in nutritional science that spend their whole life trying to figure out something as simple as why mitochondria have their own DNA and why sunlight effectively controls it's course of action, or why we have a common ancestry with fungi and how that relates to our gut microbiome and it's connection to the brain and it's influences on our metabolism. But it can start with the basics, which could undoubtably fill a full curriculum over their formal learning timeframe and still a long way from understanding nutrition without the individual taking it upon themselves to research separately, adding to their life's knowledge and application and still have questions that are unanswered, that is science, and some of those are scientists with the PhD's.

    2nd bolded statement
    Anytime someone infers an outcome in mortality and I believe this is what you're referring to, and in this respect too many Dr's, Dietitians, media and people have put too much faith in nutritional epidemiology because the basic essence of that field is to evaluate what happens over time on a population level only. Basically, the verbiage starts with "risk" and then based on the data vetted from a particular epidemiological study, comes to a conclusion extrapolated out over time, then forecasts a mortality or "risk". Pure hogwash and like I've always said nutritional epidemiology is the weapon of mass confusion. And when we have this type of science influencing policy it has broad implication that can have devastating effects.

    Risk assessment requires a control, it's that simple. What we have in nutrition are controlled trials which generally involve smaller to very small groups, because to control variables for a simple trial costs millions on average and it also requires funding and the two are difficult bedfellows sometimes, and these are the scientists with those PhD's that are doing these studies. Most of these controlled trials offer only a comparison and for further questions, theories and trials and generally draw no mortally conclusions. For a controlled study to draw a conclusion for
    mortality it again needs a control and it would also need to be started at birth then controlled for all confounders in a ward where they can be controlled all of their life until death, then you can reach a conclusion and only then.....that is a study for mortality and well as we know, that's never going to happen. Cheers
  • BartBVanBockstaele
    BartBVanBockstaele Posts: 623 Member
    edited October 2022
    No, they really don't.
    I hear this claim all the time, though I have qualify that: I only started hearing that claim when I moved to Canada. It seems therefore not impossible that there is a difference between med schools in Europe and med schools in North America, but as long as I have not been shown good arguments –i.e. not mere claims– it is something I accept hearing but have no good reasons accepting as credible. I am being influenced by the fact that I hear quacks making those claims all the time.
    A second part I think I should add to that is this: what do people mean when they talk about nutrition? It is clear, for example, and that is also true for what I experienced, that there are no cooking classes or recipe classes in med school. I also think that should not really be part of the curriculum, but it certainly is a valid subject for discussion. I have always seen dietitians as the "translators" of medical science into recipe and/or cooking recommendations.

  • AnnPT77
    AnnPT77 Posts: 30,289 Member
    Most Dr's don't have a clue, literally, when it comes to nutrition and most guidelines are political at best, and of course, that's just my opinion. I'm just over 2.0 on average. For the average westerner, protein malnutrition is never going to happen unless of course they're chronically undereating. The AMDR range is around 10-35% of energy intake, and most experts from what I've gleaned from the literature recommend at least 2g and more for elderly populations. cheers.

    I know that claim, I hear it often. I wonder where it comes from because it is contrary to my experience. When I went to med school, now a little over 40 years ago, nutrition information already started being given from the very first weeks of instruction. It was everywhere. The only thing that could be said, is that there was no course called "nutrition". Such a course would not have made much sense, because nutrition permeated everything.
    While I am always ready to be proven wrong, and having to change my mind, I'd need to see some pretty hard evidence before I accept that claim. I also find it rather suspicious that it is (seemingly) mostly quacks who make the claim. How do they know, since what they know is largely based on nothing or disproven nonsense?


    So, it would be better for me to learn about my protein needs from my individual personal general practice MD (for whom medical school was probably 40 years back) than to believe a 2013 report on the subject from a group formed for the purpose by the European Union Geriatric Medicine Society; authors of which include 10 MDs (among others); and that cites and discusses research that supports the study group's conclusions? Because such a report (together with its references) would not be evidence, and its authors would be quacks?

    Interesting.
  • BartBVanBockstaele
    BartBVanBockstaele Posts: 623 Member
    edited October 2022
    This is just my opinion on this.
    Of course it is, and there is nothing wrong with having an opinion. I am trying to understand where the claim comes from, since it is inconsistent with what I know, taking into account that what I know is over 40 years old and that things are likely to have changed.
    1st bolded statement
    I seriously don't understand this line of thinking at all. The basics in nutrition are not something that can be tosses around in general medical conversation and then assume we're good to go, it doesn't work that way. First of all, nutrition is a daunting field. There are scientists with PhD's in nutritional science that spend their whole life trying to figure out something as simple as why mitochondria have their own DNA and why sunlight effectively controls it's course of action, or why we have a common ancestry with fungi and how that relates to our gut microbiome and it's connection to the brain and it's influences on our metabolism. But it can start with the basics, which could undoubtably fill a full curriculum over their formal learning timeframe and still a long way from understanding nutrition without the individual taking it upon themselves to research separately, adding to their life's knowledge and application and still have questions that are unanswered, that is science, and some of those are scientists with the PhD's.
    Two points here: what do you mean with nutrition? I have the impression that what you call nutrition is what I call cooking or –in more general terms– preparation of food for consumption. There is –to the best of my knowledge– nothing about that in medical curricula, nor could there be. The reason for that is reality: We have a varying number of about 200 bones (more in the very young), some 600 muscles, an unknown number of blood vessels of which a few hundred (can't be more precise) are important. We have a much smaller number of organs, a very large number of important structures in the brain, hundreds of clinically important nerves... and that is just basic gross anatomy without talking about a single disease or syndrome or treatment thereof.
    The tragedy of (especially modern) medicine is that we have learned a lot and are learning more and more. Modern medicine is really only a few decades old. even in my time, a lot was still "magic" (placebo effect, non-specific effect, for example). That is why we have more and more (sub)specialties, and ever large multidisciplinary teams of specialists resulting in ever more errors in communication and an ever more expensive medical environment despite declining incomes of and pressures on physicians resulting in more and more doctors calling it quits.
    In short: if you are talking about preparing foods, I am wholeheartedly in agreement. If not, I'd like to hear/read it. I have always seen this part as a task of dietitians. Unfortunately, one only needs to look around to know that many dietitians do not seem to know much about the subject. For example, when I hear a dietitian claim there is no sugar in Greek yoghurt or that mangoes are "full of fibre", I don't know where they get that from, but I sure as hell know it is wrong.

    2nd bolded statement
    Anytime someone infers an outcome in mortality and I believe this is what you're referring to, and in this respect too many Dr's, Dietitians, media and people have put too much faith in nutritional epidemiology because the basic essence of that field is to evaluate what happens over time on a population level only. Basically, the verbiage starts with "risk" and then based on the data vetted from a particular epidemiological study, comes to a conclusion extrapolated out over time, then forecasts a mortality or "risk". Pure hogwash and like I've always said nutritional epidemiology is the weapon of mass confusion. And when we have this type of science influencing policy it has broad implication that can have devastating effects.

    Risk assessment requires a control, it's that simple. What we have in nutrition are controlled trials which generally involve smaller to very small groups, because to control variables for a simple trial costs millions on average and it also requires funding and the two are difficult bedfellows sometimes, and these are the scientists with those PhD's that are doing these studies. Most of these controlled trials offer only a comparison and for further questions, theories and trials and generally draw no mortally conclusions. For a controlled study to draw a conclusion for
    mortality it again needs a control and it would also need to be started at birth then controlled for all confounders in a ward where they can be controlled all of their life until death, then you can reach a conclusion and only then.....that is a study for mortality and well as we know, that's never going to happen. Cheers
    Actually, no, you assume wrongly. I am essentially in complete agreement with what you say in this second part. There is an enormously important difference between statistical descriptions of populations and evaluations and predictions at the clinical level. It would, unfortunately, not be hard to write an entire treatise about this. If that is interesting to anyone, I am rather fond of what David Colquhoun writes about statistics in medicine. In short, risk assessments at the population level are absolutely not to be seen as having any predictive value in individuals, a problem that is all too common in the popular literature.
    This is –for example– one of the problems with weight loss. People tend to forget that BMI (which I still know as the Quételet Index) was an attempt to study populations, not individuals. As an example, I am of normal BMI (even to Asian standards, since a day or two) but anyone who takes even a cursory look at my abdominal region will know I am still grossly overweight and could be credibly called obese by some people. I just usually say that I am a (recovering) fatty.
    As for tests: you got it exactly right. There are a lot of unknowns in nutrition and many of these unknowns are essentially impossible to solve because of financial reasons (solutions can be found for these, at least in principle) and for ethical reasons (solutions may be impossible to find for many if not most of these).
    We can even see problems like this in the relatively simple field of vitamins and minerals. We are seeing that recommended intakes are being increased quite regularly but simultaneously seeing that maximum intakes are being lowered quite regularly. On top of that, doctors are being confronted more often with mysterious symptoms that were essentially unknown in the past, as they are related to overconsumption of vitamin and mineral supplements, which could be considered to be a relatively new group of civilisation diseases.
    My thinking about this is rather simple for now: we can't blame med schools for not teaching about elements that could not possibly have been known when they were teaching. That said, if med schools cannot possibly know about them, others cannot possibly know about them either, so it does not make sense to look elsewhere for what is essentially fantasy-based disinformation, just because we would prefer to have "answers" instead of information that has been verified and confirmed.
  • BartBVanBockstaele
    BartBVanBockstaele Posts: 623 Member
    edited October 2022
    AnnPT77 wrote: »
    So, it would be better for me to learn about my protein needs from my individual personal general practice MD (for whom medical school was probably 40 years back) than to believe a 2013 report on the subject from a group formed for the purpose by the European Union Geriatric Medicine Society; authors of which include 10 MDs (among others); and that cites and discusses research that supports the study group's conclusions? Because such a report (together with its references) would not be evidence, and its authors would be quacks?

    Interesting.
    I don't think that is something that can be deduced from what I said, and it is most definitely not what I meant.
    That said, I am uninclined to "believe" anything. I am very much inclined to take a thorough look at well-studied and well-argued information while taking into account that while a single report can be interesting, it is something that is not to be used as a basis for decision-making until its findings are confirmed by other teams using different methods.

  • BartBVanBockstaele
    BartBVanBockstaele Posts: 623 Member
    edited October 2022
    vivmom2014 wrote: »
    The most refreshing information ever: you can eat whatever you'd like, and as long as you are in a caloric deficit, you will lose weight.
    You may want to look up "Robert Baron" "UCSF" on Youtube. He has a few no-nonsense videos on weight loss and obesity as part of a "mini medical school for the public". He is a professor of medicine at the university of California in San Francisco.

    What you quote has been "controversialised" in the popular press, but it remains an establish fact against which no valid objections have ever been raised, even if many have tried and are still trying, although they are usually making claims without any substantiation of those claims.

    You may also want to look up "Ruben Meerman" on Youtube. He is an Australian scientist who has made a very nice presentation about energy and weight management. The only thing I disagree with is his use of "not hard", I'd prefer to call it "not complicated", but I think it is clear that this is what he means.

    If you track your intake and your weight daily, you will see that calorie tracking can be incredibly precise, and that is despite the inherent problems with calorie counts as we currently have them.

    I have always (for the last four years anyway) used, and continue to use, a simple spreadsheet to do this, and all I can say, is that my observations are completely in line with what calorie-based information shows. The only problematic times have been when it was not possible to track accurately, and times when I changed my diet (but that was simply normal, if unpredictable, variation that turned out to be quite correct when looked at over a week or two).

    My current Excel sheet has 8708 rows, from 20181203 to 20221022 and it is very informative. One advantage of closely tracking intake and weight for longer periods of time, is that you can actually accurately deduce your personal energy expenditure and hence start to risk predictions on that basis. Once you can do that, no one needs to tell you you are right or wrong, your own information is telling you that already.

    It has taught me personally to no longer track my exercise. It was a waste of time and effort for me, the effects were too small to be noticed. That may not be the case for everyone, but it is for me. In weeks I take walks of four hours and more, I see no increased weight loss as compared to weeks during which I take no walks at all. That does not mean I stopped exercising. It may not be important for weight loss, but it certainly is for health.

    What I have done, and continue to do, with Excel can easily be done with MFP. Not everyone likes spreadsheets as much as I do, and that is perfectly fine.
  • neanderthin
    neanderthin Posts: 9,549 Member
    If I haven't been clear, well, let me just say, no, I haven't been talking about cooking. Later.
  • BartBVanBockstaele
    BartBVanBockstaele Posts: 623 Member
    edited October 2022
    If I haven't been clear, well, let me just say, no, I haven't been talking about cooking. Later.
    I am only trying to understand where our difference comes from and to reconcile those positions.
  • vivmom2014
    vivmom2014 Posts: 1,646 Member
    @BartBVanBockstaele I very much agree with your assessment that weight loss is not complicated, but definitely NOT "not hard." Your spreadsheets sound impressive, but I confess that I'm nowhere close to that level of tracking. I also don't have much extra weight to contend with, so I don't weigh myself and prefer to track ups and downs with how my clothes fit.

    I definitely record exercise, for the simple reason that it gives me more calories to eat. So it's the MFP system: attempt to hit the daily calorie goal, add exercise for additional calories, repeat. I don't like complicated, and won't do things that require inordinate amounts of time and attention to detail. (Although I sew all of my own clothes, so there's that.) We're all different, and that's great that your spreadsheets and meticulous tracking work for you.

  • BartBVanBockstaele
    BartBVanBockstaele Posts: 623 Member
    edited October 2022
    vivmom2014 wrote: »
    @BartBVanBockstaele I very much agree with your assessment that weight loss is not complicated, but definitely NOT "not hard." Your spreadsheets sound impressive, but I confess that I'm nowhere close to that level of tracking. I also don't have much extra weight to contend with, so I don't weigh myself and prefer to track ups and downs with how my clothes fit.

    I definitely record exercise, for the simple reason that it gives me more calories to eat. So it's the MFP system: attempt to hit the daily calorie goal, add exercise for additional calories, repeat. I don't like complicated, and won't do things that require inordinate amounts of time and attention to detail. (Although I sew all of my own clothes, so there's that.) We're all different, and that's great that your spreadsheets and meticulous tracking work for you.
    I agree wholeheartedly. Everybody is different. I like my spreadsheet very much, but for people who don't like that, MFP is a valid alternative. I had to fiddle the Excel sheet in the beginning, because it became so detailed that I was obsessed by it, so I dialed back, and now track only calories and weight, but I do write down protein, fat, net carbs and fibre as well, even if I don't track them. I started tracking my weight loss decades ago, but then threw it out when I had enough. Except for a few notes on paper that somehow survived that, I have nothing left. This Excel sheet I fully intend to keep though. It tracks 31 kg of weight loss. I suspect I will add another 6 kg or so, maybe more, it is impossible to know.
    I track calories and kilos because it enables me not only to determine whether my diet works, but also how well it works.
    Where exercise is concerned, praise yourself lucky that you can track the calories! In my case, all I can say is that trackers are ridiculously inaccurate,so I just ignore them. At most, I may lose the odd extra gramme or so.
    As for sewing, I used to make kimono, himo and obi myself. I loved it a lot. Still have my sewing machine, but that has essentially come to a stop when COVID hit.
    Success. Keep it up.

  • neanderthin
    neanderthin Posts: 9,549 Member
    edited October 2022
    If I haven't been clear, well, let me just say, no, I haven't been talking about cooking. Later.
    I am only trying to understand where our difference comes from and to reconcile those positions.

    Nutrition as it relates to dietary guidance and what the general population should eat is full of politics and is pretty much impossible to use most of the current recommendations let alone trying to figure from what foundation would best represent current scientific data to train medical students, going forward. Again epidemiology, regulatory capture, commercial concerns of agribusiness and large food processors, and the political concerns of scientist's intent on preserving their point-of-view. Also the simple lack of interest or/and ignoring high quality randomized control trial, which of course would fly in the face of current opinion and bias that are so entrenched in current guidance. Just the conflicts of interest are mindboggling in their scope. The whole system, telling people what to eat is based in ideology at its core and most needs to be scraped in my opinion.
  • BartBVanBockstaele
    BartBVanBockstaele Posts: 623 Member
    edited October 2022
    Nutrition as it relates to dietary guidance and what the general population should eat is full of politics and is pretty much impossible to use most of the current recommendations let alone trying to figure from what foundation would best represent current scientific data to train medical students, going forward. Again epidemiology, regulatory capture, commercial concerns of agribusiness and large food processors, and the political concerns of scientist's intent on preserving their point-of-view. Also the simple lack of interest or/and ignoring high quality randomized control trial, which of course would fly in the face of current opinion and bias that are so entrenched in current guidance. The whole system, telling people what to eat is based in ideology at its core and most needs to be scraped in my opinion.
    I largely agree with that, except perhaps not with the seemingly accusatory aspect of it. You made it clear you are not talking about cooking, that is fine, it is a relief to me, because I don't see cooking as particularly important where nutrition is concerned, even if I have at least the impression that many people think that cooking is nutrition and that nutritionists and dietitians are essentially purveyors of recipes.

    Randomised control trials are not really possible in nutrition, and they aren't in many other aspect of life either, unless we change our ethics and start using and treating some fellow humans as creatures to be caged and experimented on.

    One example that I remember from my med school days was a story about what people awaits if they decided to live on a diet that consists exclusively of raw egg whites. I will never forget my professor's remark that there really were some weirdos out there. That was during a first-year course in organic chemistry. I forgot why we learned that there, this is over fourty years ago after all, but it was totally appropriate for the stuff we were studying at the time.

    Better known, no doubt, is what we learned about vitamin C and Linus Pauling. That was during our course of inorganic chemistry. Vitamin C is clearly part of biochemistry, not inorganic chemistry, but it was nevertheless appropriate there because Linus Pauling was once a towering figure in chemistry circles but had essentially lost all his prestige by that time thanks to his embrace of vitamin C quackery. To us, it was an important lesson in more ways than one, including the fact that even highly respected scientists will lose that respect when they are shown to be wrong and also that scientists are just humans like every other human, with human failings.

    For me, nutrition is both ridiculously simple and ridiculously complex. Ridiculously simple in the sense that despite our rapidly increasing knowledge, we still know so little in the face of what there is to learn that most of it can be taught in an hour or so, and even less at university level, followed by some known and more complex problems that are taught at higher levels. It is also ridiculously complex because there are thousands of molecules, most of which are barely known and there are more possible interactions between them than there are elementary particles in our universe. In that sense, humans will be long extinct before they even scratch the surface of the subject. Needless to say, not all those interactions are equally important, but still, the numbers and the complexity is staggering.

    But, even far more down to earth, most of us don't really know much. Just ask, for example, a registered dietitian what he/she knows about lupini beans. If have, so far, never met one who even knew what they are. Yet, my local Loblaws sells three types of them, my local FoodBasics has them dried, and they are actively being studied in the European Union as part of what they call the "protein transition" because they are easier to cultivate in colder climates than soybeans. In other words, they are considered really important, yet remain essentially unknown.

    As far as nutrition is concerned, you may want to look up "Ben Goldacre", an Oxford professor of evidence-based medicine. I quote him, because he has written quite a bit for people who are not professionally active in the medical field. He is, I think, best known for his work on homœopathy and bad practices by big pharma.

    Just for fun, before I am crawling into my bed, I looked around a bit and found this article from the BMJ:
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2099529/
  • 33gail33
    33gail33 Posts: 1,155 Member
    edited October 2022
    I think it is kind of hilarious that people start threads here all the time asking for diet advice and get told they should check with their doctor - but anyone who mentions their doctor's recommendations gets told that doctors don't know anything about nutrition.
    At any rate - after my doctor told me that I didn't need as much protein as I was trying to get, I did try to do some of my own research, and came to the conclusion that the evidence for me trying to load up on protein wasn't conclusive enough to warrant the stress that particular diet change was causing me.
    (I did find some evidence that people who increase protein in order to lose weight actually end up increasing their calorie intake, so for me the priority at this moment in time is losing fat, not trying to cram more protein - which would be more calories - into my day.)
    I am still mindful of getting a variety of protein sources every day - I just don't worry about hitting an arbitrary target that is somewhat high for my preferred way of eating.
    To each their own - someone on keto would probably balk at the amount of fibre I consume in a day. :smiley:
  • 33gail33
    33gail33 Posts: 1,155 Member
    edited October 2022
    AnnPT77 wrote: »
    Most Dr's don't have a clue, literally, when it comes to nutrition and most guidelines are political at best, and of course, that's just my opinion. I'm just over 2.0 on average. For the average westerner, protein malnutrition is never going to happen unless of course they're chronically undereating. The AMDR range is around 10-35% of energy intake, and most experts from what I've gleaned from the literature recommend at least 2g and more for elderly populations. cheers.

    I know that claim, I hear it often. I wonder where it comes from because it is contrary to my experience. When I went to med school, now a little over 40 years ago, nutrition information already started being given from the very first weeks of instruction. It was everywhere. The only thing that could be said, is that there was no course called "nutrition". Such a course would not have made much sense, because nutrition permeated everything.
    While I am always ready to be proven wrong, and having to change my mind, I'd need to see some pretty hard evidence before I accept that claim. I also find it rather suspicious that it is (seemingly) mostly quacks who make the claim. How do they know, since what they know is largely based on nothing or disproven nonsense?


    So, it would be better for me to learn about my protein needs from my individual personal general practice MD (for whom medical school was probably 40 years back) than to believe a 2013 report on the subject from a group formed for the purpose by the European Union Geriatric Medicine Society; authors of which include 10 MDs (among others); and that cites and discusses research that supports the study group's conclusions? Because such a report (together with its references) would not be evidence, and its authors would be quacks?

    Interesting.

    Sounds like you are of the opinion that your doctor doesn't keep up on new research and is less capable than you of accessing said research? What make you think that your doctor isn't aware of the 2013 report?
    If my doctor hadn't updated their knowledge base in 40 years I think I would be tempted to change doctors.
  • neanderthin
    neanderthin Posts: 9,549 Member
    edited October 2022
    33gail33 wrote: »
    AnnPT77 wrote: »
    Most Dr's don't have a clue, literally, when it comes to nutrition and most guidelines are political at best, and of course, that's just my opinion. I'm just over 2.0 on average. For the average westerner, protein malnutrition is never going to happen unless of course they're chronically undereating. The AMDR range is around 10-35% of energy intake, and most experts from what I've gleaned from the literature recommend at least 2g and more for elderly populations. cheers.

    I know that claim, I hear it often. I wonder where it comes from because it is contrary to my experience. When I went to med school, now a little over 40 years ago, nutrition information already started being given from the very first weeks of instruction. It was everywhere. The only thing that could be said, is that there was no course called "nutrition". Such a course would not have made much sense, because nutrition permeated everything.
    While I am always ready to be proven wrong, and having to change my mind, I'd need to see some pretty hard evidence before I accept that claim. I also find it rather suspicious that it is (seemingly) mostly quacks who make the claim. How do they know, since what they know is largely based on nothing or disproven nonsense?


    So, it would be better for me to learn about my protein needs from my individual personal general practice MD (for whom medical school was probably 40 years back) than to believe a 2013 report on the subject from a group formed for the purpose by the European Union Geriatric Medicine Society; authors of which include 10 MDs (among others); and that cites and discusses research that supports the study group's conclusions? Because such a report (together with its references) would not be evidence, and its authors would be quacks?

    Interesting.

    Sounds like you are of the opinion that your doctor doesn't keep up on new research and is less capable than you of accessing said research? What make you think that your doctor isn't aware of the 2013 report?
    If my doctor hadn't updated their knowledge base in 40 years I think I would be tempted to change doctors.

    Your conclusion that protein wasn't warranted because of the possible increase in calories from consuming more and the fact that you eat what might be considered a very high amount of firer does lead myself for example that most of your protein are coming from plant based sources which along with protein will have carbohydrates and generally lots of them. Animal protein is nutrient dense and doesn't have carbohydrates. Maybe look to include more animal sourced protein as opposed to thinking that maybe higher protei diets might not be good, that's kinda a confirmation bias.
  • BartBVanBockstaele
    BartBVanBockstaele Posts: 623 Member
    33gail33 wrote: »
    I think it is kind of hilarious that people start threads here all the time asking for diet advice and get told they should check with their doctor - but anyone who mentions their doctor's recommendations gets told that doctors don't know anything about nutrition.
    At any rate - after my doctor told me that I didn't need as much protein as I was trying to get, I did try to do some of my own research, and came to the conclusion that the evidence for me trying to load up on protein wasn't conclusive enough to warrant the stress that particular diet change was causing me.
    (I did find some evidence that people who increase protein in order to lose weight actually end up increasing their calorie intake, so for me the priority at this moment in time is losing fat, not trying to cram more protein - which would be more calories - into my day.)
    I am still mindful of getting a variety of protein sources every day - I just don't worry about hitting an arbitrary target that is somewhat high for my preferred way of eating.
    To each their own - someone on keto would probably balk at the amount of fibre I consume in a day. :smiley:
    Your reasoning is sound. I originally thought that the claim that "doctors don't know the first thing about nutrition" interesting, but after looking around, I came to the (very predictable) conclusion that while some doctors may not be up-to-the-second about the latest controversial-or-not article about nutrition, this does not mean that "sports experts" and "physical therapists" are better sources of information. There also really are actual doctors that are quacks, and there is quite an abundance of them in the weight loss field, but all it takes to find them out is to look at discussions between those who know and those who don't to figure out that one type is evidence-based and the other conjecture-based. In a post-truth world, facts no longer matter, but reality does not care about that. Reality is what it is and not what we wish it to be.
    In the end, since we are talking about weight loss/maintenance/gain here, calories are what matter. That does not mean that other stuff, like macros/vitamins/minerals/exercise... are not important, they most definitely are, but it is also true that they have little, if anything, to do with weight. Study after study has shown that macros and exercise have next to no influence on the outcome of a diet.
    When people talk about literature, they don't tend to be interested in the goose quills, the typwriters or the computers used to write it, since these tools are essentially meaningless. They are important tools because you need them, but the kind of tools has but little influence on the final result, and possibly even none at all.
    It is no different for weight management.


  • AnnPT77
    AnnPT77 Posts: 30,289 Member
    edited October 2022
    33gail33 wrote: »
    AnnPT77 wrote: »
    Most Dr's don't have a clue, literally, when it comes to nutrition and most guidelines are political at best, and of course, that's just my opinion. I'm just over 2.0 on average. For the average westerner, protein malnutrition is never going to happen unless of course they're chronically undereating. The AMDR range is around 10-35% of energy intake, and most experts from what I've gleaned from the literature recommend at least 2g and more for elderly populations. cheers.

    I know that claim, I hear it often. I wonder where it comes from because it is contrary to my experience. When I went to med school, now a little over 40 years ago, nutrition information already started being given from the very first weeks of instruction. It was everywhere. The only thing that could be said, is that there was no course called "nutrition". Such a course would not have made much sense, because nutrition permeated everything.
    While I am always ready to be proven wrong, and having to change my mind, I'd need to see some pretty hard evidence before I accept that claim. I also find it rather suspicious that it is (seemingly) mostly quacks who make the claim. How do they know, since what they know is largely based on nothing or disproven nonsense?


    So, it would be better for me to learn about my protein needs from my individual personal general practice MD (for whom medical school was probably 40 years back) than to believe a 2013 report on the subject from a group formed for the purpose by the European Union Geriatric Medicine Society; authors of which include 10 MDs (among others); and that cites and discusses research that supports the study group's conclusions? Because such a report (together with its references) would not be evidence, and its authors would be quacks?

    Interesting.

    Sounds like you are of the opinion that your doctor doesn't keep up on new research and is less capable than you of accessing said research? What make you think that your doctor isn't aware of the 2013 report?
    If my doctor hadn't updated their knowledge base in 40 years I think I would be tempted to change doctors.

    I don't look to my individual doctor for detailed dietary recommendations. That's not his wheelhouse. He does keep up on recent research, and I have consulted with him about my weight goals, plus we've specifically done blood tests to ensure that I'm on track with specific nutritional issues (to the extent that can be determined) that could be relevant for me. You're welcome to differ, but I think an expert study-group formed by a major geriatric medical organization is worth paying attention to.

    I'm more focused on getting my doctor's guidance in personal issues more central to his scope of practice. (That's also where I think it's most important for him to keep up with research. Doctors are humans with limited time budgets, like the rest of us.)

    I don't know whether you're in the US, but in my case, we're talking about 15-20 minute appointments every 6 months (unless some symptoms develop). Those focus on things like my hypothyroidism, early COPD, status with vaccinations and screening tests, symptoms that may be relevant post-cancer, and that sort of thing.

    I'm not arguing with your personal take, or anyone else's. I'm suggesting that there are alternatives to "ask your doctor" that may be relevant to others in the MFP community who may be interested in other sources of information, in addition to "ask your doctor". That's it.

    ETA: While I consider some of the more recent recommendations (in research, or from such study groups) to be non-definitive, I do think it's odd to see the recommendation of more protein (than the USDA/WHO minimums) to be characterized as unfounded myth-making, quackery, or anything of that nature. I think there are enough hints of value to make it a good bet-hedge, especially for someone who's older, active, or losing weight. That's an individual choice.