Basic question regarding protein

I really hope people new to WLS understand that protein is the most important thing to get into our bodies post WLS. I eat protein first. If I have room I eat veggies next. I do not mind fat but I restrict carbs unless they come in the form of dairy. Carbs in the form of bread, pasta, potatoes, rice, etc. are not helpful. I rarely eat fruit.

Those of us who limit carbs are not afraid to introduce them. We understand that for most of us, carbs are what got us morbidly obese. Believe me, if I thought I could eat some bread, or a little pasta, or a baked potato or cookie, and not get carried away, I would. But those things make me more hungry.

What IS helpful to our bodies... protein and fat. And water.

First principle: every cell in your body needs protein (amino acids). They're used for cell wall construction and repair and processes inside the cell.

Second principle: your body cannot make amino acids out of anything else. Amino acids are amino acids. Period.

Third principle: your body does not "store" amino acids. Fatty acids are stored. Glucose is stored. Amino acids are not.

Therefore, you must get sufficient protein (amino acids) in your diet. They're not going to come from anywhere else. And since every cell needs them, you need a certain amount no matter how many calories you are/are not eating. :)

I think i may not have been clear in my original post. I definitely understand the nutritional value of protein and healing and health. However, protein deficiency in the US is virtually unheard of, so I was wondering more about individuals rationale for what I perceived as an emphasis on getting large amounts of protein past the initial healing phase.

It appears that it may have been just that - my perception. The several replies that addresses this specifically seem to have people getting relatively normal amounts of protein (20%-25% and 60g-120g). I had (apparently incorrectly) thought people were regularly shooting for 120g+ and 30%+ and if that was the case, was just curious as to what the catalyst was for doing so.

But thanks for all the replies, and I appreciate the concern for my health!

edit: I can't seem to type lately

I get at least 200g every day. I hit 300 a couple times a week, and have hit 400 now and then.

No one gets fat from protein. We all got fat from crappy carbs. And it always spirals back down to crappy carbs.

And protein is f$%&ing delicious.

"protein is f$%&ing delicious". Now there's a great answer! And gave me a good laugh. Thanks for that ;-)

Without protein and fat you will die. Without carbohydrate, your liver will make it from protein via a process called gluconeogenesis. Exogenous carbohydrate is inherently unnecessary for human life. 100-150g of protein a day isn't necessarily "very high." Very high protein would be well over 250g/day, to the point where you would be getting ammonia toxicity. Very few WLS patients even approach that. We also don't necessarily absorb it all. I only absorb about 20-30% of the protein I eat, for instance.

As for bariatric patients, why go protein first? There are pragmatic and scientific reasons for it. The biological reason is that being deficient in protein has long-lasting consequences which can be potentially dangerous over time, and obese individuals are often chronically malnourished despite overconsumption. Protein also stimulates both chemical and physical satiety - chemical satiety vs. stimulating a better balance of neuroendocrine gut hormones and enzymes such as PYY, ghrelin, HGH, leptin, adiponectin, etc, than carbohydrate or fruit. Fat does as well, and I'd actually argue it's preferable to also consume fat to varying degrees. Additionally, we tend to eat less post WLS, and so it becomes much harder to get an adequate amount of protein without trying. Protein also stimulates a slowing of the GI tract, so food takes longer to digest.

As for there being a concern for protein deficiency, yes, absolutely. I've seen DS patients hospitalized for it, and I've seen RNY patients with it bad enough their legs were beginning to swell. It is a legitimate concern, especially if you have absorptive procedures. If you have a DS and neglect your protein and fat you are just playing Russian roulette without reloading the gun - same for a longer RNY. The longer the RNY, the more likely you need increased protein, and contrary to what patients think, many of us have far more variation in our gut lengths than you might imagine.

Regarding weight regain, protein is less likely to be converted to fat than carbohydrate, pure and simple. Individuals who habitually consume less processed carbohydrate and get adequate protein tend to maintain their losses better according to the literature.

I think you can't simply view all WLS patients with a broad brush. Someone very tall might in fact do quite well with 200g of protein, and someone very short who is sedentary might just need 50g/day. Someone with a DS is pretty stupid if they eat 60g a day, conversely. Someone with an RNY should likely err on the higher side of things, and so on and so forth. If you are reading a message forum, all of these minutae are not able to be considered, for instance.

As always, Donna, you, your information, your experience, and your perspective all ROCK!

Thank you. :)

Thanks for your reply - well thought out and insightful, thanks.

While the studies I've been able to find (and admittedly, I haven't been able to find many) seem to show that the rate of protein malnutrition, is low but far from unheard of (have seen rates around 5% for RNY patients). However, what I can't find, and feel would be HIGHLY useful information, is how much protein were these people consuming. If that 5% were consuming an average of 75g a day, I would find that highly concerning, and definitely want to up my protein! If that same 5% was consuming 30g or protein a day, I would not be terribly worried, and feel comfortable in my current rate of consumption.

You also make a good point about limited calorie intake. If I was one of the more unfortunate ones that could only maintain on 1000-1200 calories a day, I would have to focus more on protein. I generally maintain well on ~1,800 calories a day, and even without a focus on protein (and the protein I do consume comes from plants), I almost never dip below 70g a day. Even when I cut calories down to 1200-1400 to lose a couple of pounds, I am still at or above 60g (my personal minimum target).

And when I said "very high", I didn't mean to imply dangerous or near toxic level. I agree with everything you say actually. I would love to find more data on the average daily intake of those that suffer from protein deficiency. I'm always on a quest to educate myself on health and nutrition, and am certainly open to modifying my behavior when new information presents itself. Hence why I ask these questions from time to time, and why I appreciate your responses. While I don't take internet forum advice as "gospel", of course, I do find it helpful in breaking through some of my natural confirmation bias. Research/reading independently can lead me down a confirmation bias rat-hole at times ;-)