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Episode 239:
Show Notes
Episode 239:
Transcript
Dr Mary Barson (0:04) Hello, my lovely friends. I am Dr Mary Barson.
Dr Lucy Burns (0:09) And I'm Dr Lucy Burns. We are doctors and weight management and metabolic health experts.
Both (0:16) And this is the Real Health and Weight Loss podcast!
Dr Mary Barson(0:17) Hello, my lovely friend. Fabulous to have you here on today's podcast. Dr Mary here, joined by the fabulous Dr Lucy, my lovely friend. How are you going?
Dr Lucy Burns (00:29) Again, totally awesome summer, my favourite time of the year. I don't know, I just love longer evenings. We live down in Melbourne, we get beautiful sunlight. You know, it's still light at nine o'clock, you're outside in the evening. It just, you know, it's just good for the soul. So yeah, I'm great.
Dr Mary Barson (00:48) I love it. I have a slightly opposing opinion, not completely, but you know, with kids, especially with my little toddler, trying to convince him he has to go to bed at 7.30. It's not nighttime. It's not nighttime. So we had to differentiate night time from bedtime. Yeah, so it's a little, little challenge there.
Dr Lucy Burns (01:07) Yes, I can imagine. I do. I do remember those days. And I remember actually even my own brain doing that to me as a little kid thinking, you know, yeah, it's still light at nine o'clock. Why would I want to go to bed at eight o'clock? Like honestly, who wants to do that? So yes, crazy. All right, this is a hotly requested topic this round. And we are talking protein powders. Interestingly, somebody just sent us an email this morning asking about specific collagen brands. We're not going to go into that in this episode, but we are talking about where protein powders might fit into your health and weight loss journey. What you'll notice is I've caved in with much because we're not tribal. There are no rules, but what we want to do is give you the information so that you can be empowered to make a decision on what is right for you on whatever time. So again, you might make a decision that's right for you for this week, this month, and you may change your mind later because you're allowed to.
Dr Mary Barson (02:11) You are, you are the boss of you.
Dr Lucy Burns (02:14) Excellent. So the first thing I want to do is, I mean, protein, protein is a macronutrient. It's made up of amino acids. So they're all linked together. And we have what we call essential amino acids and non-essential amino acids, which is a confusing term. Essential means you've got to eat them. So it is essential that you get them in your diet. Non-essential means that our body can make them. So we can, you know, part with autophagy, with recycling, and with the building blocks that already exist within our body, we can make particular amino acids. So clever. Aren't we clever?
Dr Mary Barson (03:1021) We are so clever.
Dr Lucy Burns (03:03) I know. So then we go, okay, so that's a macronutrient. There are health implications if you don't get enough protein. And we see this in severe famines and the things where people develop, and particularly children develop, you know, chronic diseases that bury, bury and things that we don't see in Australia in particular, and maybe wherever you are in the world. But we do know that in the long term, that protein deficiency is problematic. And one of the things we're seeing in our modern world in older people is a condition called sarcopenia. So Miss, would you like to explain sarcopenia in simple language?
Dr Mary Barson (03:50) Yeah, so simply put, sarcopenia is when there is muscle wasting and thinning of the muscles. And it's a bad thing. So it results in decreased strength, and increased fall risk, it's associated with metabolic ill health and premature death. And it's definitely something that we want to avoid. So sarcopenia is not great. We want to be able to keep our muscle mass and keep our bones and muscles strong as we age and enter our glory years. And getting adequate protein is an important part of avoiding sarcopenia. Absolutely.
Dr Lucy Burns (04:30) So our thoughts are that in general, we probably undereat protein because, you know, the Australian diet, the Western diet, so this is Australia, England, US, is heavily carbohydrate based because honestly, carbs are a quick and easy, they kind of fill a hole, most people find them pretty tasty. And so for the majority of people, they'll have a really, you know, carbs come with every meal. And often they form the basis of it. And protein seems to sort of get slipped away. So this is the opposite of our build-a-plate formula where we go pick your protein first, and add some veggies, if the protein is very lean, you can add a bit of fat to it. If the protein is really fatty, then don't add too much fat, add some flavour to make it delicious, a bit of salt, seasoning, and whatnot. And people go, where are the carbs? The carbs are in the vegetables. So you're, you know, much-maligned broccoli, love broccoli, broccoli is carbohydrates, you know, they're in there. So it's not like you're missing a macronutrient, we're just reducing them. And again, if you've got a family or you've got somebody who tolerates carbohydrates, then you can add, you know, extra carbs to their plate if you want to if you want to add rice or pasta or potato or whatever to their plate, that's fine. You know, it's not going to kill you.
Dr Mary Barson (06:07) No, definitely not. Yeah. We encourage people to eat, like, you know, to really prioritise their protein. And often we encourage people to eat a lot more protein than they already are. And this is, you know, an adjustment for people, because our protein takes moderate, you know, we encourage people to take a moderate protein, it's not like a super high protein diet, but definitely want people to prioritise it and make sure they get enough. Because having adequate amounts of protein in your diet, it doesn't just reduce your risk of sarcopenia and help you build muscle, it also improves your metabolic health. It's associated with, you know, improved outcomes in diabetes to help even avoid diabetes. It helps with weight loss, it helps with satiety. It really is such an extremely important macronutrient. And because, you know, we encourage people to prioritise their protein and really make it the star of their meals, we always get asked about protein powders, you know, because it does seem so much easier, you know, if you're used to having tea and toast for breakfast, and now we're saying, oh, you know, have some protein for a breaky, you know, that would be a really good thing to do for your health, for your metabolic health, for your longevity, that could just seem a bit hard. And the idea of being able to have, you know, some protein in a packet is really appealing. And just like to discuss this a little bit more now about how, when, why,and if packet protein is something that you want to include in your life.
Dr Lucy Burns (07:44) Yeah, absolutely. So the first thing we need to know is that protein, well, A, we've said it's good, but B, it's given a health halo, and is now used in the marketing of processed food. So there are now a gazillion products everywhere that will tell you their thing is high protein. So be aware of that, because that's a marketing tactic. And it might say high protein. And when you compare the high protein with the normal product, it's like one gram per 100 grams more, or two grams per 100 grams more like that. Honestly, that's, that's rubbish. So just be aware of that as a concept. The second thing is, there is a vast difference between whole food protein and protein powders. So protein powders are an ultra-processed product. You can't just sort of dry out some meat and make it a protein.
Dr Mary Barson (08:52) You can, but then you're looking at jerky or biltong. Yeah, yeah, yeah. You can't just dry it out and get a protein powder.
Dr Lucy Burns (09:01) No. So when we're looking at processing food, it's important to put it into sort of three categories. There's unprocessed, there's processed, and then there's ultra-processed. And so we need to make sure that we don't lump the two in together. But ultra-processed is really, it's done in a factory, and it's where the end product looks almost nothing like the original products that were the components of this end product.
Dr Mary Barson (09:29) Yeah. So common sources of protein in protein powders would be like whey protein from dairy, soy, pea, and hemp. They're probably the most common, like casein from dairy as well.
Dr Lucy Burns (09:43) Yeah. And collagen, collagen protein is in a lot of protein powders as well. Absolutely. So collagen is an animal. So the animal-based products are, yeah, the collagen, whey, and some of them have casein, yeah, as you said. The plant is, yeah, pea, hemp. I think some use rice proteins as well. And then, you know, again, just a little side note, wheat protein is glidin and it's super problematic because that is what people with celiac disease can't have. And it's what people with, people find a lot of gut problems with that as well.
Dr Mary Barson (10:25) Yeah, it can stimulate some of those irritable bowel syndrome symptoms for a lot of people.
Dr Lucy Burns (10:31) Yeah. So the other thing to know is there is also a difference between protein powders and meal replacements. And I think, again, it's important to know that. So a protein powder is literally just powdered protein of some sort. A meal replacement comes with, usually with, protein, carbohydrates, fats, vitamins, minerals, flavours, you know, things to make a palatable. And it has been nutritionally formulated, which also means that some of the formulations, again, it's not formulations for every person, because, again, as you all know, you know, we firmly believe that if you are insulin resistant, then one of the most effective, not the only effective way, but one of the most effective ways to reduce your insulin resistance is to lower your carbohydrates. And yet many of these protein, these meal replacement shakes have huge amounts of carbohydrates. So they're not actually going to do anything to improve your metabolic health.
Dr Mary Barson (11:40) They're just low-calorie, essentially. And we've discussed this many, many times over about how just low calorie, particularly in the form of processed low-calorie foods of which these diet shakes are. That's meal replacements. We're often talking about diet shakes, man shakes, and lady shakes, to name a few, they have quite a lot of carbs in them and they're processed and they also don't do a lot to reduce your hunger. And if anyone who's ever been on them, people usually experience quite significant hunger when they're taking these meal replacement products.
Dr Lucy Burns (12:15) Absolutely. Now, we have a cohort of people in our community who physically struggle to eat large amounts of protein. So, again, these are people who have had bariatric surgery and had a gastric sleeve. If you're taking injectable weight loss medications, I'm going to tell you, that it is hard to eat the amount of protein that we're suggesting because protein is highly satiating. It's not necessarily a volume thing. It's a satiating thing.
Dr Mary Barson (12:49) You just feel full.
Dr Lucy Burns (12:50) You feel so full, which is, you know, where I'm always going, oh, huzzah, great, I get to eat protein.
Dr Mary Barson (12:53) I love it. Have a nice high-protein meal and I feel fabulously full. It's wonderful. But yes, if you're struggling to get enough food in any way, then that can be a problem.
Dr Lucy Burns (13:03) Absolutely. And this is really, again, something that we talk a lot about with the injectable weight loss drugs and people with bariatric surgery, which is the concept of malnutrition within these cohorts. So there's a study recently released around the GLP-1, so the Ozempic, Wegovy, Mounjaro, talking about the discontinuation syndrome, which means when people take them, yes, there is weight. Yeah, they decide to stop them. They do regain the weight, but they end up metabolically worse off because of the psychopenia that's come. So the way to manage that risk is to, again, ensure you have adequate protein and to make sure you're doing strength training exercises. And that's just not walking. It actually has to be resistant work because otherwise that rebound and worse off than you were. That's like that's terrible. It's bad. It's not you're not going to be living your glory years. No one wants that. No. So then we go, okay, well, some people may find eating whole protein difficult. We've got sort of three categories, Miss, and I think, again, we've talked bariatrics, we've talked people using weight loss drugs, and then we've actually got people who are in what you like to refer to often as the time sandwich.
Dr Mary Barson (14:39) Totally. I'm a busy human and I know that I am not alone in this. I'm not Robinson Crusoe, but yeah, solo mom, with little kids working, time pressures, and time sandwiches all the time. Look, I can honestly see the appeal of a tea and toast breakfast as the idea of boiling a couple of eggs just can seem a bit hard. And I think there is a group of people where you've got an intact gut, haven't had bariatric surgery, are not on injectable weight loss medications, but are time poor and having a convenient high protein source is great. And I think that there are a few ways in which protein powders may come into that. But how would you recommend people use protein powders? So when we come back to the beautiful group of people you were first talking about, people who've had bariatric surgery, people who are on injectable weight loss medications, how might they use protein powders or meal replacements? Would they not use meal replacements? Would they use protein powders? What would you recommend, Dr Lucy?
Dr Lucy Burns (15:48) Yeah, great question. So I think, again, the two camps are meal replacements and then there are protein powders. Protein powder is really a supplement. So it means that you've got sort of your whole foods already going. You're already eating sort of maybe plenty of veggies. You're getting your vitamins and your minerals. But you're just finding that you can't eat 150 grams of steak. It's just not working for you. So there are a couple of ways in which you can do it. So you can supplement your meal with a protein powder. Now, we're not part of this company. I've never really even spoken to them. But there is a brand of protein powder called Tasteless Protein, which is sort of a good name. But it means that people always go, oh, what sort of protein do you recommend? I go Tasteless Protein. They go, yeah, but what brand? That is the brand. Tasteless Protein is the brand. And part of the reason I like it is that it is just protein. There are no fillers. There are no bulking agents. There are no sweeteners. There are no nasties. There are no emulsifiers. Not only is it so it's a collagen-based protein. So it's not going to be suitable if you're a vegetarian or a vegan. But it's also got the tryptophan added.
Dr Mary Barson (17:09) What do you mean by that, Lucy? Well, explain.
Dr Lucy Burns (17:16) Yes. So collagen is an incomplete protein source because tryptophan is an essential amino acid. So remember at the start where we talked about the amino acids that you can make and not make?
Dr Mary Barson (17:29) There are nine essential amino acids that we need and we need to eat them.
Dr Lucy Burns (17:33) Yes. And tryptophan is one of them, but you will not find any tryptophan in standard collagen products. So this is why I think this one is a good base. You can use it in a couple of ways, but I'm going to give you a little. So I have bought a pack of some of this. And one of the reasons I wanted to try it was that I think with all my swimming, my hair is a bit dry. Okay, and we're going to do a hair episode coming up because hair is important for women in general and men again. Let's just everyone. Your hair is important. And my hair was breaking off and it's all crappy. And I thought, oh, maybe maybe I need to add some collagen in. Now, I could do bone broth. But here's one of the things I haven't made time for. I don't have time. There's a whole heap of reasons in my brain why I don't make bone broth consistently. So I thought, oh, well, I'll give this a try. And I added it to my morning coffee and it comes in a scoop. You just plunk it in. I thought, oh, that'll be easy. Anyway, I normally have morning coffee. I do morning fasting. I'm not hungry in the morning. Well, after this, I was hungry. Stimulate your appetite. Yeah, it's really interesting. And this is the thing that we need to be aware of with powdered versions of whole foods. So we have these things called incretin hormones. In fact, injectable weight loss medications are based on these incretin hormones and they are released or we have receptors in all sorts of bodies, but they're released based on the particle size of food in your gut. And what that does, and it's interesting because it does actually stimulate insulin, which sort of seems weird that we're always
Dr Mary Barson (19:30) There's different types of incretin hormones that do different things.
Dr Lucy Burns (19:35) So part of it does stimulate insulin. However, what it actually does is slow down the passage of food in your gut. And so whilst on one hand, it's telling your pancreas to make a little bit more insulin, it's also drip feeding out the things for which the pancreas needs to make the insulin. And so it really, to quote an old COVID term, flattens the curve. So instead of getting a big whomp, you get it sort of dripped out slowly, which is part of why protein makes us feel full. This is a whole protein. However, when you take that whole protein and turn it into a powder, suddenly you lose that grit and effect and it's kind of delivered into the bloodstream much more quickly and the pancreas has to react quickly.
Dr Mary Barson (20:22) Yeah, you get a bigger insulin spike.
Dr Lucy Burns (20:25) Yeah. And that is then what stimulates your hunger earlier in the morning. So I thought, wow, that was interesting. So that was the experiment that I thought I wouldn't be repeating. Now, again, I have an intact gastrointestinal stomach. I don't have bariatric, I haven't had bariatric surgery and I'm not taking injectables. So the response for other people may well be different. But this was my response. So then as part of my other experiment, I was doing some berries, and Greek yogurt with some nuts as one of my meals. And the thing with that meal is it is often a bit low in protein. And I know it's again, it's an appealing meal because it's quick. You don't have to cook anything. You're not having to get out of the air fryer, but it is a bit low in protein. So I thought I'd just mix my protein in with my Greek yogurt to basically supplement its protein quantity. And that worked really well. So I was happy with that. I like that. So I think that's an option.
Dr Mary Barson (21:31) That's good. Yeah. Do you think that meal replacements have a role for people who've had bariatric surgery or are on injectable weightless medications or are they something that's best avoided?
Dr Lucy Burns (21:40) I definitely think they have a role. So one of the side effects of the GLP-1s is initially nausea, in particular nausea. And I mean, they stop your hunger, like that's part of their job. But for some people, they stop it really intensely to the point where they can't eat anything. They need something that's kind of easy to eat. We also know that with the GLP-1s, the side effects are that if you eat something that's too high in carbohydrates, people get really bad diarrhea or too high in fats. So, again, there are things that we would normally recommend for people to eat to keep them full that just don't work if you're on injectable weight loss meds. So, yeah, a meal replacement, so not just supplementing or not just having collagen in your coffee, can be really helpful for you because it gives you all the vitamins and minerals you need. However, there are some things to be aware of, and that is, again, not all meal replacement shakes are created equally.
Dr Mary Barson (22:48) Very true.
Dr Lucy Burns (22:49) Yeah. So there's a couple on the market that, again, we don't get any kickback here, but I guess the things that I would recommend people do, and again, the supermarket is full of these. So many. So many of them. And the majority of those are rubbish because they're filled with, again, emulsifiers, and fillers, and they're pretty high, most of them in carbohydrates. So they're using, you know, particularly soy protein, pea protein is pretty cheap. So, again, there are two kinds of out there. So there's one by a gorgeous doctor from Australia called Angela Kwong, Dr Angela Kwong, we had her on the podcast recently. Again, she's another weight loss doctor, and she found that her patients were struggling and she couldn't find a meal replacement that she was happy with. One that was low enough in carbohydrates that didn't have bazillions of fillers, that wasn't full of, you know, maltodextrin or sucralose or horrible sweeteners. And so she formulated her own, which I think is pretty good. Now, again, from a real food perspective, it's not perfect, but as you know, we're not tribal. Yeah, that's right. You know, it's sort of like, okay, well, if you are going to choose a meal replacement shake, this one is pretty good. So it's called Enlighten Me. And again, we'll put the link in the show notes. We don't get any endorsement from this. I just thought, look, it's good to know. The second one is out there, which again, is slightly anxious to recommend, but it's not the best. It's not the worst. And it's Ben Bickman. So lots of you who listen to our podcast will know Ben Bickman. He's a wonderful PhD scientist who's done lots. He's very good at being able to explain science in layman's terms. He's very good at dissecting rubbish science and producing good-quality science. So we do really love it. He recognised that sometimes people can't always eat real food. They need a solution. So he came up with one. So he's got his product. The only bad thing about it is it does have maltodextrin in it. Sort of annoying.
Dr Mary Barson (25:18) Yeah, A sweetener that kind of raises insulin. And yeah, it's not perfect.
Dr Lucy Burns (25:24) Yeah, it does have, you know, good fat sources. And, you know, yeah, it's there. But it's like right down my list. Like, you know, if somebody gave you a bag, maybe use it. But I'd probably not go out and purchase that one. And then there are ones that I don't recommend or we don't recommend in particular, basically almost anything from the supermarket. You mentioned the lady shake, the man shake before. Honestly, I mean, their marketing machine is incredible. They have billboards on buses. They're everywhere. They're providing this tempting solution that really is garbage, not really a solution. No. And whilst I'll link the tasteless protein in the show notes, I do want you to be aware of another product they sell that I don't recommend, we don't recommend called protein water. And they market this around the idea that some people don't like a milky drink, that you don't want necessarily to have your protein, you know, in coffee or whatever. Honestly, two things. One, you can add this tasteless protein to anything you put in your tea if you want. So. But this tasteless water which is flavoured, is really highly processed garbage that comes with sucralose and again, a whole heap of other things and sucralose raises insulin. It's the sort of opposite of what we're trying to do. And what some people I see doing is buying this product, thinking again, protein halo, adding it to their water bottles and then sipping it all day.
Dr Mary Barson (27:17) Not so good. No. So we've got to read the labels and keep our eyes open, don't you?
Dr Lucy Burns (27:23) Yeah, absolutely. Again, if your goal is to improve your metabolic health, and honestly, that is the goal to long-lasting weight loss, then sipping protein water all day isn't actually going to help you achieve your goal. Now, you may not know, have known that because the marketing is so enticing, but it won't. And I guess the final thing that I guess I just want to remind people of is the reason, again, we bang on about whole food proteins is not just the increase in effect like that's great. It's wonderful. But the second thing is the thermogenic effect of protein. So, Miss, do you want to just explain that briefly so people really have a great understanding of why we are always banging on?
Dr Mary Barson (28:08) Yeah, so real food is always going to be superior to processed food. And the thermogenic effect of protein is one reason why. So it actually takes a fair bit of energy for us to break down protein from whole sources, whole food sources, you know, that's your eggs, your meat, even, you know, the protein in plant-based sources, the protein in tofu and temper and in real, minimally processed real foods. It takes energy and effort. And so we actually sort of burn energy in digesting protein. And not to mention the fact that all of these whole protein sources are also wrapped up in vitamins and minerals and lots of other things that we need that we actually do get a bit of a workout just from each, which is fabulous.
Dr Lucy Burns (29:02) Oh, absolutely. I love it. Like you're just lying around burning calories for free. Honestly, that couldn't be any easier. So, yeah. So, my loves, the summary is we're not tribal. We're certainly not going to crucify you if you're using a meal replacement shake short term. Before we started recording, we coined the phrase emergency foods. So there are definitely times, you know, those times where your life feels a tiny bit out of control, where you really literally feel like you're just running from one thing to the other and you've got nothing. You haven't even done the shopping. You've got no food. You just think, ah, what am I going to, you know, I've got no space. I have got no capacity for the next week. What am I going to do? Again, you could you could have a good quality protein shake. That would be fine. Yeah, it would.
Dr Mary Barson (29:56) You could also have, you know, tins of tuna and and biltong as well. But, you know, you totally have a protein, a high-quality meal replacement shake then if you need to.
Dr Lucy Burns (30:07) Yeah. And I think the important thing is to think about the idea that meal replacements will never be a long-term option. Like they honestly shouldn't be because of the processing that goes in them. Short term options, again, short term, particularly while you're commencing your injectable weight loss medications or particularly once you've just had bariatric surgery, those sorts of things or preparing for bariatric surgery, they're they're a tool. If you've got a day where once a week you go, oh, my God, well, you know what, Lucy, I do a 16-hour shift at work. God knows anybody shouldn't be doing that. But I do know in the medical world it does happen. It's pretty common. Yeah. And I'm just going to take a shake that day. Well, again, you do you. But just choose one that's, again, the best for you if possible.
Dr Mary Barson (31:00) Love it.
Dr Lucy Burns (31:03) Love it. All right, beautiful peeps, we're continuing myth-busting, helping you make decisions that are helpful to you without judgment and know that whatever you decide to do, you're the boss. And hopefully, we can just add to your knowledge base so that you can make decisions without the, you know, undue influence of marketing sources that stand for enormous financial gain.
Dr Mary Barson (31:33) Beautiful. See you later, gorgeous ones.
Dr Lucy Burns (31:36) Bye for now.
Dr Lucy Burns (31:39) The information shared on the Real Health and Weight Loss Podcast, including show notes and links, provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.