Do proteins have a role in diets for diabetes? Expectedly, when we talk about diabetes and meal planning, we mostly focus on carbohydrates (carbs). Diabetes is also called sugar in common parlance. The connection between sugar and diabetes is strong and embedded in our minds. Not just people with diabetes, every health conscious person talks about reducing carbs in the diet. In all this craziness, we often miss the importance of proteins.
There are three “macro” nutrients in our diet — carbohydrate, protein and fats. Proteins are the building blocks of our body and are vital for growth, muscle and bone development. They are also important constituents of hormones and many enzymes at the cellular level and are important to build immunity. About half of the proteins in our body are in our muscles. Proteins are also broken down by the body into glucose and used for energy, a process known as gluconeogenesis.
India is a carb-loving country. In general, our protein intakes are sub-optimal. According to The Indian Council of Medical Research (ICMR), the daily recommended intake of protein for an adult is 0.8 to 1 gm per kg body weight. This means, for a 70 kg average Indian, about 56-70 gm protein should be consumed daily. Most Indians are way below this figure, often not even reaching 50 gm a day. This has an impact on our muscle mass. Studies have shown that Indians at all ages have low muscle mass (“sarcopenia”) as compared to populations with better protein intakes.
There are several prevalent myths around protein consumption like ‘patients with diabetes should not consume much protein’, ‘protein-rich diets may harm your kidney’, ‘protein is difficult to digest’, ‘leads to weight gain’ and is ‘only for body builders’. Some of these myths come from the Western world where protein intakes are much higher than Indians. Excess protein intake can be a concern in some of these countries, whereas for Indians, it’s a struggle to meet normal protein requirements.
How does protein intake impact diabetes?
1. When you eat carbohydrates in combination with protein (or fat), it can take longer for your body to convert the carbs into glucose, leading to lower post-meal blood sugar levels in patients with Type 2 diabetes.
2. Although 1 gm of protein provides four calories, the same as carbs, it reduces the calorie intake by providing satiety, which also helps in blood sugar control.
3. A low protein diet leads to muscle loss which increases the risk of falls and fractures in elderly diabetics. Such individuals could in any case be more prone to a fall because of nerve, muscle and eye involvement due to long-standing diabetes.
4. Low muscle mass is a contributor to insulin resistance. So, it’s not just adipose tissue but a lack of muscle mass that also contributes to insulin resistance and its long list of consequences.
5. Recent data suggests that low muscle mass — and low protein intakes by inference — promote the development of fatty liver disease, which can lead to liver cirrhosis and even cancer.
How should we be addressing the protein issue if we have diabetes?
We should aim at getting 15-20 per cent of our calories through proteins on a daily basis, and ensuring a bare minimum of 0.8 gm/kg body weight protein. This should ideally be greater than 1 gm/kg for people with diabetes, unless they have kidney involvement. Even for those with kidney complications, an intake of 0.8 gm- 1 gm/kg is recommended!
Our requirement also depends on our exercise level, so a higher intake 1-1.5 g/kg is recommended for some. Athletes often have to consume much higher amounts.
Try to get protein in every meal for maximum benefit. Having one high protein meal with other meals being devoid of proteins is not the best health management method.
All proteins are not the same. Their quality also matters. Animal source proteins are generally superior to plant proteins, although there is a lot of attempt to enhance the latter in recent times. Amino acids are the units that make up protein. Some of these cannot be made in the human body and are required to be taken through the diet. These are called essential amino acids.
The best sources of proteins are dairy products like milk, curd, paneer as well as eggs, meat, fish and poultry because they have all the essential amino acids.
Vegetable sources of proteins include lentils, beans, and nuts. Soya bean is an exceptional source. If you are vegetarian, consume dairy and dals. If you like the taste, add soya bean. If you are vegan, please have a nutritionist calculate your protein intake and ensure you don’t fall short! A combination of cereals, millets and pulses provides most of the amino acids, which complement each other to provide better quality proteins.
A variety of proteins always helps. One good principle is that every time you have a meal, search for the protein in the plate. Make sure there is protein in every major meal that you consume.
To give you some idea about what common foods to consume, have a look at this list:
100 gm of chicken = 30 gm
100 gm of fish = 22 gm
100 gm of cooked green soyabeans =12 gm
1 large egg = 6-7 gm
1 cup of milk (200ml) = 7 gm
1 katori of dal or beans = 5-6 gm
1 katori of dahi = 4 gm