For many years, I subscribed to the popular belief that protein was something easily obtained from a "clean," plant-based diet. Nuts and seeds, quinoa (!), or the ole rice and beans combo were the answers to all the body's needs. I thought I was being the healthiest. Animal protein wasn't exactly banned from my table, but it was mostly relegated to the dinner slot. I had read that it was hard to digest. My vegetarian friend told me it could turn rancid in the gut. Neither of us knew what she was talking about but the implications were clear.
Then my bae husband was hospitalized with the ulcerative colitis and my protein beliefs were turned on their heads, forcing me to relearned everything I thought I knew about the macronutrient.
First and foremost, he needed protein, and lots of it, if he was ever going to repair his ravaged gut lining.
The RDA has set the amount of protein needed by the healthy individual to avoid disease as 0.7 grams per pound of body weight. For those with healing needs, it may be upwards of 1.85 grams. We'll get into what this looks like later, but to round out our numbers section here, this put him at a minimum of 118 grams on a healthy day, and somewhere around 300 grams per day when dealing with an active flare. That's more than double a regular, manly intake. That's a whole lotta quinoa.
But wait. Back the truck up. Proteins, again?
Proteins are made up of long strands of amino acids. Amino acids are the Legos that the body is built out of, from fingernails to muscles to tendons. There are 20 different types of amino acids found in the human body, with 9 considered essential. This means those 9 amino acids must be consumed in our foods, while the other 11 can be built by our bodies when we provide enough materials (ie: other proteins).
The protein we eat can either be "complete" or "incomplete." A complete protein contains all 9 essential amino acids while an incomplete protein has a limited selection. In general, animal protein is complete, providing all 9, while plant proteins are incomplete, requiring the pairing of foods (rice and beans; not an accident!) to check all the essential boxes. While some plant proteins ARE technically complete, such as hemp, they're limited by having insufficient amounts of certain essential amino acids for adequate function in the body.
Another big hairy difference between plant and animal protein is the bioavailability of those Legos. Bioavailability refers to how much of a nutrient is absorbed and utilized from a particular food, which can be significantly less than the amount the food actually contains. Nutrition panels are basically false news. You can't even be sure the calorie count is accurate.
When it comes to absorbing protein from our foods, the FAO/WHO use a handy scale called the protein digestibility corrected amino acid score. This measures the amount of protein available from a food against the amount absorbed into our body. Meat sources, with good ole eggs leading the pack, score 1 or close to 1 (the highest score available). The most bioavailable plant sources, on the other hand, come in at 0.7 or less. That's a significant difference on a scale of 0 to 1. And while it may be a navigable difference if you have excellent gut function, it can be a deal breaker for the sick and healing, who often have both high protein needs and compromised gut function on their plates. Check out this post from Diana Rodgers, RD, for more hard facts about protein digestability.
[Side note: The plant protein exception on PDCAAS chart is soy protein, which often ranks close to 1. Hence Ensure shakes and other frankenfoods served by hospitals to the sick. It's important to note, however, that soy comes with a lot of baggage. Unless labeled organic, almost all US soy is GMO and heavily treated with questionable pesticides and herbicides, such as glyphosate. It also may or may not have a positive effect on women's hormones, depending on which study you check. And it's packed with digestion inhibiting enzymes that can cause damage to the gut lining. Unless it's in fermented form, like natto or tempeh, it's best to skip this little beaner.]
Another issue on the table when we're comparing animal to plant protein for patients with IBD or IBS is the fiber component. This normally much-loved and sought-after food component can be a veritable scourge for the sick. When the gut is inflamed with ulcers or fissures, that fiber acts as an irritant, literally scraping its way over the affected areas, slowing the healing and causing physical discomfort. In addition, patients with IBS or IBD often lack healthy digestive function in both the small intestine -where nutrients should be absorbed- and the large intestine -where excess water should be reabsorbed. The result is a gut without the ability or time to efficiently extract nutrients from fibrous food webs.
Compare this with the animal protein situation. Not only is animal protein lacking the gut-irritating fiber, but it also typically comes with high levels of B vitamins, zinc, selenium, iron, and magnesium, among other beauties. These nutrients are highly bioavailable from their fiber-less animal sources, already in usable form (as opposed to a nutrient precursor), and key players for healing and fighting inflammation.
I talk to a lot of sick people who tell me they're eating "so healthy!" With hardly any meat! And so many smoothies!! GREEN. But they're still wondering why their insides refuse to heal and how they still have nutrient deficiencies. And I'm wondering how to delicately suggest they swap the broccoli for a grass-fed filet.
The point I'm trying to make is that sometimes "eating healthy" is counter-intuitive. Sometimes in order to heal, one must think outside the politically correct diet box and dig deeper into nutrition science and digestive physiology. Our body has needs that may or may not align with our emotional ideals.
Back at the hospital bedside, we hatched some new plans for our eating strategy. We sidelined raw produce for a spell. Same to nuts and beans. Instead, eggs were popped like multi-vitamins and sustainably-caught tins of seafood were stacked in the cabinet. We bought a chest freezer and purchased grass-fed meat in bulk from a local farmer. And guess what? Healing sped up, energy increased, and digestion improved- for both of us.
We're back to eating tons of fresh fruit and vegetables now -raw, cooked or otherwise- but we count on local, ethically raised meat for our protein. It was a lesson learned the hard and scary way, but I'm glad we did. Shout-out to science for having my back!
The question of whether meat-eating is environmentally responsible in today's climate is its own epic novel, but this TED talk is a good place to start the discussion.