Stephanie Fein MD [00:00:00]:
Hello, fabulous Dr. Stephanie Fein here with weight loss for fertility. And today is about protein. When our focus is hunger. And remember, around here, we eat when we're just hungry, stop when we're satisfied, not full. We want to stay satisfied as long as possible. We don't want to have to feel hungry all the time or eat all the time. So because of that, our best friend becomes protein.
Stephanie Fein MD [00:00:30]:
Incorporating protein into each meal means you get the biggest bang for your meal buck. And here is how there's a couple different ways. And this is about how protein interacts with our body and digestion and also hunger hormones, which is really important and actually fascinating. I went down a couple rabbit holes getting this ready for you guys. And there's a lot of good in general. I just know that protein fills you up and it takes longer to digest, so you feel satisfied. Longer period. That was enough for me.
Stephanie Fein MD [00:01:07]:
But there's actually a lot more going on, and you get to know about it here today. Okay, so first, protein takes longer to chew. Now, that may not seem like anything, but remember, when it doesn't take that long, the extra time really adds to the experience. And delaying the gap of when you're finished with your meal and when you feel satisfied. So it shortens that gap by delaying when you finish. Look, all this adds up. It's helpful not only that when you're chewing and breaking it down, you're obviously breaking it down, which is very helpful, but also it triggers a lot of these digestive enzymes, again, giving you a little bit longer to digest it, which is helpful for us for many reasons, but including that gap of when you're actually done with your food on your plate and when you feel the full effect of the satiety hormones, which make you feel satisfied. So that's the first one.
Stephanie Fein MD [00:02:13]:
Protein takes longer to chew. It also protein triggers the release of the right kind of satiety hormones, and it takes longer to leave your stomach. Protein does. So all of those things together make us feel fuller, longer, and that's always what we're looking for. Because remember, our main tool is hunger scale. We eat when we're just hungry. We stop when we're satisfied, not full. And so protein helps us do that.
Stephanie Fein MD [00:02:42]:
Now, gastric emptying is when the food leaves the stomach area. Now, remember, the stomach is the one that has the stretch hormones, so you can sense when you have food in there, and that helps you tell your brain, and actually vice versa, too, that you've had enough in that meal. Okay, so if we have slower gastric emptying, we have the food in our stomach longer and we feel satisfied longer. So gastric emptying is slower for protein rich foods, especially when you compare them to carbohydrate rich foods. But the more important story, and this is what I discovered is hormonal, usually always is protein evokes higher postprandial, which means after the meal. CCK and GLP1, which remember, are the natural hormones in our body that our body makes for us and releases after the meal. And that tells our brain that we're satisfied and then eventually full. So the protein triggers those hormones, more so in a bigger quantity than other foods do.
Stephanie Fein MD [00:04:04]:
Isn't that fascinating and amazing and makes a lot of sense. And in that way, it also slows the gut emptying. Specifically, CCK is the gut peptide responsible for processing ingested fats and proteins. And it slows the gastric motility specifically to avoid overflow of protein and fat into the small bowel, because the small bowel has to deal with it. And it's better for the body if it's done that more slowly. It doesn't matter so much with carbohydrates, because it can handle that very quickly. Remember, because they're already broken down, they go pretty quickly into the bloodstream as glucose, but it requires more effort. I'm putting that in air quotes on the part of the small bowel for fats and proteins.
Stephanie Fein MD [00:04:52]:
GLP1, as we know, delays gastric emptying and also increases satiety. That's what it does. We have that naturally in our system. And when we pay attention to the hunger scale, when we're training ourselves to notice our hunger levels, we are connecting, cluing into more and more the GLP1 effect inside our body. So protein doesn't just sit in your stomach longer, it actively triggers the hormones that tell your brain you're full. And that's amazing. Yay for protein. Additionally, and this is really helpful for us with weight loss, the body needs protein, specifically essential amino acids to build muscle.
Stephanie Fein MD [00:05:41]:
And this is especially important in weight loss as we want to lose fat, not muscle. And it's also important for pregnancy when certain amino acids are required in higher quantities. Because after all, you're building a baby. Not only do we need the essential amino acids, but the non essential amino acids, which by the way, essential refers to the fact that we must consume the amino acids because we cannot make them in our bodies. So essential means we need to eat them. Non essential means we can make them in our body in pregnancy. Just as a side note, there are some requirements that are so high increased amino acid requirements as we're building humans that the non essential ones become essential because we can no longer make the quantities that we need. So protein is especially important during pregnancy.
Stephanie Fein MD [00:06:39]:
And in fact we're going to go to that here. The amount I want you to have when you're in the process of losing weight is actually the same amount for pregnancy. So you'll just get in the habit of having that much, which will be fabulous and good for you, good for baby, everything. So animal based protein is complete protein, which means it contains all nine essential amino acids. So whenever you're having animal protein, you're getting all the essential amino acids that you need. Plant based protein is often missing some, but the way we get around that is that combos of plant foods can be complete. And the one that most people think of is rice and beans. So rice by itself does not have all the essential amino acids.
Stephanie Fein MD [00:07:27]:
Beans by itself does not have all the essential amino acids. But if you eat them together, you will get a complete protein, all nine of the essential amino acids. The thing about protein from plants though is that it's not as bioavailable as animal protein. So it has, it's tied up, the amino acids are tied up more with the fiber. And I talked to you about chewing and swallowing and digesting. It's harder to digest some of the plant based things, which in one hand is good fiber and that's important for us to have. But then the amino acids aren't as available. We're going to look at a whole picture here.
Stephanie Fein MD [00:08:08]:
But the bioavailability of the essential amino acids is not as great with plant protein as with animal protein. Animal protein, it's just available. Also, the plant based protein does not trigger the satiety hormones in the same way you do not get as big a load of the satiety hormones themselves when you're having plant protein. And you may have noticed this just in your eating. And remember when we're doing weight loss, the weight loss for fertility way, and we're focusing on our hunger, we notice these things. So we notice how we're feeling after meals. How does our body feel? How long does my hunger last? How long is it satisfied? When am I hungry? Am I hungrier? Am I all that? You can notice that for your body because you're working on your hunger scale. So you will notice for yourself when you're hungry based on what you've eaten.
Stephanie Fein MD [00:09:06]:
If you've had rice and beans versus if you've had chicken breast, how do you Feel how long are you satisfied? All that sort of thing really important. And it might be affected by the fact that the satiety hormones are not as robust after plant based protein as after animal based protein. Now that being said, this is on research humans, not on your body. Your body may love plant based proteins and you're like, nope, feel great, everything's fine, amazing. Then there's no, nothing's gone wrong, no problem. This is just some information for you to take into account and to use when you're noticing what's going on with your body. Protein hunger scale the other thing with plant based protein is that you often need to have larger quantities of it in order to get the same amount of essential amino acids that you would from a serving of, let's say an animal protein. So that's something to take into account particularly when we're talking about weight loss.
Stephanie Fein MD [00:10:10]:
So it's just something to consider. In general, animal based proteins are more efficient, particularly for weight loss and pregnancy. That's one wait. Okay, now still you're going to be able to take that into account with everything, including the information you get from your very own body. Okay, now what if you're a vegan, vegetarian or pescatarian, weight loss and adequate protein can still be had. It will require intention to get the amount that works best for your body to build and or maintain muscle while losing weight and during pregnancy. So to me that's all this means, is that if you are vegan, vegetarian or pescatarian, then you're gonna have to be really thoughtful about your meals and just really making sure that they're protein based. Now the minimum recommended daily protein officially from the RDA Recommended Dietary Allowance is 0.8 grams per kg.
Stephanie Fein MD [00:11:20]:
This is your recommended daily protein intake. That is the minimum. Minimum. And from everything I looked at, people are like, that's truly the minimum. They wouldn't even recommend it. It's, that's too low. So just to make things easy, if we said what this is, the minimum is 0.8 grams. If we said 1 gram per kilogram, then for a 220 pound person, that's 100 grams of protein in a day.
Stephanie Fein MD [00:11:54]:
Now these are grams and kilograms. You can put them in your phone to get the right thing for ounces and all the rest of that stuff. But I think it's generally grams in on the nutritional information on the back of things and also when you look it up. So 220 pounds equals 100 kilograms. And if it's one gram per kilogram, then it's 100 grams per day. That would be a low baseline for someone who's. It would be half for someone who. It's a little person.
Stephanie Fein MD [00:12:34]:
So you see that there's a. There can be a big difference. Now, the most recent studies on muscle and weight loss recommend 1.2 to 1.6 grams per kilogram per day. That's very different than the 0.8. This is also. This range. 1.2 to 1.6 is also the best recommendation for pregnancy as well. It does look like you need more protein in the third trimester than in the second than in the first in terms of the recommendations of it.
Stephanie Fein MD [00:13:10]:
But if we already are eating good amounts of protein, then we're going to. So in the range of 1.2 to 1.6 grams per kilogram per day, I chose 1.5. And what that means is it's 150 grams of protein a day for a woman weighing 220 in the actively losing weight category also when they're pregnant. So 150 grams is quite different than 100 grams and 100 grams was already more than was the minimum. So this is what we're dealing with now. I just had this idea. This is not to. If this becomes something that feels very stressful, then I would.
Stephanie Fein MD [00:13:53]:
Gosh, I would love to talk to you about that. I don't want it to be stressful. It might help for a couple days to find out how much protein you're actually having and if it's very low, then making a concerted effort. But I don't think you necessarily have to count them every day. If you like that, if that feels good, good to you, amazing. If it triggers like calorie counting or diet mentality thinking or sort of traumatic dieting, then it's not going to be worth it to keep track all the time. But I do want you to aim for this. And once you have an idea of what it takes to have the right amount of protein for you, then you don't have to necessarily keep track of it as much.
Stephanie Fein MD [00:14:39]:
If you're in this general area, it's amazing. What we don't want is for you to be getting 30 grams of protein a day. We want it closer to this, depending on your weight, between 100, 150, somewhere in there, 200, depending on if that's the recommend recommendation. Also, it looks like it's best to divide your daily protein more or less equally among your meals, rather than having it all in one sitting. So just having a huge steak for dinner and not having any protein in your breakfast and lunch, not the best. And I was, again, I was looking into that too. And there's different information on whether your body can handle or not. My thought was, my understanding was that it was hard to process and we were wasting on putting that in air quotes.
Stephanie Fein MD [00:15:30]:
But it doesn't look like that necessarily is the case. And still the recommendation is to parse out your protein in the day. Now, you could have less protein in the breakfast, a little more at lunch and a little more in dinner. You can do that or equally, however that works out for you. The point is not to have no protein for two meals and all the protein in one. This is especially true for muscle building. And muscle building is slightly different than muscle preservation. So we're going to look at muscle building for a second.
Stephanie Fein MD [00:16:07]:
Protein intake alone won't have you building muscle. You need resistance training for that. Okay? So you need to tax the muscle so that it knows it needs to build. And the way we do that is resistance training. And resistance training are things like yoga, pilates, weightlifting and calisthenics. What I mean by that is push ups and it lunges and those sorts of things like orange theory. Do ask your fertility doctor about exercise though, because sometimes in some phases of the IVF process, they like you to ease up and it's worth a conversation with your fertility doctor. But muscle building requires resistance training.
Stephanie Fein MD [00:16:48]:
When you have adequate protein intake and you're losing weight, you won't lose as much muscle tissue as you would if you were losing weight and not having enough protein. Do you see? It's a slightly different thing. It's not that eating the 150 grams of protein a day if you're 220 currently means that you won't lose any muscle as you're losing weight. You might, but you would. You're going to be losing less than if you weren't having that much protein in the day. Okay, that's an important piece. That's for someone who's not doing any resistance training. Now, weight bearing activity doesn't actually help muscle building as much as resistance training.
Stephanie Fein MD [00:17:40]:
It's amazing for bones and fantastic for a million other things. I highly recommend walking. I think it's fantastic and it will help with muscle preservation. Not as much as resistance training, however. So in terms of weight loss, protein is important to keep you satisfied and to mitigate muscle loss in weight loss. Although the truth is too, if you're losing weight in a healthy way, one to two pounds a week, then this is not as much of A problem muscle loss. It's when you're losing lots of weight with really severe calorie restriction, that muscle loss is a really big deal. Now I want to talk to you for a moment about protein and infertility because there is a study and it's definitely known, it was in 2008 looking at anovulatory infertility.
Stephanie Fein MD [00:18:45]:
So anovulatory infertility is a specific type of infertility. That's, it's a small percentage, at least in this study, of the people who had infertility. And it's a specific type. And they found that animal protein versus plant based proteins made a difference. And they looked at, so they looked at the NHANES nurse questionnaire. So these are questionnaires. So they're not interviewing them. These are self reported questionnaires.
Stephanie Fein MD [00:19:20]:
They did look at medical records to verify the anovulatory infertility, but still it's questionnaires. And what they found was that people who had more plant based proteins had less anovulatory infertility than those who ate animal protein. Again, this was a small number of people, it was a large study, but a small number of people with anovulatory infertility. So I looked at the study and I was looking to see if weight was a part of it. And they did mention it, and they did mention that the higher weights often had more animal protein in their diet. That to me goes to show you that it's hard to make connections because if the people with higher weight lost weight, how would that impact the anovulatory infertility? And my answer to that is it would, because that's the whole premise around weight loss for fertility is that when there is fat tissue and we decrease the amount of fat tissue, we're changing the milieu, particularly in two ways. One, with inflammation, we're decreasing it because fat tissue itself is pro inflammatory. And the hormone picture, we are decreasing insulin insensitivity.
Stephanie Fein MD [00:21:01]:
We're making the insulin that we have in our bodies work better. When we decrease the fat, we're making our body use insulin more efficiently. That's what we want. Because if we're not using it efficiently, we have a lot of insulin. When we have a lot of insulin on board, it affects downstream sex hormones, particularly testosterone. And that can be the reason for anovulation. And so when we lose weight, just in and of itself weight loss, we are positively impacting inflammation, insulin, and therefore the sex hormones. No studies have put that head to head.
Stephanie Fein MD [00:21:47]:
So they haven't done. If someone loses weight or if they have plant based protein we which one is better? And I imagine you can't actually do that study. It would be very challenging. But I imagine what they'd find is that weight loss is more impactful. So that being said, if you're so inclined and you want to plant based proteins, let's say you have three meals and you have protein in each meal and right now it's all animal based, then if you change one of those to a plant based protein that might impact anovulatory infertility and terrible about having ill with plant based protein. It does to me. It requires a little more thinking and planning which we do around here. So it all works out well.
Stephanie Fein MD [00:22:44]:
But I just wanted you to know about that study and to know my thoughts around it, which is the same general one. I look at the studies that come out because of course I'm interested in this topic and I'm always looking at it with this lens that I've just described to you and often it's still upheld. Now you could say that's because that's how I'm looking at it and that might be true. And also it works. So there's that when we're losing weight we want to lose fat, not muscle. So protein remains an important factor in weight loss and in keeping us satisfied on the hunger scale longer, thus reducing food noise, hunger cravings and the risk of overeating. And so protein is just a real help for us as we're losing weight here, especially using the hunger scale. That's what I got for you.
Stephanie Fein MD [00:23:38]:
Now I will include a protein sources with chart for you. I'm actually, I'm just going to say a couple of them. Claude helped me create this, it was very helpful and I'm just going to say a couple just so you can see differences. Chicken breast now. So it lists the food, the serving size and then how much protein it has. So a three ounce chicken breast, which obviously is not a chicken breast, it's part of a chicken breast, is 26 grams of protein. That's amazing. Turkey breast is right around there.
Stephanie Fein MD [00:24:11]:
Ground beef is at 22 for three ounces. Salmon is 22, fish is around there. Tilapia is 21 grams of protein per serving. Shrimp is 20. These are really high. Whole eggs, each one has six or I use seven actually as my amount. Yogurt, three quarters of a cup has 17, especially Greek yogurt actually specifically. And some cheese, like one ounce of cheddar cheese which is a serving is seven grams of protein.
Stephanie Fein MD [00:24:47]:
So you can see it's much different than the 26 from chicken. And then for the plant based ones, tempeh is the Most with a 3 ounce serving at 16 and then tofu is around 10 and then it goes down from there. Hemp seeds are also 10, which is the three tablespoons which I mean I don't know how many of us eat hemp seeds. I don't know if I've ever eaten a hemp seed, but certainly it can be something that you can do. Also there's protein powders, a soy protein powder or a pea protein powder. One scoop is in the 20s in terms of how much, how many grams of protein they have. Also of note, which I forgot to mention is that soy, tempeh and quinoa are complete proteins. Remember I said that in general plant based proteins are incomplete.
Stephanie Fein MD [00:25:39]:
They don't have the nine essential amino acids soy, tempeh and quinoa do. So that's something good to know. I will attach this table to the show notes so you can feel free to go in there and have a look. But that's what I have for you. For protein. It is a really important part of the weight loss or fertility way because of the satisfaction and the fact that it preserves muscle in the way that we talked about above. So if you have any questions ever you can always contact me. Go to my website stephaniefinemd.com there's a contact me but button.
Stephanie Fein MD [00:26:23]:
Also I'm on Instagram @StephanieFeinMD. You can DM me anytime with any questions. Also, if you'd like to lose weight with me and I can help you with this, there's a lose weight with me button on the website stephaniefeinmd.com until next week. I'm sending you so much love.
