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Creators & Guests

Host
Mikki Williden

What is Mikkipedia?

Mikkipedia is an exploration in all things health, well being, fitness, food and nutrition. I sit down with scientists, doctors, professors, practitioners and people who have a wealth of experience and have a conversation that takes a deep dive into their area of expertise. I love translating science into a language that people understand, so while some of the conversations will be pretty in-depth, you will come away with some practical tips that can be instigated into your everyday life. I hope you enjoy the show!

Transcribed using AI transcription, errors may occur. Contact Mikki for clarification.

00:07
Hey everyone, it's Mikki here. You're listening to Mini Mikkipedia on a Monday. And I wanna chat about a blog post that someone pointed in my direction regarding the potential dangers of a high protein approach for women. I can link to the blog in the notes and I am not that aware of its Wendy Sweet. Not that aware of her work other than that I know that she belongs to.

00:35
lifestyle medicine, the sort of community, which is known for being more plant-based. And she does reference other plant-based experts. So I guess when it comes to areas of health, we all have our bias. And you know my bias. It's a high protein diet, actually. So it's unsurprising probably that when I read a blog post that advocates for a low protein approach...

00:59
I am wanting to dig a little bit deeper to understand better why it's being recommended and then to sort of make sense of it from my perspective. So that's what I'm going to outline for you today. And I will of course, as I said, put the blog in the notes and also by the time you read this, I will also have a blog that I've written about it on my website. So I'll also sort of put that in. So it's a little bit like the print version.

01:24
So somebody asked me to comment on it, which is why I'm making this as a mini Wikipedia episode. And then of course, as you should with all information, you need to, I guess, distill, I guess one, your own bias, but also what you actually think too, because you've got two experts, if you like, in the menopause space saying completely different things. So one of the reasons, or some of the reasons that Wendy suggested a higher protein diet is problematic for women.

01:53
is due to an increase in vasomotor symptoms such as hot flushes and night sweats, increasing cardiovascular disease risk because of plaque buildup on the arteries and arterial stiffening, and also increased risk of type 2 diabetes. And she also discussed the concept of overeating protein and this therefore increasing body fat levels and propensity to overweight. So

02:18
Eating excess protein has been shown to be the least likely nutrient to increase overall fat gain, even when eating in excess calories, which I know seems almost counterintuitive because it is, you know, excess calories and excess energy is the thing that makes our body stores fat. However, when you overeat on protein, you are definitely at less of a risk of gaining the same amount of weight as what you would be if you were to overeat on either carbohydrate and fat.

02:47
And this is due to the processing effect of all of these nutrients and it takes more energy to process protein than it does carbohydrate or fat. Of course though, increasing calories over and above your needs can cause an increase in body fat. And when protein is implicated, I often think about the protein sources which also deliver a high amount of fat. So if your protein sources such as pork belly, for example,

03:13
also delivers a lot of additional calories from fat, then of course you will gain weight. But it is the calories that it is delivering and not the protein itself. Protein is sort of termed more of a structural nutrient and carbohydrate and fat are what is considered as energy nutrient. So they provide the calories, protein of course provides calories, but it is much more utilised in the repair and rebuild of tissues and enzymes and bones and things like that. And it's interesting when

03:41
People always mention the saturated fat that animal protein provides. And of course it does contain saturated fat, but it has as much mono unsaturated, if not more mono unsaturated, than saturated fat intake. So I always find this a super interesting argument given that mono unsaturated fat is protective in all realms of heart health. So this is one of my bullet points if you like, or rebuttal points against what Wendy is suggesting regarding...

04:11
proteins role in excess body fat and of course in the cardiovascular disease risk profile. Now it is an interesting idea that a higher protein diet stimulates more phasomotor symptoms due to the thermic effect of eating more protein. So protein takes more energy, as I've mentioned, to digest and absorb in addition to the energy used in creating a muscle protein synthetic response. So all of that means that for every 100 calories of protein you eat, you're likely

04:40
is used in those aforementioned processes. And of course the thermic effect of protein is higher than that of carbohydrate and fat and this does increase body temperature. But if you look at the literature as I did, it suggests that this is minimal and it's more extreme in the rodent and pig literature. So in studies using preclin, or we call these preclinical trials, so before a human trial,

05:08
and when these are in extreme environments, such as an extremely cold environment or in an extremely hot environment. And there is minimal evidence in humans in the literature, and less so in menopausal women on this topic. I'm not suggesting that this isn't true for some women, but to warn all women against a high protein diet because of this, I think is a little bit premature based on what we understand from the research.

05:36
There is, of course, observational reports of women who following a vegan diet have less vasomotor symptoms than those that follow an omnivore diet. And this may be one of the premises behind Wendy's suggestions here, because she is more aligned, it appears, with a plant-based sort of researches. And whilst it's interesting, it's not the totality of the data. I mean, I pulled up...

06:03
some observational study that found macronutrient intake had no impact on vasomotor symptoms, and instead it was poor cardiovascular fitness and high fasting glucose that increased the risk of night sweats and hot flashes. But these were mentioned in the blog because it didn't really fit the narrative. Let's not forget though that nutrition epidemiology has several limitations and it can't be relied upon to determine cause and effect here either. So if someone who follows a vegan diet has less

06:30
vasomotor symptoms, it might be that there are other lifestyle factors that contribute to an overall healthier lifestyle because we often find that in literature. So another study looking at dietary differences in menopausal women and vasomotor symptoms found that the most notable difference in the diet came from an increased berries and vegetables which might help improve symptoms for the group in total. And it might well be that the fiber from...

06:56
vegetables and berries is the protective mechanism here due to its ability to bind hormones and remove them from the body. And another point of fact in the study that I mentioned, and again it's linked in the blog that I wrote, is that the vegan diet, the people in the vegan diet also were more active than those in the omnivore group. And as I mentioned above, activity does impact on symptom severity because those with a higher

07:24
have less vasomotor symptoms. And one other thing of note is that protein from dairy products do impact on vasomotor symptoms. And many women notice a reduction when they remove the cow's dairy that has the A1 beta casein, because the A1 beta casein can promote inflammatory processes if a person is sensitive to that. So the vegan diet may well be beneficial from a vasomotor symptom because of the increased fiber.

07:53
and the reduction or removal of dairy products, not a reduction in protein per se. So there is just a lot of nuance here that can't be just summed up as being that protein is a bad idea for women because of their vasomotor symptoms. And despite the fact that nutrition epidemiology has statistical processes that adjust away some of these factors, you cannot adjust.

08:23
fully or fully account or dismiss other lifestyle contributors. So never forget that. Interestingly, it was noted in Wendy's blog that blood pressure and cholesterol are impacted by protein. Now blood pressure and cholesterol increases during menopausal transition are something we see quite often and often they are the result of dietary and hormone changes. But it's not protein that's implicated here.

08:49
Estrogen is involved in cholesterol metabolism, so when this drops, cholesterol levels tend to increase. Blood pressure increase, though, can be a result of blood sugar elevations and increasing insulin, again due to estrogen, because estrogen is an insulin sensitizing hormone. So once this drops, a diet that is higher in carbohydrate could impact on blood pressure. That is nothing to do with protein. Most studies investigating the effect of protein on blood pressure

09:19
would suggest that the opposite is true, that those who are overweight and do have high blood pressure, a higher protein diet can improve it. And I've got a couple of studies linked that suggest this is the case. And in fact, there was a meta-analysis of clinical trials, which is an overall look at all of the available literature. And it concluded that a favorable effect of a higher protein diet was found on both blood pressure and cholesterol.

09:49
the protein is implicated in both of these blood biomarkers. While there are mechanistic trials that show an increase in macrophage activity that may promote atherogenesis, and I think this was the crux of what Wendy was sort of talking about, there are no human clinical trials to show this is the case. So Wendy cites a cardiologist who's very plant-based that found a 2024 laboratory study that

10:17
When protein is in excess of 22% of dietary energy in a mice model, there was an acceleration of atherosclerosis due to a change in the immune response in those macrophage activity. And this resulted in plaque buildup and stiffening of the arteries. Now this was a mouse trial. It wasn't conducted in humans. And in mice, there is a stronger signal in the effects.

10:46
of nutrient changes occur much more quickly due to their higher metabolic rate. And there are differences in the immune response compared to mice versus human. The T helper cells in mice which have a pro-inflammatory response are different. And mice often show a stronger T helper 1 which are pro-inflammatory response compared to humans. And humans have a more balanced but

11:11
sort of complex interaction if you like between T helper cells one and two and other T regulatory pathways. So for these reasons, it's not a good enough justification to warn people of protein based on the results of changes in the immune response in a mouse model when our immune responses are quite different. So this isn't to me or other

11:38
people who investigate this area, this isn't enough evidence to warn us off of a higher protein approach. Now Wendy also notes that protein is problematic for the liver, for thyroid and for kidney function. There is no good evidence that a high protein diet impacts negatively on liver, on gut, on thyroid or kidney health. And this is actually just a myth that won't die, and I'm sure you've heard me discuss this many times.

12:05
There is not a ton of human clinical data looking at proteins effects on the liver, I will say that. However, what data there is suggests that a higher protein diet reduces liver fat and markers of inflammation. The evidence for protein negatively impacting the thyroid is weak, and most would agree that studies that have looked at this, such as those that I've linked in my blog, are reflecting the impact of a low calorie diet, not the impact of a high protein diet. Because some of what the research...

12:33
can show is that a very low calorie diet that is delivered in the form of protein shakes, where the percentage of energy coming from protein is high, that thyroid activity is diminished. And we know that occurs with a low calorie diet. It's not about the high protein in that case. If anything, a low protein diet could negatively impact thyroid function, not a high protein one. And there are research studies that would suggest this is in fact the case.

13:03
When it comes to the gut, certainly some people struggle to digest protein-based foods. I notice this especially when people are increasing their protein intake, and it could be that their gut is not used to the additional protein and needs more digestive support, using something to stimulate stomach acid or including additional digestive enzymes. The body does adjust though, because it's a very smart and complex system.

13:32
is improved. And I will say with women in that sort of menopausal transition phase, like if we think about the time of life this is, where we are at the pinnacles of our career, we are raising children, we are looking after parents, we are running households, we are trying to balance other relationships. Like there is so much going on that stress plays a large part in digestive issues. And there are many women who I speak to at this time where stress is a big concern.

14:02
So I don't think that it's a problem that protein affects the gut. It's more that the gut is affecting your digestion of protein. It's like the other way around. And I've spoken at length on many of my platforms that there is no good evidence to suggest that a low protein diet is what's required for optimal kidney health. And if anything, the opposite is true. Of course, if you have stage four kidney disease, and you absolutely need to speak to your

14:31
doctor about your overall protein load, but I'm pretty sure that even as most recently as a couple of months ago, was found that a higher protein diet improved outcomes for people with stage four kidney disease. So there is a lot of information out there that has been available for close to 10 years now, to really put the last nail in the coffin, and the idea that protein is bad for kidneys, especially for people who have well-functioning.

15:00
normal kidney function. So it's, to be honest, a little bit disappointing that someone is out there suggesting the otherwise and scaring a woman off a higher protein diet. Because at the end of the day, what we are certain of when it comes to health risks for women, that increased body fat level, increased insulin resistance because of lower estrogen, increases the risk of cardiovascular disease. And we see this time and again with statistics showing that women postmenopause are at increased risk.

15:29
not just cardiovascular disease, but neurological disease as well. And when it comes to diet, carbohydrate intake is something to be mindful of with all of these health concerns I've mentioned, not protein. Protein stabilizes blood sugar levels, it does not drive blood sugar up, and it regulates appetite. And both of these help protect against excess body fat and the development of insulin resistance because of its effect on our ability to control what we eat.

15:57
and it is always opportunity cost when it comes to diet. If somebody is recommending a lower protein diet, then they are also advocating for a higher carbohydrate diet as we must get our calories from somewhere, particularly if you are not a fan of fat. It makes it more difficult to adhere to an appropriate calorie load without the satiation effect of protein. Thus it increases the risk of overeating and gaining body fat. This fat gain is more likely to be around our midsection due to the lower estrogen level,

16:27
And this increases our risk of inflammation and insulin resistance. So the idea that a high protein diet is problematic for our health, just as mind boggling to me when all of these very well established risks occur in this menopausal transition that are largely to do with the carbohydrate intake and calorie intake. I'm also going to point out the obvious here.

16:54
is that many, many smart people, this is sort of my appeal to authority if you like, who firmly believe that women need to be eating in excess of 1.5 grams per kg of body weight in protein. Dr. Gabrielle Lyon, Dr. Layne Norton, Professor Don Layman, Professor Stu Phillips, Professor Luke Van Loen, so many people advocate for a protein level that is at least 1.5 grams per kg body weight. And Professor Stu Phillips has done a lot of research in...

17:24
those of an older age bracket who really advocate for increasing protein at this age. Look everyone is different but to suggest that you need less than 1.5 I think is problematic, particularly if you're not someone who is also advocating for strength training, which I didn't quite get that from Wendy's blog as to whether or not she did.

17:53
a low protein diet and they quote plant-based cardiologists and sort of lean heavily on groups that have clear bias. I really want you to be mindful of placing that information within that bucket and people don't always look at the totality of data. And look, I've just spent a couple of days on this blog. I certainly have not spent an entire year writing a thesis on why I disagree with the premise of the low protein diet is what you need.

18:22
But I feel like I've got a real sense of where the research is at. We know that protein is important for bones, muscles, appetite regulation and hormone production. And our brains need more protein in one meal as we age to stimulate muscle protein synthesis. This isn't dangerous for cardiovascular disease risk. And the research suggests the obvious. The thing that is dangerous is that women are at greater risk of cardiovascular disease as we age because of lower estrogen. We are also at greater risk of early death if we have a fall that results in a fracture.

18:52
we need the substrates that protect muscle and bone, that is protein, and of course, activity and strength training. So to suggest that we need to worry about too much protein does not line up with what the majority of literature says. So that's my take on the blog, and I will post my blog and the blog I was referring to in the show notes, and of course, just come to me with any questions. And if there is a body of literature out there that I'm unaware of, unfamiliar with,

19:20
please show it to me, because I would really like to see human clinical randomized trials that proved me wrong, because I haven't found that that's a totality of information. And it's never just one study that you should look at. One study tells us nothing. We want to see what direction the entire literature and the entire field is sort of leaning. Anyway, that's my mini-Macapedia episode for this week. I have a webinar coming up this Sunday. All about...

19:50
strategies to help you feel confident going into the festive season. I'll also put a link in the show notes to that. I would love to see you. I am running it twice. You know I love doing things like this and I love sharing insights with you as we rock on closer to Christmas. You can find a link to sign up at my website mckywillidon.com, head on to Instagram or Twitter or threads at mckywillidon or Facebook at mcky

20:19
Alright team, have the best day. See you later.