Fitness freak, athlete, post-surgery patient, elderly, malnourished teen — if you fall in any of these categories, you've likely been advised to take or considered taking protein supplements like the whey protein powder.
It makes sense because protein makes and mends muscle, and even bones and cartilage.
But, the average gym bro's best friend has got itself some bad reputation recently with many experts advising against its use, linking it to possible kidney stones, liver issues, and other disorders.
Should you really avoid protein powders? The answer isn't as straightforward as a simple yes or no.
The US Recommended Dietary Allowance (RDA) for protein is a 0.8 grams of protein per kilogram of body weight for both adult men and women.
Taking a very low protein diet is also dangerous, says Dr Sajneev Gulati, Principal Director of Nephrology & Kidney Transplant at Fortis Hospital, Delhi and President, Nephrology Society of India.
A deficiency can lead to a myriad of health issues, such as,
Slow healing of injuries
Supplementary protein powder is particularly helpful for people who are losing muscle, but not able to consume the required amount, like,
Those with chronic anorexia
Patients of chronic infections
Vegetarians and vegans
People with chronic illness, like cancer
It is almost impossible to overtake protein with an average Indian diet, says Dr Gulati.
"We take about 0.8 to 1 gm of protein per serving. So we are actually on the lower side. Taking excess supplements is what leads to excessive protein consumption."Dr Sajneev Gulati, President, Nephrology Society of India
What Does Excess Protein Do To You?
Protein is metabolised in the liver into amino acids, as well as other toxic products like urea and creatinine, which are excreted by the kidney along with water in the form of urine.
"Once you start taking supra-normal protein in your diet, there is excess generation of toxic waste product. Which means the kidneys have to work extra harder. For the short term it is not a problem, but in the long term it can cause problems."
Earlier on, it was said that people with kidney diseases should stay away from a high-protein diet.
However, Dr Gulati says "I see about 1 or 2 young individuals per year. 20 to 30, and even 40 years of age. Most of the people coming to us are younger boys," adds Dr Gulati. "And it's completely avoidable."
On the other hand, Hepatologist, Dr Abby Philips, says it's not yet clear if the health issues are directly linked to the protein itself, or if it may be due to a combination of reasons such as low water intake, high intake of oxalate based foods, and genetic predisposition.
"There is no conclusive independent risk factor for either kidney or liver damage," Dr Philips adds.
What About Kidney Stones?
According to a review paper conducted by researchers at the Department of Nutritional Sciences, University of Connecticut in the US,
"Studies that claim an increased propensity for stone formation as a result of increased protein intake should be taken at face value because propensity is a surrogate marker and does not represent actual stone formation."Study authors
Furthermore, Dr Abby Philips adds "there's no conclusive evidence that's been found to support these claims yet."
In fact, of all protein supplements, Dr Philips says he prescribes Whey protein to his patients with advanced chronic liver illness because they are cannot handle protein well, and "it (whey protein) is light and has the least ammonia generating properties, as compared to animal protein."
Beware of Other Additives Too
There's also the question of quality. Dietary supplements are classified differently than medicines and do not go through the same kind of rigorous checks before they hit the market. Regulations are also laxer when it comes to labelling for these products.
These products often also contain other additives, herbal blends, and vitamins. Sometimes creatine is also often added to protein powder, as it helps supply energy to muscles and build muscle fibres.
"There are no checks for safe combinations in such cases.These, especially herbal blends, can be dangerous."Dr Abby Philips, Hepatologist
"They may also contain other preservatives, for which there isn't enough information yet on how they may affect you in the long run," says Dr Gulati.
Speaking to FIT for a different article, Dr Ankur Phatarpekar, Director Cathlab & Interventional Cardiologist, Symbiosis Hospital, Mumbai explained that although protein powder intake does not pose any cardio-metabolic risks, "some types may contain cholesterol, particularly LDL or bad cholesterol, as extra components, which can be deposited on artery walls, and increase your risk for cardiovascular disease."
To elicit notable short term results, many of these powders have been caught using caffeine and steroids as well.
"The Longer the duration you consume it for, the greater the risk," says Dr Gulati.
The Bottom Line
At the end of the day, both Dr Gulati and Dr Philips reiterate that a relatively healthy person who is eating a balanced diet does not need to take any supplementary protein. And that there are specific conditions under which a doctor might prescribe one that suits your needs.
Moreover, according to the experts we spoke to, the additives and blends that make up these products are to be watched.