Exclusive Dr. Hyman+ Ask A Nutritionist: Protein Smoothies, Lectins, And More

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Hi everyone. Thanks so much for joining us for another Ask a Nutritionist event. My name is Hershel Perth. I'm the Dr. Hyman Plus Community Manager and I'm here with Lisa Drayer, and she's one of the nutritionists from Dr. Hyman's Ultra Wellness Center. Hi, Lisa. Hello, Herschel. How are you? Doing well. Thanks so much for being with us today. We're super excited to hear your answers to all the questions from our Community. And just a reminder before we get started for our Community members that are watching and joining us here on the Zoom, Lisa is going to be giving generalized advice. If there's specific information that you're interested in or feel like applies to you, it's really important for you to speak to your practitioner and figure out what works best for your situation. So again, just general information and then you can kind of take it back to the practitioners in your life. All right, so let's go ahead and get started. So the first question is, is it okay to drink a protein smoothie every day? And we know protein has been sort of on everybody's mind, but this question also goes on to say, what vegetables should you put in your smoothies if you're worried about oxalates? And then a sort of follow up to that is, Can eating a diet high in oxalates impact calcium absorption for women with osteoporosis? So we'll let you start with the first one about protein smoothies every day and then repeat the rest if you need.

Yes, absolutely. So protein, like you said, hot topic. Everybody's talking about it. Everybody's wondering how much they need. And of course, everybody's needs are different. But when it comes to the protein smoothie question, this is really interesting because from my own personal experience, Yes, you can have a protein smoothie every day. I would always say if you're going to do it, if you plan to do it every day, think about switching up some of the ingredients. So if you're having protein powders, maybe you switch that up and I'll talk about the protein powder in just a minute. If you have certain fruit or certain vegetables or certain fats like nut butters or avocados, good way to just make sure that you're not getting too much of any one thing is to switch it up from time to time. Listen to your body because there was a really long period of time there when I was having a smoothie every single day for probably two years straight. And then after a while, I started not feeling great and I had to take a break. So if I had just kind of backed off maybe a little bit sooner or rotated in different breakfasts, it might not have gotten to that point, but it's not dangerous. You just want to switch it up a little bit.

Diversity is important, right? Adding new things in there and not getting too much of one thing. So perfect.

Yes, exactly. And then when it comes to the oxalates, so if you're worried about oxalates, my personal favorite veggie that I put into the smoothie, which happens to be low oxalate, is frozen cauliflower rice, which doesn't have a flavor, it doesn't really change the texture, although it makes it maybe a little bit creamy, more like a milkshake consistency, which who doesn't want that? So it's kind of a win-win and it's just a great way to get in like all these wonderful, think about the cruciferous veggies, the broccoli and cauliflower and kale and everything so good for detoxification, but also very low in oxalates, that particular one. But I don't, I'll kind of go into this in a little bit, but you don't want to totally write off all of the other foods that might be high in oxalates. So something, if you think about, you know, spinach, which so many people use, which is so high in oxalates, the food preparation, so like boiling, steaming, cooking foods that are high in oxalates actually decreases their oxalate content. And so something like frozen spinach, for example, they have to blanch it first and then freeze it. So it's actually had cooking done to it and that might actually reduce the oxalate content. So maybe going with like a frozen spinach might reduce it and then having some form of calcium in there can also help offset the binding that that happens with those oxalate foods, which I think is really tied into the last part of the question where it's like, is it an issue with calcium absorption in women with osteoporosis or osteopenia? And it could possibly be an issue in that population. If you're having a ton of high oxalate foods and not enough calcium rich foods, then you do have to be careful because oxalates, which think of oxalic acid, it's these acids that bind to certain minerals, including calcium. So if you have a ton of that without enough calcium in the diet, then yes, it becomes an issue. Also has to do with the health of your gut and the gut lining. There are so many other factors that are involved, but it really has to do with the preparation of the food and in the context of the rest of your diet.

That's so helpful. The tip for the cauliflower is just blowing my mind because I didn't think to do something like that. And I never thought, okay, well, I normally spoonful of spinach just for that reason. I was like, okay, now I can use frozen spinach. So that's awesome. Definitely we'll put that in. So along those lines, can you give us your opinion on the impact of lectins, nightshades, and is it phytates? Phytates, yes. Okay, phytates on your body and whether they increase inflammation. I know you previously spoke about lectins before, and we'll put the link from our last Ask a Nutritionist in there.

But what about the rest of those things? Should we fear those and not have them? I know there's so much, there is a lot of fear around these specific compounds, especially these plant compounds. A lot of people call them antinutrients and there's so many books like oxalates and phytates and lectins, everything. They're the reason for everybody's ailments, but that obviously that's not true. Like you said, you'll link it to the previous conversation that we had where I go into lectins a little bit. There is always some truth though to these bigger topics. So there are certain compounds that you mentioned, which these plant foods and plants in general, they have naturally occurring. The point of them really is to try and protect the plant from being eaten, from being destroyed. And they have, I mean, they're usually pretty bitter so that if a bug or an animal bites into them, they don't want to eat it or can actually cause poisoning to the two smaller animals or smaller bugs. In large quantities, they can be a problem for us, but you really have to think about how the food is prepared. The way that food was traditionally prepared, think about fermentation and soaking and sprouting. Things that used to be done in many different cultures really helped to reduce the load of those compounds to the point where they wouldn't be a problem. But now in our fast fast-paced culture, we want things quickly, we're kind of skipping steps that we should be taking when preparing food. That can lead to problems. There's actually a really wonderful peer-reviewed research study by the dietitian Deanna Minich. She's a PhD and she's done a ton of research on these anti-nutrients. And I think we'll link the actual article so that everybody can see it. But it goes through all of these different anti-nutrients. It goes through the risks of them and too much and what they can do and how they can bind to certain nutrients and make it harder to absorb or maybe lead to certain nutrient deficiencies in certain situations. But how do you prepare them? What kind of cooking method can actually reduce their issues? There are actually certain cooking methods that make it worse. So it's like one way or the other. Sometimes boiling, soaking, sprouting can help, and then baking or grilling could make it worse. for others. So it's a fascinating bunch of information that we could spend a whole hour talking about today, but I'll make sure everybody has the article that they can read for themselves and dive into it deeper.

Oh, that would be so perfect. And we actually are having Deanna do a deep dive with us really soon, so we'll be looking at that as well. So we'll put that in the show notes. So kind of along the topics of protein and smoothies and all that, you know, everybody has a different sort of number on what is the right amount of protein. Some say you should have 75 grams or maybe one gram per pound. Some say you should go based on your ideal body weight. Like, what are your thoughts on protein? And, you know, if you take in too much, like, let's say you're taking in 120 grams a day, does it impact your body in a bad way? Should you not be doing that?

Yeah, great questions. So I'll go through kind of what the general recommendations are and then what I do usually in practice. So generally, the standard dietary allowance, the recommended dietary allowance, is 0.8 grams of protein per kilogram body weight. That's what you'll get in more conventional advice, but this is really just to prevent protein deficiency. It's not really an optimal amount that we need to help build muscle. And you also have to think about a person's age, the health of their gut. Are they absorbing this protein? How much are they exercising? Is there stress on the body? Have they just undergone surgery or just something like that? Maybe they got into an accident. So there are different times in life. when the needs are even higher than just the average. So if we're talking about just a healthy, average adult who's looking to optimize their muscle mass and support overall health and optimal health, healthy aging, you know, all of that, you want to try to get somewhere between 1.2 and 1.5 grams of protein per kilogram of body weight. So not per pound, but per kilogram. and if, if somebody is a bit older, maybe older than like 65, 75, sometimes what happens in older adults is the amount of stomach acid that they produce starts to reduce and you really need stomach acid to break down and absorb protein. So sometimes they need as much as two grams per kilogram of body weight. And yeah, so you just really need to be aware of obviously your own situation and the health of your overall body. But to your question about, okay, so it's like 120 grams too much. It could be, but maybe not. It depends. For us, you and I, Herschel, probably 120 grams is too much, but for a larger male who does a lot of activity and everything, 120 might be perfect for them. But what I would say is too much protein, there's not a whole lot of evidence to support the benefits of going much above that 1.5 to 2 grams per kilogram of body weight. Once you get above what your body needs, not only can that put stress on the kidneys and the liver, but if you have excess protein, it can actually be stored as fat. It turns into extra calories. It can be turned into fat. So it's not like, oh, the more protein, the better. It's sort of like a U-shaped curve. You get benefits up to a certain point, and then you start to get the negative returns. And so you need to hit that.

Sweet spot for yourself. Oh, that's so fascinating. I don't think a lot of people know that once you go over that amount, it does turn into fat. So incredible. I didn't even know that. So along those lines of protein, which, you know, it's, I know we have so many questions on that, but it's like a hot topic these days.

It is. It's huge.

So if somebody is not having animal protein and they're trying to figure out what is the best way for them to get, let's say, 100 grams or 90 grams or whatever it is that works for them and for their situation. How can you increase your protein if you're not eating animal protein? Are there certain vegetables or grains they should have that are higher? If they're doing workouts, let's say, but they're not getting animal protein, should they be supplementing with amino acids? And if so, how much?

Yeah, other great questions too. So, with protein that's not animal based, I'm thinking of the amino acid profile because the amino acid, so when you think about a protein, you have to break it up into its individual parts, which are amino acids. You need all of these in order for it to be a complete, quote unquote, protein. You need to have all the essential amino acids. You need to have all the amino acids come together to create it. Some plants do have all the amino acids that are needed to create a complete protein. Others, you need a combination. complementary proteins might be like rice and beans. Individually, they don't have all the complete amino acids, but together they do. So traditionally, I think a lot of cultures just kind of knew this intuitively and they would pair certain things together and it would be a complete protein. But there are certain plant-based foods that do have complete proteins. So something like soy does tend to be more complete. It's more concentrated, you know, ounce for ounce, something like tempeh, which is traditionally fermented and a little bit easier to digest and absorb. that tends to have the protein density of something more like meat or animal protein. But things like edamame and tofu and natto, as long as it's organic, non-GMO can be a really good source of protein. There's something I love to share this with people. I don't know if you've ever heard of it. It's pumfu. So it's like tofu but with a P. It's made with pumpkin seeds. So it's just pumpkin seeds and water, but it's made into this little block where you, it doesn't really have much of a flavor on its own, but it'll just take on the flavor of whatever , whatever you're cooking it with, and you can make it into a scramble or into a lasagna or whatever it is, very concentrated in protein and healthy fats. So that's another one, just a little FYI. Um, beans and lentils, mung beans especially are very concentrated in protein, don't have too much starch and carbohydrates. That's the other thing I'm thinking of. And when you start to get into these non-animal protein sources, you get, you can get a lot of starch and carbohydrates if you're relying exclusively. on, you know, grains and legumes and everything. So that's, that's just another thing I'm thinking of. There are certain grains, though, that do contain a great source of protein, like quinoa. It's wonderful. It's got a ton of amino acids, even amaranth. I don't think a lot of people think about amaranth, but that's another great one that has a good amount of protein. Buckwheat as well. And I know Dr. Hyman always talks about the Himalayan tartary buckwheat. It is a good source of protein also, but. I think for the most part, a very well-planned plant-based diet can get you the protein that you need, but a lot of times people do wind up at least getting in one protein shake a day just to supplement, especially if they're exercising, because after exercise, within about an hour after exercise, that's when the body and that's when the muscles are primed to get what they need in order to really grow and repair. They really need something leucine, which some of you might have heard of, is one of the branched chain amino acids. And that's the amino acid that sends the signals for your muscles to actually grow. So something like a pea protein tends to have more leucine than a lot of the other plant-based proteins, especially in the form of powder. So you could potentially find a good quality pea protein that has, you're looking for 2.5 grams of leucine after exercise. if you can't find one, maybe what you do is you do a scoop of the pea protein and then a scoop of BCAA powders where you do have a bit more leucine that helps you get to that 2.5 to 3 gram, you know, kind of range. So that's what I would suggest.

And it's definitely doable. And so just for anyone who doesn't know, the BCAA is a branch chain amino acids one.

Okay, perfect.

Yes, the branch chain amino acids. That's where you get the leucine. Okay, perfect. That's super helpful. okay, so we're gonna finally move away from protein, too. Can you support or can you focus on support for Vision Health, specifically macular degeneration? Can we really influence the situation for improvement, or is it just a matter of attempting to maintain the current status? We get this question actually quite a bit, so I'm super excited that you picked this one, because I know a lot of people are interested what you to hear what you have to say about it.

Yes, I've been getting this question a ton from my own clients, and I personally have macular degeneration in my so it's a very, it's close and dear to my heart. So I've done a lot of research on it, so I'm glad that it was something that somebody asked. So there are certain nutrients that we know, well actually let me take a step back. Answering the last part of the question, is it, are we attempting to improve things? Are we attempting just to halt the progression of it? It's not like we can cure macular degeneration with our diet, but we can absolutely like slow the progression, we can improve and kind of neutralize oxidative stress and damage that's been done to the ocular nerve and things like that. But we're definitely trying to slow and just try to prevent progression of the disease, just so you know. And so there are certain nutrients and just dietary patterns in general that have been researched to show that it can actually support and reduce the likelihood of progression of macular degeneration specifically. One of the key nutrients is omega-3 fatty acids. So that in terms of its anti-inflammatory properties has absolutely been shown to be protective of the ocular nerve and everything else. So omega-3 is coming from, it could be an omega-3 fatty acid supplement, or it could just be things like the wild Alaskan salmon and sardines and those fatty fish that are low mercury. We want to make sure that but are high in omega-3. So that's I make sure to take an omega-3 supplement every single day for that reason. There are other nutrients. I know it seems pretty cliche, but vitamin A, there is a lot of research around vitamin A. Everybody's like carrots, you know, carrots are going to help your vision. There's a lot of other things other than carrots. I mean, there's spinach going back to the oxalates. See, there's not just one reason to avoid or to eat a food, but things like the leafy green vegetables, especially collard greens and mustard greens, dandelion greens, even egg yolks, you know, the, the vitamin A, the active vitamin A can be very beneficial. Pistachios and parsley and cilantro, there's a bunch of them, but definitely vitamin A. And there's actually a, the, the supplement that I take that I've done a lot of research, and it includes things like vitamin A, specifically zeaxanthin and lutein and these antioxidants that are particularly supportive of the eye and a vision is macular support formula. I believe it's called from Pure Encapsulations. I love that one and it has a nice balanced formula specific for this. But when it comes to food, I always say try to do food first if you can and really just focus on that. And there's a lot of studies actually that link the Mediterranean diet to reduced risk of developing macular degeneration and other eye-related conditions. Really, the cornerstones of that are lots of vegetables, low sugar fruit, high fiber, whole grains, legumes, really moderate amounts of poultry, those omega-3 fish for sure, and lots of extra virgin olive oil, those good, healthy anti-inflammatory fats. I would say the last thing that I think of is nitric oxide because it can help to increase blood flow to the retina and reduce the risk of developing ocular damage. nitric oxide, you know, you can, number one, breathing through your nose instead of mouth breathing. That's a great natural way to increase nitric oxide production in addition to exercise. But when it comes to diet, things like beet and beetroot juice, celery, arugula, there's a lot of different foods that can help support the body's production of nitric oxide. So that's what I would say. Oh, that's super helpful.

And we'll also, you know, as you mentioned, we're going to focus on the food, but we'll also put the link to the peer encapsulation one just in case anyone's interested in looking at that. So thank you for that information.

Sure.

So the next one is, what diet would you recommend to a person with established coronary artery disease that would reduce soft or vulnerable plaque?

I would say, going back to the last conversation, the Mediterranean diet. But I'll dive in a little bit deeper, maybe where things might change a little. I wouldn't suggest a completely plant-based but definitely plant heavy Mediterranean approach if you have established coronary artery disease and you've got this vulnerable plaque. But the Institute for Functional Medicine has put together this cardio metabolic diet plan, which is based off of the Mediterranean diet and the low glycemic diet, which is really important here too. because the low glycemic index is really just looking at foods that are going to prevent your blood sugar and insulin from spiking too high. Because the more that happens, the more blood sugar you have in your system, the more insulin you have in your system, the more inflammation you're going to have. And a lot of times people don't realize that cholesterol and coronary artery disease and all these things are the most problematic and the most risky when you have inflammation. If you can get the inflammation down, it's not as dangerous. So the Mediterranean diet, this cardio metabolic plan, it's all very anti-inflammatory and that's what we're looking for first and foremost. And again, the nitric oxide producing foods to help with circulation, all the foods I mentioned before, and lots of omega-3 fatty acids.

Yeah, definitely super helpful for that. So thank you.

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