What are the best protein supplements for dialysis patients?
Protein is important.
If you are beginning hemodialysis, you are likely going to make several lifestyle changes. One of the most common changes is increasing the amount of protein in your diet. Not only does protein play an essential role in the creation and maintenance of every cell in our bodies, but dialysis also removes proteins from the blood. This means that your protein needs are now higher than they were before the treatment.
If you do not eat enough protein to make up for what is lost during dialysis, your body will break down muscles to get the protein that it needs. This can lead to weight loss, fatigue, and put you at higher risk for infection. It is therefore imperative that you find ways to increase the amount of protein in your diet. That said, protein supplements should not replace normal food. Whenever possible, you should eat balanced, nutritious meals. For most people, this should be more than enough to cover their protein needs. Some people may need an extra protein boost, however, which is where protein supplements come in.
Although high dietary protein intake is associated with better outcomes for dialysis patients, high-protein foods may also increase dietary phosphorus burden, which is associated with worse outcomes. This is one of the main reasons why I recommend egg white protein for renal patients.
Research has shown that egg whites can be an effective way to increase serum protein and lower serum phosphorus. In other words, egg white protein is a great option for someone looking to boost their protein intake and limit the amount of phosphorus in their diet. This is because egg white protein has one of the lowest phosphorus to protein ratios. Be sure to consult your healthcare provider about your specific nutrition needs, as they may vary depending on the type of dialysis treatment that you receive. Moreover, be sure to read the ingredient list before using a protein supplement because not all protein supplements are created equal.
There are two types of protein supplements, ready-to-drink (store-bought) protein shakes and protein powder. Almost all ready-to-drink protein shakes and most protein powders are full of food additives.
Avoid food additives.
Most protein powders are full of food additives. Although they are not necessarily bad for you in small quantities, food additives can add up quickly, especially if you drink a protein shake every day. At higher quantities, food additives can cause gastrointestinal (GI) side effects.
Many food additives are hard to digest and sit in your gut for longer than they should. This gives your gut bacteria more time to ferment (eat), and as they eat, these bacteria produce gas, which causes bloating, cramps, and nausea.
In the short term, gas also slows colonic transit (the amount of time it takes food to travel through the colon), which can lead to constipation. In the long term, food additives disrupt regulatory pathways in the intestine and trigger the development of inflammatory bowel disease (IBD) and systemic inflammatory disorders.
Keep an eye out for artificial sweeteners too. Artificial sweeteners are poorly absorbed by the gut, which means that they feed your hungry gut bacteria. They also alter the composition of your gut microbiota (the collection of microorganisms that help you digest food). This can lead to serious GI problems and widespread inflammation.
Finally, artificial sweeteners, especially sugar alcohols like xylitol, can cause diarrhea because they draw water into your gut. Now you might finally have something to blame for those post-protein shake trips to the bathroom.
Here is a list of the most common food additives in protein powder:
acacia gum, acesulfame potassium, artificial flavors, aspartame, carrageenan, cellulose gum, dextrin, dextrose, erythritol, gellan gum, guar gum, gum arabic, inulin, locust bean gum, “natural” flavors*, maltodextrin, rice syrup solids, soy lecithin, silica, sucralose, sunflower lecithin, xanthan gum, xylitol
When it comes to identifying food additives, go with your gut. 😉 As a rule of thumb, they are the ingredients that you cannot pronounce. Food additives are not the only thing to look out for when buying protein powder, however. There are several other ingredients that can upset your stomach.
egg whites, coconut, cocoa, monk fruit
Protein Matrix Comprised of (Whey Protein Concentrate, Whey Protein Isolate, Calcium Caseinate, Micellar Casein, Milk Protein Isolate, Egg Albumen, Glutamine Peptides), Polydextrose, Sunflower Creamer (Sunflower Oil, Corn Syrup Solids, Sodium Caseinate, Mono- and Diglycerides, Dipotassium Phosphate, Tricalcium Phosphate, Soy Lecithin, Tocopherols), Natural and Artificial Flavor, MCT Powder (Medium Chain Triglycerides, Nonfat Dry Milk, Disodium Phosphate, Silicon Dioxide), Lecithin, Cellulose Gum, Salt, Yellow 5, Sucralose, Acesulfame Potassium, Papain, Bromelain.
*This is the actual ingredient list of one of the best-selling protein powders in the United States.
Dairy-based proteins like whey can casein are byproducts of cheese and yogurt production. They are known to cause digestive issues, especially for people with lactose intolerance and irritable bowel syndrome (IBS). Over one in three Americans are lactose intolerant, and the prevalence of IBS is somewhere between 10 and 15 percent in the United States. It follows that you may be lactose intolerant or have IBS and not even know it.
Irritable bowel syndrome (IBS) is a poorly understood condition, and it is unclear why dairy triggers symptoms. Lactose intolerance, on the other hand, is clearly understood. People with lactose intolerance are unable to fully digest lactose, the sugar in dairy. As you just learned, partially digested food feeds the bacteria in your gut, which produce gas.
Avoid protein concentrates and isolates.
Finding an additive-free, dairy-free protein powder is hard. Finding an additive-free, dairy-free protein powder made with real foods is next to impossible. Why? Most protein powders are made with protein concentrates and isolates, foods stripped of everything but the protein. They are listed on the ingredient list as “pea protein,” for example, as opposed to “peas.”
We will not go into the details, but protein concentrates and isolates undergo heavy mechanical and chemical processing before becoming protein powder. Sometimes, manufacturers use chemical solvents like hexane to separate the protein from the food. This means that what you end up putting into your body looks nothing like real food.
The potential problem here is that your gut might not know what to do with ingredients like these. Your gut prefers the real thing, not some heavily-processed imitation, so protein concentrates and isolates might be hard to digest for people with sensitive stomachs.
Instead of protein concentrates or isolates, we use egg whites and chickpeas. Egg whites are simply broken, pasteurized, and dried before becoming protein powder. Chickpeas are just dried and ground. Minimally-processed ingredients like these are easy to digest and a stomach-friendly alternative to protein concentrates and isolates.
Unless you have a sensitivity or allergy to eggs, egg white protein is the best protein for people with sensitive stomachs. Egg whites are low in fiber, low-FODMAP, and have the highest protein digestibility-corrected amino acid score (PDCAAS) of any whole food. Our customers have experienced fewer digestive issues with egg white protein than with any other type of protein.
If you cannot eat eggs, try our chickpea protein powder. We like chickpeas because, compared to other plant protein sources, they are high in soluble fiber. Unlike insoluble fiber, which can have a laxative effect, soluble fiber increases in size as it moves through your digestive tract. This can help make your bowel movements easier and more regular.
“I just finished my first bag and ordered 2 more! I Iove this stuff! I have IBS and every protein powder hurts my stomach…except drink wholesome!”
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.