Are protein supplements bad for you?

The Indian Council of Medical Research (ICMR) released dietary guidelines mentioning, "protein supplements are not advisable." So, we dug deeper to understand what it's all about.

Short answer – Protein supplements are good for you. They can help you maintain a healthy and well-functioning body.

Long answer – Here is ICMR's exact statement "Protein powders may also contain added sugars, non-caloric sweeteners and additives such as artificial flavouring, hence, are not advisable to be consumed on a regular basis." view report [pdf page 77]

Since protein powders are consumed on a daily basis, it's important to understand the long term effects of sweeteners. Here's a quick summary, Table Sugar < Artificial non-nutritive sweeteners (NNS) < Natural NNS. For detailed information on Sugars and Sweeteners, read our blog on it. We recommend using more of natural NNS if it fits within your wallet, otherwise artificial NNS are quite good too.

If you are fine without any sweeteners, nothing is better than that. Although we do understand that raw whey can be hard to drink daily.

ICMR's statement is only true for some brands which are heavily adulterating and/or mislabeling their protein supplements.

What to do then?

Be mindful and buy supplements which use well-researched ingredients. You can aim to go as natural as your pockets allow.

How to choose a good protein powder?

Buy from a brand that uses natural and well-researched ingredients.

To make your life a little simpler, here's a list of brands that make good quality protein powder (not an exhaustive list)

Controversies around protein powder

Besides what ICMR mentioned about added sugars and other additives, there is one more thing they mentioned: BCAAs and it's link to non-communicable diseases like Type 2 Diabetes.

Quick answer – BCAAs and EAAs do not cause non-communicable diseases.

⚠️ Caution: If you are reading further, please read till the very end so that you don't end up with half information, which can potentially be misleading and even dangerous.

"Recent evidence suggests that BCAAs may increase the risk of certain non-communicable diseases (NCDs)" said ICMR while discussing protein powders and their impact on our health.

What did we find?

Let's look at the result table from the research ICMR used. (see table)

Amino Acids	Case (n=113) Median (IQR) (gr/day)	Control (n=452) Median (IQR) (gr/day)	p-value
Branched-chain	8.15 (4.74)	7.78 (5.10)	0.04
Aromatic	4.08 (2.38)	3.93 (2.54)	0.04
Alkaline	7.16 (4.78)	6.82 (4.45)	0.03
Sulfuric	1.71 (1.03)	1.55 (1.00)	0.02
Acidic	13.50 (7.00)	12.71 (7.78)	0.04
Alcoholic	3.99 (2.34)	3.78 (2.42)	0.05
Small amino acids	4.18 (2.67)	3.98 (2.54)	0.03
Proline	2.49 (1.49)	2.38 (1.51)	0.09
Essential	18.12 (10.98)	17.00 (11.35)	0.04
Non-essential	27.69 (15.25)	26.12 (16.49)	0.04

Definitions of Case, control, median, IQR and p-value

• Case: 113 people got Type 2 Diabetes
  
• Control: 452 people did not get Type 2 Diabetes
  
• Median: The middle value. It's similar to the average, but extreme values do not impact it.
  
• IQR: Measures the spread of the data, indicating the impact of small increments.
  
• p-value: Is related to the uncertainty level. Lower the p-value, lower the uncertainty and hence higher the confidence in data. We consider lower than 0.05 as quite confident.
  

This is where the absurd part begins! With quite high confidence, the researchers point out that for an average person, consuming 7.78g of BCAA per day doesn't correlate to higher chances of Type 2 Diabetes, but consuming 8.15g per day does. This range is so small that it's hard to believe a mere 0.37g increase can correlate to Type 2 Diabetes. Moreover, given the IQR (how far spread the data is), we can see that some people who consumed 10g of BCAA per day did not get Type 2 Diabetes, while others who consumed the same amount did. Given the number of case and control subjects, we can estimate that for every person who got Type 2 Diabetes by consuming 10g per day, there were four people who did not.

What we don't know is how those BCAAs were consumed. If a person takes in a lot of simple carbs and sugar in their meals or if they simply eat more, they will end up with more BCAAs than an average person. This doesn't mean that BCAAs cause Diabetes; it means that overeating does.

To drive the point home, let's take another example. There are two people: X and Y. X is overweight and eats more food, while Y is an active person who maintains a healthy weight. If we now measure their Vitamin A levels, X will have higher levels than Y, but that doesn't mean that Vitamin A causes Diabetes! It's being overweight that does.

To be fair, researchers don't ever say that BCAAs cause Type 2 Diabetes. They only show there is a correlation between higher BCAA amount and Type 2 Diabetes. In fact, in a later paragraph they mention that accounting for all other factors like age, family history, food habits and others, there is no measurable correlation. The actual causation can be totally different and a higher BCAA amount is merely an effect of that. It's the ICMR which drew the conclusion that BCAAs may increase the risk of certain non-communicable diseases (NCDs) which is totally untrue and should not have been concluded.

The researchers have generously provided more data they collected. Let's have a look at it. (see research [download Additional File 1])

Dietary food groups (gr/day)	Case (n=113) Median (IQR)	Control (n=452) Median (IQR)	p-value
Whole grains	24.60 (36.23)	17.83 (28.75)	0.005
Refined grains	441.64 (223.28)	438.12 (243.56)	0.758
Legumes	24.54 (30.70)	23.49 (29.22)	0.334
Fresh fruits	209.22 (209.20)	177.41 (217.54)	0.018
Dried fruits	17.35 (29.29)	14.97 (23.87)	0.055
Fruit juices	0 (3.78)	0 (3.12)	0.909
Nuts	6.69 (10.62)	4.36 (8.62)	0.002
Red meats	9.86 (21.69)	9.86 (21.69)	0.968
Processed meats	0 (1.27)	0 (0.65)	0.146
Organ meats	1.78 (3.61)	1.80 (3.28)	0.881
Chicken meats	0.98 (4.27)	0 (3.45)	0.034
Poultry	34.19 (47.01)	25.64 (34.19)	0.084
Fish	2.46 (8)	2.08 (5.75)	0.349
Eggs	11.83 (21.69)	13.31 (21.69)	0.454
Saturated fats	17.35 (37.19)	19.25 (25.61)	0.426
Unsaturated fats	4.27 (11.59)	2.48 (10.26)	0.113
Leafy vegetables	26.91 (29.15)	21.19 (24.38)	0.014
Other vegetables	433.04 (323.13)	365.67 (298.14)	0.029
Dairy products	308.05 (397.58)	314.55 (422.10)	0.968
Drinks	697.56 (485.43)	690 (537.47)	0.411
Salts	3 (3)	3 (3)	0.390
Condiments	20.72 (26.14)	17.18 (21.43)	0.007
Sweets	27.36 (37.52)	36.84 (34.59)	0.004
Desserts	12.82 (16.75)	10.24 (15.30)	0.849

The table shows that eating more fresh fruits, more nuts, more leafy vegetables, and surprisingly, eating fewer sweets, have a correlation to Type 2 Diabetes. Not just that, look at their p-values: they have really high confidence about eating fewer sweets and it's correlation to Type 2 Diabetes.

Our Hypothesis: The likely cause of people showing higher chances of Type 2 Diabetes was not the food itself but people eating too much of it. For sweets, it's possible that these people are overly restrictive in their diets and don't eat a balanced diet. They may not be consuming excess sugar from sweets but rather from other sources with high glycemic index.

Conclusion

Eat a well-balanced diet. If eating two chocolates a week helps you enjoy the healthier food you eat the rest of the week more, it's a better tradeoff and will keep you in shape longer than overly restrictive diets. BCAAs and EAAs are of no concern for most healthy adults. We suggest getting as much protein from whole foods as possible because they contain other micronutrient as well which your body needs and completing the remaining using a high quality protein supplement.

Stay healthful! See you on another Good Food blog.