Practice & Prosper Newsletter -Feb 2023

Protein Quality Rankings

Not all dietary proteins are created equal. Proteins break down into smaller building blocks called amino acids. From these amino acids our body can create mood stabilizing chemicals like serotonin, dopamine, and our sleep hormone melatonin. 1 in 3 Americans over the age of 50 has a protein deficiency. This deficiency leads to greater incidence of chronic disease, poor wound healing, muscle loss, a slower metabolism, and an increase in total body fat.

Studies show that the greater amount of lean muscle mass we retain in the later decades of life, the greater our longevity and the lower our risk of chronic disease such as obesity, type 2 diabetes, heart disease, and even cancer. Weight bearing exercise is both a preventive and therapeutic intervention to build and retain optimal lean muscle mass as this primes your metabolism and slows the aging process.

There are a total of 20 amino acids that the body needs in order to make hormones, collagen, enzymes, hemoglobin in blood cells, and immune cells that are found in plant and animal proteins to varying degrees. Our bodies can make 12 of these amino acids but the remaining 8 aminos acids we cannot and, therefore, we rely exclusively on our diet to supply these amino acids. If the protein source contains all 8 essential amino acids to meet the needs of the body, it is called a complete protein, nearly all animal sources of protein are complete proteins. If the protein source is missing one or more of the 8 essential amino acids, it is called an incomplete protein, and the insufficient amino acid is called the “limiting amino acid.” Most plant proteins are incomplete proteins.

A system has been created to evaluate the nutritional value of plant and animal proteins. The current system is called the “Protein Digestibility Corrected Amino Acid Score”(PDCAAS). The essential amino acids are considered the most important for growth and metabolism but they are often the limiting amino acids in foods.

Food categories such as grains have a limiting amino acid of lysine which is essential for making collagen and immune antibodies. Diets high in grains and low in other animal or plant proteins are more susceptible to hair loss, brittle nails, skin wrinkles, and herpes virus flare ups. This can be offset by combining grains with other plant proteins such as legumes/beans which contain sufficient lysine but inadequate methionine which is supplied by the grains.

Also in the grain category is corn which contains methionine but has insufficient lysine and tryptophan amino acid levels. This can lead to sleep issues and anxiety/depression since tryptophan makes the sleep hormone melatonin and the mood stabilizing hormone serotonin. Gluten-free diets are most susceptible to this deficiency since corn often replaces other grains like wheat.

 Another “gluten-free substitute is rice which has a limiting amino acid of lysine and threonine. Deficiencies in the amino acid threonine results in poor digestive and liver function as well as an increased risk of neurodegenerative diseases including multiple sclerosis and ALS since threonine is used heavily by the brain and central nervous system.

While digestibility is the primary system of protein rating, we are also interested in the bioavailability of proteins which assesses how much of the amino acids can be used by the body tissues beyond what is capable of being digested. We are what we absorb, not what we eat.

The importance of eating enough dietary protein cannot be understated, but the low protein scores of some of the most popular animal and plant proteins may surprise you. The chart below ranks animal and plant proteins by their corrected amino acid scores, which are further calculated to determine the “Digestible Indispensable Amino Acid Score” (DIAAS) to regulate protein claims on nutrition fact labels.

  Digestibility Score                    Bioavailability Score

Whey (from milk)                              1.0                                            100%

Egg                                                     1.0                                             100%

Casein (from milk)                             1.0                                              77%

Soy protein                                         1.0                                              74%

Salmon and tuna                               0.94                                            83%

Beef                                                    0.92                                            80%

Chicken /turkey                                 0.91                                             79%

Chia Seeds                                          0.89                                          unknown

Pea protein                                         0.73                                              72%

Chickpeas                                           0.71                                               75%

Kidney beans                                     0.68                                            unknown

Dehulled hemp seeds                        0.66                                            unknown

Pinto beans                                        0.63                                             unknown

Rolled oats                                          0.57                                               55%

Black beans                                        0.53                                               unknown

Lentils                                                  0.52                                               unknown

Peanuts                                               0.52                                                83%

Rice protein                                         0.47                                                64%

Almonds                                              0.45                                                unknown

Wheat gluten                                      0.25                                                 54%

Digestibility- the amount of a given protein that is broken down in the digestive tract. 1.0 = 100%

Bioavailability- The amount of the amino acids from the protein that is incorporated into the body tissues.

If we look at the digestibility score of egg it is 1.0 which means 100% of the protein contained in the egg can be broken down and the bioavailability score of 100% means that the entire amino acid profile can be absorbed and utilized to repair the body or make enzymes, collagen, or neurotransmitters. If you notice whey protein is higher on the chart, this is because whey protein from dairy has the highest amount of the amino acid leucine which is the most anabolic or “muscle building” amino acid so it has become the new gold standard that all other proteins are compared to. Whether or not the whey is well tolerated by the immune system and the digestive system can be determined with the food sensitivity testing.

Beef has a digestibility score of 0.92 which means 92% of beef protein is digested and 80% of the amino acids are absorbed and utilized by the body tissues. The fat content of beef also determines its digestibility and bioavailability with leaner cuts having higher scores and fatty cuts having lower scores. This is why blood type A has difficulty digesting red meat, it’s partly due to the acidity of the beef but the saturated fat content is the more problematic component of beef for type A.

At the bottom of the list is wheat gluten with the lowest digestibility score of 0.25 which means 25% of gluten protein is digested and 54% of its amino acids are utilized by the body tissues. This is why blood type O does not tolerate grains well, most of the undigested gluten enters the gut to activate the immune system to create inflammation leading to a slower metabolism. The best plant proteins are organic soy/tempeh, chia seeds, and pea protein, a digestibility score of 0.80 or above is preferred.

By now you are likely familiar and quite savvy with the blood type diet so I will share the less known nuances of this habit of eating and highlight the new testing tools we can use to tell us which foods you cannot digest or specifically trigger your immune system beyond the general food lists associated with your blood type. We’ll explore the surprising nutritional facts about protein digestibility and how it relates to blood type.

 Research shows the blood type diet is 80-85% accurate in predicting beneficial, neutral, and problematic foods based on your blood type. However, this does not account for the individual, non-genetic factors influencing digestion and food intolerances such as enzyme deficiencies, leaky gut, and other acquired digestive changes over time due to chronic diseases such as obesity, diabetes, stress, and autoimmune diseases. We need to understand your individual needs as 2 people with the same blood type can have different food sensitivities and have different health outcomes from eating identical diets. Applying the blood type diet is a good starting point, but to get definitive answers we must test for food sensitivities and food intolerances unique to your body.

Maximizing food variety is key to optimal gut health and nutritional status, but even the blood type diet has its limitations. Blood type is a unique genetic inheritance pattern because you can inherit the blood type from both parents and have more than 1 blood type. This is called co-dominance, hence why some people have the blood type AB, they express both genes. This is also true for people who have a single blood type A or B, you can be AA, BB, AO, or BO. This is how 2 blood type A parents can have a blood type O child, both parents were AO and both passed on the O gene so the child is OO.

For medical purposes, if there is an A or B blood type then that is what is reported because they show up on blood tests as distinctly different. There could still be a co-dominant O blood type with A or B, but the O is not reported because O is the universal blood donor and the A or B is dominant to the O when both are present. Type O blood has no distinct blood marker like A or B which is why type O is the universal blood donor and anyone can receive type O blood without rejection.

For nutritional purposes, having AO or BO blood type can change the course of the blood type diet and offer greater variety of foods. If you’re a BO you might tolerate chicken unlike type BB. If you’re type AO you might tolerate red meat unlike type AA. If you’re type OO, then there is still a 20% variability to the degree you tolerate certain foods compared to other type O’s because of geographical ancestry and the non-genetic digestive factors described earlier. 

Advances in food sensitivity testing now provide accurate testing tools to assess for the presence of antibodies to foods we eat everyday that are otherwise considered healthy and beneficial to our blood type as well as determine the foods we actually need to avoid. This could be the difference between a type O person who can actually tolerate some grains and which ones and the type O person who needs to avoid grain altogether. Similarly, a blood type A may or many not need to avoid nightshades like tomatoes or a blood type B person that may or may not need to avoid lentils. The food testing can also remove some of the obstacles in adopting the blood type diet due to availability of certain foods, multiple blood-type households, and conflicting values between blood type and lifestyle like a type O or B person who prefers to eat vegetarian which is not genetically compatible in most cases.

What signs and symptoms indicate the need for food sensitivity testing?

1.      Persistent or recurrent:

- headaches, nasal congestion and allergies, brain fog, abdominal bloating, heartburn, constipation or diarrhea, skin rashes, poor memory, mood swings, ADHD, feelings of anxiety and/or depression, and joint pains

The food sensitivity tests provide a lifetime of value because they only need to be completed once to determine whether a food sensitivity is present or not. An additional benefit is that some of the tests have an intestinal permeability test built-in to also determine if leaky gut is present. Below are the food categories that can be tested individually or bundled together.

1.      Wheat – This test is recommended for all blood types as anyone can have a food sensitivity to gluten or any of the 4 non-gluten proteins which are all covered in the test. The leaky gut test is also included with this test.

2.      Corn- This test is recommended for those who eat a “gluten-free” diet or have a known gluten sensitivity as the proteins in corn are similar in composition to gluten and can create a cross-reaction similar to celiac even when avoiding gluten. Corn is also a grain so blood type O would benefit from this test to determine if it should be avoided with the broader grain category.

3.      Dairy- This test is recommended for all blood types who consume cow’s milk dairy or those who consume whey protein powder after exercise to test for sensitivity to whey and casein proteins. If no sensitivity is present, whey is the preferred protein for muscle recovery after exercise.

4.      Egg- This test is recommended for children and all blood types who consumes eggs on a regular basis. It can differentiate between a sensitivity to the egg whites or the egg yolk.

5.      Lectin- This test is recommended for all blood types as it serves as the basis for the recommendations in the blood type diet. Lectins are proteins that attach to sugars on the red blood cells and then causes the cells to stick together which decreases oxygen transport in the body, slows down the metabolism, and leads to weight gain, fatigue, and inflammation.

6.      Nuts- This test is recommended for those of consume nuts regularly including- almonds, cashews, walnuts, Brazil nuts, pistachios, pecans, or macadamia nuts and experience digestive issues or brain fog frequently.

7.      Peanuts- This test is recommended for children or anyone with a history of a peanut sensitivity and tests for 17 different markers that are known triggers of peanut sensitivity. This test is especially useful in cases of eczema when wheat and dairy have been eliminated from the diet and eczema flares still occur.

8.      Seafood- This comprehensive test will look for antibodies to shellfish like shrimp and lobster, clams and oysters, a variety of white fish like cod and pollock, cold water fish like salmon and tuna, and freshwater fish like trout, catfish, and tilapia. This test is recommended for people who eat fish 2 or more times a week.

9.      Soy- This test is recommended for vegetarians and vegans who consume soy as a major protein source or for those who have a history of asthma as soy is a top trigger of asthma symptoms. Soy is often hidden in foods as an additive and is heavily contaminated with pesticides if not organic, this test will identify antibodies to any of 11 proteins in soy including the pesticides.

10.  Grains- This test is recommended for all blood types who consume rice, quinoa, oats, or buckwheat more than twice a week. This test is especially beneficial for blood type A or anyone eating a primarily plant-based diet as well as blood type O because rye, barley, teff, and sorghum are also tested with cross-reactivity to gluten and listed in the avoid categories.

11.  Mammalian milk- This test is helpful for those who replace cow dairy with goat or sheep milk, yogurt, or cheese. If consuming these foods creates abdominal bloating or skin rashes, this test is recommended.

All the tests are blood tests, and we can draw your blood in office, or you can perform an at home finger-prick test. All tests are self-pay and eligible for FSA or HSA benefits.

Fortunately, the lab has agreed to discount the lab tests when bundled in groups of 4 or more and will include a free add-on test of either a comprehensive 209 food sensitivity panel, a test for SIBO if digestive issues are present, or a neurotransmitter test if you experience brain fog, anxiety, or depression at no extra charge.

The individual tests cost $340 each but are reduced to $195 each when 4 or more tests are ordered plus your choice of 1 of 3 free add-on tests mentioned above. Again, these are tests you only need to perform once to get the exact specificity of which foods should be avoided and save yourself months or years of guesswork trying to eliminate foods based on non-specific symptoms. You can email Dr. Kiselka to ask which test bundle would be most beneficial for you based on your blood type, case history, and treatment outcomes to create the foundation for a vibrant metabolism, longevity, and immune resilience.

Mental Health Check:

We are energetic beings, Einstein proved it with his theory of relativity, E= mc² , which simply means that energy is anything with mass moving at the speed of light. Our thoughts, attention, feelings, self-talk, suppressed emotions, and how we experience the world are all inputs of energy that occupy mass in our bodies. Be selective of the energy you exchange and allow into your life; cut loose any energy depleting inputs like watching the “news”, gossiping, and taking on the problems of others- you can’t fix them and it’s not your fault. Focus and follow through on your intentions, be present, and practice gratitude daily because the mind is moving at the speed of light and what you allow into your life becomes your energy and either occupies mass as anxiety and fear or grounds you in authenticity and resilience.  

“In Health, We Prosper.”