Amino acids are the building blocks of proteins, essential for numerous bodily functions. While our bodies can produce some, others, known as essential amino acids, must be obtained through diet. This article explores the effects of essential amino acid deficiency, its causes, and potential solutions.
The Importance of Amino Acids
Each of the neurotransmitters that support brain health is made from protein building blocks called amino acids. Protein is one of the body’s main building blocks. It plays a key role in the structure and function of muscles, skin, enzymes, and hormones. These are basic nutritional elements produced within our bodies or ingested through the food we eat.
Effects of Essential Amino Acid Deficiency
A deficiency in essential amino acids can manifest in various ways, impacting overall health and well-being. Some signs and symptoms of protein deficiency include edema, hair loss, increased hunger, and more severe infections, among others. Protein deficiency is when your intake is unable to meet your body’s requirements.
Physical Manifestations
- Edema: This condition, characterized by swollen and puffy skin, is a classic symptom of severe protein deficiency, particularly kwashiorkor. Researchers suggest it may be caused by low amounts of human serum albumin, which is the most abundant protein in the liquid part of blood, or blood plasma. One of albumin’s main functions is to maintain oncotic pressure - a force that draws fluid into the blood circulation. In this way, albumin prevents excessive amounts of fluid from accumulating in tissues or other body compartments. Because of reduced human serum albumin levels, severe protein deficiency leads to lower oncotic pressure. As a result, fluid accumulates in tissues, causing swelling.
- Fatty Liver: Protein deficiency has been associated with fatty liver disease in developing countries. This condition may cause inflammation, liver scarring, and potentially liver failure. It’s not clear why fatty liver disease occurs with protein deficiency, but research suggests it may be due to changes in the gut microbiome, mitochondria, and peroxisomal cells. This may lead to impaired synthesis of fat-transporting proteins, known as lipoproteins.
- Skin, Hair, and Nail Changes: Protein deficiency may be associated with changes in the skin, hair, and nails, which are largely made of protein. For instance, protein deficiency may affect hair growth and structure, which could lead to a hair loss condition known as telogen effluvium. Kwashiorkor in children is also distinguished by flaky or splitting skin, redness, and patches of depigmented skin.
- Muscle Wasting: Your muscles are your body’s largest reservoir of protein. When dietary protein is in short supply, the body tends to take protein from skeletal muscles to preserve more important tissues and body functions. As a result, a lack of protein could lead to muscle wasting over time. Even moderate protein insufficiency may cause muscle wasting, especially in older adults. In fact, research suggests adults ages 65 years and older should consume at least 0.5 grams (g) of protein per pound (lb) of body weight, which is more than the recommended daily allowance of 0.36 g. Increased protein intake may help prevent sarcopenia, which is the slow loss of muscle associated with aging.
- Bone Weakness: Not eating enough protein may weaken your bones and increase the risk of fractures. A 2021 study found that participants who ate higher amounts of protein had up to 6% higher bone mineral density in their hips and spine than those who ate less protein. After 5 years, the researchers found that those who ate more protein were less likely to experience bone fractures.
- Growth Impairment in Children: Insufficient protein intake may delay or prevent growth in children. In fact, stunting is one of the most common signs of childhood malnutrition. In 2020, over 149 million children had stunted growth. Children who don’t regularly consume enough protein may be four times more likely to have stunted growth.
Systemic Effects
- Immune Dysfunction: A protein deficit may take a toll on your immune system. For instance, eating enough protein is important to help build antibodies. These are produced by your white blood cells to help fight infections. A 2013 study in male athletes who engaged in high intensity exercise found that participants who consumed a high protein diet experienced fewer upper respiratory tract infections than athletes consuming a low protein diet.
- Appetite Dysregulation: Protein plays a key role in appetite maintenance and total calorie intake. If you’re not consuming enough protein, your body attempts to restore your protein status by increasing your appetite and encouraging you to find something to eat. This may lead to consuming foods high in carbs and fat to compensate for the lack of protein, which is known as the protein leverage hypothesis. However, foods high in carbs and fats aren’t as satiating high protein foods. Over time, this may lead to eating too many calories, causing unintended weight gain and obesity.
Causes of Essential Amino Acid Deficiency
If our bodies produce some of the amino acids we need and we ingest others, why do so many people lack the necessary amino acids to help regulate appetite? Several factors can contribute to this deficiency:
- Insufficient Protein Intake: The primary cause is insufficient protein. Protein is absolutely necessary for the body to make amino acids. And because amino acids are not stored for very long, people need to eat enough protein every day. People who get most of their calories from sweets and starches are likely to be deficient in protein. In addition, vegans and vegetarians are often protein-deficient. Adolescents, who tend to subsist on a diet of pasta, are at greatest risk of amino acid deficiency.
- Poor Protein Digestion: It’s sometimes not enough just to eat more protein. Protein must be broken down into its constituent parts before it is of any use. A second cause of a deficiency can be poor protein digestion. In other cases, insufficient protein digestion comes from a lack of hydrochloric acid. The breakdown of protein occurs in the stomach, which secretes the powerful gastric acid called hydrochloric acid. Hydrochloric acid converts a substance called pepsinogen into pepsin, an enzyme that cuts up protein into smaller pieces known as polypeptides. In a sense, hydrochloric acid takes the “dull” pepsinogen and turns it into the “razor-sharp” pepsin. Without pepsin, the human body cannot digest protein, so a decrease in the production of hydrochloric acid means that protein digestion will be less efficient.
- Aging: Insufficient amino acid levels can also result from the aging process. As we age, stomach acid levels decrease. Stomach acid drops by almost 40% from the teens to the thirties and almost half again by the seventies. Of course we can’t help aging, but there are things we can do to help sustain our bodies’ protein synthesis.
- Antacid Use: The fourth cause of low amino acid levels is antacid use. Millions of people who experience stomach discomfort and develop indigestion from overeating treat themselves with antacids. Taking antacids actually makes the problem of overeating worse. People trying to medicate their discomfort may unwittingly exacerbate problems with protein digestion by reducing their already low levels of hydrochloric acid even further.
- Other Underlying Conditions: Several causes may lead to protein deficiency, including malnutrition, pregnancy, eating disorders, liver disorders, kidney problems, and inflammatory bowel diseases.
Addressing Essential Amino Acid Deficiency
Because low levels of amino acids are a very frequent culprit in disordered eating, and because low levels are very common, I encourage you to have your amino acid levels tested. Both the tests and the treatment are simple, safe, and inexpensive.
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Dietary Strategies
The best way to fix low protein levels is to eat foods high in protein. Both animal-and plant-based foods contain amino acids, but only animal foods contain all of the essential amino acids. Some animal-based foods rich in amino acids are meat, turkey, chicken, eggs, milk, cheese, and yogurt. All of these are high in protein.
- Animal Sources: Meat, poultry, fish, eggs, and dairy products are complete proteins, meaning they contain all essential amino acids.
- Plant Sources: Legumes, nuts, seeds, and whole grains are good sources of protein, but they may not contain all essential amino acids in sufficient quantities. Combining different plant sources can help ensure a complete amino acid profile.
Supplementation
In some cases, supplementation may be necessary to address specific amino acid deficiencies. However, it's crucial to consult with a healthcare professional before starting any supplementation regimen.
Considerations for Specific Populations
- Athletes and Bodybuilders: There are many people who consume chronically high amounts of amino acids as a dietary supplement. These are mainly athletes and bodybuilders who use amino acids and their derivatives to increase muscle mass and strength and delay the onset of fatigue. The amount of protein you need to consume per day may depend on several factors, such as your age, level of physical activity, and fitness goals. The Dietary Guidelines for Americans 2020 to 2025 recommends adult females consume 46 g and adult males 52 to 56 g of protein daily. On average, this equates to 0.36 g per lb (0.8 g per kilogram [kg]) of body weight. However, research suggests this is the minimum requirement to prevent muscle loss and chronic conditions. If you’re trying to gain muscle mass, the International Society of Sports Nutrition recommends eating 0.6 to 0.9 g per lb (1.4 to 2 g per kg) of body weight. The authors note that people who resistance train may also benefit from eating up to 1.3 g per lb (3 g per kg) of body weight.
- Vegans and Vegetarians: Vegans and vegetarians are often protein-deficient.
- Elderly: Research suggests adults ages 65 years and older should consume at least 0.5 grams (g) of protein per pound (lb) of body weight, which is more than the recommended daily allowance of 0.36 g. Increased protein intake may help prevent sarcopenia, which is the slow loss of muscle associated with aging.
- Individuals with Medical Conditions: Humans also consume amino acids to support immune system, improve memory, ameliorate depression, prevent headaches, and to help insomniacs. Several amino acids are recommended or investigated in therapy of muscle wasting disorders, sepsis, multiple trauma, liver cirrhosis, renal insufficiency, eczema, and ageing-related disorders.
Potential Risks of Excessive Amino Acid Intake
It may be assumed that chronic intake of high amounts of individual amino acid or its derivatives alters various biochemical pathways and cellular functions. Enhanced intake of most amino acid supplements may not be risk-free and can cause a number of detrimental side effects.
General Risks
Several studies have examined possible toxic, mutagenic, cancerogenic and teratogenic effects of high doses of specific amino acids and tried to assess the safe limits of their increased intake. Many studies have evaluated effects on the digestive system, for example, whether or not nausea, abdominal pain, vomiting, and diarrhea are present.
Specific Amino Acid Supplement Risks
- Arginine (ARG): A common dosage is 6 g per day; higher doses, up to 30 g per day have also been reported. There are reports of gastrointestinal distress, such as nausea and diarrhea. A significant increase in weight and protein content in the kidneys was observed after a two-month intake of ARG-enriched diet in the rat. Overstimulation of NOS by ARG load may induce hypotension due to NO-mediated vasodilatation, which was observed in subjects receiving a large dose of ARG intravenously. A serious problem with the use of ARG in therapy of cardiovascular disorders is that its beneficial effects disappear if it is given chronically.
- β-Alanine (BA): The recommended dose is 1-3 g/day. There is no information on toxic or carcinogenic effects. The only reported side effects are short-term paresthesia and a slight increase in alanine aminotransferase levels.
- Branched-Chain Amino Acids (BCAAs): A common dose of BCAA supplementation is 10-20 g/day, in some studies 60 g/day, resulting in 4-fold and more than 10-fold increase in plasma BCAA, respectively.
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