Laura Schoenfeld: As far as protein aversion, if they’re really not interested in eating it, as far as a functional medicine perspective, the first thing that I would think about is zinc deficiency, potentially. Zinc deficiency is known to cause some level of anorexia—which just means loss of appetite; I don’t mean anorexia nervosa—if somebody has a history of vegetarianism or veganism and they really just don’t have a lot appetite for meat, I would suggest either testing their zinc status or if they can’t get a test, maybe doing a little bit of zinc supplementation, maybe like 15 mg a day, just because zinc is pretty low in a vegetarian/vegan diet and if you’re low in zinc, unfortunately the only way to get higher in zinc is to eat meat and fish and shellfish, but if somebody doesn’t have the appetite for it, then you can see how it could be a kind of vicious cycle, so supplementing with some zinc could be helpful there. If somebody is not zinc deficient, then assuming that they’re not having any sort of indigestion from meat, because that’s something that can cause protein aversion, if they’re having either excessive fullness or reflux or something after eating meat, which could be related to hydrochloric acid production, so make sure that their HCl production is adequate or possibly supplement with that if necessary. But if it’s just an aversion to …
Actually, Julie, if you don’t mind, can you give me a little bit more information about what kind of aversion this person is having? Again, it could be more of just a low appetite, or it could be that physically they feel uncomfortable when they eat meat. If they were a vegan or a vegetarian in the past, obviously that makes a little difference with their zinc status and other nutrients like B12 or general minerals, that kind of thing. I’ll give her a minute to answer, or if she has any sort of … Let’s see, “Not a vegetarian, but it seems that she doesn’t really feel like cooking it.” OK. If she doesn’t feel like cooking it … This is why it’s hard to answer these questions because I feel like when you’re doing a really in-depth nutrition conversation with a patient, there are a lot of questions that you end up asking to get more information. When you say she doesn’t really feel like cooking this meat, is she grossed out by the meat? Is she just kind of tired and doesn’t feel like cooking it? If she’s just fatigued and is not interested in cooking, what kind of foods does she like cooking? Is there something that she prefers to cook when it comes to protein? Those are some of the questions that I would want to know from a patient. I don’t know, Julie, if you have any answers about that, if you’ve asked her why she doesn’t feel like cooking meat. While I’m waiting for Julie to answer or expand even further, I keep asking her to expand, but if somebody is having a hard time getting protein in their diet …
OK, she says, “I think she’s kind of grossed out and tired. She’ll eat meat at restaurants or if someone cooks for her.” OK, Julie, one last expansion question: Is she cooking other things that she doesn’t feel like there’s a problem cooking? When she wants to get protein, does she prefer to cook beans or lentils or something, or does she just prefer to eat vegetables? Is there anything that you see that she’s eating a lot of that she doesn’t seem to have this issue with cooking?
If somebody is having an appetite issue or a digestion issue that they can’t get enough protein, this is something that’s really common in older adults especially.
OK, so Julie says she will cook beans and protein shakes. OK, so the protein shakes thing is a good example of a pretty easy way to get protein into people that don’t really have the appetite for meat or just don’t have the digestive capacity to eat a lot of meat. I know Chris has written an article about this, and again, it’s really common in older adults because their appetite just gets low in general, and you don’t want older adults eating low protein because they really need that protein to keep their bones and their muscles healthy and protect them against muscle wasting and loss of bone density, that kind of thing. I’d say protein shakes are fine. They’re not ideal, but if that’s how somebody needs to get their protein, then doing some kind of either beef protein or maybe throwing some hydrolyzed collagen or gelatin powder into the shake would be helpful. I know Chris has recommended that PurePaleo Protein powder, and that’s the one that I typically use with my patients just because it tends to be the most well tolerated by everyone I’ve worked with and it tastes pretty good, I’d say. It doesn’t really have that gritty taste that a lot of plant-based proteins have, and it’s good for people that can’t tolerate dairy. If somebody can tolerate dairy, then whey protein is a good option. A good-quality grass-fed whey is always possibly a good choice for somebody who needs extra protein that won’t eat a lot of protein foods.
You don’t want somebody doing all their protein from protein shakes. It’s just not an ideal way to eat protein. I think it could potentially make somebody’s ability to digest protein worse if they are not eating full proteins because, as you guys might be aware, it’s one of those use-it-or-lose-it situations, where if you’re not eating a lot of certain types of foods, your body starts to downregulate the production of the enzymes that would digest those foods, which is a big reason why a lot of people that have been avoiding foods for a really long time, once they add them back in, a lot of times they get intolerance reactions because they haven’t been eating them in so long. That can happen with meat if somebody is not eating meat and then they’re going either from a vegetarian/vegan diet or if they’re just doing protein shakes, then going to full protein would be potentially rough on their digestive system.