Protein and Special Needs
Each step of the metabolic process must have an enzyme and usually a co-enzyme in order to complete its function. If these are not present in any stage of the process, systemic problems result.
Low protein diets are desirable in some cases and decidedly necessary in others. Since protein foods entails more work for the liver and kidneys, it is understood that any diease affecting these two organs should have the protein intake monitored. With high protein diets comes the increase in nitrogenous wastes; and with this comes the need for more water to excrete them. Those in chronic renal failure have a decreased ability to excrete these wastes and are cautioned about their water intake.
There is also an increase in their blood urea levels with high protein diets. A "high-protein" diet to a person in renal failure usually means anything above 25 grams of protein per day. Those on dialysis, usually require 1.0 gram of protein per kilogram of body weight to compensate for the loss of amino acids during dialysis. Children on dialysis may need 1.2 to 1.5 grams per kilogram per day. These patients are generally exposed to diet counselling.
Premature and very young infants do not have the ability to excrete any additional nitrogenous wastes when ingesting high protein formulas. Excessive intake of high proteins during the first month of life can also result in neurologic damage. In addition, enzymes that are necessary to synthesize amino acids are often missing in low birthweight infants. Consequently, many infant formulas have to be adjusted to compensate for this deficiency.
Limiting protein in the diet has been known to reduce the amount of levadopa needed for a Parkinson's patient. The total amount of the protein is spread over four meals rather than three.
The elderly and the mobility-restricted often require additional protein. As the digestive system slows, these people are unable to digest and metabolize meat sources of protein with chronic constipation the result. Yet, vegetable protein sources are rarely recommended and do not pose the problems of digestion and elimination.
Pressure sores (decubitus ulcers) are an ever-present threat to the immobile. Proper healing of these takes considerable time and effort. A major factor in this healing process is protein. A deficiency is often a contributary cause, and their healing is accelerated with the addition of protein. A person with a decubitus ulcer can lose up to seven times the amount of protein that another would under normal circumstances. Drainage from an ulcer contains about 400 mg. of nitrogen, corresponding to almost 2.5 gms. of protein. It is not uncommon for as much as 30 grams of protein to be lost in a 24-hour period just from drainage. There is also an increased need for Vitamin C and zinc since they are vital for the synthesis and maintenance of collagen, the chief protein component of connective tissue.
