Damn Medical Students !

Ok, fellas, I need some assistance. Both of my workout partners got “lectured” last night by one of their girlfreind’s and by one of their friends, both are in medical school. They were trying to tell them that eating a lot of protein, and more specifically, “protein powder” was bad and even dangerous for them. Can anyone send me a website, or some sort of proof that has been written by a actual dr. or something substantial, so I may print it out and shove it up their a$$.

Better yet. Have these medical students produce their “facts”. Make them prove it. The best defense is a good offense. Besides, it will save you time and train these Future Doctors to do their research. If they show you a text book, check the reference and get a copy of it. A large percentage of materials site in text books are take out of context.
Hope this helps

Ignorance in nutrition and training? They are well ahead of pace in the medical field

Most if not all information medical students and doctors know is what is in the books. And Older Lifter is right, check out the references because they are no doubt taken out of context. I work with MD’s & PhD’s & all go silent when I speak on lifting and the nutrition behind it. They only “know” what a book said from research conducted 2-3 decades ago. Do what Older Lifter said and have them prove it to you not the other way around. MD’s as a whole don’t know about research and just regurgitate information they’ve been told or read in a textbook. No offense to the MD’s reading this as you are no doubt different but you would be the exception and not the rule.

I’m in agreement with Older Lifter here. Tell them to put up or shut up. If they can pull out studies, great, but every one I’ve ever seen that supports the idea that high protein diets are unhealthy has had more holes than a sieve. Sadly, there is likely little that you can do or say to change their minds, because even in the face of insurmountable evidence most people stick to their position.

I agree with everyone else here in that Older Lifter is right on. Here’s another thing - have these medical students present their “facts” here on the forum. Well provide a spirited discussion on this topic!

If you do a search for the Experimental Biology conference or seminars this year, I think it was held in Arizona but could be wrong, there was data presented that showed high protein diets showed NO ill effects on the body. Kidneys, liver etc all fine.

since these are medical studients that you are talking about, it makes sense that now is the perfect time to help shape their minds. Expose them to the protein studies published in Int J Sports Nutr, J Applied Physiology, etc. Very clear studies that indicate the relative safety and efficacy of moderate to higher protein intakes. Do a medline search, show them your results and ask them to do the same to support their beliefs. Limit the studies to within the past 5 or 7 years as to keep things current. Just an idea

I used to work in a doctor’s office, and it made me very frustrated. Every patient would come in with a preventable disease, every time the doctor would prescribe a sensible (limited) diet and moderate exercise program, and every time the same lazy fuck would be back in two months. “Doctor, my diabetes is worse. I’m only mainlining beet sugar twice a day now, and I don’t understand why it’s getting worse.” Then, the doctor would patiently give them the same advice, give them drugs to keep them from dying, and wait for the inevitable return. When I finally asked the doctor about it, and asked him (a slim, fit man) how he dealt with it, he explained to me that his job was not to beat them into doing what was right. It’s their life, whatever he felt about their lifestyle. What was he going to do – give them the information and then refuse to help them with medication, and let them die to prove his point?

Self-righteous people like these students are of course being stupid, but the criticism of the medical field as a whole seems off target. How many times in the career of a normal general practicioner will they have to deal with people who are interested in any kind of nutrition past “Gee, doc, I’m 56% bodyfat and it’s killing me what should I do”? 99.9999999999999999999% of the time they will be dealing with lazy fat people and the simple, repeated prescription of “Don’t eat so damn much, try to get a little exercise” will be the starting point that their patients will never get to. My doctor has suggested diets for all kinds of obesity-related programs, and guess what? If you were mostly sedentary and followed them they would prevent many common health problems, but almost no-one will actually have the discipline to follow them.

I received an e-mail from Will Brink which included this letter from the American Journal of Clinical Nutrition on the danger of low carbohydrate diets. This letter deals mostly with the premise that low carbohydrate diets have not proved beneficial or harmful, but the same can be said for high protein diets since lower carbohydrate diets are typically higher in protein.

American Journal of Clinical Nutrition, Vol. 75, No. 5, 951-953, May 2002

Letter to the Editor

Is dietary carbohydrate essential for human nutrition?

Eric C Westman

Department of Medicine Duke University Medical Center Suite 200-B Wing
Box 50, 2200 West Main Street Durham, NC 27705 Email: ewestman@duke.edu

Dear Sir:

I read with interest the article by Dewailly et al (1) regarding diet
and cardiovascular disease in the Inuit of Nunavik, but I was
disappointed that no information regarding macronutrient intake was
presented or considered in the estimation of cardiovascular risk. The
traditional Inuit diet consists primarily of protein and fat, somewhat
similar to the low-carbohydrate diets promoted in popular
weight-reducing diets (2). These diets have caused concern among
nutritionists because of the metabolic changes and health risks
associated with limited carbohydrate consumption (3). However,
in exploring the risks and benefits of carbohydrate restriction, I was
surprised to find little evidence that exogenous carbohydrate is needed
for human function.

The currently established human essential nutrients are water, energy,
amino acids (histidine, isoleucine, leucine, lysine, methionine,
phenylalanine, threonine, tryptophan, and valine), essential
fatty acids (linoleic and -linolenic acids), vitamins (ascorbic acid,
vitamin A, vitamin D, vitamin E, vitamin K, thiamine, riboflavin,
niacin, vitamin B-6, pantothenic acid, folic acid, biotin, and
vitamin B-12), minerals (calcium, phosphorus, magnesium, and iron),
trace minerals (zinc, copper, manganese, iodine, selenium, molybdenum,
and chromium), electrolytes (sodium, potassium, and
chloride), and ultratrace minerals (4). (Note the absence of specific
carbohydrates from this list.)

Although one current recommended dietary carbohydrate intake for adults
is 150 g/d, it is interesting to examine how this recommendation was
determined at a recent international conference (5):

‘The theoretical minimal level of carbohydrate (CHO) intake is zero, but
CHO is a universal fuel for all cells, the cheapest source of dietary
energy, and also the source of plant fiber. In addition,
the complete absence of dietary CHO entails the breakdown of fat to
supply energy [glycerol as a gluconeogenic substrate, and ketone bodies
as an alternative fuel for the central nervous system
(CNS)], resulting in symptomatic ketosis. Data in childhood are
unavailable, but ketosis in adults can be prevented by a daily CHO
intake of about 50 g. This value appears to approximate the
quantity of glucose required to satisfy minimal glucose needs of the CNS
and during starvation. The Group therefore concluded that the
theoretical minimum intake of zero should not be
recommended as a practical minimum…about 100 g of glucose/d are
irreversibly oxidized by the brain from the age of 3­4 y onward.
However, this excludes recycled carbon, gluconeogenic
carbon, for example from glycerol, and it does not account for glucose
used by other non-CNS tissues. For example, in the adult, muscle and
other non-CNS account for an additional 20­30 g of
glucose daily. For this reason a safety margin of 50 g/d is arbitrarily
added to the value of 100 g/d and the practical minimal CHO intake set
at 150 g/d beyond the ages of 3­4 y.’

Thus, although carbohydrate could theoretically be eliminated from the
diet, the recommended intake of 150 g/d ensures an adequate supply of
glucose for the CNS. However, it appears that during
starvation (a condition in which the intakes of carbohydrate, protein,
and fat are eliminated), an adequate amount of substrate for the CNS is
provided through gluconeogenesis and ketogenesis (6).
The elimination of dietary carbohydrate did not diminish the energy
supply to the CNS under the conditions of these experiments. Second,
carbohydrate is recommended to avert symptomatic
ketosis. In the largest published series on carbohydrate-restricted
diets, ketosis was not typically symptomatic (7).

The most direct way to determine whether carbohydrate is an essential
nutrient is to eliminate it from the diet in controlled laboratory
studies. In studies involving rats and chicks, the elimination of
dietary carbohydrate caused no obvious problems (8­12). It was only when
carbohydrate restriction was combined with glycerol restriction (by
substituting fatty acids for triacylglycerol) that
chicks did not develop normally (13). Thus, it appears that some minimum
amount of a gluconeogenic precursor is essential for example, glycerol
obtained from fat (triacylglycerol) consumption.
More subtle abnormalities from carbohydrate elimination might not have
been observed in these studies. In addition, the essentiality of some
nutrients is species-specific; therefore, these studies do
not provide convincing evidence that elimination of dietary carbohydrate
is safe in humans (4).

The usual way to discover the essentiality of nutrients is through the
identification of specific deficiency syndromes (4). I found no evidence
of a carbohydrate deficiency syndrome in humans.
Protein deprivation leads to kwashiorkor, and energy deprivation leads
to marasmus; however, there is no specific carbohydrate deficiency
syndrome. Few contemporary human cultures eat
low-carbohydrate diets, but the traditional Eskimo diet is very low (50
g/d) in carbohydrate (2). It is possible that if more humans consumed
diets severely restricted in carbohydrate, a
carbohydrate deficiency syndrome might become apparent.

When carbohydrates are eliminated from the diet, there is a risk that
intakes of vitamins, minerals, and perhaps yet unidentified beneficial
nutrients provided by carbohydrate-rich foodstuffs (eg,
fiber) will be inadequate. There are case reports of extreme dieters who
probably developed deficiencies. One dieter who only ate cheese, meat,
and eggs (no vegetables) was reported to have
developed thiamine-deficient optic neuropathy (14). Another dieter may
have developed a relapse of acute variegate porphyria (15). However,
most of the current low-carbohydrate,
weight-reducing diets advocate the consumption of low-carbohydrate
vegetables and vitamin supplements.

Although there is certainly no evidence from which to conclude that
extreme restriction of dietary carbohydrate is harmless, I was surprised
to find that there is similarly little evidence to conclude
that extreme restriction of carbohydrate is harmful. In fact, the
consequential breakdown of fat as a result of carbohydrate restriction
may be beneficial in the treatment of obesity (7). Perhaps it is
time to carefully examine the issue of whether carbohydrate is an
essential component of human nutrition.


1.Dewailly E, Blanchet C, Lemieux S, et al. n-3 Fatty acids and
cardiovascular disease risk factors among the Inuit of Nunavik. Am J
Clin Nutr 2001;74:464­73.[Abstract/Full Text]

2.Shaffer PA. Antiketogenesis. II. The ketogenic antiketogenic balance
in man. J Biol Chem 1921;47:463­73.

3.Westman EC. A review of very low carbohydrate diets for weight loss.
J Clin Outcomes Manage 1999;6:36­40.

4.Harper AE. Defining the essentiality of nutrients. In: Shils MD,
Olson JA, Shihe M, Ross AC, eds. Modern nutrition in health and disease.
9th ed. Boston: William and Wilkins, 1999:3­10.

5.Bier DM, Brosnan JT, Flatt JP, et al. Report of the IDECG Working
Group on lower and upper limits of carbohydrate and fat intake. Eur J
Clin Nutr 1999;53(suppl):S177­8.[Medline]

6.Cahill GF. Starvation in man. N Engl J Med 1970;282:668­75.[Medline]

7.Palgi A, Read JL, Greenberg I, Hoefer MA, Bistrian BR, Blackburn GL.
Multidisciplinary treatment of obesity with a protein-sparing modified
fast: results in 668 outpatients. Am J Public
Health 1985;75:1190­4.[Abstract]

8.Follis RH, Straight WM. The effect of a purified diet deficient in
carbohydrate on the rat. Bull Johns Hopkins Hosp 1943;72:39­41.
9.Renner R, Elcombe AM. Metabolic effects of feeding
‘carbohydrate-free’ diets to chicks. J Nutr 1967;93:31­6.[Medline]

10.Renner R, Elcombe AM. Protein as a carbohydrate precursor in the
chick. J Nutr 1967;93:25­30.[Medline]

11.Renner R. Effectiveness of various sources of nonessential nitrogen
in promoting growth of chicks fed carbohydrate-containing and
‘carbohydrate-free’ diets. J Nutr 1968;98:297­302.

12.Renner R. Factors affecting the utilization of ‘carbohydrate-free’
diets by the chick. I. Level of protein. J Nutr 1964;84:322­6.

13.Renner R, Elcombe AM. Factors affecting the utilization of
‘carbohydrate-free’ diets by the chick. II. Level of glycerol. J Nutr

14.Hoyt CS, Billson FA. Low-carbohydrate diet optic neuropathy. Med J
Aust 1977;1:65­6.[Medline]

15.Quiroz-Kendall E, Wilson FA, King LE Jr. Acute variegate porphyria
following a Scarsdale Gourmet Diet. J Am Acad Dermatol

For another review dealing more with the safety and efficacy of high protein diets read John Berardi’s chapter on protein in the new Sports Supplement Encyclopedia. It is very informative and well referenced.

1 Like

Hey, bro–I’m a medical student, myself (graduating in June, baby!), and I’ll be the first person to say don’t listen to a MD about nutrition unless you have diabetes, kidney or liver failure, and perhaps coronary artery disease. Our nutrition training is really pretty lame, consisting of nutritional diseases (defficiancy), treatment, and calorie maintance. The shit these med students are talking is perhaps related to THEORIES regarding kidney physiology: ie, high nitrogen diet resulting in increased kidney work resulting in kidney burnout, and also that whey can be calcium poor, and b/c of protein’s binding calcium in the body could possibly result in calcium leaching. Dude, here’s the real question. How “in shape” were these medical students? I my class, and school in general, future MD’s (w/o regard to myself) are a bunch of doughnut eating fatties. Anyway, no one probably eats more protein powder than me, just drink plenty of H2O and take calcium supplements. That should do it.

I totally agree with dogbitecat. They know what they talking about from a pathophysiological standpoint. Also, most nutrition taught at universities is focused on achieving a healthy diet and avoiding deficiencies. If you want to know about nutrition to look better naked just look up any of the references that Berardi or any of the other writers that deal in bodybuilding nutrition have citied. They will definitely help back up your view. Remember, there is no such thing as a scientific fact besides maybe some laws of thermodynamics. Every other physiological occurence is just very well supported. There is simply just evidence that is so well supported that you can bank on it 99.99% of the time. Find more evidence to support you own theories and go with it, who can logically say that you are wrong?

I heard something similar from my biology teacher last year. Their teacher probably told them that “the kidneys can’t handle that much nitrogen.” (Nitrogen is a byproduct of protein metabolism, if my memory serves me correctly.) Well, my kidneys are handling it, and I’m sure most of the people on this forum have no kidney problems.

I am also in medical school (3rd year) and it absolutely doesn’t surprise me what they are hitting you with. Coincidentally, I got into a very similar argument the other day with my professor. He saw me drinking my AP at break and came up and started with the very same argument. My response: If you can show me one study, just one showing where increased protein intake proved harmful to healthy kidneys, I’ll buy you the biggest steak oops, I mean vegetarian meal you want, at ANY restaurant you choose. He wouldn’t shake on it, and walked away muttering incoherently, flapping his chubby chin.

Like many have said, ask them to show you one study that proves their beliefs (they won’t be able to do this; there is none). And don’t let 'em break out this crap where people already had only one kidney, kidney diseases, shriveled livers, etc. before going on a high protein diet…healthy people only please. (Give me someone who’s got AIDS and i’ll prove to you that water is hazardous to your health.)

After they sit there looking pretty dumb, you can say "A high carbohydrate intake is dangerous." When they ask "How?," tell them to look at their fat ass nutrition professor.

I just wrote a protein chapter for the Sports Supplement Encyclopedia (you can find it at www.supplementbooks.com). I cover all of this pretty comprehensively in there.