From allergies to kidney failure, the many side effects of protein powders

Madhukar (name changed), a 26-year-old software engineer based in Hyderabad, has always wanted to maintain a healthy lifestyle and be physically fit. So like many people his age, he decided to hit the gym. Claiming that his diet was ‘irregular’, his gym instructor advised him to take a dietary supplement to improve his protein intake. The protein supplement was offered to him at a 20% discount at the gym. However, soon Madhukar developed rashes on his body. When he consulted a doctor, he was told that it could be because of the protein powder, as some proteins are potential allergens. After he stopped consuming the same, his allergy subsided.

While Madhukar faced an allergy due to his high protein intake, nutritionists say that they have seen patients with health issues ranging from kidney failure to fatty liver and other gastrointestinal issues to bone demineralisation. All these cases were reportedly due to improper, high consumption of protein supplements, especially among teens and youth.

How much is good?

For those into fitness, it seems that taking protein supplements is inevitable. However, doctors argue that not everyone requires protein supplements. An adult human body requires 0.8 to one gram of protein per kilogram of body weight per day, as per the Indian Council of Medical Research (ICMR) guidelines. People who take protein powders, which are usually measured in scoops, consume about 15 to 25 g of protein per scoop.

Dr Janaki Srinath, executive member of the Nutrition Society of India, told TNM, “Recently, I was shocked when a patient discussing his protein intake with me said that he takes four scoops per day. The protein content in each scoop was about 20 g. He was consuming far more than what is required from the supplement alone. On days that he consumes a good diet, overall protein intake would go up to two to three g per kg of body weight, which can have a negative impact, such as on kidney function.”

Nutritionists say that dietary supplements are required only when a patient has malabsorption of nutrients or when there are strenuous workouts in their routine, which tires the muscles. “For a software professional who wants to be fit and healthy, no supplement is required. One or two hours of workout does not demand dietary supplements. It is only necessary for bodybuilders or sports persons,” said Dr Premlatha, senior nutritionist at Yashoda Hospital, Hyderabad.

She added that even for those performing intensive workouts, several parameters such as frequency, type and duration of exercise need to be assessed before prescribing protein supplements. They need supplements as they are likely to become weak and fatigued after exercise, she said. Premlatha cautioned that protein should always be combined with fruits and vegetables in order to avoid gastric issues.

Who prescribes?

Many a time, it is gym instructors and social media influencers who suggest and also sell protein powders –often at discounted prices – through YouTube videos and other platforms. Gym instructors claim that they prescribe protein powders only after checking the person’s body composition. JP, a Hyderabad-based gym instructor, said, “We usually advise protein powders as a substitute to those clients who are trying to build their physique but skip meals.” Gym instructors blame online influencers for promoting protein powders and convincing clients to take them even when they do not need it.

JP outlined how they usually check the body composition of clients. “We have a machine to check the body composition, through which we get to know the fat percentage, lean muscle mass and bone density. Based on that, we advise the client on additional nutrition. We also ask about their health history, as we are seeing an increase in cases of diabetes and blood pressure among young people.”

However, doctors say that prescribing protein powders solely based on body composition is not advisable. Nutritionists also stress on the importance of understanding that everyone’s nutritional needs are different and unique.

Premlatha said, “Gyms merely check body composition through a machine which notes details about muscle and fats. They often miss the diet component, which should be seen in correlation with body composition. One needs to check their regular protein intake as well as the variety and pattern of their diet.”

Janaki said, “Several parameters need to be taken into account before suggesting any supplement. These include height, weight, physiological condition, whether they are sick or in their growth phase, whether they have any conditions like diabetes or hypertension, whether they are undergoing chemotherapy and much more.”

Side effects

Explaining the effects of protein intake on the human body, Premlatha said, “Out of the three macronutrients – carbohydrates, proteins and fats – only protein contains nitrogen. Nitrogenous compounds can be excreted only through the kidney. Consuming more than required levels of protein can hence be a burden on the kidneys. Regular high intake of proteins can increase intraglomerular pressure, which causes deterioration in kidney function.” So doctors recommend that proteins should be accompanied with good water intake.

Premlatha added that she has seen patients, especially young adults and teens, who had to be hospitalised following consumption of protein powders without proper knowledge. She listed bone demineralisation, fatty liver, kidney failure, high uric acid levels, gastrointestinal issues and micronutrient deficiency, among others, as side effects of high protein intake.

Nutritionists also said that there could be several other side effects that often go undetected. “Not many guardians or parents of patients have knowledge about this. Many cases are never taken to a doctor and thereby go unreported. As a result, details of such cases are not scientifically documented,” Janaki said.

No regulations for manufacturers

While there is a lot of ongoing discussion on protein supplements, there are no specific regulations in India for the manufacture of protein powders. Manas Muralidharan, who co-owns a protein powder business in Bengaluru, said that they follow the general FSSAI (Food Safety and Standards Authority of India) regulations.

While whey and casein protein are extracted from milk, there are several others that are plant-based. Manas started making plant-based protein powders 2.5 years ago. “I’m a regular user of protein powder as I work out often. Earlier, I used to take whey protein powder, but as I faced some stomach issues I switched to a plant-based one. So we started making protein from soy, ragi and sprouts,” he said.

In his opinion, people can take protein powders as long as they don’t overdo it and follow the recommended dosage.