Limits of adaptation to high dietary protein intakes

Abstract

Ingested protein is made available to the body following digestion and absorption as amino acids and contributes to the body’s demand for amino acids for protein synthesis and other metabolic pathways. As the pattern of amino acids required for metabolism is substantially different from that ingested, extensive metabolic interchange serves to improve the match. As a matter of course oxidation of amino acids contributes to satisfying the energy needs of the body. Amino acids in excess of immediate requirements follow degradative pathways and if the capacity of these pathways is exceeded adverse consequences ensue. In pathological states, such as inborn errors of metabolism, there is an obvious constraint on metabolic flow with serious sequelae. Pathways may be constrained to a lesser extent due to genetic polymorphisms, metabolic programming, limitation of cofactors or lack of associated substrates. Any of these can result in metabolic derangements, which do not manifest as overt disease, but limit normal function. There is the need to determine the dose response to increases in dietary protein and amino acid availability, using critical metabolic intermediates as outcome indices in order to clarify the upper limit of intake with which the body can cope under a range of physiological and pathological states.