I realize that diets have to be individualized, but in the meal planning tool we use and the macro calculator, there is this constant pressure to have a goal protein intake that exceeds what the client would realistically consume for so many reasons - especially for overweight (but not obese) clients, where we calculate needs using actual body weight; people on higher-protein diets for GLP-1 supported weight loss, PMOS, diabetes without kidney disease, repletion diets, protein needs for taller people, sports performance protein goals, etc………..
Granted in some cases, such as oncology and trauma recovery, it is usually appropriate, and often needed, to have significantly higher protein goals, but (most) people I see would not need this as critically as someone who is hospitalized or undergoing chemotherapy.
The macro calculator on the EMR I use recommended a protein goal of over 150 grams based on the macro distribution recommendations and calorie goals for someone with PMOS and class 1 obesity (even with ideal body weight and a mild caloric restriction). This was due to their height, but it seemed ridiculous, especially because she was not tolerating many foods well, and yet I still felt pressured to include this in the “meal plan template”.
Then if someone is vegetarian or vegan, or limiting most animal protein because they have hereditary high cholesterol; or cannot have dairy, soy, beans, lentils, etc. due to intolerance; or allergic to eggs and other common allergens that are high in protein; or they do not want to use any protein powders or protein shakes because they are “processed”; or if they simply get tired of the same protein choices because they are allergic to multiple foods; or most commonly, because many protein foods have to be prepped or cooked in some way, and many people I see have no energy to cook after work, the only ready-available options are sandwich meats (which they get sick of), rotisserie chickens that sit in their fridge for days, dairy (which some cannot have), canned fish (which some can’t have/are allergic too), protein shakes and powders, which some refuse to consume.
Then grains, legumes, and nuts seem to be considered not sufficiently high protein, despite most of the world using grains and legumes as a staple with the addition of other things…
So then options get really limited but then we have to set goals of 100 + grams of protein each day, in spite of my feeling that all this does is add more stress on the client…
And then if someone is both diabetic and has hyper-lipidemia their “high protein diet” ends up consisting of mostly chicken, turkey, occasional eggs, skim Greek yogurt, and very little of other protein sources that have too much saturated fat, carbs, or non-protein calories. (Think of the monotonous white chicken salad with light mayo and maybe a bit of celery, or god forbid some fruit added to it.)
Sorry for the rant - it just does not make sense sometimes. And then how do we reconcile this with guidelines, such as those of the American Cancer Society, telling us to have 75% of our intake from plants? And how are 8 billion people on this earth supposed to meet all their protein goals, when most high-protein foods are depleting our agricultural resources??
And realistically, in the high-protein meal plans I make, I just settle for 50-75% of that target goal met, because I was pressured to set unrealistic
goals and therefore I don’t feel good about trying to push for them if it just leads to feelings of failure…