ArcaMax

DEAR DR. ROACH: I know this maybe an ignorant question, but what exactly constitutes protein? I know that it naturally comes from livestock and their byproducts. But one can find diverse categories -- such as cereals, pasta, sweet/salty snacks, and even soda pop -- with "protein" displayed on the packaging. What's up with that? -- E.M.

ANSWER: I'm sure that many people have the same question. There are three major macronutrients (molecules for us to get the calories that we need for all of our activities), and most foods contain some amount of all three macronutrients. One is carbohydrates -- simple sugars and starches that provide most of the calories in fruits, vegetables and grains, including all the products that we make from grains like bread and pasta.

Another is fats, which are high in a few fruits like avocados but otherwise mostly come from animals (meat, milk, cheese and eggs) or are extracted from seeds or olives. Fats have the most calories per gram. Finally, proteins, which are strings of amino acids, are the major component of the calories in meat (along with fat and a little bit of carbohydrates). But milk and cheese, nuts and seeds, and most vegetables and grains have some protein in them.

Wheat is relatively high in protein compared to many grains, with wheat flour containing anywhere from 7% to 14% protein. Food manufacturers can use a higher content of wheat flour to increase the protein content of their products, but drinks (and perhaps the other snacks) probably have protein added to them.

Having more protein doesn't always make a food "healthier." We need a balance of carbohydrates, fat and protein in our diets, and most North Americans get plenty of protein without having to search for products that are especially high in it. Still, higher protein meals tend to be more filling, so often people will eat less from a high-protein meal than a high-carbohydrate one.

DEAR DR. ROACH: I wanted to write in regarding your recent column on using turmeric as supplement for pain relief from osteoarthritis. While research indicates that black pepper can increase the bioavailability of turmeric by up to 2,000%, AI tells me there's no definitive research showing that turmeric and black pepper give greater pain relief than turmeric alone. Is AI correct on this one?

If so, is there any other reason to take turmeric with black pepper? For example, learning that pepper increases turmeric's bioavailability by up to 2,000% creates a big placebo effect for me, which can be a good thing. -- R.L., PhD

ANSWER: You're quite right that black pepper (or its extract, piperine) dramatically improves the absorption of turmeric's active ingredient (curcumin). It'd make sense that this would prove its effectiveness, but no study has been powered well enough to prove it.

This reminds me of a well-known paper that was published in 2003. It ironically argued that parachutes had never been proven to be safe and effective to reduce injuries when jumping out of an airplane. (The point is obviously that some things don't need a study.) The authors advised those who disagreed to volunteer for the parachute study.

In a major challenge to this paper, a 2018 study did randomize 23 people to a parachute versus an empty backpack when jumping out of aircraft, and parachutes didn't reduce injuries. Though, this was likely due to the fact that the planes and helicopters being used in the study were on the ground and unmoving at the time, so no study subjects were injured. (Who said researchers don't have a sense of humor?)

For people who want their turmeric or curcumin to work most effectively, supplements should be coadministered with piperine (many come formulated together). Those who use their turmeric with food should also use black pepper.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.

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