Whey protein is rapidly becoming a popular ingredient in clinical applications, thanks to its full complement of essential amino acids as well as several other bioactive constituents that together support treatment regimes for a number of common conditions, including sarcopenia, obesity and malnutrition, post-illness recovery. Such far-reaching potential is seeing rising global demand for whey protein in clinical nutrition, heading for USD 1.5 billion in sales by 2023.
With such a broad spectrum of benefits, it’s useful to dive a little deeper into the conditions whey protein can be applied to, which patient groups stand to benefit, and which types of whey protein are most suitable for clinical nutrition.
Aging and muscle atrophy
Aging causes physical, psychological and social changes in older people, making the maintenance of good health difficult for adults over the age of 60. Nutrition has an important role to play in supporting the globe’s aging population, and, with the number of people aged over 65 projected by the UN to triple from nearly 530 million in 2010 to more than 1.5 billion in 2050, it’s a challenge that is becoming more and more pressing.
Increased protein in the diet is, for example, an important tool for combatting the effects of skeletal-muscular atrophy. In clinical settings, whey protein appears to be able to outperform other commonly administered supplements, in part due to its high leucine content, which is believed to kickstart muscle synthesis even in the absence of physical activity. So it’s highly useful, for example, in the recovery processes of post-operative patients.
In older populations, the gradual wasting away of the muscles is called sarcopenia, and its effects are particularly obvious in sedentary or bed-ridden individuals. Lost muscle mass and strength saps quality of life by leading to frailty, greater risk of falls, lost functional independence, and increased mortality. The advance of sarcopenia – as well as some other forms of muscular atrophy – can be slowed by whey protein supplements.
Malnutrition
Malnutrition is highly prevalent around the globe, affecting, for example, around 20 percent of the world’s under-five-year-olds in 20171. In fact, malnutrition causes around 300,000 deaths per year in children younger than five in developing countries, and more than half of all deaths in children worldwide.
Protein is often lacking in the diets of such patients, and whey’s high quality and easily absorbed proteins offer safe and highly effective treatment as part of malnutrition management efforts. While affordable access to protein supplements is still a challenge in developing countries, malnutrition will be a key driver behind market demand for high-quality, clinically applicable whey protein in the years to come.
Preterm birth
Another group in particular need of protein are the very smallest individuals: babies born prematurely. Around fifteen million babies are born preterm each year, a number that is rising in both developing an developed countries, and it is currently the leading cause of death globally of under-five-year-olds2.
Very preterm infants face the possibility of neurodevelopmental disabilities – and supplementing human milk with extra protein improves a number of health outcomes, including brain development3, and this extra nourishment is increasingly delivered in clinical settings in the form of whey protein.
Bioactive constituents
Whey contains many bioactive constituents that can add great value to clinical nutrition. Like human milk, it’s high in lactoferrin, which may help infants to absorb iron, reduce inflammation and oxidation, and fight infection4,5. It also fights infection in adults, including serious viruses such as hepatitis6.
Whey protein also boosts the body’s ability to manufacture a particularly potent antioxidant that has been called the mother of all antioxidants: glutathione. It’s present in every cell, removes toxic compounds including carcinogens, and protects cells from damage. And it declines significantly in old age7. Research shows that whey, and especially its cysteine content, increases glutathione production, including in older people8.
Other bioactive whey components that may benefit patients include alpha-lactalbumin and milk fat globule membrane (MFGM), which appear to improve neurological development in infants and function in adults, and improve immunity9. And if that wasn’t enough, whey has been shown to improve blood glucose control by promoting the body’s natural insulin and insulin-assisting hormones, and to lower blood pressure and other cardiovascular risk factors.
Choosing whey wisely
The most suitable and effective versions for clinical purposes are often the most highly processed, making them more easily absorbed and tolerated by people who can’t consume other dairy products.
The choice boils down to three versions of whey:
- Whey protein concentrate
This is the least processed and cheapest form. Some lactose and fat are removed, leaving a protein concentration ranging from 25 to 90 percent. It is primarily used for post-illness recovery and as a sports supplement. The lactose and fat make it taste good. - Whey protein isolate
Almost all the fat and lactose are removed from this more concentrated version, leaving a product comprised of 90 to 95% protein and making it suitable for lactose-intolerant people. It tastes bitter, and the extra processing makes it more costly. - Whey protein hydrolysate
This is the highest quality and most expensive version of whey protein. Its fat and lactose are removed, and it is further processed to shorten, or “hydrolyse”, whey’s long protein chains. This improves absorption and reduces the potential for allergic reactions. It is often used in medical nutrition products, including infant and enteral nutrition formulas.
The right form of whey protein can minimize the side effects some people experience, which are primarily diarrhea and bloating. Products with minimal lactose are less problematic for lactose-intolerant people, and hydrolysed versions are gentler for those with milk protein allergies (although whey protein is less allergenic than milk’s other main protein, casein). Side effects can also be minimized by ensuring that excessive quantities are not consumed.
Whey protein does have other challenges in clinical applications. One of these concerns pricing. It’s costly to manufacture whey protein powder, and pricing is highly dependent on fluctuations in supply and demand, which are in turn influenced by global economic conditions.
While whey protein is generally safe to consume in required amounts, clinicians should also be aware of potentially adverse interactions with certain medications. Additionally, according to the National Institute of Health (NIH) excess protein may increase a person's risk for calcium loss and osteoporosis.
Expansive future
Whey components are increasingly being preferred as active medical agents for functional foods and nutraceuticals, driving a wave of development of new whey protein products. Regional and cultural aspects are also in the spotlight, with more suppliers getting their products Halal-certified (a prerequisite in most of Southeast Asia) and increasingly focusing on adhering to ingredient specifications in order to meet the needs of dissimilar cultures.
While there are still a number of challenges to overcome, whey protein’s benefits are already backed by a broad body of evidence, making it a prime candidate for clinical nutrition products, and helping to fuel rapid growth over the next five years.
Way to go, whey!
- http://apps.who.int/gho/tableau-public/tpc-frame.jsp?id=402
- http://www.who.int/news-room/fact-sheets/detail/preterm-birth
- https://www.ncbi.nlm.nih.gov/pubmed/25046444
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5551045/
- https://www.cochrane.org/CD007137/NEONATAL_enteral-lactoferrin-supplementation-prevention-sepsis-and-necrotizing-enterocolitis-preterm-infants
- https://www.ncbi.nlm.nih.gov/pubmed/25282173
- https://www.ncbi.nlm.nih.gov/pubmed/26362762
- https://www.ncbi.nlm.nih.gov/pubmed/26362762
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5934683/
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