Tuesday, August 7, 2012

High Protein, Low Carb Diets: Key to Management of Obesity in Cats


As in humans, obesity is a major problem in cats in this country. Unfortunately, the feline obesity epidemic appears to be getting worse, rather than better (1,2). Many veterinarians and cat owners who have tried traditional feline weight loss diets (generally high fiber/low fat) have found this approach frustrating, since it usually fails to achieve significant loss of weight.

Another approach in treating and preventing feline overweight and obesity revolves around our understanding of basic feline nutritional needs and their feeding behavior (1-7). The way we feed our cats and what we feed them tend to violate all principles of "ideal" feline nutrition.

Indoor cats are commonly fed energy-dense, high-carbohydrate dry foods in a free choice manner, which provides the cat with much more energy than he or she can possible use. Outdoor cats in the wild must maintain fitness, and therefore a lean body weight, in order to successfully hunt for food. Such fitness is not required in sedentary, indoor cats, and they take advantage of the highly-palatable food that is readily available, without any undue physical effort to sustain. Free access to plentiful amounts of cat food plus little physical activity leads to overweight and obesity in cats, as in other species (5-8).

Obesity and the Composition of the Diet
One important factor that is important to consider, both in the development of and treatment of obesity, is the role of carbohydrates (carbs) in the diet – not because carbs themselves are directly associated with fat (although excess carbs are stored as fat), but because of the effect on protein levels in the diet.

The higher the concentration of carbs in the diet, the lower the intake of protein. This can result in a lower-than-needed intake of protein for maintenance and energy. We can never forget that cats are evolutionary designs to use protein and fat preferentially as energy sources (3,4). Cats have absolutely no requirement for any carbs in their diet.

Because of the metabolic requirement for cats to utilize protein as an energy source, diets with modest amounts of protein (with an average digestibility) can result in loss of muscle mass or sarcopenia (6,7,9-11). The loss of lean muscle mass leads to a lowering of the metabolic rate and can make weight gain even worse!

Traditional Weight Loss Diets Lead to Muscle Wasting
Traditional weight loss plans include feeding an energy restricted (e.g., low-fat, high-carbohydrate, high-fiber) diet. However, while these diets may result in weight loss, they do so to the detriment of lean body mass— especially in cats who use protein for energy even in the face of other energy sources in the diet.

Successful weight loss regimens requires loss of adipose tissue as well as maintenance of lean body mass (5-7). We must remember that lean body mass is the driver of basal energy metabolism (loss of lean body mass is a major contributor to weight regain as appetite is not reduced and satiety not reached).

Feeding High Protein, Low Carb Diet Best
Several recent studies have evaluated use of a high-protein, low-carbohydrate diet (protein 45% or higher) for weight loss in cats (5-7,12,13). In those studies, cats lost weight but maintained lean body mass. Importantly, high-protein, low-carbohydrate canned diets not only result in sustained weight loss in these cats, but also will help reduce the cat's urge to eat constantly. This is simply because the cats are more likely to be satiated when feeding a canned food versus a dry food with fiber.

Because dry foods must be extruded (i.e., made into a biscuit), carbohydrates are required in the cooking process. Thus, it is difficult to achieve a low-carbohydrate diet that is dry. Further, many of the available high-protein, low-carbohydrate dry foods are NOT low-calorie foods, so it is extremely easy to feed too much. Too many calories, including too many protein calories, will also cause weight gain or failure to lose weight, as well (6,7,14).

At this time, the best commercial diets for achieving a high protein, low carbohydrate profile, along with controlled calories, are canned foods. But it is important to remember that just because you are feeding a canned food, it does NOT mean that you are feeding a high-protein, low-carbohydrate diet (you must read the label), and it also doesn’t mean you are feeding a high-quality protein.

Stop Free-Choice Feeding
An important follow up point to remember about all diets is that calories count. You cannot "free choice" feed most indoor cats—even with high protein, low carb diets— because if they consume too many calories, they will become or remain obese.

The daily allotment of food should be fed in multiple small meals to mimic the cat's natural feeding strategy of hunting and catching about 10 small prey animals per day. This also increases the thermal effect of food, which increases the metabolic rate and assists in weight loss.

Calculating Calories for Weight Reduction in Cats
One key point for obesity prevention (or correction) is balancing the energy intake/energy expenditure equation. In indoor cats, where exercise is reduced by the nature of the lifestyle, energy restriction becomes paramount to obesity prevention or correction (5-7). Most indoor cats do not need more than their resting energy requirement (RER) to meet their daily nutritional requirements (this is approximately 180-200 kcal/day for a 10-11 pound cat).

Cats that are very obese will likely need to reduce their intake by 20% to 40% (or 60-80% of their RER) to lose weight (5-7). So, for a cat that is 16 pounds (7.5 kg) that should weigh 11 pounds (5 kg), it may require a reduction of calories to only 120-130 kcal/day. It is much more difficult to reduce calories using dry food rather than canned food because of the small amount of kibble that must be fed.

The key point is this: set a target calorie intake, make sure you are feeding a high protein food to protect muscle mass and prevent protein malnutrition, then weigh the cat monthly, and adjust the amount of food based on weight loss.

The Bottom Line
Energy restriction can be achieved by low-fat, high-fiber diets, but most of those diets are not high enough in protein to preserve muscle.  Such loss of muscle mass results in an unhealthy weight loss and a strong tendency to regain weight (i.e., the loss of muscle mass will always increase the likelihood of rapid regain of lost weight or failure of weight loss).

High-protein, low-carbohydrate, low-fat diets are ideal for weight loss in cats: they help preserve muscle mass while restricting energy sources that will induce fat loss. However, portion control is ultimately the key to controlling energy intake.

The easiest way to both feed a high-protein, low-carbohydrate diet while achieving portion control is to feed canned food. In cats that won’t eat canned food, there are only a few high-protein, low-fat, low-carb dry foods – but these should be selected for use in weight loss programs only when absolutely needed.

References:
  1. Zoran DL. Obesity in dogs and cats: a metabolic and endocrine disorder. Veterinary Clinics of North America Small Animal Practice 2010 Mar;40:221-39
  2. Zoran DL, Buffington CAT. Effects of nutritional factors and lifestyle choice on the health and well-being of indoor catsJournal of the American Veterinary Medical Association 2011;239:596-606. 
  3. Zoran DL. The carnivore connection to nutrition in cats. Journal of the American Veterinary Medical Association 2002;221:1559-1567. 
  4. Zoran DL. The unique nutritional needs of the cat. In: Ettinger SJ, Feldman EC (eds). Textbook of Veterinary Internal Medicine, 7th edition. Saunders Elsevier, 2010;652-659. 
  5. Laflamme DP. Understanding and managing obesity in dogs and cats. Veterinary Clinics of North America Small Animal Practice 2006;36:1283-1295. 
  6. Zoran DL. Feline obesity: recognition and management. Compendium for Continuing Education for the Practicing Veterinarian 2009;31:284-293. 
  7. Zoran DL. Protein: the key to metabolism, health, and management of obesity in cats. 2012 OVMA Conference Proceedings. http://www.ovma.org/pdf/sa_program_clinicalpearls.pdf
  8. Harper EJ, Stack DM, Watson TD, et al. Effects of feeding regimens on bodyweight, composition and condition score in cats following ovariohysterectomy. J Small Anim Pract 2001;42:433-438. 
  9. Hannah SS, LaFlamme DP. Effect of dietary protein on nitrogen balance and lean body mass in cats. Veterinary Clinical Nutrition 1996;3:30. 
  10. Perez-Camargo G. Cat nutrition: What is new in the old? Compendium for Continuing Education for the Practicing Veterinarian 2004;26 (Suppl 2A):5-10. 
  11. Wakshlag JJ. Dietary protein consumption in the healthy aging companion animal. Proceedings of the Nestlé Purina Companion Animal Nutrition Summit: Focus on Gerontology 2010;32-39.
  12. Vasconcellos RS, Borges NC, Goncalves KN, et al. Protein intake during weight loss influences the energy required for weight loss and maintenance in cats. Journal of Nutrition 2009;139:855-860.   
  13. Nguyen P, Leray V, Dumon H, et al. High protein intake affects lean body mass but not energy expenditure in nonobese neutered cats. Journal of Nutrition 2004;134:2084S-2086S. 
  14. Wei A, Fascetti AJ, Liu KJ, et al. Influence of a high-protein diet on energy balance in obese cats allowed ad libitum access to food. Journal of Animal Physiology and Animal Nutrition 2011;95:359-367.      

7 comments:

Monty James said...

Like in human,High protein and low carb feeding of protein is the best option to choose for a perfect diet for your cat.

0s0-Pa said...

I agree a VLC diet is the way to go, although cats seem to know no bounds when it comes to eating, so make sure to limit his portions!
-Jackie

Kerry said...

Thank you for your comments on feeding low-carb canned food for weight loss in cats. I have been using this approach for the past 5-6 years with good success. However, I do have a few cats that still develop loss of muscle mass, especially along the spine, and worry that these cats are not getting enough protein. Do you have any tips on deciphering the food labels to figure out exactly how much protein a food contains, and how many grams of protein each cat requires?

Kerry said...

Thank you for your comments on feeding low-carb canned food for weight loss in cats. I have been using this approach for the past 5-6 years with good success. However, I do have a few cats that still develop loss of muscle mass, especially along the spine, and worry that these cats are not getting enough protein. Do you have any tips on deciphering the food labels to figure out exactly how much protein a food contains, and how many grams of protein each cat requires?

Dr. Mark E. Peterson said...

It is almost impossible to look at the label to determine how much protein, fat, or carbs are in the cat food. It's best to look at the composition of the diet based on the % calories coming from the protein. I like 30-50% of a cat's diet to be protein.

This website may help you pick a good OTC food to feed: http://binkyspage.tripod.com/canfood.html

Jen H said...

Great blog and info here, Dr. Peterson. My 16 year old boy went into remission from diabetes (after a period of time) and I know feeding him a more 'species appropriate' wet diet helped him.

I wanted to let you know that Dr. Lisa Pierson of catinfo.org has a new, much more comprehensive and up-to-date food chart with food composition values which she just compiled and now has on her site:

http://www.catinfo.org/docs/Food%20Chart%20Public%209-22-12.pdf

She also has a second chart more with phosphorus values of canned food in ascending order. Very helpful for cat guardians like me who have kitties with CKD. It would be great if you could post more about your thoughts on CKD. This is such a difficult and challenging disease.

Dr. Mark E. Peterson said...

Yes, I know that Dr. Pierson posted up the new links on dietary composition of cat foods last week. They are "up-to-date" and will replace the info on the Binkys site. I would strongly encourage anyone interested in feline nutrition to take a look at those links.

Dr. Pierson is a good friend of mine and I only have the upmost respect for her and her work. With many of my nutrition posts, I had asked her to review them for her comments before I posted them.

I'll try to get a blog post done about renal disease soon! Thanks for the input!