Nestlé Purina PetCare Company

D. P. Laflamme

DVM, PhD DACVN

Feline Fantasies:

Feeding the

carnivore

Cats are Carnivores

Carnivores are “flesh eaters”

Carnivores are NOT “meat eaters”

What is a

“Natural” Diet?

Prey: mice, insects, birds, etc

High protein, low carbohydrate diet

Hunting :

– Provides exercise

– Provides mental stimulation

– Expends energy

Natural or

Evolutionary

Diet

Nutritional

Requirements

Optimal diet?

Ingredient based

Opportunistic

Supported survival

Nutrient based

Defined by lifestage,

lifestyle, genomics

The average lifespan of feral cats is about 2 years

How are MOST cats fed today?

Study involving 367 U.S. cat owners

>95% cats fed 100% commercial foods

Dry cat food:

– ~ 57% receive 100% dry food

– ~ 87% received > 50% dry food

“Human” foods– < 5% receive home-prepared diets,

table scraps or other non-commercial foods

Prey?

How do NUTRIENTS

compare: Commercial

dry food v “Natural”?

Dry food higher in carbohydrate,

lower in fat and protein vs “prey”

Commercial food balanced for all known

nutrients vs ??

Commercial foods delivered without the

hunt (exercise)

Concerns about Feeding Cats

Carbohydrates

– Unnecessary?

– Cause of disease?

Protein

– Animal v vegetable?

– Quality?

– Quantity?

“Cats have a decrease in the ability to utilize carbohydrates

due to the lack of specific enzymatic pathways and they lack

a salivary enzyme called amylase.”

“carbohydrates wreak havoc on a cat’s blood sugar

balance”

“Feeding your cat food that is high in carbohydrates is

very detrimental to your kitty’s health.”

“Intake of carbohydrates is the number one cause of

obesity in cats.”

Perceptions about Carbohydrates for Cats

Do cats REQUIRE dietary CHO?

Carbohydrates (CHO)

FACT: Cats do NOT require a DIETARY

source of CHO

– Does this mean cats do not

require CHO?

– Does this mean cats cannot

use CHO?

FACT: Cats do NOT require a DIETARY

source of CHO

Carbohydrate (glucose) is . . .

so important that

multiple systems are in

place to assure a

consistent level at all

times

It is a not an essential

dietary nutrient, but it is

PHYSIOLOGICALLY

ESSENTIAL

Cells

GLUCOSE

Dietary carbohydrates

Glycogen

Fatty acids

Fats

Proteins

Glycerol

Amino acids

Gluconeogenesis

Nitrogen group

Cellular Energy: Sources of Glucose

Protein oxidation vs intake

(Green, A. S. et al. J. Nutr. 2008;138:1053-1060)

Myth or Fact? : Cats cannot digest

carbohydrates in their diet

Can cats digest

carbohydrates?

Cats lack salivary amylase (as do dogs)

Some studies suggests lower levels of digestive enzymes (pancreatic amylase, intestinal disaccharidases) in cats vs dogs

– (Meyer & Kienzle 1991; Batchelor, 2011)

Other data shows higher levels of intestinal disaccharidases vs dogs

– (Hore & Messer 1968)

Dietary NFE, % dry basis

0 10 20 30 40 50 60

Appare

nt dig

est

ibili

ty %

20

30

40

50

60

70

80

90

100

Kendall CAT

Kendall DOG

Fekete CAT

Thiess CAT

Digestibility of CHO: Impact of amount

Digestibility of Diets*: Dogs v Cats

Corn Sorghum Rice Pea

Cat CHO 97.5 93.9 98.6 96.3

Dog CHO 99.1 99.1 99.3 98.7

Cat Prot 83.2 80.6 87.7 82.3

Dog Prot 86.1 85.0 89.0 83.4

Percent apparent digestibility

* C&B extruded diets made with Grains (32% to 40% starch in

diet dm); Protein from PBM & soy protein isolate (28 – 37%

protein in diet dm)

(Carciofi et al 2008; de-Oliveira et al 2008)

MTYH or REALITY?Cats are not able to metabolize sugars from

grains and dietary carbohydrates so high CHO

diets cause hyperglycemia and diabetes in cats

Carbohydrate Metabolism

GLUCOSE

+ Glucokinase

Glucose-6-Phosphate

+ Hexokinase

Glucose-6-Phosphate

GLUCOSE

Dietary SUGAR

Dietary sugars at 28 – 40% of diet dry matter resulted in glucosuria

Dietary sucrose (40% of diet) and lactose (28% of diet) also caused diarrhea

– Dietary lactose @ 11% of diet did not cause diarrhea

Dietary galactose (39% of diet) appeared to induce cataracts in one cat

(Kienzle J Nutr 1994)

NONE of these problems occurred when cooked starch

was used

Effect of CHO on Blood Glucose

Hours post prandial

0 2 4 6 8 10 12

Pla

sma G

luco

se m

g/d

l

50

60

70

80

90

100

110Rice

Corn

Sorghum

Pea

(de-Oliveira et al 2008)34 – 37% CHO

Effect of HIGH CHO Diets Hewson-Hughes et al 2011: 41% NFE/30% Protein

(Hewson Hughes

2011)

41% NFE

31% NFE

12% NFE

Effect of HIGH CHO, Low Protein Diets

Coradini et al 2011: 51% NFE/22% Protein

– 51% NFE resulted in mean PEAK glucose 7.6mmol

– Worsened after cats gained weight

51%

NFE

23%

NFE*

Lean Cats

Effect of HIGH CHO, Low Protein Diets

Coradini et al 2011: 51% NFE/22% Protein

– 51% NFE resulted in mean PEAK glucose 7.6mmol

– Worsened after cats gained weight

Obese Cats

51%

NFE

23%

NFE**46%

Protein

*22%

Protein

Effect of HIGH CHO, Low Protein Diets

In some cats, diets with very HIGH CHO and

LOW PROTEIN may cause increase in blood

glucose

– Effects is worse in obese cats

– Role of low protein Vs high carb not known

» Protein and/or amino acids shown to stimulate

insulin secretion

Implications of this not currently known.

– Profile not typical of commercial foods

Is there Evidence that High Carb OR

Commercial Cat foods Cause Diabetes?

No published studies reporting on controlled,

long-term studies comparing high v low intake

Epidemiology: 3 studies

Control Cats

N = 778

Diabetic Cats

N = 139

P Value

Mixed Foods 71.2% 71.2% --

Dry Only 22.0% 23.0% 0.92

Wet Only 6.8% 5.8% 0.81

(McCann et al 2007 - UK;

Slingerland ea al 2009- Netherlands)

Is there Evidence that High Carb OR

Commercial Cat foods Cause Diabetes?

Sallander et al 2012: Study in Sweden

– 85% of cats consumed dry food and 70 – 75%

consumed canned food, so mix was typical

Control Cats

N = 20

Diabetic Cats

N = 20

P Value

% of total intake, D.M.

Dry Foods 79% 44% <0.05

Wet Foods 20 48 N.S.

Table Foods 6 10 N.S.

Study suggests that dry food intake may be

protective against diabetes

Do high CHO diets cause

diabetes mellitus?

> 75 millions cats in U.S.

87 – 99 % of cat owners feed commercial food

~50% fed dry (“high CHO”) foods exclusively

79% fed dry most often

Incidence of DM is less than

0.25% of VMDB patients

Increasing Prevalence of DM? Why?

Primary epidemiological risk factors:– AGE (8.3x if 7-10 yrs; 14.4x if >10 yrs)

» % of cats in VTH > 10 years increased from 10% in 1983 to 40% in 1995

– OBESITY (3.8 – 4.8 x)

» Prevalence of overweight and obesity in cats = ~25 - 40% of adult cats seen by first-opinion vets

Lifestyle:

– Inactivity and genetics are independent risk factors for NIDDM in humans. Possible also for cats.

High Protein/Low Carbohydrate Diets

in Feline Diabetics

Addresses compromised ability to clear blood

glucose by slowing glucose entry into the blood

Research supportive of enhanced insulin

sensitivity

Ongoing reports highly supportive of clinical use

Diet-induced vs

Diet-responsive

Disease

MTYH or REALITY?

High CHO diets cause obesity in cats

CHO v Fat on Lipogenesis

Dietary CHO stimulates insulin release & lipogenesis

– Excess CHO stored as TG

– Lipogenesis 3x greater with High CHO

(Brunengraber 2003)

Dietary FAT stimulates TG storage

– Net TG deposition 2.5X with High Fat vs High CHO

Diet as risk factor for obesity (Scarlett & Donoghue 1994, 1998; Coradini 2011)

– High fat diet = higher risk

– High CHO diet = lower risk

Hi v Low Dietary Fat in Cats

% chg

wt

% chg

body fat

IF-HF 36 157

IF-LF 25 66

SF-HF 69 179

SF-LF 47 95

IM-HF 28 76

IM-LF 19 37

NM-HF 55 292

NM-LF 44 108

(Nguyen et al AJVR 2004)

Fat, Percent of Dietary Energy

10 20 30 40 50 60 70

Body fat, P

erc

ent

5

10

15

20

25

30

35

40

(Backus et al Brit J Nutr 2007)

Do High CHO diets Cause Obesity?

Intake of calories in excess of need causes obesity

• Fats are more energy dense vs

CHO or Protein

• Low Carb diets usually higher

in fat & calories, and may

increase risk for obesity

• No evidence that Low CHO

promotes weight loss or

prevents weight gain unless

calories restricted

Low Carb OR High Protein?

How much protein do cats need?

Basis of estimating needs:

– Nitrogen balance

– Protein turnover

– Lean Body Mass

Protein Turnover

AMINO ACIDS PROTEINS

DIETARY

PROTEIN

Synthesis

Catabolism

ENERGY

LEAN BODY

MASS

Enzymes

Insulin

Immunoglobulins

Etc, etc.

Changes in Lean Tissue (g) of Cats with Age

(n=256)

1000

1500

2000

2500

3000

3500

grams

1 to 3 3 to 5 5 to 7 7 to 9 9 to 11 11 to

13

13 to

15

15 to

17

17 to

20

Years

(Perez-Camargo 2004)

Implications from loss of LBM

LBM serves as reservoir for protein turnover

– Decreased protein turnover associated with decreased immune function and greater susceptibility to infection, toxins and stress

LBM loss associated with atrophy of muscle mass (strength) and viscera

LBM loss is associated with increased morbidity and mortality

Does Diet have an Effect on LBM?

Effect of Method on

Protein Needs in Cats

Adult Cats

*Grams protein/kg body weight

Min. Requirement* 1.5

Nitrogen Balance

Optimal Protein* 5.2

Lean Body Mass~34% of calories

from protein(Laflamme JFMS 2013)

Protein Needs in Senior Cats

38 cats completing 6 month study

– Starting age 7 - 17 years

– Protein needs to maintain LBM 4.8 – 5.4g/kg

body weight/day

30 cats completing 12 month study

– AGE drove loss of LBM

– Apparent protein needs to preserve LBM

increased with age

“Cats need to have a meat

based diet rather than a

plant based diet in order to

survive and be healthy. A

cat’s body cannot properly

utilize plant protein.”

Myth or Reality?

Protein Quality

Based on:

– Content of essential amino acids

– Bioavailability (digestibility) of protein

– Amino acid requirement (by species)

Biological Value of Single

Protein Ingredients

Whole egg 93.7

Milk 84.5

Fish 76.0

Beef 74.3

Soybeans 72.8

Rice, polished 64.0

Wheat, whole 64.0

Corn 60.0

(FAO 1970)

There is no perfect protein – a single protein source that provides 100% of the essential amino acids in the right proportions for dogs or cats

Complementary proteinsprovide each other’s limiting amino acids

Complementary Proteins

+ = High biological

value

Protein quality defined

by lowest amino acid

relative availability

Low quality

protein

High quality

protein

Cats need NUTRIENTS not

INGREDIENTS

Kitties are NOT small dogs. . .

But, they are not so different.

Cats have the ability to adapt metabolism to intakes

of different amounts of protein, and different energy

sources

So long as protein is sufficient, the non-protein

energy can come from fat and/or carbohydrate

A low carbohydrate diet may be better for diabetic

cats, but a low fat (higher carbohydrate) diet may

be better for reducing obesity

QUESTIONS ?

Nestlé Purina PetCare Company