Protein quality

Measures

Primitive measures of protein quality use relatively few measurements about the body, mainly mass measurements.

• Protein efficiency ratio (PER) is the ratio of weight gain to the amount of protein ingested. It is usually tested with rats.
• Biological value (BV) essentially estimates the proportion of food nitrogen kept in the body by subtracting out nitrogen found in urine and feces. Nitrogen is assumed to originate from protein.
• Net protein utilization (NPU) is similar, except it only subtracts out urine nitrogen. They are methods based on nitrogen balance.

Modern measurements analyze two separate aspects: protein digestibility and amino acid balance. The former is measured by comparing how much protein is found in the food before and after it goes through the digestive tract or a part of it. The latter is measured by taking the amino acid profile of a protein and comparing it to essential amino acid needs of an organism, typically humans.

PDCAAS

The earlier "modern" measurement is the PDCAAS of 1989. For protein digestibility it compares the amount of protein-nitrogen that goes into a rat and out of the rat through feces, with a correction for "metabolic fecal protein": the amount of protein that occurs in feces when the rat is on a protein-free diet. For the amino acid score, it considers the quantity of each essential amino acid in the food as a proportion of the food's protein content and compares this to nutritional recommendations for preschool-age kids. The amino acid score used is that of the lowest, or 'limiting', amino acid. The amino acid score is then multiplied with the fecal digestibility score to get an overall score between zero and one.

The PDCAAS has a tendency to over-estimate digestibility, because it measures feces instead of what remains at the end of the small intestine, where most protein absorption is believed to occur. Antinutrient factors like phytic acid and trypsin inhibitors may decrease absorption of protein, as does the absorption of protein by gut bacteria in the test subject's large intestine. In addition, older rats show lower PDCAAS-estimated fecal digestibility compared to young rats when the protein source contains anti-nutritional factors.

DIAAS

To address the problems of PDCAAS, DIAAS was introduced in 2013. It measures digestibility from the mouth to the end of the ileum (the final section of the small intestine) individually for every amino acid. The absorbed amount of each essential amino acid is compared with the reference pattern. In other words, it scores the amino acid profile of what is actually absorbed. It also considers age by using different reference patterns for infants, toddlers, and people over three. DIAAS is considered the superior method to PDCAAS.

DIAAS is more complicated to measure than PDCAAS partly because the contents of the ileum are harder to obtain than simple collection of feces. Moreover, DIAAS prefers digestibilities measured in humans, though a growing pig or growing rat are acceptable alternatives. For measurement in humans, a minimally invasive dual-tracer method has been developed for the DIAAS method.

Protein sources

Notes:

• With scores greater or equal to 1.0 or 100%, the concept of "limiting amino acid" technically still applies as the amino acid with the lowest ratio compared to the amounts in the reference protein. It is hardly relevant, however, so such columns are parenthesized.
• PD is determined per PDCAAS ("true fecal") unless otherwise stated.
• AAS explicitly does not take into account digestibility. It compares the amino acid profile to a reference profile, which is the PDCAAS profile unless otherwise stated.
• Limiting AA may be determined by either PDCAAS (or a similar profile-only method) or the DIAAS (which gives the limiting absorbed AA). If unstated it is more likely to be PDCAAS.
• PDCAAS values are officially capped, but the limit can be removed by manually calculating PD × AAS. Examples of 5 uncapped values are seen in Schaafsma (2000).

Implications

Since their introduction, modern measures of protein quality have been used to justify nutritional advice on the selection of protein sources and related public policy. As typical values for plant sources of protein are often considerably lower than those of animal protein, the PDCAAS and DIAAS have been used in discussions of the merit of plant-based diets, and arguments around plant-based diets have been used to evaluate the merits of protein quality measurements. Advocates of the importance of animal proteins point to the health benefits of such a diet, as well as the potential for protein insufficiency in a plant-based diet. On the other hand, advocates of a more plant-based diet point to the environmental impacts of meat production, the health risks of a diet rich in red or processed meat, as well as other unrelated health benefits of plant sources of protein.

The choice of protein quality measurement also has implications for debates around plant-based diets. Plant sources of protein are more likely than animal sources to have a lower DIAAS than PDCAAS, so the use of DIAAS rather than PDCAAS may increase nominal discrepancies in protein quality between plant and animal sources. On the regulatory scale, this may affect how plant sources of protein may be marketed. For example, the USDA allows foods with at least 10% of RDI of protein to be labeled as a "good source" of protein, and for a food to be labeled "high" in protein, it must contain at least 20% of RDI, accounting for quality. The use of DIAAS would change which plant foods may be marketed as high protein, and thus consumer perception of their dietary choices.

The comparison of different sources of protein has implications on both the consumer level and the policy level. Especially as nutrition labels generally describe a food product as sold, they do not necessarily reflect protein quality or changes due to food preparation, so consumers may use measures of protein quality of the food as prepared as an additional source of nutritional guidance. In the developing world, malnutrition may be characterized by a lack of protein. Measuring protein quality may further detail the nature of this malnutrition and have implications for treatment. Additionally, in the context of global development, research on the relative merits of plant and animal proteins takes on an environmental significance, because the trajectory of dietary improvement in developing nations could significantly affect the environment.

Limitations and Future Directions

Determining ileal digestibility

While more accurate, the determination of ileal digestibility of various protein sources requires human or porcine subjects, making research much more difficult than in mice. While the body of research on food ileal digestibilities has grown since the introduction of the DIAAS, as of 2025, more research is still needed, particularly on foods outside of Western or Eastern diets.

Focus on individual food sources

A common criticism of both the PDCAAS and the DIAAS is that calculating the PDCAAS/DIAAS of a diet solely based on the PDCAAS/DIAAS of the individual constituents is misleading, because one food may provide an abundance of an amino acid that the other is missing, in which case the PDCAAS/DIAAS of the diet is higher than that of any one of the constituents. To arrive at the final result, all individual amino acids would have to be taken into account, so the protein quality of each constituent would be superfluous.

For example, various cereals have protein qualities between 0.4 and 0.8 and are generally limited by lysine, but contain more than enough methionine. Legumes, with the exception of soy, generally have protein qualities between 0.5 and 0.8 and are limited by methionine rather than lysine. When eaten together in the optimal ratio, the quality of the combined constituent may be as high as 1.0, because each constituent's protein is complemented by the other.

A more extreme example would be the combination of gelatine (which contains virtually no tryptophan and thus has a PDCAAS close to 0) with isolated tryptophan (which, lacking all other essential amino acids, also has a PDCAAS of 0). Despite individual scores of 0, the combination of both in adequate amounts has a positive PDCAAS, with the limiting amino acids isoleucine, threonine, and methionine. Further, according to a 2000 study by Gerjan Schaafsma, "The questions about the validity of the amino acid scoring pattern and the application of the true fecal rather than the true ileal digestibility correction, as well as the truncation of PDCAAS values warrant a critical evaluation of PDCAAS in its current form as a measure of protein quality in human diets."

Use of multi-amino acid scores

While the DIAAS has come to supersede the PDCAAS as the measurement of choice, the original recommendation of the FAO when proposing the DIAAS was that each essential amino acid be treated as a separate nutrient. This would eliminate the need to consider protein content or quality, and would arguably simplify the analysis of the nutrition of meals rather than individual foods. One proposal along these lines is the EAA-9 score, which would measure the percent of RDI of the limiting amino acid of a serving of food. These would be used to determine the EAA-9 Equivalence Serving, or the amount of a food necessary to provide the same amount of that amino acid as an egg.