Her diet consisted of chicken, red meat, egg whites, "and always a protein shake to wash it all down," her mother said.

By Julia Malacoff and Julia Guerra/SHAPE.COM
Jul 17, 2019 @ 3:45 pm
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This article originally appeared on Shape. For more stories like it, visit shape.com.

In 2017, Meegan Hefford, a 25-year-old mother of two, died after following a protein-heavy diet that triggered an undiagnosed condition called urea cycle disorder. Now, two years later, Hefford's mother, Michelle White, is calling on the health industry to enforce strict regulations over the kinds of protein shakes and supplements that may have contributed to her daughter's death.

"Only certified nutritionists should offer advice on dieting, and I urge people to get medical checks before drastically changing their food intake," White told Mirror UK. "It's too late for Meegan, but I hope by sharing her story she can save another family from this pain."

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When Hefford's death was first reported it was said that she was eating a high-protein diet that also included protein supplements when she suffered a buildup of fluid in her brain that eventually led to her death, according to Perth Now.

Now her mother is speaking out about the dangerous diet exercise obsession that could have been the precursor to her daughter's untimely death.

Hefford developed a passion for fitness prior to giving birth to her first child, but her love of exercise and nutrition turned into more of an obsession after the birth of her second child, said White.

"She suffered crippling post-natal depression," and was prescribed medication, White told the publication. It's when the medicine made the new mother of two gain weight that her interest in exercise took a turn for the worse.

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Aspiring to transform her body, Hefford committed to bodybuilding competitions, which required her to not only follow an intensive workout schedule but to also follow a restrictive diet.

"Her meals were always the same," said White. "Chicken, red meat and egg whites, sometimes with steamed veggies on the side, and always a protein shake to wash it all down."

What Hefford didn't know before switching up her diet was that she had a rare condition that made it impossible for her body to properly process all the protein she was eating. The cause of death listed on her death certificate? "Intake of bodybuilding supplements."

Before you get freaked out, here's a little information about what really caused Hefford's death. Hefford suffered from an undiagnosed condition called urea cycle disorder. This is a genetic disorder caused by a deficiency in one of the six enzymes in the urea cycle, explains Robert Glatter, M.D., an assistant professor of emergency medicine at Lenox Hill Hospital, Northwell Health.

"In healthy people, the liver supplies several enzymes to convert nitrogen into urea, a much less toxic substance which is then removed from the body in urine," says Dr. Glatter. "Those persons with a urea cycle disorder lack an enzyme that is required to convert nitrogen into urea."

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That means that instead of your body processing protein in the normal way, there's no way for it to exit your body effectively, explains Caroline J. Cederquist, M.D., a bariatric physician and co-founder of bistroMD. This leads to excess ammonia in the bloodstream, and in Hefford's case, a buildup of fluid in the brain.

This type of condition is fairly uncommon, with an estimated one in every 8,500 births affected, according to the National Urea Cycle Disorders Foundation. At this time, the condition can only be diagnosed through genetic testing. Dr. Cederquist says it's often diagnosed in early infancy and childhood, especially when it's severe, however, the national foundation says the condition can often go undiagnosed in adults because symptoms are generally subtle, or are not appropriately recognized. And adults who have this deficient ability to process protein "can have issues with excessive ammonia buildup that leads to coma and even death if they are under metabolic stress," she explains. Examples of metabolic stress are a viral infection, childbirth, excessive exercise, certain drugs like steroids, or a very high protein intake-like in Hefford's case.

Again, there's not much reason to panic here, as Dr. Cederquist emphasizes that for the average woman who is working out and eating a high-protein diet, the risk of developing a buildup of ammonia in the blood is small. In order for it to happen, the "perfect storm" of factors, like a mild form of the genetic defect that causes urea cycle disorder, heavy exercise, and very high protein intake would *all* need to be present. And before things get dire, there would be symptoms such as nausea, vomiting, fatigue, slurred speech, acute confusion, disorientation, agitation, aggressive behavior or even seizures, explains Dr. Glatter. Needless to say, "a woman who is bodybuilding, eats a very high protein diet, and has odd symptoms needs to seek medical care," says Dr. Cederquist. 

While protein might seem like the bad guy in this particular story, this macronutrient is still an important part of a well-balanced diet, and also plays a key role in meeting your fitness goals. "You're continually using protein to support hormones, enzymes, immune cells, hair, skin, muscle, and other protein tissues," said Cynthia Sass, R.D., a performance nutritionist based in New York and Los Angeles. Your body also uses protein to help your muscles recover from the stress of training, she explained.

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But is it possible to overdo it on protein? Not so much, according to Shawn Talbott, Ph.D., a nutritional biochemist who spoke to us previously about the possibility of ODing on protein powder. Unless you have a kidney issue, he explained, there aren't really any drawbacks to eating more protein than you truly need. Instead, issues more often arise from additives that are found in some protein supplements, like vitamins, creatine, caffeine, fat burners, and energy boosters, or the fact that people rely too heavily on protein powders and miss out on the nutrients that come from real food.

Determining how much protein your body needs to consume can be tricky. While The National Institutes of Health's Dietary Reference Intake (DRI) suggests you consume 0.36 grams for each pound you weigh, (roughly 46 grams of protein a day for the average woman), how much protein you need depends on a variety of factors, such as your age, how active you are, and, evidently, genetics.

In short, too much protein probably isn't going to cause problems for you. But if you notice any weird symptoms after starting a high-protein diet, it's best to play it safe and check in with your doctor. What's more, if your activity level drastically changes, Dr. Glatter always suggests talking to your doctor or a registered dietitian to make sure you're properly fueling your workouts.

 

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