Dr. Gabrielle Lyon: How to Exercise & Eat for Optimal Health & Longevity

Welcome to the Human Lab podcast where we discuss science and science-based tools for everyday life.

I'm Andrew Huberman and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine.

I'm pleased to announce that my new book, which I've been working on for more than five years, is now available for pre-sale purchase. The book is entitled, protocols in operating manual for the human body. And within the book,

you can find, as the name suggests, protocols for everything from how to

improve and even optimize your sleep, for increasing your motivation and

focus, for nutrition that is specific nutritional guidelines to follow for

health and performance, as well as exercise,

stress control, your oral and gut microbiome, both of which are critical for brain and body

health, as well as protocols for creativity and much more.

Within the book you'll also find the scientific basis that is the mechanisms and specific

studies that substantiate these protocols.

And the book is designed to be incredibly easy to use such that if you're

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underlies the protocols that can improve your mental health, physical health and performance.

To order protocols, go to protocolsbook.com and there you will find links to any number of different

vendors and you can select the one that you prefer. Again, that's protocolsbook.com. My guest

for today's episode is Dr. Gabrielle Lyon.. Dr. Gabriel Lyon is a medical doctor who did her clinical and research training at Washington University in St. Louis.

She's an expert in geriatrics, in nutrition, in health, and longevity.

And during today's episode, Dr. Lyon explains how if we are interested in our immediate and long-term health,

muscle is the organ that we need to pay attention to.

She explains how this is true for everybody, men and women alike, and that there are

specific things that we all can and should do with our nutrition and our exercise in order

to maximize the health of our muscular tissue.

Now in some cases, people will be interested in building more muscle, but it's important

to point out that much of today's discussion is simply about improving the health of your muscular tissue and the specific ways to do that in order to support

brain health, body health and movement, of course, as well as the health of every organ

system in your body.

Again, placing a focus on improving muscular tissue itself as a way to improve all the organ

and tissue systems of your body.

Dr. Lyon explains the specific science and protocols that can be applied in your everyday life

at the level of what you choose to eat or not eat, as well as how much of certain foods

to eat or avoid, as well as specific training regimens, most of which take very little

time, but they can vastly improve the health of your muscular tissue and therefore the

health of your entire brain and body.

I'm certain that by the end of today's episode,

you will have a much more thorough understanding

of what you can do to improve your immediate and long-term health

and thereby potentially your lifespan,

all of which are based on the most modern understanding

from basic research, from clinical studies,

and from practical application in the real world.

Before you begin, I'd like to emphasize that this podcast is separate from my teaching

and research roles at Stanford.

It is, however, part of my desire and effort to bring zero cost to consumer information

about science and science related tools to the general public.

In keeping with that theme, I'd like to thank the sponsors of today's podcast.

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Today's episode is also brought to us by Helix Sleep.

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mattress that's ideal for your unique sleep needs. Right now HelixLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxLyxL Dr. Gabrielle Lyon, welcome. Thank you so much. So great to have you here. You have a tremendous range and depth of expertise. You treat men,

you treat women. You know a ton about exercise physiology, nutrition. You've done work in

psychiatry, you've done work in geriatrics, you know so very much about how to get

healthy and stay healthy and today we're going to talk about all of that. To kick things off,

I would love to dive into your take on this unique aspect of our physiology that most people

when they hear about think about weight training or maybe body building or have some immediate reaction to, but

you have a different stance on this incredible organ that we call muscle.

So, if you would just tell us how you look at this thing that we call muscle, in men and women women, in kids, in old people, young people,

how should we think about muscle?

Well, first of all, muscle is the organ of longevity.

And we've always thought about muscle just as you said

when it comes to exercise performance, mobility,

and strength, which, by the way, all of those things

are important and critical for life.

But there's something very unique and special

to scale to muscle.

First of all, it's an organ system.

It's an endocrine organ.

It is responsible for a large component of glucose disposal.

Roughly 80% of glucose disposal.

And we all hear about these things like cardiovascular disease,

type-to-diabetes, obesity.

Largely, many of these metabolic diseases begin in

skeletal muscle, decades before.

Interesting.

Skeleton muscle is also an amino acid reservoir.

It is the place that your body pulls from amino acids.

And that is something that changes as we age, this idea of protein turnover, and we

require healthy skeletal muscle.

Of course, it's the body armor that we all know and it is really responsible for how we age. By the way, I came to this

understanding through an experience. I'd love to share with you. I did my fellowship in

geriatrics and nutritional sciences and at the time we were looking at, you know, every

fellow has to have a project lucky for us and we were looking at, you know, every fellow has to have a project, lucky for us.

And we were looking at body composition and brain function.

And there was one patient who I just adored. She was a mom, three kids, and she'd always yo-yo-died it.

We image her brain and her brain looked like the beginning of an Alzheimer's brain. And I thought to myself, and I felt very responsible,

thinking, why was this woman who was doing everything

that we told her to do? She was exercising,

she was eating a low fat, high carbohydrate diet.

Why was she so metabolically unhealthy?

And I realized that at the end of the day,

it wasn't that she was overfat.

It was that she was under muscle.

And we spend decades and have spent decades

trying to treat obesity

when really what we need to be looking at is skeletal muscle.

Super interesting.

We know that the brain is among the most metabolic

reactive organs in the body.

And muscle two, one of the most metabolicically active organs in the body, you'll probably

tell me that one is more active than the other, which one is it?

Muscle is actually quite frankly not very metabolically active at rest.

Interesting.

For every pound of skeletal muscle, it might address burn 10 calories.

Primarily, burns fatty acids at rest.

Okay, I learned something new and I imagine many other people did as well.

So this woman that was overweight, you looked at the problem through different lens that she's

undermuscled. How does one go from being undermuscled to properly muscled? And what is that?

And as I say this, I realize that many of our listeners probably don't resistance to train,

I say this, I realize that many of our listeners probably don't resistance to train,

or if they do, they may not want to carry a lot of muscle, thinking that that would

not to buy a new wardrobe.

You know, certainly some of our listeners probably want to gain more muscle, but is

a new wardrobe wardrobe?

Or a new wardrobe?

Is there a way to view increasing muscle mass in a way that is compatible with kind of, I don't

know, we go like a traditional aesthetics or with overall health in a way that sort of

distinct from quote unquote body building.

I mean, again, as soon as we talk about muscle, we think about slabs of meat added to

different parts of our body and surely, certain people probably want to add muscle

to certain parts of their body for aesthetic reasons.

But how should we think about muscle in the context

of some of the two do's in terms of nutrition and exercise?

And we'll segue into that.

Again, how should we conceptualize this business

of being under muscle and getting to,

I guess what we call, appropriately muscle?

I think that that's a really good point.

This idea of being appropriately muscleed.

So the truth is, I can't tell you

how much skeletal muscle mass you should have

for optimal health.

I don't know how much skeletal muscle mass

I should have for optimal health.

We haven't done a good job in the literature

and just as a population,

being able to track skeletal muscle

and know what is optimal.

We are really good at looking at body fat

and we're really looking good at looking at bone.

But when it comes to skeletal muscle,

Dexa is an extrapolation.

So for example, we use Dexa as the gold standard.

And I'm going to come back to what we need to do

to gain healthy skeletal muscle.

But I think that it's really important

to put things into perspective and a framework for how we think about things.

We traditionally use dexa.

Dexa looks at bone and it looks

at lean tissue collectively.

Part of lean tissue is skeletal muscle mass.

It doesn't determine the health of skeletal muscle mass.

It doesn't determine anything about the quality of that tissue.

It purely looks at lean tissue, which then we determine part of that lean tissue,

maybe it's 40% is skeletal muscle.

And that's important to understand as we begin to frame up the conversation

as how much skeletal muscle should I have?

I have no idea.

But what I can tell you is that if I were to look at your blood work and I saw

something like elevated triglycerides or elevated insulin or elevated glucose, I would begin to

understand that the health of your skeletal muscle isn't where it should be. And by the way,

the health of skeletal muscle mass begins when we're young. This idea of sarcopina, which for the listener or the viewer, the definition of

sarcopina, by the way, became in disease.

It wasn't even classified as a disease until 2016.

Wow.

Yes, wow, which is very recent for a disease.

It is a decrease in muscle mass and function.

But interestingly, we don't necessarily know what one should have.

So I think it's important to understand

that when we're talking about the health of skeletal muscle,

we're still pretty much in the infancy of understanding

the trajectory of where it isn't and where it's going.

So when we think about how we maintain the health of skeletal muscle,

one of the things that I didn't mention is that skeletal muscle is a nutrient sensing organ. It is uniquely sensitive

to the quality of our diet. The quality of our diet defined as the quality of the amino

acids that we're gaining. And that would be for the listener dietary protein. Skeleton

muscle is sensitive to one of the amino acids loosing and depending on the quality

of the diet, meaning how much loosing that you're getting in any given meal will then stimulate

muscle health.

Not just muscle size but muscle health.

Muscle health.

And the way that we think about muscle health is by proxy is this concept called muscle protein

synthesis, which we can measure. And when we get a dietary protein amount,

which is between 30 and 50 grams of high-quality protein,

it stimulates skeleton muscle.

So I love this idea of focusing for a bit

on muscle protein health,

because it divorces us from this conversation

at least temporarily about muscle size, which I have to imagine is correlated but it's a separate thing altogether.

Actually, I should just ask the question, is it possible for somebody to have a lot of muscle?

But their muscle health is poor?

Yes.

Okay, conversely, can somebody have a moderate to low amount of muscle, but their muscle quality

is high or is that less common?

Well, the first thing that you said is absolutely something that we see is that in an individual

that carries a lot of muscle and say they're inactive. There is a big discussion about how

heavy individuals will have more muscle mass. But what we have to recognize is the health of

that skeletal muscle is fat deposition can be this

real fat deposition, fat around the organs, and it can be

also fat infiltrate into the tissue like not to gross

anyone out a marble stake.

And that's exactly what can happen to unhealthy skeletal

muscle, which then affects its ability to contract, which

also affects there's a ton of mitochondria and skeletal muscle.

It affects the efficiency of skeletal muscle.

Yes, someone can have potentially more muscle,

but more unhealthy muscle.

Interesting. When you say a marble steak,

I think at the extreme wagu, a raw wagu,

looks like there's as much white fact in it as there is red meat in it.

And it's a very different taste and texture.

So that's what we're talking about.

My understanding is those cows don't move around much.

There's somewhat said in theory, compared to say a free range

grass eating cow.

Is that right?

Yeah, that's absolutely correct.

OK, so we want quality, healthy muscle.

And then we can talk about muscle amount. And then the other thing that I'll say about it is part of what defines

muscle health is that flux, that movement. So if you were to think about

skeletal muscle like a suitcase and an individual was say going on a trip for

four days but chooses to eat or pack for 30 days. We know these people.

Yes, I know.

I'm maybe one of them.

I have my suitcase here.

I was only coming in for a day,

but I may have packed for four days,

not sure what I was doing, but that's beside the point.

When an individual is overeating calories

over eating carbohydrates,

I had mentioned earlier that skeletal muscle,

one of its primary roles is glucose disposal. And I'm we're going to get in the mechanisms of glucose disposal, whether it's insulin dependent

or insulin independent, depending on if someone is moving or contracting that muscle.

One in individual is eating food, carbohydrates.

It gets stored in skeletal muscle as glycogen, because as we know glucose at a high level

as toxic to the body, so the body must move glucose

out of the bloodstream into the cells.

Now, what happens is, is there becomes this stasis,

so if an individual is inactive and not exercising,

then that skeletal muscle becomes overpacked.

Skeleton muscle at rest burns primarily free fatty acids, which is interesting, most people

think about skeletal muscle as burning carbohydrates, but actually at rest, skeletal muscle burns

fatty acids. As you can imagine, when that muscle is full, and you are not exercising it,

then the substrates have nowhere to go. And it remains in the bloodstream.

And that would be a sign of unhealthy skeletal muscle,

which then loops back to what you see in blood work.

Elevated insulin elevated blood glucose.

Elevated free fatty acids, elevated branch chain,

amino acids, all of these things,

which again as skeletal muscle as the metabolic sink,

have nowhere to go.

So I'm starting to get a picture where in order to have healthy muscle we need to think

about the feeding of that muscle, the providing of nutrients to that muscle that is as well

as the use of that muscle.

We let's start with the feeding or the providing of nutrients to that muscle.

You mentioned that muscle at rest mainly burns fatty acids.

It can store glycogen.

How do we know when a muscle is full of glycogen?

I mean, there's the visual representation of the muscle seems fuller as opposed to flatter,

but these are not specific or these are not precise terms.

How much carbohydrate does it take

to fill all the muscle of the body with glycogen

and then what sorts of things perhaps to plead that?

I think it's a great question.

We know that when we're talking about glycogen,

the liver stores, glycogen, maybe 100 grams

and then skeletal muscle depending on your size.

For example, you might store much more muscle glycogen,

whether it's four, 500 grams compared to someone who is my size.

And can we do the standard conversion of four calories per gram, so if the liver is 400 grams,

you know what you just say okay, is about 1600 calories worth of energy there.

So if I go out and I do some exercise and burn 1,600 calories over time, does that mean that

the liver is then completely depleted?

So, well, the liver will deplete through an overnight fast.

So, the liver maintains blood glucose.

So, skeletal muscle doesn't maintain blood glucose directly.

The way that you would leverage muscle glycogen would be through exercise.

The way in which you would deplete muscle glycogen would be through exercise. The way in which you would delete muscle glycogen would be through more intensive exercise.

And when you think about the foods and the way in which, you know,

your original question is how would we know how much muscle glycogen

or how much we need to refuel? I typically think about it as overall

activity levels. So if someone is sedentary, then the current

recommendation for carbohydrates would be 130 grams per day.

Per day. At four calories per gram. At four calories per gram. And is that

both simple and complex carbohydrates? Five versus carbohydrates? Yes. It would just be

overall 130 grams. Yes. If they're completely sedentary. Yes. So just a little bit of

walking getting up, going to the computer, to to the bathroom to the car, et cetera, but basically said.

Yes.

And the average American takes in 300 grams of carbohydrates a day.

So more than double.

And as you can imagine, this can distort metabolism.

When we think about glucose disposal, the way in which I think about glucose disposal,

if an individual is sedentary is thinking about how many carbohydrates and individual can

ingest at one time that would mitigate insulin response and would be able to be

disposed of safely. And that number is between 40 and 50 grams of carbohydrates

at a meal outside of exercise. The rest of carbohydrates would be

earned through exercise and through every hour of exercise depending on the

intensity that could be between 40 to 70 grams depending on how intense an

individual exercises and that would be safely disposed of in a two-hour

period. I mean when you think about an oral glucose tolerance test,

that's a 75 gram load you assume within two hours

that that blood sugar regulation should come back

to a normal range.

So at 40 to 50 grams of carbohydrate every two hours,

does that mean that if somebody were to eat 40 to 50 grams

of carbohydrates every two hours, or they shouldn't, which they shouldn't, but because

you're going to quickly exceed that 130 grams per day. And even if exercising with

resistance training, say hard for an hour, which can afford somebody maybe what another

couple hundred, 300 grams of carbohydrates.

Probably not that much. OK.

I think that if people care about body composition,

which I would say everyone should,

because you want to have an appropriate level of body fat

and to help these skeletal muscle,

then you wouldn't necessarily unless you're

doing some kind of cardiovascular activity,

you're not using a ton of muscle glycogen,

depending on how much you're not using a ton of muscle glycogen,

depending on how much you're training.

And how much glycogen is the brain using?

So that is a good question.

The brain uses a lot of carbohydrates.

That would be a primary source.

When they come up with the numbers of 130,

it's really based on brain and then the rest of the body.

Can we safely say that for somebody that's thinking a lot,

they need more carbohydrates?

You could say that, then your brain, yes,

your brain is very metabolically active.

Interesting.

So we're going to draw in rough estimates,

not knowing people's body weight, not knowing

their body composition.

But what I'm arriving at here is you know if somebody

does a little bit of cardiovascular training maybe a little bit of

light resistance training I'm describing the activities of many people

out there maybe 250 grams of carbohydrates you're kind of at the threshold

that's a lot that's a lot for four calories per gram those carbohydrates

and so let's say 200 grams of carbohydrates per day.

But that's not a ton of calories overall.

So what should the remainder of the calories be made up of?

So I think what we're really talking about here is how do we design a nutrition plan

for people to have healthy skeletal muscle?

Right.

And if I were to say, OK, what are we thinking about

for the listener or for the people out there?

They're thinking, you know, I really

want to have a healthy body composition

and healthy skeletal muscle mass.

The way in which they would do that is number one,

you have to prioritize dietary protein.

So we're talking about carbohydrates here,

but carbohydrates shouldn't be the primary focus.

Nobody has challenges getting carbohydrates in.

130 grams would be a safe recommendation if someone is overweight or struggles with

type 2 diabetes or any of these other metabolic conditions.

There is evidence to support a lower carbohydrate intake.

I mean 130 grams is one little micro packet of pretzels on an airplane ride.

That actually has probably closer to 37 grams of carbohydrates.

Okay, good.

So I had a pretzel packet before or through when it robbed on the way in, but no.

Right.

Okay, so I'm way off there.

So they have one of those bagel in the, and they shouldn't, but they do, and then they have some

pasta dinner, and so most people are probably exceeding that 130 grams bio-huge margin.

Yes, they are. And there's a couple things there that it's really important that you said.

Is that individuals when we're thinking about designing a plan for skeletal muscle health?

That first meal is most important.

That first meal of the day having dietary protein

will set you up metabolically for the rest of the day.

And we say first meal, we'll talk a little bit later

about intermittent fasting.

And I, for instance, eat my first meal at,

you see 11am.

It's just kind of how I'm wired,

I've never wanted to eat breakfast first thing.

I forced myself to eat some eggs first thing in the morning

from time to time and

felt fine, but do you recommend that people

eat a true breakfast like within a certain number of hours of waking up four sake of

muscle health and

Metabolic health when we think about

That first meal. I frankly don't care when you have it. One also has to understand that you're coming out of an overnight fast

If you are young and healthy then the timing of that first meal likely doesn't matter because you are robust

your body is very efficient and capable to

withstand

protein degradation

It's able to withstand protein degradation

and protein turnover, which is ultimately why we're eating.

So that's one reason why we're eating.

And we'll talk a little bit more about that.

That first meal of the day, if you are young

and healthy, the timing doesn't really matter.

And I would say when it begins to matter

is when you're older, when you are in your sixties,

fat continuing to fast maybe a negative, negative for muscle, muscle health. That first meal of the day is important because we know that when you get between 40 and 50 grams of protein,

that first meal of the day, you stimulate muscle protein synthesis.

Muscle protein synthesis is by proxy what we use to measure as a marker for overall muscle health.

Now there's a lot of history here

when we think about designing a meal plan

that first meal has between,

we'll say, give it between 30 to 50 grams

of dietary protein.

That will do a number of things.

Number one, it will stimulate skeletal muscle what we would consider the health of skeletal muscle. It also

will affect the brain. It'll improve satiation. You know, we're talking

previously. It releases a handful of gut peptides like glucogon

like peptide one, which is. To help make it talk about those epic

Mondioros. C. K. P. Y.Y.Y. things that will affect appetite for that second meal.

And there's some very interesting research out of Heather Lydys lab. And basically,

when she put individuals younger adolescents on a meal of 30 to 40 grams of protein,

they were much less likely to choose say donuts or something outside of what

we would consider a healthy nutrition plan.

Later in the day or in the same meal.

Later in the day.

So is essentially augmenting their well power?

Okay, so it sounds like for young people they can delay breakfast if they want.

For older people probably not, but that the first meal of the day should include what you're

calling dietary protein,

30 to 50 grams.

Yes.

And maybe we should talk about the quality of that protein.

Because I think a lot of people understand that

their meat proteins, their plant proteins,

how important is the quality of that protein?

This tends to be a hot topic in somewhat very controversial.

Great.

When we, great for you.

I know, great for everybody.

I mean, we're a controversy on this podcast is embraced in the following way.

We state what we know, we state what we don't know, and we are always happy to return to

the conversation of future time to adjust any stance is based on the data and how we

evolve as people.

So.

Okay.

Well, I love that.

Dietary protein, we speak about it is if it's one thing.

But actually it's 20 different amino acids, nine of which are essential, the rest we can

generate in our body.

And when we think about skeletal muscle, we think about the essential amino acids.

And the essential amino acids, primarily four skeletal muscle health, think about the essential amino acids. And the essential amino acids primarily

for skeletal muscle health are the branch-chained amino acids,

losing being one of those.

So, losing is uniquely stimulating to skeletal muscle.

And when you have enough losing,

it triggers muscle protein synthesis.

And when you say stimulating and muscle protein synthesis,

I think a lot of people get a picture in their mind

of a muscle growing, but you're not necessarily talking

about that.

You're talking about the organ that is muscle,

that it's health, it's metabolism being cultivated,

so that it can do all the hormone endocrine related things

and the glucose disposal related things

that we'll get into in a bit more detail later.

Is that right?

Yeah.

And so when you have a breakfast of 30 to 50 grams, you appropriately stimulate muscle protein synthesis.

And one has to recognize that if you eat below that threshold, you do not stimulate the

health of that skeletal muscle. You do not stimulate muscle in a way that would be necessary for outcomes that matter and outcomes that matter are

sarcopenia outcomes that matter are body composition prevention of obesity. You must get

this nutrition right it's the thing that 100% of people do is eat. As many of you know

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back in 2012. There is so much conflicting information out there nowadays about what proper

nutrition is. But here's what there seems to be a general consensus on. Whether you're

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Again, that's drinkagAG1.com slash

Huberman. It's great that we're focusing on muscle and then referring to obesity

because I think so many people. Virtually everybody thinks, okay, reduce

body fat. How do you do that? You get the calories in calories out, equation, in a

certain direction. By the way, I believe in a law thermodynamics and

calories in calories out. But by focusing on muscle protein synthesis and muscle health through the ingestion of

quality protein early in the day, I see that you're entering this all through it through a

different channel, but that the end points have reduced, body fat, et cetera, as we'll get into

later, one can still arrive there. So just for practical purposes, what are some excellent sources of quality protein

for that first meal?

Well, now the quality of protein is defined

by the amino acid composition.

And typically animal-based proteins have higher quality,

these are hard-fast biological numbers.

The dietary protein in, say say a steak is very similar to the protein amino

acid in skeletal muscle. So the quality of the proteins like eggs like way protein, like beef,

like poultry, those compositions are similar to the human body composition. So they contain

the amino acids in the appropriate ratios for

skeletal muscle health. Now plant-based proteins have a different composition and they

have a composition obviously similar to plants and one can get enough of the

essential amino acids if the total caloric load of that protein is high enough. And I think that that's important to recognize

because right now the American diet is 70% plant-based.

And we seem to be moving more towards a plant-based diet.

Is that right?

I mean, I know there's sort of a movement

toward that you hear about plant-based, but so most people

are not eating, steak and eggs for breakfast.

Well, most people, when I say 70% plant-based diet,

I'm talking about refined carbohydrates, sugars,

and minerals.

And when we think about it,

so the 70% of our diet comes from that,

we're 30% come from animal-based proteins,

which contain a ton of nutrients like bio-available zinc and selenium B12.

But when it comes to muscle health,

one could, as long as they are thinking about,

making sure that the overall protein load is high enough

in that plant-based protein.

For example, one would not choose quinoa as a protein source.

So quinoa would six not choose quinoa as a protein source. So quinoa would, six cups of quinoa would equal the same as one small chicken breast.

When it comes to an amino acid profile.

So I think one has to be aware that plant-based proteins typically have carbohydrates that

ride along with them.

And that just becomes important for overall metabolic control when we think about total

chlorochloric load and total carbohydrates. Someone could use a rice pea

blend of protein for that first meal. That was certainly be

sufficient. Certainly if someone is geared towards a more plant-based

item, doesn't want to consume animal proteins, that's what I would use.

Is there any evidence that combining a high quality protein with carbohydrate in that first

meal is more or less beneficial than having the protein alone?

That's a good question.

I would say that we don't have evidence for that that it would be more beneficial because

the question would be what is the benefit that we're looking for?

If the benefit that one is looking for is diversity, then certainly because we know carbohydrates

cannot fiber, phytonutrients, if you're going to combine it with berries, that could certainly

be advantageous, but not necessary.

What becomes interesting is when we think about designing a diet does that second meal

matter.

And not to get too technical, but maybe I'll, we could get a little technical here

is that when you stimulate muscle protein synthesis, that will last about two to three

hours.

Now, the next thing one would think is, well, I know that I need a certain amount of protein

for overall muscle health.

The amount of protein for overall muscle health could be anywhere from one gram per pound ideal body weight to lower.

And when we think about how we are designing a diet, we have to recognize that the current recommendations are the minimum to prevent a deficiency.

The way in which diets are designed now, according to the RDA is point eight grams per kg.

Point eight grams of protein per kilogram of body weight.

Which comes out?

Total body weight.

Yes, which comes out to be point three seven grams per pound.

So if someone was 115 pound female that current RDA would be 45 grams of protein.

Way below what we talked about earlier.

And these are very important concepts to understand the foundations of how we think

about dietary protein.

The current RDA, which is a minimum

to prevent indifficiencies based on nitrogen balance,

nitrogen balance, and by the way,

the recommendations for protein that were set

in the 80s have not changed, which means one of two things.

We haven't had new science come out,

or we just haven't recognized the importance of protein.

And I think that it's more likely the latter

that we have not yet recognized even though there's a plethora

of data.

And I worked on some of these earlier studies,

which I'll share, I even brought the numbers to make sure

that I said them right because this is the human lab podcast.

Well, I've made numerical areas before on the podcast,

but great that you brought the numbers.

We always try and correct any errors,

but great to be precise the first time.

So thank you.

You know, when we think about how we design a diet

for optional muscle health is very different

than how we design a diet for, again, just life.

And the two are very different.

The RDA for loosing, which is that essential amino acid,

meaning we cannot make it, we must get it from the diet,

is that at 2.7 grams per day.

That's a trivial amount.

That is a trivial amount and to 0.7 grams.

2.7 per day per day.

And one must understand that this came from

nitrogen balance studies and typically those are

young men, 18 year old men.

That does not support healthy aging or anyone

that is struggling with obesity or any kind of

chronic illness or anything.

And so then when we begin to think,

well, what do we actually need?

The evidence would support two to three times that amount closer to nine grams of loose

in per day.

And just to calibrate us, nine grams of loose in, again, is essential amino acid.

We can only get from food per day.

What is that equate to in terms of the total amount of, let's say, egg or steak protein

that one would need to eat in order to ensure that.

Just rough, roughly. Yes, wonderful question. So there's a meal threshold for skeletal muscle health,

and that meal threshold is a minimum of 30 grams. Now, that would equal a four, four and a

half ounce steak. Dare I say six eggs, which is a lot of eggs at one time or a scoop of way protein. Scoop of way protein might have 18 grams of protein and 2 1 1 1 1 1 1 1 1 2 1 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 1 2 1 1 2 1 1 2 1 1 2 1 1 2 1 1 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 about, you know, the reason why I was so excited to come on this podcast is because I think

that if we can correct our nutrition and we gear it towards skeletal muscle health, then we can

change the trajectory of aging. And we can stop focusing on obesity and really focus on skeletal

muscle health, but the only way that we're going to do that is if we get this nutrition right,

because skeletal muscle requires dietary protein. There's only two main ways that we

can stimulate skeletal muscle.

And that is through exercise, primarily resistance training,

and dietary protein.

And so when we think about how we design a diet,

if you look back at the history,

we have to recognize a handful of things.

Number one, that these essential amino acids,

primarily loosing, is necessary to trigger muscle protein synthesis. Number one, number two, that these essential amino acids, primarily loosing, is necessary to trigger muscle proteins

synthesis.

Number one, number two, that aging impairs the efficiency

of muscle proteins synthesis.

I see, so it's a runaway train.

If you start getting sarcopenia, if there's obesity

and other markers of aging, it relies obesity,

you can occur at young ages too.

But muscle loss, then basically you're losing muscle quality,

AK protein synthesis, and other things,

and as a consequence, it makes it harder to increase muscle quality.

So you have to short-circuit this pretty early.

Yes, and I would even say that we talk about

sarcopenia as a disease of aging,

but I think that there is a youthful phenotype of sarcopenia.

If we define sarcopenia as decreased muscle mass and strength, that can easily affect our youth.

You know, we talk about health span,

we talk about lifespan.

There's also muscle span.

And muscle span is this concept that is really about

the skeletal muscle health as we age.

And there's three primary components to that.

That's understanding that

skeletal muscle health begins very early on. And we're going to talk about, because I know

that there's parents. I have two little kids. So I want to talk about the amount of protein

necessary for children, of course. And then as we think about this muscle span, there is

early on early age where you're laying down in the foundation, where you're hopefully training, doing exercise, just doing movement. Being sedentary is a disease state in

an of itself, period end of story. Being sedentary is not the opposite of activity,

being sedentary is in an in and of itself a disease of inactivity. Then midlife, we

have to maintain the tissue. We get a peak muscle mass in our 30s.

We get a peak bone mass around the same time.

And then that later half of life,

we have to do everything that we can to maintain that tissue

because of this decrease in efficiency of skeletal muscle.

So skeletal muscle as a nutrient sensing organ

can respond like youthful tissue.

And the way that it responds like youthful tissue

from an amino acid perspective, just thinking about how

we need to maintain that, is that when we increase our dietary

proteins, so older individuals or as they age require more

protein to then stimulate M. Torr.

So does that mean instead of eating 30 grams of protein per meal minimum that people

older than say 50, 60, shitty 40 or 50 grams of protein?

I would say that's true.

Interesting.

And by the way, skeletal muscle will mount a youthful response.

There's, you know, this was the initial work was out of Bob Wolf's lab. He's an icon in the industry of protein. He's one of the, can I say ground fathers now? I mean, that's pretty embarrassing. And when I think about Bob Wolf and Don Laman and these guys, you know, I trained with Dr. Donald Laman, you know, these initial studies that we think about and we take for granted dietary protein. We think, okay, well, the bros have always known this, but we have not.

And when you are younger, there is a somewhat of a linear response.

Let's say a younger individual still growing.

We'll just call them 10, 12 years older or my children. I have a three and

a four and a half year old. They will respond with five grams of dietary protein, 10 grams

of dietary protein, 15 grams of dietary protein versus an older individual will not respond respond it all to that. However, that response can be augmented by increasing the dietary

protein at that meal, so an older individual will respond like a younger individual by 30

grams of protein, 30 to 50.

Later we're going to talk about supplements, but I'm very curious.

Is there a place for supplementing loosene and other brands, training me know acids?

Specifically, I always assumed that supplementing with brands, training me know acids was

kind of the unique domain of people post exercise, trying to build more muscle.

But as you're telling me all this, it seems that adding loosucine in powder form to a meal seems like it would be great for

muscle health. Is that true? I would say that we do not add

lucine alone because lucine is elucine and

valine go hand in hand. It would not be advisable to add a

single amino acid. The amino acid levels are maintained in the blood.

By adding more of one would have effects on the other.

The way in which I would think about supplementing

essential amino acids and or branch chains

would be if an individual is choosing to have a lower protein

meal.

I remember when I was in residency, the food choices were not

very good, and maybe I had

two ounces of fish which wasn't enough to bring me up to a threshold.

That would be a place that I would add in branch chaining amino acids or essential amino

acids.

That would bring someone's amino acid threshold up.

But we have to understand everything that we're doing we should be doing with a purpose.

The idea of just sipping on branch chain amino acids

or just adding amino acids would be the equivalent

of putting a key into a car and trying to turn the car on

but not having any additional substrate.

So you need the full spectrum of all the amino acids

to affect skeletal muscle health.

Well, that's reassuring to hear

because I love the taste of scrambled eggs and steaks

and also like tuna and I also like chicken

and I love all those things.

And I have to imagine that as you mentioned before,

there are other things in these quality animal proteins,

like you mentioned,

Selenium, you mentioned other,

perhaps essential fatty acids and other vitamins that

perhaps have something to do with what the animal ingested during its life that also benefit

muscle is that true?

It is and the big standout to me is creatine.

We know that creatine at five grams of creatine will affect skeletal muscle, but 12 grams of creatine affects brain health.

And there's a lot of interesting research coming out

on creatine and brain health.

Can you remind me the rough amounts of creatine

and say, you mentioned, I mean,

I must say a four and a half state feels rather

poultry to me.

That's probably the size of it.

Which is a huge meal to me.

Right.

So let's say six sounds.

Let's be generous.

So six ounce steak or four scramble

eggs.

I mean, how much creatine are we talking?

Eggs don't have much creatine, right?

Not much.

And I was just recently looking at this,

the amount of creatine in a pound of steak

you're going to cringe is something like two

grams. So it's not very much. But when we think about eating foods as in a food matrix,

what you're saying is absolutely true there. It's interesting. We don't eat single nutrients. While

we think about dietary protein as a single nutrient and we think about carbohydrates. But what we

really do is we eat mixed meals. And when we think about that,

the quality of the protein matters

from a protein perspective,

could you get plant-based proteins

and animal-based proteins

and could it be equal, yes, it could.

So I want to be very clear to say,

and have a very balanced perspective

that we could get all of our dietary protein

from plants, from plant-based sources.

A few caveats there is that that RDA that I gave you earlier is based only on high quality

proteins.

And that being the minimum to prevent a deficiency.

If an individual was plant-based, they would require closer to 1.6 grams per kg.

A higher amount of total protein if it's coming from plants.

And that becomes important to understand.

Speaking of an ideal world, you had a magic wand.

I do.

What would be the,

my kids think I do.

I bet you do.

What would be the amount of protein

that you would have everybody eat?

In terms of a number of grams per pound

or kilogram per point. That's actually an easy question number of grams per pound or kilogram of

a pound. That's actually an easy question. One gram per pound ideal body weight.

Total body weight, not ideal body weight actually. Where you want to be, if an

individual is 200 pounds, but would prefer to be 150 pounds, then I would have

them eat towards their ideal body weight. There's no evidence that a higher protein diet is detrimental to kidney health, to bone health.

And we use these terms loosely, like a high protein diet, when we have to recognize that 0.8 grams per kg is a low protein diet.

So where did the idea come from that if you eat, say 1 gram of quality protein, per pound of ideal body weight, that you're going to get gout,

you're going to have liver issues,

you're going to have all sorts of issues.

Where did that idea come from?

Frankly, I'm not sure,

but the conversation around dietary protein

is probably been the most controversial.

What do you think that is?

We don't, I'm not trying to get political

around the sodium health of ideas, but I won't share them.

Okay.

But I do feel as if nutrition is not just science.

Nutrition is complicated because it's something that people tie emotion to.

They tie religion to.

There's a lot that goes in to dietary protein and food recommendations

in general.

But it sounds like we can safely say that if you eat one gram of protein per pound of

ideal body weight that you're not going to cause liver damage or get gaued or increase

to your risk of cancer, right?

My understanding is that even if it comes from red meat, there's no increase in risk of cancer,

is that right?

Well, here's what I would say to that. I would say that this idea about red meaning

cancer, number one we would have to even define what kind of cancers that we're talking about.

There's many different types of cancers and there's many different causes.

It would be important to understand what risk factors are. And a primary risk factor to many cancers is obesity. The question then becomes,

how do we design a diet that mitigates obesity? The evidence is also very clear that a more

protein-forward diet optimizes body composition. And you combine that with resistance training

and you will see a tremendous amount of change. I worked on some of these early studies.

And I'll share with you some of the early studies

and this came out of Don Laman's lab with the University of Illinois.

Well, you and Lane Norton both worked there, yes.

Did you overlap the?

We did.

And while he was, he was.

He was.

So what does he say?

He sat in the back of the glass and I sat in the front.

OK.

All right.

There you heard it.

John's fired.

No. And all Kenny's side lane is a very, he's like my brother.

We've known each other for 20 some years.

And I'm very popular guest former guest on this podcast and a very spirited guy.

And I just like to say, I don't know why his skin looks

that good, but, um, whatever.

So I love you Lane.

I worked on, yes, we do.

I worked on some of these early studies and this And these studies were some of the first studies to come out about dietary protein, nutrition,

and resistance training.

In fact, to my knowledge and to, I think, the knowledge of many of my colleagues, this

was the first study.

And what it was, it was a 12 month study, 130 overweight men and women.

So it was robust.

And basically what they did is they had two groups.

One group was a food guide pyramid diet.

So it was 55 grams of carbohydrates,

a RDA of protein, which was 0.8 grams per kg,

and 30% fat, 30% fat was in both groups.

The second group was 40% carbohydrates.

This is remember the zone diet, 40, 30, 30?

Yeah, I liked that diet.

Okay, I mean, there's average.

I mean, I don't follow it anymore,

but I try it for a while.

And it works great.

And there's some evidence to support

that that is a great ratio of our people.

Coming off the low fat era of the late 90s, the zonediate felt like the best thing ever

because it was like, oh, you know, you can enjoy some fats and wow your satiety is improved

and get stronger.

You just feel better when you're adjusting some ideally quality fats.

That's my experience anyway.

Yeah.

And also we know that it influences hormonal status.

You don't want to push fats too low.

So the second group had a 40, 30, 30 split.

So it was 40 grams of carbohydrates, 30 grams of protein,

30 grams of 30 percent fat.

So these are all percentages.

Yeah, 40, 30 percent.

Now, we didn't talk so much about the distribution,

but what is really important to understand is they were isocloric.

So they both had the same calories.

The difference was the percentage of where the calories came from

and how they were given.

And there was actually four different arms to this.

So there was individuals that exercise and individuals that didn't.

Okay, so either Zonedi or let's call it,

I hate to say this, but more

standard American diet.

That's how it was designed.

Standard American versus zone diet.

Yes, so it was designed that way.

And then exercising or non-exercise for each of the...

For this 12 months study.

And by the way, I had to pack a bunch of meals.

It was not pretty and I had to do.

You're an analysis, it was terrible.

But anyway, this besides the point. So the first group had a protein distribution

of 10 grams in the morning, 15 at lunch and 45 at dinner.

And it's kind of standard American stuff. So that's a good idea.

Yeah, some cereal for breakfast with a little bit of milk and then for lunch like I say

in which exactly. And so this mirrors what people do.

The other group had 45 grams of protein at that first meal.

Six, five, six eggs.

Five, six eggs.

35 grams of protein at lunch and 35 grams of protein.

Chicken breast and a salad at lunch with a little piece of toast.

And then it dinner how much?

It was 35 grams.

Alright, piece of fish and some rice and a vegetable.

But it was an even distribution.

So what you're seeing here is now,

these meals are meeting a loosey and threshold

of muscle protein synthesis.

Now it's 100, this is collectively 130 individuals

and they were older.

I think that they were all in their 40s or beyond.

If we just compare first the groups

that did not exercise two different diets,

what did they see?

What did you see?

You participated in this job.

Yeah, yes, I did.

You saw what said it was.

Unfortunately, no, I won't.

But what was so interesting is that those individuals, everybody lost weight.

So the average weight loss, gosh, I wish I had better handwriting, but I'm a doctor.

And so it's pretty bad.

The average weight loss was 24% greater in the high protein group.

So they lost 24%.

And you said it was isocloric between the two groups.

That's right.

That was it.

Sub-chloric overall.

That's a very smart.

Yes, it was 500 calories less.

Then what they needed to maintain body weight.

Correct.

So 24% more weight loss total.

Total. And the group that distributed their protein evenly and followed the so-

zone diet for the third. Yeah. They lost more fat than the high carbohydrate group. So the

high protein group lost a total of 16 pounds versus the calorie controlled group lost 11 pounds of fat.

A fat, which is great.

Everyone's at home thinking this is wonderful.

I so coloric.

I so coloric, but the thing here is the lean body mass change.

So again, this was done using Dexa and we know Dexa only looks at lean body mass.

You mentioned Dexa earlier, just very briefly is De Dex a, how does Dex a work?

Not at a mechanistic level.

What does it look like?

I go into the clinic, am I floating in water?

No, I'm holding the paddle.

Will you might be because you're under hubo in the bottom?

No, no, no, but you hold the paddles and you're standing.

I'll say it's what's it?

So Dex, you just lay on, depending on the machine,

you can just lay on this machine and it's a dual x-ray, and it measures bone fat,

and then lean body mass.

Okay, that's a problem.

That's a problem.

Great.

So the lean body mass loss, and again,

this is everything other than bone and body fat.

So that was 34% in which group?

In the standard American diagram.

Versus 26% in the high protein group.

Now where it gets fascinating, so what the big takeaway is is understanding that protein

had a sparing effect.

Protein protected muscle, more body fat loss, at the same coloric amounts.

Yes.

Same amount of deficit relative to body weight.

Right. In this group, exercise was thought introduced. So this was purely the food guide

pyramid, changing protein in the morning versus having it at two small meals and then

having it at dinner. And did they emphasize what we're calling high quality protein? He did. Okay.

That is also very important.

Me fish, yes, chicken, it's a fish.

Yes, they did.

So then this led to another study.

So then the second study was a two by two design.

And this is a...

Sorry, it interrupt.

In that previous study, what was the effect of exercise between the two?

So we didn't do exercise.

Got it, okay.

That was my fault.

They did not do exercise.

They were just doing whatever. it was that they were doing.

But what was so important to understand was that this set the stage for this idea that protein

had a sparing effect.

And then following that, the other study.

So then there was a series of a few other studies.

The second study looked at died in exercise, so this combined effect.

So this was one of the first studies, and this was 48 women with a BMI of 33, 46 years old.

So this is your post-Perry Post-Manipalsal woman who was either in one of four tree mingrips. A low protein group, low protein with exercise,

high protein, high protein with exercise.

The low protein group was defined as the RDA.

Pointing grams, the high protein group was defined as 1.6 grams,

KJ.

So starting their approach at 1 gram per pound.

It's about about 7 gram.

Yeah, so starting to get there, but not quite there.

Yeah.

So this was a 16 weeks study and what they found overall was that the high protein

group lost 18% more body fat and 25% less lean mass overall.

And 12% more total body weight.

And so now we start moving into this synergistic effect

of dietary protein and resistance training.

And it was the type of exercise

that they performed there resistance training.

This is the good news.

It didn't take much.

It was five days a week of walking

30 minutes and two days a week of resistance training with just body weight. It was like yoga activity.

So air squads down dogs, some warrior poses, maybe some hands stand attempts.

So yeah, so what do you do in the summer? Are you doing hands hands? No, I do.

This is some yoga classes where I look to the sides of me

and people are doing something pretty difficult.

The very important.

The one that teaches and things like that.

Definitely not me, do not invite me.

Life is better this way.

I'm not going to those classes.

But 16 weeks, they did a high protein with protein and exercise.

Those individuals.

So now, so the study, the group that I just mentioned,

this was dietary intervention alone.

With exercise, high protein plus exercise,

very simple exercise.

So if someone is listening to this and they're thinking,

what can I do to make very practical changes

to massively impact my life outside of hormonal replacement,

outside of any super-sub hormone replacement, outside of any

super supplement, outside of anything.

Diet and exercise has a dramatic effect.

Those individuals that were doing 1.6 grams per kg, which is 0.7 grams per pound, of bodyweight,

plus exercise, lost 46 percent more body weight.

That's substantial.

60% more fat.

And 40% less fat free mass.

From organs, muscle, whatever that is.

Compared to the low protein group, plus exercise.

And was it subcloric?

Were they low, below, may it was?

It was. It was.

So they're eating to ideal body weight, but still 500 calories or so

below their current color needs to maintain body weight.

So I've heard before that when we protein a certain amount of energy is required to

metabolize that protein, can that be translated as, you know, the caloric load of protein is not what it appears to be.

Yes. You know, let's say that six ounce sake, I'm

making this up. I'll probably get the numbers badly wrong.

But if it's, you know, six ounces of steak and maybe

that's a, let's just say, a 450 calories or 500 calories,

does that mean that only 400 of those calories are actually

equal to equal utilized? What you're talking about is a thermic effect of food, 100 calories does that mean that only 400 of those calories are actually, quote unquote,

utilized?

What you're talking about is a thermic effect of food, the thermic effect of feeding.

And that's the idea that certain macronutrients require a certain percentage of energy or the energy from those calories to be utilized. For fat, it's something like 3% for carbohydrates, maybe it's 5 to 10% and

then for protein, it could be anywhere from 20 to I've seen even studies that are

a 30%. Well, I know, but here is the thing. It's not that it's the energy that

it takes. So if we were going to make it simple, we'll say 100 calories from straight protein. The body would net

80 calories because 20% of that energy is being used for what I would say is

muscle protein synthesis. It's not the handling of nitrogen, it's none of that,

and there's variations in the literature, and the variations come from how an

individual dose is protein.

So the dosing, depending if you've hit that minimum 30 grams, then you will see a more optimal utilization of protein and I think that that's where that number comes from. It's actually

the stimulation of muscle because that is such an energetic process in and of itself.

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Slightly tangential question, but I think meaningful

given the context of what we're talking about.

Why is it that if I eat a plate of scrambled eggs,

or a steak, or chicken chicken breast and some vegetables,

I feel very say-edit.

And unless I did some hard resistance training, I'm kind of good with that.

But that if I eat any of those same foods and one piece of a baguette or one forkful

of pasta that then I want a lot more pasta and I want half the loaf of bread.

Why is that?

Is it the blood glucose response?

Is there something about carbohydrate

at the level of the mouth?

I mean, what is it, you know, a former guest on this podcast,

Dr. Diego Bordkis, who studies gut brain sensing,

explained to us and this is separate from the microbiome

that we have receptors all along the length of our gut from our mouth out to the rectum that are sensing the

amino acids and are looking for those essential amino acids but also

sensing sugar and things like that and signaling to the brain about how

much more we should eat of a given food or forage for a given food. And I just

have to say at a psychological level subjective level there's something so

fundamentally different about eating protein and vegetables,

or protein fruits and vegetables.

In the absence of starchy carbohydrates,

and when ads start to carbohydrates,

or each starts to carbohydrates alone,

and it's like, it's not a runaway train,

but it's almost as if, like, it's never quite enough

until there's a physical volume in the gut

that it is like at threshold.

And I don't think I'm alone in this.

You look at the way people eat chips, you look at the way people eat pasta, you look

at the way people eat risotto.

And it's just different.

I mean, there are a few, you know, freaks out there that probably two rib eye stakes.

But for most people, a rib eye stake is like enough.

One rib eye is enough.

What is going on there?

And it feels free to speculate.

But is it amino acid sensing?

And because I think this is really important

because I think is you're suggesting,

if I may, that people prioritize protein

from the first meal of the day and throughout the day,

I think people are imagining, well,

gosh, what happens to my pasta,

what happens to the bread, what happens to all these things.

And, you know, perhaps overlooking the fact that eating protein vegetables and maybe fruit,

maybe a little bit of starch is just a completely different experience than

eating starch alone or starch in larger volumes.

Now, I'm going to speculate here, the foods that we have access to are highly palatable.

And potentially, we weren't necessarily designed we have access to are highly palatable.

And potentially we weren't necessarily designed to have access to those kinds of foods.

And this kind of moves into this idea of something called the protein leverage hypothesis.

And the protein leverage hypothesis is that individuals will continue to eat.

And this is one way people explain obesity is that individuals will eat to satisfy an amino acid need.

Now your original question was,

when we eat carbohydrates or risotto,

there is a component of blood sugar regulation that happens.

So as you go beyond that 50 gram threshold,

you tend to release more insulin.

So there's an insulin-genic effect

of dietary carbohydrates, which some people will experience

as lower blood sugar.

We've all had that experience where you're,

I mean, not all, but eating your kids,

macaroni and cheese, and then you just can't stop.

And then you probably feel very tired.

There is an Evan flow of blood sugar.

The interesting thing about dietary protein

is you will hear people say,

I'm gonna reduce my dietary protein

because it's insulinogenic as well.

So dietary protein does cause a phase one insulin release

and that's preformed insulin in the pancreas.

It is a component for muscle protein synthesis,

but it is roughly 20% of the insulin response

and the same amount of carbohydrates.

And when you eat a meal that is robust and dietary protein,

your body will be able to then generate its own glucose.

Roughly for every 100 grams of protein, your body will be able to then generate its own glucose, roughly for every

hundred grams of protein, your body will generate 60 grams of glucose over a period of

time through the process called gluconeogenesis. And that is one of the benefits of a higher

protein diet. You generate the glucose that you need. And can that be converted into glycogen?

Yes. Can you repack muscle that you've? That is a good question. The process is very slow, so it's a much slower process than if you were to have your

bread or risotto.

So you told us about essential amino acids.

Are there any essential carbohydrates?

No.

There are essential fatty acids.

Yeah, there are.

And you know, it's interesting.

We're talking about protein. And as I mentioned before, we simplified in the way that we talk about it is it's one thing,

but it's 20 different amino acids.

These amino acids each have unique metabolic roles in the body.

It's not interchangeable.

For example, the essential amino acid, I will just pick a brain one, a triptychone, for

serotonin production,

or three ining for mucin production in the gut,

which helps the gut lining,

or take your pick, phenylalanine.

These, all of these essential amino acids

do various things in the body.

For skeletal muscle, the primary essential amino acid is loosing.

And while, again, it is very complex in the way

that we would think about how do we eat enough lice in,

or how do we eat enough methionine.

It's not a great way to think about it

because then things become very complex.

And someone is like, well, what do I do?

But if you eat for the needs of skeletal muscle health,

everything else falls into place. My mom is 79 years old.

She's relatively lean.

By my read, I haven't seen her dexa results,

but she's probably had some muscular atrophy.

She does yoga, she walks, she gardens,

and seems to be in good health.

I think goodness.

My guess is she's lost a muscle in the last decades.

If she were to increase the amount of quality protein

that she eats, especially in that first meal of the day,

would the health of her muscle and her muscle mass change,

even if she does no resistance exercise.

I'm gonna suppose she gets a little bit of resistance training from the yoga, but I haven't

been doing yoga class with my mom.

You guys aren't doing headstands?

Definitely not doing headstands.

She's actually, you know, she's very mobile and very sharp and I'm very by the issues.

But I don't think she's doing the more advanced inversion things that yoga.

So let's assume that she's doing some moderate exercise three, three, four times a week,

but not training with weights.

If somebody like her or a younger male that has a similar pattern of behavior, you know,

desk worker for the most part, jogs a little bit, gets on the, on the,

recumb in bike or whatever it is.

But is not doing resistance training. Increases their quality protein and take throughout the day.

And especially at that first meal,

ensuring at least 30 and up to 50 grams of intake,

what changes are likely to happen

even without resistance exercise?

Well, the first thing is that if she is eating a sub- amount of protein,

let's say she's eating the RD of protein and the average woman eats around 68 grams of protein a day.

40% of women over the age of 60 are deficient in protein. They're eating

below the RDA. And what's happening to their body? Is their body robbing their

existing skeletal muscle of amino acids in order to supply what the brain and

other organs need? In part, in part, one of the things that happens with aging is the body, the whole body protein

turnover becomes less efficient.

So the body is turning over roughly 300 grams of protein a day.

That's a lot of protein.

It is a lot of turnover.

300 grams of protein a lot. It is a lot of turnover. It is a lot of turnover. 300 grams of protein of turnover.

Yes.

And muscle only accounts for maybe 25% of turnover.

An individual might eat an average female.

Like your mom is eating probably around 68 grams of protein a day.

Yeah, from luck.

She's not big on beef or chicken.

And listen.

She eggs in a little bit of fish and lots of vegetables and fruits.

But maintains again like a healthy lean body weight. And that is wonderful because so she's balancing

her lower protein intake with physical activity. Remember there are two main ways to stimulate

skeletal muscle and that's through resistance training, which one would argue she is doing

and or dietary protein. But when we think about muscle protein synthesis,

there's really four inputs.

There's resistance training, there's energy,

there's insulin, growth hormones, and then there's loosen.

When you are younger, your body is driven

by more of the animal hormones, which is one reason

why we believe that a younger individual can get away with

five to 10 grams to 15 grams of dietary protein.

Because their levels of testosterone and or estrogen are driving proteins synthesis in

a way that lets them offset any dietary deficiency.

Well, that their bodies just highly anabolic.

They're growing.

They're growing up.

They're growing, they're growing up, they're growing. When an individual like your mom who's now stopped growing, the body becomes much more

reliant on losing and resistance training because the main pathway that these things go

towards is something called M. Tour. Memorial and Target of Rapamizing. The influence on

those pathways changes as we age. So the lever in which you pull changes.

And the importance of that lever changes.

So the best thing that your mom could do

to maintain skeletal muscle.

So why?

And what happens to skeletal muscle as we age?

Skeletal muscle if it is not contracted

and utilized gets this fat infiltration,

mitochondria changes, protein turnover changes.

It becomes less efficient at sensing amino acids.

There's a decrease in capillary profusion,

which is why one reason why exercise is so important.

In order for her skeletal muscle to respond

like a younger muscle,

what she should do is do some kind of resistance training

and then add in some kind of dietary protein.

Because when we think about the protein hierarchy,

the amount of protein in a 24-hour period matters the most.

Protein hierarchy, again, closer to one gram per pound,

ideal body weight, the evidence would say 1.6 grams per kg.

I'll never forget when the protein study came out.

I can't believe I've been out of fellowship that long, when the ProDage study came out.

I can't believe I've been out of fellowship that long, but the ProDage study was a

position paper, and it talked about how the current recommendation for dietary

protein is too low, and that to support how the aging you need 2.5 grams of