Protein Myths Busted: DO THIS, Do Muscle & Are residing Longer | Dr. Gabrielle Lyon & Dr. Steven Gundry


Protein Myths Busted: DO THIS, Do Muscle & Are residing Longer | Dr. Gabrielle Lyon & Dr. Steven Gundry

(bright music) – So most of us have an ahamoment that got us started. What was your aha momentthat guided your book? – Yeah, actually I did have an aha moment and this was during mygeriatric fellowship. So I did a fellowship in geriatrics and nutritional sciencesin Washington University. So part of the deal was in order for me to do advanced nutritional sciences,.

I had to do a fellowship,a medical fellowship. And the medical fellowship that I had to do was in geriatrics. For those listeners or viewerswho don't know what that is, that is specializing inindividuals over the age of 65. And geriatrics, they dealwith falls, musculature, memory, Alzheimer's, diabetes, et cetera. You name it, Dr. Gundry, you're very well aware of the conditions.

That a geriatricianwould be challenged with. In the mornings and in the evenings, I was doing metabolic research, muscle biopsies, fat biopsies, and cardiovascular testingas well as brain imaging. And this one participantchanged everything for me. We'll just call her Betty. She was a mom of three in her mid 50s, and always cycled with the same 20 pounds.

She did exactly what the medical community was telling her to do, whichwas exercise more and eat less. And in the process, she lost weight. But over the years, shedestroyed her metabolism. She destroyed her skeletal muscle and really impacted her brain because of her metabolic dysregulation. So when we imaged her brain, her brain looked like thebeginning of an Alzheimer's brain.

I felt really responsible,even though again, she hadn't been my patient,she was a study participant. But it was at that moment that I realized that we had been chasing the wrong tissue. It's not about fat, itwasn't about obesity. And I started to think whatwere some of the things that all my patients had in common, whether they were in the nursing home, whether they were in the dementia unit.

And it wasn't that they were over fat. It was the unifying factor was that they all had unhealthy skeletal muscle and that was wheremuscle-centric medicine was born. – So take us through that. Sarcopenia is the fancy word for a loss of muscle as we get older. And certainly, we see that extensively in not only our older patients,.

But certainly many quote,”seemingly healthy people,” who are over fat or obese arestruck when, for instance, we get a CAT scan for some other reason. And they have thighs that were just as big as they were when theywere in high school, but their thighs now aremostly fat rather than muscle, whereas when they were in high school, the odds are that it wasmostly muscle and not much fat. But their circumference was the same,.

So they're oblivious to the fact that their external size may be the same, but it's totally different internally. – Yeah, that's what we thinkabout sarcopenic obesity. And it really is that theweight remains the same, but the body composition changes. And one of the thingsthat we have to recognize is that although sarcopenia,which is exactly what you said, it's the loss of skeletal muscle mass,.

Which is size andfunction and/or strength, is typically thought aboutas a disease of aging, whether you are in your 50s or 60s, 70s, this is when skeletalmuscle would decline. I would argue that sarcopeniaand obesogenic sarcopenia also begin in your 30s, just as Alzheimer'scardiovascular disease, insulin resistance, which probably begins well beyond your 30s, that thediseases that we think about.

With aging and metabolicdysfunction are in fact related, if not in part due to skeletalmuscle changes in your 30s. – All right, I think you and I both agree that muscle health is absolutelyessential for longevity and that it has everythingto do with metabolic health. So, as I've written and you've written, muscles are metabolic organs. So tell us about your researchon this metabolic organ, the muscle that we've neglected.

– Yeah, skeletal muscleis quite fascinating. And I was so fortunate to train with one of the world leading experts in protein and skeletal muscle metabolism. He's an individual by thename of Dr. Donald Layman, Professor Emeritus at theUniversity of Illinois. And all of the protein and muscle research that we see now really stemmed in part from much of his workthat was in the '80s.

He really started to understandthat the amount of protein that we have really stimulates the health of skeletal muscle. And we have to ask ourselves,why skeletal muscle? Why is skeletal muscle so important? Number one, based on thepercentage of body weight, it makes up 40% of our body weight. Sheer mass alone, it is thelargest endocrine organ. Yes, endocrine organ in the body.

Skeletal muscle's also the primary site for glucose disposal, meaning the carbohydrates that you eat, skeletal muscle is theprimary place that it goes. Skeletal muscle is alsoan amino acid reservoir for when someone, not ifbut when they get injured, because the reality is injured or sick, whether it's the flu, et cetera, something at some point is going to happen.

Where you will be in ahighly catabolic state, where your metabolism is kicked up due to infection or inflammation. Skeletal muscle is the primary reservoir for the body protective compounds. Skeletal muscle is also criticalfor fatty acid oxidation. People care about cholesterol. But skeletal muscle atrest is the primary site for fatty acid oxidation,making it important.

As it relates to, again, fats and lipids and cholesterols in your body. And another importantpoint about skeletal muscle is that it's an immune regulator. The organ system, when youcontract skeletal muscle, skeletal muscle secretes mykines and mykines influence andinterface with the immune system to help balance out other kindsof inflammatory processes. And then of course, theother side to skeletal muscle.

Is how it responds to dietary protein, which I'm sure that we're gonna talk about the thermic effect of feedingand the actual influence that skeletal muscle mass has on our baseline metabolic rate. – This actually is agood spot to talk about, what do you think aboutthe current GLP-1 agonists that are sweeping thecountry and your thoughts on skeletal muscle and these compounds?.

– It's a great topic of conversation and I'm sure that you've spokenabout this quite frequently about GLP-1 agonists and GIP-1 agonists. So Ozempic has gottenquite a lot of press, which is Semaglutide. And quite recently, peoplehave been talking about how the use Ozempic orSemaglutide or these GLP-1s have been negativelyimpacting skeletal muscle. I've actually looked into this data.

To see what is the mechanism of action and I have not found any. I believe that the use of these agents with the decrease in overall food intake and the decrease in protein intake without sufficient trainingis actually what is leading to skeletal muscle mass loss. Because I'll tell you this, Dr. Gundry, we use these agents all thetime in our clinical practice.

So I have a clinical practice,we use the combination agents and we track their bodycomposition and muscle mass. With a protein forward diet and sufficient resistance training, all of our patients are able to maintain skeletal muscle mass. – That would seem to bethe exception to the rule and thank you for maximizing exercise and protein consumption in these folks.

What I see, unfortunately in my patients, and I've actually neverwillingly prescribed these drugs, but my patients who havebeen placed on them, by well-meaning physicians,their insulin levels go up, which is one of the actions of the drug, which to me is a bad thing. But their skeletal muscle mass, their weakness is impressive. And my patients noticethe loss of their muscles.

And literally to a person. And they bring it up to me,not the other way around. And certainly, there are somestudies, not all of them, that muscle mass is aconsequence of long-term use. – Yeah, the unfortunate partabout some of those studies is they haven't controlledfor diet or exercise. – Correct.- And as I can see in clinical practice, Ido see the maintenance and I've seen all theirblood markers improve,.

Including insulin as well as skeletal muscle mass maintenance. So I think in part, is it thedosing that is being used? Is it the dosing? Is it the training? Is it the nutrition plan? And I'll tell yousomething else that I think is also surprising is thesemedications are spoken about as if someone can never come off of them. In my clinical practice,we are able to help.

Really make metabolic change and then take individualsoff these medications. It is not something thatwe foresee individuals having to stay on indefinitely. – That's encouraging because as you know, a paper just came out this week, placebo controlled trialwith using these medications for six months and then changing over with a diet and exercise program,.

One group continued on the active drug, the other group got a placebo shot. The placebo group unfortunately gained 50% of their weight back in three months, despite a diet and exercise program. And that's hot off the press this week. So it worries me to say the least. Okay, we're down to the brass tacks. Obviously, protein isnecessary to build muscle mass,.

But I think probably thanksto Dr. Atkins way back when, people were under, I think,the mistaken impression that, “The more protein I eat, the more muscles I will grow.” What say you? – (chuckles) We know that that's not true. The only time that you'regoing to put on muscle mass with consuming more proteinwould be if you were actually under-consuming proteinin the first place.

You cannot… And I think that youmake a really good point. You cannot simply eat proteinand put on muscle mass. Skeletal muscle is a very dynamic tissue. It requires adaptation,it requires stimulus, and of course it requires dietary protein. But I will also say thatfrom my understanding, the Atkins diet was notconsidered a high protein diet, which I think we should define.

I think it was more of a higher fat diet where a protein percentagefrom a percentage of calories may have been 20, was it maybe 20%? – Well, the original Atkin'sdiet was a high fat diet, but he got into so much trouble with the American Medical Association that he morphed intoa high-protein doctor. And I've argued in my books, 'cause I knew his co-author very well.

When he morphed to a high-protein doctor, that's when his weight began going up. Now he was, I think thelast person to say he was into fitness and exercise. So I think that's a big part. But one of the things that Ithink you and I would agree on is that we have no storagesystem for excess protein, but we do not waste calories. And so, we will convert protein.

Via gluconeogenesis into sugar. And we have a storage systemfor sugar. It's called fat. Have argued in my books thatthat's one of the reasons Atkins did die a fat man. – Hmm. – So, but tell us about your protocol to prevent that fromhappening, the LION protocol. – Yeah, I think thatmetabolism is very complicated and when we think about dietary protein,.

We have to think aboutin the overall picture what would be considered high protein. So the current recommendationis 0.6 grams per kg. I'm sorry, 0.8 grams per kilogram, which is the minimum toprevent deficiencies. And for those that use pounds, that's 0.37 grams perpound of body weight. So for example, if youare a 115 pound female, then the recommended dietary allowance.

Would be 45 grams of dietary protein. Now, what we do know is that that is not sufficientto protect against aging. There's many things thathappen with skeletal muscle as it relates to being ableto maintain protein turnover. The body turns over around 250 to 300 grams of protein a day. And that system and that process becomes more challenged as we get older.

That is why increasingdietary protein above the RDA has been shown in nearly everystudy that 0.8 grams per kg, those individuals thatincreased to 1.2 grams per kg fair significantly betterfrom a blood sugar regulation, from triglycerides, fromblood pressure, from insulin. You know, the dietaryprotein as we increase it, can have really important benefits. And you mentioned about gluconeogenesis. I agree with you.

It is a substrate driven process, is what you were saying isthat for every a hundred grams of dietary protein you mightconvert 60 grams to glucose. The question becomes ishow fast is that conversion and the process and time that it were to take for that to happen. And then the otherthought process behind it is when you improve dietary protein and you get the numbers right,.

You actually stimulate thehealth of skeletal muscle. And that becomes reallyimportant, especially as you age. I didn't know Atkins,but I would fair to say that his total calorie consumption was probably way too high. – Yeah, I think we wouldboth agree with that. He actually was one of the first people to talk about and recognizethat one of the benefits, and I wrote about this actuallyin my first book years ago,.

That protein is very thermogenicin that we literally, we can argue about how much, wastes 30% of the calories and protein in the process of digesting protein into absorbable amino acids. And it clearly does havea thermogenic effect. And he was one of the first to propose that if you were going tochoose a macronutrient, that you might as well choose.

The thermogenic effect ofprotein for that benefit. Controversial subject in its own right, in that mTOR is a sensingmolecule of protein availability and that there are a classof drugs like Rapamycin that suppresses mTOR. And I certainly come from the field of, I think expressing mTORis a wonderful thing the older we get. And you would probably argue that mTOR.

Would be a really greatthing the older we get. And yet, when I look at my superold patients, 95 and above, and I have a big practicein the super old, these people run insulin-likegrowth factor levels, IGF-1s, quite low, in fact remarkably low. And most of us useinsulin-like growth factor 1 as a stand-in, as a measurable stand-in for mTOR activation. So one of the things thatI keep coming back to.

Is the Italian cyclist study, which you're probably aware of, where they took Italian cyclists, put them on a trainingtable for three months where everyone had the exactsame amount of calories and had the exact same training program. And one group ate in a 12 hour window. They had breakfast at eighto'clock, lunch at one, and they had to finishdinner at eight o'clock.

The other group had to eatthe same number of calories but had breakfast at oneo'clock in the afternoon, lunch at four o'clock and then had to finish dinner at eight. And the people, they bothhad the same muscle mass at the end of the period. The cyclists who had theseven hour eating window lost weight, the other group didn't. And the cyclist in theseven hour eating window.

Plummeted their IGF-1, whereasthe other group was the same. And I use that to justifytime restricted eating and the benefits of that. So, they're eating thesame amount of protein, and they both have the same muscle mass, but one has a lot lowerIGF than the other. – Yeah, I think youbring up a a great point. When we think about mTOR, which is mechanistic Target of Rapamycin,.

We have to recognizethat it's in all tissues. It's in the brain, it's in the pancreas, it's in the kidneys, it's in the liver. And mTOR is sensitiveto different influences depending on where it is in the tissue. So for example, mTOR in liver may be exquisitely moresensitive to insulin or overall calorie burdenfrom carbohydrates. Same with the pancreas,.

Versus mTOR and skeletal muscle is exquisitely sensitiveto protein, leucine. In fact, that's nearly the only place. So, while I think that we can both agree that mTOR stimulation over aperiod of time is not ideal. The worst of all worlds would be to eat a high carbohydrate diet, small amount, over the entire day andcontinuously stimulate mTOR. I think that that is a terrible idea.

Quite frankly, probably one of the worst. Where I think– We agree. (both laugh) – And where I think mTOR isvery beneficial and necessary is in skeletal muscleand in very discreet ways of stimulating it andthen allowing it to reset. So for example, exerciseand resistance training also stimulates mTOR. It stimulates mTOR in skeletal muscle,.

So we can't say, well, stimulating mTOR in all tissues is bad becausethat would be the same as saying exercise is bad. And we clearly know that that's not true. So I think we can frame the conversation that mTOR is stimulated byvarious different mechanisms in various different tissues. And the worst of all worldsis to continuously stimulate this mechanistic Target of Rapamycin.

Because it is a growth promoter over time. Where stimulating mTOR is very necessary is through skeletal muscle,through dietary protein, which has an on and offswitch, and exercise. So I think that we can think about it in this kind of whole picture, which leads me to time-restricted feeding. I think that there isgreat benefit for that. I do not think that we should be feeding.

At all times, continuously. Time-restricted feeding, weinitiate that in our practice. I think that it is verybeneficial for gut rest, for calorie control, and quite frankly, for some of the mechanismsthat you're talking about, turning on mTOR and then allowingit to reset and turn off. So, surprisingly we'renot in disagreement. – Great.- And not at all. – Now you mentionedsomething I think, just now,.

That I think is really important that in my new book, “GutCheck”, I make a strong case and it's good to hear you say it. The gut needs periods ofrest to repair itself. And we, in our current American diet, like Satchidananda has shown, Americans eat 16 hours aday nearly continuously. And that repair processis really important. I suspect…

Well, although I thinkwe'll talk about this, I'm a big fan of Valter Longo's work from the USC Longevity Center. And as you probably know, Valteris a low protein proponent. – 0.3 grams per kg. So he recommends below the RDA. – Correct, he believesand the data support him, that as we get older, let'ssay across 65 years of age as a threshold, ourprotein needs increase.

And I think even he will admit that. Now I've argued with him, andI'll show you where I'm going, that the reason our protein needs increase is because we have damaged the absorptive surface of our gut wall. And in my patient population,most of the people that I operate on for heartdisease back in the day, had low albumins and low total proteins. And this was a view…

This was, you know, these people were old. They were sarcopenic, blah, blah, blah. Makes sense. Interestingly enough, whenI put them on my program of removing major dietary lectins, and actually reducing animal protein, their albumins and theirtotal proteins rose. Almost… Just, you wouldn't believe it.

But I have come to the belief, and I've been doing this for 25 years now, that much of our problem with protein is we have damaged the wall of our gut so that a lot of the protein we eat is not available for proper absorption. Any thoughts on that? – Yeah, first of all, we can't discount your decades of experience and practice.

I know I certainly see things that seem amazing in my own practice. So I think that it'sjust very fascinating. And we do know that there is changes in gastrointestinal health and splanchnic extraction of nutrients. So again, could it besomewhere or something that could be used cyclically? If you are certainly seeingthis kind of improvement.

With somewhat of a protein restriction, I mean, I think it's unusual. But again, it soundsas if there are things related to gut lining and gut integrity. You know, the one thing that I think about is that for example, threonineis an essential amino acid, that we have to get from the diet that is important for mucin production. And without it, and when protein is low,.

We don't utilize protein to rebuild and repair gut lining, et cetera. So, from a mechanistic standpoint, I don't necessarily understand why, but I certainly can appreciate that dietary protein absorption as we age becomes much more challenging. So would it be a way inwhich it would be cyclical, that if you are removingsomething that is irritating.

To the gut lining, allowing it to heal? But I think it's very interesting. – Yeah, and the reason I bring it up is I think your concept of gutrest is a really good idea, 'cause it does allow for repair. You know, all the longevitystudies with C. elegans has certainly convinced me that death begins as the gut wall becomes porous. And the more porous it becomes,.

The more death approaches more rapidly. – And these are newer studies,maybe a few years old. And what they've found thatthere are a certain percentage of the population that may potentially be able to use the gut microbiome to extract essential amino acids. – Oh, yeah. – This was out of Don Layman and Suzanne Decoda at Cedar-Sinai,.

Who worked on some of thesestudies where that they saw that certain populations may be able to, their own gut microbiomemay be able to generate essential amino acids.- Correct. – Which would somewhat go to your concept of if we remove dietary proteinor is there a possibility of a cyclical protein ingestion, then perhaps the body hasmechanisms to make up for this in a window of time, whetherit's four or six weeks.

I think it's very fascinating. – Yeah, and to complete that circle, I've written in previousbooks and in “Gut Check”, that exercise actually promotesa different gut microbiome that becomes efficientat producing amino acids and extracting amino acids. So there's another goodreason to exercise. – Yeah, I have to tell you. My book, “Forever Strong”,which hit the New York Times…

It was an instant NewYork Times Bestseller as a first time author, which is pretty- – Congratulations. – Which is a pretty big deal. It outsold “Atomic Habits”and Arnold Schwartzenegger, its first week, whichis just extraordinary. I hadn't anticipated that. And really, the concept is that muscle is the organ of longevity.

And that skeletal musclehas really been underserved. We've always focused on obesity and we've always focused on fat, but we've gotten the tissue wrong. We've gotten the question wrong. It's really a midlife muscle crisis. And if you talk about agingand you talk about gut health like you do in your book, “Gut Check”, and if that is in fact thebeginning of illness and disease,.

Then the things that we can do early on, like taking care of thehealth and wellbeing of our skeletal muscle, can change the trajectory of our aging. Because if skeletal muscleis at the focal point of metabolism, of guthealth, of immune health, of our body armor, of our mobility, then it truly stands to reason that muscle is at the pinnacleof health and wellness.

And not just as it relatesto looking good in a bikini or having power and strength. Like all of that iswonderful, but certainly, a byproduct of a much moreimportant conversation, which is focusing on resistancetraining and dietary protein because food is somethingthat 100% of people do. And really dialing it in. You know, it's interesting 'cause I think that wehave different approaches.

On nutrition and I bet you both of them could be used in conjunctionin a cyclical manner. My protein recommendation is one gram per pound ideal body weight, which is on the higher end. Again, it's would be considereda higher protein diet. And that is to protectskeletal muscle as we age, and of course body composition, et cetera. And I bet you, there's a wayin which both of our programs.

And plans work in conjunction because of what is the targetat any one point in time. – Let me ask you, sincea couple weeks ago, I got to a debate a vegan cardiologist. – I only know one. I know who it is. She's very sweet. I'm sure, anyway. – Well you may not know her. She's from the West Coast.

Anyhow, do you care in your book, or do you care where your patients get their dietary protein from? – Yes, I've been studyingthis for 20 years. I've studied under one of theworld leading protein experts. I have trained seven yearsin nutritional sciences and done a fellowshipat Washington University in nutritional sciences. – Which is a great place, by the way.

– Yes, and the evidencesupports that it does matter where your protein comes from. And I think that when we look at plant versus animal proteins,the profile of amino acids defines whether something isconsidered a high protein, a high quality proteinversus a low quality protein. It is hard, fast biological numbers that are not up for debate. A high quality protein is something.

That has a robust profileof the essential amino acids that mimic what is needed in a human. For example, a lean cutof beef or fish or chicken has an amino acid profile thatmatches the needs of a human. A plant-based protein hasthe amino acid profile necessary for plants or matches plants. If we were to take it one step further, we don't eat for protein, we eat for the essential amino acids.

And it is a much bigger conversation than just the dietary protein. But we'll start there. So if someone were to say, “I am going to get all of myprotein from plant sources.” Dr. Gundry, you and I both could agree that we would look at a chicken breast and we would look at a plateof broccoli or peanut butter and say, “These two are not the same.

They are not the same in structure, they are not the same in nutrient value. They are clearly not the same.” And when you look atthe amount of chicken, so for one ounce of a chicken breast, in order to get those same amino acids… Which what we talked about was leucine. We talked earlier in thisconversation that you require two and a half grams ofleucine to stimulate muscle.

In order to get the appropriateamount of amino acids to equal that one small chicken breast, you would require six cups of quinoa and over a thousand calories and hundreds of grams of carbohydrates. If you were to do it from edamame, you might require an entirecup or two of edamame. You would be requiredto eat 35% more calories from that plant-based protein source.

To meet the amino acid needs. That is metabolicallydevastating for people. And that's just the dietary protein. The point that we talkabout these equivalents, this one ounce equivalent. So for example, a one ounceequivalent of dietary beef. So a one beef ounce equivalent, and you take a one ounceequivalent of peanut butter. Peanut butter might have 1.5%of the essential amino acids,.

Whereas the one ounceequivalent of dietary meat has an exponential amount ofthese essential amino acids. So these proteins are clearly not equal. And there's a digestibility aspect. A recent paper out of Luke Van Loon's, one of the first papersof its kind came out. And Luke van Loon, who's aprotein researcher, muscle guy, one of the best in the business, looked at two meals that were isocaloric.

And had the same amount of protein. One was a beef based meal thathad carbohydrates, et cetera. Everything was equal. Each had around 40 grams of protein. The other was a chickpea vegan meal. And what they found wasthe plant-based meal never reached the peak amino acids in the blood to stimulate muscle. And this was looking at women, 75.

And they did a crossover design study, so each group did both the same. It was a very well-designed study. And I caution individualswho think that they can get all of their proteinfrom plant-based sources because they're not the same. They're not the same in digestibility. They don't trigger muscleprotein synthesis the same, especially as you age.

Especially Dr. Gundry,if you have gut issues, where exactly what you were saying, where you're not absorbing it. And I think that it's a real problem when we tell our aging populationto go more plant-based. Now, we also have to think about what about iron, zinc,selenium, creatine, and serine. The amount of nutrientsin an animal-based source is really, really important.

It has essential nutrients thatyou cannot get from plants. And as a trained geriatrician, I can't think of worse adviceto give someone as they age. – Well, as my audience knows, the good news is I wouldnever recommend a human being eating peanut butter,chickpeas, quinoa, or edamame. So we agree on that completely. (laughs) I hope you enjoyed this episodeof the Dr. Gundry podcast. Make sure to check out the next one here.

One packet of Splenda kills off 50% of your microbiome, one packet. Imagine doing that severaltimes a day like I used to do. No wonder I was sick all the time.

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3 thoughts on “Protein Myths Busted: DO THIS, Do Muscle & Are residing Longer | Dr. Gabrielle Lyon & Dr. Steven Gundry

  1. I’m 65 years feeble, on no medications, and had been on the carnivore diet for the final 6 months. Cellulite gone, vitality very supreme pores and skin improved, gout in tremendous toe gone, arthritis most nice 10% of what it ancient to be. No sugar, no bread, rice no fruit, no greens….most nice animal products mainly meat. I don’t even crave any of the diversified the diversified stuff. I feel tremendous doing what I’m doing.

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