00:00:00If we can correct our nutrition
00:00:02and we gear it towards skeletal muscle health,
00:00:04then we can change the trajectory of aging.
00:00:06There's only two main ways
00:00:07that we can stimulate skeletal muscle,
00:00:09exercise and dietary protein.
00:00:11We talk about lifespan.
00:00:12There's also muscle span.
00:00:14Being sedentary is not the opposite of activity.
00:00:16Being sedentary is a disease state in and of itself.
00:00:19Period, end of story.
00:00:20When we increase our dietary protein,
00:00:22skeletal muscle will mount a youthful response
00:00:25because skeletal muscle requires dietary protein.
00:00:30When we think about how we design a diet,
00:00:33we have to recognize a handful of things.
00:00:35Number one, these essential amino acids,
00:00:37primarily leucine, is necessary
00:00:39to trigger muscle protein synthesis.
00:00:40Number two, that aging impairs the efficiency
00:00:44of muscle protein synthesis.
00:00:45I see. So it's a runaway train.
00:00:46If you start getting sarcopenia,
00:00:48if there's obesity and other markers of aging,
00:00:50you're losing muscle quality,
00:00:52AKA protein synthesis and other things.
00:00:53And as a consequence,
00:00:54it makes it harder to increase muscle quality.
00:00:57So you have to short circuit this pretty early.
00:00:59Yes. And I would even say
00:01:01that we talk about sarcopenia as a disease of aging,
00:01:04but I think that there is a youthful phenotype of sarcopenia.
00:01:07If we define sarcopenia as decreased muscle mass and strength,
00:01:11that can easily affect our youth.
00:01:13You know, we talk about health span.
00:01:15We talk about lifespan.
00:01:16There's also muscle span.
00:01:18And muscle span is this concept
00:01:20that is really about the skeletal muscle health as we age.
00:01:24And there's three primary components to that.
00:01:27That's understanding that skeletal muscle health
00:01:30begins very early on.
00:01:31And we're going to talk about,
00:01:33'cause I know that there's parents, I have two little kids.
00:01:35So I want to talk about the amount of protein
00:01:37necessary for children, of course.
00:01:39And then as we think about this muscle span,
00:01:42there is early on, early age,
00:01:44where you're laying down in the foundation,
00:01:46where you're hopefully training, doing exercise,
00:01:49just doing movement.
00:01:50Being sedentary is a disease state in and of itself.
00:01:53Period, end of story.
00:01:54Being sedentary is not the opposite of activity.
00:01:57Being sedentary is in and of itself,
00:01:59a disease zone of inactivity.
00:02:01Then midlife, we have to maintain the tissue.
00:02:04We get a peak muscle mass in our thirties.
00:02:07We get a peak bone mass around the same time.
00:02:10And then that later half of life,
00:02:13we have to do everything that we can to maintain that tissue
00:02:16because of this decrease in efficiency of skeletal muscle.
00:02:19So skeletal muscle as a nutrient sensing organ
00:02:22can respond like youthful tissue.
00:02:24And the way that it responds like youthful tissue
00:02:27from an amino acid perspective,
00:02:30just thinking about how we eat to maintain that,
00:02:33is that when we increase our dietary protein,
00:02:35so older individuals or individuals as they age
00:02:38require more protein to then stimulate mTOR.
00:02:41- So does that mean instead of eating 30 grams of protein
00:02:44per meal minimum, that people older than say 50, 60,
00:02:49should eat 40 or 50 grams of protein?
00:02:51- I would say that that's true.
00:02:53- Interesting.
00:02:54- And by the way,
00:02:55skeletal muscle will mount a youthful response.
00:02:58There's a, you know, this was,
00:03:00the initial work was out of Bob Wolf's lab.
00:03:03He's an icon in the industry of protein.
00:03:06He's one of the, can I say grandfathers now?
00:03:09Bob Wolf and Don Lehman and these guys, you know,
00:03:12I trained with Dr. Donald Lehman, you know,
00:03:14these initial studies that we think about
00:03:17and we take for granted dietary protein.
00:03:19We think, okay, well, the bros have always known this,
00:03:22but we have not.
00:03:25And when you are younger,
00:03:27there is a somewhat of a linear response.
00:03:30Let's say a younger individual still growing.
00:03:34We'll just call them 10, 12 years old or my children.
00:03:38I have a three and a four and a half year old.
00:03:40They will respond with five grams of dietary protein,
00:03:4310 grams of dietary protein, 15 grams of dietary protein
00:03:46versus an older individual will not respond at all to that.
00:03:50However, that response can be augmented
00:03:55by increasing the dietary protein at that meal.
00:03:58So an older individual will respond like a younger individual
00:04:03by 30 grams of protein, 30 to 50.
00:04:07- Later, we're going to talk about supplements,
00:04:09but I'm very curious.
00:04:10Is there a place for supplementing leucine
00:04:13and other branched chain amino acids specifically?
00:04:15You know, I always assume that supplementing
00:04:18with branched chain amino acids
00:04:19was kind of the unique domain of people post-exercise
00:04:23trying to build more muscle.
00:04:24But as you're telling me all this,
00:04:25it seems that adding leucine in powder form to a meal
00:04:30seems like it would be great for muscle health.
00:04:33Is that true?
00:04:33- I would say that we do not add leucine alone
00:04:36because leucine, isoleucine and valine go hand in hand.
00:04:41It would not be advisable to add a single amino acid.
00:04:45The amino acid levels are maintained in the blood.
00:04:48By adding more of one would have effects on the other.
00:04:52The way in which I would think about
00:04:54supplementing essential amino acids and or branched chains
00:04:58would be if an individual is choosing
00:05:00to have a lower protein meal.
00:05:02I remember when I was in residency,
00:05:04the food choices were not very good.
00:05:06And maybe I had two ounces of fish,
00:05:08which wasn't enough to bring me up to a threshold.
00:05:10That would be a place that I would add
00:05:12in branched chain amino acids or essential amino acids.
00:05:15That would bring someone's amino acid threshold up.
00:05:19But we have to understand everything that we're doing,
00:05:22we should be doing with a purpose.
00:05:23The idea of just sipping on branched chain amino acids
00:05:27or just adding amino acids would be the equivalent
00:05:30of putting a key into a car and trying to turn the car on,
00:05:35but not having any additional substrate.
00:05:38So you need the full spectrum of all the amino acids
00:05:42to affect skeletal muscle health.
00:05:44- Well, that's reassuring to hear
00:05:46because I love the taste of scrambled eggs and steaks
00:05:49and I also like tuna and I also like chicken
00:05:51and I love all those things.
00:05:54And I have to imagine that as you mentioned before,
00:05:55there are other things in these quality animal proteins,
00:05:59like you mentioned selenium,
00:06:01you mentioned other perhaps essential fatty acids
00:06:04and other vitamins that perhaps have something to do
00:06:08with what the animal ingested during its life
00:06:11that also benefit muscle.
00:06:13Is that true?
00:06:13- It is and the big standout to me is creatine.
00:06:16We know that creatine at five grams of creatine
00:06:20will affect skeletal muscle,
00:06:22but 12 grams of creatine affects brain health.
00:06:25And there's a lot of interesting research coming out
00:06:27on creatine and brain health.
00:06:30- Can you remind me the rough amounts of creatine and say,
00:06:35you mentioned, let's just, I mean,
00:06:37I must say a four and a half ounce steak
00:06:39feels rather paltry to me.
00:06:41That's probably the size of it, yeah.
00:06:43- Which is a huge meal to me.
00:06:44- Right, so let's say a six ounce, let's be generous,
00:06:46a six ounce steak or four scrambled eggs.
00:06:49I mean, how much creatine are we talking?
00:06:51Eggs don't have much creatine, right?
00:06:52- Not much and I was just recently looking at this,
00:06:56the amount of creatine in a pound of steak
00:06:59you're gonna cringe is something like two grams.
00:07:02- So it's not very much.
00:07:03- It's not very much.
00:07:04But when we think about eating foods as in a food matrix,
00:07:08what you're saying is absolutely true there.
00:07:10It's interesting, we don't eat single nutrients.
00:07:13While we think about dietary protein as a single nutrient
00:07:16and we think about carbohydrates,
00:07:17but what we really do is we eat mixed meals.
00:07:19When we think about that,
00:07:21the quality of the protein matters.
00:07:23From a protein perspective,
00:07:25could you get plant-based proteins and animal-based proteins
00:07:28and could it be equal?
00:07:29Yes, it could.
00:07:29So I wanna be very clear to say
00:07:31and have a very balanced perspective
00:07:33that we could get all of our dietary protein from plants,
00:07:38from plant-based sources.
00:07:39A few caveats there is that that RDA that I gave you earlier
00:07:43is based only on high quality proteins
00:07:45and that being the minimum to prevent a deficiency.
00:07:48If an individual was plant-based,
00:07:49they would require closer to 1.6 grams per kg,
00:07:53a higher amount of total protein if it's coming from plants.
00:07:56That becomes important to understand.
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