Jeffrey Moss, DDS, CNS, DACBN, founder of Moss Nutrition, joins Dr. Ruscio for this episode to tackle the topics of muscle mass, protein intake and aging.
The importance of muscle…..8:29
Gut health, blood sugar regulation and muscle mass…..15:12
Simple ways to determine muscle mass and functionality…..17:07
Muscle fibers and aging…..22:02
Insulin and muscle mass…..27:52
Optimal protein requirements and calculation…..33:10
Protein Intake Calculations
Classic – 0.8g of protein for every 1kg (2.2lbs) of body weight
Contemporary – 1.2 to 1.5g of protein for every 1kg (2.2lbs) of body weight – needs increase with age and illness
Protein and leucine supplementation…..42:37
- (27:52) Paper reviewing strategies to combat anabolic resistance http://www.ncbi.nlm.nih.gov/pubmed/21975196
- (43:26) Dr. Ruscio’s protein recommended protein powders:
- Whey protein https://dr-michael-ruscio.myshopify.com/products/pure-whey-choc-sfh
- Pea protein https://dr-michael-ruscio.myshopify.com/products/pea-protein-dutch-chocolate-2lbs
- Leucine https://dr-michael-ruscio.myshopify.com/products/leucine-powder
- Ruscio article on exercise, nutrition and hormones https://drruscio.com/getting-the-metabolic-edge/
Right click on link and ‘Save As’
Dr. Jeff Moss Ideal Protein Intake for Body Comp Longevity
Welcome to Dr. Ruscio Radio, discussing the cutting edge of health, nutrition, and functional medicine. To make sure you’re up today on this and other important topics, visit DrRuscio.com and sign up to receive weekly updates. That’s D-R-R-U-S-C-I-O.com.
The following discussion is for educational purposes only, and is not intended to diagnose or treat any disease. Please do not apply any of this information without first speaking to your doctor.
Now, let’s head to the show!
Dr. Michael Ruscio: Hey, folks. This is Dr. Ruscio. Welcome to Dr. Ruscio Radio. I am here with one of my good friends, and I guess I could say, in part, a mentor to me over the years, Dr. Jeffery Moss. Hey, Jeff, thanks for being here.
Jeff Moss: Thanks so much for having me.
DR: You are very welcome, and we are very happy to have you here. This is your first podcast ever, right?
JM: It is my inaugural podcast.
DR: All right!
JM: Thank you for bringing me up to the current century here. I needed some upgrading, so thank you.
DR: All right. I am happy to be a part of that experience with you.
DR: Why don’t you tell people a little bit about yourself, and what you do, and kind of how you got into the field.
JM: Sure. My background is actually dentistry; I graduated from the University of Michigan dental school in 1974, and I was living in Michigan. I established a practice in my hometown, in Grand Rapids, Michigan. I did routine dentistry for five years. But, in about 1980, I became interested in alternative medicine – in particular, nutrition, nutritional biochemistry, and started having a more alternative, holistic practice. About in 1985, I kind of reached a crossroads of sorts. Grand Rapids, Michigan in 1985 was still a fairly conservative environment; I found that I was getting more and more resistance to doing alternative types of medicine/alternative practices in dentistry. So, I decided to sell my practice, and get involved with clinical nutrition full-time. I went to work for one of the major vitamin companies as a sales rep. And I moved out east. And during that time, I found out that what my customers were needing, as much or even more than the supplements per say was some information on what to do with them, how to use them, (and) how to determine need. There was a really a glaring deficiency and a glaring desire to have more information on the emerging research. And, of course, nutritional research is really exploding in the 80s and 90s. Customers just wanted to know more about them. So, I started writing articles, writing commentaries on various research papers that were related to clinical nutrition, both assessment and the supplements themselves – again, how to determine need, (and) how to use them. This was quite popular and I did this more and more, and I’ve been writing newsletters since 1985. Now I do them every other month.
Ultimately, this led to developing my own business: Moss Nutrition I started in 1992. Currently, we are focusing on our own product line. We were distributing other people’s products for many years. I found that a bit limiting in many ways. So now we are focusing on our own product line where I can really have control over formulation, and, even more importantly, I can have total control over quality-control issues, which we all know is becoming more of a controversy and a concern these days. But I continue to educate. I continue to teach. I teach, in addition to my customers, I do teach at the University of Bridgeport, their Masters in nutrition program; I teach assessment in vitamins and minerals classes – I’ve done that since 1999.
And one of the area that has become more and more interesting to me, probably in the last five to 10 years…we are seeing literature, but certainly from my customer’s reports in the small practice that I run, is chronic illness in aging populations. The baby boomers are getting older, and they don’t want to lose the functionality that they saw their parents losing. They don’t want to end up in the nursing homes. That don’t want to, at 55-60 years-of-age, not be able to do the things they did when they were in their 20s and 30s. So, a great deal of interest. What can we do to maintain functionality, youthful vigor as we age. And so, I become very interested in the research on this subject.
The research kept leading me to two things: 1. muscle mass, and we’ll talk more about that; but also, the primary dietary constituent that may be lacking in so many Americans is optimal protein intake, and how they go together, and how these two relate to exercise. And I’ve become more and most interested in this; I’ve written a lot about it, and I’ve gotten very positive responses, not only in terms of my readers, but also I’ve seen positive responses in patients who have undergone these types of programs, these lifestyle modification programs. They are feeling better, and they can do the things that they want to do as they age. So, it’s a very exciting area. And, like I said, as the population ages – the baby boomers are getting older – it’s very gratifying to see the things that we can do in this area.
DR: Absolutely. I agree 100 percent. And a few things that you said, I just want to note on. We have a great listener question about protein intake to optimize and maintain muscle mass as we age. So, we will play that question in a second.
And to a few of the other points you made, namely about your writings. I have to say, Jeff, that I read a lot, right? All of us in the profession read a lot. But, I have to say, you are one of the few people that I find approaches an issue purely objectively. You don’t do what I really dislike, which is have a preexisting opinion and then just look to farm references to support your opinion, and then ignore any contradictory information. That’s one of the things I really enjoy about your writing, where you provide a narrative on both sides of the story. There is evidence showing that this works; there’s evidence showing this doesn’t work. Here is what I think based upon the research, and here is why. And I really, really appreciate that – I want to actually thank you for that approach, because I have a lot more confidence in taking a recommendation from you because of that, because I think you’re looking at both sides of the argument.
DR: So I’m going to play the listener question, and then we can jump in, speaking to protein for maintaining muscle mass as one ages.
Listener question: Hi there. Glad to see you have a podcast going. Quick question from the myself, Chris, in the UK. I am coming up to 48 years old and I’ve been doing quite well on a paleo-style diet and natural fitness – going out in the forest and throwing logs around and things. My question is about protein as you get older. And muscle, I know it gets harder and harder to maintain muscle as you get older. So, I was just wondering: At the age that I am at, should I concentrate now on trying to build muscle before it’s too late? And, how much should I go for, and what kind of protein levels should I look at? So, maybe you could explain something about that, that would be great. I look forward to listening to the podcast.
DR: So, there we have it. Great question.
DR: And I love that he’s getting out in nature and throwing logs around; it sounds like a pretty fun workout, actually.
DR: So, I’ve got some thoughts of my own, Jeff. I know you’ve been really looking this issue and writing about for a while. So, why don’t you just jump in with your thoughts, and I’ll maybe ask a few questions…
DR: …and add some of my thoughts along the way.
The importance of muscle
JM: I think the first question, or first issue we need to discuss, is why it’s important to pay attention to muscle? It’s very interesting when you look at medical specialties. We have specialties for almost every organ system: We have gastroenterologist, we have cardiologist, endocrinologists. But what’s very interesting is that we don’t really have any specialist specifically on muscle. We all know Rodney Dangerfield – he didn’t get any respect. Well, I think muscle is the organ system that gets no respect.
JM: We have the osteopathic physicians. (They) are the closest thing that we have to really focus on muscle in terms of its physiology, in terms of its anatomy, and particularly in terms of how it relates to health. In fact, there is one profession that, over the years, has really emphasized muscle – one medical profession, healthcare professional – and, of course, that’s chiropractors. They’ve been saying it for years how important muscle is, not just to local…you know, I have sore back pain, dysfunction – but to systemic health. They are the first to say it. They’ve been probably saying it for 50-60-70 years.
JM: That’s very impressive. Now, of course, the research is now saying that chiropractors were right. They were right. We are now finding, research is now showing, that good muscle function, good muscle health is one of the strongest predictors for what they call overall mortality; in other words, death rates. As your muscle function/muscle health declines, you’re much more likely to die. This is as strong a predictor as, you know, better diet, smoking, many, many different factors. But, even more important in terms of a predictor of when we are going to die, there’s an even bigger concern, particularly among the aging these days, particularly among the baby boomers: ‘I’m concerned about dying prematurely, but I’m even more concerned both functionality.
JM: That, as I get into my 60s and 70s, I can do things I want to do. This is what they call morbidity – the quality of life. And one of the strongest indicators for quality of life is your muscle; can you do what you want to do? And beyond the research, just take a look. Walked down the street. When you see people, ‘I’m in pain,’ almost all the time, what does the pain relate to? It relates to something to do with muscle. We all know about heart issue; that’s a muscle. Intestinal function/intestinal dysfunction, largely regulated by muscles in the gut lining. You think of the little things that create quality of life: The ability to get up and go to the bathroom, muscle; the ability to climb the stairs, go shopping, go out and fix breakfast. All of these are dependent on muscle. And when we see people who are in extended-care nursing home-type scenarios, one of the main reasons that they are there is they have lost enough muscle mass/muscle function that they can no longer do the simple things, like I mentioned, that we take for granted. I can get out of a chair and go to the bathroom. I can get up and cook my dinner and go get the mail. They’ve lost this ability. So, we now recognize that it’s extremely important to pay attention to muscle function, and also the amount of of muscle you have. It’s really two separate issues: The amount of muscle you have and how well that muscle functions. It’s two equally important issues that we need to focus on.
DR: Yeah, and I your thinking…or just your citation of the literature showing that muscle mass is one of the strongest predictors of all-cause mortality or overall chance of death. One of the criticisms I make of functional medicine is that the testing sometimes just gets crazy; very, very (far) away from the science, very speculative, very, very costly. And so, anytime we have a highly validated, simple-to-administer measure, I’m all for it. And so, I am sure you’ll talk about some of the assessments that can be used…
JM: Yeah, sure.
DR: …a little bit later. Like rib strength, for example. But yeah, just some great, simple things people can look at to have a large impact on their health.
JM: Let me give you another example of why this is so important: Many of you may have heard that one of the greatest causes of death in the elderly are falls. You get a broken hip, for example. In the elderly, that’s pretty much a death sentence.
JM: Now, why is this mainly a problem in the elderly? Think about it. People of all ages fall. Why is it important in the elderly? Well, think about it. When you fall -let’s say you take a spill – what happens? Your hands immediately come out and you’re going to break the fall. Now, someone who has good muscle mass, no matter what the age, what’s going to happen? At the very worst, what will happen is you break the fall with your hands, you break your hand, you’ll break your wrist. That’s no picnic, that’s not a good thing. But, if something’s got to break, I’d rather have it be my wrist than my hip.
DR: Uh-huh. Absolutely.
JM: It’s an inconvenience. A hip is a death sentence. That is the big difference in the elderly. They’ve lost so much muscle mass, particularly in the upper body. When they fall, there’s no way they can break the fall. There’s nothing there to protect them.
DR: Excellent point.
JM: They fall on their hip, and, again, a tragic outcome.
DR: So, we know that muscle is important. And I think a lot of people listening probably get that to a greater or lesser extent. Maybe it’s partially motivated by vanity, which is fine. I get that. I think we all want to look good. Part of it, as Chris noted, is for performance.
Gut health, blood sugar regulation and muscle mass
DR: So, some things that I like to look at when someone is struggling with body composition – and this is definitely biased by the population that I see in the clinic. But, a few things that people should be aware of should they be noticing their body composition is not favorable. Of course, celiac disease, or high-level gluten intolerance can cause damage to the intestinal cells, and essentially will cause a chronic syndrome of malabsorption, and that can lead to weight loss.
DR: And does that happen in non-celiac gluten sensitivity? No so much it doesn’t appear. But there’s also this new entity called celiac lite. Really, one of the first things I would recommend people do is just try a gluten-free diet to see if it has a positive effect. Rather than going through all of the testing, just a simple, easy method of a 30-day trial. See if you feel better. It’s an easy one to do.
Another one would be small intestinal bacterial overgrowth (SIBO) because small intestinal bacterial overgrowth in some cases has been shown to cause similar damage to the intestinal lining as celiac. You will see chronic weigh loss is one of the complaints of some cases of SIBO. Some cases of SIBO will also be very under weight. Or any other kind of issue impairing GI health. It may be other food allergies. It may be may be a leaky gut. It maybe some other kind of chronic infection. But, I would definitely look to gut health, of course, because that’s the gateway through which the protein is going to get in to be able to build muscle. That’s one I’d look at.
And then the other – and this is not an exhaustive list, but just two of the first ones I’d look at – would be blood sugar regulation, and more specifically if someone is insulin resistant. Insulin is anabolic, but if you’re resistant to insulin then you are lacking that anabolic signal. That’s why you’ll see many with insulin resistance who will be fat but skinny at the same time – they will be high in fat mass but low in muscle mass.
DR: OK, so where do you want to go next, Jeff? Anything else; another topic?
Simple ways to determine muscle mass and functionality
JM: I think it would be important to talk about how do you know? How can you…what are some simple ways that we can determine if you have an inappropriate level, inefficient or not enough muscle mass or muscle that’s not working well. There are some very simple ways of determining it. In terms of the amount of muscle mass, there is a very, very simple technology that’s highly accurate. And you don’t even need to go doctor’s office. The technical term for it is bioelectric impedance analysis or BIA. They are technical, professional units that you can see in professional offices. But you can go to virtually any big-box store, and you can get these low-tech body fat scales that have, basically, the same type of mechanism, same technology. You can measure your percent body fat. As you alluded (to), Michael, if your body fat is too high, that means the percent of muscle masses is too low. In men, we like to see the ideal range about 12-to-18-percent body fat, and women about 22-to-28 body fat. And it it’s too high, you automatically know that your muscle mass is too lows. So, that’s a very easy way of determining if you’re lacking in muscle.
The other key thing to determine is how well does muscle function. There’s a very interesting technology. The devices involved are a little bit more expensive. You can get a body-fat scale for $20-to-$30 at the big-box stores. To measure the functionality, there are many research papers on what is know as grip strength. Basically, it’s a device that measures the amount of pressure you can (exert) when you grip something.
JM: This is call the dynamometer. They’re not terribly expensive; they are certainly more expensive than the (body-fat) scale. You can buy them online for a couple hundred dollars. Most professionals now who are doing this type of work with their patients do have these devices in their offices. Certainly you go to that route also. But you can measure the functionality – how well is the muscle working? Two different areas. There is a third test (that’s) very simple to do, very simple to do. And this is particularly important in the elderly, who will experience loss of muscle mass not in the upper body, but in the lower body. At what point are they in situation where they’ve lost too much. There’s something called gait speed. It’s very simple. You just measure out a six-meter course. Again, this is largely very helpful for the elderly population, particularly those on walkers – How long does it take to walk six meters? If it takes longer than six seconds, you’re consider to have a significant loss of muscle mass in the lower body, and, again, an indication that we need to address that through diet, supplementation, and exercise.
DR: Now, Jeff, I’ve heard criticisms of the bio-impedance scales. Or at least some of the less expensive units. Is that something that you’ve found to be a valid criticism, or are they all fairly effective?
JM: Certainly, there are issues with these units, but from a practical standpoint, does this inaccuracy really matter? Ah, no. From a practical standpoint, what we are looking for is not necessary an absolute number. We are looking for improvement or change. Let’s say somebody, for example, the initial reading is, let’s say, 35 percent body fat, it’s a female – which would be too high. In reality, could it be 36 percent or 32 percent? Yes, it’s possible; there is a margin for error. But either way, we know it’s too high.
JM: And so, when we do our follow-up, after we’ve done various things, such as exercise, diet supplements, etc,. as long as we are using the same unit, and we continue to get improvement, that’s all that really matters from a practical standpoint. So yes, even though they aren’t 100-percent accurate, as long as you’re looking for change, you’re heading in the right direction, or conversely, you’re heading in the wrong direction, they’re are still very useful and very economically practical tools.
DR: Sure, OK. And I think that makes a lot of sense.
Muscle fibers and aging
DR: So, a couple things that are important to me in terms of things I educate my patients on in terms of muscle mass and how to, through an exercise approach, maintain muscle mass. And I am sure a lot of listeners have probably heard a little bit of this to a greater or lesser extent. As we age, we tend to lose muscle mass. From my understanding, we tend to lose more of the Type-II , the fibers you would associate with…when you say someone is muscular, more so you are referring to Type-II fibers. Those are more so the fibers you see, the fibers that make you strong, the fibers that make you fast, the fibers that give you deltoids, biceps, (the) ripple in your back, your ab. That population seems to decrease with age, and so we see a relative increase in the other muscle fiber family, which is a Type-I muscle fiber. These are more of the postural muscles; the muscles that are more so used for endurance running. They can generate a small amount of power for a long period of time.
So, one of the concerns that I have is, if you lose your stronger, faster muscles as you age, and you maintain your your cardio muscles as you age, then reason would suggest to maintain optimal muscle mass and function, you would want to have an exercise regime that is tailored to fighting that process. So, what that really means is, if someone is elderly, for example, and their workout consists of walking, treadmill, elliptical, I’m happy to see them exercising. But, a better exercise plan would be one that may include squats, lunges, dead lifts, pull-ups, push-ups, lateral lunging, situps, rowing – things that are going to maintain this Type-II muscle fiber population. So, to put it really simply, your cardiovascular exercise-type muscles seem to maintain as you age, but you lose your more resistance training-type muscles as you age. So, it’s important to exercise in such a way to maintain those populations. So, Chris, to your question, I love what you are doing out in the woods. It sounds like you are doing things similar to a dead lift pattern, or a lunge pattern, or a push pattern. I would keep doing those things that are explosive; that would require you to lift somewhat heavy things to maybe even accelerate them quickly, because that will help you maintain that population of muscles.
JM: I think your point is very well made, needing the variety in exercise. Ken Cooper, in the 60s everybody kind of got the aerobic exercise thing, the walking, or jogging, that type of thing. But certainly the issue of weight-bearing exercise certainly has been under appreciated and under emphasized. We need to have that balance, so good point.
DR: Not that I am an advocate of the body building community at large, but that was one of the things the body building community had right was just the importance of muscle, and doing some of these more old-school body building exercises. Like squats, and deadlifts, and bench press, and lunges just to help maintain good functional muscle mass.
DR: For people looking for what thus would look like in the gym, keeping your rep range anywhere between 8-to-15 reps would probably be the sweet spot on that. If you go too low in reps, you seem to get more of what’s called a neuromuscular response, where it’s more the electricity that tells the muscles to fire, the wiring if you will, or the electrical system. That becomes well-trained with really heavy lifts, like 1-2-3-4 rep lifts. If you go too much about 15, you get more of the endurance response, more of this Type-I muscle fiber response. So, it seems like somewhere between the 8-to-15 will give you more of what’s called the phosphocreatine system, or just a muscle mass-type gain. Another interesting tidbit is circuits and circuit training, which is also popular. I think (it’s a) another good option, as long as….You have the spectrum where if the circuit is too long, then it becomes more like a cardio class. So you want to make sure that if you’re doing a circuit, maybe you keep the circuit a little bit on the shorter side, where you have some intervals dispersed in between. And one of the interesting things about circuits is circuits will help your body to produce lactic acid. And lactic acid actually helps stimulate growth hormone. Growth hormone helps maintain muscle mass. And the way I like to use this for some people is a circuit-type training recommendation along with a moderate or lower carbohydrate diet. Charles Poliquin, who is a really big strength and conditioning coach – I believe it was in his book called him German Body Composition Training or German Volume Training – took this out of the Eastern Block, where you combined essentially circuits with low-carb diets. Both of those help to potentiate growth hormone. So, just a few notes out of my training background years and years ago.
Insulin and muscle mass
DR: Maybe a good topic, Jeff, would be insulin (1).
DR: Insulin is kind of like a double-edged sword, right? I can help you. But, if you’re excessive in insulin, it can really harm you. So, what are your thoughts on how insulin ties into all of this?
JM: Well, insulin…When it comes to hormones, we have to understand what a hormone is. A hormone is like a traffic cop. It’s telling the body what to do. It’s directing traffic. Generally speaking, what is building muscle, from a biochemical standpoint? Basically what it is, as you mention, you have proper nutrition. And assuming it’s properly absorbed, where is it going to go? Where are all these nutrients going to go? Is it going to go where you want it to go? In this case, of course, we want it to go inside the muscle cell. It’s not going to go there on it’s own. It basically need a traffic cop to send it there. And that traffic cop is insulin. It’s what they call the primary anabolic hormone. What does anabolic mean? Basically it means ‘takes stuff and put it into cells; make them grow, make them work better.’ That’s what insulin does.
Now, we have to understand something, though. And you alluded to this before, is (that) the body prioritizes need. You talked about the importance of protein. Insulin is important to put protein into the muscle cell. But, the body always has to make a decision at any given time – ‘Where is the best place to put the protein?’ And you may think, it’s it always important to put it into muscle? Well, from the body’s standpoint, not necessarily. Let’s say you have some type of infection, or you have some type of inflammation, as you talk with celiac-type situation, gluten sensitivity. The body starts thinking…wants re-prioritize. Now, it basically says, ‘You know, I am basically being attacked by this gluten. I need some inflammatory mediators to deal with this gluten.’ And so, the body re-prioritizes, and it says, ‘You know, instead of sending the protein to the muscles, I think I’ll send it over to make inflammatory compounds.’ There are certain compounds that have the name of cytokines, for example. There is one many of you might have heard of called C-reactive protein. They call these inflammatory mediators.
And so, what the body says when I’m being attacked by gluten, for example, ‘I will leave muscle for later, after the gluten’s gone. Right now, I want to build more inflammatory mediators.’ So, as you alluded to, if we are inflamed, we aren’t going to get protein going to the muscle, we’re not going to increase muscle. But, let’s get back to insulin. What the body is saying, ‘I don’t want the protein in the muscle.’ So the body says, ‘Why don’t we do this: Why don’t we make the insulin not work?’ This is something called insulin resistance. The insulin is there, but it’s not working. Now sometimes what will happen to even compound the problem, the body says, ‘Well, the insulin is not working, so I better make more insulin.’ And we get more and more insulin – this is called hyperinsulinemia. We have more insulin, but it just doesn’t work. Now, this is the classic pattern of the Type-2 diabetic. And yes they are inflamed, and yes they do have problems with muscle and all of the things that we have talked about. So, it’s very important to have insulin working well, so it can direct the protein to the muscle. But, one of the biggest things that will keep the insulin from doing that, like I said, is inflammation. And one of the biggest causes of inflammation, Michael, as you mentioned, is a poor diet, pro-inflammatory diet, gluten and other inflammatory foods.
DR: Absolutely. It’s a very poignant point you make, because just a week or two ago, Susan and I were discussing the issue of detox, and the need for what I would call highly robust detox support supplements. One of the points that we made was, a lot of these supplements are very rich in amino acids, and rightfully so. They help to fuel detox pathways. But, if you are inflamed, you end up using a lot of your what could be proteins for detoxification to make inflammatory molecules instead. So, this kind of underpinning point of how inflammation can really derail how your protein is used, and how a good first step is to try to rectify that source of inflammation.
JM: You make a very good point. There is a hierarchy in the body, when it comes to where does the protein go. If the body perceives, ‘I need to be inflamed;’ like I said, ‘I’m being attacked by gluten, or there is some virus, a cold, whatever it is.’ The body will always prioritize the inflammation first over muscle, over detoxification. Virtually any other structure or entity that involves protein will come second to the inflammation. That is why it is so important to deal with inflammation in these scenarios.
Optimal protein requirements and calculation
DR: Right, right. And so, let’s assume now that we have someone, like Chris, for example. It sounds like Chris is pretty healthy. He’s eating very well. He’s taken the steps to get all of the allergens out of his diet. (His) lifestyle seems like it’s pretty dialed in. Let’s say if he has any kind of gut infection or other chronic infection, he’s investigated and treated that issue. Now he wants to just optimize his protein intake for optimizing his muscle mass. And he was 48. What kind of recommendations would you have for him?
JM: There has been a lot of research on what is the right amount of protein to take in. And what we all learned as nutritionists is the standard textbook was a measurement…it’s based on your kilogram body weight. The conversion factor is 2.2. In other words, you take your body weight in pounds, divide by 2.2 and you get kilograms. Let’s just give an example: A person, let’s say, weighs 150 pounds. And we divide by 2.2, roughly they weigh about 70 kg.
JM: The classic measurement that we learn is that, for every kilogram (of) body weight, you would need 1.8 grams of protein. So, a little less than a gram. Now, there’s 28 grams in an ounce. So, the thinking was, let’s say that 70 (gram) person would need about 60 grams of protein, or roughly little over a couple of ounces.
DR: A 70-kilogram person?
JM: Yes – they would need…the classic thinking was about 60 grams of protein, or about two ounces. So, that was the classic healthy person. And this is what we all learned about in school – that healthy person, that’s all they need.
What we are now learning is that, well, two-thirds of the population is overweight. About half is obese. We are all aging. Those healthy people were…basically (who) they were researching were 20-year-old college students. Well, there are more and more people who are not 20-year-old college students anymore.
JM: As you age, and as you get sick for whatever reason – and aging does involve getting sick – your needs go up. And they go up dramatically. The current thinking right now, as we age, as we get into our 50s, as things start happening, wherever they are – the ailments of aging. As they say, nobody gets out alive. Certainly, there are a lot of things we can do with lifestyle, as he been talking to repeatedly, to slow down the aging process, to keep us more functional, to keep us more able to do things that we want to do. But still, aging takes its tool. Because of that, we need more (muscle). The thinking now in all of the research is right around…anywhere from 1.2-to-1.5 grams-per-kilogram body weight. So, let’s take that 70 kilogram person now. Now we are going to multiply that by about 1.2 (grams) on the conservative side – about 80-to-90 grams of protein. So, much more as we age. Part of this has to do with the issues of lifestyle; the decisions that we make. We talked about foods, exercise, lack of exercise, too much exercise, the things that cause inflammation – that does come into play that requires additional protein so that we can maintain our muscle mass and function. But there’s one other thing that happens strictly as we age. And there is really nothing we can do about it. Like I said, nobody gets out alive. The term is known as anabolic resistance. Now, I talked about that term before. Insulin is the primary anabolic hormone that puts stuff into cells – in this case muscles cells, so they will grow and they can function better. But, as we age, we lose this anabolic capacity. So, no matter what you do, the fact that you’re 60 instead of 20, the protein will not go into your muscle cells as readily. It will not be incorporated into key systems in the cell to allow for optimal function, and optimal muscle mass, and optimal repair.
There is an analogy that I like to use: Why is it there are no 60-year-old NBA players? Why is that? Why isn’t Michael Jordan still in the NBA? Well, there is a very good reason for it. Michael Jordan right now, even today, probably for about five minutes could beat almost anybody. But as he ages, what happens? He loses the ability to build muscle quickly. The NBA players, after the game are pretty sore. The young ones are able to heal quick enough for the next game is coming up in the next 4-5-6 days or whenever it is. But as you age, you lose this anabolic potential; you can’t repair as fast, and that’s why Michael Jordan isn’t playing professional ball right now. He just couldn’t repair in time, and why we don’t see 60-year-old basketball players. So we get this anabolic resistance that is strictly a function of aging. That’s another reason why we are going to need more protein in our diet.
DR: So, a couple of points I have. That’s really awesome information. I love having…for those who really like to have a very strict diet, there is a great calculation you can make there to achieve what would be your ideal protein intake. As you were describing that, I couldn’t help but think this might be part of the reason why some people can do a vegetarian diet and be OK with it, and other people are decimated by it. And they find when they come over to a more paleo approach, they feel a lot better. I think the reason why I see a fair amount of that is probably because the sample I am seeing are the people that were really sick, and they vegetarianism as a cure, so to speak, but that put them into a further state of protein deficiency, because of the underlying illness that was causing them to be sick in the first place. And so, that diet was just totally at odds with their biology. So, that’s a really interesting point regarding what you said.
And then the other one I think of in this regard is sometimes we will hear something of the story of, ‘Well, these Buddhist monks didn’t eat any protein and they were really happy and enlightened and what have you, and so we should replicate that. And I am not saying that we shouldn’t. But, I think it’s a very different population. I mean, if we were wearing robes all day and just hanging out around the monastery and meditating four hours per day, I think our macronutrient needs would probably be quite a bit different than typical American who has a lot of a lot of stress and a lot of stuff to do and go, go, go. Or any really Westernized country. And so, yeah, I think your protein requirements are probably going to go up significantly as your lifestyle changes.
JM: Exactly. We aren’t here to judge, but Americans have certain priorities in terms of how we want to live our lives. Again, is it better than the Buddhist monk or not? That’s really an individual decision. It’s not a qualitative issue; I’m not here to make it a qualitative issue. What I am saying, given the lifestyle that most of us want to live, we are going to need more protein.
DR: So, Jeff, what do you think causes the anabolic resistance? Is it product of cellular aging? Is it androgen and other hormone declines? Is it a combination of all these factors?
JM: It’s really all of the above. Certainly, aging is a factor which is going to affect general cellular function. It certainly has an impact on endocrine function, particularly testosterone – beyond insulin, (testosterone is) probably the next most important anabolic hormone. But, lifestyle comes into play also. It’s a combination. It’s a combination.
JM: All of the decisions that we make, whether it be diet, exercise, state of mind, how much sleep we get; all the things that compose our lifestyle. We can’t change the aging thing, but we can change our lifestyle. We can improve our lifestyle. So that’s why, whatever age your at, if you improve your lifestyle, all things being equal, you’re going to have better muscle mass and better muscle function no matter what your age is.
Protein and leucine supplementation
DR: Sure, sure. In terms of supplementation to help people get to that ideal protein intake – should they not be able to get there through normal dietary consumption – I know we talked about of the importance of not over consuming one protein.
DR: I think you forewarned, and I totally shared your your concern, that we are going to see people have allergies to things like pea protein if everyone starts leaving whey and just having pea. Which is why I, personally, and also recommend to my patients, oscillate. What I do is, I do a couple days of whey protein, usually Monday-through-Wednesday. Then, Thursday-through-Sunday I use a pea protein blend, so that I don’t overly expose myself to one protein source. And I’ll Include some links (2a, 2b, 2c) in the show notes if people want to see the proteins that I use.
And also, Jeff, you’ve written about – and I’ve used (this) with some patients with what I think are good results. It’s kind of hard to tell how much because I’m not isolating out the variable – but leucine supplementation to increase muscle mass secondary to protein intact. And I know you’ve written about that…
DR: (Any) comments on protein you’ve seen in any other kind of synergists?
JM: As we all know, protein is made up of individual amino acids. In particular, the ones that are most important are what they call the essential amino acids – the ones the body can’t make from other amino acids. In particular, leucine is probably the most important essential amino acid for muscle, for people who want to build muscle. Why is that? It’s not so much that it’s inherently more important. It has to do with the fact that the average person who is losing muscle mass is going to be quite deficient in leucine. There is a lot of complex biochemistry that I won’t get into – why the body becomes so depleted in leucine. But we become very depleted in leucine very quickly with the kind of lifestyle that we live in this country; the chronic stresses, the lack of sleep, poor diet, whatever it is. Lack of exercise, too much exercise. We tend to lose leucine. And it’s been found that under these scenarios, we start introducing extra leucine, beyond what is in your protein powder. There have been studies that have shown – and the studies I’ve seen you generally use whey protein, and maybe add a couple of extra grams of leucine powder per day – you get an extra anabolic push if you will – better muscle building. One of the main reasons it is, as you start introducing leucine to a scenario where it’s deficient to begin with, it has a powerful, positive impact on insulin; not only making more, but making it work better. Remember I talked about, we have a scenario in many people where the insulin is not working well.
JM: And some people, I talked about the hyperinsulinemia – some people are still not producing enough. Leucine can help do both – produce more insulin and help it work better.
DR: That’s a key point. You want to make sure you’re not just pushing insulin into someone who is, maybe, not very insulin sensitive to begin with. I mean, if you are pushing insulin and also potentially increasing insulin sensitivity at the same time, that seems like a ideal combination. In reading some of the writings you’ve put forth, reviewing some of the literature on leucine, there have been some very well performed clinical trials in humans that track outcomes.
JM: Very impressive.
DR: Not these obscure – and I oftentimes criticize when we over extrapolate from a study. Let’s say it’s a study on a rat, or a cell line study, or a muscle biopsy culture. Those are definitely interesting, and that research is very important to be done. But, when it comes to health consumer making a choice about some kind of intervention, or purchase, or a test, I think we should really demand for some kind of clinical trial or interventional data in humans. You said a lot of that when writing about leucine.
JM: You’re right. There is so much on leucine. Now, leucine – for those of you who might be athletic: body builders know – that it’s just one of the branched-chain amino acids. Supplementation of all of the branched-chain amino acids has been done by body builders for years with very positive benefits. Of the three – there are three branched-chain amino acids – it appears the most important is leucine. The human studies have just been incredibly impressive, not only on young body builders but lots of research on elderly populations. You know, it’s very interesting, when it comes particularly to nutritional supplementation, sometimes it…what catches on and what doesn’t catch on, you know? For example, for years nobody talked about vitamin D. And then for whatever reason, about 10 years ago everybody was talking vitamin D. It’s just these trends. And for whatever reason, there is a ton of research on leucine, and for whatever reason, it’s not catching on to the popular consciousness. It’s very impressive with what it can do for aging individuals. It’s my hope that, at some point, it will catch on like vitamin D.
DR: And you know, I was thinking exactly that when I was reading the literature on this – when I was reading your review of the literature on this, I said, ‘Jeez, this really compelling information on leucine.’ I was surprised that wasn’t more popularity around this issue. Maybe, in time, it will come more into fashion. I should also mention that, I don’t want people to think that, if you have very little muscle mass, if you take leucine for a month, you’re going to look like Arnold Schwarzenegger. This is not an anabolic steroid or something that’s going to produce these dramatic results. But, it has been documented to help push you in that more anabolic direction when coupled with protein intake.
JM: And coupled with the kind of exercise we are talking about. I cannot emphasize that enough. Whether you talk about leucine or protein. Yes, there have been some studies that have shown some benefit, like in sedentary elderly populations. They have seen some benefits. I can’t say it doesn’t work without exercise. But the vast majority of studies have demonstrated that the weight-bearing and aerobic exercise really needs to be there to get the maximum outcome from your supplementation, whether it be leucine or protein. It’s not a panacea. It’s far from it.
DR: Sure, sure. Well, I think we’ve done a pretty good shakedown on this topic. Before we close, do you have any points that are important regarding this topic that you want to mention?
JM: I guess I would want to reiterate what I said before. Muscle just doesn’t get the respite it deserves in terms of the things that really concern us the most as we age – quality of life, I want to do the things I’ve always done. It may be running a marathon; it may be as simple as when I’m 80, I still want to be able to get out of a chair without a walker and walk to the bathroom.
JM: More than anything else, that is a concern. I know it’s a concern I have, and probably all of us. Don’t forget the protein, don’t forget the weight-bearing exercise.
DR: I couldn’t agree more. The fundamentals are fundamental for a reason, right? They work and they produce results. Jeff, anything that you are working on or anything you’d like to make people aware of?
JM: Oh yeah, sure. Actually, one of my interests right now, and this is somewhat connected or relates to muscle but in a different direction, and particularly the heart muscle, there’s a whole other facet of muscle function we didn’t touch on. Particularly the heart. I’ve talked briefly about this before. Basically there is an issue of fluid – what they call conductivity, particularly the heart. Anytime you have conductivity, electricity, you need fluid and you electrolytes, in particular magnesium – we’ve all heard about that. But the one we don’t hear about that much is like the flip side, the other side of the coin of magnesium is potassium. That’s the area I’ve really been look at now. The literature is really clear that, because were are not eating the green leafies that we used to, and that’s where most of the potassium is, we really are a potassium deficient nation. We have too much sodium and not enough potassium, and it is certainly an issue for muscle function, but particularly the heart. And this is an area that I’ve been looking at quite closely; looking at the literature on potassium intake and heart attack. It’s quite sobering and quite fascinating, and I think needs much more publicity and exposure.
DR: And where can people track you down if they want to follow your…is the newsletter weekly or is it monthly? I’m sorry.
JM: It’s bi-monthly.
DR: Bi-monthly, OK.
JM: And the best way to get it right now it’s generally available to practitioners. But if you send me an email at [email protected]. That’s [email protected] if you’d like to get access to newsletters, certainly I’d be glad to allow that to happen on our website
DR: I don’t know how you could put that out weekly because your writing is so reference-full, and just so dense. It’s great but it’s very information-packed. You would not be sleeping at all if you were doing that.
JM: That’s for sure. It is heavy reading. I don’t try to sugarcoat anything. There are no soundbites. It’s basically: Here’s what the research says in detail; and here’s all the complexity, the positives (and) the negatives. Again, in our soundbite society, I realize that’s not for everybody. But for those of you how want to see the full story as it came from the researcher, not whitewashed, not homogenized by the media as it actually came from the researcher’s mouth, that interests you. That’s what I write about.
DR: I think a lot of the practitioners on the line will appreciate that. All right, Jeff. Well, that you so much for coming on. And maybe we’ll do a followup call at some point in the future about supplement quality, and quality assurance, and all that good stuff.
DR: Awesome. Thanks again.
JM: Thank you.
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