Dhru Purohit Show - Are You Eating Enough Protein for Optimal Health?

Episode Date: June 13, 2022

This episode is brought to you by InsideTracker and HigherDOSE. Skeletal muscle is a widely overlooked part of our metabolic health. From how well we control glucose and insulin to how well we age, skeletal muscle regulates many processes. One of the most important factors for how much muscle we create and retain is our protein intake, which has become a divisive topic in the nutrition world and one still hotly debated in some dietary camps. On today’s mini-episode, we are featuring key takeaways on the topics of longevity, muscle, and protein from one of our most popular interviews this year with Dr. Gabrielle Lyon.  In this episode we dive into: -The importance of muscle when it comes to our health, especially for women -The connection between muscle and metabolic health -Myths about dietary protein  -Why breakfast is the most important meal of the day -What women need to know about fasting  Dr. Lyon is a Washington University fellowship-trained physician in Nutritional Science and Geriatrics and is board certified in Family Medicine. She is the founder of the Institute for Muscle Centric-Medicine and has a private practice that services leaders, innovators, mavericks, and executives in a number of fields. In addition, Dr. Lyon also works closely with special-operations military personnel. Her goal is to change the paradigm of medicine from obesity-focused to muscle-centric and change the way we think about health and medicine with high scientific integrity.  Listen to the full episode here. For more on Dr. Gabrielle Lyon, follow her on Instagram @drgabriellelyon, Facebook @doctorgabriellelyon, Twitter @drgabriellelyon, YouTube @drgabriellelyon, and through her website, drgabriellelyon.com. Check out her podcast, The Gabrielle Lyon Show, here. This episode is brought to you by InsideTracker and HigherDOSE. InsideTracker provides detailed nutrition and lifestyle guidance based on your individual needs. Right now, they’re offering my podcast community 20% off. Just go to insidetracker.com/DHRU to get your discount and try it out for yourself. The Infrared Sauna Blanket from HigherDOSE gives you all the benefits of infrared in an easy-to-use, portable blanket at a much lower cost than a stand-alone sauna. Right now, you can get 15% off your own Infrared Sauna Blanket at HigherDOSE.com with my exclusive promo code DHRU15. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hi, everyone. Drew Proud here on today's mini episode, we're featuring a few golden nuggets on the topic of longevity, muscle, and protein from one of our most popular interviews this year so far with Dr. Gabrielle Lyon. Dr. Lyon was recently on the podcast advocating for her approach, which is called muscle-centric medicine. And we had a fantastic conversation, but I know a lot of people missed the gems inside of it, because it was a longer interview. Well, we've shortened it in today's mini episode and brought you the key takeaways that are super important, especially for women, women in protein, and women who are considering and focused on optimizing their health for longevity. You're going to learn why that's an important part of Dr. Lyons' approach and advocacy work. The next thing we're going to be doing is we're going to be sharing some takeaways talking about the

connection between muscle and metabolic health. We've done so many episodes on metabolic health. If you want to improve your metabolic health, you've got to build up your muscle. And we're also talking about some of the myths around dietary protein from Dr. Gabriel Lyon's perspective. She has a very unique perspective and she's going to be talking about some of the myths versus some of the facts from her perspective when it comes to protein. By the way, if you eat breakfast or if you skip breakfast, there's also a conversation between Dr. Lyon and I on that topic. A lot of gems here, and we've taken the best of a two-hour-plus interview, and we've shortened it down in a simple mini-episode for you to enjoy today.

Let us know what you thought about this segment and these shorter episodes by leaving a review, or better yet, share this episode with a friend who wants to focus on optimizing their health for longevity, being the happiest, healthiest version of them to a ripe old age. Let's dive in, right? Yeah. It's been a while since our last episode. So it's important to revisit your central core thesis about the importance of muscle when it comes to our health. Yeah.

Share that message with our audience. Okay. So the main focus of my message and my driving mission is muscle is the organ of longevity. And right now, everybody is focused on adiposity. They're focused on being and losing weight. And that is really the core central theme that we see. What if I told you we are not over fat, but we are under-muscled as a society? And the reality is one of the reasons obesity is so hard to treat is because fundamentally

we are looking at the wrong problem. And issues like obesity, diabetes, cardiovascular disease, Alzheimer's, these are diseases of skeletal muscle first. Boom. That's a big deal. It's a big deal. And we're going to unpack it all. Now, let me start off with something that you shared.

Okay. It's that you were saying that we're not over fat, we're under muscle. Yeah. Now, can it be both and asking the context of the pandemic and everything that we saw with people that had poor metabolic health, people that were obese, being a higher risk, passing away, unfortunately. Yeah. Isn't it a little bit of both?

So it is a little bit of both. And when I think about the idea of core treatment and symptomology, obesity is a symptom. It's not at the root. If individuals have healthy skeletal muscle, their survivability across all illnesses, which is very rare to be able to say that in medicine. So I am saying, Drew, if you have healthy skeletal muscle, if you have enough, if you have enough body armor, you are not only going to be able to survive through issues that happen during the pandemic, but also you'll be metabolically healthy. And I know that that's a

core theme of yours. You talk a lot about metabolic health. And in my mind, when we think about skeletal muscle, we have to think about what it does. So let's get into that. Yeah. Let's talk about it for especially our audience, which is primarily female, but shout out all to the men. Which I actually think that that's amazing and love that. Yeah, I love it. I love it. Shout out to everybody who's listening, of course. Yes. But for our audience, and through the different stages of life, how, and can you give some examples of how important muscle is and what it actually helps people do, especially for women? Yes. Well, of course, this happens to be my favorite topic. When you think about muscle, we often think about it in the fitness realm. And of course, that's what we hear. You think about

bodybuilders, you think about protein, and really that's a conversation that is typically thought of in their 20s, right? And it's so interesting because muscle, and we're talking about skeletal muscle now, is so much more valuable than that. The idea of locomotion and physical fitness is one small aspect of what muscle does. Muscle is actually, and by the way, makes up 40% of your body, it is the largest organ system in the body. Skeletal muscle is an organ system. And we must, if we want to change the trajectory of how people are aging and what we are seeing and obesity, we must address skeletal muscle as the organ system that it is. Now, I know it sounds like a very basic question.

No, no question is basic because we do have to lay the foundation of what muscle does, how do we stimulate it, how it relates to health and wellness. Of course, of course. That's what you're here to do. Yes. So you're saying skeletal muscle. What muscle is not skeletal muscle if you can break that down? So smooth muscle, things that you don't have voluntary control over.

Got it. You know, and there, of course, is cardiac muscle and smooth muscle and then the skeletal muscle, which you have direct control over. And again, just mention a few of those. So like a uterus. A uterus would be a smooth muscle. Yeah, exactly. That's not what we're talking about.

No, we are not talking about this. We are talking about muscles that have voluntary control. that, like, for example, your bicep or your quadricep, things that you can move. Now, we know, and we've talked about on this podcast before, that one of the leading indicators of, you know, old age is grip strength. Yep. Right? And that's one of the greatest predictors of your likelihood of death, I believe.

Yeah. Is that right? Yep. And so we understand that especially as people get older, having muscle is actually what protects their bones from fracture, from breaking. And when older people, especially break a bone, I was just talking to a friend of the day, her mom unfortunately fell down while playing pickleball. And she's a walker, my friend was saying, but she doesn't really do a lot of muscle

boating activities, no resistant training. She fell in a very simple fall, ended up shattering her ankle. And my heart goes out to her and her mom. It was a very sad story. And in the hospital, like a lot of people get into the hospital, they start to rapidly decline, especially when they're bedridden. You know, it's really interesting, and I'm going to share a very scary statistic. For women over the age of 65, if they fall, 50% of them will never walk again.

Wow. Say that one more time, because that's like mind-blown. For a woman, 65 or older, if she falls, there's a 50% chance she will never walk again. So that would look like what? She is bedridden or wheelchair bound. Yeah, she, yes. I mean, you know, there's an extreme risk of death. Oftentimes people end up having to go to assisted living.

There are very tragic and predictable outcomes that happen if you don't address skeletal muscle midlife. And again, there's multiple things that skeletal muscle does, which I think we should discuss as it relates to metabolism. And also, there's a natural decline in skeletal muscle as we age. It's really interesting. There's a physiological process that happens, one of which is called anabolic resistance. And it's this idea that skeletal muscle is actually a nutrient sensor. It senses protein. And the efficiency by which it does that decreases as we age.

Which is why it's harder to put on muscle as we age. And also there's a decrease in hormones for women, especially during perimenopause, menopause, that is the time in which they have the most rapid decline in muscle mass. And we're more likely, I've heard you on many interviews talk about, we're more likely to become insulin resistant. Yes, isn't that interesting? Just explain how that works because we've done so many episodes on metabolic health. I love this.

And we always talk about glucose monitors and the benefit and looking at your fasting insulin, but make the connection between muscle and I would love to. I'm turning 40 years old and I can honestly say that I've never felt better. So many people have this looming fear around getting older because they think it has to come with chronic disease, losing their mobility, maybe losing their agility and losing their mental acuity, which means not being able to do all the things they love anymore. If that were the case, I would be worried about getting older too, but it doesn't have to be that way. I learned that through the power of epigenetics, I can turn off my aging genes and turn on my longevity genes simply by living a healthy lifestyle, optimizing my diet, and taking the right supplement. I'm here to tell you that it is possible to get older and to truly stay young on the inside. But sometimes we need a little help knowing exactly how to do it.

That's why I'm super excited to tell you guys about Inside Tracker. Inside Tracker was founded in 2009 by top scientists from acclaimed universities in the field of aging, genetics, and biometrics. Its mission is to help people live long, healthy, productive lives by optimizing their bodies from the Inside Out. Inside Tracker's cutting edge technology analyzes your blood, DNA, lifestyle, and fitness tracker data, and gives you actionable, personalized. That's the keyword personalized tips on how you can improve your health span.

Their new inner age test allows you to see how your inner age compares with your chronological age and gives you a longevity-focused plan with science-back recommendations to help you make sure your best days are still ahead of you. And now you can connect Inside Tracker to your Apple Watch to unlock deeper, more precise insights into your personalized health plan with real-time exercise, resting, heart rate and sleep data synced within your InsideTracker plan, you can truly wear your health on your sleep. Right now, InsideTracker is offering my podcast community 20% off. Just go to inside tracker.com slash drew. That's D-H-R-U to get your discount code and to try it for yourself.

That's InsideTracker.com slash dHRU for 20% off. This episode is brought to you by higher dose. Regular sauna use is a game changer. Saunas can reduce inflammation, improve detoxification, support overall stress levels, and increase energy production down to the freaking cellular level. But the thing is, saunas can be expensive. Not everyone has the extra room for them in their home. That's why I'm excited to tell you about the portable higher dose infrared sauna blanket. It's an affordable way to get all the benefits of sauna use,

including supporting the process of autophagy or cellular cleanup, which kills off our body's old zombie cells that hang around and take up a lot of space and energy. Killing these old zombie cells is key when it comes to longevity and optimal health. That I mentioned that higher dose blankets are also low in EMF and made of premium non-toxic materials that keep you safe and cozy throughout the sauna season. Just another reason why my team and I love them. If you've been hearing about the benefits of regular sauna,

use, but you just haven't pulled the trigger, higher dose infrared sauna blanket is designed for you. So jump right in. Right now, you can get 15% off your own infrared sauna blanket at higherdose.com with my exclusive promo code, Drew 15. That's higher, H-I-G-H-H-E-R-D-O-S-C dot com with the code D-H-R-U-15. That's Drew 15, D-H-R-U-15. Now let's get back to today's episode.

I believe that obesity is a disease of skeletal muscle. And here is why. Insulin resistance, which you've talked about probably in many podcasts, insulin is the peptide hormone that is necessary to move glucose out of the bloodstream into cells. And glucose is very interesting because it's a double-edged sword. We need it, yet it is toxic. So, skeletal muscle is the site for 80 plus percent of glucose disposal. 80 to maybe 90 percent of glucose disposal is skeletal muscle.

It's used by those muscles. Yes. Which is why, just to connect the dots, we're listening, if you eat like a big meal and then you go on a fast-paced walk or you're doing like some curls or some squats or whatever, that actually helps lower your blood sugar. Yes. Well, initially, you might see a little spike, but you're, blood sugar on average comes down afterwards.

Skeletal muscle is really at the focal point of metabolic regulation. And most importantly, insulin resistance starts in skeletal muscle first. So let's think about that. So it's 40% of our body weight. It's the site for glucose disposal and it's the site where insulin resistance starts first. Think about muscle as a suitcase. If you fill it up, right, if you're eating and you fill it up, and you don't unpack it by training, then what happens?

You can only stuff so much in, and then the rest, fatty acids, their increase in glucose, it goes back into the bloodstream. That is why I believe the diseases of insulin resistance, obesity, and these issues that go alongside of them begin in skeletal muscle. And it's actually in the literature. yet we, for whatever reason, have not focused on skeletal muscle as the focal point, as the pinnacle. It is always a periphery.

And really, in fitness, there's this huge gap between exercise and fitness and muscle as this metabolic organ. Very superficially, we kind of divide the two. But ultimately, if you care about these diseases of aging, you. then you must optimize skeletal muscle and you must transition the way in which you eat, the way in which you train as you age. Wow. It's fantastic to get a chance to go through all that because for a lot of people, I think you would say,

which is why you are so focused on your message. You've launched a podcast. Yeah. By the way. Yep. What's the name of the podcast? The Dr. Gabrielle Lyon Show. A link to the show notes.

A book coming out in October. It's an important message because it feels like it makes sense when you're listening to it. Now, people are trying to understand all the behind the scenes. Right. And they're also trying to compare to some of the other content that they're hearing out there. One of the ones that people hear, which would be a great opportunity to just bring up early, is that actually too much protein in the diet, which how does muscle get made? Protein is a key element of it.

Not the only element, but a key element of it has been linked to a lot of different chronic diseases. Let's just touch on that. We'll dive deeper into it later on. Let's just touch on that for a second. Well, now I'm a trained geriatrician from Washu, which is a very excellent institution. And one of the things and one of the most important aspects of health, longevity, aging has been protein. And there was a lot of myths about dietary protein, none of which, by the way, have been validated. Observational data, epidemiology data does.

one thing. And typically, when we think about the hierarchy of evidence, we take epidemiology and then we do randomized control human trials. And what we know is that based on the randomized control human trials, that now the RDA is 0.8 grams per kilogram, which is the bare minimum of protein per day. So that is the bare minimum set to prevent deficiencies. It is not the maximum. And I would just like to bring up this example of vitamin C. Vitamin C, do you know the RDA of vitamin C? I don't know. 60 milligrams, very, very low.

Now, if you were getting sick or you needed an extra boost, would you hesitate to take more vitamin C? Not at all. In fact, you would be like, I'm not feeling great. Maybe I'll take some vitamin C, right? Well, the RDA there is clearly that it's 60 milligrams to prevent deficiencies, but most people, nearly everybody, would be willing to say that is not a maximum.

Yet when we look at dietary protein that's set at 0.8 grams per kilogram per day, people say, no, no, no, that's the maximum. I am using this example to highlight the huge dichotomy that we have between nutrients and then this macronutrient protein, which is arguably the elephant in the room. It is the black sheep of the macronutrient family. The data would support that nearly double that is what is more optimal. In human randomized control trials, we know that optimizing for protein, those people always do better. They have better body composition.

They have healthier lean muscle mass. They have better insulin and glucose control. These are very important measurable outcomes that we know. We also know that it improves station. and it protects tissue. And in fact, the body, there's protein turnover that happens about 300 grams a day. We have to account for that. And not only that, but protein is essential. And there's never any evidence. There has not been, to my knowledge, nor in the literature, to support higher levels of dietary protein having any kind of negative effect. Ever. Ever. But epidemiology, it's really

interesting so if you look at the relative risk so the relative risks is what we consider in medicine when it is two or or above two we consider it clinically significant so we'll say smoking and lung cancer the relative risk would be 12 okay and this is just based in the data so they have looked at protein and the relative risk of protein intake and any kind of illness is 1.2 So according to the evidence, it's not clinically significant. And I'm really glad you bring up this point because the evidence doesn't support the narrative. Now, I thought I heard you say earlier in the interview that breakfast is kind of like one of those things.

The most important meal. Right. The first meal. We should say the first meal the day is the most important. The first meal of day. And I've had a lot of women come on the podcast and talk about. how, you know, women's needs are a little bit different than men and they're on the infradian rhythm and other stuff. And again, there's variation in individuals, even within

genders that are there. Yeah. And how often there can be pros and cons, especially if a woman is in her prime fertility years, right? For fasting, you mean? For fasting or eating like a later window of, like, lunch is the first meal. Any hot takes on that? Yeah, sure. So let's talk about the first meal the day. And why that's so important? Because this really services everybody. First meal of the day is most important whenever you have that because it is the meal that you are primed for. You have not eaten. You're in a catabolic state. You are fasted, essentially. So the definition of fasting is anything greater than eight hours without eating. So if we say, hey, Drew, got to go get your fasting blood work. That would mean eight hours or more of not eating. That first meal of the day,

is priming your body to get your muscle, right, and your blood sugar regulation, right? The way in which you do that, this is a 100% mostly fail-proof way. If you get high protein, and I would argue between 40 and 50 grams, that first meal, you are going to set yourself up for metabolic regulation for the rest of the day. And here's why. Number one, you are going to stimulate, regardless of your age, muscle protein synthesis. Whether you are 20 or you are 65 or you are my dad at 74, you will stimulate muscle protein synthesis. You must hit that first opportunity.

The other part is protein is very satiating and there's work by Heather Lydie and they looked at brain fMRIs. It's almost as if protein augments willpower. It releases certain gut hormones that really help with satiation. Also, it has a high thermic effect of food, meaning it takes energy to utilize it. So if people are concerned about weight management, optimizing for muscle, this is the way to do it. It takes 20% of the calories. So, for example, if you have 100 calories of protein, and I'm making this very black and white,

nobody just eats protein, right, unless you're maybe just eating egg whites. But for every hundred, so if you eat 100 grams of protein, then 20% of those calories, so 100 calories, sorry, a protein, 20% of those calories will be utilized to metabolize that protein. So your net caloric is 80 calories. So by leveraging the dietary choices, number one, you're stimulating muscle. You must hit that opportunity. You are being able to balance blood sugar, again, if you train. the body to be accustomed to eating protein, your body will not require external carbohydrate sources in that way.

You become very efficient. Your blood sugar will remain stable. So that first meal the day is most important. Again, and also carbohydrates, I think about carbohydrates in a meal threshold amount. And I recommend people do not exceed between 40 and 50 grams. And this is just a great take-home point for your listener. between 40 and 50 grams of carbohydrates per meal. And the reason is because we cannot at rest, unless you're out exercising, dispose of more.

And when you think about glucose disposal, you think about muscle, you think about what's required for liver and gut and all of these processes, brain. So, and again, the definition of diabetes is a two-hour blood, you know, blood sugar seeing over greater than 120. So in order to manage blood sugar, we are, looking at a 40 to 50 grams or less of carbohydrates per meal. Got it. So that was a very long-winded answer to your question, but I wanted to make sure that

there's some great takeaways for your listener, especially the woman, 50, 40 to 50 grams of protein per meal. Knock that out. Get that right. And any thoughts on, you know, how soon that happens? Because I know it's a unique day for you. You were on one podcast. You're on another podcast.

So I know a lot of times when I'm not eating, I feel a little bit more focused and But do you think that there is some importance or truth and it's okay if you don't for, you know, making sure that women, again, in their prime fertile years, fertility years, whether they're interested in having kids or not, you know, typically like you hear a lot of conversation in the space of fasting of like, I'm going to skip breakfast and I'm going to go. My first meal is typically like a lunch meal. Right. Right.

Is that more detrimental to women? Do you have a hot take on that? Yeah. Let's think about what the body has in store to manage. elevated levels of blood sugar. So the body has one way to deal with glucose. That's insulin. One way. The body has multiple ways to deal with low blood sugar, whether it's glucagon, whether it is cortisol, whether it is growth hormone. So if an individual's blood sugar is getting too low, you do see increases in cortisol. You do see increases in counter-regulatory

stress hormones. That being said, if someone is trying to get pregnant, I personally do not recommend fasting. It is an added stress. Just, you know, from an anecdotal perspective, I had two babies in two years or whatever, two and a half years. I don't necessarily recommend that. But I was not fasting during that time. I wanted to eliminate that kind of external stress on my body. And also for my patients, I don't recommend them fasting if they're trying to get pregnant.

I mean, it's a stressor. There's one other thing that has seems to be some poll. You know, again, these are observational studies. So we have to weigh them out. Which means they're low quality data. Okay, got it. Is there one takeaway, because it's good to talk about this, is that some of them seem to show that people who eat breakfast, right?

Again, not getting into the quality. We're not talking about cereal and other things like that. We're talking about higher quality, what would be considered maybe more like a European-style breakfast. breakfast, right, chakuri board or some chequisties or things like that and maybe some, you know, a little bit of food in the morning do better. And would you say that we just don't have the data because observational is too low quality, we can't come to that conclusion? I think that it depends on what health outcome we're looking at.

Is it that they do better because their blood sugar is maintained? Do we have an idea of what the macronutrients are at that meal? I think that if a meal is high-quality protein, I think that's amazing. But in terms of, again, we always have to think, well, what is the health outcome we're looking at in that way? But I also am not against fasting, and I'm certainly not against breakfast. Again, I believe that we do have to think about, you know, protein is very important in a 24-hour period, what you are getting. And then the second layer to that is protein in a discrete meal threshold. which is really important to understand, which again, the science is there, but the recommendations

have not yet caught up. That is going to be what I believe to be the future when they start understanding that meals are, there's an amino acid requirement per meal. So 24-hour period of dietary protein, understanding that meal distribution is really important, whether someone is eating breakfast or not eating breakfast or wanting to get pregnant or not wanting to get pregnant, we have to account for the essential need for protein.