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Why You’re Probably Not Eating Enough Protein (How to Know for Sure) [transcript]

Written by Christopher Kelly

Feb. 21, 2020

[0:00:00]    

Chris:    Well, Megan, thank you so much for joining me this morning. How are you doing? How is it in Colorado right now? Is it snowing?

Megan:    It’s good. We’ve gotten a ton of snow the last couple weeks. It just snowed a little bit earlier this afternoon, but we’ve literally gotten probably 30 just in the last 2 weeks and that’s down like in the Denver area, the mountain of a ton more. So, it's been fun. 

Chris:    I was gonna say are you having fun with it. That's the thing. It's one thing to shovel out your driveway and it's another thing to go snowboarding on it. Right?

Megan:    Yeah. Yeah. And actually, I’m learning how to snowboard this season. So, it’s been a humbling experience, but I can finally get down. The green runs really well and I did my first blue run last weekend. 

Chris:    Oh, good for you.

Megan:    It’s a lot of fun. Yeah. 

Chris:    Excellent. Yeah, I remember my first day when I learned to snowboard and I was pretty gung ho. This was 1997 I believe. The day ended in the emergency room in Austria and I had several stitches put in my head. This is before anyone really wore helmets. Like I don't remember seeing anyone wearing helmets at that time. And a simple bit of [0:00:58][Inaudible] would have saved my head, you know, but yeah. Lesson learned. The board can hit your head if you do a rag doll down the slope faster enough. It will happen.

Megan:    Oh, dear. Yeah. I cringe at the people that are not wearing helmets these days. It's a little bit scary. 

Chris:    Yeah. Yeah. Let’s talk about protein. Why should we talk about protein? What was it that motivated you to record this podcast?

Megan:    Yeah. So, a lot of times we have our clients who work with us at Nourish Balance Thrive do like a food diary at the beginning of working with us just so that we can make sure they’re eating enough of the right thing, getting enough of the right macro and micronutrients, appropriately timing their meals, etc. And one thing that I see consistently probably 99% of the time is people not getting enough protein even when they're coming to us eating a relatively, you know, Paleoish style diet. They're still eating enough protein. So, I wanted to talk today about a little bit of like a short review of the protein literature, why it's so important to kind of prioritize the protein in your diet, what we see as far as people coming to us in general, and then how to fix that. Some tips about kind of how to get enough of the right protein at the right times. 

Chris:    Well, that sounds excellent. Let's dive in. Let’s talk about why protein is so important. And of course, this is your area of expertise as scientific director. Can you give us an overview of the literature? 

Megan:    Sure. So, there's a lot of reasons why protein is important. First and foremost, protein contains amino acids, which are the building blocks for muscle. And there are many studies to show that muscle mass and strength are some of the most important predictors of longevity. And I would also argue health span as well because having muscle strength and function as you age will allow more life in those years whether that means, you know, playing with your grandchildren or whether that means continuing to do the activities you love. So, just a couple of studies to highlight. We’ll put all of these in the show notes, but there are certainly many more. So, one study in Hawaiians looked at muscle strength and longevity up to age 100. And they show that high midlife muscle strength and they measured this by grip strength was a positive predictor of longevity. Another study used leg and bench press to assess strength and they found an inverse association between strength and all-cause mortality. So, higher strength, lower all-cause mortality in men and that was even after adjusting for cardiovascular fitness. So, we know that cardiovascular fitness is very important as well, but independent of that strength is also really important.

Chris:    Can you explain a bit about why this is true? Because intuitively, I mean, it's obvious. Right? Like “Oh, well, muscle mass is a good thing.” But why do you think it’s important for health span? What do you think is going on here? So, I mean, what most people say is especially like lower body muscle mass, if you were to, you know, fall or break your leg and you ended up in the hospital, it’s not typically like that break that is what takes you out. It’s being in the hospital getting pneumonia, etc. So, being able to, you know, prevent a break like that by having muscle mass, having more muscle coordination, having more muscle strength is really important. The other thing is just in general for health span, not necessarily lifespan, but if you have more muscle mass, if that muscle is more functional like I just mentioned, kind of you'll be able to continue to do the things you love to be more social in doing the things you love. And we know that social connection, and physical activity out, and all these things are really important for longevity and health span as well. 

Chris:    Yeah. It’s funny you mention Hawaii. I’m in Hawaii at the moment and I saw that yesterday on the beach. There’s all these people out snorkeling. I mean, it’s mostly older people if I’m honest. And you see them come out of the water and they slither out on to the sands like the turtles— I’m not kidding— or the seals, you know. And rather than walking out, they have to like slither out on their belly and then have somebody help them up to their feet. Like these people can’t get up unassisted. 

[0:05:00]

    Of course, when you’re on the beach, there’s nothing you can grab on to to pull yourself up. I thought that was amazing. Apparently, it’s really common.

Megan:    There’s another study that looked at muscle mass. And typically, muscle strength is the greatest predictor of mortality versus actual mass, but they typically go hand in hand. The study that looked at muscle mass in particular found a lower total mortality risk in older adults like older being greater than 55. They did use bioelectrical impedance as a proxy for muscle mass, which isn’t the gold standard, but still that there was a correlation there. As far as other things, why we want more protein in our diet, why we want more muscle mass, glucose disposal. So, we know that the more muscle mass we have, the more glucose we’ll be able to dispose of into it versus elsewhere like adipocytes or keeping it around in our bloodstream where we don't want it. And this is important for everybody, but particularly important for those people with diabetes or prediabetes. 

Chris:    So, skeletal muscle is the primary place that you dispose of glucose and that's really what we're looking for; is rather than trying to put less down the hatch, you're trying to create a better sync. 

Megan:    Yeah. Exactly. And you can do that, you know, in general by just having more muscle mass. You can also do that by strategically timing your glucose rich meals around when you exercise, but in general more more muscle mass is going to be better. Also, protein is really important for maintaining a healthy weight. There's something called the protein leverage hypothesis. I’ll link to a study about that. I think it was the original study where that term was coined in the show notes. But basically, the protein leverage hypothesis is based off of two observations. One is that protein largely makes up about 15 or so percent of the daily energy intake for the average person and then the total amount of protein intake has stayed relatively constant despite the obesity epidemic where we see, you know, calories in general going up. So, the protein leverage hypothesis then posits that when a diet is lower in protein, appetite will increase until a minimum amount of protein is meant. And if this is true, then maximizing the amount of quality low energy density protein becomes very important for maintaining a healthy body weight and body composition.

Chris:    So, protein has this satiating effect. Right? 

Megan:    Yeah. And it's almost like our body intuitively knows that. You know, we require a certain amount of protein to live. And if we're not getting not that, then we're going to keep eating, and eating, and eating until we meet that requirement.

Chris:    Okay. And you don't necessarily crave protein specifically. You just get hungry. 

Megan:    Yeah. I mean, some people do. But oftentimes, the theory says that we’re eating to kind of get this minimum amount of protein in our diets. 

Chris:    I’m pretty sure it’s Ted Naiman. Do you know Dr. Ted Naiman? I've heard him talk about this idea of protein dilution when you look at the changes that have happened to our diet over the past decade. That's what you see. It’s like in all areas. It’s like protein has been diluted and replaced mostly with refined carbohydrates. So, I wonder if that’s the same thing.

Megan:    Yeah. I mean,  that's why it's really important to kind of really focus on the quality low energy density proteins versus something that has like a little bit of protein, but a lot of carbohydrate fat. So, you would need to eat a lot more calories from something like that, then you would need to eat out of a breast or a piece of steak. 

Chris:    Right. 

Megan:    And then I want to talk a little bit about recommendations. The current RDA, which is simply the amount needed to not waste away or die, or if you want put it more nicely, how much one person needs to maintain basic physiological function— So, the current RDA is 0.8 grams of protein per kilogram of body weight per day. That's far too little and it's not nearly enough to optimize health. 

Chris:    Why would that be? Why would they put the RDA so low?

Megan:    I mean, it's the definition of the RDA. It's just the very basic minimal amount that you need. It's not talking about optimization at all. So, to optimize things, what kind of protein “experts” recommend is that adults get a minimum of 0.25 grams of protein per kilogram of body weight per meal and that's assuming that you're eating 4 to 5 means. So, if you're eating only 2 or 3, you need to address that based on your meal frequency. I think 3 to 4 meals a day was probably optimal to allow for sufficient overnight fast and then to allow for 3 to 4 hours in between meals and then to also get enough protein throughout the day.

Chris:    Right. Right.

Megan:    And then in aging adults—  so, typically aging is defined as like over 70 years old— need even more than that. So, they need 0.4 grams per kilogram per meal. Again, assuming that's 4 to 5 meals per day. So, adjust up or down depending on how many meals you eat. And then infants and children also have higher protein needs per kilogram of body weight than adults. So, they typically need 0.3 grams of protein per kilogram per meal. 

Chris:    Right. And so, the initial number you said, adults minimum 0.25. So, the adjustment for over 70, 0.4. That’s a huge adjustment. Wow. Yeah. I mean, how many people listen to this have got parents that are eating 0.4 grams per kilo per meal of protein, right?

[0:10:07]

Megan:    Well, very few people are doing that unless you have some kind of maybe like strength or physique goal. So, it’s pretty eye opening that, you know, the aging population will kind of transition now into special populations. The aging population is arguably the population that eats the least amount of dietary protein. They need the most amount and they're also most negatively affected by insufficient protein intake. So, we know that there's this gradual loss of muscle mass and function with age and anabolic resistance also occurs, which is when the body needs more a stimulus than it did in younger years to maintain muscle mass. This is basically needing more protein to elicit the same muscle building or maintenance response than it did when the person was younger. So, again, that 0.4 grams per kilogram per meal spaced between kind of 3 to 5 meals throughout the day is ideal. There was a really interesting study from Luc Van Loon’s lab that showed the ground beef was more readily and rapidly digested and absorbed in older men than steak was. So, preparation of the protein could be something to consider in older populations whether that's because they have a little bit less stomach acid or whether chewing is a little bit more difficult for them or, you know, maybe it's just the slightly more processing in the ground beef just makes it more digestible. That's something to consider for people who are a little bit older or people in general who have digestive distress. We work with a lot of people who, you know, have gut issues and it's possible that, you know, if they had ground beef versus steak that you have to chew, and chew, and chew. They might be able to digest and absorb more of the amino acids and nutrients from the ground beef versus the steak. 

Chris:    Right. And so, this is the recommendation for older people. So, you just said working with clients is something you’d often recommend.

Megan:    It is something. The study was just in older people. But again, if somebody is having some digestive distress and they’re having problems either digesting protein or just in general they feel like their digestive system is off, then oftentimes— or if they’re transitioning from like a vegan or vegetarian diet into an omnivorous diet, then sometimes using ground beef instead of like whole steaks can be helpful. 

Chris:    I do remember that transition. 

Megan:    Yeah. And I never did that transition, but I've heard about it. 

Chris:    Yeah. Yeah. It took me about 10 seconds to get over I think once I started eating my first egg. But yeah, I did realize that certain types of meat were more easily digestible, but not soon after. Right? 

Megan:    I don’t know if there’s any studies on this. It’s just something that popped into my head. Slow cooked meats might be very similar to something like a ground beef versus like a steak. So, you know, play with preparation if you have digestive symptoms or if you're somebody who is older and looking to get more digestability from the protein that you're eating. And then there is some controversy with this, but some longevity experts say that, you know, we should restrict protein, we should be doing more fasting as we age. And protein restricting and fasting are probably even more detrimental as we age because that is allowing, you know, fewer opportunities throughout the day to get this sufficient protein to support lean muscle mass preservation. So, if we go back to, you know— Chris, you said your parents aren’t eating 0.4 grams per kilogram per day. And you know, if they only had 2 meals and 8 hours to eat that, it would be near impossible. Right?

Chris:    Right.

Megan:    So, fasting (not so much protein restriction) maybe has this place. But in older people, we do have to be a little bit more careful. And then athletes are another kind of special population here. So, endurance athletes, we need protein to repair the wear and the tear that endurance training has on our bodies. There's about 10 grams of amino acids that are burned per hour of endurance exercise and those need to be replaced. Otherwise, the athlete will tap into their own body source of protein, which is your muscle, which we don't want. So, kind of the range for endurance athletes per day would be 1.2-1.6 grams per kilogram per day, would probably strive to err on the higher side of that. And then for strength training, for those who want to optimize muscle size and strength, the ideal protein intake seems to be slightly higher than for endurance athletes. So, it would be probably 1.4-1.8 grams per kilogram per day and that would include a calorie excess. 

Chris:    And do you think timing is important here? For example, would you recommend, you know, for insurance athletes them supplement with some form of amino acid during activity or immediately after? Anything like that?

Megan:    I will talk a little bit about amino acids later. But  in general, if somebody's eating enough protein throughout the day, they don't need amino acid supplementation. If somebody's training fasted or they're doing a really long training or racing event, then I think that's where some essential amino acids can come in handy. 

[0:15:01]

Chris:    Okay. Got it. 

Megan:    And then weight loss and calorie deficits, that's another situation where people might need more protein. In fact, they do need more protein. So, when people embark on a weight loss endeavor, they typically want to lose body fat, not lean muscle mass. So, in order to favor that fat loss over lean muscle mass in a calorie deficit, protein becomes even more important. And in these cases, the recommended amount is like 1.8 to 2.2 grams per kilogram, so up to about 1 gram per pound of body weight. And there's no harm in going over 1 gram per pound or 0.2 grams per kilogram, but it’s likely unnecessary for the majority of the population.

Chris:    Okay. That’s a lot of protein.

Megan:    Yeah. Especially if you're just getting protein from whole food sources and not, you know, shakes and bars, it's pretty hard to get your body weight and protein everyday. You have to be really cognizant and conscious of getting that.

Chris:    Right. The other thing, I wanna talk here about a couple more things before we talk about some practical aspects, but timing. So, the average American has— and this is very similar to meal sizes that we talked about before— but the average American has like minimal protein at breakfast, a little tiny protein maybe with lunch, and then most of it with dinner. Now, ideally, protein is spread relatively evenly throughout the day with probably like 3 to 4 hours in between meals. And there was a study showing that 20 grams of protein— I will link to this in the show notes— 20 grams of protein 4 times a day was better than 10 grams of protein 8 times a day or 40 grams twice a day. So, this shows that we want periods of high and low amino acids in the blood for maximizing muscle protein synthesis. And then we come to the amount of protein and also something called the leucine threshold. So, if we’re talking about protein in the context of triggering muscle protein synthesis, which is one of the main reasons we want protein around, we need not only want this pulsatile stimulation of mTOR, which is the protein kinase that's largely responsible for muscle growth, but we also want to make sure that we're meeting the leucine threshold. To back up a bit, leucine is the amino acid that's most responsible for regulating mTOR. And every time we eat, we want our protein rich meal to contain about 3 grams of leucine to stimulate maximal protein synthesis. The leucine threshold may be higher in older people because of that anabolic resistance that occurs. And I'm not necessarily advocating that people go and count, you know, the milligrams of leucine and whatever protein they're eating. But if you're eating a good source of 30 to 40 grams of an animal protein with a good amino acid profile, you should be hitting that leucine threshold. 

Chris:    I see. So, no need to do anything special there, but just know that 3 grams of leucine is required to maximally stimulate mTOR. 

Megan:    U-huh. Yeah. And then I’ve wanted to just briefly talk about a couple of myths that people talk about when high protein diets are discussed. And I'm not even talking about necessarily high protein diet. So, in my mind, just like low carb or even high fat, there's no set amount of protein in the literature that says this is a high protein diet versus this is a low protein diet. In general, I would say probably if you're eating above a gram per pound of body weight, that would be considered high in my mind. But as far as myths go— So, one myth is that high protein diets are bad for your kidneys and in truth there's very few health conditions where low protein diets are recommended. And the kidneys actually seem to become more efficient at clearing protein, metabolizing protein with higher protein diets. And we also see an increase in GFR with higher protein intake. And one thing I just wanna note because we see this all the time and a lot of people get concerned about it, but blood urea nitrogen or BUN on a blood test— Higher BUN in a healthy person with normal creatinine levels who are eating normal or proper amount of protein like we just talked about as far as recommendations go, that's not a bad thing. So, that's probably just indicative of you having more amino acids in your body, which is again not— 

Chris:    Right. So, BUN doesn't tell you anything about the source of those amino acids. If they were coming from your bicep, then you might be concerned. If they’re coming from your diet, then not so much. And I almost guarantee that everybody listening to this is going to see higher than say the American population average BUN when they do a blood test and you should not be overly concerned with that. 

Megan:    Yeah. Yeah. And a lot of people are concerned about like for kidney function with high BUN. But if creatinine is normal and your other kidney markers are fine, then a high BUN in the context of a healthy person eating enough protein, you know, not a problem at all. One of the other myths is that high protein diets are bad for bone health. And this comes from the idea that protein leeches calcium out of the bone and that's not true. There is an evidence to support that for bone health protein actually supports it. So, bone has a protein matrix. Minerals are important, but it's not the whole story for bone health. So, protein is definitely important for overall bone health and bone density.

[0:20:02]

Chris:    I've not heard that one before. Where did you find it? Is that with working with clients you heard that or did you see it somewhere else? 

Megan:    No. It’s just kind of a relatively well-known— not myth— but a lot of people think their high protein diets will kind of leech calcium out of your bone.

Chris:    Interesting. 

Megan:    I don't know where it came from. Well, it came from this idea that protein leeches calcium out of the bone, but there's no sciences to support that. If anything, it's the contrary. Okay. One of the other arguments people hear about higher protein diets is that mTOr simulation is bad. So, this idea is the idea behind the so-called longevity diets that are low in protein. The idea for those is to lower mTOR and thus extend lifespan. And I don’t think any of these people have ill intentions. I think they’re relatively smart people. I don't necessarily agree with their recommendations. So, Dr. Valter Longo, David Sinclair, Steven Gundry, Ron Rosedale, they all talk about this idea of wanting mTOR as low as possible for longevity. And I know that there's a study that— Was it Longo? Longo was one of the authors on it, right, Chris?

Chris:    On this study that cited here loads of protein intake is associated with a major reduction in IGF-1 cancer and overall mortality in the 65 and younger, but older people. Yeah, I think Valter Longo is the principal investigator on that paper. 

Megan:    Yeah. Yeah. I personally haven't read that study since it came out because I thought it wasn’t a very good study. But if I recall, their data didn't necessarily match their claims. I can go back and look at ‘em in more detail if you wanna talk about it on the forum. But yeah, there was a lot of uproar when that study came out. 

Chris:    Right. Right. And you probably heard Valter Longo. You’ve been listening to all the podcast. You probably heard him say things like we provide convincing evidence that high protein diet particularly if the proteins are derived from animals, it’s nearly as bad as smoking for your health, which I do not think that data justifies that claim. The main thing you gotta watch for is the nutritional epidemiology. Right? So, people love to torture the enhanced nutritional epidemiology data, which is all based on food frequency questionnaires, which are really, really bad like I how many sticks of butter did you eat last year, how many grams of salt did you eat— Nobody knows the answer to those questions. And you know, even if they were keeping a diary, it still probably wouldn’t be accurate data. So, you can basically learn nothing from it. But for some reason, scientists love to just keep coming up with new bogus claims using that data. It’s completely bizarre. Mr. Valter Longo has done some really interesting and great work. I've no idea why he would publish a paper like that. It has to be some sort of political, some sort of opinion, I mean, I’ve seen the same thing. I just read The Good Gut by Justin Sonnenburg. He says exactly the same thing like ruins and in perfectly good book with these bogus protein recommendations. It’s really sad.

Megan:    Yeah. Yeah. For sure. And in truth like we want to do specific periods of mTOR activation. So, something like resistance exercise followed by protein ingestion that up regulates mTOR activity in the muscles, but not necessarily the other tissues. We know that the best way to chronically activate mTOR where we don’t want it such as, you know, adipocytes and maybe liver is to become overweight and/or obese and be in a constant state of energy excess. So, you know, having mTOR up regulated in the muscles because you’re resistance training and eating proper amounts of protein is not a bad thing at all. And a part from supporting muscle growth, we need mTOR to do things in our body like mount a proper immune response. So, I'm very skeptical of something like either very low protein diets or something like rapamycin, which is an mTOR inhibitor that globally decrease emptor activity. Ultimately, what is probably ideal is having periods of high and low mTOR that is tissue specific. 

Chris:    Yeah. I'm always suspicious when the answer is too simple. Right? There’s black and white thinking. And the same thing with nutritional bogeyman, right? I’ve heard Chris Masterjohn talk about this. He’s very good on this topic, you know. First, it was fat. Now, it’s carbohydrate like, oh, let’s just switch up the bogeyman. Oh, now it’s protein. Yeah. I don’t think so.

Megan:    Yeah. For sure. And one other myth that people talk about is that eating animal protein and meat is bad for the environment. There are a couple of podcast recommendation. So, Dana Rogers talked about kill versus cow on the Nourish Balance Thrive podcast a while back. And I would point people to her podcast just because it could be whole discussion in and of itself obviously. 

Chris:    Yeah. Absolutely. That was the reason why I was trying to be a vegetarian, was because I thought I was doing something for climate change. And now, I have absolutely no idea whether that's the right thing to do or not. And in fact, if anything, I think it's probably not the right thing to do and that was part of my motivation for interviewing Dr. James Estes about his work on keystone species and trophic cascades. 

[0:25:02]

    I'm not sure that was entirely clear from the interview, but my point was you can't really say anything about sustainability until you know something about an ecosystem. And a monoculture of soybeans is not a diverse ecosystem and there's nothing to recycle the minerals and all the other good stuff that needs to go round and round in circles and that is exactly what a large ungulate does. And so, I don't think you can get rid of those without there being consequences. And you know, we've just been down to San Diego zoo where they were showing you all the mega fauna that was present even 12,000 years ago, you know, these giant elephants that were as big as Woolly mammoth, but had no chair, and these huge saber tooth cats. That was just 12,000 years ago just before the invention of agriculture and there was a lot of big animals before that was that type of climate change. So, you know, I think it’s a little bit more complicated than that. 

Megan:    Absolutely, I would definitely agree. And I would encourage people to go and listen to those two podcasts for sure. Another myth is the branched-chain amino acid myth. So, we talked a little bit about amino acids in the context of like an endurance training session or race. But just to recap, there’s probably no need for them if you’re getting sufficient dietary protein. And now that we know about this losing threshold and wanting pulsatile stimulation of mTOR, the last thing you want is a constant IV drip of amino acid. So, a lot of people think that, you know, sipping on this branched-chain amino acid drink throughout the day or throughout their workout will be a good thing. That's probably not the case. And then another myth is that too much protein will kick you out of ketosis. I would direct people to Ben Beckman's low carb talk where he talks about glucagon versus insulin. And the gist of it is in the context of a low carbohydrate diet, we really don't need to worry about protein stimulating insulin. And also, there is typically no need to chase really high amounts of blood ketones for the sake of having high amounts of blood ketones unless of course you are using a ketogenic diet for therapeutic purposes like cancer or neurodegenerative disease. I'd much rather people, you know, eat sufficient protein as we recommended previously versus trying to keep protein as low as possible to keep ketones as high as possible. 

Chris:    Right. And that’s interesting then. So, you, yourself, being a researcher in ketogenic diets, you don’t think it’s important for clients to measure their blood level of ketones unless they have a very specific reason for doing so.

Megan:    I think sometimes it can be helpful to know if you’re in ketosis or not, but there’s two problems. One is people tend to really like focus on the number. Typically, as they adapt and get more “fat adapted” or “keto adapted” if you wanna say that, the level of ketones actually tends to drop and that’s probably because your body is able to utilize those ketones better. And then the other thing is just in general like blood ketones don't necessarily tell us anything about the flux and how you're using those ketones. So, it’s possible that higher isn’t necessarily better. Having some ketones around is obviously important. That's the definition of the state of ketosis. People don’t need to be striving for these, you know, levels of three or more ketones in the blood. 

Chris:    What would you think is a better metric for most people then? Can you give an example of a client that shows a different metric that works better for them? Because that's the nice thing about measuring the blood levels of something, is it lets me know that what I'm doing is working. Right? In general, in health and fitness, you don't get that much rapid feedback and that rapid feedback can be really helpful for me learning what works. So, can you tell us about something that’s maybe a better metric?

Megan:    Yeah. Well, first of all, like I said, I don't necessarily think that measuring blood ketones is a bad thing. I think they’re getting hung up on the number is a bad thing. So, measuring to know that you're in ketosis is fine and I do recommend that sometimes. But in general, like I would ask (A) like why are you doing a ketogenic diet. And then if you have reasons for that, so, is it for cancer or neurodegenerative disease where you do need those ketones higher, or is it for weight loss, or is it for maybe trying to become better fat adapted or something like that? Then use those metrics. Are you losing weight? Are you able to go do a fasted run versus you couldn't before? Use those metrics for whether or not the ketogenic diet was working.

Chris:    Okay. One more myth before we kind of get into some general recommendations and what we see. And this myth may have kind of died out, but some people might have heard that the body can only use a certain amount of protein at a time. Typically, that's like 20 to 25 grams. And we’ll link to an article that talks about this, but I think some of this idea came from the fact that a lot of the protein literature uses whey protein, which is a really fast-acting protein. And in the real world, people are usually eating mixed meals where there is a slower release and digestion of amino acids. And there was a lot of controversy about like an exact ceiling about how much protein your muscles can use for muscle protein synthesis at a given time. 

[0:30:08]

    However, the fast-acting proteins like whey given in isolation, 0.4 grams per kilogram of body weight per meal seems to be about right to maximally stimulate muscle protein synthesis after exercise. There’s some evidence suggesting that that ceiling may be higher, so as high as 0.6 g per kilogram in older individuals experiencing anabolic resistance as far as like stimulating in that muscle protein synthesis post exercise. As the authors of this paper that we’ll put in the show notes speculate, the ceiling is probably larger for a mixed meal, so you can eat more protein than 20 to 25 grams and a mixed meal where the amino acid release indigestion is delayed. So, I’d rather people be more concerned with how much protein they’re eating throughout the day than with the details of just how much will be used in this setting.

Chris:    Right. Okay. This myth I have heard of. Okay, that makes a  lot of sense to me especially given your protein recommendations because if you could only use 20 to 25 grams at a time, then that is in direct contradiction with what you said earlier about the daily requirements. Right?

Megan:    Yeah. Exactly. Okay. So, I wanted to kind of transition and talk a little bit about what we often see with our clients. And I kind of alluded to this in the beginning. But a lot of our clients come to us— Some people wanted to just optimize. Some people have overt health conditions that they want to get to the bottom of, but many of them are coming to us eating kind of a Paleo-ish diet already, at least like a wholefoods diet. Most of them are eating, you know, the standard American diet, but they're still eating far too little proteins. When we do a food diary and I look to see kind of how many protein feedings are getting throughout the day and then like the amount of protein, it's way too little. And it's not uncommon for me to see people who are snacking a lot between meals and they feel hungry. They have inconsistent energy levels throughout the day. They may have a blood glucose dysregulation for no apparent reason. And all of these things can be potentially fixed by prioritizing regular protein throughout the day with meals. So, for example, this is not atypical. This is very, very common for what I might I see. So, somebody might be having like 2 eggs with avocado and some berries for breakfast; a sad with a can of sardines for lunch; and maybe some chicken, and vegetables, and potatoes for dinner. So, if we add all of that up, that's 7 grams total max for each of 2 eggs. So, that’s 14 grams there let's say if they're large eggs, 18 or so grams for a can of sardines. And if I’m being generous, let's say 30 grams of protein with the chicken at dinner. So, that equals out to 62 grams of protein. And a small female typically requires much more than that. 

Chris:    So, there's no that’s enough. But it sounds good, doesn’t it? It sounds like a decent amount of protein. You’ve got protein every meal at least, but it’s not even close to your target or your recommendations from earlier.

Megan:    Exactly.

Chris:    Could you tell us what you had? So, what’s a typical day for you, Megan? That’s an interesting question. You’ve got all this knowledge. So, what would be the substitutes for you?

Megan:    Typically, for breakfast, I’ll do eggs either plus protein from the night before to kind of equal out to somewhere between 30-40 grams of protein or I'll just have leftovers from the night before. For lunch, I’ll either do like 2 cans of sardines or again some kind of meat or fish that’s already prepared. I like to prepare in bulk just because it's a lot easier than, you know, spending 30 minutes in the kitchen 3 times a day type of thing. And then for dinner, you know, having somewhere between like 5-8 ounces of beef, or lamb, or poultry, or something like that. And then if needed, you either add in another meal to, you know, get to where you need to be as far as your protein target or a snack as well. 

Chris:    Right. Okay. So, how many grams of protein do you think you eat in a day?

Megan:    I try to get between 100 and 120.

Chris:    Okay. Okay. 

[Crosstalk]

Megan:    That’s about 1.8 to 2.2 grams per kilogram for me. Anywhere between there. 

Chris:    Okay. Yeah. I think you put me to shame on at least one occasion. I remember the first time I saw you putting 3 cans of sardines on to your salad and I was like “Man, I guess you’re right.” Yeah. You look at the back of the can. You’re like “Blimey, a can of sardines is only—” What’s it? 18 grams or something? 

Megan:    Uh-huh. Yeah.

Chris:    So, you can easily do 2 cans of sardines.

Megan:    Yeah. For sure.

Chris:    I do like breakfast though. I mean, Julie gets this and has got this from the beginning like I don’t think we’ve ever changed our position on this. And she was saying it’s actually the same thing to clients 5 years ago. You’re seeing exactly the same problem 5 years ago. And a typical breakfast for us— So, this morning, I had 3 eggs and maybe 1 or even 2 cups of ground meat. You know, when it's cooked, if I put it in on one of those Pyrex jugs, I think it would come up to the 2 cup line in addition to 3 eggs. 

Megan:    Yeah. That's great. That's great breakfast.

Chris:    Yeah. And that’s just like the default for— 

[0:35:01]

    Julie does— I’ll be honest. She does all the cooking. I just do the eating part. That’s just a sensible default for her. That's always what she does. I mean, I’m on my own for lunch and, you know, dinner’s the same. I mean, that’s what the word means. It’s like primary. Right? Protein.

Megan:    Yeah. Absolutely. And it's typically like ideally, you know, you get those 3-4 protein meals throughout the day, but people are most lacking in protein at breakfast. And it's arguably like the most important time to get protein just because of the overnight fast. It kind of sets you up for good blood glucose regulation throughout the day. So, yeah, it’s really important to prioritize protein in general. And so, as far as like how to fix the problem of not eating enough protein, building your meal around protein, which you kind of just alluded to, Chris, that's what you guys do in your household. If you are getting— I mentioned this before. But if you are getting protein from real whole food sources, so not bars or not shakes, most people— You have to be consciously aware of eating enough protein at each meal to reach the amount that they should reach. I also like to recommend having like quick protein handy ready to go so that would be like cooking in bulk and having leftovers, having canned fish around, sardines, salmon, having jerky, having dairy if you tolerate it, cottage cheese, or yogurt, or cheese and then hard boiled eggs as well can be good kind of quick sources of protein. A lot of times, people— It’s not necessarily that they don't wanna eat the protein. It’s that it’s inconvenient to eat the protein. So, having it ready to go is a really great thing to do. I wanna talk about like what counts as a high quality protein versus and low quality protein. 

Chris:    Oh, yeah, of course. You haven't talked about this. Yeah. It’s actually the bioavailability of the protein varies depending on whether that comes from an animal or a plant source. 

Megan:    Yes. Absolutely. So, if somebody is an omnivore, only animal proteins count. So, that would be fish, shellfish, poultry, beef, lamb, wild game, eggs, dairy if tolerated. Collagen protein does not count. So, if you're doing a smoothie in the morning and you're doing a scoop or two of collagen protein, I think collagen protein is great. It's great for your tendons and ligaments. It may be helpful for gut health, but it does not count as a complete protein source because it doesn't have sufficient amounts of all the amino acids. Collagen is particularly low in leucine, which, you know, as we talked about before is the key amino acid for mTOR simulation. 

Chris:    So, if you're working with somebody— Wait, you just don't count the plant sources of protein. 

Megan:    No. If they’re an omnivore, absolutely not. If they're a vegetarian or vegan, it's definitely harder to get sufficient protein. It's not impossible. The issue comes with the— one, the quality and then the amount of calories and carbs that typically come along with the plant protein source. So, ultimately, you know, plant protein, legumes, nuts are less concentrated source of protein. For example, 100 grams of dry lentils, which obviously expand when they’re cooked, 352 calories, 62 grams of carbs, 25 grams of protein, which is an incomplete protein source, so it doesn’t have like the full spectrum of all the amino acids and the proper amounts, and 1 gram of fat, about an equivalent amount of protein from 100 grams of lean beef would be 117 calories compared to the 352 calories in lentils, 23 grams of protein, so relatively comparable, and 3 grams of fat. So, you can see, you know, it's almost 3 times more or 3 times more calories from that the steak to the lentils.

Chris:    All right. And can you even really compare those two? Because surely the protein from the steak is going to be far more bioavailable than from the lentils. 

Megan:    Yes. Yeah. Absolutely. I was just kind of illustrating the fact that, you know, you have to eat many, many more calories and carbs from plant protein than from animal protein and that's not even to say that, you know, the plant protein is incomplete and the bioavailability will be less for sure and that's because of the amino acid profile. It’s also because plant proteins typically have, you know, lectins, and phytates, and other kind of “antinutrients” where you may not be absorbing as many of the nutrients as you would in— 

Chris:    Right. But being vegetarian or vegan, is that a deal breaker for you? Will you work with a client that has those requirements? 

Megan:    You broke up there for second. Were you saying is it a deal breaker? Will I still work with them?

Chris:    Yes. Exactly.

Megan:    Yeah. I absolutely will. It’s harder especially if they’re experiencing gut symptoms and they're reacting to a lot of plant foods. In my mind, it might be a little bit. They might experience more symptom relief sooner if they were to add in some animal foods that they were okay with, but sometimes they don't wanna do that and then it's, you know, the process of figuring out which plant foods are less harmful for their gut. And sometimes people who are vegan or vegetarian end up transitioning into, you know, more of an omnivorous diet and sometimes they don't. 

[0:40:00]    

Chris:    Yeah. And I think there’s always restrictions. Right? There’s always something you can’t fix just that easily. I mean, that should be no different. It does make it hard. I mean, the thing that makes it really impossible is when there's no openness or curiosity, whatsoever. Right? Like I just want you to send me a magic pill that's gonna fix my gut like that’s the thing that’s impossible. 

Megan:    Yeah. Yeah. Absolutely. One more thought on kind of vegetarian, vegan diets. So, for those who don't wanna eat animal protein, it's typically imperative that they supplement with a plant protein powder if they wanna get the recommended amount of protein in their diet. Many of which have their downsides such as heavy metals and less than optimal digestibility and amino acid profiles, but they are better than nothing.

Chris:    Yeah. I definitely wanna see a certificate of analysis for any products that are concentrated, plants, powder. I mean, we saw this recently. I can link to this in the show notes. The amount of arsenic that’s in baby foods that’s made from rice is really quite unacceptable. And you can probably expect to see something like that with any concentrated source of plant food because plants do seem to accumulate these environmental pollutants and it's not to say that they’re all bad. It's just that you should ask your supplement manufacturer for a certificate of analysis, which they should willingly do. And it may even be on the website where you purchase the product. And if they won't do that, then I would just buy stuff from someone else. 

Megan:    So, ideally, if you’re getting enough protein, you shouldn't necessarily need to snack. But if you feel like you need to snack, I would definitely opt for higher protein food. So, EPIC has some really good like meat bar and meat bite products, cans of sardines or salmons, leftover protein, hard boiled eggs, etc. Those can be really kind of good snacks for protein if you feel like you need to snack. And the other thing is a lot of times, you know, people ask “Oh, what can I snack on?” I say, “Just make your snack another like mini meals. So, have a protein and a fat in or a carb, you know. It doesn’t have to be “snack food.” But in general, I really don't think that people should need to be snacking too much if they're getting, you know, sufficient amount of protein with a good fat in or carb source at every meal.

Chris:    Right. And you know this when you got little kids. I know you don’t know this yet, Megan. Maybe one day you will. But yeah, certainly, if they don't eat their protein at the meal, then you just— 

Megan:    Hungry 2 hours later.

Chris:    Well, it’s just like you spend the whole day like a short order chef, you know. It’s like just running around. And then if you don’t service them, then they start rooting around in the cupboards. And they don’t choose protein, right? Like I don’t know why that is. But yeah, they’re always gonna go for the readily available, usually like anything resembling dry fruit or something like that, not sometimes, but usually it's carbs that they go for if they can get their hands on ‘em. 

Megan:    Uh-huh. Yeah. And then the last thing as far as like, you know, what to do, I know this is not necessarily directly related to protein, but it's definitely indirectly related. I'd be remiss not to mention the importance of resistance exercise for the preservation and gaining of lean muscle mass. I absolutely think that certainly all exercise including cardiovascular exercise is really important for health, longevity, but resistance exercise in particular or just lifting relatively heavy things compared to your body weight is a really critical part of healthy aging. And I don't think it's ever too late to start strength training. But ideally, you know, we’ve had some older clients who are endurance athletes who have been endurance athletes for years, and years, and years who never really picked up a barbell, or a kettlebell, or a dumbbell. And you know, they really find that, you know, for injury prevention, for maintaining strength, the strength training is really important going forward. So, like I said, never too late to start strength training. Ideally though, you take advantage of kind of gaining as much muscle mass as you can while you're younger so that you're protected against things like sarcopenia and its related conditions like type 2 diabetes, nonalcoholic fatty liver, etc. when you're older.

Chris:    Yeah. My experience working with endurance athletes including myself actually when you crossover and start doing more strength training, the problem is the motivation is low in the beginning. Right? You have very good competency at some other discipline like— So, for me, that’s riding a bike and then you go to the gym and you pick up a barbell. You’re like “Wow, this is not fun at all. I wish I was out on the trails riding my bike with my dogs right now.” But really, what you need in the beginning is commitment. Simon's been really good on educating us in this area and then the motivation comes later with competencies. So, you’re just gonna suck it up in the beginning and then you get good at it later and then you start looking forward to going to the gym. I mean, usually the athletes are really good at this, right, discipline and commitment. They’re super good at that. But just know that. That’s why it sucks in the beginning. It’s just that you haven’t gained competency yet.

Megan:    Yeah. Absolutely. And for endurance athletes in particular, if you can kind of frame the reason that they're doing the resistance exercise around their endurance exercise, so say that, you know, it's one of the major reasons that endurance athletes should strength train is because of the injury prevention. 

[0:45:08]    

    So, if you strength train, then you can absolutely, you know, decrease your risk of injury on the bike or when you're running or whatever. You know, that sometimes is a helpful way to frame it, but I agree sometimes that the barrier there is a little bit hard, but that's not even for endurance athletes. It’s for people who have never set foot in the gym. It can be intimidating. 

Chris:    Right. Right. Right. That's so crucial as well. Yeah. You're right. When working with athletes, you have to frame everything in terms of performance. Yeah. For me, it’s a mountain bike. This happened to me the other day I was there when I just clicked my bar on a redwood tree like in a narrow piece of trail and I went over the handle bars and into the ground really hard. And I sat up and I was kind of winded and a bit disorientated and I felt “Shit. I just got away with that.” You know, that could have been a broken collarbone. It could have been a broken wrist. It could have been a lot of stuff. And it wasn’t. You know, I got away with it. I'll never know. If I had less muscle mass, I wouldn't have gotten away with it, but you have to assume you’re more resilient when you’re carrying more muscle mass. 

Megan:    Yeah. Absolutely. I think that's all I had as far as protein goes. Chris, do you have anything else that you wanna talk about or any other comments?

Chris:    The only thing I was gonna ask you about, what do you think about protein timing? So, I’m pretty sure I can cite some data in the show notes that showed that eating the protein first might be beneficial for the glycemic response and certainly anecdotally— You know, I think I saw this data. I thought “Oh, that’s interesting. I should try that.” And then it's like completely obvious once you do it. If you eat the steak first, then you tend to want less of everything else especially carbohydrates, you know. And so, now, I always do this and I don't know. Is that something you ever thought about when working with clients? 

Megan:    Yeah. I don’t know the exact study name or researchers off the top of my head, but I have seen some evidence to support especially for glucose regulation and also appetite control that eating— You know, if you have a meal with say steak, and salad, and rice or potato, eating the steak and the fibrous vegetables first is going to be better for both glucose response and also for satiety purposes. 

Chris:    Excellent. Well, this been fantastic, Megan. Thank you so much. I really appreciate you.

Megan:    You're welcome. It's great. 

Chris:    And if you have any questions, then come over to the forum. Supporting Nourish Balance Thrive on Patreon comes with perks including access to our expert moderated forum. And then each week, Megan takes an hour on Zoom where she answers your questions from the forum. And if you show up at that time, then you can ask her questions in person, which I think is fantastic. I've really been enjoying this and Elaine does such a good job both on the show notes for this podcast and then also for office hours. So, if you search on the forum, you’ll find all the citations for the previous episodes of office hours. What's it been like during office hours? I wanted to ask you that, you know. It’s a lot of the technical and what we might call quadrant 3 and 4. Does it get boring or do you enjoy doing that stuff? 

Megan:    No. I absolutely love it. You know, I don't get a lot of quadrant 1 and 2 kind of diet lifestyle questions. That's more digging into the nitty gritty quadrant 3 and 4 stuff. And most the questions are actually very good. Sometimes I get something a little bit out there. Maybe something that somebody heard on a certain podcast that will be named or something like that. But still, you know, it's interesting to dig into the literature and I always know something's out of my wheelhouse as far as, you know, my knowledge is concerned. But most the time, I can go into PubMed and sometimes I spend, you know, an hour on a question because I don't know a lot about how it, but then I learn a lot and can hopefully kind of share that knowledge with other people in office hours. But yeah, I always kind of try to go into the literature and, you know, find good scientific references for people's questions and kind of chime in my own personal and clinical experience where possible. And it's been a lot of fun. And it’s great when— I don't mind when it's just me talking into the microphone. But when people join and can kind of chime in and there's some conversation there, it's a lot of fun. 

Chris:    Yeah. Absolutely. Yeah. It’s a very efficient way for us all to learn, you know. There's no good in you doing one on one calls where only the person listening gets the benefit from your research. It’s like way more efficient when you can record it and make the notes and make those notes searchable. So, yeah, thanks so much for doing that, Megan. I really appreciate you and I really appreciate all the work you've done into putting this podcast together as well. Thank you. 

Megan:    My pleasure.

[0:49:36]    End of Audio

 
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