299 ‒ Optimizing muscle protein synthesis: protein quality and quantity, & the key role of training

[@PeterAttiaMD]

In this episode, we discuss: 0:01:06-Luc’s background & insights about fuel selection during exercise 0:07:35-Fuel utilization during endurance exercise 0:16:14-Fat metabolism, intramuscular lipids, & the nutritional dynamics of endurance sports 0:24:50-The optimal window for replenishing intramuscular fat stores & glycogen post-exercise 0:32:50-Luc’s interest in protein metabolism & exploration of amino acids' dual role as building blocks & signaling molecules in driving muscle protein synthesis 0:40:15-How protein metabolism differs between sedentary individuals & those engaged in predominantly strength training or endurance training 0:53:14-The basics of how proteins are digested & absorbed, & how muscle protein synthesis is measured 1:03:23-How factors like food texture, cooking methods, & protein composition impact muscle protein synthesis, & the importance of protein distribution throughout the day 1:07:43-Differences in whey & casein proteins, & the ability of ingested protein to stimulate muscle protein synthesis 1:13:46-Dietary protein distribution & quantity for the maximization of muscle protein synthesis 1:22:43-Muscle loss with age & inactivity & the importance of resistance exercise to maintain type II muscle fibers 1:35:02-Differences between whey & casein proteins, & the importance of both quantity & quality of protein sources 1:44:10-Optimizing muscle protein synthesis: exercise, timing of protein intake, protein quality 1:54:11-How to preserve muscle while trying to lose weight 2:04:41-Anabolic resistance & overcoming it with physical activity 2:16:15-Importance of protein intake & physical activity in hospitalized patients 2:23:41-Reviewing the efficacy of collagen supplements 2:31:45-Plant-based diets: how to ensure a balance of amino acids, & other considerations 2:35:12-Protein metabolism in the brain

[@whoatethechocolate]

Peter, I listened 2 x and the question on "raw or cooked eggs" was never answered in spite of the teaser that there's a, "huge affect on digestion & absorption." Was Rocky wrong?

[@OfficialBeeswax]

​@@whoatethechocolate Heating egg protein makes it more bioavailable in almost every instance. There's a review on this: Bhat, Z. F., Morton, J. D., Bekhit, A. E. A., Kumar, S., & Bhat, H. F. (2021). Effect of processing technologies on the digestibility of egg proteins. Comprehensive Reviews in Food Science and Food Safety, 20(5), 4703-4738. doi:10.1111/1541-4337.12805 Additional benefit is cooking eggs lowers the risk of salmonella

[@MUST-TRT]

I believe Professor Luc said that cooked eggs are more readily assimilable than uncooked. But I don't recall if and what he explained as to the "why" (the mechanisms behind this).

[@marktureaud4094]

Raw eggs do not assimilate as effectively - and has mild counteractive effects - lightly cooked with runny yolk has been shown to be ideal.

[@tonydelatorre7265]

Love the content you post it's really helpful . Just turned 58 since I've adjusted my protein to a 1to1 ratio I've had a jump in fat loss while gaining muscle mass at 213 lbs Also getting more out benefits since I adjusted vitamin intake I'm sleeping 1000 x better !

[@drironmom6815]

68 yo female and did my first pull-up during covid. The gym closed so I did body weight at home. Pushups, planks, and got a pull-up bar and stated just doing negatives- going down as slowly as I could. One day I realized I could go back up. Worked up to 5 sets of 5 pull-ups. Also changed my diet to mostly carnivore.

[@marciamakoviecki3295]

Same here.. switched to carnivore at 65 and became a gym rat!

[@oolala53]

I know it’s the time worn question: how’s your LDL-C cholesterol ? What’s Peter’s stance on that?

[@drironmom6815]

@@oolala53 my total cholesterol and LDL are high. But so is my HDL, and my triglycerides are very low. So my ratios are excellent, putting me in the lowest risk range. And my coronary calcium score is ZERO

[@oolala53]

@@drironmom6815 Awesome! was the coronary calcium test routine from your doctor or did you have to ask for it specifically? Thank you.

[@drironmom6815]

@@oolala53 I seriously just walked into the radiology department and asked the technician for it myself. And they did it for me and sent the results to my provider. Last week I put in a request to my primary provider for a CT angiogram to get a better look. I might have to push for it, if I have to I’ll claim shortness of breath on exertion or something. I think you have to take charge of your health yourself. If you wait for your provider to order something, it’s gonna happen too late

[@gemmaaspiras2792]

I gained more muscle now that i am almost 60 because of push ups, planking and dead hang exercises which i did not do during my younger days. It’s never too late to gain muscles. I did my first full marathon at age 51 and 4 more…..Never too late !

[@pirateslife4me]

Great job!! I love it 🏃🏃🏼‍♀️🏃🏾🏃🏻‍♀️🏃🏼🏃🏾‍♀️

[@idsavo]

You are an inspiration sir.

[@cp37373]

Because of flanking? Really….

[@gemmaaspiras2792]

@@cp37373 yes try it. 6 mins a day will do wonders. Add air squats to for your legs….

[@4242brvrdbd]

Congrats! Wish I could convince parents to listen to this. They are classic example of who Dr. attia is trying to help. Aging, surgeries, becoming more immobile every day, early 70’s and If they just walked / lifted 2lb weights and added protein they’d probably add 10 years. Dr attia is my guy! He’s helped me so much too. Came off acl surgery and was so worried about muscle loss that I was on my indoor bike 6 days later.

[@tsi2568]

This was one of the all-time best episodes in my opinion!

[@bobafet5363]

Yessssss🙌🙌🙌🙌🙌🙌

[@dhfitinc4252]

I’m only 90 minutes in and my jaw has dropped too many times to count

[@4242brvrdbd]

This and the zone 2 episode is all you need! I’d say his book too!

[@erastvandoren]

Worst

[@amyw5998]

Agreed!

[@Eysc]

🎯 Key Takeaways for quick navigation: 00:00 *🏋️ Anabolic Response to Exercise and Aging* - Activity may be the main determinant of anabolic resistance in aging individuals. - Muscle responsiveness to physical activity remains high regardless of age. 01:11 *🎙️ Guest Introduction and Background* - The guest discusses his academic journey and research interests. - Highlights include studies in exercise physiology and movement sciences. 03:13 *🍽️ Substrate Selection and Exercise Metabolism* - Initial research focused on substrate selection during exercise, primarily carbohydrates. - Utilized stable isotope research to track carbohydrate oxidation rates. 08:14 *🏃‍♂️ Preparing for Endurance Events* - Continuous glucose supply during exercise helps preserve liver glycogen. - Combining glucose with fructose can enhance carbohydrate oxidation rates. 16:01 *🧠 Intramyocellular Lipids and Insulin Sensitivity* - Athletes demonstrate dynamic turnover of intramyocellular lipids during exercise. - Contrast between athlete and diabetic metabolism highlights the importance of lipid turnover. - Endurance athletes rely on a combination of ingested carbohydrates and endogenous fat stores. - Repletion of intramuscular triglycerides is crucial for sustained endurance performance. 22:25 *🏃 Protein metabolism in endurance athletes* - Fat repletion post-exercise is crucial for endurance athletes, especially during multi-day events. - In ultraendurance events, athletes reported decreased performance without sufficient fat intake, indicating the importance of intramuscular fat levels. 24:55 *🕰️ Optimal window for replenishing intramuscular stores* - The optimal window for replenishing intramuscular stores extends up to about four to five hours post-exercise, with insulin-independent glucose uptake. - Glycogen storage is self-limiting, with deposition inhibited by its content, preventing muscle disease. 30:56 *🍔 Medium-chain triglycerides (MCTs) for performance* - MCTs were explored to enhance fat oxidation during exercise and spare glycogen, potentially improving performance. - While MCTs showed promise in theory, practical applications often resulted in gastrointestinal distress, limiting their effectiveness. 32:59 *💡 Transition to studying muscle quality* - Observations in muscle quality differences between athletes and sedentary individuals sparked interest in muscle metabolism and protein synthesis. - Muscle quality alterations in diabetic and sedentary individuals led to a shift in focus towards understanding protein metabolism. 35:19 *🧬 Basics of protein and amino acids* - Proteins consist of amino acids, which serve as building blocks for tissues, enzymes, and hormones. - There are approximately 20 amino acids, with nine essential amino acids required from the diet due to the body's inability to synthesize them. 41:05 *🧪 Techniques for studying protein metabolism* - Stable isotopes, like carbon-13 labeled amino acids, are used to trace amino acid incorporation into muscle protein. - Fractional synthetic rate (FSR) is calculated by measuring the increase in labeled amino acids in muscle protein over time, indicating protein synthesis rates. 44:55 *🧬 Muscle protein synthesis and turnover complexities* - Muscle protein turnover involves complex processes that are influenced by various factors. - Stimulating muscle protein synthesis is crucial for maintaining muscle mass. 46:40 *🏋️‍♂️ Differential protein synthesis in athletes* - Different types of athletes exhibit distinct phenotypic responses to exercise. - Resistance exercise leads to the synthesis of myofibrillar proteins, while endurance exercise stimulates mitochondrial protein synthesis. 51:29 *🧠 Regulation of muscle protein synthesis* - Understanding the cascade from stimulus to muscle protein synthesis remains a challenge. - Signaling pathways, such as mTOR, play a role in muscle protein synthesis regulation. 54:26 *🍖 Protein digestion and absorption* - Protein digestion involves processes in the stomach and duodenum, leading to the release of free amino acids and small peptides. - Different protein sources, such as steak and milk-based proteins like whey and casein, undergo varying digestion and absorption kinetics. 01:07:17 *🍖 Understanding protein digestion and absorption* - Different proteins, like whey and casein, digest at different rates. - Pre-digested proteins, like hydrolyzed collagen and whey protein, are more rapidly absorbed. 01:10:57 *🥩 Factors influencing muscle protein synthesis* - Three factors affect muscle protein synthesis: digestibility, rate of digestion, and amino acid composition. - The amount of protein consumed, particularly leucine, influences the duration of anabolic response. 01:16:07 *🏋️‍♂️ Optimizing protein intake for muscle health* - Consuming at least 20 grams of protein per meal is optimal for healthy adults to stimulate muscle protein synthesis. - The type of protein, such as milk and egg protein concentrates, influences the recommended intake. 01:28:30 *🏋️‍♂️ Understanding Age-Related Muscle Loss* - Age-related muscle loss is not simply a gradual decline but rather short successive periods of reduced physical activity contribute significantly. - Muscle loss is not solely a physiological inevitability but can be attributed to discrete declines precipitated by periods of inactivity, whether deliberate or forced. 01:32:22 *💡 Muscle Centric View: Importance in Overall Health* - A muscle-centric view suggests that muscle health is pivotal as it impacts other bodily systems like cardiovascular and brain health. - Sedentary behavior accelerates the deterioration of various bodily functions, emphasizing the importance of maintaining muscle health. 01:35:13 *🥩 Protein Quality and Quantity Comparison: Whey vs. Casein* - Whey protein leads to a quicker spike in essential amino acids and stimulates muscle protein synthesis more rapidly than casein. - Over time, casein catches up with whey in terms of its impact on muscle protein synthesis, showing a delayed but sustained response. 01:36:49 *📈 Protein Ingestion and Muscle Protein Synthesis* - Ingesting higher amounts of protein, such as 100 grams, can result in an extended and greater muscle protein synthesis response over time. - Longer-term studies challenge conventional beliefs that muscle protein synthesis plateaus after a certain protein intake threshold. 01:50:42 *🍽️ Protein consumption considerations post-exercise* - Consuming adequate protein becomes more crucial for individuals with limited protein intake. - Whey protein post-workout can efficiently deliver amino acids for muscle synthesis. 01:54:22 *🍽️ Strategies for eating less* - Caloric restriction involves directly reducing calorie intake, which bodybuilders often employ. - Dietary restriction, such as vegan or ketogenic diets, indirectly reduces calorie intake by eliminating energy-dense foods. 01:59:10 *🍽️ Balancing fat loss and muscle preservation during time-restricted feeding* - Adjusting protein intake and timing can help preserve muscle mass during time-restricted feeding. - Incorporating resistance training can mitigate muscle loss during caloric deficits. 02:12:18 *🏋️ Anabolic Resistance: Effects of Immobilization and Aging* - Immobilization causes significant anabolic resistance, reducing muscle protein synthesis by 35%. - Exercise can mitigate anabolic resistance in both young and older individuals, normalizing muscle response. 02:16:26 *💊 Resistance Training and Hormone Therapy in Cancer Patients* - Resistance training effectively increases muscle mass and strength in patients undergoing androgen deprivation therapy (ADT) for prostate cancer. - ADT-induced muscle loss and fat gain can be attenuated through resistance training, preventing adverse metabolic effects. 02:19:01 *🏥 Medical System and Lifestyle Interventions* - There's a disconnect in medicine regarding the emphasis on lifestyle interventions like exercise and nutrition. - Lack of integration of exercise and nutrition guidance erodes trust in the medical establishment. 02:20:26 *🍽️ Protein Timing and Muscle Synthesis* - Providing protein prior to sleep can enhance overnight muscle protein synthesis, aiding in muscle recovery and adaptation. - A protein-rich evening snack may help attenuate muscle loss, especially in hospitalized or sedentary individuals. 02:23:40 *🥩 Protein Supplements and Collagen* - Collagen supplements may not offer significant benefits for muscle protein synthesis compared to other protein sources like whey or casein. - Collagen is rich in glycine and proline, important for connective tissue health, but its impact on muscle synthesis remains inconclusive. 02:32:13 *🌱 Plant-Based Protein Quality and Quantity* - Plant-based proteins may lack certain essential amino acids like lysine and methionine, impacting overall protein quality. - Combining different plant-based protein sources can help compensate for amino acid deficiencies and improve overall protein quality. Made with ChatGPT

[@CeeGeeZ]

THANK⏱️Y😇U❕️

[@cherlgolja5402]

I thank God I started running at 27 , then added weight training , yoga swimming Pilates , now 72 😊and still very health no prescriptions drugs ! And love my natural path doctors !!!!

[@catherinedickerson9236]

A fantastic interview It’s amazing to me that in all the podcasts I’ve listened to in regard to muscle I haven’t heard from Luc Van Loon before. His research and knowledge is far more comprehensive than anyone I have heard from in this space particularly in regard to his research and understanding of anabolic resistance. This is all such important information for general health and healthy aging.

[@MUST-TRT]

This guy is DA Man. I've heard a lot of SMART (Superior Mind Above Recognized Threshold) lecturers over the years. Wish I could have had a professor like this way back in my ancient undergrad days. Fascinating depth of knowledge and well explained throughout with end take-aways that are tangible and applicable to the real world. Thank you gentlemen. 🙏

[@kahaki]

I’m stoked. I’ve been dealing with a knee injury for four months and I have lost so much muscle and strength. I hope I can pull myself out of this deterioration.

[@The93badger]

I heard all I need with: "At the end of the day we know what you need to do, control what you can control, be more active, consume more protein." BOOM!💣

[@Feel.The.Furs.Photography]

This has got to be on the top 5 episodes!

[@slider292]

Incredible episode. This will be one of the podcasts that I listen to multiple times, so I can soak it all up.

[@Marx1963]

I’m 60 years old and just competed in my first bodybuilding contest unfortunately I injured my shoulder and need surgery. Hopefully my recovery is smooth so I can get back at it.

[@drironmom6815]

Keep at it! Keep up the other parts while your shoulder is healing!

[@kimnelson1602]

On the loss of muscle when in the hospital following a fall or fracture. My experience with my parents in this situation is the hospital insurance only allows three days a week of therapy. So even when the doctors advise patients to get up and move around post surgery there’s no one to assist them unless family members come in and help. Even then, they often are not allowed to. It can take weeks to get them to a rehab facility at which time they are allowed five days a week of therapy. The therapist typically spend maybe 20 minutes with them, actually doing any sort of physical therapy. And then there’s the hospital food….They often prescribe a “heart, healthy diet“ which from what I can tell seems to be high sugar, low protein, high carb. It’s a miracle that my parents are both alive at age 92 and 93 after various falls, broken neck for one broken femur for another. My siblings and I see them every day. I think without family advocacy things would happen much differently.

[@roncruise4]

The general nutrition formula never changes. First, Eat properly. Always eat well. Supplement second.

[@bigpicturegains]

One of the most, if not most, informative and thought provoking protein discussions I’ve ever had the pleasure of listening to. Glad I stopped by to listen!

[@fransinigiraldo4695]

My mind is blown and I’m just in minute 20. Wow 🙌🏼🙌🏼🙌🏼 I’m a diabetes educator, RN and kinesiologist and this is why I love what I do: exercise, oír most powerful tool for our patients. Thank you for this amazing podcast. 🙏🏼

[@nfkb]

I have followed Luc Van Loon work for years, very good podcast, thank you

[@nutrition194]

This video is my introduction to Luc Van Loon. Do you happen to have any suggestions for other videos that he is featured in?

[@christinegiustra_aesthetics]

I gained muscle just listening to this

[@oolala53]

I haven’t listened yet. Should I buy some smaller clothes before I do? 😉

[@TheMowpow]

Wow, that example of the new arm every 50 to 100 days dropped me. This episode was incredible thank you!

[@PerryScanlon]

This guy is so real, great on podcasts. For collagen questions it would be interesting to hear from Keith Baar.

[@gordonhalstead9846]

❤❤❤❤truly educational health podcast Dr attia thanks for sharing your professional wealth of knowledge 👍 God is with you 🙏 ❤Lucy watching your lectures

[@oskadoska]

Re collagen supplementation: Shaw, G. et al., 2017. Vitamin C-enriched gelatin supplementation before intermittent activity augments collagen synthesis. The American journal of clinical nutrition, 105(1), pp.136-143. This indicated that collagen ingestion must occur well prior to the exercise stimulus (1 hour), not after the exercise, so that the collagen is available at the time of stimulus. Unlike protein intake for MPS, collagen intake after exercise has missed the bus.

[@davidgrimes4726]

Yes, this seems to be the best evidence for collagen supplementation for collagen synthesis: "Subjects who took 15 g gelatin 1 h before exercise showed double the amino-terminal propeptide of collagen I in their blood, indicating increased collagen synthesis." I've been taking 15g prior to workouts and have some definite improvements in tendonitis pain. The study also used 48mg Vitamin C from a blackberry cordial, whatever the heck that is ;) I mix mine in coconut water which has 55mg VitC in 500ml. Also a good pre-workout with 31g carbs, nearly 1g potassium.

[@amonadar1]

😊😊😊

[@mattfisano]

The collagen after a workout is beneficial also, I put 40 grams of isolate protein with 15 grams of collagen and 2 raw eggs in my post workout shake. The collagen is a dirty protein yes I know but it helps with the tendons and skeletal connective tissue from heavy strength training.

[@orcanimal]

God, this podcast is just a treasure trove!

[@yusufismaila832]

It is one of the best episodes of The Drive. Thanks, Peter and the guest, for the insights.

[@saflosana]

One if the best interviews I've ever listened to, on a par with Dr Stacy Sims', very thorough. I just wish he'd specified his cohorts for all these studies, as we now know (through Dr Stacy Sims' excellent body of research) that women respond very differently to protein, we don't synthesise it as easily as men (eg: the window for optimal absorption is 30 mins post exercise, not 3±h like it is for men, among other things) so some of his recommendations may differ slightly for women, especially for those who are peri- or post-menopausal, when it comes to what's covered here, like protein intake but also collagen supplementation.

[@backfru]

This was the best episode I've heard Exciting and fascinating every minute from beginning to end Luc is the OG of protein research

[@sebenzalover]

Probably the most important podcasts on KZbin at the present time.

[@mTaR36S]

What a great interview Peter !!! Luc is a remarkable scientist ! So interesting and he speaks so well ! Thankyou !

[@rachelr589]

The end of this about amino acids in the brain was the biggest teaser!! Such an important podcast. So many eye opening statements from Luc. Absolutely loved this.

[@lizschmitt2228]

That was an amazing podcast. It was so lovely to see Peter relax and smile a lot. Luc is a such good communicator and you could really feel the mutual respect between them. Pure magic and lots of real data. I’m 62 and ready to build muscle 💪 and now I know exactly how to do it !! Thanks guys 😊

[@shiftyneems]

One of the best episodes from any podcast or show. Truly.

[@GallantCrypto]

This one was one of the better I’ve heard in a long time. It’s rare I learn anything new in the training and nutrition area.

[@jeffreyharrison4045]

Wow! Incredibly fascinating episode! Thanks Peter!

[@jihanefarrellphdlongevityc3920]

This is my favorite episode of the drive in a long time. Not that I don't get a lot out of the podcast, but this one takes the cake!

[@joanfrisinabowles1369]

Thank you Dr. Attia! You are spot on and thanks for helping us learn real facts.

[@m.oneill3694]

What a great episode! The depth and detail of the questions and answers was completely satisfying.

[@AnestisPsaltou]

Just an absolutely great podcast, thank you so much Peter and Luc

[@coffeeli4417]

Fascinating research, Luc. Thank you for your sharing.

[@hennychen8784]

Dr.Attia thank you so much for reitterating all the important points ❤🎉 it helps us the non medical people to understand better ❤

[@PrashantVaze-t4n]

Mind blowing- one of the very best episodes of all time! Thank you Peter and Luc!!

[@ai-baking-f1]

Fascinating podcast. Thank you Peter and Luc. Going to change my behavior with my protein shakes after exercise and a protein snack before bed

[@fernandomazeris5684]

What a fascinating discussion, Congrats Dr Attia for bringing such podcast w such amazing experts! 2 hs 38 minutes passed like nothing…

[@jdanmiller]

Doesn't get much better than this episode! Thank You.

[@willemvanriet7160]

Incredible talk! So much content and value!! So glad I’m one of the few who do t feel a 2.5hr flog is too long for my ability to focus

[@georgekoury3647]

@PeterAttiaMD I am that man you described at 2:17:30 in this video. When I expressed concern to my oncologist about the extreme weight gain (50#) and muscle loss, his answer was "eat less and walk more". I even fasted for three days and did not lose any scale weight. Before I began this "standard of care, my labs were awesome. I even had a super clean heart CT. I can only imagine what is going on inside right now. Can you please guide me?

[@skonklin]

With regard to supplementing with collagen and rebuilding. I have been doing that for almost 4 yrs. My dexascans X 3 showed osteoporosis, spine and osteopenia hip, then osteopenia, then all normal! I also take D3, 125 mcg and eat mineral rich vegetables as well as weight bearing exercise. Of course, it is multifactorial, so I would like to see more research on collagen. I am going to keep this regimen going for myself though.

[@Free.Press.]

Best interview I’ve seen on KZbin.

[@debbiesc.5957]

Peter i heard you ask the qestion is dairy protien as good as meat protien? I didn't hear the answer.

[@cezarras]

So great your podcast Peter, you always tech me something new about fiziology. I'd love to had Professor like you in a medschool

[@pirateslife4me]

A forgotten population in this discussion could be prenatal bedrest patients. I was put on bedrest for 6 weeks plus 2 in the hospital before delivering prematurely. Even at 26, I was incredibly weak after getting up again, dragging myself through everything and fatiguing so easily. It's humbling how quickly it steals away your function.

[@barbarafairbanks4578]

@pirateslif4me I would add to that - the entire population left out of this data are females. The majority of ANY fitness studies have been done, and currently are done on male subjects, not females.

[@Cathy-xi8cb]

Now you can get PT that will provide a safe home exercise program to slightly reduce your muscle wasting, if your providers refer you for it. But everyone that is in bed for that long will weaken profoundly. Then your hormones made your pelvis unstable, your body wanted to feed the baby, and babies need a lot of physical care. A ton of protein would not have prevented most of what you went through.

[@barbarafairbanks4578]

​​​ I think you may be using a bit of story-telling to imagine what the OP may or may not need at this point. That's fine, but you may be presumming alot here. (?) The impression I drew from this comment was that she was making the point of how easily & profoundly one can lose muscle mass & strength - even at the relatively young age of 26 - with prolonged bedrest. She did not mention her protein intake during that time. Or whether she did receive PT care, or not. Or, whether she now feels that a higher protein diet may have helped her. She did not mention her protein intake, so we really do not know whether it was lacking, or plentiful at that time. Nor do we know when this bedrest occurred, and what her health status is at this point in time. You are correct to imply that PT (hopefully with light resistance training, plus a protein-forward diet) would have helped her maintain some strength and/or recover muscle mass & strength faster. Imo, though, I do think that, hypothetically, if her protein was low during that time, a protein-forward diet could have made a positive difference to support her MM via MPS with increased protein. (Maybe only minimally, but even a minimal change could have made a positive physiological impact, in my opinion. (There are study-supported data to this effect in the scientific literature).

[@liorsegal2505]

Wowww I have to say one of your best podcasts ever so much valuable information and such interesting trials.

[@dreamervanroom]

At about the 2 hour mark on the video, Attia is talking about 2 simultaneous goals in the under-muscled, heavy woman building strength and getting protein. In your plan, you are recommending a pure protein shake, PPS, alone as a meal. This woman is also insulin resistant. As I understand it this PPS will give her a glucose spike. If I would like to moderate this glucose spike, what might you suggest? I would think a certain amount of low calorie vegetable eaten ahead of the shake would be a good idea. The purpose of the vegetable is to blunt the glucose spike, per Jessie @glucoserevolution. Perhaps priming with a vinegar drink would also be helpful. Do you think this makes such an effect? Myself I would prefer something green leafy followed by fish, or egg (white). When looking at the population with too much fat, I think that watching out for glucose spikes is a worthy goal. Am I wrong? Attia also said that there is no metabolic difference between a TRE pattern and none -- metabolically. I am not sure what "metabolically means here. Do you mean that the person's metabolic rate doesnt change? Do you mean that the person will build the same amount of muscle? Do you mean that the person will burn the same amount of fat? I would say yes to the first., I dont know to the second, and no to the third. Why not agree with the thins which is what I understood you to mean? I have listened to Dr. Fung who points out that If there is glucose available then even with lower calorie diet that you dont burn fat. He reports that when your insulin-burning system is on you burn glucose and only hwen you liver glycogen is consumed does your fat-burning start. Is this correct in your estimation? -- I would like some references to help me understand this. If you refer me to some of your interviews, or those of Huberman or andyone else, I would certainly listen and appreciate the directed input. Thank you.

[@lloydn6095]

So then, working out on an empty stomach for 60 minutes is perfectly fine (or more beneficial)? Because the muscle protein synthesis will be higher and stay longer till the next day?

[@barbarafairbanks4578]

@lollydn6095 ...possibly - but for males, not females. ...based on new studies done on female athletes. Findings ( females do not benefit from exercising fasted - males do). This is due to basic hormonal differences btw men & women. Source - Dr. Stacy Sims, PhD (Physiologist [& Nutritionist] specializing in female athletes. AND...advocating for fitness/health studies in healthy women (whereby, until recently, the majority of health/fitness studies have been done on men , or, a handful done on non-healthy females). P.S. I would bet (my current income lol) that the majority of studies these guys are mentioning here were based on male, not female, studies. ..."Women are not small men" Dr. Stacy Sims

[@nutrition194]

it’s pretty simple. Even spread of protein through out the day. A lot of studies conducted are with concentrated protein/aminos. The absorption rates with real life meals would be slower and timing would realistically be different.

[@oceanasistermoon5069]

​@@barbarafairbanks4578 Thank you for this info. So glad people are starting to figure this out!

[@marciamakoviecki3295]

​@@oceanasistermoon5069seems so obvious!

[@teflonarmored]

PHENOMENAL information!

[@ashdgee]

Very illuminating. One of my goals is to optimise muscle gain and this was a great podcast

[@scottcrosser]

Great insights on high reps to failure. Anecdotally, it's been experienced by many for years but refuted in literature till recently.

[@barbarafairbanks4578]

@scottcrosser - He said 'to exhaustion' - not 'failure'. There is a difference.😊 Imo, - from all I've heard/read on the subject - hypertrophy would probably be a lesser/lower adaptive factor with light lifting to exhaustion. Rather than the adaptive stress applied to muscle fiber that comes with a heavy weightload... especially with a longer period incorporated into the eccentric movement. So, heavy/slow offers a more optimal rate of muscle hypertrophy, imo... (somewhat educated opinion -🤔) AND, fast/light lifting (to exhaustion) does nothing for connective tissue - which is a factor that many tend to ignore, to their own disadvantage (& eventual vulnerability to injury). Connective tissue fitness needs are different from muscle fiber needs. Fast/light to exhaustion can be very useful for helping to maintain muscle maintenance (especially to allay a loss of fast-twich type 2 muscle fiber) where a heavier weightload may not be feasible. Fast/light lifting is useful where one has sustained an injury (or for a post-surgery situation) - to the point that they cannot lift heavy without pain, and/or the possibility of re-injury. (Jmo - -some of which I inferred from what Luc said about *fast/light here - as well as other physiologists , Nolan, Galpin, etc. - plus Scott Hogan's book, 'Built from Broken.' *Luc was suggesting lightload lifting 'to exhaustion' here, for those who may need to modify their lifting protocol, in the case of a post-surgery scenario. But, not in lieu of a heavy weightload protocol - at least that's what I've inferred by what he had to say about it.

[@oolala53]

@@barbarafairbanks4578what is the difference between to exhaustion and to failure? TY.

[@sheldonkerr]

Quick question: Which was better Steak vs Mince? I know Peter Asked the question but the response went in a lot of directions.

[@1morrel]

Great video. I have a question for you regarding the idea of collagen supplementation. It has been over a quarter century since my college biochemistry classes but I recall one of the unique features of collagen is that its synthesis makes use of an enzymatic modification of proline. Collagen has stable, tightly coiled helical structures that are only able to form due to the incorporation of hydroxyproline. Hydroxyproline allows for increased intramolecular-hydrogen bonding giving collagen its strong structural properties. Hydroxyproline is made from proline via enzymatic hydroxylase reaction. Perhaps weaker expression of the hydroxylase enzyme due to aging could result in reduced supply of hydroxyproline resulting in slower collagen synthesis. My thought is that by consuming a collagen supplement one might be able to obtain hydroxyproline directly rather than relying on the enzymatic modification of proline. Does this seem plausible? I do not take a collagen supplement. This is purely a speculative matter for me but would be curious if viewers or your team have any thoughts on the matter.

[@Ummonchinable]

I'm confused by the Tom Layman interview and this one. In the Layman interview, we were encouraged to get 30 grams of protein in our first meal to stop catabolic activity due to overnight fast. In this interview with Luc, however, Luc says we can maintain our muscle with a couple of weight training sessions per week. Was Layman wrong?

[@bobafet5363]

There’s a difference between the sedentary individual, active or high training individual.

[@barbarafairbanks4578]

@Ummonchinable Welcome to the world of scientists offering their educated OPINION on all things titled, 'scientific findings.' I think it would behoove us to take all of these varying findings & opinions with a grain of salt. THEN, when we come up against TWO opposing 'opinions' - we can always do an 'Nof1' experiment on ourselves. (I.e., try both hypotheses (opinions lol) out on ourselves - keep a journal of our 'findings', in order to determine, anecdotally, which 'hypotheses' (scientific opinion) seems to work for us. P.S. that being said...I don't see (in rereading your question) I'm not seeing your question being relevant to what Luc is saying here, vs. Layman's statement -?? Imo, your Q compares apples to oranges. Just sayin...

[@miaash3870]

Dr Peter, Would you please share what the required tests and procedures are to determine the correct dose of progesterone, testosterone, and estradiol? Thanks

[@clivejonathan614]

Hi guys I’m 66 yrs old. I do strength training 3 times a week and diligent in my protein intake including whey protein isolate. My issue is that I’m on a 80g statin due to a cardiovascular issue. Am I waisting my time? I believe statins affects muscle growth. Appreciate your response.

[@RudyMettia]

I’m 64 and am on 80g as well. 6’ 220 pounds and have the same muscle mass of when I was a bodybuilder at 30 so I doubt it prohibits gains except on the extreme. Just my 02

[@hunghenry]

Hope Peter will have a dermatologist as a guest and ask the same question about collagen peptides. From what I learn, it does make difference in elasticity in skin.

[@m62hunting]

Peter, it would be great if you get a chance, if you could over your nutrition the day before and the day of your endurance race. Thanks

[@DD1-b7m]

This is such a fascinating episode. Well done!!!

[@ThisGuyDude]

Awesome. We are Ships of Theseus. Thank you for the revelatory vision.

[@aa-xn5hc]

Among the Betty best interviews ever

[@Artzimer1958]

Listening to this podcast gave me some hope. I am in my late 50s. I recently had a ski accident and Tore bilateral ACL and MCL. I was so devastated when it happened a month ago. I thought I was going to die of being inactive. My world crashed down, specially when I found out that I injured both my knees. I am a very active person who have been trying to stay safe and not get injured at this age so I can build and reserve my muscles. I am now starting with just Physical Therapy and maybe getting back to my Walks . I feel that I lost most of my muscles as soon as three weeks after the accident. Prior to the accident prior to the I was lifting weights, rucking, Hiking and riding my bicycle. Now I have to work so hard to get back to the same level of fitness so I can build all the muscles that I’ve lost. Very informative podcast Thank you

[@jimking6484]

Fantastic interview! Some serious advanced nutrition information. #KickAss100YrOld.

[@jennyretief4978]

Brilliant podcast. Thank you.

[@mohamedelshafie1596]

Right on time,I'm 60 years, I went down from 190 LB to 185 in the last month and half and continue on 10/14 hours schedule. I feel I reached plato and not losing any more. I'm 5' 8" with BMI 23%. I'm worried I may lose muscles too, even I exercise 4-5 (40 min ) / week. Should I take whey protein and amino or food will be enough ?

[@mariabravo5270]

Such a fantastic topic; learned a lot!! Thanks Peter 🙏

[@gordonhalstead9846]

❤❤❤❤😊maintains muscles health podcast presentation Dr Peter attia absolutely best 👌 podcast presentation podcast thanks

[@bradstudio]

I guess @athleanx will have to revise their video on not gaining muscle after 40. I've been a hard gainer all my life due to a super-high metabolism. I've been on the carnivore diet for six years of only steak and eggs, plateauing my weight for the last three years. By a simple modification of adding an orange to my breakfast and adding three weekly resistance trainings, I've put on 10 lbs. of lean muscle since January 1st. This podcast answered so many questions and destroyed so many myths that I've been searching for years. Thank you for this great public service, it is going to change so many lives if people are willing to invest the time and take notes.

[@Ice-Fall]

You don't have a super high metabolism because you are thin. At rest, a heavier person will have a higher metabolism due to the energy expenditure of more mass. Also, it takes time to gain lean mass versus adipose mass., unless you use PED's.

[@jallen8862]

Excited to get into this.

[@perrantustin4475]

Really enjoyed this! Very informative, let the gains roll in 🎉

[@standUpForTurtles]

Amazing interview! Thank you both.

[@hbarisic]

What a legend! Awesome episode

[@dqzj565]

I'm interested in beef protein isolate. As effective??My skin hates whey and casein 😟🙁😕

[@caitlinann1708]

Strong interview 💪 Thank you both!!

[@gronis9]

If I eat to much sugar one night or during several days my calves get stiff to etremly painfull if use them sometimes up to ten days if ive been really naughty. Just limited tio the calves So if i just lay around, no problem. Nowdays i get more and more sensitive. Im lean and excericed all my life. Done two biopsies but still no real answer . Obviously I need to be careful with sugar and including carbs as too much bread even. But would be very curious to find out what it really is all about. Great episode. thanks.

[@sanketjain9320]

The 2-3g of leucine per meal that's said to be the threshold for Muscle protein synthesis, is it the peak value at any given time after the meal or is an integrated area in the graph across time? If it's the peak value, wouldn't this value depend on how much fiber I had in my meal, along with my protein source in it?

[@ElmerCruz-mt5yq]

Very informative podcast, thank you for sharing!

[@keithseymour9316]

Absolutely fantastic conversation.

[@DZ-vv2ky]

Peter, you are the Best!!!

[@willemvanriet7160]

Will the faster digestibility of whey cause blood sugar-insulin spikes and if so should someone who wants stable insulin rather use casein?

[@fitnessbyraquel]

One of the best podcasts! 💪🏼

[@capcomfan82]

Im still amazed at how much we dont know yet. We are still in the dark ages. Atleast progress is being made.

[@denisethor]

Wow! That was a GREAT episode. Captivating. Thamks

[@simpleman7203]

I wonder is there a difference in anabolic response from food from the next day after training if you had sufficient meal after the workout in 5 hours window in comparison to if you had small or no protein meal after training

[@SignOfTheTimessssss]

This is so interesting as Don Laymen and Gabrielle Lyon have been preaching at least 30g a meal to spark Leucine optimizations. Thanks for a great podcast!

[@malagoke]

You can still recover way faster, if you're warping in the window of max. muscle synthesis rate, right?

[@nightsfalling]

Great interview, I am curious to find out what is the 20 hours event Peter is preparing for?

[@arianasilesia2500]

I am 49 years old female I have bone on bone osteoarthritis in my hips I have lost the ability to walk. I live in Canada public medical care wait list for surgery is 1.5 years. I have been sitting in a chair for 6 weeks so far I feel horrible and I feel like my health is deteriorating. What will happen to me in a year ?

[@nes4362]

excellent episode, Loon is so knowledgeable and Peter asked some great ?

[@khalidbhat676]

@peterattiaMD, Can we assume that if someone does 3 -4 days resistance training followed by 2 days of endurance training ,chances are both Type 2 & 1 will have some kind of hypotrophy resulting in overall increase in muscle mass especially in folks who may be close to saturation in one of these training types ?

[@deanwilkerson9124]

I've seen recommendations that it's better to take amino acid supplements to build muscle as opposed to whey protein for example, but in this episode they never talk about that option. Does supplementing with amino acids work better or does it matter?

[@stevelegg9901]

Absolutely fascinating and informative 💪🏻👏🏻

[@dfinma]

1:53:46 I think critically important to clarify what is being asked. Almost always, and by almost I mean always, when someone asks about losing weight they mean fat. You almost never want to lose muscle and since muscle helps burn fat the response should [almost 😝] always be -- build and use muscle, reduce food intake, particularly crappy food.

[@oolala53]

At age 70, and a female who has grappled with this for decades and had been on a weight loss site that was mostly women from 2007 until it closed down in 2021, Women mostly will laud other women for weight loss no matter what is lost. I can tell you they are not tracking fat loss. There’s even a popular add out now from Kelly Clarkson gushing about how she has lost weight without any exercise. But I think even the emphasis on exercise for weight loss is a mistake. In my experience and watching hundreds of women on that website, the problem with emphasizing weight loss or even appearance in general is that if there is not some kind of rather quick feedback of success, people lose their motivation. They have to be convinced that there are even better reasons to live an active lifestyle. It seems like it should be obvious, but if you look around, obviously it’s not. There is not a great deal of wide Cultural reinforcement for being active and especially for preserving or increasing strength. We might like admiring celebrities for it, but it’s often for such extreme examples that most people are not going to be motivated in the face of the extreme programs that they have to go through for it. I definitely agree that Bodycomp should be the focus, but it’s usually not. I myself found it easier eventually too, not eat more than I needed than it was to add in exercise. Even with all I know, it’s still not automatic and is incredibly easy to drop.

[@christopherdennis6785]

Very interesting how improved fitness can improve your body’s ability to process fat as an energy source, akin to improving your VO2 Max.