Transcription
What would be the amount of protein that you would have everybody eat? What, in terms of a number of grams per pound or kilogram of body weight? That's actually an easy question. One gram per pound ideal body weight. Total body weight, not ideal body weight. Actually, where you want to be. If an individual is 200 lbs, but would prefer to be 150 lbs, then I would have them eat towards their ideal body weight.
There's no evidence that a higher protein diet is detrimental to kidney health, to bone health. And we use these terms loosely, like a "high protein diet," when we have to recognize that 0.8 grams per kg is a low protein diet. So where did the idea come from that if you eat, say, one gram of quality protein per pound of ideal body weight, that you're going to get gout? You're going to have liver issues? You're going to have all sorts of issues? Where did that idea come from?
Frankly, I'm I'm not sure. But the conversation around dietary protein has probably been the most controversial. Why do you think that is? I mean, we don't, we're not trying to get political here. I'm just, so I have some ideas, but uh, I, I won't share them. But I, fine. I do feel as if, um, nutrition is not just science. Nutrition is complicated because it's something that people tie emotion to, they tie religion to. There's, um, a lot that goes into dietary protein and food recommendations in general.
But it sounds like we can safely say that if you eat one gram of protein per pound of ideal body weight, that you're not going to cause liver damage or get gout or increase your risk of cancer, right? My understanding is that even if it comes from red meat, there's no increase in risk of cancer. Is that right?
Well, um, here's what I would say to that. I would say that this idea about red meat and cancer, number one, we would have to even define what kind of cancer that we're talking about. There's many different types of cancers and there's many different causes. It would be important to understand what risk factors are. And a primary risk factor to many cancers is obesity. The question then becomes, how do we design a diet that mitigates obesity?
The evidence is also very clear that a more protein-forward diet optimizes body composition. And you combine that with resistance training, and you will see a tremendous amount of change. I worked on some of these early studies, and I'll, I'll share with you some of the, um, early studies. And this came out of Don Layman's lab with the University of Illinois. Both you and L. Norton both worked there. Did you overlap there?
We did. And while he was, what was he like? No, I'm just came. Let's just say he sat in the back of the class and I sat in the front. Okay. All right. There you heard it. Shots fired. Um, and all kidding aside, Lane is a very, he's like my brother. We've known each other for 20 some years, and he's a very popular guest, former guest on this podcast, and a very spirited guy. I just like to say, I don't know why his skin looks that good, but, um, whatever. So I work, love you, Lane. I worked on, yes, we do. I worked on some of these early studies. And this was, these studies were some of the first studies to come out about dietary protein, nutrition, and resistance training. And in fact, to my knowledge, and to I think the knowledge of many of my colleagues, this was the first study. And what it was, it was, um, a, it was a 12-month study, 130 overweight men and women. So it was robust. And basically, what they did is they had, um, two groups. One group was a food guide pyramid diet. So it was 55 grams of carbohydrates, an RDA of protein, which was 0.8 grams per kg, and 30% fat. 30% fat was in both groups. The second group was 40% carbohydrates. This is, remember the Zone diet, 40, 30, 30? Yeah, I liked that diet. Okay. I mean, there's evidence. I mean, I don't follow it anymore, but you know, I tried it for a little while, and and it works great. And there's some evidence to support that that is a great ratio for people coming off the low-fat era of the late '90s. The Zone diet felt like, um, the best thing ever because it was like, oh, you know, you can enjoy some fats, and wow, your satiety has improved, and, um, you get stronger, you just feel better when you're ingesting some ideally quality fats. That's my experience anyway. And also, we know that it influences hormonal status. You don't want to push, uh, fats too low.
So the second group had a 40, 30, 30 split. So it was 40 grams of carbohydrates, 30 grams of protein, 30 grams or 30% fats. These are all percentages. Yeah. 40, 30, 40% now, right? We didn't talk so much about the distribution, but what is really important to understand is they were isocaloric. So they both had the same calories. The difference was the percentage of where the calories came from and how they were given. Um, and there was actually four different arms to this. So there was individuals that exercised and individuals that didn't. Okay. So either Zone diet or let's call it, I hate to say this, but more standard American diet. That's how it was designed. Standard American versus Zone diet. So it was designed that way. And then exercising or non-exercising for for each of the for this 12-month study. Um, and by the way, I had to to pack a bunch of meals. It was not pretty. And I had to do urine analysis. It was terrible. Um, but anyway, this besides the point. So the first group had, um, a protein distribution of 10 grams in the morning, 15 at lunch, and 45 at dinner. Kind of standard American diet. Steak for dinner. Yeah. Some cereal for breakfast with a little bit of milk. And then for lunch, like a sandwich. Exactly. And so this mirrors what people do. The other group had 45 grams of protein at that first meal. Six, five, six eggs. Five, six eggs. Um, 35 grams of protein at lunch, and 35 grams of protein. Chicken breast and a salad at lunch with a little piece of toast. And then at dinner, how much? Um, it was, it was 35 grams. All right. Piece of fish and some rice and a vegetable. But it was an even distribution. So what you're seeing here is now these meals are meeting a leucine threshold of muscle protein synthesis. Now it's 10. This is collectively 130 individuals, and they were, they were older. Um, I think that they were all in their 40s or beyond.
If we just compare, first, the groups that did not exercise to different diets, what, what did they see? What did you see? You participated in the, yeah. Un, yes, I did. And said, un, unfortunately, no, I, I won't. Um, but what was so interesting is that those individuals, everybody lost weight. So the average weight loss, um, gosh, I wish I had better handwriting, but I'm a doctor and so it's pretty bad. Um, the average weight loss was 24% greater in the high protein group. So they lost 24% and you said it was isocaloric between the two groups? Was it subcaloric overall? I mean, people were, that's a very smart. Yes, it was 500 calories less than what they needed to maintain body weight. Correct. Okay. Got it. So 24% more weight loss. Total. Total in the group that distributed their protein evenly and followed the so-called Zone Diet, 40, 30, 30. And they lost more fat than the high carbohydrate group. So the high protein group lost, uh, a total of 16 pounds versus the calorie-controlled group lost 11 pounds of fat. Of fat, which is great. Everyone's at home thinking this is wonderful. Isocaloric, isocaloric. But the, the thing here is the lean body mass change. So again, this was done using DEXA. And we know DEXA only looks at lean body mass. You mentioned DEXA earlier, just very briefly. Is DEXA, how does DEXA work? Not, not at a mechanistic level. What, what does it look like? I go into the clinic. Am I floating in water? Am I holding? I'm holding the the paddles because you're Andre Hubin. No, no, no. But, um, you hold the paddles and it, um, and you're standing on something. It's what's it? So a DEXA, you just lay on, depending on the machine, you can just lay on this machine and it's a, a dual X-ray and it, it, um, measures bone, fat, and then lean body mass. Okay. That's sufficient for this conversation. Great. So the lean body mass, um, lost, and again, this is everything other than bone and body fat. So that was 34% in which group? Uh, in the standard American diet group. Okay. Versus 26% in the high protein group. Now, where it gets fascinating. So what the big takeaway is, is understanding that protein had a sparing effect. Protein protected muscle. More body fat loss at the same caloric amounts? Yes. Same amount of deficit relative to body weight? Right. In this group, exercise was not introduced. So this was purely the food guide pyramid, um, changing protein in the morning versus having it at, um, two small meals and then having it at dinner. And did they emphasize what we're calling high-quality protein? They did. Okay. That is also very important. Meat, fish, eggs, chicken, etc. Yes, they did.
So then this led to another study. So then the second study was a 2x2 design. And this is, oh, sorry, sorry to interrupt. In that previous study, what was the effect of exercise between? So we didn't, they didn't do exercise. Sorry, that was my fault. We, they did not do exercise. They were just doing whatever that it was that they were doing. Um, but what was so important to understand was that this set the stage for this idea that protein had a sparing effect. And then following that, the other studies. So then there was a series of a few other studies. Um, the second study looked at diet and exercise. So this combined effect. So this was one of the first studies, and this was 48 women with a BMI of 33, 46 years old. So this is your post-menopausal woman who, um, was either in one of four treatment groups: a low-protein group, low-protein with exercise, high-protein, high-protein with exercise. The low-protein group was defined as the RDA, 0.8 grams. The high-protein group was defined as 1.6 grams per kg. So starting to approach that one gram per pound? Yeah. So starting to get there, but not quite there. Yeah. So this was, um, a 16-week study. And what they found overall was that the high-protein group lost 18% more body fat and 25% less lean mass overall, and 12% more total body weight. And so now we start moving into this synergistic effect of dietary protein and resistance training. And was the type of exercise that they performed there resistance training? This is the good news. It didn't take much. It was five days a week of walking, 30 minutes, and two days a week of resistance training with just body weight. It was like yoga activity. So air squats, down dogs, some warrior poses, maybe some handstand attempts. So yeah. Are you doing handstands? No. Been to some yoga classes where I look to the sides of me and people are doing some pretty difficult things. Lunges and things like that. Definitely not me. Do not invite me. Life is better this way. I'm not going to those classes. But 16 weeks, they did a high protein with protein and exercise. Those individuals. So now, so the, the study, the, the group that I just mentioned, this was dietary intervention alone with exercise. High protein plus exercise. Exercise, very simple exercise. So if someone is listening to this and they're thinking, what can I do to make very practical changes to massively impact my life outside of hormone replacement, outside of any super supplement, outside of anything? Diet and exercise has a dramatic effect. Those individuals that were doing 1.6 grams per kg, which is 0.7 grams per pound of body weight, plus exercise lost 46% more body weight. That's substantial. 60% more fat and 40% less fat-free mass from organs, you know, muscle, whatever that is, you know, compared to the low-protein group plus exercise. And was it subcaloric? Were they below, below maintenance weight? It was, so they're eating to ideal body weight, um, but still 500 calories or so below their current caloric needs to maintain body weight.