Protein: The Questions with Dr Jeff Bland and Dr Jonny Bowden

Well, welcome, everyone. I can't tell you how excited I am to have the opportunity to work with my colleague and friend, Dr. Johnny Boden in this update on protein. It seems like there's a lot of interest out there in the world. Given our first response, people really said, this is a topic we want to dig a little bit deeper into. And I couldn't think of anybody better to moderate this follow on than I. Dr. Johnny Bowden, who you will, if you don't know him already. You're going to meet him and have the privilege of learning some things from him. And the two of us have his repartee. So I'll now turn it over to Johnny. Johnny, you're the moderator of our Protein Take two, so take it away.

And it's such an honor to be doing this with you. So we got several hundred questions, and people are really interested in this topic. So what I did was I kind of put them in categories, so people may not get their exact question answered, but the subjects were very clear. And I think maybe the best place to start would be with the most controversial, which is plant versus animal protein. It's a kind of macro picture, but there are a hundred different questions regarding that. So why don't we spend the first few minutes discussing the differences between plant and animal protein, Whether one is more desirable, whether one is more dangerous. There's just a lot of mythology around it. So take it on. Start with that, if you will.

Yeah. Thank you. So this is a really important topic that has history that goes way, way back in the whole development of human nutrition and its understanding. I was really brought into this topic. Now, it would probably be nearly 40 years ago with having met Vernon Young and Nevin Scrimshaw, who were at Massachusetts Institute of Technology and were and still are regarded as some of the founding individuals on establishing the need for protein for producing healthy bodies and the type of protein and the difference between different types of protein. They worked on what was called the protein efficiency ratio. Which kind of proteins might be most efficient in nourishing the human body. I'm going to summarize from my perspective, a lot of stuff here. So there are really two thoughts about vegetable versus animal protein. The first has to do with what are the amino acids that make up that protein, because we know the proteins are manufactured off the genes of the organism that has those proteins. And so plants have different genes, obviously, than humans. So plants then construct their proteins to have different amino acids in them in the way that the pop beads on a chain are produced. If you Think of protein as being collections of amino acids on a chain, like a necklace. So those amino acids on the chain are different in their composition and ordering than in animal protein. So then you say, well, does that really make a difference in terms of human nutrition? Or is it just like it'll all get digested anyway down into amino acids and get absorbed into the body? But it turns out that animal protein generally has higher levels of what are called essential amino acids. Now, why are they essential? You would say that. Shouldn't all amino acids be essential because they are important for the building of body's proteins and enzymes, but some cannot be made by our metabolism. They have to be produced and taken directly into our diet in the form that they're going to be used in the body. That's why they're called, essentially. And there is eight or nine of those that are members of this family. I won't go through the full number of them, but suffice it to say that they break down into certain kind of subcategories. These eight or nine essential amino acids, one of the families that you've heard a lot about are called the branched chain amino acids, isoleucine, leucine and valine. And that particular family of three amino acids constitutes what are abbreviated BCAAs, branched chain amino acids. And they're very necessary for building of muscle protein and of enzymes. And it turns out that the carrier of protein in our blood that takes protein out to other cells is what's called serum albumin. And serum albumin is actually very high in these branch chain amino acids because it needs to deliver those amino acids out to cells so they can make muscles and other tissues. So BCAAs branching amino acids are generally higher in compositional percentage in animal protein than vegetable protein. So we generally have said that animal proteins have a higher biological value than vegetable proteins. However, there are certain animal proteins that whose branching amino acid composition is not much different than certain vegetable proteins, because there are certain vegetable proteins that have a fairly high percentage of branch chain amino acids, and there are certain animal proteins that have lower levels. So there is overlap between vegetable and animal proteins. Now, it turns out that certain vegetable proteins that are balanced between grains and legumes contribute to the body about the same ratio of branch chain amino acids, these essential amino acids, as does animal proteins. The now we know that egg protein is one of the highest biological value proteins and it's very high in these essential branch chain amino acids. We know that lactobumin from milk protein is reasonably high in essential amino Acids. But we know beans and grains, when put together in complementary proteins in vegetable diets, have pretty good ratios of essential amino acids. And we were actually very surprised to learn when we were studying Himalayan tartary buckwheat, that its range of essential amino acid, the branched CH amino acids, is actually very high for a vegetable protein, which means it has a biological value of about 0.85, meaning it's 85% the same as if you were to eat a high value animal protein. So I think this concept of vegetable versus animal protein comes down to what type of animal protein are we talking about? What type of vegetable protein? When you're eating vegetable protein, are you eating complementary proteins from different food families that balance out different to give the proper amino acids that your body needs to build healthy tissue. And that's why we basically talk about the amount of protein per body mass. So we say your body probably on a daily basis needs something like, depending on your age and physical fitness and activity levels, something between one and one and a half grams, say of protein per every 2.2 pounds of your body weight. And so that would mean that if you get something on the order of 70 to 100 grams of reasonable high quality protein in your diet per day, you're in that area of being able to provide the essential amino acids necessary for building muscle protein, enzymes, body structure and function properly.

I've got many follow ups to this. I just don't want to take us too far afield. Before you even started talking about the branch chain amino acids, I made a note to myself to ask you about branch chain amino acids. Is there an advantage for, for example, bodybuilders have long thought that branch chain amino acid supplements will help them build muscle. If someone's eating a vegetable protein that might be low in BCAAs, would a supplement make up the difference? Is, is, are BCAs something we should think about supplementing with?

Yes. So when we go from a state of normal diet and nutrition for people that are moderately active, that are reasonably healthy, and don't have any unique kind of protein metabolic genetic characteristics of concern. So that's the great unwashed of most of us.

Got it.

You know, one to one and a half grams of protein for every two pounds of body weight is going to be really probably very sufficient, maybe even on the upper limit of sufficiency. However, in individuals who are really trying to drive anabolic function, that means muscle building function, and who are on heavy exercise, strength and conditioning programs with a lot of stress being put on the myocyte, the Muscle cell. So the muscle cell is in a state of repair from that heavy exercise. Then increasing amounts of these high essential amino acid branching amino acids may be desirable. It has anabolic like effects. It helps to stimulate and support that. So it really depends upon the status of that individual, their lifestyle and how they're pushing their muscles for restoration. As to exactly how valuable the branch chain amino acids would be, I don't think we can make an argument that for the average Weekend Warrior, the BCAAs are going to build you into a muscle bound person. But if you're pushing yourself in a level of really anabolic drive, then the BCA supplementation can be valuable.

You had mentioned the one to one and a half. The government recommendations have always been 0.8 grams per kilogram of body weight, which translates pretty much to what you said. But there is a lot of discussion in the health space now that these recommendations are too low. And this leads us very much into the next area that we're going to ask about. But for example, I've interviewed two menopause experts in the last year, both of whom were saying women need to have 100 milligrams a day. We were lied to. It's too little. And they are concerned that we're not getting enough. Do you believe that the dietary guidelines, the traditional point, a per kilogram of body weight which translates to one to one and a half grams. Do you think that those are good or do you think they need to be re evaluated?

Yeah. Thank you. That's another really important question. This is a two edged sword question. Let me speak for a group of individuals who, who I happen to have seen these individuals, so I know they do exist, who have super benefits from being on a paleo carnivore diet by.

All kinds of difference, so that the people understand that those are not the same by any means. So we might want to make a distinction between an all meat diet and a paleo. And for those who might not know this, because a lot of people think paleo is all meat. The original research, Boyden, I forgot his partner's name that did this in the 80s, the actual Paleo diet was about 65% vegetables and 35% meat. Now their vegetables and fruits were very different than ours. They were bitter and they were fibrous and all of that stuff. But it was really a more vegetable than it was animal.

Thank you for pointing that out. That paper that appeared in the New England Journal of Medicine, who it was? Yeah, it was Eaton and well, Boyd Eaton and Melvin Kohner. Were the authors of that paper from Emory Medical School. And we actually had Mel Connor come speak to us at the Institute for Functional Medicine back when that paper was first published. And I really appreciate you bringing that up, that the true paleo diet that they published in the New England Journal of Medicine was a diet that indicated from Paleolithic records that it was more vegetable than animal. So I. But they were different vegetables and animals today.

Yes, exactly.

There are some people then have taken the paleo concept to this carnivore that they. They are only eating meat.

Yeah.

And so that seems really extreme, which I think I would say it is. However, there are those individuals, again, who I have met personally and have evaluated, who have extraordinarily valued from this extreme example of eating only animal protein. And some of their allergies go away, some of their digestive issues go away. This is not a diet that I'm necessarily recommending for everyone, but for specific cases, because as we know, the diets of one can be the poison of another. We're all uniquely different. There can be some advantage to this kind of a diet in some people. However, I think there is the problem we always have to address. And when you take a good idea and you take it to the extreme, is there some adverse effect of too much protein? And the answer is absolutely yes. And I tried to speak a little bit to that in our first session on protein, saying that protein is the only of the macronutrients of protein, carbohydrate and fat that has a lot of nitrogen in it. The amino acids contain the element nitrogen. And the body has some very special ways to try to get rid of nitrogen so it doesn't build up to toxic levels in the body as urea or uric acid or a variety of nitrogen containing toxic substances to the body. So the body has the urea cycle in the liver to manage nitrogen and the breakdown of protein and amino acids, and then excrete it out into the urine as urea and also in fecal release. And so if you overload that system, which is principally found in the liver, you will then have some problems of producing adverse effects of these nitrogen byproducts, which can be toxic, they can be neurotoxins, they can produce their own adverse effects on mitochondrial bioenergetics. They can lower our energy, they can produce changes in our body ph, which can be not so good when you start to move into an acid ph situation. So, like all ideas, this has to be handled with the recognition that too much of a good thing is not good. And so protein again to me should be approached cautiously. Just as we would say, too much carbohydrate could not be so good for blood sugar control or too much fat might not be so good for overloading your fat enzyme metabolic pathways and encouraging fat deposition and tissues. So I think that we have to be very conscious, particularly at this time where protein is kind of like in the center point. We go through different phases in my 40 or 50 years in this field and I'm sure you've seen this Johnny as well, where some things get highlighted all of a sudden like it's a new discovery, it's back to the future and now it's all about protein. But it has to be kept in balance with regard to what is adequate, what is sufficient and what is not too much for the body's ability to manage at the liver and kidney level to excrete and to maintain proper regulation of cellular function.

There's one question that I'm going to give to you verbatim because I think it was very interesting and I'd love you to comment on it. Somebody asked, haven't studies shown that people who eat less protein live longer? I'll leave that up to you.

So that's a superb question as well. If we look at the blue zone diets, these people that presumably lived in places around the world that have a lot of centenarians, one of the characterist you find is they eat a lot of plant based rich diets. They do have animal products. These are generally wild game or game that they shepherd on fields that are not treated with a bunch of chemicals. And, and so their meat in their diet is there, but it's not, it's not the major part of their, of their diet. And so you start to say, well what happens if a person then has a lower level of animal protein in their diet? Would they be then suffering from very severe issues of muscle protein loss and get into sarcopenia which is muscle loss. And the answer doesn't appear yes to that, that these individuals, they're very lean but they're not weak, they have good muscle strength, that good muscle, their body compositions are very, very actually high in, in muscle protein relative to the overall composition of the body because they're very low in body fat. So I don't think we can necessarily say that low protein diets. And I want to emphasize again it's a curve between too low or too much. You want to be in the middle of that curve of that U shaped curve. You want to be in the optimal zone of protein nutrition. And that's why I was saying something like a gram to a gram and a half puts you at the upper limit of optimal nutrition, Particularly if it's easily digested protein. It has a high digestibility and a high biological value. And that's why you can get that actually from vegetable based diets as well as animal containing diets. There's not like one path to protein enlightenment.

Can I do a footnote on the blue zone thing, Something I learned from Robert Crayon back in the 100 years ago, my original mentors. There's always a danger, I think, in extrapolating from these other cultures and taking something with some nugget and trying to transpose it to our lifestyle. Robert used to say, we find out that olive oil is great. Americans will now pour olive oil on their cornflakes. So the thing about the blue zones that I think people should know is the whole lifestyle is different. They exercise constantly. They have their meals in the daytime. In their big meals, they laugh. They have tremendous social connections. They're shepherding up the hills all day. So they're doing a lot of stuff for their muscles that wouldn't necessarily show bone loss and the way it might if you're living a sedentary life in America. So I just want to put that in there that there's so many other factors when we look at these other diets. Japanese and we sometimes take one thing. Well, the Chinese eat a lot of rice and they're not fat, by the way they are now. They have a huge obesity problem. But it's not from the rice, it's from the importation of, you know, all, all the. I went to Beijing to speak and I actually debated a dietitian there and she said, oh, we have this terrible obesity problem. And I had just arrived in the city and I saw the main street and it looked like 42nd street in New York City, Kentucky Fried Chicken, Domino Pizza. And I asked her, well, what do you think it is? And she says, oh, that the Chinese use too much oil. And I know that's not the problem, that's the problem. So I think, I think it's important to kind of look at the context of all that. But that kind of leads us to another category of question, which is age. We got lots of questions about is it different for 50 year olds and 60 year olds and 70 year olds. It went all the way up to 90. So I think if you could address for a while protein needs through the life cycle, do they change does it matter if you're active or not? What's the story with 50 year olds versus 80 year olds and things like that?

Yeah, thank you. So I want to change a little bit the context of this discussion to be different than you hear from a lot of individuals who talk about segmenting protein intake based upon age. And that's the number of birthdays that we've experienced. Because I think the need for protein is not just the number of birthdays, it's the functional stage of the individual to digest, assimilate and utilize protein. Now why do I say that? Because we know that protein is only good for the body if it gets into cells as amino acids. And it's not good if it just stays in the digestive tract. It just travels through unabsorbed. So what is it that leads to the appropriate assimilation of the quality of protein that we're consuming the diet? It's this digestive process that starts in terms of protein as contrasted to carbohydrate. Carbohydrate digestion starts in the mouth with a salivary amylase, but protein digestion starts in the stomach with the release of pepsin and acid, hydrochloric acid from the parietal cells of the stomach lining. And if you do not have proper stomach acid secretion to acidify what's called the chyme, that's the partially digested material from food, if it doesn't get acidified by the proper release of hydrochloric acid, when it then is released out of the stomach and goes into the southern portions of the digestive system, into the duodenum and ultimately the small intestine on down, it then doesn't properly stimulate the release of digestive enzymes from pancreas that are involved with the breakdown of dietary protein, so called pancreatin, that then ultimately releases the amino acids so they can be absorbed and utilized in the body for making body's proteins. Because we don't take the protein from our diet directly into our muscle cells, they have to be broken down and then reassembled on the other side of the digestive system into our body's cells. And so you say, well, what happens with this secretion of hydrochloric acid from the parietal cells over age? And what we find out is that in general, as people have more birthdays in life, that the parietal cells undergo some atrophy and they don't secrete as much hydrochloric acid. That's called hypochlorohydria. And there is a condition called achlorhydria, where actually the stomach acid is almost lost. And those people have really severe digestive problems with regard to protein. And they may eat a lot of good protein, but it doesn't end up going into their body because it just gets passed through. And it feeds the gut bacteria to produce endotoxic problems. So you have to have proper digestive capability of protein. Now, how do you do that? By making sure that you have proper stomach acid secretion. There's a condition called atrophic gastritis, type B, where the parietal cells have lost their ability to secrete proper stomach acid. That also causes the lowered absorption of other nutrients, particularly vitamin B12, when you have that particular condition. So you need to look at the digestive system more than just the age of the individual and say, are they able to digest protein now? Many years ago, and in this case, for me, it was probably 40 years ago, we talked about the use of digestive aids, pancreatin, porcine pancreatin, digestive age derived from the pancreas of pigs to help digestive function in humans who had this problem of protein maldigestion. We were criticized. We talked about pancreatic insufficiency, and people said, oh, that doesn't exist. You either have something like serious protein deficiency as a consequence of no stomach acid or you have proper stomach acid secretion. There's nothing in between. And the condition cystic fibrosis is associated with pancreatic enzyme insufficiencies. You either have a disease or you're normal. We said, no, no. There are all sorts of shades of gray in between those two extremes. Well, now, some 40 years later, we're seeing a lot of publications in public media about pancreatic insufficiency syndrome. I find it very interesting, and that's exactly what we were talking about 40 years ago, that there are many people who are not pancreatic disease, but they're just not secreting adequate acid and not adequate, then pancreatic enzymes to properly digest their protein, and so improving their digestion by addition, by acidifying their CHYME and giving them pancreatin or other pancreatic digestive aids can be helpful in absorption of their dietary protein so they can build proper muscle protein and body protein. So it's more than just age. It's the functional state of our digestive assimilative systems. And then we say, well, but does that mean that older age people always have bad protein digestion? And the answer is no. There are papers showing that people that have Healthy body composition in older age. And these would be octogenarians, maintain their proper protein digestion capability, they have good stomach acid. They didn't burn out their parietal cells in younger years by too much sugar and too much alcohol and drugs and things that actually injure their parietal cell activity. And so they still have proper stomach acid secreting activity. So my feeling about how we grade protein need based upon age really should be protein need based upon function. And we should talk about the digestive system before we start just giving people a lot of protein.

What do you think of digestive enzymes as a precautionary prophylactic for people over 40?

I think anyone that shows undigested food in their stool that has evidence of protein maldigestion because they have symptoms that occur every time they eat a protein rich meal is a candidate for evaluating prophylactic use of pancreatic low enzyme replacement therapy. That's what the whole concept of protein or pancreatic enzyme insufficiency, I'm not talking about disease insufficiency, is, is, is all about.

But since many people won't be tested thoroughly like that, is there any harm in people taking digestive enzymes just even if they don't need them?

Well, the only potential risk obviously is the same, same kind of risk that I would say for people who do hormone replacement when we're replacing things that the body makes it then kind of quiets the body's normal process because the body says, well I guess I don't need to do this now because it's being done for me. So it then kind of silences the body's normal process by giving augmented levels of certain things. Now it depends on what level you're giving. Augmented. If you give too much of something, then the body's function can shut down. If you give just a little help, then the body's function is assisted. So I think it's the dose response, that relationship and remembering that the old adage a little is good but too much might not be so good, we need to always balance those concepts together.

Before we leave protein quality. Let's talk just a bit about protein powders. A lot of questions about is pea protein as good as beef protein as good as casein? Lots of different ones. Whey protein for most of my career has been kind of the gold standard. How do you feel about protein powders?

Yeah, I think the use of these values that can be measured and should be labeled on protein supplements. Protein efficiency ratios, net protein utilizability, npu, these are standards that you can test your protein against. That gives you some validation of their ability to be digestion and assimilated against a marker high quality protein like that of, of lactobumin. And so I think that you want to get high quality, high digestibility protein. It has good protein utilizability numbers 80% or better and net protein capability delivering essential amino acids at 80% or better, 0.8 or better. And I think that that then along with the amount that you're consuming, this one to one and a half grams per day per every two plus pounds is going to put you in the right range of protein sufficiency as a blend of vegetable and animal proteins. You don't have to be so worried about the specifics. Now there is and I want to guess one caveat. We know that there is a protein source. It's very good therapeutically for skin, hair, nails, and that's collagen protein. And predigested collagen protein has some therapeutic value. However, collagen is a unique protein in its composition. It's very, very high in hydroxyproline and proline and glycine, but it's very low in branch chain essential amino acids. So if a person was to say I'm going to just use collagen protein as an animal protein for my protein intake, that probably would put them in an imbalanced protein situation because they would not be getting adequate levels. If they use collagen protein as say 5 to 10 grams a day as an adjunct for specific benefits for skin, hair and nails, that's good. But as a protein source for general body conditioning, the answer is no. So I think again it depends upon the personality of the protein. We've seen this a little bit recently in dog nutrition, as you probably know that there is this cardiopathy, this heart problem that's occurred in dogs, particularly certain breeds of dogs who are fed dog food that was low in a non essential amino acid. It's not in protein called taurine. And taurine was, was found in certain proteins, complete proteins. It's not part of what I really should say. It's part of a diet that's rich in protein of animal source. And if you don't get adequate taurine in a dog's diet, then it can develop in certain breeds this risk to cardiac disease. So this concept of whole diets that contain the full complement of nutrients is important versus just an isolated protein which doesn't contain that whole companion of nutrients that is necessary for proper cell physiology.

Understood. We got One question that I thought was going to be too technical for most of the audience, but since you kind of brought it up anyway, this protein assessment stuff has changed a lot since I started. I mean, this biological banyan, it was replaced by pdcaas, and now it's diaas. Could you address the different standards by which these proteins are evaluated? Because I know that any given protein, say soy, is going to weigh differently on those different standards. So which one should we be looking at?

Yeah, thank you. That's another really interesting question. I'll try to collapse a lot of stuff into a short statement here. So when the first protein efficiency standards were established, they used what was called, this came from Scrimshaw and Young's work at mit, came out of what were called protein efficiency ratios, or pers. And I use PERS as a kind of a standard for decades, actually, because it was the standard for evaluating protein. But then again, out of the laboratories of Young and Devin Scrimshaw and Vernon Young, they recognized actually the way that these studies were being done were on rodents, they weren't on humans. So you fed rodent animals certain amounts of protein. You looked at the ability to convert it into muscle protein in the body, and you develop these PER ratios. But then they found in more exhaustive study of the metabolism of protein by rodents, that they are unique in their metabolism of one of the amino acids of the essential amino acid family. That's the sulfur containing amino acids, methionine, cysteine and cysteine. Cysteine and cysteine. And it turns out that the rodent is not very efficient in the way that it utilizes those sulfur amino acids. So it has to have higher levels of those in the diet to produce protein sufficiency, much higher levels than humans need. So when you adjusted for the different in sulfur amino acid metabolism, it led to new standards that then made vegetable proteins appear better, because vegetable proteins were lower in these sulfur amino acids, which in rodents were not so good, but in humans were better under than this difference in the metabolism. So we went to these new standards that included the new metabolic understanding of the sulfur amino acid metabolism that then raised soy protein in its sufficiency above what it was originally in the per. So the new standards that have these long abbreviations are the ones that are more complete for human protein sufficiency. And again, we wanted those to be at 0.85 or better. It would be considered a good protein quality.

Got it. I want to clean up one loose end before we move to the next topic. You mentioned collagen A lot of people asked about it. Does collagen. A lot of people take collagen for different reasons, for joint health and mobility or for skin and nails and all that. Does that count as part of your protein? I know the answer. I want to hear it from you.

Well, it does count because we know that these collagen peptides, because generally when you take collagen as a supplement, it's pre digested collagen that where it's been enzymatically treated to break down the big collagen molecules into smaller, what are called peptides and those are more capable of being absorbed. They've been shown to be in the blood after oral consumption and they then nourish the cells in different way than if you were just feed them shoe leather, which is collagen. So if we then look at the effect that that has on the body, it's very, very contributing to the amino acids that we would take in. However, again going back to my previous concepts, collagen is very low in the branched chain essential amino acids. So it would contribute, but it wouldn't contribute a complete balance of protein that you need for optimal nutrition. So I would not rely upon collagen peptides as a source of overall body nutrition. So I would use them more for therapeutic adjunctive effects, as you mentioned, are on joints and hair and skin and nails and so forth.

Understood. We just got a question on the board that is one of the ones that I had for you, which is different conditions such as kidney problems. And I think a lot of people when they hear high protein diets or higher than we've been expected to consume before they get very nervous about kidneys. I'd love you to address the issue of kidney problems. And then I've got a couple of other conditions that might require modifications. How do we modify our protein needs if there is pre existing kidney disease or if we're trying to prevent kidney disease?

There is a very large series of studies that were done to try to find ways to improve blood pressure in individuals who were hypertensive. And that became known as the Dietary approach to stopping hypertension. If you look at the abbreviation, it's D A S H. So that's the DASH diet. Well, the DASH diet turns out to be fairly low in protein relative to the numbers that I was describing before. More like a half a gram of protein per 2.2 pounds versus the one to one and a half. And so the lower protein diets were then studied in kidney related problems because blood pressure is in part related to our kidney function. I won't go through all the reticulo endothelial physiology, but let's just say that there is a connection between kidney function and blood pressure control through angiotensin and the production of these hormones from the kidney. And it was found that low protein diets were not only able to lower blood pressure, but they were able to lower uremia kidney dysfunction in people that had mild or maybe even moderate kidney issues. So the DASH diet and even lower protein than the DASH diet was started to be used as kidney compliant diets for people that have kidney issues. The real question is in a person with normal kidney function, are you really worried about these levels of protein that we've been discussing? The one to one and a half grams of protein intake per day per two pounds of body weight, ideal body weight? The answer is no, that the body can handle that. As long as you don't have liver dysfunction, as long as you don't have existing nascent kidney dysfunction, which you can get from a standard blood and urine analysis, then you're, you're in the, the garden variety people that can manage that level of protein quite efficiently. But I think we should keep in mind that protein, because of that nitrogen that I talked about, when it's increased above a certain level, everybody can become toxic to their own protein. And I can say the same thing about carbohydrate or fat. Everything can become toxic eventually to overloading those nutrients as well. So it's in moderation, in balance, based upon your own liver and kidney function and the, the kind of protein you're consuming.

What about osteoporosis? That came up a lot. Bone loss, I remember. I don't have the encyclopedic memory you do, but I seem to remember a couple of studies of elderly people and bone mineral loss was greatest in those who eat the least amount of protein. So the kind of the, the takeaway message that I remember from those studies was that older people should not, because first of all they're not as hungry, they don't eat as much food. I know this from my 80 year old grandparents and they eat tea and toast and they're done. So there's a big tendency to get very little protein sometimes when you're up there in your 80s if you're not paying attention to it. What about that?

Yeah, so that's another interesting controversy actually. And I go back to this U curve that I talked about before. Too little protein can lead, contribute to bone loss. Too much protein can contribute to bone loss. So it almost always comes back to the story is where do we want to be in that zone of self regulation that is for optimal function. And for individuals with normal liver and kidney function, again, this level that we're talking about of one to one and a half is in that range of safe and effective. Now what about a person who's eating like a bird? They don't want a lot of food, they don't have a lot of appetite. Well, the body has natural intelligence, you know, it kind of will vary its dietary calorie intake based upon need. And maybe you don't want a lot of anabolic drive at a certain phase of your life. So you want to have a very lean body type. And maybe that's part of the natural aging process. You don't want to too much drive of protein producing anabolic response. But I think again, it comes back to this zone of adequacy. We don't want to be too little, we don't be too much. We don't want to be pulling calcium out of the body. We want to be actually contributing to osteoblastic activity so that the bone is being remodeled properly. And that's proper dietary protein intake with proper essential amino acid intake.

I know a lot of people that have been given this formula are going to go, I can't do the math. I'm not going to think about it. What's a good number? So when I wrote the book Smart Fat with Dr. Steven Massley, who was a real research kind of guy, we were trying to struggle with this. What should we recommend the range to be for 95, 96% of the population? We came up with 80 to 100 grams. How do you feel about that? I mean, for average. Yeah, yeah, we can make a general recommendation. We both.

Yeah, that's, that's, you know, when you translate that down to what that would mean in terms of animal foods or animal protein, it's, it's very easily achievable. It would be considered at a higher end of what the standard food nutrition board might say. But I think it's in the range of actually helping to improve blood sugar. By the way, that's the other thing that people don't understand is that too much protein can actually create blood sugar problems. Just like too much carbohydrates.

Yeah.

So we forget about that glucogenic effect of protein. So everything, again, balance. But that number you just gave, you know, six to eight ounces of good lean protein from an animal source a day is in that range of what you're talking about. I think that's a practical amount.

Just to not be remiss. There was a bestseller that was on the New York times list for six months, outlived by a doctor we both know, Dr. Peter Attia. And he was talking about one of 20 as a goal. I thought, okay, what do you think about that? That sounds a little bit high to me for the average person, but what's your feeling about that number?

Well, I, I think there are many people that, that get that amount of protein daily in their diet for long periods of time and do fine. So I don't want to, you know, to say, oh, that's, that's really dangerous. But again, as we become more intelligent about our bodies and we have information that we can access about that now that we couldn't before. You know, before we didn't even have access to our blood chemistries from our doctor. Now we can get full information, full disclosure if we want to. And as we learn more about our bodies, we learn what our metabol type is. We understand, are we more protein type, are we more complex carbohydrate type, Are we more Mediterranean diet, are we more Mediterranean diet type? So I think this intelligence that we're able to access now about our body's capability then allows us to define, personalizing our intake. What is our lifestyle? Are we heavy exercises? Are we trying to build body mass? Are we trying to maintain what's our immune system function? All of these things pertain to making intelligent decisions and it's not just formulaic. This is the age of personalization. That's the information we're trying to provide.

I couldn't agree more. Some people asked about food combining. When I first started, that was a big thing. I haven't heard much about it recently, but is the amount of protein you eat in any way related to the amount of fat? I have something I can contribute about this, but what do you think about that? Protein, carbs, Protein and fat. Is there some idyllic balance in there that we should be aware of?

Well, I try to go back to the way our digestive system works under ideal circumstances. So it depends on the total load that you're providing the digestive system it has to deal with. You know, I often think of what happens if you go out on a Friday or Saturday night and you really celebrate. You have a full large size pizza all by yourself and then you end up with some kind of a eclair dessert and you've really had a fantastic time. So what do we know about that we know it's going to produce postprandial endotoxemia. That's been proven. So you're going to produce some holes in your digestive tract that is going to lead to release of some toxic materials into your blood that's probably going to activate your immune system. Now, you can afford to do that occasionally if you're healthy and your body will recover its function. You might feel a little hungover the next morning after you've overdone it without even having alcohol, but your body has the resilience to do that. But if that becomes a standard affair where you're, you're loading up too much of any one nutrient or combination thereof, particularly those that are more difficult to digest. And quite honestly, fat and protein are more difficult to digest than carbohydrates. Carbohydrate, as I said, starts digestion in the mouth if you chew and have saliva, salivary action, whereas your protein and fat has much more demands on enzymes, lipase and protease enzymes, and uptaking into the lymph system of your fatty acids and getting things down through the pancreatic digestive system for protein. So again, balanced amounts of those, not overloading the system. That's why some people have said smaller meals, multiple days are better than huge gorging at one time of the day, because that overloads the capacity of your digestive system. So I think all of these are about the intelligence of eating and how you put into your system what you're going to ask it to do.

Speaking of that, I've commented on this a lot. I'd love to know what you think about it. I don't think that that was great advice. I was one of the people telling when I started as a personal trainer at Equinox, eat, graze, eat every two hours. There's a couple things wrong with that I'd love for you to comment on. One is people don't understand mini meals in this country. They think an Olive Garden meal is a real meal. So half of that is a mini meal. So that never worked. They were not eating mini meals. The second thing is because one of my passions is educating people about insulin resistance and pre diabetes, which I think is the metabolic plague of the 21st century. And to me, eating every two hours pretty much guarantees your insulin is never going to go down. So do you want to address that? I mean, I think that that was not great advice. Was I wrong about that?

No, no, I think you're right on target. And when I say smaller meals, I don't mean five or six portions a day. I mean trying to balance out. So you don't say I'm going to eat 80% of my calories at one meal. You, you want it to be balanced out. But I, but I think, you know, I'm a, I'm a believer personally in this time restricted eating. So I think trying to have your meals within a certain period of time, probably like a third of the a day from morning till your last meal in the, in the evening is where you should eat. And then you give your digestive and the rest of the body rest for re rehab for the other 16 hours a day. So some people might say, well that's a little extreme. I think 12 and 12 is better. I have a 12 hour window for eating and then 12 hours for rest. Whatever in that range is best for that person is a good idea. And then to divide your, you're eating up so it's not all of just one meal that you're getting all the calories.

Yeah. I have fielded lots of questions about intermittent fasting and I'd love to know what you think about that. The 12 and 12, which is basically you fast from dinner to breakfast, is the way Everybody ate in 1950. It's really not that different. You eat three square meals a day, you don't snack and you don't eat after. And I am a big believer also in that I kind of usually do that 12 and 8. But I also feel that there are certain lessons from the intermittent fasting community that even non fasting people could really benefit from. And I'd love to know whether you agree with this. Let four hours go between meals. Don't eat in between meals. Don't snap even whether you're fasting or not. And if you are doing the 12 and 8, don't take that eight hours to gorge every single hour you can get in there. But, but do the same kind of thing. Maybe two to three meals separated by a few hours and not eating after dinner and you would address digestion. I think that it probably improves digestion. It definitely improves insulin because it gives you some time to. So what do you think about that kind of an eating pattern for people who want to lose weight or just stay healthy? And how does that fit into our protein needs? Can we get enough?

I'm right on on. I'm right on track with you. I'm right in synchrony. I think that this concept of what is, what is the energy cost of our body to digest a meal is an interesting Question. So it turns out that the energy required of your body to digest protein and fat is higher than the energy required to digest carbohydrate. And so your body, if you load a lot of stuff onto it at one time, your digestive system is going to mobilize a lot of energy in the digestive process. That is the muscle activity, the digestive enzyme activity. Everything takes energy to do that. And that's sometimes called the thermic effect of food. You can feel your body temperature go up because your body's working hard to digest a lot of calories very quickly, particularly protein and, and fat. So I, I think the construct that you're describing to, to deliver over a certain measured period of time your calories that contain your adequate amount of protein and your essential fatty acids, particularly omega 3 fats. Want to make sure we get those into the body and your, you know, time released carbohydrate, which is minimally processed fiber rich carbohydrates coming from plant foods. That's, I'm just basically describing kind of the modified Mediterranean diet approach that delivers then a blood sugar stabilizing protein adequacy, digestive friendly. As long as you're staying away from foods that might actually activate your immune system. For instance, I talk about gluten. In some people, that is a problem. As long as that all is fulfilled within your diet, you're going to end up with a favorable outcome in your body's ability to reconstruct itself. Its own muscle, protein, its own enzymes, all the things necessary to do your metabolic function.

We just got a question. It's pretty interesting. Don't people with GI issues like GERD or low blood sugar need 5 to 6 small meals? What do you say?

Well, I think that people with gastrointestinal esophageal disorder, I would first look at what their digestive system is doing because there's a very high prevalence of hypochlorhydria in those people. They may actually have some digestive difficulties. That what you're not treating as the cause, you're treating the effect, the cause is a digestive problem. So I would look at digestive sufficiency first and then make sure that that digestive system is being properly supported. Before I started saying, well I'm just going to do a workaround by eating a lot of small meals a day and then I have additional problem of blood sugar control.

Yeah, there was a question regarding weight loss which is always, always comes up. No matter what the topic of the webinar, there's always people who are concerned with that with good reason. And I wanted to ask you about this. There was a popular diet a number of years ago called the Ducan Diet. It was based on a doctor in France named Pierre Ducan. He was treating one of the princesses when she was getting married or something like that. So he got a lot of publicity and he had a term tongue in cheek called Protein Thursdays. And he said if you want, if you're losing weight or you started to gain it back and you want to kind of do a metabolic reset, take one day and eat nothing but protein and you'll probably drop that couple of pounds and get back on track. What say you about that concept?

Well, I think if a person was to take one day of the week to be conscious of their diet, no matter what they were eating, because it would probably eat less, it would be more conscious of what they are eating and it would have a positive outcome. Because the problem is that we're all, to some extent, all of us are unconscious eaters. And I mean, some people are really unconscious, some are only marginally. I mean, I think I'm marginally unconscious. I try to be very, very thoughtful about it, but there are times where I avoid my own rules or I don't live to my own rules. And so I think if you're a conscious eater, you're going to be whatever you need to put in place to become a conscious eater, whatever tool becomes your guidepost that is going to help you to not just lose weight, but to regulate digestive function, health and vitality of your cells. Because you're going to be making intelligent decisions versus just subliminal decisions about what you're going to be. Because if you're not a conscious eater, then you're deferring your eating to Madison Avenue marketing of ultra processed foods. I mean, I've overstated it to make a point, but you're no longer, you're no longer in charge. Somebody else is in charge then.

Yeah, that's, that's great. We are almost out of time. Can, Is there anything you want to leave the audience with kind of top, you know, top of line take homes about protein and health or anything in general that you want to say to them?

Yeah, I'd like to just quickly relate once again what I've learned as a consequence of us kind of diving deep into this, this Himalayan tartary buckwheat culture, this 4,000 year old food and how did it end up, end up in culture in Asia for so many generations and in The Yellow Emperor's Handbook of Nutrition and Nutrition Therapies. I think that there's wisdom that we, we need to relearn. It's back to the future about things that people ate historically because they didn't have all the food processing and all the technology that produces shelf stable food and, and they didn't have modern medicine either. And somehow these cultures, by the nature of interfacing with their environment and natural products, animal and vegetable products, created outcomes in their belief systems. It became part of their medicine. So we have traditional Chinese medicine that's very food centric. We have Ayurvedic medicine that's food and spice centric. We have Amazonian medicine, this food. I mean, they've used their cultivars of traditional types to create a interface between health medicine and food. That is food is medicine. And so I think this is what I've learned from our work with himalayan tartery buckwheat. This 126 different phytochemicals that this plant makes, which all influence our immune system in favorable ways, is part of nature's gift of diversity that we need to relearn. It's back to the future as we get away from things that are very simple in which basically all our foods are made from soy or from corn or from, well, to some extent, I guess we would say wheat. But if we then move away to look at the way cultures have eaten historically to produce health, health, it's not just from those three food ingredients that are remade into all these fabricated high sugar, high fat products. So that's, that's my learning. My learning is that vegetables can produce high quality nutrition. They contain protein with are rich in essential amino acids. We should be very mindful that you can get all sorts of different dietary varieties by eating naturally and that that is really the recipe to good health.

I think that's a great place to end and wonderful advice. It's been an honor. Thank you so much for spending this hour and I've been just delighted to be able to interact with you and ask the questions on the part of the audience.

Well, thank you. Fantastic teamsmanship, Dr. Baden and I look forward to doing this again with you. This is really a blast. Thank you.

Bye bye.

Bye bye everybody.