Protein Consumption in Menopause

Real quick, before we dive into this episode, I have a little sleep secret I want to tell you about. Look, sleep is crucial for your fitness, but it's crucial for just plain old everyday life and function. And I find I sleep great unless I have a migraine. And I've had more than my fair share since perimenopause all the way through postmenopause. My secret weapon was Blue Sky CBD sleep gels. Each gel contains 25mg of CBD and 25mg CBN for deep restorative sleep. Something about it helps to reduce inflammation, which I believe for me was key in helping me get to sleep. But the biggest thing is so many of the over-the-counter solutions, whether for sleep or migraines, can ruin gut health, and liver health. Neither one of those did I want to be problematic for me. So this option is recommended by healthcare providers worldwide and backed by thousands of happy customers, many of whom come from our Flipping 50 community. There is zero THC, so it's non-habit-forming. It's made by a trusted family-owned company that we all can feel good about. Third-party tested for purity and potency. And if you're interested, you too can try a sample for just $6. But even better, you can get 30% off forever with discount code FLIPPING50. That's FLIPPING50. Just go to flipping50.com/blueskycbd. We'll put that link in the show notes and you'll find it everywhere on Flipping 50 at My Favorites. What are you waiting for? Good night. If you are still confused about how much protein to consume and how it relates directly to your support of lean muscle mass, lower body fat in, during, or post-menopause, this is your episode. I'm Debra Atkinson. You're listening to Flipping 50. I started this podcast over a decade ago to answer questions about fitness in menopause and beyond before you knew to ask them. The goal: to help accelerate your results with science and the practical application of proven protocols while living your best life. There's no more powerful health influencer in the world than a midlife woman. And it's not just about you, but the 3 generations that you influence. My unique 40-year career, including being a university senior lecturer in kinesiology, an industry subject matter expert and an international speaker to founder of the first and the only exclusively made-for-menopause and beyond fitness membership in the world. Every week I interview experts behind the scenes and the science of optimal hormone-balancing fitness and longevity and share answers to our community's questions so you can have the vitality and the energy that you want, need, and deserve. As we dive into this episode, I got to warn you that you might be triggered, and a lot of women are. And I have to stop and really reflect on why this is. But number one, protein and many of our protein sources have eyes, they're alive. It deals with animals. You also have a certain set of limiting beliefs based on the way you were raised and the way that you've eaten in your adult life. Our adult lives and our habits probably right now are, for the first time, a significantly larger portion of our lives than those that we were raised with. So while you might look at how you were raised, and if it's at all like mine, breakfast was very low protein for me. I mean, habitually, even if there was protein available, I don't think I partook. It was very high carbohydrate, and any source of protein for me would have been the milk on top of my carbohydrates. Are you with me? Okay. And then in my adult life, it was much more of a skip or skimp. And then it was also very high carbohydrate until I was 30. And at some point, it was actually at age 31 when I was training for my first marathon that I realized the importance of protein and recovery from exercise, and that knowing I was going to run again tomorrow, I needed to recover a little bit quicker. And it had nothing to do with the fact that I was 30, not 20, and probably wasn't quite at peak muscle mass anymore, might be starting to lose it. Although I was, so I got lucky. But what I know now is that indeed I got lucky because then at the very least I was taking in at least 3 meals a day of at least 30 grams of protein, which is pretty easy to do if you simply do eat animal meat and protein and Then when I was about 45, a little younger than that, I experimented with a vegetarian diet for 3 months. Now let me just tell you, this happened Memorial Day weekend. I read a book, I committed to, I gotta try this. This is very compelling. So I did. For the first month, I actually felt great. My digestion was improved. I felt lighter. I didn't know my digestion needed to be improved. By month 2, and I had only committed to 1 month, by month 2, I said, I'm still feeling good. I want to continue it. But probably midway or beyond, I started to feel like It's not quite as good. Like, I think I've gotten all the benefits, but by month 3, I looked significantly leaner and liked that because we get praised for that, right? We get noticed for that. But I started feeling weaker. Like, the workouts I was doing, I wasn't as strong. I didn't have the endurance, and I wasn't recovering from them, so I stopped. I didn't make it the full 3 months, and I realized that while maybe I had lost or improved body composition, as I do believe— I wasn't measuring my body fat and my lean muscle mass specifically at that period of time. I do believe I lost some amount of muscle mass, but it was probably a low enough amount, negligible, that it was really focused on the weight loss overall and the fact that I look leaner. And that lasted. But by month 3, I actually could see that I'd lost lean muscle mass as well. Wasn't showing signs of fat because for me, the point where I was was very, very early in perimenopause, just coincidentally. But now the point is, what I'm about to tell you could give you reason for concern. You're doubting whether high protein is safe, or you're coming from a standpoint of, I can't eat all that much, I'm getting full too fast. There are a lot of things that could be going on. This is not a short podcast. So I want you to pay close attention, split it into two listens if you need to, or make this day a longer hike. So when it comes to protein consumption in menopause, there are several things to consider in terms of the why you might be resistant. And even though there's no science or medical evidence to show that higher— and what I mean by higher is than you grew up with or are used to— that higher protein intakes cause kidney renal issues. Many people still believe it's true. Doctors sometimes still believe it's true. There's no scientific evidence that this is true. There's no medical evidence unless somebody has an existing renal issue. So if you are already experiencing that, you've already been told, your lab tests inevitably have come back with some suggestions that something isn't quite right, and/or you are diabetic or pre-diabetic, there's reason to say, okay, don't just increase your diet or transfer this into high protein without consulting your medical professional first. But for anybody else, high protein diets don't cause kidney problems, period. So what is true for anyone who has an existing renal issue, diabetes for instance, high protein diets should be considered and discussed then monitored with your physician. So let's backpedal, though, to again, what is high protein? It's very personal interpretation because you might think just simply having more protein than you're used to having is a quote unquote high protein diet. The truth is, if we do the math with recommendations that we've learned since grade school, high protein is always recommended. It's always been there. Few of us have taken it. So let's reflect a minute. If you eat, say, 2,500, or we could say we could choose 2,000, but I'm going to say 2,500 just so it's just slightly higher for us active people. You consume 2,500 calories a day and you consumed only 10% protein. That would be 250 calories from protein. Protein contains 4 calories per gram. So that would be 62 grams of protein. That's about average. Actually, the person sitting next to you on the other side are probably below average for intake. But if you ate 35% of your diet from protein, and if you remember from science, the range of protein recommendation is 10 to 35%. So here's the thing, I taught health studies to college students for 15 years, and it's like just solving a puzzle. We don't actually say, you in the back row on the right, you, I want you at 10%. And we say, okay, you over here in the middle, I want you at 35, or I want you at 20. And we don't help anybody determine, well, which percent of my diet should my protein be ever. No one does that. We just say if you get in this range, you're good. That would be like shooting at a target, a bullseye, and saying if you hit the house, you're good. Okay, that's a pretty broad target is what I'm saying. So I want you to realize There's holes in this system about protein recommendations that have been there forever. 10 to 35% is a crazy, crazy amount of swing from one side to the other. And if you're looking at, all right, my calories are going to stay about the same, if your protein is on the low side, your either carbs or fats or a little of both are high. How well do you think that's going to go for you? Well, after midlife, it's not going to go really well for you, I can tell you that. So let's say you'd consume in this $2,500 calorie diet, you consume 875 calories from protein, and that would be 218 grams of protein if you were at 35%, anywhere between Your range of 62 and 218 grams of protein per day is within recommended daily amount. That's nuts. Again, faulty system. We've had this from the beginning. So you're left to your interpretation, or maybe the way your family ate and what it ended up being. And so am I. So hopefully we already see there's problems with both. Such a wide range and a way to determine that is right for you. There isn't one. There never was. The RDAs, I want you to realize they're not law. And I think that sentence may take a moment to sink in, but we often treat it like, oh, but the guideline says this. It might be that it's outdated. Might be that it was problematic to begin with. And it might be that how do you know you need 35% versus you need 10% or vice versa? You've just chosen to be there where you are naturally. And remember when we were— they were derived in why? So the RDAs, Recommended Daily Allowances, pre-war, they were suggested to keep young men going off to war from getting scurvy and rickets. And just to maintain normal health and to look at what should rations be like. Consider the length of time that it takes to induce any significant change in governmental guidelines. RDAs have been initiated and they've influenced us for decades. But what if they're wrong and we continue to blindly follow them instead of evidence that you're losing muscle, gaining fat, lack energy, have blood sugar issues? What if all those things are going on and just a tweak in your protein intake could make a huge difference? And I believe it can. I've seen it happen for myself and for many clients, and we have hundreds and thousands of women who've gone through programs. We've seen consistently over time energy levels increase, sleep improves, body composition improves. Strength increases. For athletes, performance increases. RDAs are actually the minimum to prevent deficiency. Consider the meaning of that versus how do you want to live? Do you want to live just so that you don't die, just so that you don't get a disease, or do you want to live with lots of energy doing the things you love to do? So 1.2 to 1.6 grams of protein. Then this is per kilogram of body weight, by the way, is a more optimal range. So what does that look like? Okay, for those adults losing muscle strength or trying to lose weight in a caloric deficit, a higher intake of protein might be required to minimize muscle loss. And this is across the board seen in literature, scientific peer-reviewed journals, longevity studies again and again. The current recommended daily or dietary allowance, RDA, to prevent deficiency in minimally active adults is 0.8 grams of protein per kilogram of body weight. However, newer research suggests that individuals trying to build muscle need more than this, or individuals who are older and trying to preserve lean muscle, meaning not lose it, hold on to it. We have to work a little harder to do that. It also makes sense that women over 50 with greater anabolic resistance, meaning our ability to gain lean muscle is— it's like we have a wall, we have to crawl over it, and maybe everybody has to crawl over it, but our wall is higher. So we have to have more protein to help us overcome that anabolic resistance to build muscle, therefore lose fat. We will want to pay special attention to the need for protein. Consuming less protein than the body needs has been linked to decreased muscle mass. In contrast, increased protein intakes above the RDA may help increase strength lean muscle mass when compared— when it's paired with resistance training. And in studies by and mentioned by Bill Phillips, PhD, he was recently on a podcast, he was on the summit. What I want to remind you of, the lowest hanging fruit is don't change your calories at all, but the number of calories that comes from protein, if you increase that you would potentially increase your fat loss. Did I say enough, right? No deprivation. In fact, you're probably going to be more full, more satisfied, and have more energy if you keep your calories the same. But of those calories, eat more protein. Simple assignment. Try it. Okay. In order to build muscle, a person must consume more protein than what is broken down. This is referred to as a net positive nitrogen balance because protein is high in nitrogen. So what we're looking at is on one side you have muscle protein breakdown, on the other side we have muscle protein synthesis. So with muscle protein synthesis, we're using protein, we're also using resistance training to boost muscle repair and growth. And with muscle protein breakdown, we either could be sedentary in bed because we're sick or injured, not moving, inactivity, not eating enough protein, or overall not eating enough calories. Both are problems when it comes to muscle protein synthesis causing muscle protein breakdown. So we're looking for a positive nitrogen balance. Muscle protein synthesis has to be greater than muscle protein breakdown for nitrogen balance to be achieved. According to the 2020 to 2025 Dietary Guidelines for Americans, so know this, that those will be redone, revisited again next year. Most healthy adults over 19 should get between 10 and 35% of their daily calories from protein, 1 gram of protein provides 4 calories. Again, did we say that's a wide range? Yes. So that's not changed for decades. It means that a person who eats 2,000 calories a day would need to consume between 50 and 175 grams of protein to be in range. But that is a huge range. It's huge, right? Doctors generally agree that healthy adults can safely tolerate a long-term protein intake of up to 2 grams per kilogram of body weight per day without any negative side effects. However, some groups of people such as healthy, well-trained athletes may tolerate 3.5 grams per kilogram of body weight of protein. Now let's do some math because I know you're thinking, well, what does that equate to? 2 grams per kilogram equals 120 grams of protein. Okay, just to give you an idea, that is for a 130-pound individual. So it is almost ballpark, right, of 1 gram of protein to 1 pound of body weight. Shoot for that. If you're a little bit less, you're, you're still in a perfect array. 3.5 grams per kilogram is 210 grams of protein. I'll tell you straight off that for, say, a 130-pound individual— and actually that happens to be my body weight, give or take. I'd rather give, if you're asking, but wouldn't we all? But 210 grams of protein would be a lot. That would be a part-time job. And I've heard many of you say this, it feels like a part-time job. And I don't think it's actually the eating. I think it's the figuring out what would this be, what would this look like, you know, because I can easily have 40 to 50 grams of protein at a breakfast smoothie or a post-workout smoothie that is at breakfast time basically, and, you know, then hit 35 easily at lunch, and I can then get probably 45, 50 at dinner. So are you doing math? So let's say 50 at dinner with 40 at breakfast. I'm at 90 and then 35. So I'm at 125. I can get that pretty easily. 210. Whoosh. Right. So I would have to be doing some real activity to work up an appetite so that I wanted maybe another mid-afternoon shake. Where I could bump my protein up again. But even if I did that, I'd be at maybe 170, 175. 200 to him would be significant. I would probably have to supplement with essential amino acids capsules or powder in order to do that. Just personally, just to give you an idea of what that means. So age can be an issue. So older people generally need twice as much protein for the same muscle protein synthesis as a young person. Gender— females have less muscle mass to begin with, so it's definitely going to require that we have more protein stimulus for muscle protein synthesis than a male does. Activity level— this is where the literature goes both ways. So highly active, whether it's resistance training activity or it's endurance requires more protein because there's generally more breakdown happening because of the activity. So we're countering that. However, for very inactive, they synthesize protein very poorly. The more active and conditioned you get, your body actually gets better at not only with oxygen, delivering oxygen and pulling the oxygen from it for the working muscles, but also the protein the same. So when you eat protein, you actually synthesize it better if you're more athletic or very active. By the way, if I use that word athletic and you exercise regularly, intentionally, 3 to 4 times a week, consider yourself athletic. Okay, love it. Your health— somebody with poor health actually may require more protein depending on who they are and if it's tolerated. But for healing, for immunity, protein is really one of the necessary pieces for weight loss effort. If we calculated what you need right now just based on weight, but you were trying to lose weight, so you're creating a small caloric deficit and they're therefore doing that, you're trying to create that caloric deficit. You want to increase the amount of protein that you're taking in. So that's an important distinguishing factor. It's not just about caloric deficit. Anabolic resistance— again, you need more protein. So who would that be? It would be somebody who's probably a female, not a male. That would be a woman in midlife. A woman who's 40 probably doesn't have quite as much anabolic resistance as a woman who's 50, a woman who's 60, and then 70, more anabolic resistance as we get older. Sarcopenia. So let's talk about this. What is it? It is a loss of strength. We have a significant loss of strength at around 50. We have a loss of muscle mass that occurs at 60 at an increased rate. So if from about age 30 onward, every decade we lose between 3 and 8% of our lean muscle mass if we're not doing something about it— we weren't strength training, correctly. We weren't eating adequate protein and maybe calories correctly. 3 to 8% per decade. But at age 60, that suddenly shifts. So it's much more significant. It's 1 to 2% a year. So do the math. That's 10 to 20% in a decade. That's pretty significant increase. Again, though, if you're not doing something about it, I'm 60. That's not happening on my watch. Not here. And why? Because I have things to do, because I feel 20, because— and I'm smarter. Isn't that a great thing? All right. I feel 20 and I'm smarter than when I was 20. There's that. But also, I think it's really important for you to realize that you're going to choose resistance training that will stimulate you unless you have fear about it. So my other job, not visiting that today, is to talk to you about what ideally you'll be doing and how you onboard that, because we don't start there, but we have to start somewhere. Let's talk about osteoporosis for a moment. How is this related to the discussion on protein? Well, it used to be we thought that protein was actually a contraindication for somebody who had osteoporosis. We now know that was foolish. In fact, The very research that was used to share this probably prevented some people from gaining bone density who otherwise could have easier, more naturally. But bones are about 70% protein. So what you gain from the muscle strengthening and the muscle pulling on the bone and the bone itself from eating protein is far greater than any detriment. The World Health Organization, WHO, in their official report on protein stated The most widely quoted potential problems of a high protein diet relate to renal function and damage, but as discussed, the evidence for such claims in otherwise healthy individuals does not stand up to scrutiny. That was the World Health Organization. So it's not personal opinion that I shared with you earlier. It is from research I've done and included on a book that I published in 2013. But this is extremely important, and we need to hear it over and over again, because somewhere in the back of your head you have a limiting belief, and if it's been there for a while, it takes a while to get it out. Talk about bone— higher protein diets increase the absorption of dietary calcium to compensate for any calcium loss that might happen because of greater protein. Furthermore, a meta-analysis— that means a a large study comprehensive of protein supplementation studies showed small but significant benefit of increased protein intake on bone mineral density, possibly due to direct insulin-like growth factor that was mediated— or mediated anabolic influences from bone tissue. This comes from Stanford Lifestyle Medicine and Longevity. I want you to understand here that I'm going to give you numbers that are different and numbers that are same. But this is where some of our confusion comes from, that the entities that put out recommendations even confuse us because they're sharing slightly different nuanced ways of relating information, which is not user-friendly to an individual sitting down to decide What's for dinner? Or what will I order? What will I buy at the grocery store? So we've got to really work on that. Potentially, that's you and I asking for better clarity to understand it. So again, from Stanford Lifestyle Medicine, for adults age 50 and over, we recommend consuming 1.2 to 1.6 grams of protein per kilogram of body weight per day. And that is 0.54 to 0.72 grams of protein per pound of body weight. So realize that that's under what I've suggested to you. For a 60— 165-pound adult, that roughly translates to 90 to 120 grams of protein per day, a little bit lower than previously mentioned. To build muscle past the age of 50, We need to eat protein and do weight training and consume 30 to 35 grams of protein within 2 hours of the workout, also helpful. So at each meal, 35 grams to overcome anabolic resistance— that is the next statement by them, by the way— and 30 to 35 grams within about 2 hours of a workout. Now, I also want to throw this out to you. Recent research published or shared— let me say that— shared by one of my respected sources for longevity and protein information, Dr. Stuart Phillips, shared that, you know, we're seeing it's not as important for it to be timed correctly as long as your overall intake of protein is adequate. If you miss that window of 2 hours after, it's still okay. However, when you can do it, talking to you, an audience of females in midlife with greater anabolic resistance, I would try to stay between the navigational buoys whenever we can. Most often I want to do it right. So think about that. So again, Anabolic resistance increases with age, so it's recommended to increase protein intake per meal to 30 to 35 grams to overcome that anabolic resistance. And either in addition, or one of those meals should occur about 2 hours after weight training. And here's the benefit: we bump muscle protein synthesis with resistance training, we bump it with high protein meals. So if we're doing both even better, right? We really get a great bolus for those over 65. Another study recommended higher amounts of protein, 1.2 to 2.0. But again, the range is as low as it was earlier but goes slightly higher. So I want you to take this into account. And here's why a study like that might not have published even higher because they didn't test it. It doesn't mean that it wouldn't have been true that higher or even higher might be better, but it wasn't tested. So they can only report on what they tested. So just realize that nothing is out there maybe to say it yet, and in a way that you're waiting to hear it. But it is there, and I want you to keep listening because I'm going to share information that some of you are really asking, where is this? Where is it said that it's 1 gram of protein per pound of body weight? And I'm going to get to that. Data from the Health, Aging, and Body Composition Study support these findings, showing that intake of animal protein, because it's got a greater concentration of essential amino acids but not plant protein, was significantly associated with the preservation of lean body mass over 3 years in older adults. In dieting adults, especially dieting older adults— that's eating significantly below adequate calorie intake need— the loss of muscle percent was much greater in studies than in those adults consuming twice the recommended daily amount of protein. Subjects with the highest protein intake had 40% less muscle loss than those with the lowest amount of protein. It's very, very important that you understand we lose a percent of muscle when we lose weight. We want to minimize that percent to a smallest amount we can, and then we also simultaneously want to be offsetting it with resistance training, good quality sleep, so that we are doing everything to put it back on. Further, with a reduced ratio of carbohydrate to protein improved body composition and blood lipid profiles during weight loss in adult women, and that is from way back in 2003, published in the journal Nutrition. But I want to caution you, reduced ratio— that means reduced carbohydrate— is low, not no. Carbohydrates are required for getting lean muscle mass. You will do better if you're taking them in a particularly post-workout in order to help rebuild glycogen. Although women use more fat for fuel during exercise than do men, We still want a little bit of carbohydrate, so it's lower, not no. When the energy content of protein sources accounted for, the caloric need to meet the essential amino acid requirements from plant source of protein is considerably higher than the caloric intake from animal sources of protein. It's important to consider since obesity, especially with aging, is a major public concern Obesity is the most predominant factor limiting mobility in the elderly. So I understand and respect your choice for maybe veganism or vegetarianism, but it is harder to live a healthy, a life in older adulthood. And it's one of two problems. It is potentially obesity or it is sarcopenia and severe osteoporosis because of frailty. Neither of those are great choices. So you could— the amount of total, by the way, intake with at least 35 grams per meal, but not the pattern of intake matters most. So that means you could have 60 grams of protein for breakfast, you could have 50 or 60 for dinner, and then hit it in the middle with a little bit less, as long as you hit your quota. That was the most important piece. So you've got to hit Total, yes, and at least 30 to 35 grams per meal to be optimal. So snacking a little bit here and there doesn't actually do you good and may also not be beneficial if you're trying to burn fat because you're fueling. Why would your body use fat stores? That's harder to go downstairs to the basement to get that out of the freezer than it is to pull it right here. You're just giving it to me. Okay, so you could do a large intake at breakfast and dinner, moderate lunch during the day. You could take a simple shake pre-workout followed by high protein post-meal, two other additional meals. There's lots of ways to solve this problem or puzzle. Protein anabolism is synthesis minus breakdown. So we want your muscle protein synthesis minus the breakdown to be a positive number. So 35 grams at meals. Do the weight training, resistance training, movement, and physical activity during the day also matters. Get good sleep, optimize your stress levels. You know, all of those things are going to be super important in order to optimize your lean muscle mass. There may be reduced sensitivity to leucine, which is one of your essential amino acids with age, which is why quality of the protein that you consume is really important. So as you age, animal protein may be even more beneficial because animal protein, particularly beef, contains the most leucine. So if you're eating animal protein, you're probably getting 2.5 per each of 2 meals for a total of 5. But if you're eating plant-based diet, you're not getting that leucine. It may have just minute amounts, but you might want to then supplement with it and probably supplementing with all essential amino acids in taking a supplement form, either capsules or powders, either one, very beneficial. Don't just isolate one of them if you know you're not getting a high degree of all essential amino acids. For more options about improving or increasing your leucine on a daily basis, ask me about Burn Boost because it's one product that we've added to the family this year I've been using it probably 3 to 4 mornings a week because, you know, I don't lift early in the day. I don't always do anything like high intensity or hard early in the day. So if I'm trying to stay in a slight— I'm not necessarily fasting because I'll have a cup of coffee or matcha early with coconut milk or coconut milk powder. I've broken the fast, but you can still stay in a relatively ketogenic state because coconut milk powder is fat, right? So I'm not having a high sugar spike from that. And I will do a little burn boost, which will help me by taking in some specific salts that kick you into ketosis for fat burning a little bit longer and getting a dose of leucine in that for lean muscle mass. The absorption of proteins becomes a really important issue at midlife, and the benefit of digestive enzymes or something called betaine HCl prior to your meals supports better breakdown of protein so that can be absorbed for your use. After just 5 days of bed rest, older adults have reduced sensitivity to essential amino acids and greater muscle breakdown compared to young adults. So I want to call you back to the importance of muscle protein synthesis is better in the very active and athletic than it is in the sedentary. But that change happens as rapidly as 5 days. You have the flu, you have a sprained ankle, can't move as much, you're caregiving, you've got to find a way if that's the case to be active and to get some exercise. So any illness or injury resulting in decreased muscle function, to be followed by decreased lean muscle mass and strength, we've got to really work on increasing your essential amino acids. Try to increase your stimulus if possible and getting back on track as soon as possible. Very important. It is important to eat enough protein if you want to gain or maintain muscle mass. To maximize muscle protein accretion with resistance training, daily protein intake should be approximately 0.7 to 1 gram per pound body weight and 35 grams or more per meal. Just use that as your standard. Promote lean muscle mass retention during weight loss. Protein intakes of 2.3 3 to 3.1 grams of protein per kilogram of body weight have been advocated. The human body is capable of digesting large quantities of dietary protein. Now, we used to think— there's a limiting belief that we can only assimilate or synthesize a certain amount at once. We now know that is not true. Lean individuals and those with more training experience appear to be more susceptible to reductions in skeletal mass with relative to heavier training naive individuals, right? So if you're a beginner, you're probably going to easily gain skeletal muscle mass as you resistance train and you eat more protein. The more experienced you are, the greater chance if you have a higher volume of training that you'll lose more muscle mass in doing so. That doesn't bode well for some of us, right? Reductions in lean body mass are primarily driven by reductions in post-absorptive rates of muscle protein synthesis and a reduced sensitivity to the presence of a protein bolus. So what did I just say there, right? Reductions in lean body mass, they're driven by— we don't have that muscle protein synthesis we used to have, and there's this reduced sensitivity to even when you get the protein, you're not taking in as much. To effectively prevent those declines during both post-absorptive and post-prandial, post-meal Daily protein intake have been recommended to be increased to 2.3 to 3.1 grams of protein per kilogram a day, and leaner athletes may wish to aim for intakes at the higher end of this range. What does that look like? So again, I weigh 130 pounds. 2.3 grams per kilogram equals 138 grams of protein per day. 3.1 is 186 grams of protein per day. Those are actually still fairly reasonable, right? All of the science, and there is a lot, is within the show notes. So if you are a prove it to me girl and what's the study, I'm going to make you work a little bit because if you really are curious, you don't want just this single study. I'm going to give you about 10. So you can open that up, you can look at all of them and read as closely as I did through all of the literature here. Let's talk about anabolic resistance again in postmenopausal women. There's no sex difference in basal or fed muscle protein metabolism in young people, but postmenopausal women have a greater anabolic resistance than do older men. Anabolic resistance is also known as decreased pathways related to increased essential amino acids. It just means we have this blunting effect. Basically, we have this blunting effect when it comes to our use of protein that we're getting. We're getting more but absorbing less. Peri- and postmenopausal women are increasingly resistant to muscle protein anabolism, or gaining lean muscle. Due to a lack of response to exercise and to amino acid uptake. It's due to the change of the ratio of estrogen to progesterone, and the sensitivity of our receptor sites is not quite as great. So research also shows that with age, we need more protein for the same training adaptations to occur. So unfairly, we have to get as much or more protein, not less. So many of you are going the opposite direction thinking, but I want to lose weight. I know you need more protein in order to lose weight and boost that metabolism. Combine that with resistance training for gold. Current recommended dietary guidelines for protein again 0.8 grams per kilogram per day might be inadequate for maintaining muscle health in older adults, probably as a consequence of anaerobic resistance in aging muscle. In a report using data from over 1,000 adults age 55 to 85 years old, more frequent consumption of meals containing 30 to 45 grams of protein resulted in the greatest association with leg lean mass and strength. So again, significant results appear without negative side effects. Total body strength, but particularly lower body strength, is closely correlated with longevity or mortality rate, depending on which side of the coin you want to look at. Put briefly, consumption of higher protein diets does not have detrimental effect on health, including kidney function, bone health, or liver function and blood lipids, according to multiple sources of research. Now, I want to say a word on this because you may be listening and you have noticed that your cholesterol level— that's your blood lipids— has increased during menopause. And simultaneously, you may have come and found me or another professional who has suggested to you more protein. And as you've increased your protein, your cholesterol simultaneously went up and you're thinking, what is this? I shouldn't have protein. I should go on a plant-based diet. The reason the body, the human female body particularly, increases the cholesterol is because We produce hormones in fat. So your body is saying, oh, well, I'm going to create more cholesterol then because we're not getting the same stimulus of estrogen, testosterone, progesterone. So I'm going to make more cortisol— or yes, cholesterol— in order to create more. Now the body has to figure that out. It takes a little bit. But it will balance out. You don't want— you don't want cholesterol meds. You don't want to, you know, not eat animal protein. You want to have lifestyle habits. Yeah, you want to watch it. Realize that this happens to several— many high numbers of midlife women. So a protein intake of 1 to 1.2 grams per kilogram a day recommended for the preservation of healthy aging muscle. Well, 1 2 to 1.5 of protein may be necessary in older patients with acute or chronic diseases. Elderly people with severe illness or malnutrition may need as much as 2.0 grams of protein per kilogram of body weight. So again, I read to you all of these numbers differently because of the multitude of resources that I pulled showing you that each one the WHO, the longevity Stanford study are giving us a variety of input and they're expressing it in a different way. They're expressing it in grams per kilogram of body weight. None of us sit down and do that calculation before we eat, I promise you, right? But what is easy is a gram per pound of body weight per day. We can calculate that pretty easily in our heads. We can look at 30 to 35 grams of protein. What is that? It's about 5 ounces of animal protein. That's your fist or your palm to your first knuckle, and it's about 3/4 of an inch thick of a chicken breast, a piece of salmon, a piece of pork, you name it. Very active and athletes have always been advised to consume additional protein for midlife and older women to overcome anabolic resistance. Active and menopausal women's daily protein intake, again, should fall within the mid to upper ranges of current sports nutrition guidelines. Now I want you to listen to this. Active and menopausal women's daily intake should be the same as current sport nutrition guidelines. Here it is: 1.4 to 2.2 grams per kilogram per day. If you're an active woman exercising intentionally 4 or more times a week, these numbers apply to you. Using 2.2 kilograms per— or grams of protein per kilogram of body weight— is the equivalent of 1 gram of protein to a pound of body fat. It is not out of the ordinary. Athletes— and let's include us— in the very active, aiming to reduce fat mass while exercising, preserving your fat-free mass, should consume protein intake in the ranges of 1.8 to 2.7 grams of protein per kilogram of body weight per day, or 2.3 to 3.1 grams of protein per kilogram of fat-free mass. I'm going to do math for you again. Okay. And what does that equate to? That's a little bit more than a gram of protein per kilogram or per pound of body weight. So we're getting this over and over and over from multiple sources. It is in the upper range and always have been. It's just never been presented to you in this way, and it's never probably been presented to you in this way enough that most governmental agencies even writing about this in places like the Applied Physiology, Nutrition, and Metabolism Journal and the Nurses Health Study Cohort, the American Journal of Clinical Nutrition, These sources, International Sports Nutrition, Sports Nutrition and Exercise Science, and Metabolism, again, they are all really saying the same thing in a slightly different way. And that's where the confusion often happens. I wanna tap into two other things for you. HNB, because I get this question, and what is that? HMB is an inactive leucine metabolite. I mentioned leucine earlier, and that's one of the 9 essential amino acids, but it is the one, one we isolate as branched-chain amino acid that consists of 3. But leucine is the most related to aging and loss of muscle mass by having too little leucine in the diet and/or turning it around and having more The stimulation seems to be greater for inducing lean muscle building with more protein and resistance training. So HMB is an active leucine metabolite, part of it which activates or activates the mTOR signaling pathway in muscle. mTOR is required in order to get this muscle protein synthesis Following its absorption, dietary leucine is converted into a substrate which is further metabolized into another coenzyme or HMB. So under normal conditions, the majority of these subfactors, while only approximately 5% of leucine is metabolized to HMB,, and that implies that in order to reach a pharmacological level of HMB, the compound needs to be administered directly rather than via increasing leucine dosage. It's recently been suggested that HMB may be used to protect or restore muscle mass in older persons with reduced body mass. I've been asked, and very rarely, but have been asked, do I need HMB? Should I be taking that? Well, here's the study is based on if you are really, you know, at bedrest, if you're very frail, you're very weak, HMB may be what you need. But again, I would not go directly to that. I would first look at, are you active? Are you doing the resistance training? Are you eating animal protein? Because if you are, you're getting leucine from it and your body is most likely breaking that down and absorbing it. If you are for some reasons at bedrest and you are frail, and this is an urgent situation because just even a few days of bedrest can be detrimental to an aging adult. We can't stand too much of that and too much repeated time doing that because it will be cumulative and the loss of muscle, the loss of strength, will cause frailty, will cause greater likelihood of falls, and then a fracture may be the actual thing that takes us out, but all because of the loss of muscle or sarcopenia as we know it. HMB has been and originally was discovered by Dr. Steve Nissen in the College of Veterinary Medicine at Iowa State University, where I was privileged to attend as an undergraduate. As a graduate student and to teach there. And after that, for 15 years in the Department of Kinesiology, I hosted or was a co-host for a protein summit in 2013, where after Dr. Steve Nissen had had a stroke, he was recognized by world leaders in protein from around the world who flew in. And HMB was bought by Abbott companies and put in products like Boost and Ensure and First Use in hospital situations where older adults were at bed rest, finding that it helped to prevent or slow the loss of lean muscle mass. Now, no contest, somebody at bed rest is going to get weaker and lose muscle mass. And if you're 90, you will potentially lose significantly more than if you're 20 and not getting it back. But use of Boost and HMB solved a couple of problems. Number one, got directly this derivative of leucine in their systems to help improve it and helped to kind of fund consumption of calories, and quality ones, when appetite was reduced in older adults. So many of us, you may be one of these, but I certainly was, you know, with a high schooler. I remember who it was a struggle to get him to eat anything, and then he was a golfer and out on the course for hours, and for whatever reason he would not eat while he was on the course, you know, was a great appetite afterward. But, you know, every time somebody looked at a picture of my golfer, they were like, feed that kid. Like would use Boost and Ensure products for him, you know, try to get him to drink one before he went out to the course or before, you know, as breakfast on the way to school, you know, better than nothing. So the use of that in where it falls is something to consider. But essential amino acids, all of them first through the diet if possible, supplementing then if not. Possible through the diet, then looking at if you've got all the essential amino acids, potentially greater amount of leucine. And then maybe if you're at bed rest, you're really at high risk, HMB as a supplement may be beneficial, but it would not be, again, in the first line of defense. In the show notes today, I know this was a long one. I hope you've enjoyed a wonderful long hike. You will find many references. So feel free to come over, look at those, and again, realize that all of this has been in existence for a very long time. The studies I'm quoting are fairly new because I'm always trying to do something within the last 5 years, certainly within the last 10. But there are studies here from 2024, '23, '22, from 2009 though, also 2018, 2017, and you'll find a mixture of things. And if you really follow this backward, you'll look and see that this was widely known back in the '90s, but not yet had it reached mainstream. And it often takes an average of about 20 years to reach mainstream. So hopefully we're here. And if you have questions, please drop them below the show notes or tag us in our Facebook group at facebook.com/groups/Flipping50Insiders. And we'll put that link in the show notes as well, which will be at flipping50.com/proteinconsumptioninmenopause. And what are you waiting for? Let's start Flipping 50 today. Thank you for listening. 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