Protein vs Sarcopenia
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Protein vs Sarcopenia
This is Dr. Gabrielle Lyon. A medical doctor, she’s board-certified in family medicine, and has also engaged in research and clinical practice in the fields of geriatrics and nutritional sciences.
A quick note…
We’re going to be talking a bit about protein metabolism today, and it’s worth noting that Dr. Lyon personally is vehemently against vegetarianism/veganism, and considers red meat to be healthy.
Scientific consensus on the other hand, holds that vegetarianism and veganism are fine for most people if pursued in an informed and mindful fashion, that white meat and fish are also fine for most people, and red meat is simply not.
If you’d like a recap on the science of any of that:
- Protein: How Much Do We Need, Really?
- Plant vs Animal Protein: Diversity is Key
- Do We Need Animal Products to be Healthy?
Nevertheless, if we look at the science that she provides, the advice is sound when applied to protein in general and without an undue focus on red meat.
How much protein is enough?
In our article linked above, we gave 1–2g/kg/day
Dr. Lyons gives the more specific 1.6g/kg/day for adults older than 40 (this is where sarcopenia often begins!) and laments that many sources offer 0.8g/kg.
To be clear, that “per kilogram” means per kilogram of your bodyweight. For Americans, this means dividing lbs by 2.2 to get the kg figure.
Why so much protein?
Protein is needed to rebuild not just our muscles, but also our bones, joint tissues, and various other parts of us:
We Are Such Stuff As Fish Are Made Of
Additionally, our muscles themselves are important for far more than just moving us (and other things) around.
As Dr. Lyon explains: sarcopenia, the (usually age-related) loss of muscle mass, does more than just make us frail; it also messes up our metabolism, which in turn messes up… Everything else, really. Because everything depends on that.
This is because our muscles themselves use a lot of our energy, and/but also store energy as glycogen, so having less of them means:
- getting a slower metabolism
- the energy that can’t be stored in muscle tissue gets stored somewhere else (like the liver, and/or visceral fat)
So, while for example the correlation between maintaining strong muscles and avoiding non-alcoholic fatty liver disease may not be immediately obvious, it is clear when one follows the metabolic trail to its inevitable conclusion.
Same goes for avoiding diabetes, heart disease, and suchlike, though those things are a little more intuitive.
How can we get so much protein?
It can seem daunting at first to get so much protein if you’re not used to it, especially as protein is an appetite suppressant, so you’ll feel full sooner.
It can especially seem daunting to get so much protein if you’re trying to avoid too many carbs, and here’s where Dr. Lyon’s anti-vegetarianism does have a point: it’s harder to get lean protein without meat/fish.
That said, “harder” does not mean “impossible” and even she acknowledges that lentils are great for this.
If you’re not vegetarian or vegan, collagen supplementation is a good way to make up any shortfall, by the way.
And for everyone, there are protein supplements available if we want them (usually based on whey protein or soy protein)
Anything else we need to do?
Yes! Eating protein means nothing if you don’t do any resistance work to build and maintain muscle. This can take various forms, and Dr. Lyon recommends lifting weights and/or doing bodyweight resistance training (calisthenics, Pilates, etc).
Here are some previous articles of ours, consistent with the above:
- Resistance Is Useful! (Especially As We Get Older)
- Overdone It? How To Speed Up Recovery After Exercise
- How To Do HIIT (Without Wrecking Your Body)
- Exercises To Do (And Ones To Avoid) If You Have Osteoporosis
Take care!
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10% Human – by Dr. Alanna Collen
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The title, of course, is a nod to how by cell count, we are only about 10% human, and the other 90% are assorted microbes.
Dr. Collen starts with the premise that “all diseases begin in the gut” which is perhaps a little bold, but as a general rule of thumb, the gut is, in fairness, implicated in most things—even if not being the cause, it generally plays at least some role in the pathogenesis of disease.
The book talks us through the various ways that our trillions of tiny friends (and some foes) interact with us, from immune-related considerations, to nutrient metabolism, to neurotransmitters, and in some cases, direct mind control, which may sound like a stretch but it has to do with the vagus nerve “gut-brain highway”, and how microbes have evolved to tug on its strings just right. Bearing in mind, most of these microbes have very short life cycles, which means evolution happens for them so much more rapidly than it does for us—something that Dr. Collen, with her PhD in evolutionary biology, has plenty to say about.
There is a practical element too: advice on how to avoid the many illnesses that come with having our various microbiomes (it’s not just the gut!) out of balance, and how to keep everything working together as a team.
The style is quite light pop-science and, once we get past the first chapter (which is about the history of the field), quite a pleasant read as Dr. Collen has an enjoyable and entertaining tone.
Bottom line: if you’d like to understand more about all the things that come together to make us functionally 100% human, then this book is an excellent guide to that.
Click here to check out 10% Human, and learn about how we interact with ourselves!
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Eyes for Alzheimer’s Diagnosis: New?
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It’s Q&A Time!
This is the bit whereby each week, we respond to subscriber questions/requests/etc
Have something you’d like to ask us, or ask us to look into? Hit reply to any of our emails, or use the feedback widget at the bottom, and a Real Human™ will be glad to read it!
Q: As I am a retired nurse, I am always interested in new medical technology and new ways of diagnosing. I have recently heard of using the eyes to diagnose Alzheimer’s. When I did some research I didn’t find too much. I am thinking the information may be too new or I wasn’t on the right sites.
(this is in response to last week’s piece on lutein, eyes, and brain health)
We’d readily bet that the diagnostic criteria has to do with recording low levels of lutein in the eye (discernible by a visual examination of macular pigment optical density), and relying on the correlation between this and incidence of Alzheimer’s, but we’ve not seen it as a hard diagnostic tool as yet either—we’ll do some digging and let you know what we find! In the meantime, we note that the Journal of Alzheimer’s Disease (which may be of interest to you, if you’re not already subscribed) is onto this:
See also:
- Journal of Alzheimer’s Disease (mixture of free and paid content)
- Journal of Alzheimer’s Disease Reports (open access—all content is free)
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High-Octane Brain – by Dr. Michelle Braun
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True to the title, Dr. Braun jumps straight into action here, making everything as practical as possible as quickly as possible and giving the most attention to the science-based steps to take. Thereafter, and almost as an addendum, she gives examples of “brain role models” from various age groups, to show how these things can be implemented and benefitted-from in the real world.
The greatest strength of this book is that it is the product of a lot of hard science made easy; this book has hundreds of scientific references (of which, many RCTs etc), and many contributions from other professionals in her field, to make one of the most evidence-based guidebooks around, and all presented in one place and in a manner that is perfectly readable to the layperson.
The style, thus, is easy-reading, with references for those who want to jump into further reading but without that being required for applying the advice within.
Bottom line: if you’d like to improve your brain with an evidence-based health regiment and minimal fluff, this is the book for you.
Click here to check out High-Octane Brain, and level-up yours!
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Ice Baths: To Dip Or Not To Dip?
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Many Are Cold, But Few Are Frozen
We asked you for your (health-related) view of ice baths, and got the above-depicted, below-described, set of responses:
- About 31% said “ice baths are great for the health; we should take them”
- About 29% said “ice baths’ risks outweigh their few benefits”
- About 26% said “ice baths’ benefits outweigh their few risks”
- About 14% said “ice baths are dangerous and can kill you; best avoided”
So what does the science say?
Freezing water is very dangerous: True or False?
True! Water close to freezing point is indeed very dangerous, and can most certainly kill you.
Fun fact, though: many such people are still saveable with timely medical intervention, in part because the same hypothermia that is killing them also slows down the process* of death
Source (and science) for both parts of that:
Cold water immersion: sudden death and prolonged survival
*and biologically speaking, death is a process, not an event, by the way. But we don’t have room for that today!
(unless you die in some sudden violent way, such as a powerful explosion that destroys your brain instantly; then it’s an event)
Ice baths are thus also very dangerous: True or False?
False! Assuming that they are undertaken responsibly and you have no chronic diseases that make it more dangerous for you.
What does “undertaken responsibly” mean?
Firstly, the temperature should not be near freezing. It should be 10–15℃, which for Americans is 50–59℉.
You can get a bath thermometer to check this, by the way. Here’s an example product on Amazon.
Secondly, your ice bath should last no more than 10–15 minutes. This is not a place to go to sleep.
What chronic diseases would make it dangerous?
Do check with your doctor if you have any doubts, as no list we make can be exhaustive and we don’t know your personal medical history, but the main culprits are:
- Cardiovascular disease
- Hypertension
- Diabetes (any type)
The first two are for heart attack risk; the latter is because diabetes can affect core temperature regulation.
Ice baths are good for the heart: True or False?
True or False depending on how they’re done, and your health before starting.
For most people, undertaking ice baths responsibly, repeated ice bath use causes the cardiovascular system to adapt to better maintain homeostasis when subjected to thermal shock (i.e. sudden rapid changes in temperature).
For example: Respiratory and cardiovascular responses to cold stress following repeated cold water immersion
And because that was a small study, here’s a big research review with a lot of data; just scroll to where it has the heading“Specific thermoregulative adaptations to regular exposure to cold air and/or cold water exposure“ for many examples and much discussion:
Health effects of voluntary exposure to cold water: a continuing subject of debate
Ice baths are good against inflammation: True or False?
True! Here’s one example:
Uric acid and glutathione levels (important markers of chronic inflammation) are also significantly affected:
Uric acid and glutathione levels during short-term whole body cold exposure
Want to know more?
That’s all we have room for today, but check out our previous “Expert Insights” main feature looking at Wim Hof’s work in cryotherapy:
A Cold Shower A Day Keeps The Doctor Away?
Enjoy!
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Caesar Salad, Anyone? (Ides of March Edition!)
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The Mediterranean Diet: What Is It Good For?
More to the point: what isn’t it good for?
- It’s been found to reduce all-cause mortality, which is about the best thing one can say of any diet.
- It’s especially good for heart health and against cancer.
- It’s particularly recommended for the prevention or management of diabetes.
- It’s also been found, societally, to reduce general healthcare costs—basically, people get sick less and so have fewer healthcare costs.
What brought it to the attention of the world’s scientific community?
Back in the 1950s, physiologist Ancel Keys wondered why poor people in Italian villages were healthier than wealthy New Yorkers. Upon undertaking studies, he narrowed it down to the Mediterranean diet—something he’d then take on as a public health cause for the rest of his career.
Keys himself lived to the ripe old age of 100, by the way.
When we say “Mediterranean Diet”, what image comes to mind?
We’re willing to bet that tomatoes feature (great source of lycopene, by the way), but what else?
- Salads, perhaps? Vegetables, olives? Olive oil, yea or nay?
- Bread? Pasta? Prosciutto, salami? Cheese?
- Pizza but only if it’s Romana style, not Chicago?
- Pan-seared liver, with some fava beans and a nice Chianti?
In reality, the diet is based on what was historically eaten specifically by Italian peasants. If the word “peasants” conjures an image of medieval paupers in smocks and cowls, and that’s not necessarily wrong, further back historically… but the relevant part here is that they were people who lived and worked in the countryside.
They didn’t have money for meat, which was expensive, nor the industrial setting for refined grain products to be affordable. They didn’t have big monocrops either, which meant no canola oil, for example… Olives produce much more easily extractable oil per plant, so olive oil was easier to get. Nor, of course, did they have the money (or infrastructure) for much in the way of imports.
So what foods are part of “the” Mediterranean Diet?
- Fruits. These would be fruits grown locally, but no need to sweat that, dietwise. It’s hard to go wrong with fruit.
- Tomatoes yes. So many tomatoes. (Knowledge is knowing tomato is a fruit. Wisdom is not putting it in a fruit salad)
- Non-starchy vegetables (e.g. eggplant yes, potatoes no)
- Greens (spinach, kale, lettuce, all those sorts of things)
- Beans and other legumes (whatever was grown nearby)
- Whole grain products in moderation (wholegrain bread, wholewheat pasta)
- Olives and olive oil. Special category, single largest source of fat in the Mediterranean diet, but don’t overdo it.
- Dairy products in moderation (usually hard cheeses, as these keep well)
- Fish, in moderation. Typically grilled, baked, steamed even. Not fried.
- Other meats as a rarer luxury in considerable moderation. There’s more than one reason prosciutto is so thinly sliced!
Want to super-power this already super diet?
Try: A Pesco-Mediterranean Diet With Intermittent Fasting: JACC Review Topic of the Week
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Thinking about cosmetic surgery? New standards will force providers to tell you the risks and consider if you’re actually suitable
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People considering cosmetic surgery – such as a breast augmentation, liposuction or face lift – should have extra protection following the release this week of new safety and quality standards for providers, from small day-clinics through to larger medical organisations.
The new standards cover issues including how these surgeries are advertised, psychological assessments before surgery, the need for people to be informed of risks associated with the procedure, and the type of care people can expect during and afterwards. The idea is for uniform standards across Australia.
The move is part of sweeping reforms of the cosmetic surgery industry and the regulation of medical practitioners, including who is allowed to call themselves a surgeon.
It is heartening to see these reforms, but some may say they should have come much sooner for what’s considered a highly unregulated area of medicine.
Why do people want cosmetic surgery?
Australians spent an estimated A$473 million on cosmetic surgery procedures in 2023.
The major reason people want cosmetic surgery relates to concerns about their body image. Comments from their partners, friends or family about their appearance is another reason.
The way cosmetic surgery is portrayed on social media is also a factor. It’s often portrayed as an “easy” and “accessible” fix for concerns about someone’s appearance. So such aesthetic procedures have become far more normalised.
The use of “before” and “after” images online is also a powerful influence. Some people may think their appearance is worse than the “before” photo and so they think cosmetic intervention is even more necessary.
People don’t always get the results they expect
Most people are satisfied with their surgical outcomes and feel better about the body part that was previously concerning them.
However, people have often paid a sizeable sum of money for these surgeries and sometimes experienced considerable pain as they recover. So a positive evaluation may be needed to justify these experiences.
People who are likely to be unhappy with their results are those with unrealistic expectations for the outcomes, including the recovery period. This can occur if people are not provided with sufficient information throughout the surgical process, but particularly before making their final decision to proceed.
What’s changing?
According to the new standards, services need to ensure their own advertising is not misleading, does not create unreasonable expectations of benefits, does not use patient testimonials, and doesn’t offer any gifts or inducements.
For some clinics, this will mean very little change as they were not using these approaches anyway, but for others this may mean quite a shift in their advertising strategy.
It will likely be a major challenge for clinics to monitor all of their patient communication to ensure they adhere to the standards.
It is also not quite clear how the advertising standards will be monitored, given the expanse of the internet.
What about the mental health assessment?
The new standards say clinics must have processes to ensure the assessment of a patient’s general health, including psychological health, and that information from a patient’s referring doctor be used “where available”.
According to the guidelines from the Medical Board of Australia, which the standards are said to complement, all patients must have a referral, “preferably from their usual general practitioner or if that is not possible, from another general practitioner or other specialist medical practitioner”.
While this is a step in the right direction, we may be relying on medical professionals who may not specialise in assessing body image concerns and related mental health conditions. They may also have had very little prior contact with the patient to make their clinical impressions.
So these doctors need further training to ensure they can perform assessments efficiently and effectively. People considering surgery may also not be forthcoming with these practitioners, and may view them as “gatekeepers” to surgery they really want to have.
Ideally, mental health assessments should be performed by health professionals who are extensively trained in the area. They also know what other areas should be explored with the patient, such as the potential impact of trauma on body image concerns.
Of course, there are not enough mental health professionals, particularly psychologists, to conduct these assessments so there is no easy solution.
Ultimately, this area of health would likely benefit from a standard multidisciplinary approach where all health professionals involved (such as the cosmetic surgeon, general practitioner, dermatologist, psychologist) work together with the patient to come up with a plan to best address their bodily concerns.
In this way, patients would likely not view any of the health professionals as “gatekeepers” but rather members of their treating team.
If you’re considering cosmetic surgery
The Australian Commission on Safety and Quality in Health Care, which developed the new standards, recommended taking these four steps if you’re considering cosmetic surgery:
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have an independent physical and mental health assessment before you commit to cosmetic surgery
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make an informed decision knowing the risks
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choose your practitioner, knowing their training and qualifications
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discuss your care after your operation and where you can go for support.
My ultimate hope is people safely receive the care to help them best overcome their bodily concerns whether it be medical, psychological or a combination.
Gemma Sharp, Associate Professor, NHMRC Emerging Leadership Fellow & Senior Clinical Psychologist, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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