Protein and the Elderly

Here’s a good study/article on Protein and the Elderly (Adv Nutr. 2014 Sep; 5(5): 599S–607S. Published online 2014 Sep 1. doi: 10.3945/an.113.005405
PMCID: PMC4188243. Keeping Older Muscle “Young” through Dietary Protein and Physical Activity. Daniel R. Moore*). One of the points

…35 g (∼0.45 g/kg) of whey protein stimulates mixed muscle protein synthesis in older adults, whereas 10 and 20 g (∼0.13 and ∼0.28 g/kg, respectively) do not.

And:

Individuals who more frequently elicit a maximal stimulation of muscle protein synthesis throughout a daily meal feeding cycle would be more likely to maintain muscle mass and possibly function. This could explain in part the greater retention of lean body mass in older adults who consume more than the current RDA for protein [i.e., ≥1.2 g/(kg ⋅ d)] relative to those who habitually consume a suboptimal amount [i.e., <0.8 g/(kg ⋅ d)]

 

 

Another Protein Experiment

I did a previous Protein Experiment where I compared the response of my Blood Sugar to 50 grams of Whey Protein vs 50 grams of Casein Protein. Since both of those were “pure” Protein with very little fat, I was curious how those results would compare to animal protein which had fat.

For this experiment I chose Chicken Drumsticks. I weighed them amount of mean (total minus bones left at the end) and the nutritional information shows them to have been close to 50g of Protein:

Here is the Blood Glucose numbers (smoothed) over several hours added to the data from the original Whey/Casein test.  The chicken drumsticks are in yellow.

Accounting for Differences

  1. The drumsticks (in yellow) are lower overall because I have been on the PSMF longer and my blood sugar levels have dropped. This is evidence, at least to me, that the PSMF is doing good things for my metabolic health.
  2. There was a dip at the start of the chicken wing experiment which was due to exercise. In this case it was a particularly grueling Saturday morning routine with a lot of lifting and burpees, etc.  That explains the drop from 72 down to 64 at the start.
  3. The highest number was very comparable to the Whey and Casein numbers in terms of rise from the minimum. The max rise in Blood Sugar in all of these cases was no more than 20 units.
  4. The slope down with the animal Protein is longer and slower. That may explain less feelings of hunger as the consumption of the Protein ends.
  5. The curve is longer than either of the “pure” Proteins. The fat may extend that longer than the pure proteins. I’d like to repeat the experiment with low fat chicken breasts and see if it’s the fat or if it is the animal Protein vs Milk Protein of the Whey/Casein choices that makes a difference.

Conclusions

50 grams of Protein is a decent serving size. It is more than enough to stimulate Protein Muscle Synthesis.

All in all, I see nothing to worry about with eating Protein even for Type 2 Diabetics like myself. With all of the “Protein turns into candy bars” fear mongering out there, some sanity needs to be applied to the subject.

Disclaimer

Of course, I would encourage any diabetic to test to see where they are with this same test. At least this way they know what effect Protein would have on their body. If they are a Type 1 Diabetic this information could be helpful to determine what amount of Insulin they should add for Protein.

 

Explanations for Blood Sugar Rise with Protein Consumption

 

Here’s my questions/comments for the KetoGains thread on this subject.

I’ve been trying for a while to wrap my head around this subject. Here’s what I think at the moment. Would welcome any feedback on where I am missing it.

1 – My blood sugar meter shows that my blood sugar goes up 25 points with Protein (50g of whey) for a couple of hours. Not a bad increase since it’s only from 85 to 110 (US units). I have documented this at: http://land-boards.com/T2D/2017/09/26/blood-sugar-response-to-proteins/ .

2 – My blood sugar drops fairly rapidly at the end of the two hours (makes me hungry) which decreases when the blood sugar levels out. As long as I keep that in mind and keep food out of reach in that time frame I am OK. Otherwise, it seems like my body is telling me that it wants is ready to eat more Protein (or just food).
3 – Blood sugar production proceeds at a constant rate which isn’t all that much affected by Protein consumption. I’ve seen enough studies to believe that is probably the case such as //diabetes.diabetesjournals.org/content/62/5/1435. Also, the demand vs supply GNG argument seems strong. This rules out the idea of GNG being increased by the Protein.
4 – In a non-diabetic blood sugar doesn’t rise as much with ingested Protein as it does in a T2 Diabetic. It may not raise at all. I plan on an experiment with a “healthy” friend to confirm this for myself although the studies say it is “minimal”. But is that difference due to broken Insulin Resistance in the T2 Diabetic? As the Insulin goes up to deal with the Protein does that increase the Insulin Resistance of the cells at the same time and block the glucose from being consumed?
5 – The failure for a T2 Diabetic seems to be able to reduce the production of glucose in response to consumption of Protein (or one of the downstream aspects of the consumption). The Glucose (argued above) is getting “backed up” in the process and not being disposed by Insulin since the Insulin is “busy” dealing with the Amino Acids (all in all a very good use of Insulin).

So although arguably Protein doesn’t turn into glucose directly since Protein does lead to a rise in Blood Sugar (in T2 Diabetics) then what difference does it make if it is increased levels of GNG or an inability to reduce the rate of GNG or due to Insulin Resistance? Either way, the result is the same, Blood Sugar goes up (for T2 Diabetics) with protein consumption.

So then the question for me is whether or not Blood Sugar going up by a relatively small amount in a keto dieter who is eating lots of Protein actually a problem? Normally, us diabetics are trained to do things to minimize their blood sugars. This notion is leading a lot of people to eat a lot of fat and less Protein than they probably should.

Put another way, does the advantage of eating more Protein (maintain or growing Lean Body Mass among others) outweigh the disadvantage (marginally higher blood sugars for short periods of time)?

Survey of the Scientific Literature

From an 20 year old article (Diabetes Educ. 1997 Nov-Dec;23(6):643-6, 648, 650-1. Protein: metabolism and effect on blood glucose levels. Franz MJ):

Insulin is required for carbohydrate, fat, and protein to be metabolized. … Protein has a minimal effect on blood glucose levels with adequate insulin. However, with insulin deficiency, gluconeogenesis proceeds rapidly and contributes to an elevated blood glucose level. With adequate insulin, the blood glucose response in persons with diabetes would be expected to be similar to the blood glucose response in persons without diabetes. The reason why protein does not increase blood glucose levels (sic: in a non-diabetic) is unclear. Several possibilities might explain the response: a slow conversion of protein to glucose, less protein being converted to glucose and released than previously thought, glucose from protein being incorporated into hepatic glycogen stores but not increasing the rate of hepatic glucose release, or because the process of gluconeogenesis from protein occurs over a period of hours and glucose can be disposed of if presented for utilization slowly and evenly over a long time period.

Questions raised by this article:

  1. They don’t define “minimum effect” so is a 20 point rise considered to be a “minimum effect”?
  2. Another study indicates that GNG is much more efficient in a Diabetic. Is that because of an Insulin deficiency (the way it is worded above)? Or is that due more to Insulin Resistance?

Here’s a curve from one paper which shows the body’s Insulin response to Protein vs Carbohydrates which shows that the body has a similar response to Protein as it does to Carbohydrates when it comes to Insulin Levels:

This seems to be a reasonable study (Claire Fromentin1,2, Daniel Tomé1,2, Françoise Nau3, Laurent Flet4, Catherine Luengo1,2, Dalila Azzout-Marniche1,2, Pascal Sanders5, Gilles Fromentin1,2 and Claire Gaudichon1,2. Dietary Proteins Contribute Little to Glucose Production, Even Under Optimal Gluconeogenic Conditions in Healthy Humans. Diabetes 2013 May; 62(5): 1435-1442.) which concludes:

We showed that after a normal intake of protein (20–25 g), the contribution of dietary protein to glucose production was small and did not exceed 10% of the total flux during the 8-h postprandial period, contributing the production of 4 g glucose to 50 g of total glucose production.

While that is true in healthy humans (the subject of this study), is it also true of Diabetic persons?

From one of the comments in this thread

Higher protein intake, which needs insulin response to get it where it needs to be, will increase physiological insulin resistance (adaptive glucose sparing) in order to get the protein into where it needs to go without pushing more glucose into the cells. this will result in seeing a higher fasting blood glucose, and lower circulating ketones, as they replace glucose as a fuel for the tissues that previously used more of it.

Here’s the pieces of the puzzle.

  • Body produces a relatively constant level of blood sugar
  • Non diabetics have little to no rise in Blood Sugar when they eat Protein
  • In a diabetic the down regulation of blood sugar in the presence of Insulin is faulty
    1. Eat Protein
    2. Body begins digesting Protein
    3. Pancreas increases Insulin production to push protein into muscle cells
    4. As Insulin goes up so does Insulin Resistance of the muscle cells to Glucose (difference between a diabetic and a non-diabetic)
    5. Because Glucose is not being disposed by the muscle cells as well, the level of Blood Sugar rises temporarily
    6. After the Protein is processed by the body the Blood Glucose drops

So the theory here is that while the blood sugar rises over the short term it is not being pushed into the cells.

 

mPSMF – Weight Loss Progress

My modified Protein Sparing Modified Fast is moving along very well. Here’s my weight loss chart (from Cron-o-meter):

I had a nice drop over the past couple of days. Note that I started teh food diary in Cron-o-meter on Oct 24th. That may contribute to the losses due to the increased attention to intake. Before that I was using my own spreadsheet to track diet.  Cron-o-meter may be making me more accurate with measuring food intakes.

Goals Changes?

My newly adjusted weight goal is 170 lbs. That’s 144.4 lbs of Lean Body Mass and 15% body fat. That’s in the middle of the athlete range of body fat and on the low end for an older man like myself.

Modified Protein Sparing Modified Fast (PSMF)

I am calling what I am doing a Modified Protein Sparing Modified fast (PSMF) since the classical PSMF does not factor in fat oxidation rates.

I think it’s useful to factor in fat oxidation rates since that’s the maximum amount of fat a person can pull from their body per day. See my post, “Hypophagia – How much fat can I lose in a day?” for details.

Lyle McDonald’s Rapid Fat Loss Book

Lyle McDonald’s book “Rapid Fat Loss” (RFL) simply puts people on a particular amount of protein depending upon what stage of the diet a person is on. As the diet goes on and a person loses body fat their protein amount increases on Lyle’s method. So basically, his method is Very Low Carbs (except certain unlimited green veggies).

I think the fault in Lyle’s method isn’t so much that it leads to excessive protein consumption. Some would say that there’s no such thing as too much protein and within limits they could be right.

I think the fault in Lyle’s method is not factoring in the limits of hypophagia. Drop your calorie intake too low (below what the body can provide) and something has to give. If you can’t lose more than a particular amount of fat per day then why would you eat at a lower calorie amount than that?

 

Ideal Body Fat Percentage

The article (Ideal Body Fat Percentage Chart: How Lean Should You Be?) lists two different idea body fat percentage charts:

And:

Note the references to Jackson, A., & Pollock, M. (1978). Generalized equations for predicting body density of menBritish Journal of Nutrition, 40(3), 497-504. doi:10.1079/BJN19780152 (Full Text).

By age (second chart) my ideal body fat percentage is  20.9%. At a LBM of 144.4 lbs, that’s:

144.4 / (1 – .209) = 182 lbs or about 10 lbs to go to that goal.

 

 

Goal Weight Calculation

I discovered that I did the calculations wrong for my target weight. Lyle McDonald has a formula on his Body Composition site:

Goal Weight = Current Lean Body Mass / (1-Goal Body Fat percentage as a decimal)

My LBM is 144.4. My Goal Body Fat percentage is 15%. So the correct goal weight is:

144.4/(1-.15) = 170 lbs

Checking it backwards, if my fat percentage is 15% then my LBM is 85%:

170 x 0.85 = 144.5 – so that’s the correct formula.

I was calculating it as LBM x (1 + Body Fat percentage as a decimal) which was a number of 166 lbs. I know it’s not a huge difference but at 190.8 lbs getting to 170 seems slightly more doable than 166 lbs.

I really like Lyle’s site. Lot of good information. And better math than my own math.

 

Body Fat Measurement via BodPod

Well, I got the answer I was looking for. I went to the West Virginia University Human Performance Lab and had my body fat percentage measured with the BodPod.

My numbers came back as:

  • Body Fat: 25.3%
  • Current Weight: 193.3 lbs
  • Lean Body Mass: 144.4 lbs

So to get to my 15% Body fat number, I need to get to:

144 x 1.15 = 166 lbs

So I still need to lose 27 .25 lbs. I should be able to do this if I stick with the PSMF diet for the next few months.

Which Metric does it Correlate Best with?

The USN Calculator puts me at 25.0% Body fat. That’s very close to BodPod number and is much closer than both the caliper method (17%) and my body composition scale (30%).

What about Exercise Factor?

The whole idea about muscle vs fat is oversold. According to Lyle McDonald an untrained person can put on something like 2 lbs of muscle in a month. And that is for someone young, etc. But let’s assume that in 3 months I can actually put on 6 lbs of Lean Body Mass as muscle. That would put my LBM at:

144.4 + 6 = 150.6 lbs

At 15% Body Fat that would be

150.6 x 1.15 = 173.2 lbs

So there’s only a bit of leverage with the muscle. Instead of having to cut weight to 166 I could cut weight to 173.2 lbs. Either way, that’s still 20 lbs down from where I am now. And that’s the maximum amount possible.

Put another way, that 6 lbs of LBM gain results in 7.2 lbs less of fat loss needed. It does help somewhat with Base Metabolic Rate.