How to Optimize Your Nutrition for Results| Donald Layman PhD
Dr. Donald Layman is Professor Emeritus in the Department of Food Science & Human Nutrition at the University of Illinois at Urbana-Champaign. Dr. Layman served on the faculty at the University of Illinois from 1977 – 2012. Dr. Layman has been a leader in research about protein, nutrition for athletic performance, obesity, diabetes and cardiovascular health. Dr. Layman has over 100 peer-reviewed publications. He has received numerous awards for his research from the American Society for Nutrition and the National Institutes for Health and for his nutrition teaching. Dr. Layman served as Associate Editor of The Journal of Nutrition and the Journal of Nutrition Education and Behavior and on the editorial boards of Nutrition & Metabolism and Nutrition Research and Practice. Dr. Layman earned his B.S. and M.S. degrees in chemistry and biochemistry at Illinois State University and his doctorate in human nutrition and biochemistry at the University of Minnesota.
In this episode we discuss:
• How to create a balanced diet
• Where does incorrect health information come from?
• What is cardio metabolic health?
• How you can tailor dietary protein, fats, and carbohydrates to your needs.
Dr. Gabrielle Lyon [0:00:01]
Welcome to the Dr. Gabrielle Lyon Show where I believe a healthy world is based on transparent conversations.
Hi, friends.Welcome to the Dr. Gabrielle Lyon Show, and I’m very excited to have my best friend and mentor of two decades, Dr. Donald Layman, Professor Emeritus from the University of Illinois, a world-leading expert in protein metabolism.Again, if you’ve been following me for any length of time, then you knowDon Layman.In this episode of The Dr. Gabrielle Lyon Show, we’re going to shift up the conversation a little bit. We are going to talk about muscle-centric health. But we are also going to spread our wings and move beyond the primary focus of protein. We’re going to talk about how to create a balanced diet. We’re going to discuss some of Don’s earlier studies as how he thought about protein, carbohydrates, and fats and really balancing a nutritional plan for the individual. We’re going to take a deep dive into cardio metabolic health and how that actually relates to skeletal muscle health and so much more.
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Don, welcome to the show.
Dr. Donald Layman [0:04:15]
It’s great to be back. You’ve been out on a world tour with your new book. I’m excited for you. It’s good to see you again.
Dr. Gabrielle Lyon [0:04:23]
For those of you guys who do not know, I recently released my book with Atria called Forever Strong, and it is dedicated to Dr. Donald Layman. No pressure there, buddy. But the book is really meant to change the conversation. The world is ready for it, so I’m grateful that you guys are taking a moment to listen and be on board with this mission and message because this mission and message does not exist alone. We need you to go out there and spread the message.
Dr. Donald Layman [0:04:54]
Yeah, it’s exciting. I think the message is important. I think peopleinherently know the importance of muscle and protein and exercise, but I think a lot of times the lay public needs to be reassured. Theyneed to have the permission to go ahead and do what’s right. I think it’s a great contribution.
Dr. Gabrielle Lyon [0:05:18]
Today, I wanted to talk a little bit about not just the macronutrient protein, but some of the thoughts behind how we can add in or take away just how we think about carbohydrates and fats, the other macronutrients that have really paled in comparison with our discussion to protein.
Dr. Donald Layman [0:05:38]
Yeah, we’ve been a bit proteincentric, but I think everybody needs to recognize that a diet is made up of all three macronutrients, and we’re always going to want to talk about balance. When we talk about muscle-centric health, we need to think about how the muscle uses fuels. How does it prioritize things and that balance?I think it’s an important conversation to have.
Dr. Gabrielle Lyon [0:06:03]
Well, bringing us full force forward, how does the body prioritize macronutrients?What dominates metabolism?
Dr. Donald Layman [0:06:13]
We’ve heard so many negative things about fat. But I think one of the things people need to begin with is muscle’spriority for metabolism for energy is actually fat. That’s its first choice.Until you get muscle working at really high levels, above, say, 65% of your maximum capacity, the priority is always for using fat. I think that’s important. Again, we have to always balance calories, but fat is always the first priority for a fuel for muscle.
Dr. Gabrielle Lyon [0:06:50]
Is that fat from the diet, or is that just free fatty acids that are being utilized in flux? Where’s that coming from?
Dr. Donald Layman [0:06:58]
The muscle really doesn’t care. Those fats aren’t really labeled as this one’s from the diet, and this one’s from storage. The body always maintains a certain level of free fatty acids in the blood.After a meal, a lot of that can be coming from what you just ate.But during in between meals, it’s coming out of adipose tissue. The body maintains an excess of free fatty acids in the blood all the time, so that it fuels, and one of the muscles is the heart. Another one is the diaphragm. These muscles all use fatty acids continuously. Muscle is another one of those.
Dr. Gabrielle Lyon [0:07:41]
If someone were to have a mixed meal, and they are not exercising, they are sedentary. They have a mixed meal of, we’ll just say, 50 grams of glucose and a handful of fat and dietary protein, how can we begin to think about what dominates metabolism in that kind of picture?
Dr. Donald Layman [0:08:03]
I think everybody needs to recognize that glucose is an important fuel, it’s essential for the brain, red blood cells, but it’s also a risky fuel. It’s the origins of diabetes. If you have too much in the blood, thenyou’re diabetic, and you get all of the problems with it, so that’s a really critical balance. Youmade the question more complicated by picking 50 grams.
Dr. Gabrielle Lyon [0:08:32]
By the way, I did that on purpose. But what you guys don’t know is Don and I talk frequently, and then every day and we chat about this. But the goal is that we make our conversations public for you guys. I picked that number on purpose.
Dr. Donald Layman [0:08:48]
I’m going to bracket your 50 first and just say that the average American is eating almost 300 grams of carbohydrate. That means they’re getting,let’s say three meals, ignoring snacks, they’re getting 75 to 100 grams of glucose at a meal. What we know is the body if it’s only using glucose for a fuel, it can burn maybe 20 grams per hour. We know that one of the definitions of diabetes is blood glucose stays high longer than two hours after a meal, 20 grams, so 40 grams is an important threshold. You picked just over it, so now we’re a little bit in excess.The question is, where’s it going to go? People will say, well, we stored glycogen.That might be true after an overnight fast, but how about the person who wakes up and has 100 grams of carbohydrate forbreakfast, sits in front of a computer all morning, and then has another 50 grams at lunch? Where is it going to go? The only way we handle it is you shut down all fat metabolism in the body, and that extra 10 grams have to actually get made into fat for storage.That’s the threshold, how much carbohydrate can you use per hour. Again, if you shut down all of the metabolism, you can use about 20 grams per hour.Then you have to basically store it in some form.That’s the threshold. The body would rather store fat than to convert glucose into fat.
Dr. Gabrielle Lyon [0:10:32]
Why is that, just from an energy expense standpoint?
Dr. Donald Layman [0:10:37]
If you’re storing fat, it’s coming in at fat, and you can directly store it. If it’s coming in as glucose, basically, you have to make it into fat either in the liver or in adipose tissue.As you begin to make it into fat in the liver, you begin to get some of the cardio metabolic problems. You get higher triglycerides.You see increased free fatty acids in the blood. You get fatty liver. You get all of the beginning indications of insulin resistance and what we might refer to as metabolic syndrome.
Dr. Gabrielle Lyon [0:11:16]
Yeah, I love that.We will be publishing a paper, hopefully this year, discussing thosevery things.Cardio metabolic disordersexpress a cluster of metabolic and physiological risk factors, including, just what Don had mentioned, elevated body fat, abnormal blood triglycerides, insulin resistance.This is originally termed syndrome X or metabolic syndrome. When we’re discussing carbohydrate loads, 50 grams or higher, which seems to stress the system at rest, not inactivity, so we’re talking about a sedentary state, I suppose the next question would be how long would someone be able to continue to do this?If this is a daily thing over time is probably when we get to see some apparent markers versus once a week or once every few weeks. Have you thought much about the timeframe in which this really impacts a person?
Dr. Donald Layman [0:12:23]
I think you’re exactly rightthat the longer you expose the bodyto this excess carbohydrate, the more you begin to stress it, the insulin sensitivity, etc. We actually did some experiments like that in animals where we definitely showed that.The longer you feed an excess carbohydrate diet, the more likely you’re going to create insulin insensitivity.People get confused aboutwhat causes insulin resistance and insulin insensitivity. There are experiments out there that you can use really high-fat diets to cause it, but we need to think about you can really cause it with high-carbohydrate diets.So then you need to step back and say, well, what’s the American diet full of? Is it full of fats? Is it full of carbs? If you look at the data, basically, Americans are eating about 50% of their energy from carbohydrates, particularly refined carbohydrates, and about 35% from fat. Are you going to say it’s the 50% or the 35% that are causing the biggest problems? We did a lot of experiments, three major clinical experiments, looking at replacing the carbs with protein.What we showed is we can dramatically change glycemic regulation, lower percent body fat, lower triglycerides in the blood, lower blood pressure, so we know that reducing the carbohydrate fraction is very effective.
Dr. Gabrielle Lyon [0:14:03]
Which is a little bit interesting because in the literature, or I think that there’s really two groups.There’s the calories in, calories out camp, and then there’s the carbohydrate insulin model camp.What I’m hearing you say is it’s probably somewhere in the middle.
Dr. Donald Layman [0:14:20]
The calories in calories out camp islooking at body compositionas opposed to glycemic regulation. What we showed in our studies is that– and we had two groups, we had one that was following the food guide pyramid, which was basically a high-carb low-protein diet, another that was following a higher-protein, lower-carb diet.What we showed is that in the food guide pyramid, as they lost weight over a month or two months,they would slowly improve some of those markers. Body fat has an effect, but what we showed with the reducing carbohydrate is we could correct the metabolic problems in two weeks. It’s not purely a calorie issue. It’s not purely a weight or body fat, it’s a metabolic issue. Both outcomes will affect it, but you will affect it far quicker by lowering the carbohydrate component.
Dr. Gabrielle Lyon [0:15:30]
That’s fascinating,this idea that one is affecting the metabolic outcome quicker versus a body composition change. When you were looking at these two groups, I’m assuming was this a 2005 paper, do you remember?
Dr. Donald Layman [0:15:46]
There was one in 2003, 2005, and I think the last one, maybe 2007 or 2008. There were three of them.
Dr. Gabrielle Lyon [0:15:53]
Okay, because I have one pulled up, no surprise. There was one paper that I do think is important to mention.This paper was a 2005 paper, and it looked at the additive effect of exercise and dietary protein.Basically, the low-protein group, which, not surprisingly, was the RDA of dietary protein at 0.8 grams per kilogram.
Dr. Donald Layman [0:16:21]
And also the food guide pyramid, we did it exactly the way people would map it out.
Dr. Gabrielle Lyon [0:16:27]
Which is, I think, important, because while we don’t discuss the food guide pyramid anymore, and we’ve moved to my plate, I would argue that the food guide pyramid is still representative of what we’re putting on our plate right now because 50% of our diet is in carbohydrates.
Dr. Donald Layman [0:16:46]
It comes very heavily from grains. I mean, grains were the foundation of the food guide pyramid, and that still remains the foundation of our carbohydrate intake. I mean, I don’t think any nutritionists would argue that people wouldn’t be healthier if we ate more broccoli and green beans, but Americans are eating wheat bread.
Dr. Gabrielle Lyon [0:17:04]
I do want to circle back where we got the recommendation of carbohydrates because the RDA is really closer to a maximum on carbohydrates versus again, sedentary people versus the protein recommendation is a minimum.
Dr. Donald Layman [0:17:22]
I think the majority of people, even nutritionists, don’t even realize we have an RDA for carbohydrates. The RDA for carbohydrates is 130 grams per day, whichis designed around the brain and red blood cell and kidney needs for glucose. But the average American is really close to 300 grams per day, so almost three times the RDA, where with protein, the RDA is 0.8. Americans are eating about 0.9 grams per kg, so we’re just barely above the minimum for a deficiency. We have very different attitudes about those two RDAs. In one case, we ignore it.In the other case, we think it’s a threatening issue.
Dr. Gabrielle Lyon [0:18:06]
Do you have a sense as to why that is?
Dr. Donald Layman [0:18:12]
I think that it’s embedded in a lot of things. Dating back to the fear of cholesterol and the fear of saturated fat, we drove the diet based on guesses about fat.Where did the 30% fat concept come from? Well, that’s a pure guess.Where did the 10% saturated fat come from? Well, that’s a pure guess.There’s no data to back that up.If you started from a fat content, then you say, well, grains are cheap, we’ll bring in as you should have a lot of carbohydrates, and protein is not very important.That’s how they really constructed the diet.As you and I try to make people understand, you need to start your diet with your protein decision. If you make a higher protein decision, that’s one decision. If you make a lower protein, that’s another. But once you make that decision, everything else about the diet has to start and balance it, and everything about your lifestyle, your exercise, things related to your age, all come into play. Once you make a protein decision, everything else has to follow it.
Dr. Gabrielle Lyon [0:19:23]
Would you say that’s the most important decision?
Dr. Donald Layman [0:19:28]
I think it is.I think you and I would agree that exercise is right up there. But if you’re not willing to do the exercise you and I do, then proteinsis the most important of the diet decisions.
Dr. Gabrielle Lyon [0:19:41]
Just to point out again from this paper, and you guys, we will link this paper. Maybe I’ll even put a pop up here, but one of the highlights of it was that it had the low-protein group, and then it had what you call a high-protein group, which was double the RDA at 1.6 grams per kg, which I would argue and say is not high protein. I would say that’s more optimal, semantics.
Dr. Donald Layman [0:20:07]
I have tried to slowly stop using the term high and call it higher. I think thatif you look at dietary reference intakes for every nutrient, there’s a range. I don’t think highreally comes into play until you get up to around 2.5 grams per kg. I think above that is high. We have a range from 0.8 to 2.5 at least, so 1.6 isright in the middle.
Dr. Gabrielle Lyon [0:20:39]
I would absolutely agree with you.Looking at the data here, because I’m actually looking at it, and basically, this was a pretty long study if I am getting the right one.
Dr. Donald Layman [0:20:51]
That study was four months, 16 weeks. We did a 12-month study, but that specific one was four months.
Dr. Gabrielle Lyon [0:21:01]
One of the things that was so interesting is that the exercise that this group did was not intensive at all. Do you want to elaborate on that?
Dr. Donald Layman [0:21:11]
One of the things we wanted to do ispull it out of thebody builder category. This was a study done with midlife women who tend not to like to go to gyms and lift a lot of weights.What we set up was, we had them do, supervised, five days a week, they had 30 minutes of walking, and two days a week, they had a 30-minute session of yoga and using Nautilus machines, but basically, we didn’t require them to put weights on them. They could do whatever they wanted. It’s really more about stretch. Stretch is one of the main parts of the resistance exercise. People will say, well, gee,how much did I lift? People forget that theeccentric motion as you stretch back out is almost or maybe as more important as the concentric. This was really about stretch. What we found was in part an additive effect in both groups.Whether you had a low protein or higher protein, the exercise made a difference. They lost more body fat and tended to spare lean tissue. They didn’t lose as much muscle mass. But I think one of the fun conclusions is these groups were supervised for 16 weeks of daily exercise.In the low-protein group, they lost a total of 0.5 kg, so about 1 pound more of fat with 16 weeks of exercise. Where in the higher protein group, exactly the same exercise, they lost 6 kg, so almost 14 pounds more body fat doing 100% the same exercise. You can either saythat the protein made the exercise more effective, or the low-protein diet made it less effective, depending on what you want.
Dr. Gabrielle Lyon [0:23:19]
That’s fascinating. Do you have any thought as to which side of the coin that falls upon?
Dr. Donald Layman [0:23:27]
I’m not really sure. I think that as we were talking before, the macronutrient balance, having high carb, low protein, is probably the worst-case scenario in terms of a diet help. I think it probably minimizes the effect of exercise. Increasing the protein, reducing the high glycemic carbohydrates, I think is a beneficial approach to exercise.I think it protects the muscle. Again, I sort of skirted your question. I’m not sure which is most important, but the data was 100% clear.
Dr. Gabrielle Lyon [0:24:11]
What I think is really fascinating, and I’m sure you guys have picked this up, I have a lot of researchers on the podcast, and the way a researcher will answer a question typically is framed very specifically. I think that goes to the integrity of how a researcher thinks and really their scientific integrity of asking and answering questions. I just want to point that out because we did have alsoChris McGlory on, and he answered questions very similarly, as well as Emily Lantz and many of these other researchers. When it’s their opinion, they will certainly say well, this is my opinion, but really this is what the data will show.When it comes to protein, weight loss, and muscle mass, why is it that when an individual shifts away from a higher-carbohydrate diet–and is it fair to say anything above 100? How do we define a higher-carbohydrate diet, just so that we have a vocabulary that is consistent?
Dr. Donald Layman [0:25:13]
Theway we’ve tried to frame that is that we have this basic need for carbohydrates, as I’ve said before, for the brain, red blood cell, and the kidney.You can say that ends up being around 100 grams per day.The way we frame it is then your use of carbohydrates relates to your muscle activity.That range is about 40 to 70 grams per hour, depending on the intensity of exercise. We usually give people credit and say that for every gram of carbohydrate above the RDA, 130, you have to account for it with exercise, and it’s, rule of thumb, around 60 grams per hour of exercise. For the average American with 300 grams of carbs per day, they have to be doing three hours of fairly intense exercise per day, and very few Americans are doing any exercise, let alone three hours. So we’ve got this disconnect between our carbohydrate intake, which as we were saying earlier, that is a threat to insulin sensitivity. Everybodywas taught in your first class in nutrition and biochemistry and even med school is that insulin is a regulator of blood glucose. I don’t think that’s true at all. I think insulin is a safeguard. It’s an insurance policy against excess blood glucose. If you continuously day after day, meal after meal threaten that insurance policy, essentially, it burns out.That’s exactly what diabetes is. Basically, type 2 diabetes is insulin failing to be effective enough to maintain your blood sugar.
Dr. Gabrielle Lyon [0:27:10]
On a side note, one way to utilize blood sugar or blood glucose in general, without the use of insulin, would be exercise. Exercise improves the ability to utilize again, glucose without the requirement of insulin.
Dr. Donald Layman [0:27:29]
To that point, muscle has two glucose transporters, one of which is insulin sensitive, and one of which isn’t. At baseline levels of low carbohydrate intake, a lot of the glucose that gets into muscle gets in with a non-insulin dependent transporter.
Dr. Gabrielle Lyon [0:27:50]
Which is fascinating to understand. What about carbohydrates and fiber? We talked about carbohydrates, and the majority of the way that we’re talking about carbohydrates is really not within a fiber matrix.You’d mentioned that it’sthe worst thing that if someone wanted to just completely blow themselves up from a health and metabolic perspective, they would eat a high carbohydrate, low protein diet. Fair to say that?
Dr. Donald Layman [0:28:19]
I think that we’re beginning to get sensitive to the concept of refined carbohydrates. But a lot of people say, well, that’s sugar.But actually, bread is probably more of a risk than table sugar because it’s pure glucose. That has a bigger effect on blood insulin. SoI think we have to think about that. I’m sorry, I lost the train of thought there. What was your question?
Dr. Gabrielle Lyon [0:28:47]
The question is we were talking about carbohydrates.Really, in this carbohydrate-centric way of eating, which really has been happening since it’s been ingrained in the US Dietary Guidelines, for over 50 years,again, the average American is eating 300 grams of carbohydrates. You saida statement that I think is important and a statement that we should clarify and take another layer of approach to, and the statement was, the worst thing someone could do would be to eat a high-carbohydrate diet with low protein. Then my follow-up statement was, where does fiber play into a role here? What kind of carbohydrates are we really talking about?
Dr. Donald Layman [0:29:34]
Fiber is actually an unknown at this point. We have theseinsoluble, soluble fiber things that aren’t actually very measurable. I was at a meeting just a few weeks ago, and one of the big discussion is what’s the future of fiber? Howdo we understand it in the realm of microbiome and prebiotics and things like that. ButI think one of the ways I think about it is thatwhen you look at grains, when you look at wheat flour, oat flour, or corn flour, those have very low fiber contents, and even calling them whole grain doesn’t make it a lot different. When I think about issues of beans and legumes and things,now what I think about is that, okay, so these have a three to onefibercarbohydrate to protein, and it’s heavily fiber. I think of beans and lentils as outstanding carbohydrate foods that happen to have some protein.People want to make them protein foods, but they’repoor protein foods. It’s hard to eat enough ofquinoa orred beans or black beans or lentils to get enough protein. But they’re absolutely outstanding carbohydrate foods. So now what we have is a carbohydrate fiber matrix, the fiber slows down the rate of digestion of the carbohydrates, blood glucose appears much slower, insulin’s not stressed as much, so the form of that. White bread versus beans are vastly different carbohydrates. One, the beans is pretty healthy form, and the white bread is a pretty unhealthy form.
Dr. Gabrielle Lyon [0:31:34]
When you’re thinking about designing a diet, and when you were designing diets for studies, was there a certain percentage that came from refined versus percentage that came from what you call higher quality carbohydrates?
Dr. Donald Layman [0:31:51]
When we designed those studies, again, these were back in the early 2000s, so the food guide pyramid was still the gold standard. When we designed them, both diet groups got five servings of vegetables per day, exactly the same. Both groups got two to three servings of fruit per day, so we did exactly as the food guide pyramid. The real difference was one group then got grains, and we tried to select whole grains as much as possible. It wasn’t all candy bars and sugar. It was what the food guide pyramid would recommend you ate, so cereals and breads and things like that. Then the other diet, we replaced 50 grams of those carbohydrates with 50 grams more protein, and that was the effect. In essence,wedesigned the high-carb, low-protein diet as absolutely best we could design it. We didn’t set it up to fail. We didn’t give it a whole bunch of sugar and really lousy foods. We did it as good as we could do it.
Dr. Gabrielle Lyon [0:32:59]
You simply swapped out an additional 50 grams of dietary carbohydrates for an additional—
Dr. Donald Layman [0:33:07]
The whole diet was lower in carbohydrates. Again, these were weight loss studies, so both groups had a calorie restriction of 500 calories.In both groups,we restricted the carbohydrate and fat intake off the top. It went down in both cases.For the treatments, we substituted out 50 grams of carbs for 50 grams of protein. The net decrease in carbs in the protein group was probably closer to 70 grams a day, 70 or 80 grams from their baseline.
Dr. Gabrielle Lyon [0:33:47]
I think it’s important to point out because everyone listening can simply do that if you guys do nothing else.Again, let’s say you don’t want to count calories, which by the way, I do think that you should have a baseline understanding of how many carbohydrates or how many calories that you are ingesting. But by simply translating what Don is saying, by reducing your carbohydrates and swapping it out for protein,there were significant, not just body composition effects, but there were also metabolic effects. Why do you think dietary protein has this influence in this way? What are some of the mechanistic ways in which perhaps the provider listening and then the lay public listening, why do you think that there’s that impact?
Dr. Donald Layman [0:34:38]
A lot of research has suggested thatpart of the issue of yo-yo dieting is loss of lean body mass. Your net ability to burncalories,that’s your active tissue, and certainly muscle is part of that, if you lose active tissue as you lose weight, then your calorie balance has gotten lower.People will lose weight, and they lose lean body mass.Again, depending on the rate of which you lose weight, if you do it with a low-protein diet, somewhere between 35% and 50% of the weight you lose is coming from lean body mass. Starvation, for example, 50% of your weight loss will be lean body mass.That lowers your ability to burn calories. A big part of it is that we’re looking for a protein-sparing effect. We want to protect muscle both for functional mobility as you get older, but also because it burns calories, this whole metabolic issue.
We also know that protein has a thermogenic effect.When you increase your protein, particularly early in the day, it increases yourthermogenic, your ability or the fact that you burn calories, basicallyyou wasted as heat.There’s a lot of debate about where that comes from. If you read a freshman nutrition book, they’ll say it’s from digestion, absorption, and metabolism or protein, which makes people think it has something to do with protein is harder to digest or absorb. That’s not really the case at all. We’re pretty confident that the thermogenic effect is from the fact that meals trigger protein synthesis and muscle.That is a very energetic, expensive process.We like to think of three meals a day to stimulate muscle protein synthesis.That’s where the energy expenditure comes from.What we found with our weight loss studies is that consuming the equal amount of calories in both diets as much as we could, the people on the higher protein diet lost about the equivalent of 300 calories a day more body fat. Basically, they’re burning more calorieswhile consuming the same amount of calories.
Dr. Gabrielle Lyon [0:37:03]
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That is fascinating. Do you think that one would see that if the distribution is different? What you did is you looked at a distribution of dietary protein, an equal distributionI’m assuming.It was around 30 or so grams per meal in the higher protein group.
Dr. Donald Layman [0:39:49]
Again, meal distribution, I think, is a confusing issue. I think the most important meal of the day to correct is breakfast. I think that just adding a lot more protein to a big dinner meal, I think is pretty useless to do.There have been experiments, some of the Australian group thatdid that type of thing and didn’t see much effect. I think the issue is, when you come out of the overnight fast, the body is very sensitive to protein. It’s alsosensitive to carbohydrate. If you want to buy the insulin regulation theory, the worst of all worlds would be to have a high carbohydrate breakfast, so breakfast cereal with a banana and a glass of orange juice is probably a pre-diabetic diet.If I was going to create diets that cause diabetes, that’s how I’d start the day.
Dr. Gabrielle Lyon [0:40:46]
No one is coming to your house for breakfast. Fascinating, truly, interesting. Let me circle back, and let me ask this question in a different way. When you have that first meal, and really, what I’m getting at is this thermic effect of feeding or why or potentially how we could distribute protein that would increase thermogenesis, and again, I’m saying this loosely. Would we see an additive effect if we hit enough protein, minimum of 30 grams, to trigger the mechanics of skeletal muscle? Would we see an increase in the thermogenic effect? In the literature, you will see this thermic effect of feeding variable. In some data, you might see 20%.In some data, you might see upwards of 25% to even 30%.There are variations within the literature. I would love for you to highlight as people are thinking, how can they leverage the food that they’re ingesting and create a way of eating that provides even more utilization of calories, if at all?
Dr. Donald Layman [0:41:58]
I think it’s a great question.As you know, I always think in terms of mechanisms. If I’m going to discuss something, I’m going to underpin it with a mechanism.The answer to your question is, what do you think the mechanism is? If you think it is something to do with digestion, absorption, and handling of nitrogen, then it doesn’t matter when you digest the protein. However, if I’m right, and it has to do with triggering muscle protein synthesis, then moving protein to the first meal is critical. I think that’s the variation in literature. If you see some of the diets that have been used, they’re not paying attention to meal distribution. I think if you group all of the protein in the last meal of the day, you’ll minimize the thermogenic effect, and so maybe only observed 10% maximum. Where if you begin to distribute it differently, especially to the first meal, I think you can make it 20%. We’ve done some research that shows the ATP expenditure of that first meal, and I’m convinced that’s the thermic effect. It’s not digestion, absorption, and nitrogen metabolism. It’s protein synthesis in muscle.
Dr. Gabrielle Lyon [0:43:16]
Which is a very important point. It’s a very important point.You guys, this is just to highlight that there is variations in the literature. There’s something else that you had mentioned that I’d love for you to elaborate on, and you said that a high-fat diet would also cause insulin resistance.
Dr. Donald Layman [0:43:38]
You can go into the literature, and you can see both human and animal models where people have fed high-fat diets, really high-fat diets 40%, 50%, 60% fat, and they can show insulin resistance. But you always have to start as you’re thinking about it as is this an excess calorie diet?Is the body in a net storage issue? A 60% fat diet,a ketogenic-type fat diet, where people are eating less than their calorie balance probably won’t have any negative effects. But if you’re overeating calories, then whether you’re eating carbs or fat, both of them are going to get you into trouble.You can see studies where they fed high fat, and you’ll get increased blood levels of triglycerides, increase free fatty acids, you’ll get increased things like ceramides and diacylglycerides,which will inhibit insulin sensitivity. There’s no question that can happen. But you can do exactly the same thing overeating carbohydrates.So back to my earlier point, what are people overeating the most? Well, 50%is coming from carbohydrates, and 35% is coming from fat.Is it the bigger number or the littler number? I think both are important.As you know, I don’t go out and try and create high-fat diets.But I don’t think there’s anything wrong with a 35% fat diet oreven up to a 40% fat diet as long as the calories are in check.
Dr. Gabrielle Lyon [0:45:22]
I would absolutely agree with you. This brings me to something that I do want to bring up because I’ve had a lot of people send me this study.This is a study published in the American Journal of Clinical Nutrition.Researchers looked at health data from 200,000 people from the Nurses’ Health Study, the Health Study 2, and Health Professionals’ Follow-up Studyin the US.What they found was that those who ate the most red meat had a 62% higher risk of developing the condition compared with those who ate the least. I think that the condition that they were talking about was type 2 diabetes. In light of everything that we are talking about, it seems a bit counterintuitive that the idea of swapping out any kind of carbohydrate for some high-quality protein would actually thus lead to a type 2 diabetes risk. I will say that this first came across my desk because it was published in The Guardian. Do you have any comments of this Harvard University study?
Dr. Donald Layman [0:46:32]
Do you want me to trash Guardian?
Dr. Gabrielle Lyon [0:46:33]
By the way, guys, you have to understand, I know these answers and what he is about to say, but it’s important that you hear it because, again, the goal of this podcast is to have transparent conversations.If we cannot have transparent conversations with world experts in a meaningful way, then what are we doing? I’m going to kick the ball over to you, my friend.
Dr. Donald Layman [0:46:58]
It’s a Harvard study, and they have published this multiple times. It’s from the Nurses’ study, which I think people need to understand, it’s an interesting group that they have followed for a lot of years. But what’s important to understand is, it’s a proprietary data set that nobody else can look at. They basically can dream up answers and manipulate the data any way they want and publish results, and they’ve published this before. There are other groups that have looked at the same kind of data with the enhanced data, public data, and what they’ve actually shown is that red meat reduces the risk of diabetes. Soyou have tolook at it. First of all, the first thing that you and I’ve said before, and most people listening probably have heard, is that epidemiology proves nothing. Basically, it says, okay, here’s something look at.
One of the things to realize is thatwhen you start looking at red meat, you have to think about are you looking at people who have a healthy diet or an unhealthy diet?If I take somebody who is overeating calories, and I have them put a sausage pizza per day on top of an unhealthy diet, I guarantee you, it’s going to get moreunhealthy. Was it the sausage in the pizza? Or was it that 1200 calories from the cheese and the bread? It’s an association issue, and you have to look at it.
The studies that you and I were talking about,the three clinical studies that we did, and one of which was 12 months long with 130 subjects, these are random controlled trials. These are trials where we actually know what they’re eating, we’re monitoring it week by week, day by day. These aren’t justretrospective, I asked the nurse what she ate yesterday. These are controlled trials.What’s important about it is when we added in the protein, that 50 grams, we did it primarily with red meat. Substituting red meat into lower carbohydrates always improved pre-diabetic conditions and glycemic regulation. If you look at that in the literature in actually controlled studies, what you see is it’s always beneficial.
When the epidemiology and the pure science, the random control trials, don’t agree, then you have to start asking why.The why is because the epidemiology is making vague associations that are hidden behind lifestyle, how much fiber they eat, how many calories they eat, and they’re not factoring it out. Again, you really have to look at those things and when they continue to publish the same thing without ever doing randomcontrol trials to back it up, then you have to start looking for agendas. I think most people would recognize, well, Willethas an agenda-driven individual. He’s the author of the EAT-Lancet that basically said you should eat more sugar than protein. I think there’s some highly questionable science behind his thinking.
Dr. Gabrielle Lyon [0:50:21]
Also, isThe Guardian a peer-reviewed journal, or is this a journal that receives funding to publish certain medical research?
Dr. Donald Layman [0:50:33]
They’re definitely a magazine that is doing some sort of reporting, but they’ve clearly been funded for by groups that are anti-cattle. They’ve most notably published a lot of things related to EAT-Lancet and also to environmental sustainability that are anti-cattle.They’ve been funded to report that. I think they’ve lost a lot of credibility. A magazine or a journal that, I think, had a reasonable credibility has basically said, well, funding is important.We have to stay in business.They’ve kind of sold their soul, which is sad to see.
Dr. Gabrielle Lyon [0:51:22]
I wanted to bring this up, you guys, because by the time we publish this episode, this has been circulating around. I’ve seen this circulate through The Guardian. I’ve seen it circulate through. I think that this was an NPR or Times Tech article, and the headlines say this blanket statement, red meat eaters had a 62% higher risk of having the metabolic condition,The Guardian reported, and what they’re talking about is type 2 diabetes risk.What Don is pointing out is epidemiology data is data that is collected.
Dr. Donald Layman [0:52:01]
I mean, 62% unto itself is just a stupid number. If you look at the paper, they say that one serving of red meatper week increases your risk by 46%. I mean, that’s just a stupid number. I mean, 65% of the protein in the American diet comes from animal sources. That means every single person in the United States has type 2 diabetes. I mean, it’s just a ridiculous statement.
Dr. Gabrielle Lyon [0:52:28]
We have to be able to at least provide some basic understanding. Now, on the flip side, that’s not to say that a plant-forward diet and plants are bad. We’re not having that conversation. I am just bringing up this headline because again, it seems as if every four months, the same conversation gets circulated. But it again continues to be epidemiology. It does not end up being randomized controlled trialswhere the data is available and can be evaluated and can be challenged and repeated.
Dr. Donald Layman [0:53:04]
The bottom line to that is from 1975 till today, the red meat consumption, the beef consumption, has gone down over 35% in the US, which is exactly when type 2 diabetes and obesity went up. We know the data is not in the same direction. When you go out and you say, well, this quartile who eats the most red meat is most likely to be diabetic, that relates to the fact that they’re overeating calories, the red meat is all coming from fastfoods. They eat pizza five days to seven days a week. I mean, it’s just a lifestyle-dependent answer that makes no sense at all.
Dr. Gabrielle Lyon [0:53:45]
I appreciate you highlighting that because again, the goal is how do we get people healthier? The only way that we’re going to be able to get people healthier is if we can provide information that makes sense, that there’s a mechanism of action, and then there’s a way to begin to think about it.
Dr. Donald Layman [0:54:03]
Again, we’re not in any way saying plant-based diets aren’t important. Fiber is very important. Phytochemicals are very important. Unfortunately, the average American gets 70% of their calories from plant-based foods now, and it’s all pretty much crap. It’s basically low-fiber, ultra-processed foods, and we’re getting no nutrition, just a lot of excess calories.
Dr. Gabrielle Lyon [0:54:30]
Yeah, absolutely. Well, luckily, we’re shifting this conversation. My next question is something that has come up for individuals that are switching to increase more protein in their diet. How fast and what are some of the things, from a mechanistic perspective, needed to be thought of as they’re adapting? Is there an enzymatic adaptation? Talk to me a little bit about what we can just as we project and thinking as we add in more protein to the diet.
Dr. Donald Layman [0:54:59]
That’s an interesting question that people don’t consider enough. We talked about digestion, absorption of protein a few minutes ago. I think that one has to recognize that process is, in fact, enzyme dependent. If you’re on a really low-protein diet, if you’re only eating 60 grams of protein per day, and all of a sudden, you want to go to 140, if you do that in one day all of a sudden, you’re going to feel really bad. The body doesn’t have the digestive enzymes. It may not have the fat digestive enzymes that it requires. Chances are, you’re going to feel bloated. You’re probably going to have gas issues. You’re going to be constipated, etc. When we start counseling people, we try and get a sense of where they’re currently at. If they’reeating 90 grams of protein per dayand they want to go to 120, fine, add it in.
I would certainly always look at their meal distribution. If you’ve got meals that contain 50, 60 grams of protein, you don’t want to add another 50 to those. You want to put it in a different meal.Again, I’ve highlighted the first meal of the day, I think, is the most critical. I think those are important. But if you’re on a low-protein diet, you need toease into it.What we’ve shown in various studies is it has taken us a week to 10 days to really readapt for that problem. If you’re going from 60 grams of protein, I’d go to 80, 85 for a few days, then to 100, then maybe to 120. I would do it at steps over a seven to 10-day period. Otherwise,what you’re going to see is that the protein will draw fluids into the GI tract, the enzymes aren’t there to digest that. You’re just not going to feel good. I think that’s an important thing for people.Where are you starting from, and where are you trying to get to?
Dr. Gabrielle Lyon [0:57:14]
Yeah, it is a good point.For the listener, one of the things that we do in clinic is we often have patients take a digestive enzyme support. But again, it is it an easy thing to do and titrating oneself up slowly. I’m also going to hold your feet to the fire because you said a very low-protein diet at 60 grams. What does the average female have in terms of protein a day?
Dr. Donald Layman [0:57:42]
The average across all ages is around 70 grams for females.It’s on the low side. We know that around 40% of women over 60 are actually below the RDA.We know that vegetarians in general, worldwide, the average is around low 60; 60 to 65.Vegans tend to be in the mid-50s. They’re getting down to the very low end and for the most part, below the RDA. We think those are really risky. If you make that lifestyle choice, where do you get enough protein to stay healthy? For a 25-year-old, that’s one thing. But for a 45-year-old, that’s a big risk.
Dr. Gabrielle Lyon [0:58:31]
It’s not just a risk for muscle health. Again, that is the foundation, but you need dietary protein for multiple other reasons. The body’s always going through protein turnover.Each of these individual amino acids have various roles in the body above and beyond skeletal muscle health. Would you agree with that?
Dr. Donald Layman [0:58:54]
Yeah,totally. I was just reading a paper this morning that was recovery from stroke was heavily dependent on aromatic amino acids, so the neurotransmitters, phenylalanine, tyrosine, tryptophane. If you have higher-protein diets, your potential to recover from those kinds of things seems to be better. We just published a paper in Journal of Nutrition which basically argues, we need to move away from talking about protein and talk about essential amino acids. We have nine essential amino acids, each with individual requirements, and we need to focus on them as nutrients. They’re not some interchangeable part of protein. They’re individual nutrients that we need to think about. Neurotransmitters or leucine and protein synthesis, orthreonine and gut health formucin levels, lysine and carnitine for fatty acid metabolism,there’s just all kinds of different issues that we need to directly address as nutrients and not just some vague issue of protein.
Dr. Gabrielle Lyon [1:00:06]
Which brings us to the paper that he is describing, and I’m going to read you the title, and we’ll link it here.It was in the Journal of Nutrition, August 2023, Perspective: Developing a Nutrient-Based Framework for Protein.That is going to be the next frontier is that we move away from thinking about protein as this generic recommendation, and then we begin to think about each of the nine essentials, and maybe three of the more limiting essentials, as individual nutrients,as things that we can really target. I am going to guess that it’s going to circle all the way back to whole foods again as a primary standpoint of how we can improve our diet. Do you think that we will begin to identify, for example, things like lysine deficiency?Not overt deficiency, but again, you had mentioned the aromatic amino acids, for example, phenylalanine.Do you think we will eventually begin to pinpoint perhaps inefficiencies of recovery or changes in let’s say, eyesight because of taurine, things that we have attributed to other vitamins and minerals? Do you think that we’ll be able to circle back and bring it into those individual nutrients? The idea that each amino acid is an individual nutrient, I think, has been long overlooked from a health and wellness perspective.
Dr. Donald Layman [1:01:39]
Yeah, I totally agree. The reality is we haven’t studied amino acids for their metabolic roles very well. I’m trying to think of some examples and which way I want to take the conversation. Let’s use leucine for a minute. If you look at the actual–well, let’s step back one more step from that. If you look at what we consider protein quality right now,PDCAAS has an amino acids score.If you add up the nine essential amino acids with that score, it only comes up to 23% of your protein requirement, which, as we’ve already said, is really low. If you look in the human body, essential amino acids make up over 50% of the amino acids in your body, but yet our requirement is only saying you need 23% of it. There’s a real disconnect.
If we take an amino acid likeleucine, the daily requirement for that is around 2.7 grams.The argument is, well, that’s related to nitrogen balance and things like that. But if you really think about the blood levels of that, the blood levels that actually will support nitrogen balance are probably tenfold below what we would ever get to. But if we look at protein synthesis and muscle, what we know is it takes about 3 grams per meal. Instead of 2.7 grams per day, which is that minimum number that we’re currently using for labeling and everything else, it’s actually closer to 7.5 to 9 grams per day. There’s this huge gap between what we’re calling minimums.That’s true for whether we’re talking about threonine or tryptophan or cysteine, methionine, all of those.We’re not thinking about the metabolic outcomes. The minimum to sustain nitrogen balance is a totally different answer than what’s the optimum for metabolic regulation.I think that is next frontier.
The reason we published the paper in Journal of Nutrition is as we hear this debate about a more plant-based diet, we need to shift from saying, well, all proteins are equal to understanding essential amino acid requirements. One of the things I’d like people to understand is when you look at protein on a label, that’s not protein, that’s a nitrogen analysis. Basically, you’re doing a nitrogen analysis and then claiming it’s protein.Basically, it could be anything. It could be nucleic acids, it could be urea, it could be some sort of nitrogen contaminant like melamine or something unhealthy, and they’re claiming it as protein.Once they claim it’s protein, then they multiply it by 6.25, which assumes that all amino acids have exactly 16% nitrogen.But that’s not true. If you look at a non-essential amino acid, which is very prevalent in plant proteins, glycine, it’s 32%.If you look at methionine amino acid, one of the essentials that are prevalent in animal proteins, it’s 9%. Basically, the label is 100% meaningless in terms of what actually is there.We need to move beyond that. We treat vitamins as individual nutrients on the label. Why don’t we treat amino acids as nutrients?
Dr. Gabrielle Lyon [1:05:20]
A really important point. How long do you think it will take for us to get there?
Dr. Donald Layman [1:05:29]
For a long time, we’ve talked about protein because nitrogen was an analytical skill we had; we could chemically do that. Amino acids were very hard to measure. But now we have GC-mass specs with fluorescent detection, and we can do them in large quantity. There’s no excuse not for us to now identify essential amino acids.Back in the ‘70s, there was reasons. But now in2020s, there’s no reason we don’t talk about it. The analogy people have probably heard me say istalking about protein is like talking about a vitamin pill.We don’t talk about the color or size or digestibility of the pill, we talk about the 14 vitamins inside of that.Protein is really nothing more than a food delivery system for essential amino acids.It’s time that we talk about essential amino acids as nutrients.
Dr. Gabrielle Lyon [1:06:31]
I love that perspective. I know that you are paving the way. I’m hoping it will eventually get out to the public, which I’m sure these scoring systems will.
Dr. Donald Layman [1:06:44]
I’ll just add one more thing on that is that we’re currently about to add, and we’re currently about to submit another paper looking at what’s called ounce equivalents.If you go into the USDA on MyPlate, you’ll see that there’s ounce equivalents, and it says one eggis equal to 1 ounce of salmon or 1 ounce of chicken. But it says 1 tablespoon of peanut butter or half ounce of almonds, and those aren’t equivalent at all.So again, as we think about plant-based diets, we need to come to grips with they’re not actually equivalent.We’re looking at a paper that basically says, okay, you can make substitutions, but you also have to realize it’s going to take more total protein and more total calories to be equal.That’s what the average consumer needs to understand.
Dr. Gabrielle Lyon [1:07:35]
What would you say to someone who was concerned? And again, this is a little bit of a sidetrack, but it is something that has come up. What would you say to someone who was discussing this methionine ratio being concerned about skeletal muscle meat versus collagen? Is there data to support what that kind of blend would be?For you guys listening, collagen has a protein score of zero. While it is high in glycine and hydroxyproline, some of these other potentially also di and tripeptides, there is some discussion that somehow balancing these other amino acid sources with muscle meat could be beneficial. Do you have any thoughts on that?
Dr. Donald Layman [1:08:24]
Your question is about use of collagen?
Dr. Gabrielle Lyon [1:08:27]
My question is the ratio between muscle meat and other forms of amino acids.
Dr. Donald Layman [1:08:36]
It’s important to understand that our actual protein requirement has two parts. One is what we call the essential amino acids that we’ve already talked about.The other is what we call nonspecific nitrogen.If you have a diet that has 70 grams of high-quality protein in it, and you put in a really crappy protein like collagen as a source of nonspecific nitrogen, that’s probably fine. If you have a diet that has 60 grams of protein and it all comes from collagen, you’re going to die in a few weeks because it’s totally deficient. So again, you have to think about how you use it. I think collagen is an awful protein and anybody spending money for it is wasting their time. I see no benefit.
Dr. Gabrielle Lyon[1:09:36]
By the way you guys, I don’t agree.
Dr. Donald Layman[1:09:38]
Once again,I look for mechanism. So if you want to argue that collagen is good, then you have to come up with a mechanism, and I haven’t seen any viable one. If you want to say glycine has some effect on growth hormone, okay, prove it. If you want to say it has an effect on arginine, okay, prove it. If you want to show me hydroxyproline, which can never be used in protein, actually has an effect, okay, prove it.I’m open to it. I’ve heard a lot of testimonials about it. But based on any biochemistry that I’ve ever done or seen,it’s a crappy protein.
Dr. Gabrielle Lyon [1:10:19]
What? You heard it from him. What about in terms of skin and gut health?
Dr. Donald Layman [1:10:25]
I know that people claim it, but I’m still looking for a mechanism. I’m a mechanism guy.Prove it to me, what does it do?Just throwing a bunch of collagen on,I don’t see a mechanism. Until I see a mechanism,it’s a Weegee board issue.
Dr. Gabrielle Lyon [1:10:47]
Friends, this is how our conversations go on the daily. If I believe something, I’m going to have to now spend the next two hours looking at the literature. I anecdotally love collagen. I think collagen, while may not be a good source of dietary protein, I do think it does something for my hair and my skin.Again, but that is anecdotal.
Dr. Donald Layman [1:11:09]
Is that topical or internal?
Dr. Gabrielle Lyon[1:11:11]
Internal, and he’ll say, no way. But I’ll have to get back to you on a mechanism with that. It will take me the next couple of hours. Don, is there anything else?
Dr. Donald Layman [1:11:20]
She knows there’s always a risk of asking me certain questions.
Dr. Gabrielle Lyon [1:11:23]
Always. Oh, yes, many, many years of this. Is there anything else that we should cover? There are other things, but we’ll save this for a part two. Anything else that you feel is important based on some of the topics that we discussed, all of which are relevant.For a more lay understanding, the book,Forever Strong is written in a way where these concepts are put into play in a very actionable strategy. But is there anything else that you wanted to touch on?
Dr. Donald Layman [1:11:57]
I’m currently writing a review article on meal distribution, so that’s definitely on my mind.I think one of the things that people need to understand is that meal distribution is probably far more meaningful to adults than it is to kids. The whole concept of leucine stimulating protein synthesis is something that we know happens, but it seems to be particularly important in older adults.By older adults, I mean non-growing individuals, so 35 and older. But it doesn’t seem to be as meaningful to children or young adults. I thinkas a lay person, as a mother out there thinking about, wow, I need to balance my kids’ diet, really for children, it’s about protein per day. But as we get into adults, and particularly older adults, where they don’t need as many calories per day, their diet needs to be much more specific, I think meal distribution becomes a much more important issue, and that first meal is critical. Again,that’son my mind because I’m writing a review about it. I think it’s very confusing in the literature, and part of the confusion is my fault because we published some of the first data on it.We used an even distribution, which has blown everybody’s mind. But it’s really all about the first meal and getting that corrected.
Dr. Gabrielle Lyon [1:13:30]
I’ll mention that there are benefits to an even distribution, but not from the standpoint of what we’re talking about.The benefits to an even distribution may be of course, getting that first meal correct. The second meal will help balance your blood sugar if calories are controlled, carbohydrates are managed.Getting in that dietary protein, especially for people that have been skewed toward 300 grams of dietary protein with much lower levels of carbohydrate, one could argue that an even distribution helps with number one, blood sugar regulation, number two, hunger control, and number three, really staying consistent, minimizing chaotic eating.
Dr. Donald Layman [1:14:10]
Absolutely. We started this whole conversation with issues of type 2 diabetes, and I don’t think there’s any question that using protein to reduce carbohydrates at each meal has a huge benefit. The other one is, from a muscle standpoint, we have some pretty decent data that you probably maximize the muscle effect somewhere around 50 to 60 grams at a meal, so adding another 50 grams on top of a higher-protein meal doesn’t make it better. You’d be better off to add another meal or put it at a different meal. We know that there’s a lower end of the threshold,around 30 grams. We have less data, but we think there’s an upper threshold somewhere around 55 grams, and so adding more protein should go in a different meal.
Dr. Gabrielle Lyon [1:15:00]
Is there a max? Do we know what the max number of stimulation throughout the day would be in terms of a benefit of 24-hour protein synthesis?It wouldn’t nitrogen balance.It would be at 24-hour net protein synthesis.
Dr. Donald Layman [1:15:19]
I think the point I just made about there’s probably a maximum benefit at an individual meal, so adding in another meal, there’s some really good data that adding a fourth meal late in the day before bedtime is beneficial for people trying to gain mass and strength. Luc van Loon has done a lot of good data on that. I think that your target per mealis in a 30- to maybe 60-gram range, and then you just distribute it from there. If you’re a vegan, if you’re a vegetarian, your first goal is getting a single meal that has 40, 45 grams of protein. There’s pretty good data about that. If you’re not a vegetarian or veganand you have 120 grams, then you should get at least two to three meals. If you’re trying to use 200 grams, probably you should go for four meals.
Dr. Gabrielle Lyon [1:16:23]
I like that. That’s easy to do. Again, the first question is, what is your ultimate goal? Is it weight loss? Is it longevity? Is it hypertrophy or muscle building? Then the next potential question is, how are you getting yourdietary protein?That may direct the amount of meals and where you really need to focus your attention and then almost really thinking about this metabolic correction.The goal is to get this paper published, or at least work on it, and get that out there, a protein-centric perspective for skeletal muscle metabolism and overall cardio metabolic health. When we look at what are the causes of mortality for our population, at least for us here in the US, we have heart disease– I feel as a bit you and Igo back and forth on that, is it really heart disease? What happens when someone’s heart stops? Do they write it down as heart disease? Oris it heart attack, and does that get classified as heart disease? Diabetes is also on there, Alzheimer’s is on the list. Cancer is also on the list. Many of these diseases have roots in metabolism, and really metabolism and health of skeletal muscle, but it is not directly spoken about. I do thinkthat’s important to mention.That’s it.
Dr. Donald Layman [1:17:50]
I totally agree.
Dr. Gabrielle Lyon [1:17:52]
Dr. Donald Layman, thank you so much for coming on. I am so excited to see you, even though we talk just about every day. This book,Forever Strong, was dedicated to you for a lifetime of mentorshipand caring and really teaching me, and you continue to teach me. I’m so grateful to be able to bring you to the general public because if not, you may be sitting behind the computer and doing other things. But not anymore, my friend.We are going to bring you to the masses. But I’m just so deeply grateful, and I just love you so much. You guys, if you like this episode, please take a moment to review it, to share the message. That is free of cost. The goal is to provide you with transparent conversations, and yes, I ran right into that because Donis extremely awkward if I tell him anything touching or mushy. So I have spared you, Dr. Donald Layman, you can thank me later.As always, I love you guys.
Dr. Donald Layman [1:18:54]
Well,great fun to join you. I certainly appreciate and honored by the dedication. I cherish our friendship and interaction, so thank you.
Dr. Gabrielle Lyon [1:19:08]
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