Q&A #36: How Much Protein After 50?—Sources, Timing, & Leucine

Hello everyone. Welcome to our Crowdcast number 36. It's pretty awesome, 36 episodes of this Q&A. Glad to see everyone here in the chat from Tennessee, Chicago, Toronto, Florida, all over. So for those of you that are new, this Crowdcast, the way it goes is I have I've looked through the questions that were submitted in the Ask a Question section, and I choose questions that are questions I think I haven't answered before, questions that I think many different audience and members would be interested in, questions that I'm interested in diving deep into. And I do a mixture of questions that are sort of more of a deep dive and questions that are a little more rapid fire, what I call. So sometimes I can answer those in a a sentence or even a word.

I think now I'm sort of expanding my rapid fire to even just a short paragraph. So today we have a mixture of all those types of answers. And they're kind of a— usually I do rapid fire towards the end. I kind of have everything mishmashed together because I didn't do such a good job organizing my document this time around since I was Super, super busy with work. So we're going to start off with a couple of high voted. It was one high voted question, but a couple of people have asked it in some form. So this Sybil and Riley were asking about Botox. They wanted to know my thoughts on Botox and its long-term effects on overall health. And I'm assuming both of these individuals. Are interested in Botox injected in the skin. There, there are other uses of Botox. So Botox is a toxin.

It's produced by the bacteria Clostridium botulinum, and it prevents the release of acetylcholine, which is— it prevents the release of acetylcholine at the neuromuscular junction. So it makes muscles unable to contract. So it causes basically like muscle paralysis. And, you know, that obviously could be a very dangerous thing if that happens in something like the diaphragm, because then you wouldn't be able to breathe. So it could be incredibly lethal, but Botox is not injected into the diaphragm. It is not injected into the bloodstream, and that would be the concern if it gets into the bloodstream. So it's really good at paralyzing muscles, and it can treat wrinkles.

You know, I would say, you know, I know people that use Botox and, you know, you can— when they move their forehead, you know, and make facial expressions, like, the lines and all the things you can see, like, don't occur. So it's, you know, it can be a little apparent when people are, you know, using their facial expressions. But generally, you know, I've seen it In, in like older family members, for example, I've seen it really help with like deep wrinkles that they have on, on their, on their forehead and stuff. So it definitely works and it can, it can look good.

I think younger people kind of get a little too gung-ho about it, and I don't know that they really need to do it so early because the, the problem you face is that when you start doing Botox really young is it can have the opposite effect because there's sometimes a little And this, I think, may be a little bit more relevant for even just fillers in general, maybe not necessarily Botox, but fillers in particular. They have a certain plumped look where it makes you kind of look older because you usually associate people using that stuff, you know, they're usually an older age. So, um, Botox can be used for a lot of other things. They use it to treat hyper— the excessive sweating. So they, they inject it into sweat glands. They can inject it into larger muscles.

So it can be used to treat dystonia or overactive bladder or pelvic pain, tremors, tension headaches. So it really depends on the dosage and formulation, and it lasts anywhere from a couple weeks to several months. It's always locally injected, so it's usually intended for the muscle, and you never want to have it in the bloodstream, as I mentioned. So really, there's not been any long-term negative effects when it's used correctly in the muscle that I've been able to see. Certainly no long-term effects for treating skin wrinkles. You know, so I think people that are perhaps have, maybe if you guys have, if someone has some deep, deep creases in their skin, it could be an option if you have someone that's really good at doing it.

Personally, so Sybil's asking in the chat here about Pregnancy. And I always tend on the side, you know, I err on the side of caution during pregnancy. Probably it would be okay, to be honest, but you just never know. You just never know. And I think that if it were me, I've never done Botox, but if I were to do it and I was pregnant, I would definitely probably take the 9 months off during pregnancy because it's really not that big of a deal. So, you know, and in fact, a lot of times when the Botox wears off, most of the time it's not— it like, there's still some effects where it's like, it seems to, even though, you know, technically it's like, oh, it lasts a couple of months.

But like I've seen, again, I've seen people that I know that have done it and not have done it for like a year and still like you can see a difference. In some of their wrinkles. So personally, I think it's best to hold off on any of that stuff. Like, you just don't really need to do Botox while you're pregnant, you know, right? It's not like you got a big belly. I mean, there's already, you know, changes in your body that are different. So that would be something that I would do. I would definitely not be doing Botox while I was pregnant. But not because it's known that there's a negative side effect, just because the possibility of something that we don't know yet is, you know, it's like, why take the risk? Okay. So the next question was submitted by James.

And James was asking about a stress test and what a stress test can tell about a person's risk for a heart attack or a stroke. He says, I know blood pressure, cholesterol, diabetes, obesity, etc., are typical factors, but do those things adversely affect one's endurance for a treadmill stress test that the stress test can say much on its own about one's risk. Okay, first of all, if the question is about whether or not being in shape affects the validity of a stress test, there are many different types of stress tests and depending on a person's exercise capabilities, so the physician usually chooses the stress test that's best fitted for you. It could be a treadmill or a stationary bike or a chemical stress. Stress tests do not and cannot determine a person's heart attack or stroke risk.

That is not what stress tests do. Stress tests can you are usually used to assess the risk of mortality and mortality and screen for coronary artery disease. So with respect to mortality, there was one study that found that those who were not able to do at least a 2.5 mile per hour. With a minimal incline basically run had a 15% chance of dying in the next year, while those who were able to do it, do at least 4.2 miles per hour with a 16% incline had a 1%, less than 1% chance of dying in the next year. So that, like, that's one way stress tests are used to assess mortality, but most often they're also used to look at stable coronary artery disease. So an abnormal stress test means that you can have a high risk for stable coronary artery disease.

The stress test is designed to test that, but it cannot assess heart attack or stroke risk. So basically, the stable coronary artery disease is a progressive narrowing of the arteries supplying blood to your heart with, you know, basically the plaque is building up. blocking blood supply to the heart. So heart attacks can happen when the plaque actually ruptures and forms a clot, so when the plaque is not stable. The chances of a plaque rupturing depend on stability of it, so not the size of it. It's actually just the stability of it. So a person with a normal stress test can actually have a heart attack the next day and die. So really, the best way to assess a heart attack in the next 10 years is by using the ASCVD calculator.

So this is something you can find on the American College of Cardiology website. It's the American College of Cardiology ASCVD estimator. And I'm going to give you guys a link right now in the chat so you can link to it. Okay. So I think, you know, basically speaking, the stress test is mostly looking at stable coronary artery disease and heart attack risk, and the risk of heart attack is not something that's basically even predicted by stable coronary artery disease. So maybe that's something that physicians are not communicating properly. And so, you know, that would be something to talk about with a physician. Coronary calcium score. Yeah, I mean, these are all included in looking at the coronary artery disease risk, you know, as well.

So, like, you know, there's lots of different things that can be measured, and I don't think one thing in isolation really— you know, it's always better to measure a battery of tests, right? Measure a battery of things and have several different biomarkers to look at because it's really the totality of them that's important. So on the heart disease topic. Shakira is posting another question that she had from last Q&A, and she's asking about the Ornish diet, which is pretty vegan, vegetarian. I think it's mostly vegan, no oil, and it claims to reverse heart disease. She says someone she knows had a 70% blockage and went on the Ornish diet, and their LDL, triglycerides, everything dramatically went down, but their HDL also went down. So this diet advises against olive oil or any meat.

And Shakira wants to know if I can talk a little bit about this diet or another diet to help reverse plaque formation and not just prevent it. So yes, the Ornish diet has been shown to improve heart disease risk factors, not by reversing plaque formation. So with the 5 years of There was a study with 5 years of intensive lifestyle modification. So people that went on this Ornish diet, they basically were exercising a lot more. I mean, and they were, you know, they changed their diet from a standard American diet to a mostly vegan diet. They achieved a 3% reduction in atherosclerotic plaques. And I would say that most of the improvement in heart function is by growth of new collateral blood vessels in the heart, and that happens from exercise.

Exercise is one of the best things that you can do from, you know, with a diet or with a lifestyle change, basically. Diet is critical for stopping plaque progression. So the plaque can become more stable, and like we were talking about, when the plaque is stable, That really reduces the risk of a heart attack. So the Ornish diet's really plant-based, and there's there's the big exercise component in it. There's a reducing of stress, so there's meditation involved, improving wellness. It does have a lot of evidence behind it, but again, it's not just a dietary change; it's also adding exercise and doing like meditation and yoga, and there's also some vitamins and stuff involved. So. Yeah.

People that adopt it lose a lot of weight and a lot of— losing weight in and of itself is a huge— it's a huge lifestyle change that can reduce the risk of many different diseases, including heart attacks and strokes. And there's many different ways that people can lose weight. It doesn't necessarily have to be on a vegan diet. Just literally like reducing calorie intake, being in a caloric deficit can also like lead to really massive, you know, weight loss reduction. So I think that that's something to also keep in mind. There's also some controversial points with the Ornish diet. So he recommends a fat-free milk and low-fat dairy. And really the bias against dairy comes from the fact that dairy is rich in saturated fat and It's thought that saturated fat in general can raise cholesterol.

And we talked about— we've talked about many different Crowdcasts about the link between saturated fat and cholesterol and the types of cholesterol and LDL and small dense LDL. And really, the link between dairy and increasing small dense LDL can depend on a lot of factors, mostly combination of refined carbohydrates will do it, or perhaps some people are genetically predisposed, and we'll talk about this in a little bit to a phenotype B, which means they genetically are more predisposed to making small dense LDL particles. In that subpopulation of people who have a phenotype B lipid profile, meaning they have more small dense LDL and fewer of the large buoyant LDL particles, they can have more adverse biomarkers for heart disease if they eat a high saturated fat diet.

So it really depends on many different factors. And then the Ornish diet also recommends, again, only 10% of calories from fat. Well, there have been studies, and again, we're going to talk about this with another question about ApoB. Some people that are phenotype A, meaning they have large buoyant LDL, which is a good type of LDL that is transporting triglycerides throughout our our circulation to other tissues so our tissues can have energy, transporting, you know, other fatty acids and also some cholesterol to some degree. You know, this— the large buoyant LDL is not so much the problem. So people that have predominantly large buoyant LDL, if they go on a lower-fat diet, they can actually increase their small dense LDL. It has like the opposite effect.

So it's really not just this— it's not this one overall, you know, overarching like diet that fits all. Like people respond differently to diets, they do. And without measuring anything, you wouldn't know that. So it's really important to keep that in mind. He also recommends limiting coffee to 1 cup per day. You know, I think there's been There's been quite a quite a bit of studies that have come out that's shown that sometimes you know the coffee polyphenols themselves can be beneficial and it's not necessarily going to cause arrhythmias. So you know there's a it's the association between arrhythmias and coffee consumption is pretty much anecdotal.

And you know I just think that the Ornish diet there's a lot of problems with the, the background behind why it's supposed to be valid, I think it can work for people because they're essentially getting off the standard American diet. And I think that's like the biggest factor, honestly. So, you know, people can go on a Mediterranean diet and, and have improvements on it. You know, like I said, people that are just losing weight and becoming physically active, like those are the 2 main things, like losing weight and becoming physically active. And you can lose weight just by, you know, intermittent fasting, by becoming, you know, getting in a caloric deficit, by reducing refined carbohydrates and eating more whole foods.

You know, of course, I think plants are important, but you can also have some nice healthy meats and exercise, really, really important. I think that's kind of like the most important bottom line. Bernardo's asking about dairy promoting inflammation and intestinal permeability, which, um, if you guys haven't caught my, my presentation that I posted, you really should. It's a really great talk. I talk all about intestinal permeability. And one of the major— one of the major driving factors lifestyle-wise of intestinal permeability is a really high concentrated amount of saturated fat without A fiber complex, and it is possible like drinking heavy cream, for example, can induce intestinal permeability.

But again, you you can look at studies of people eating dairy, and you're not seeing you're not strictly seeing high biomarkers of inflammation. So I think my best guess here is you know if you're eating. The dairy, you know, and it's— I guess, you know, the question is, okay, what if I'm just eating cheese? Well, the cheese is complex with protein, but you don't have a lot of fiber, you know, so it's probably good to also have some fiber with the meal, you know. So maybe it's not good to just sit there and munch on like a bunch of cheese by itself. But I think having a little bit of cheese on your salad, like feta, is not like going to cause intestinal permeability. I really think it has to do with the dose and also whether or not it's complex with fiber.

Like that seems to be— it slows the way the body digests fat when it's complex to fiber, much like glucose. Like when glucose is packaged in a whole fruit, it changes the way glucose is absorbed and it changes postprandial glucose levels. Similar sort of concept. when dietary fat is eaten with a— in the context of like fiber, it also slows the absorption and release of bile acids and things like that that can lead to intestinal permeability. So I guess like Bernardo, to some degree, I would say that's accurate, but I think it's a little bit— it's not capturing the nuance there, right? So it's not like all dairy is necessarily bad. Yeah.

Like people that are eating cultured like kefir and yogurt don't have intestinal— in fact, their intestinal permeability is lower because of the probiotics present there. So it's not like this one, all dairy is bad, don't ever eat dairy. I think it's really like, okay, is the dairy a fermented type of yogurt with probiotic bacteria that is actually beneficial for the gut? Is the dairy super high, high fat with absolutely no food also being, you know, so you're basically just drinking some cream or something like that, right? Like that causes, that can cause intestinal permeability. Is the dairy being eaten with a refined carbohydrate? Because saturated fat in combination with refined carbohydrates is a sure thing for intestinal permeability.

So again, it's like, okay, well, combining those things is definitely not good. A little bit of feta cheese on a salad, I think, is not going to cause intestinal permeability. There's so much fiber in the salad. So that's kind of my thoughts on that question. Cameron's asking about those— there's these water kefir drinks. You can find them everywhere. They're kind of like a sparkling probiotic drink and, you know, there hasn't been as much scientific evidence backing that up with respect to showing empirical data that that is improving gut health, that it is improving biomarkers of inflammation, for example, like kefir and cultured yogurts, like they're shown to improve inflammatory biomarkers, they have been shown to improve different species of bacteria that are producing butyrate, for example.

So I think in theory, they should be beneficial because they do contain some of the probiotics and stuff. I think there's just a lack of real data to definitively say yes, they're going to do the same thing. Okay, briefly, there was a question from Lanny or Lonnie about Carbon 60 oil. I covered this in a Crowdcast last year, so I'm just going to kind of speed through it. It's an oil made of fullerene molecules that have 60 carbons. So the 60-carbon molecule is known for its unique Kind of like a soccer ball shape. And there's been some in vitro studies showing it's an effective direct antioxidant, but it's never really been shown in animals or humans.

So there's all these commercial products claiming that it's able to extend lifespan, it's able to improve cognition, improve sleep, reduce pain, boost energy. I mean, just everything you can imagine. However, there's no human studies supporting those claims. There is one study that showed a cream containing carbon 60 could reduce facial wrinkles. There's animal studies showing that high dosage— high dosages of it can be toxic. And in humans, there's been a safety study showing it to be safe in very low doses. The upper limit of safety in humans is still unknown. So I would say overall, There's really no information to recommend humans taking it at all. That's sort of my take. Nick is asking if zinc oxide sunscreen is safe. I think it is. I think the mineral sunscreens are safe.

I'm more concerned about the chemical ones. A lot of the chemical sunscreens, when UV rays hit them, it oxidizes them and they be— they become, um, they become a little bit more of a— how would I say it— reactive oxygen species generating compound rather than something that is protecting us. So, um, I typically use the mineral-based sunscreens, and I haven't really— I mean, these have been around for decades and decades and decades, and, and, um, I think it— we've, we've had since the chemical sunscreens have come out where there's been some evidence that the chemical sunscreens may contain some carcinogenic activity, again, once they react with the UV radiation. But the mineral-based sunscreens, I really haven't seen evidence that they're causing a problem.

Okay, so now we're gonna get to some interesting stuff. Not that what we talked about wasn't interesting, but there was a handful of questions submitted that had to do with protein intake and muscle mass. And I just filmed a podcast yesterday with Dr. Stuart Phillips, who's— anyone that's in that world knows that he is one of the world-leading experts on muscle protein synthesis. Like, he is just— he has really increased our understanding of what is regulating muscle protein synthesis, what is not regulating muscle protein synthesis. And so, I'm really excited to kind of dive into some of these questions. I will just tell you that my favorite mineral-based sunscreen that I'm using is the CeraVe one. Unfortunately, you have to just use a little bit because it does make your skin look white.

Okay, so the muscle protein synthesis, Stuart Phillips. You guys, this podcast is amazing. I am so excited for it. We filmed it yesterday. I think we're probably going to— we've got a jump start on post-production. So I think that that's something we'll be released in 3 to 4 weeks. So I'm really excited about that. So the first question related to this was submitted by SC, and SC asks, what protein powder do you recommend, vegan or non-vegan, for losing weight and building muscle after 50 years old? What is the sweet spot in older adults for IGF-1? Okay. So talking about building muscle and losing fat, I think my take-home— I spent a week really diving into this literature. I've learned a tremendous amount.

I mean, I'm much more— I think I understand much more about muscle protein synthesis and what regulates it than I did last week for sure. And what's interesting is that, so there's 2 real major, major regulators of muscle protein synthesis. And those are mechanical stimulation. So resistance exercise, resistance training, big one. And essential amino acids and particularly leucine. So that would be where the protein comes in. And they're both very important. And they're both big, the most important regulators of muscle protein synthesis. And Stuart has done a lot of studies looking at optimal amount of protein intake to promote muscle protein synthesis, not just, you know, preventing breakdown.

The RDA, if you look at the RDA for adults in both the US and Canada, it's 0.8 grams per kilogram body weight per day. And Stuart has published a study where they have done a bunch of isotope tracing studies. And he basically argues, and it's much like the RDAs for micronutrients. the way they have been determined is preventing deficiency. And there's a difference between preventing deficiency, an optimal amount, like an optimal intake to support metabolism, to support our metabolic functions, right? So, for example, vitamin D, like preventing deficiency where your bone starts breaking down versus supporting the over 1,000 genes that vitamin D is regulating. It's a steroid hormone, right? There's a big difference.

And so, when the RDA was set for protein intake, it was set to prevent deficiency, basically to prevent— it was like, it's— the way he explains it is much clearer, but what he figured out was, okay, well, like, It shouldn't be called the recommended daily allowance. It should be called the minimal daily allowance, meaning like the minimal amount that you should get in to make sure you're not constantly in a catabolic state. That doesn't mean you're going to be supporting new muscle protein synthesis if you're only getting 0.8 grams per kilogram body weight per day. He's shown, and others, that 1.2 grams of protein per kilogram of body weight is what is necessary to support muscle protein synthesis, both in adults younger than 65 and adults older than 65.

And with adults older than 65, he went on to— Well, actually with both. Okay, so with both younger and older adults that are also in addition doing resistance training, if a person was really wanting to maximize the amount of muscle protein synthesis they can get from their dietary intake in combination with resistance training and exercise in general, then the real kind of like limit to that is 1.6 grams of protein per day. Now that is, again, for people that are really kind of trying to get the last little drop out of their protein intake. And it's— that is a lot of protein. In fact, 1.2 grams for me. So I'm, you know, for me, that means he basically thinks it's better to split them up into like 3 meals.

And so doing— so for me, that would be So for all of us, that would be 0.4 grams of protein per kilogram of body weight per meal if you're going to split that up into 3 meals. And for me, that's about 24 grams of protein per meal, which is quite a bit than I usually do. I usually am having 1 meal with the most protein. And he said you could do that. You could have your 1 meal with— but that's like a lot of protein for 1 meal. I mean— I just don't know that I even would be able to do that. So, again, this is for, you know, people that are not like obese. Like those people that are obese, like they're already getting enough protein. And in fact, they need to be in a caloric deficit.

So that— it's a little bit of a different game when you're talking about someone that is obese and, you know, obese and sedentary, for example. So, and we kind of talk about that in the podcast. It's like first, This podcast is not like for people that are obese and sedentary. Like you need to lose that weight first and then get into the muscle protein synthesis, right? Like that's the next step. Losing the weight, becoming physically active. So I think 1.2 grams for healthy, you know, people that are trying to support their muscle protein synthesis, I think 1.2 grams per kilogram body weight is a good, a good number to aim for. Foods that are high in leucine are the ones that are really going to support that. You know, I typically like egg white powder. You know, eggs have some leucine.

They're not like the highest, highest food. It's best to get it from food, but supplementing with protein powders is, you know, and specifically if, you know, one that's higher in leucine can also help with that. Getting the 1.2 grams per kilogram body weight. And then the other thing to do is resistance training. Like if you're really wanting to build muscle mass, you have to like have that mechanical force. Resistance training 2 to 3 times a week. 2 times is really like, I would say, he says like the bare minimum, like to really get that optimal muscle protein synthesis. 1 time a week is better than none, obviously. So like anything you do is better than nothing. But for people really looking for that sweet spot, he says 2 to 3.

You start to get to 4 times a week, Then you're talking about like the elites. You're getting 4 to 5, like you're starting to get in those people that are like the bodybuilding kind of people, right? So so that's like that's like another level, right? And then he also says that, and this is really interesting. We'll get in, and I learned something from this podcast. He he talks about growth hormone. He talks about hormones in general. He's done a lot of research. Trying to figure out what— if— what role hormones play in steroid hormones like testosterone, growth hormone play in actual muscle protein synthesis. And he has been unable to find a role, a direct role for normal growth hormone levels that are produced from exercise, normal testosterone that is produced from exercise.

In muscle protein synthesis. And he says that, um, that's because it's a transient increase and it's kind of— it's part of the normal diurnal cycle. Now, he doesn't think there's not a role for it at anything. Um, he's saying that you're not like— that's not directly increasing muscle protein synthesis. Now, when you take someone and you get, you get someone that's injecting testosterone or growth hormone to supraphysiologic levels, then you can actually affect muscle protein synthesis when you're like going like many standard deviations outside of the normal range. But when you're just talking about exercise itself, that's not the thing that's majorly like majorly controlling muscle protein synthesis.

And he doesn't recommend doing the supraphysiological doses of testosterone or growth hormone because it can It can lead to negative health consequences like increased cancer risk, diabetes, and things like that. So he did say that people, older individuals undergoing hormone replacement therapy under the care of a physician where they're getting hormone replacement therapy to their normal levels, what they would have had when they were younger, isn't something— that seems fine. That's not— he's— that's not the supraphysiologic, you know, problem that he was talking about. He did mention that growth hormone induced by exercise— and we'll get into the sauna in a minute because sauna also does it— growth hormone does play a role.

And, and, and the levels that are increased from exercise and from sauna do play a role in helping you decrease fat. So burning fat, it does— growth hormone helps with burning fat. And It helps with collagen synthesis. This is like new research of his, and I was so excited about this. Like, I had never heard of this. Growth hormone increases collagen synthesis, and so like joints, skin. So I'm definitely going to try to dive into this, but I think this is a very new thing that he was sort of working on. So I don't know how much data there is, but it was super exciting for me. So that's kind of my overview of that question when it comes to an older individual. And you guys, this podcast is phenomenal. We get into like, you get something called anabolic resistance with aging.

And that is basically your body becomes less— muscle becomes less sensitive to leucine and protein intake. And so it's not as sensitive to increase muscle protein synthesis from the same amount of protein that you usually would be getting. And so, um, again, that's where like making— when people are older, making sure they're getting at least that 1.2 grams per kilogram body weight becomes really important. The other thing is heat stress, and I talked about this. Heat stress increases heat shock proteins, which prevent muscle atrophy, and it becomes even more important with age. So I really think there's a role with this combining sauna with exercise and for maintaining muscle mass and also for helping increase fat loss with the growth hormone. I didn't know that.

And so that seems like a really interesting aspect that I'm definitely going to read more about. So really the best things, the 1.2 grams per kilogram body weight. Again, we're talking about physically active people that are not obese, right? Getting Getting that resistance training, like bare minimum two to three times a week ideally. I mean, if you're really wanting to to keep that muscle mass, that's what that you should do. You know, twenty minutes, twenty minutes, you know, per session. So like you're talking forty minutes, maybe an hour per week of resistance training, and then doing the sauna for the heat shock proteins to prevent atrophy. And oh, the other thing he said was omega three really prevents atrophy as well. And and he's done like a few studies on that as well.

So I was really excited to hear that. And he said vitamin D also, like my favorite stuff. So I think, I think those are, those are the really the major things when it comes to maintaining muscle mass. Going over— so Bernardo's asking in the chat, do you think going over 1.6 grams per kilogram is bad for mTOR activation? Lately Peter Attia is pounding on the importance of muscle mass. And I tend to stay around 1.8 to 2 kilograms. Of protein per kilogram of body weight. Um, you know, I— so, so I, I can tell you that what Stuart said was after, after 1.6, you're really just not— you're not really getting much anything beneficial from it. So, uh, I don't see why you would go up that high. Um, and he's like, he's like a big proponent of muscle protein synthesis.

So, uh, if he says going above 1.8— 1.6 is like You know, doesn't really do anything, then I kind of believe him. With respect to the mTOR activation, you know, the the problem with the mTOR activation again, it comes in the background of unhealthy lifestyle factors: being obese, being sedentary. Like you don't want to just sit around and eat 1.6 grams of protein per kilogram body weight and never move. You know, so because you know you there can there can be a role and for mTOR and IGF-1 in terms of growth growth signaling factors that can of course allow precancerous cells to then form a tumor.

So you know obviously you don't you don't want to just be obese and sedentary and taking in all this protein like this is this is like we're talking about I really think 1.2 grams is for most normal people that are not like getting into that like, you know, 3, 4 times a week resistance training kind of person. Like there are people that do that. And, you know, so in some cases, it could make sense to go above 1.2. But I really think 1.2 is— and even Stuart said, he's done studies, he's looked at both young adults, like younger than 65, and adults older than 65. that resistance train. And most of those people had a baseline intake of 1.2 grams per kilogram body weight protein. So they're already getting what he thinks is an optimal amount of protein.

And then he said, okay, well, what happens if they go up to 1.6? And what he found was there was a little bit of an increase in muscle protein synthesis. There was a little bit of an increase in strength in lower body, lower leg, but not in like hand grip, but it was really not a huge increase from the 1.2. So to me, that was kind of interesting because it's like, really, it seems like 1.2 is a really good kind of sweet spot for protein intake. So Richard is asking in the chat if intermittent fasting and following supportive circadian rhythms best to get protein in the morning. Yeah, so I asked again, I asked Stuart about this, and he thinks it's best to get protein— like, he thinks getting it in the morning is very important, particularly for older adults.

And there has been a study showing that getting protein in the morning is— having a higher dose of protein in the morning versus evening for older adults does seem to facilitate increases in— I don't remember if it was lean muscle mass, which isn't directly just measuring only muscle mass, right? But And it could be circadian dependent, like some of these amino acid transport and all that stuff. There's circadian component to it. But I think also just getting that because protein isn't stored, it's used, right? It's used. And what's not used is excreted, right, through urea. I mean, I think that You're good. It's good. He thinks it's good to have a constant flux throughout the day of it.

He doesn't think there's any— like, you can still do one big dose of it, but he thinks it's better to kind of get a constant flux. He doesn't think that it has to be the timing around exercise. Like, that's all been— like, it's not really important, you know, honestly. The most important thing is getting the 1.2 grams daily. That's the bottom line that he said. Ewa is asking in the chat if there's a difference between efficacy from various types of protein, for example, plant versus animal. Yes. So again, essential amino acids and particularly leucine. Leucine is the major signal for mTORC1. And mTORC1 is really responsible for this muscle protein synthesis trigger from amino acids. mTORC2 plays a role in muscle protein synthesis from mechanical force, you know, so the resistance training.

Stuart said that his belief and his viewpoints on the quality of protein in terms of like getting it from plant versus animal sources have changed over the past 10 years because Nowadays, you know, well, first of all, if you are only eating plants and not supplementing and things like that, you do need to make sure you're taking in more of it because there is less leucine in plant sources. But he says nowadays there's, there's so many ways that, um, the plant, plant protein powders and all these things are— people are trying to maximize getting more like leucine and getting more of these essential amino acids for people that are vegetarian. In, in them that they're, um, they're a lot better than they were 10 years ago.

And, um, also like firm tofu is, is really high in leucine, so that would be a, a good vegetarian or vegan source of essential amino acids, or particularly ones that would support muscle protein synthesis. Um, Christopher's asking in the chat if he talked about creatine. Yes, I asked him at the very end of the podcast about creatine. The the thing he said about creatine was also very interesting. So he said creatine monohydrate. Don't listen to anything else. Like that's you know that's the form you need, and that it is it does play a role particularly in muscle function, and and that people particularly people that are older and sedentary and more prone to muscle weakness really. Notice a difference from supplementing with creatine. I think he said about 2 to 3 grams.

And he thinks it's a good one. I mean, it's— he says he supplements with it mostly when he's having a real big bout of work. And so he's spending less time doing resistance training. But honestly, there's an argument to be made to just supplement with it. And he's also increasingly interested in the effects on the brain, as am I. So if you guys look at our topic page on creatine, you'll see there's quite a few studies that have come out about benefits on brain function as well. He said it's really safe. Like, he's, you know, over many years looked into safety and it's just, it's really a safe thing to supplement with. So it gets the thumbs up. I'm Honestly, I think I'm going to experiment with it. I'm also definitely giving it to my father who is prone to muscle wasting.

So he's taking the omega-3 right now. I'm going to get him the creatine. I'm also going to try to get him— we talked about leucine supplementation, particularly for older adults. Like for any of you guys that have aging parents, I mean, when you start to have a parent that, you know, is over 65 and starts to get into their 70s, like their appetite decreases. Like, they just don't eat as much food as, like, younger people do. And some of that has to do with they're not as physically active as well. And so it's really hard to get older people to eat 1.2 grams per kilogram body weight of protein, you know, like, so I was asking him, can we supplement and particularly supplement with leucine since that's, like, what's known and to trigger protein synthesis with respect to dietary triggers.

And he said, yeah, so leucine, he said, third-party testing for leucine is essential because there's a lot of crap brands out there that you could just find like on Amazon. So don't just go to Amazon and get a leucine. Look for third-party testing from people like ConsumerLab, Labdoor, people that are doing consumer— doing third-party testing on it. I haven't looked into this yet. So when I do, I will let you guys know and remind me again on the Q&As. He said again, I think he said three grams, about three grams of leucine. It's bitter tasting, so you have to like kind of like broccoli sprout powder or moringa. You kind of have to mask the taste. So maybe like pineapple juice or something like that can help mask the taste.

And that's something to really consider with older adults who are battling sarcopenia. Of course, they're not as physically active as they were, so they're not getting that mechanical. Force or stimulation of muscle protein synthesis. And really, he said the major thing, if a person is not in a disease state, if they're not— if they don't have cancer, if they don't have type 2 diabetes— disease states really ramp up inflammatory cytokines, and those increase muscle protein breakdown. He said for the most part, aging, when you get over the age of 65, The biggest cause of muscle atrophy, also known as sarcopenia, is decreased muscle protein synthesis. And so really focusing on trying to increase muscle protein synthesis is important.

And the 2 things, again, that do that are protein, which, you know, leucine, and resistance training exercise. You guys in the chat asking me about food sources, like I don't I don't have the you know index of that in my head memorized yet, but like there's a lot of sources on Google that you can just find foods high in leucine, and you know for the most part they should be accurate. So I think I think that's a good start for people that are looking for foods that are high in leucine, and you know like meat. Like if you're talking about like red meat's really high in it, but like eating salmon, like fish is high in leucine too. Like it may not just have the same amount of red meat, but like it has omega-3, which also counters muscle atrophy.

You know, like I think there's just like obsessing over— so eggs also are high in leucine. Eggs are a great protein to have, like a great protein source for breakfast. And there's every more reason to like eat eggs, especially as you start to get older and you're battling that muscle atrophy. I think it's really important. And Christopher is asking about the leucine as a supplement. Okay. So ideally, you get your leucine from food. You can get it from food because then you're also getting other things, right? Like food isn't just one component, right? It's not just one amino acid. But for people that cannot eat 1.2 grams of protein per kilogram body weight per day, it can be beneficial to get some additional leucine. That's what he said. It's not necessary, but it does— it can help.

And so, but again, you can also— he said you can also do branched-chain amino acids like those. The powders have stuck around for a while. There's 3 of them in them. But he said really the only one that's having an effect is leucine. You know, branched-chain amino acid, branched-chain supplementing with like those branched-chain amino acids are more common. And I think there's a lot more flavors and stuff that you'll find in some of those brands. But really what's having the effect on muscle protein synthesis is the leucine. I don't have any brand recommendations for creatine or leucine or any of that yet because I haven't— I literally just filmed this podcast yesterday. yesterday morning. So he just happened to be in San Diego. I called him up.

I was like, I really want to do a podcast with you. You're the guy that I've seen that's the most credible. And he's like— I told him I was in San Diego and he's like, I'm going to be there tomorrow and I'll be there for a week. And so we scheduled it for like— it gave me a few days of work to kind of do my background reading and then we did the podcast. So I know you guys are really going to love it because a lot of you guys ask me a lot of questions about protein intake and muscle mass. And in fact, there's some more questions I need to go on to, but he really, he really delivered on the podcast. It was awesome. So Bob was asking about regular sauna use, combining sauna use with resistance training to increase muscle mass above that of what resistance training does alone.

And then he asked if growth hormone The growth hormone increase from sauna is enough to increase muscle mass? And I think I've kind of answered some of these already, but there's no— so the sauna isn't going to directly increase your muscle mass. It is going to prevent muscle loss. And the other thing that it's going to do, and it prevents muscle loss through increasing heat shock proteins. The growth hormone increase that the sauna gives is going to help with collagen synthesis, and it's going to help with increasing fat loss, which is also important.

So I think, I think that my hypothesis would be that overall, if you're talking about net protein synthesis, yeah, the sauna plus resistance training is going to be better than resistance training alone, because not only are you increasing muscle, increasing muscle protein synthesis with resistance training, but you're decreasing the atrophy with the heat shock proteins. And with respect to growth hormone, the levels that are increased from sauna, while they're high, they're transient. And it's not enough in Stuart's mind to directly stimulate protein synthesis. Although I don't think he's measured it from sauna directly. He's measured it from exercise. But I'll take his, you know, his data is pretty solid on that.

And so we don't really have any data directly showing growth hormone from sauna will do it. Plus the growth hormone from sauna is transient, much like much like the increase from exercise. So I think the growth hormone from sauna, whereas I used to think it was beneficial for net protein synthesis, I now think that it's the heat shock. Well, I've already known heat shock proteins do that. I did publish a review article and I talked about heat shock proteins being involved in preventing atrophy. But growth hormone, I think I was a little bit misunderstood. Because I had seen studies where people were injecting growth hormone and it does increase protein synthesis.

But again, people that are injecting growth hormone, they're getting growth hormone elevations that are lasting throughout the day. That does not happen with the sauna. With the sauna, it's a very transient increase. It goes down after a couple of hours. And what Stuart did say is that benefits from that, much like what happens with exercise— exercise increases growth hormone— is that you're getting collagen synthesis. which helps with joints and skin, and you're getting— it helps burn fat better. So I think those are the benefits. And the next question was from Jen W., who asked about my thoughts on supplementing with hydroxymethylbutyrate to preserve muscle as we age. I'll text Stuart that.

I didn't ask him about that, but he thinks that basically, number one, getting the protein, 1.2 grams for most people, 1.2 grams per kilogram body weight. For the elite athlete, 1.6 grams per kilogram body weight. And he thinks omega-3, vitamin D are really 2 supplements that not only help preserve muscle mass, but are important for other things. Creatine monohydrate, also good. And then heat shock proteins help prevent atrophy as well. Whether or not the hydroxymethylbutyrate is going to have an effect on top of those things, I don't know. I, he didn't, he didn't really mention it as like a big thing. Why not eat more protein than 1.2 if it has additional benefit and gives you the creatine if it's from meat sources?

I don't know about the bioavailability of creatine from meat sources versus supplemental sources. That would be something to look into. But people that are not at like at that elite exercise level, like they don't, like they don't need that extra protein to facilitate muscle protein synthesis because it's such a small increase from 1.2 to 1.6. So again, if people are elite, then, you know, getting that 1.6 can have a little bit of an additional effect or benefit. But that's only when you've got the people that are like, you know, they're exercising 5, 6 times a week. So, so that's not like the average person for sure. Richard, so Stuart in the podcast about leucine supplementation, I believe, and when this comes out, well, and we have the transcript and everything, we'll know.

I think he said it was like 2 to 3 grams. I think he's what he said for leucine. And again, he said finding a reputable source is critical for this because he said there's a lot of leucine supplements out there that are just an Like just terrible, and so third-party testing is crucial when trying to find a leucine supplement. And then the last question related to the protein was from Debbie, and Debbie asks, "I'm a 68-year-old marathon runner. I appreciate when you explain when you have what you have your mom taking. I wonder again how much protein you suggest for someone very physically active at my age." Okay, so I'm going to tell you.

According to what Stuart's data shows, someone who's very active, particularly when they're, you know, getting close to 70, 1.6 grams per kilogram body weight would be a good protein intake for someone who is at the elite level, like a marathon runner, 1.6 grams. And that's a lot of protein. So, you know, take it or leave it, but it seems like that's what data supports. And then again, I think, The breakdown of muscle and all that. Also, I think that having a little bit of sauna can help, and the omega-3 with the— there's a lot of inflammation generated from being a marathon runner. And so I think those things become important as well. Okay.

So I'm going to move on, but first, Hillary's asking about this mTOR question, if I'm concerned about stimulating mTOR, particularly with leucine, leading to cancer. I will say that there is a concern for that in people that have unhealthy lifestyle factors. So what does that mean? It means obesity, being sedentary, smoking, excessive alcohol consumption. You know, I think the data, if you start to look at the data with protein intake and all-cause mortality and cancer mortality, they're really Particularly with younger people, because as you get older, increased protein intake is actually associated with lower mortality. It's completely the reverse.

So, and even people that are sedentary and stuff like older people, actually, because they're such a huge risk, and Stuart gets into this, it's the events of disuse and disease. In other words, as we become older, things like the flu, things like if someone gets a surgery or You know, just little things can take a person out and they like, you know, they're on bed rest for a couple of weeks and they lose an immense amount of muscle mass, but they just cannot ever get back. And that sets them up for being frail. And then, you know, just getting up out of the chair becomes a risk. And like the frailty index just shoots through the roof and then the mortality risk goes up. So protein intake in old age is important regardless.

I mean, mTOR activation is— You know, if someone hasn't already gotten cancer, you know, in their 70s, you know, they— it's not, you know, the bigger concern is that they're actually— the frailty is going to lead to mortality. When you talk about protein intake and mTOR activation, it is a concern when you're talking about someone who is not healthy, who is sedentary, not physically active, not using, you know, that mTOR activation for making proteins in muscle, like you want it to. To be doing, right? So, so I guess the answer is yes, there would be a concern for people that are unhealthy, obese, and that's why I said, look, if you're already if you're obese, if you're sedentary, like that needs to be fixed before you even start to worry about protein intake.

Losing weight and becoming physically active are are the most important things, and then start to worry about you know your your muscle mass, and and Stuart even says that as well. L is asking about people that are overweight that are exercising and walking daily. That's a good start. I mean, being physically active is really the cornerstone of health. It really is. It's like one of the most important things that you can do to improve health, like period. So I think that that's a good start. Another good start would then be to limit calorie intake and try to lose some of that weight as well. And add some sauna in there, growth hormone helping with the fat loss. So I think all those things are good to do for someone that is overweight.

And there are some people that they have a hard time losing weight. I do think that I've seen people that have a really hard time losing weight by doing different dietary changes. They do— it does help them to do a prolonged fast. And for whatever reason, some of the satiety and hunger hormones and things like that, and some of those things reset and then help with other traditional ways of weight loss, like the caloric restriction and stuff, generally speaking, which does help. Sauna versus exercise matched for heart rate, which is more time efficient? Exercise is the best. Exercise is king. Sauna comes after exercise. No question about it. So Isabel asked, Database of questions.

As someone previously suggested, it would be immensely helpful to have a database of previous questions that were asked in Crowdcast, even if you just link to the Crowdcast in which they were answered. I often know I heard something before. There is a lot to listen to to find a previous question. Thank you for all your amazing work. Okay, so we are working on this. We, we've added a timeline button to all of our À la Quad episodes on the dashboard, but not the Q&As yet. We'll have hopefully we'll have this sometime soon. I don't know when. I will say this though: go through your emails that I send on the summaries of the crowdcast, and you can take those emails. We have the timelines in them, very detailed timelines of all the questions.

And in those, and you know you guys are asking, but like can't you just do that? Like all the programming stuff, like you just have no idea. It's like so much more complicated than you can ever think. Even little simple things. Like this. So for now, I really suggest you can search, you know, all the email. I think there's a title that we send and it's like summary of the Q&A and, you know, copy those down in a Google Doc or something. You'll have all the questions there because our questions are in the timelines. So that's what I would do for now. David asks about addressing heavy metal issues with moringas, in moringa like coulis coulis. Which now has a Prop 65 warning for lead, and they weren't very responsive when I inquired.

So I reached out to them, and they said they were going to get back to me with some data. They said that the Prop 65 warning is like— California is pretty crazy about it, and it's like anything that's even like a minuscule amount has to have it on there. But I'm waiting for them to give me back data, so when I get the data, I can tell you guys about what they've shown me. So, stay tuned for that. Is blood donation really good for you? Could getting rid of some old blood and causing the body to generate new blood have anti-aging benefits to skin to what was seen in parabiosis mouse studies? And conversely, are there any significant risks? What about phthalate exposures from the donation procedures?

So, I would say here, First of all, donating blood can help get rid of, you know, excess iron, ferritin. So that does help. The parabiosis studies, actually, those were some of the initial studies where hooking up young animals and old animals' circulatory systems could make— could sort of reinvigorate old animals to, you know, their organs were younger, including the brain. There have been a lot of studies that have come out since then, and it seems as though young blood is not necessary to do that. In fact, possibly just diluting plasma is enough to do that.

That was a recent study from the Conboy's lab, both Conboy's lab at UC Berkeley, where they showed that diluting plasma was able to dilute out some factor that is yet to be identified in old plasma that may be accelerating the aging process. And so this is something people that have some kind of severe autoimmune diseases, they undergo something called therapeutic plasma exchange. It's similar. It's exactly— it's pretty much exactly what was done in this animal study where the plasma was diluted. And so essentially what's done is some plasma is replaced with saline and albumin. And basically what this did in animals was— in old animals was it rejuvenated many different organs, including the brain.

So I think there's some excitement there with respect to, you know, so donating blood is one thing. Again, donating the blood, I mean, it can help with, you know, excess iron and ferritin and stuff. But that doesn't dilute plasma. The therapeutic plasma exchange isn't something that's available for people who do not have autoimmune disorders, but it is something that is safely used currently. And I think there's the potential, as more data comes out, for this to be a potential treatment for aging. Although we still have a lot more time for that. I mean, we need some clinical studies first and we haven't even gotten there yet. So that— I think that's some stuff that I'm actually pretty excited about.

In fact, I'm going to be inviting the Conboys on the podcast to talk about all their research. Lisa and Isabel asked about decaf coffee during pregnancy. Does decaf coffee have the same health benefits as regular coffee? Why not switch to decaf during pregnancy? There are many health benefits from decaf coffee due to the polyphenols and stuff that are in the decaf coffee still. There's still some caffeine in decaf coffee. So, you know, I guess, you know, switching to decaf could be okay. But again, there's, you know, there's a little modest amount of decaf coffee, Sorry, if you have caffeine present in decaf coffee. So, you know, I think switching to decaf is better than drinking caffeinated coffee. And if that's what works for you, then, you know, perhaps that can work.

I just chose to kind of cut it all out. I did switch to decaf during my first few months of breastfeeding, and then eventually I added 1 cup of coffee back because, you know, I just couldn't not have any coffee when I was like waking up 3, 5 times in the middle of the night breastfeeding. So eventually I added back 1 cup of coffee, I think after 6 months. All right, there was a question about the sardine brands I used and whether or not I still do the Vital Choice. I still have a bunch of Vital Choice sardines that I'm eating up, but I do think someone mentioned— so SC was mentioning the Season brand because the Consumer Lab had done some arsenic testing and their brand was really, really low in arsenic.

So sardines are low in mercury by nature because they're small fish and mercury really accumulates in the fat of bigger fish that are eating other fish. But apparently, there can be a problem with sardines having arsenic. And so I've tried the Season brand. I really like them. And if I can't establish whether or not the Vital Choice has any arsenic content to be worried about, then I will switch to Season. So you might as well just, if you're looking for a brand, go for the Season. I think it's a good brand. David asked about choline. Most people don't get the RDA, which is 550 milligrams per day, especially if they're not eating meat or eggs. Yet vegan advocates like Dr. Greger dismiss this and say that plants have plenty of choline.

That doesn't seem sufficient unless eating soy at every meal. What form of choline supplement do you like? Alpha-GPC, phosphatidylcholine, what? I like the sunflower phosphatidylcholine from Pure Encapsulations, which is 550 milligrams in 2 capsules. Robin says, I know that there are sauna— you're the sauna guru and have talked about the benefits of many different platforms on many different platforms. I have heard you discuss infrared sauna but not the use of sauna blankets. I do not have space for a sauna, but I got a sauna blanket which I use 3 to 4 times a week. It heats up to 160 degrees Fahrenheit and I stay in it for I can't see this. There's an symbol for the minute sign, but she wants to know if she's wasting her time.

I think, I mean, I honestly think that it's the heat stress that's important. And in fact, there's been some studies looking at just local heat therapy and preventing muscle atrophy. So sauna blankets sound like they're good, you know, as well. And really just being able to get, get up to 160 is great. And in fact, Dr. Ashley Mason's Heat bed protocol is, you know, it's it's it's like a little chamber, kind of like a big sauna blanket in a way, where people's bodies are in it and their heads are out. So it's kind of sounds it sounds kind of similar to to a sauna blanket, to be honest. And I think that if you're getting really hot, your heart rate's elevating, you're sweating. I mean, those are all those are all examples that you know. Are responses that you are undergoing heat stress.

And I think someone was also asking in the chat about saunas, infrared saunas as well. And again, I really think that if your heart rate's increased, if you're sweating, if you're hot, that you're probably activating heat shock proteins. And I mean, that's— heat shock proteins get activated from exercise as well. You know, it doesn't have to just be the sauna. So, you know, just it's the heat stress, which can be from, you know, you can achieve that in an infrared sauna if you're in there long enough, and exercise as well. So, I think that just really keeping that in mind, you know, that you're hot and sweating and your heart rate's elevated, all those things that are happening when your body is experiencing heat stress. Nick's asking if fish oil should be avoided.

for someone with low blood pressure. I've never heard of any rationale why people with low blood pressure should avoid fish oil. It's nothing that I'm personally aware of, honestly. Wesley's asking about damage to the eyes with infrared saunas or regular saunas. I think that some people, their eyes can be sensitive to extreme heat. So I am not one of those people. But my husband, who has very, very light blue eyes, is sensitive to our level of heat, which we're like up to— these days I'm going more towards 179, like 175 to 179, not quite 190, because sometimes it's just a little too hot.

He's sensitive to that and he wears— there's these eye masks that you can put in the freezer and they freeze and then you put them on your eyes and he puts those on his eyes when he gets in the sauna and it seems to completely negate any problems with his, you know, eyes getting like red and hurting and stuff from too much heat. Isabelle is asking about my kefir smoothie. Can you please share the recipe, my rough recipe? Yeah, so I use a NutriBullet. And I fill it up to the max line. So I do, I mix it with kefir, goat kefir usually. If they're out of goat kefir, I'll just do regular whole milk kefir. And then I add either a big handful of raspberries or a big handful of blackberries, or I'll do blueberries, or sometimes I'll cut up some strawberries.

It all depends on what I have and what's not, you know, what I have in my fridge at the time. I've also been doing a little bit of pomegranate. And then I add one little container of Bio-K yogurt, regular Bio-K yogurt, and then I blend it up. And actually recently, since I've come across some interesting pomegranate juice studies, I've been doing like a little, I would say, like a tablespoon, maybe 2 tablespoons of pomegranate juice in there as well. But that's, you know, fresh pomegranate is better. So if I have that as well. Ernest asked about the genetic report, if there's going to be any update to it. He says it's been a couple of years since the update. Yeah, we're kind of slowly adding stuff to it. I just don't want to like update it when I don't have enough SNPs.

So it's not something— it's kind of in the background of other things that we're working on. But we will update it again. Josh is asking about measuring core body temperature in the sauna, if a good cheap oral thermometer is good enough. So the only way to really measure that core body temperature is rectal. It has to be done rectally. So you want to make sure you're getting the kind of thermometer that can be put in that region of your body, unfortunately. So Christian says, testing if my fish oil is turning rancid by smell seems very subjective to me. I assume it's okay if it smells a tiny bit like fish. Are there more objective ways to test oxidation or other tips for knowing what smell is acceptable? Um, yeah, it should, it should smell like fish. It's fish, it's fish oil.

Uh, the best way to look at your fish oil brand would be the International Fish Oil Standards website, IFSO. I've talked about this many times. I've linked to it. And that, you know, looking for a brand that's on there with low oxidation is a really good way to do it. Metagenics is a great brand that has a pretty good concentration of EPA and DHA and also low in oxidation. Hi, Rhonda. About going from hot sauna to cold shower, you've previously mentioned concerns with changes in blood pressure and you recommended waiting a few minutes in between, but considering how cold exposure Following exercise can blunt some of the adaptive benefits of exercise. Could it do the same for the sauna? Could you elaborate on the mechanisms? Thank you so much for your highly educational content.

So first of all, I want to point out that cold exposure following exercise only the cold exposure following strength training exercise blunts muscle hypertrophy. Adaptations to strength training. Cold exposure following endurance training does not blunt adaptations from endurance training, at least so far. It really seems to be important for strength training. However, I still think it's good to avoid cold exposure in all respects. Like, I would wait a couple of hours before doing cold exposure after exercise. And with respect to sauna and cold exposure, I continually see the concern for potentially blunting some effects. But I will say this, a lot of responses are similar between the two. It's amazing. So both sauna and cold increase heat shock proteins.

It's because heat shock proteins are part of a stress response. They are increased by sulforaphane. Heat is the best way to increase them, but just as an example, cold does it too. Both sauna and cold exposure increase norepinephrine. Both sauna and heat exposure, and this is a new study, increase mitochondrial biogenesis in adipose tissue, which is really interesting. I know cold exposure I knew, but heat was— that was a new thing. So I do think there's— a lot of these overlapping responses that are similar between the two, just because we're talking about a hormetic stressor that you will find a lot of overlapping responses, like stress response pathways are sort of activated, but some do it better than others.

You know, like the norepinephrine is much higher with cold exposure than sauna, and the sauna's heat shock protein response is much higher than cold. So, I think based on that data alone, it seems like it's not going to really blunt. But, you know, I think the cardiovascular benefits from the sauna, there's a lot of the same physiological responses that happen with exercise. And so, I do, in the back of my mind, there's a little part of me that is a little concerned. But it's just a little bit, to be honest. I personally like to use the cold. I have my cold plunge, and I like to use that completely independent of my sauna. I just like to use it in isolation in and of itself, and I do it mostly for mood-enhancing benefits. And so that's that's kind of all I have for you on that.

Sorry, I I just wish we had definitive data. But I can see an argument to be made, you know, with a little bit of concern for the cardiovascular benefits. But again, we don't really know. And because a lot of responses are similar between the two, you know, that makes me feel a lot better. Okay. I've got just a couple more rapid-fire questions, one from Michelle. Michelle says, hi, Rhonda, loved your podcast with Dom D'Agostino. I was wondering, Why you're interested in the cyclical ketogenic diet as opposed to just maintaining ketosis. Are you worried about long-term effects of staying in a permanent ketogenic state, or is it just too difficult to maintain at all times? Are you at all concerned that repeatedly cycling in and out of ketosis would have detrimental effects?

So, first of all, to answer the last part of the question, the detrimental effects I'm not concerned about. In fact, Dr. Eric Verdin, at least in animal studies, showed that a cyclical ketogenic diet was able to extend their healthspan and extend their average lifespan and improve— particularly improve their cognition and brain aging. So cyclical ketogenic diets are at least healthy and not dangerous in animals. As far as why I'm more interested in doing it, I think a couple of reasons, and you mentioned one, which was compliance. It is very difficult to maintain a ketogenic diet. All the time. And so that is one reason. The other reason is I do like to have my bouts of extreme micronutrient-dense foods and fruits, and I think they're important. And so I like to have those.

I think that cycling those in my diet are good, but I also would like to have some benefits from ketosis. So I do think That cycling the ketogenic diet. And I kind of cycle through it. Like, I'll have times where I'm eating a lot of the, you know, most— I'm eating fewer fruits and plants and most— I'm eating a lot of the polyunsaturated fats from fish and sardines, and I'm eating the olives and olive oil and, you know, cooked— sorry, raw, some of the raw vegetables and stuff. So that's— That's the cycle. That's basically why I was doing it. When pregnant, what does the literature say about taking moringa powder, moringa, curcumin? I really avoided— I avoided moringa powder. I avoided all that stuff during pregnancy.

I just kind of think it's important to kind of strip down to the bare essentials because a lot of stuff really isn't looked at in pregnant women because it's such a delicate time that it's really hard to get any kind of trials done. And so you're kind of left with observational data, and even— and that's kind of shaky at best. Lisa asks, hi Rhonda, some follow-up questions from the last Q&A on pregnancy and breastfeeding. During breastfeeding, did you take 20 milligrams of PQQ daily? Did you use Life Extension? Are you concerned about non-medical amounts of monk fruit and rosemary leaf and extract and fish oil? If I wanted to take a choline supplement, is choline by bitartrate a good one? And, uh, thoughts on protein powders during pregnancy and breastfeeding?

So yes, I took PQQ from Life Extension, 20 mgs while breastfeeding. I'm not concerned about like small, small amounts of monk fruit and rosemary leaf extract and fish oil. Pure Encapsulations makes a really good, as I mentioned, a good sunflower phosphatidylcholine supplement for pregnancy, I think that, you know, so the 550 milligrams in 2 capsules, I think that it was one capsule was even enough for some of those benefits for cognition in offspring. And for protein powders, I avoided them during pregnancy at the time just because I didn't want to deal with finding reputable sources. And I'm always concerned about contamination with stuff with any type of powder. And so I just decided I was going to get my food and protein and everything from whole foods.

And I think that's the best thing to do during pregnancy because you really want micronutrient and nutrient-dense foods. And you're going to— the best way to get that is not from powders and supplements. It's from foods. It's from whole foods. So I really put a strong emphasis during pregnancy in particular on getting everything from whole foods. And then, of course, taking the omega-3 and vitamin D and prenatal supplement. All right. This will be the last question, and then I have some other ones we're going to start off next talk, next Crowdcast with. Why do you take EPA and DHA separately? Are you worried about AFib, or there's some other rationale or theoretical risk?

The reason I take it is because the supplement that I have, packages— they package them separately, like in a concentrated amount of DHA and EPA. There was one kind of— there's been a couple of little studies that have shown taking them together, you might have— DHA might inhibit some of the benefits of EPA in the brain for depression. I wouldn't be too concerned with that. I think just getting your fish oil, like if you're taking Lovaza, for example, and is a good thing. So there was also a related question about— from Spencer about EPA and DHA impacting sleep. There's been some studies that show DHA improves sleep. So I do take my DHA before— I take my DHA at nighttime and I take my EPA in the morning time.

I did give you guys a list of supplements that were high in EPA and high in DHA that I had kind of put together from the International Fish Oil Standards site. And so I think I would pull from those as well if you're wanting to kind of do something that I do, which is supplement with them separately. But I don't think that's necessary. I think I'm just kind of— again, it's something I'm doing mostly because of the fish oil I take an unusually high dose of fish oil. And, you know, combined, I'm actually getting 6 grams. I know I used to say 4 grams, but it's actually 6 grams because some of the high EPA I take in the morning has DHA in it. And then the high DHA I take in the evening has EPA in it. So I'm actually taking 6 grams of fish oil a day, which is really high.

So if I, you know, if I were to take a brand that had the EPA and DHA all in one, then I would You know, it would be fine. I actually think one of the most important things that I really wasn't aware of until I started doing a lot of research on intestinal permeability and factors that are regulating it, I really think that having omega-3 with every meal can help blunt LPS responses. Really, I do. And so I think that spreading omega-3 doses throughout the day is better than taking one large bolus of it whenever you take your vitamins, whether that's in the morning or the evening. I really am trying to make a big effort now to, you know, I used to take them again morning and evening. I'm also trying to spread out my dose with meals.

So like instead of just taking them in the morning and evening, because I really do think that that helps. And to some degree, just eating food does increase LPS. And it's not— I don't know how bad that is, but I do know this: LPS binds to lipoproteins. It does. It does it. And if you don't ever have small dense LDL proteins, then your LDL will be— the LPS will be recycled back. But nobody has zero small dense LDL lipoproteins. And LPS activates toll-like receptors. Toll-like receptors, I mean, this is like the gateway to inflammaging. It's like the gateway to, you know, the aging of the brain. It is accelerating aging.

And I think that just low, low-dose chronic activation of toll-like receptors, even in the background of healthy people, I think I think that's something that once you've already dialed in everything else, once you've, you know, if you're not obese, you're physically active, you got your muscle protein synthesis dialed, you have all that stuff dialed in, you're getting, you know, you're not eating food 3 hours before you go to bed, so you're having a period of rest for your intestines, all that stuff. I do think that like little things like this, like we could still kind of try to dial in these little last bits and kind of— Um, try to make a big— is it a little— like little differences that we can, right? So, um, with that, I'm gonna say that, uh, this was a really interesting session.

I got sidetracked a little bit talking a lot about muscle protein synthesis. You guys are obviously very interested in that, and so I'm excited that you're going to really enjoy the podcast with Dr. Stuart Phillips coming out within the next month. And I have a lot of good questions that I will start off with next time, and please submit any questions. If you guys did watch my intestinal permeability presentation, if you have any questions about that, submit them in the Crowdcast. I would enjoy answering those next time, and thank you so much for your questions. Kevin's asking about my list of EPA and DHA. Supplements again, that that is something that I will also.

I have a video that that I just am I'm gonna put together probably either this week or next week, and you guys will be the first to see that one. So it's a it's a short little video, and it's a really a short little list on on some of the top supplements. So I'll I'll get that to you guys. I will I will do that. I'll make sure you guys have that. In the meantime, I said Metagenics is a pretty good brand, but that's not separating the 2 EPA and DHA doses. If you really want to do that, then my list will have those. I did separate some of these, some of the high EPA and DHA-containing supplements that are also low in oxidation. You guys are awesome. Thank you so much. My brother-in-law's in town, so I'm going to go enjoy his company before he heads back to Tennessee on Monday. Bye, guys. Thanks so much. Talk to you soon. Bye.