Is Creatine Good For The Brain?

Creatine And Energy Metabolism

Author: Dr. Stephen Chaney

Creatine has developed a reputation as the “go to” supplement for athletes.

  • In a recent survey of NCAA Division I athletes, 48% of male athletes use creatine on a regular basis.
  • Over 80% of professional athletes in power sports like football use it.

But you may have seen recent reports that creatine is also good for the brain. You may be wondering:

  • Are those reports true?
  • If you are not an athlete, should you be taking creatine for a healthy brain?
  • If so, how much should you be taking?
  • Is regular creatine use safe?

I will review a couple of recent studies and answer these questions below. But first, it is time for my favorite topic: Metabolism 101. This week’s Metabolism 101 topic is, “Creatine And Energy Metabolism”.

Metabolism 101: Creatine And Energy Metabolism

Energy Metabolism: Before discussing the role of creatine in the body, I should start at the beginning by describing the basics of energy metabolism in our body. As you have probably heard, ATP is the energy currency of the cell.

Our cells generate energy in two ways:

  • Anaerobic (without oxygen) metabolism can generate ATP quickly but can only sustain high-intensity work for a few minutes.
  • Aerobic (with oxygen) metabolism requires oxygen and organelles called mitochondria to generate ATP. Aerobic metabolism can provide enough ATP to sustain moderate to low intensity work for hours.

Our cells don’t store ATP. They use it as fast as it is produced to:

  • Synthesize protein and many other components of the cell.
  • Synthesize DNA and fuel cell division.
  • Repair and regenerate cell membranes and cellular organelles.
  • Pump nutrients in and out of the cells and transport them to where they are needed within the cell.

And this is just the tip of the iceberg. Thousands of cellular reactions require ATP.

The Role Of Creatine In Cellular Energy Metabolism: Let’s start with the basics:

We can think of creatine as an energy bank.

  • When the cell has plenty of ATP, it makes a deposit into its energy bank by converting creatine into creatine-phosphate.
  • When the cell needs energy quickly it makes a withdrawal from its energy by converting creatine phosphate to creatine and generating ATP.

Creatine is found primarily in high energy tissues (muscle, brain, and testes) – No, I’m not going to talk about creatine and fertility today.

Every time the creatine-creatine-phosphate cycle occurs in high energy tissues, a small amount of creatine is converted to creatinine and filtered through the kidneys. There are two important consequences of this fact:

#1: The faster the phosphocreatine/creatine cycle turns, the more rapidly creatine will be converted to creatinine and drained from the body.

#2: Our body needs to constantly replenish its creatine stores. It does this in two ways:

  • Creatine is synthesized by the liver, kidneys, and pancreas. But it is not stored there. It is released into the bloodstream for use by high energy tissues. It is also synthesized by the brain. But creatine synthesized in the brain can only be used by the brain. It is not released into the bloodstream.
  • Creatine can come from muscle-containing foods – primarily red meat, chicken, and fish. Plant foods provide no creatine.
  • Creatine can also come from supplements – the topic of this article.
  • High-energy tissues have transporters that allow them to take up creatine from the bloodstream.

Creatine plays slightly different roles in muscle and brain.

Creatine Supplementation For Optimizing Muscle Function

Creatine in the muscle is primarily used for high-intensity short duration exercise. In muscle you can think of creatine as being used to “jump-start” high intensity exercise.

  • It takes a few seconds for anaerobic metabolism to go into overdrive. Creatine-phosphate stores fill that gap.
  • Muscle creatine-phosphate stores can fuel high-intensity exercise for 8-15 seconds (average = 10 seconds).

Creatine supplementation is well accepted for sports requiring short, intense bursts of power, speed, and strength, such as football, basketball, hockey, soccer, wrestling, bodybuilding, and sprinting. It is supported by dozens of published clinical studies.

The rationale is not hard to understand.

  • Muscle normally contains enough creatine-phosphate to support around 10 seconds of high-intensity exercise.
  • Creatine-phosphate supplementation increases muscle creatine stores by 20-40%. That supports another 2-4 seconds of exercise.
  • That may not sound like much. But anaerobic metabolism does not kick in until creatine-phosphate stores are exhausted, so the total amount of high-intensity power attained during each rep of a workout is increased by 2-4 seconds.
  • Over a period of weeks or months that extra 2-4 seconds of high intensity exercise during each rep of training translates into real gains in lean muscle mass, muscle strength, and exercise performance.
  • Of course, creatine supplementation provides little benefit for athletes involved in endurance sports.

Here are some other notable points about creatine supplementation for athletes:

  • Creatine supplementation benefits most athletes involved in high-intensity sports, but it appears to be particularly useful for vegans and vegetarians who may not be getting creatine from their diet.
  • Clinical studies and real-life experience have shown that creatine is safe when used properly. (I will discuss mild side effects and cautions below).
  • The doses used most frequently are:
    • Around 20 grams/day for quick results. For optimal absorption, it is best to divide it into 4 daily servings of 5 grams.
    • Around 5 grams/day for maintenance and for general use.
    • The eventual amount of muscle creatine is the same with 20- and 5-gram doses. The only difference is the speed at which optimal creatine levels are attained.
  • Creatine is best utilized when taken with food or smoothies containing both carbohydrate and protein.
  • Adequate hydration is important (more about that below).

Creatine Supplementation And Brain Health

Brain HealthBrain is different from muscle in that it depends on aerobic metabolism and is always using ATP at a high rate. Brain accounts for 20% of our body’s energy demand. In brain we can think of creatine as a buffer or reserve.

  • Brain creatine-phosphate stores are used in situations where the brain needs to increase its energy use over baseline (more about that below).

The initial excitement about creatine supplementation optimizing brain health came from mouse studies. However, we need to remember that mice aren’t humans. In this case the difference is clear.

  • Creatine supplementation increases brain creatine levels by 50% in mice, but only around 5-10% on average in humans.

So, it is not clear whether the results obtained with mice also apply to humans. The results of clinical trials with humans are mixed. They are promising, but not definitive.

Is Creatine Good For The Brain?

To answer that question I will share two recent reports with you as examples of where the creatine and brain health hypothesis stands at present.

Study #1: Creatine Supplementation And Alzheimer’s Disease.

Memory loss due to Dementia and Alzheimer’s disease with the medical icon of a tree in the shape of a human head and brain losing leaves.

This study (AN Smith et al, Alzheimer’s & Dementia, 11270101, 2025) was designed to test the hypothesis that creatine supplementation might be beneficial for Alzheimer’s patients. It was a pilot study – designed to determine whether there was enough evidence to justify a larger clinical trial.

How Was This Study Done? Twenty participants, 60-90 years old (average = 73), were enrolled in this study. They had been previously diagnosed with Alzheimer’s disease and had been taking Alzheimer’s medication for at least 30 days. Each participant had a partner (spouse, family member, or friend) to support them and aid in accurate participation and reporting.

  • Participants consumed 20 grams of creatine, split into two 10-gram doses for 8 weeks.
    • Participants and their partners were given compliance trackers with two boxes to be checked each day to measure adherence to the supplementation protocol. Adherence was 90%.
  • Blood creatine levels were measured at baseline, 4 weeks, and 8 weeks as another measure of adherence.
  • Two measures of cognitive health were administered at baseline and at 8 weeks.
    • MMSE (a 30-item cognitive test).
    • The NIH Toolbox Cognitive Battery, which measures attention, category switching, episodic memory, working memory, speed of processing, written language, and auditory language.
  • Brain creatine levels were measured using nuclear magnetic resonance (NMR) spectroscopic imaging.

What Did The Study Show?Question Mark

  • Participants and their partners reported 13 incidences of mild side effects, which included cramping/muscle pain, diarrhea, constipation, nausea, facial flushing, and sleep disturbances.
  • Blood creatine levels increased 23-fold in 4 weeks and remained elevated at 8 weeks.
  • Brain creatine levels increased by 11% at 8 weeks.
  • When assessed with the NIH Toolbox Cognitive Battery, creatine supplementation (20 grams/day) improved:
    • Total cognition by 4%.
    • Fluid cognition by 7%.
    • List sorting working memory by 11%.
    • Oral reading recognition by 5%.
    • Attention by 7%.
  • There were no significant changes in the 5 other cognition categories in the NIH Toolbox Cognitive Battery.

The authors concluded, “Our study provides the first evidence in humans that creatine supplementation is feasible and may increase brain creatine and offer cognitive benefits to patients with Alzheimer’s Disease.”

These results are preliminary and suggest that future efficacy trials comparing creatine to placebo are needed to generate evidence that can be compared to other Alzheimer’s Disease clinical trials.”

“Should creatine provide benefit, the public health implications may be substantial given Alzheimer’s Disease cases are anticipated to rise and creatine is cost-effective with a good safety profile.”

Why Did I Include This Study? You may be wondering why I included such a preliminary study in my review. The answer is simple: It provides a graphical view of individual variability.

Every study mentions individual variability, but because this study has only 20 participants, the authors were able to graphically show the response of every individual in the study. And the results were informative.

  • In terms of brain creatine levels:
    • Some individuals had increases in the 25-30% range.
    • Others had increases of around 2-5%.
  • Similar variability was seen with each individual measure of cognition.

However, the most interesting result was that several measures of cognition were highly correlated with the changes in brain creatine levels. This suggests that the limiting factor in the brain health benefits of creatine may be the ability of creatine supplementation to influence brain creatine levels.

Study #2: Creatine Supplementation And Brain Health.

This study (H Roschel et al, Nutrients, 13, 586, 2021) is a review of 16 studies looking at the effect of creatine supplementation on various aspects of brain health.

  • All the studies were small.
  • They used different measures of cognitive health.
  • Most of the studies were short (2-15 days).
  • They used different measures of brain creatine levels (Creatine levels vary according to the region of the brain that is scanned).

While emphasizing the weaknesses and inconsistencies of published studies, the authors said:

  • “Creatine supplementation may positively influence some aspects of cognition under stressful conditions such as:
    • Hypoxia (reduced oxygen flow to the brain caused by chronic conditions like atherosclerotic narrowing of the carotid arteries, asthma, and COPD.
    • Sleep deprivation, especially when combined with exercise.”
  • They also discussed the theory that creatine supplementation may be beneficial for conditions associated with reduced brain creatinine levels such as:
    • Alzheimer’s disease, cognitive decline in general, mild traumatic brain injury, and depression.

They put particular emphasis on the potential benefits of creatine supplementation for mild traumatic brain injury, saying:

“Collectively, despite limited data, creatine supplementation seems potentially beneficial in reducing severity of or enhancing recovery from mild traumatic brain injury (mTBI), warranting further studies on its role not only as a post-injury therapy but also as a neuroprotective agent in populations at high risk of mTBI”

“Encouraging supplementation to reduce damage from or enhance recovery from mTBI…would ordinarily be considered premature. However, in this instance, given the devastating effects of mTBI, combined with the large body of safety and efficacy creatine supplementation data, encouraging supplementation for populations who are at high risk for mTBI might be considered more prudent.”

Finally, the authors concluded,

“There is a potential for creatine supplementation to improve cognitive processing, especially in conditions characterized by brain creatine deficits, which could be induced by acute stressors (e.g., exercise, sleep deprivation) or chronic, pathologic conditions (e.g., mTBI, cognitive decline, Alzheimer’s disease, depression).”

What Does This Study Mean For You?

Questioning WomanIf you are interested in creatine to support any kind of high intensity, short duration activity, the data are clear. Creatine supplementation in the 5-20 gm/day range with adequate hydration is both safe and effective.

Creatine offers little benefit for endurance events. But if you engage in any kind of high intensity training to build muscle mass in preparation for endurance events, creatine is likely to be of benefit.

However, we are at the early stages of understanding the effects of creatine supplementation on brain health and cognitive function. Most of the results are promising, but preliminary.

Here is a brief summary:

  • The effectiveness of creatine supplementation at increasing brain creatine levels and improving brain function is highly variable.
    • For some individuals, creatine supplementation results in a 25-30% increase in brain creatine levels. Those individuals are likely to experience brain health benefits.
    • For other individuals, creatine supplementation results in 2-5% increase in brain creatine levels. These individuals may not experience noticeable brain health benefits.
  • These reason for this variability in the effect of creatine supplementation is unknown at present.

This reminds me of my last decade (2002-2012) of cancer research at the University of North Carolina. At the beginning of the decade, here were certain cancer drugs that were considered unproven because their effectiveness was variable. They appeared to help some cancer patients, but were ineffective for others.

The we started to look at the genetic mutations that caused individual cancers. By the end of the decade we had discovered those drugs were amazingly effective for cancers with certain genetic backgrounds. Those drugs went from being “duds” to being “stars”.

Creatine supplementation for brain health is where those cancer drugs were in 2002. Until we can predict which individuals will experience a significant increase in brain creatine levels with supplementation, clinical studies will continue to be inconsistent, and the scientific community will continue to consider creatine supplementation for brain health to be “unproven”.

  • But the good news is that, with adequate hydration, creatine supplementation is safe. So, you can take it for its muscle benefits. And, if you also experience brain health benefits, consider it an added benefit.

And there are certain situations where even the medical profession often recommends creatine supplementation for brain health. For example:

  • Studies suggest that creatine supplementation may improve brain function for people with sleep deprivation, mild traumatic brain injury, cognitive decline, conditions that restrict blood flow to the brain, Alzheimer’s disease, and depression.
    • For example, it is often recommended for mild traumatic brain injury because the health consequences of untreated traumatic brain injury are severe and the risks of creatine supplementation are low.

Finally, the optimal dosage and duration of creatine supplementation for brain health benefits is unknown.

  • Most studies use 20 grams/day divided into two or three smaller doses.
  • But the effect of body weight on dosage recommendations has not been studied. People in the sports medicine field tell me that female gymnasts use significantly less creatine than male football players. If your body weight is low, you might want to aim for 10-15 grams/day.

Creatine Supplementation Cautions 

While the safety of creatine supplementation is well established, there are some cautions you should be aware of:

  • Creatinine, the breakdown product of creatine metabolism, puts some stress on the kidneys.
    • While this is not a problem if your kidneys are healthy, you should consult with your health professional about taking creatine if you have any indications of impaired kidney function.
    • Even if your kidneys are perfectly healthy, creatine supplementation may increase blood creatinine levels. If your health professional is using creatinine levels to measure kidney health, you should let them know that you are supplementing with creatine.
  • Adequate hydration (preferably with water) is important because creatine pulls water with it as it enters your muscle cells.
    • This plumps up your muscles, which is great if you are a body builder.
    • This dehydrates you, which can cause side effects like muscle cramps, headaches, nausea, stomach cramps, and diarrhea.
    • These side effects are usually transitory and can be avoided or reduced by adequate hydration. If symptoms continue despite adequate hydration, you should lower the dose or discontinue creatine supplementation.

The Bottom Line 

If you are interested in creatine to support any kind of high intensity, short duration activity, the data are clear. Creatine supplementation in the 5-20 gm/day range with adequate hydration is both safe and effective.

However, we are at the early stages of understanding the effects of creatine supplementation on brain health and cognitive function. Most of the results are promising, but preliminary.

I discussed two studies on creatine supplementation and brain health in this article. Here is a brief summary of their findings:

  • Creatine supplementation may improve brain function for people with sleep deprivation, mild traumatic brain injury, cognitive decline, conditions that restrict blood flow to the brain, Alzheimer’s disease, and depression).
    • Although the effectiveness of creatine supplementation on brain function is uncertain at present, many experts recommend it if you fall into one of the categories listed above because creatine supplementation has been shown to be safe by decades of sports medicine studies.
  • The effectiveness of creatine supplementation at increasing brain creatine levels and improving brain function is highly variable.
    • For some individuals, creatine supplementation results in a 25-30% increase in brain creatine levels. Those individuals are likely to experience brain health benefits.
    • For other individuals, creatine supplementation results in 2-5% increase in brain creatine levels. These individuals may not experience noticeable brain health benefits.
  • But the good news is that, with adequate hydration, creatine supplementation is safe. So, you can take it for its muscle benefits. And, if you also experience brain health benefits, consider it an added benefit.

For more information on this study, what it means for you, and cautions about using creatine supplements, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

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My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance 

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About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading Biochemistry textbooks for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

Protein – The Longevity Nutrient

How Much Protein Do You Need?

Author: Dr. Stephen Chaney 

breaking newsIn 2016 the New York Times ran an article with the title, “Can You Get Too Much Protein?” The article asserted that most Americans were getting too much protein in their diet and that protein supplements were useless and perhaps dangerous.

At the time I wrote a “Health Tips From the Professor” article summarizing recent research showing that many people needed more than the RDA for protein and that those people were often consuming too little, rather than too much, protein.

In the 9 years since then the evidence that many Americans may not be getting enough protein has only gotten stronger.

  • The standard for protein intake used to be a “one size fits all” recommendation of 46g gm/day for women and 56 gm/day for men with slight increases recommended for pregnant and lactating women. Today we know:
    • That standard was based on outdated methodology from the 1930’s. Recent studies suggest protein intake should be at least 50% higher.
    • That standard was based on studies with healthy, sedentary adults (the adult “couch potato” crowd). Protein requirements are significantly higher for anyone who doesn’t fit that description.
  • We used to think in terms of total daily protein intake. Today we know that:
    • Protein intake should be divided equally between the 3 primary meals.
    • Protein quality is important. Protein requirements should be increased if low-quality proteins are consumed.
  • We used to worry that high protein intake might damage your kidneys. Today we know that:
    • Protein intake does not cause kidney disease. It is not a concern as long as hydration is adequate and excess alcohol is avoided.
    • Protein intake is only a concern if someone has kidney disease.

Protein – Your Longevity Nutrient

If you want to delve into the latest protein research and what it means for you, I highly recommend the book, “Forever Strong: A New, Science-Based Strategy For Aging Well” by Dr. Gabrielle Lyon.

Her book is focused on helping each of us create adequate healthy muscle mass. She says, “Adequate muscle mass is essential for health and longevity. And muscle is the only organ over which we have voluntary and complete control.”

Of course, adequate muscle mass requires both exercise and adequate protein. Dr. Lyon covers both in her book, but exercise is not my expertise, so I will only cover adequate protein intake in this “Health Tips From the Professor” article.

In her book, Dr. Lyons details recent research on the amount of protein needed to optimize muscle mass. Dr. Lyon was the one who alerted me to the fact that the current protein RDA is based on outdated methodology from the 1930’s and that actual protein needs are much higher.

Dr. Lyon concludes that most Americans are not consuming enough protein to optimize their muscle mass and that adequate protein intake is essential for longevity, metabolic function, and quality of life. Specifically, she says that optimal muscle mass:

  • Improves strength and mobility.
  • Improves blood sugar control.
  • Decreases blood triglyceride levels.
  • Strengthens the immune system.
  • Improves bone mineral density and strength.
  • Reduces all-cause mortality (risk of dying) and morbidity (risk of disease).

I will use the latest science on protein needs described in her book and in recently published clinical studies to answer the important question, “How much protein do you need?” But first I want to help you understand the dynamics of protein metabolism.

The Dynamics Of Protein Metabolism 

ProfessorMost people associate muscle mass with strength and endurance. Many understand the important role muscle mass plays in burning off excess calories and keeping us slim. But few people understand the important role that muscle protein plays in our everyday energy metabolism.

Whenever we eat a meal containing protein, we store some of the protein we eat as increased muscle mass, especially when protein intake is coupled with exercise. But muscle protein plays other very important functions. It is a precious resource.

The synthesis of new muscle in the fed state is driven by:

  • Insulin, which is released into the blood stream whenever we eat a meal.
  • Exercise because it makes muscle more sensitive to the effects of insulin.
  • The amino acid leucine, which is most abundant in high quality protein sources.

In the fed state most of our energy is derived from blood glucose. This is primarily controlled by insulin.  As blood glucose levels fall, we move to the fasting state and start to call on our stored energy sources to keep our body functioning. This process is primarily controlled by a hormone called glucagon.

  • In the fasting state most tissues easily switch to using fat as their main energy source, but…
    • Red blood cells and a few other tissues in the body are totally dependent on glucose as an energy source.
    • Our brain is normally dependent on glucose as an energy source, and our brains use a lot of energy. [Note: Our brain can switch to ketones as an energy source with prolonged starvation or prolonged carbohydrate restriction, but that’s another story for another day.]
  • Because our brain and other tissues need glucose in the fasting state, it is important to maintain a constant blood glucose level between meals.
    • Initially, blood glucose levels are maintained by calling on carbohydrate reserves in the liver.
    • But because those reserves are limited, our body starts to break down muscle protein and convert it to glucose as well – even in the normal dinner/sleep/breakfast cycle.

Simply put, in addition to its other important roles in the body, muscle protein is also an energy store. You can think of it like a bank.

When we eat, we make a deposit to that energy store. Between meals we make a withdrawal from that energy store. When we are young the system works perfectly. Unless we fast for prolonged periods of time, we are always adding enough muscle protein in the fed state to balance out the withdrawals between meals.

But there are many physiological situations where protein metabolism becomes unbalanced, either because protein breakdown is accelerated or because protein synthesis is diminished. In each of those situations, our protein needs are increased.

I will describe each of these situations and how they affect our protein needs in the section below.

How Much Protein Do You Need? 

couch potatoThe Coach Potato Group: If this is you, I won’t be judgmental. But I highly recommend you read Dr. Lyon’s book. It may just inspire you to increase your fitness level and your protein intake.

As I said before the standard RDA recommendation for the coach potato group is 46 gm/day for women and 56 gm/day for men. That’s based on 0.36 grams of protein per pound of body weight and assumes that women weigh around 127 pounds and men weigh around 155 pounds.

There are two major problems with the standard protein RDAs:

1) The protein RDA should not be a “one-size-fits-all” recommendation. The standard used to calculate the RDA is based on weight. If you are a woman weighing 127 pounds or a man weighing 155 pounds, you are to be congratulated. But in today’s world the average woman weighs 170 pounds, and the average man weighs 201 pounds.

  • That means the average protein requirement should be 61 gm/day for women and 72 gm/day for men.
  • And that’s just the average. Your protein requirement is based on your weight.

2) As I mentioned earlier, the 0.36 gm/pound standard is based on outdated methodology from the 1930’s. Based on current technology, Dr. Lyon says the standard should be closer to 0.54 gm/pound.

  • If you use that standard and use the current average weight for men and women, the average protein requirement for the couch potato group is closer to 91.5 gm/day for women and 108 gm/day for men.
  • And since protein intake should be divided equally between meals, that amounts to 30 gm/meal for women and 36 gm/meal for men. If you weigh significantly more or less than the average American, you should adjust your intake accordingly.

The Over 50 Group: When we are young muscle protein deposits in the fed state and muscle protein withdrawals during the fasting state are in balance. And if we add exercise and increase our protein intake, it’s pretty easy to increase our muscle mass.

But once we reach our Golden Years things start to change. Muscle protein synthesis becomes less efficient. We need to increase the intensity of our workouts and increase our protein intake just to maintain our muscle mass.

If we fail to do that, we gradually lose muscle mass as we age, a process referred to as sarcopenia. Between 50 and 60 we lose 5-8% of our muscle mass, and the rate that we lose muscle accelerates with each subsequent decade. And that loss of muscle mass has severe consequences. For example:

  • It interferes with daily activities like playing with our grandchildren and engaging in activities we love.
  • It decreases our metabolic rate which increases our risk of obesity and obesity-related diseases.
  • It increases our risk of falls.

In short, our quality of life is diminished, and we become unhealthy and frail.

Dr. Lyon describes the training program needed to prevent sarcopenia as we age in her book Forever Strong. But we also need more protein.

On average older adults need around 35 – 45 gm of protein per meal to prevent sarcopenia. There are not enough published studies for me to provide more specific recommendations. But here are some guidelines:

  • If you are at ideal weight and in your 50’s or 60’s, you can probably do well at the lower end of the range.
  • If you are overweight or in your 70’s or 80’s, you should probably aim for the upper end of the range.
  • I recommend getting a body composition test on an annual basis and adjusting your exercise and protein intake based on your change in muscle mass. My doctor has a simple device for measuring my body composition as part of my annual physical. If your doctor doesn’t have a device like that, find out who does in your community.

Happy woman on scaleThe Weight Loss Group: If you are actively trying to lose excess weight, I congratulate you. But the sad fact is that up to 35% of weight loss on most diets comes from muscle, not fat.

That’s because your body interprets caloric restriction as starvation and increases the rate of protein breakdown.

But you can prevent that by adding resistance training to your diet plan and increasing your protein intake. By increasing your protein intake from 15% of calories (which is what most Americans get) to 30% of calories, you can rebalance muscle metabolism by increasing muscle protein synthesis. When you do this, you can reduce muscle loss to less than 10% of weight loss.

You may be wondering, “Why set the recommendation as a percentage of calories rather than gm/pound or gm/meal”. The answer is simple. Your caloric intake changes significantly you are on a diet, so expressing protein as a percentage of calories makes more sense.

For example, 30% of calories on a 1,000-calorie diet translates into 25-30 gm/meal. You might look at that recommendation and say, “That’s less than you recommended for the couch potato who is not trying to lose weight.” My answer would be, “Yes, but the couch potato is eating 2-3-times more calories.

So, the recommendation that’s easiest to understand if you are trying to lose weight is to aim for 25-30 gm of protein/meal/1,000 calories per day.  

  • Adjust your protein intake per meal based on the daily calories allowed on your diet. 
  • And if you are on a diet that restricts the kinds of food that you can eat or the amount of time you can eat, track your actual caloric intake for a few days. The “hidden secret” behind those diets is that most people eat fewer calories because of the restrictions.

Final thought: The latest data suggest that GLP-1 drugs accelerate the muscle loss associated with dieting. This is a significant concern, especially for people over 50. Some experts are recommending as much as 35-50 gm of protein/meal if you are using a GLP-1 drug to aid your weight loss.

Weight TrainingThe Fitness Group: The question I get most often from the fitness group is, “How much protein do I need after my workout to maximize recovery and muscle gain?” This has been well researched, and the answer is age dependent.

  • If you are in your 30’s, most experts recommend 15-20 grams of protein after your workout.
  • If you are in your 60s, most experts recommend 30-35 grams of protein after your workout.
  • While precise recommendations are not available for every age, you can extrapolate from these numbers.

Does Protein Quality Matter? 

I’m often asked whether all proteins are equally effective at building muscle mass or does protein quality matter? The answer is, “Yes. Protein quality matters, but not in the way that we have thought about it in the past.”

We used to think that protein quality was measured by the balance of all the essential amino acids. While balance is important, the increase in muscle mass is driven primarily by the amino acid leucine. That’s because leucine is the only amino acid that directly stimulates muscle protein synthesis.

Simply put, proteins that are high in leucine are used more efficiently by our bodies to increase muscle mass. In fact, Dr. Lyon measures protein quality solely based on its leucine content.

Many studies have looked at the optimal amount of leucine content in protein. The numbers vary somewhat from study to study, but they average around 1 gram of leucine for every 10 grams of protein.

If you look at the leucine contents of various proteins, it is clear that a 1:10 ratio is primarily found in animal proteins. Soybeans are the only vegetable protein source that comes close.However, there are many health reasons for consuming a primarily plant-based diet. Dr. Lyon doesn’t tell her patients to avoid plant proteins. But if they are consuming primarily plant proteins, she recommends that they increase their protein intake by 35-45%, so they will be getting enough leucine to maximize muscle protein synthesis.

What Role Do Protein Supplements Play? 

Protein SupplementRemember that New York Times article that said protein supplements were useless and perhaps dangerous? That’s outdated advice. In fact, you should view protein supplements as essential for reaching your protein goals.

That’s because our protein intake needs to be divided equally between our 3 major meals, but that’s not how we eat. Most of us have no trouble getting 30-40 grams of protein at dinner, but…

  • We only get around 15 grams of protein at breakfast, and…
  • 15-20 grams of protein at lunch.

But that’s assuming we eat a typical breakfast or lunch. If we eat…

  • An unhealthy breakfast of croissants and coffee or a healthy breakfast of cornflakes, skim milk, and fruit slices, we only get around 6 grams of protein.
  • A healthy green salad for lunch, we may get as little as 2 grams of protein.

A recent study has shown that adding a protein supplement to your low protein meals can help you increase your muscle mass in as little as 24 weeks.

What Does This Mean For You? 

how much protein do athletes needProtein is your longevity nutrient. My advice is:

  • Use the information in this article to set your protein goals (Talk with your doctor first if you have any health issues that may limit your protein intake).
  • Use a simple protein tracker to identify your low-protein meals.
  • Add additional protein foods or supplements to your low-protein meals to bring your protein up to recommended levels.
  • Focus on high-leucine protein foods and supplements. (If you eat more plant protein than animal protein, as I do, increase your recommended protein intake by 35-45% to make sure you are getting the leucine you need to maximize your muscle mass.)

As for what kind of protein supplement, I recommend a plant protein supplement with added leucine.

The Bottom Line 

In her book, “Forever Strong”, Dr. Gabrielle Lyon says, “Adequate muscle mass is essential for health and longevity. And muscle is the only organ over which we have voluntary and complete control.” She goes on to state that the current RDAs for protein intake are outdated. And if we look at protein needs based on the latest research, most Americans aren’t getting enough protein in their diet to achieve adequate muscle mass.

In this article, I summarize her findings. And based on the latest research, I provide protein intake recommendations for:

  • Adult couch potatoes.
  • Fitness enthusiasts.
  • People over 50.
  • People who are trying to lose weight.

I also discuss protein quality and protein supplements.

For more information on these topics and what they mean for you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

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About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

Are High Protein Diets Your Secret To Successful Weight Loss?

Do High Protein Diets Reduce Fat And Preserve Muscle?

Author: Dr. Stephen Chaney

Healthy Diet food group, proteins, include meat (chicken or turkAre high protein diets your secret to healthy weight loss? There are lots of diets out there – high fat, low fat, Paleolithic, blood type, exotic juices, magic pills and potions. But recently, high protein diets are getting a lot of press. The word is that they preserve muscle mass and preferentially decrease fat mass.

If high protein diets actually did that, it would be huge because:

  • It’s the fat – not the pounds – that causes most of the health problems.
  • Muscle burns more calories than fat, so preserving muscle mass helps keep your metabolic rate high without dangerous herbs or stimulants – and keeping your metabolic rate high helps prevent both the plateau and yo-yo (weight regain) characteristic of so many diets.
  • When you lose fat and retain muscle you are reshaping your body – and that’s why most people are dieting to begin with.

So let’s look more carefully at the recent study that has been generating all the headlines (Pasiakos et al, The FASEB Journal, 27: 3837-3847, 2013).

The Study Design:

This was a randomized control study with 39 young (21), healthy and fit men and women who were only borderline overweight (BMI = 25). These volunteers were put on a 21 day weight loss program in which calories were reduced by 30% and exercise was increased by 10%. They were divided into 3 groups:

  • One group was assigned a diet containing the RDA for protein (about 14% of calories in this study design).
  • The second group’s diet contained 2X the RDA for protein (28% of calories)
  • The third group’s diet contained 3X the RDA for protein (42% of calories)

In the RDA protein group carbohydrate was 56% of calories, and fat was 30% of calories. In the other two groups the carbohydrate and fat content of the diets was decreased proportionally.

Feet_On_ScaleWhat Did The Study Show?

  • Weight loss (7 pounds in 21 days) was the same on all 3 diets.
  • The high protein (28% and 42%) diets caused almost 2X more fat loss (5 pounds versus 2.8 pounds) than the diet supplying the RDA amount of protein.
  • The high protein (28% and 42%) diets caused 2X less muscle loss (2.1 pounds versus 4.2 pounds) than the diet supplying the RDA amount of protein.
  • In case you didn’t notice, there was no difference in overall results between the 28% (2X the RDA) and 42% (3X the RDA) diets.

Pros And Cons Of The Study:

  • The con is fairly obvious. The participants in this study were all young, healthy and were not seriously overweight. If this were the only study of this type one might seriously question whether the results were applicable to middle aged, overweight coach potatoes. However, there have been several other studies with older, more overweight volunteers that have come to the same conclusion – namely that high protein diets preserve muscle mass and enhance fat loss.
  • The value of this study is that it defines for the first time the upper limit for how much protein is required to preserve muscle mass in a weight loss regimen. 28% of calories is sufficient, and there appear to be no benefit from increasing protein further. I would add the caveat that there are studies suggesting that protein requirements for preserving muscle mass may be greater in adults 50 and older.

The Bottom Line:

1)    Forget the high fat diets, low fat diets, pills and potions. High protein diets (~2X the RDA or 28% of calories) do appear to be the safest, most effective way to preserve muscle mass and enhance fat loss in a weight loss regimen.

2)     That’s not a lot of protein, by the way. The average American consumes almost 2X the RDA for protein on a daily basis. However, it is significantly more protein than the average American consumes when they are trying to lose weight. Salads and carrot sticks are great diet foods, but they don’t contain much protein.

3)     Higher protein intake does not appear to offer any additional benefit – at least in young adults.

4)     Not all high protein diets are created equal. What some people call high protein diets are laden with saturated fats or devoid of carbohydrate. The diet in this study, which is what I recommend, had 43% healthy carbohydrates and 30% healthy fats.

5)    These diets were designed to give 7 pounds of weight loss in 21 days – which is what the experts recommend. There are diets out there promising faster weight loss but they severely restrict calories and/or rely heavily on stimulants, they do not preserve muscle mass, and they often are not safe. In addition they are usually temporary.  I do not recommend them.

6)    This level of protein intake is safe for almost everyone. The major exception would be people with kidney disease, who should always check with their doctor before increasing protein intake. The only other caveat is that protein metabolism creates a lot of nitrogenous waste, so you should drink plenty of water to flush that waste out of your system. But, water is always a good idea.

7)     The high protein diets minimized, but did not completely prevent, muscle loss. Other studies suggest that adding the amino acid leucine to a high protein diet can give 100% retention of muscle mass in a weight loss regimen – but that’s another story for another day.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Health Tips From The Professor