#369 ‒ Rethinking protein needs for performance, muscle preservation, and longevity, and the mental and physical benefits of creatine supplementation and sauna use | Rhonda Patrick, Ph.D.
In this episode of The Peter Attia Drive, Peter Attia and Rhonda Patrick address protein requirements for health and performance, challenging the standard recommended daily allowance. The hosts discuss how aging affects protein utilization and explain why many people, particularly older adults and those who are less active, may need to increase their protein intake beyond conventional guidelines.
The conversation also explores two additional topics relevant to physical and mental well-being: creatine supplementation and sauna use. Patrick and Attia examine creatine's role in muscle function and cognition, along with proper dosing strategies. They also detail the cardiovascular and neuroprotective benefits of regular sauna sessions, including the relationship between different sauna types, temperatures, and health outcomes.
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Protein Requirements and Importance For Health and Performance
In their discussion, Peter Attia and Rhonda Patrick challenge traditional protein recommendations, suggesting that the current RDA of 0.8g/kg/day is insufficient. Patrick explains that the nitrogen balance studies used to determine these requirements are flawed, and more accurate studies indicate higher protein needs. They recommend at least 1.2g/kg/day, with Attia personally aiming for 2g/kg/day to ensure adequate intake.
The hosts emphasize that aging and inactivity increase "anabolic resistance" - the body's reduced sensitivity to amino acids. Patrick notes that older adults may need twice the protein to achieve the same muscle synthesis as younger individuals. However, Attia points out that regular resistance training can help offset this age-related resistance.
Creatine Supplementation For Muscle, Strength, and Cognitive Function
Patrick explains that creatine plays a crucial role in recycling ATP during exercise, recommending 5 grams daily to saturate muscle stores. For cognitive benefits, she suggests higher doses of 10-20 grams may be necessary, particularly during periods of stress or sleep deprivation.
The hosts emphasize the importance of using NSF-certified pure creatine monohydrate, with Patrick noting that third-party testing has revealed quality issues in some products. They identify vegetarians, older adults, and young athletes as populations that might particularly benefit from supplementation.
Sauna Use: Cardiovascular and Neuroprotective Benefits
Patrick describes how sauna use can mimic moderate cardiovascular exercise, with studies showing improved VO2 max when combined with endurance training. Attia highlights research indicating reduced risks of cardiovascular disease and dementia among regular sauna users.
The conversation turns to heat shock proteins, which Patrick explains are activated during sauna use and help prevent protein misfolding associated with neurodegenerative diseases. However, they caution against extremely high temperatures, with Patrick noting that sauna temperatures above 200°F may actually increase dementia risk. They also discuss how infrared saunas might require longer sessions to achieve the same benefits as traditional saunas.
1-Page Summary
Additional Materials
Counterarguments
- The recommendation of at least 1.2g/kg/day of protein may not be necessary for all individuals, as protein needs can vary based on a person's age, sex, physical activity level, and overall health.
- Some research suggests that excessive protein intake can lead to kidney strain in individuals with pre-existing kidney conditions, though this is not a concern for healthy individuals.
- The efficacy and safety of high creatine doses (10-20 grams) for cognitive benefits are not well-established, and such high doses may not be necessary or beneficial for all individuals.
- The recommendation for NSF-certified pure creatine monohydrate overlooks the fact that other forms of creatine, such as creatine hydrochloride, may also be effective and have different absorption rates or effects.
- While sauna use has been associated with various health benefits, it is not a substitute for cardiovascular exercise and should not replace regular physical activity.
- The benefits of sauna use, particularly in relation to cardiovascular health and neuroprotection, may not be as significant for individuals who already lead a healthy lifestyle with regular exercise and a balanced diet.
- The claim that extremely high sauna temperatures may increase dementia risk is not widely supported by evidence, and more research is needed to establish a direct causal relationship.
- Infrared saunas may offer different benefits compared to traditional saunas, and some individuals may prefer them due to the ability to tolerate longer sessions at lower temperatures.
Actionables
- You can track your protein intake using a food diary app to ensure you're meeting the suggested 1.2g/kg/day target, adjusting as needed if you're older or less active to account for anabolic resistance. By logging your meals, you'll be able to see if you're consistently hitting your protein goals and make dietary adjustments, such as incorporating more lean meats, dairy, or plant-based proteins like lentils and chickpeas.
- Incorporate a mix of resistance training exercises into your weekly routine to combat age-related anabolic resistance, even if it's just bodyweight exercises like push-ups, squats, and lunges at home. This habit not only supports muscle synthesis but also can improve overall strength and mobility, which is beneficial at any age.
- Experiment with integrating sauna sessions into your weekly schedule, starting with shorter durations and gradually increasing as you become more comfortable, to potentially reap cardiovascular and neuroprotective benefits. If you don't have access to a traditional sauna, consider visiting local gyms or spas that offer sauna facilities, ensuring you stay hydrated and listen to your body to avoid overheating.
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Protein Requirements and Importance For Health and Performance
Peter Attia explores the importance of adequate protein intake for health and performance, highlighting its role in achieving body recomposition goals and the flaws in using traditional protein RDA values.
Increase Rda For Protein By 50% to Prevent Negative Balance
Flaws In Using Nitrogen Balance Studies For Rda Determination
Rhonda Patrick critiques the standard use of nitrogen balance studies for determining the Recommended Dietary Allowance (RDA) for protein. These studies measure nitrogen excretion in urine but are flawed due to the varied nitrogen-to-protein ratios in different foods and the incomplete collection of urine which affects the accuracy of the studies. Additionally, nitrogen is lost through means other than urine, compromising the accuracy of the result. She also mentions more accurate methods like stable isotope tracer studies using L13 carbon labeling phenylalanine that measure metabolized tracer oxidation through breath, highlighting that the current RDA underestimates the actual protein requirements.
Protein Need: 1.2g/Kg/Day for Positive Balance
The hosts suggest that everyone should consume at least 1.2 grams of protein per kilogram per day to maintain a positive nitrogen balance, with the implication being that this surpasses the flawed RDA point of 0.8 grams per kilogram. Attia personally strives for two grams per kilogram per day to ensure that even on days when he falls short, he exceeds a positive balance threshold. Rhonda Patrick endorses the higher RDA, adding that conditions like energy deficits from training or simultaneous fat loss and muscle gain require considerable protein intake.
Age and Inactivity Increase Anabolic Resistance; Protein Intake Crucial
Aging Reduces Muscle Sensitivity to Amino Acids, Needing More Protein For the Same Synthesis
Anabolic resistance, the reduced sensitivity of muscle to amino acids, is more pronounced in older adults, necessitating a higher protein intake to achieve the same muscle protein synthesis as younger people. Rhonda Patrick explains that older adults may need up to twice the protein amount due to this resistance, which is particularly problematic during periods of inactivity such as post-surgery or illness. This suggests that not only age but also physical inactivity can exacerbate the body's need for protein.
Regular Resistance Training Can Offset Age-related Anabolic Resistance
Resistance training can mitigate anabolic resistance, according to Peter Attia, who mentions research showing how regular activity can maintain normal muscle protein synthesis rates and prevent significant anabolic resistance. Rhonda Patrick adds that exercise can counteract anabolic resistance by increasing the uptake of branched-chain amino acids like leucine into skeletal muscle, which activates muscle protein synthesis. This highlights that resis ...
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Protein Requirements and Importance For Health and Performance
Additional Materials
Counterarguments
- The recommendation of 1.2g/kg/day of protein may not be suitable for everyone, as individual needs can vary based on factors like genetics, metabolism, and overall health.
- Some studies suggest that excessive protein intake could potentially lead to kidney strain in individuals with pre-existing kidney conditions, though this is debated and may not apply to healthy individuals.
- The environmental impact of high-protein diets, particularly those reliant on animal sources, could be a concern, and alternative viewpoints might emphasize the need for sustainable protein sources.
- The role of protein in preventing frailty and sarcopenia is important, but it's also essential to consider the balance of other nutrients and overall diet quality.
- There may be differing opinions on the degree to which resistance training can offset anabolic resistance, with some arguing that while it helps, it may not fully counteract age-related muscle loss.
- The concept of "banking" muscle could be challenged by the idea that maintaining muscle mass is not only about early life preparation but also about continuous adaptation and lifestyle choices throughout one's life.
- The emphasis on protein might overshadow the importance of other factors in muscle health, such as hormonal balance, sleep, and overall lifestyle.
- The assertion that ...
Actionables
- You can track your daily protein intake using a food diary app to ensure you're meeting the recommended 1.2g/kg/day. Start by calculating your weight in kilograms, then log every meal and snack you consume. The app will tally your protein intake, and you can adjust your diet accordingly to hit your target.
- Incorporate a "protein audit" in your weekly meal planning by reviewing the protein content of your usual grocery items. Swap out lower-protein options for higher-protein alternatives, such as choosing Greek yogurt over regular yogurt or adding a scoop of protein powder to your morning smoothie.
- Engage in a "resistance training challenge" with friends or family to ...
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Creatine Supplementation For Muscle, Strength, and Cognitive Function
Peter Attia and Rhonda Patrick delve into the multifaceted benefits of creatine supplementation on muscle, strength, and cognitive function, suggesting recent insights that could influence its use.
Creatine Enhances Exercise Performance By Supporting Atp Recycling
Creatine serves a critical role in exercise performance, particularly in high-intensity and endurance training.
Creatine Recycles Atp in Muscles During Exercise
Rhonda Patrick explains that creatine, stored in skeletal muscle as creatine phosphate, recycles ATP, the major energy currency in cells. This is particularly helpful for workouts as it rapidly revitalizes ATP, enabling shorter recovery times and improved performance.
5 Grams Daily Saturates Muscle Creatine Stores
Rhonda Patrick recommends a daily intake of 5 grams to saturate muscle tissue with creatine, a process she says takes about a month if done consistently. Peter Attia echoes this, stating that taking five grams daily without a loading phase should suffice in maximizing muscle creatine stores. Patrick adds that at this dosage, creatine is predominantly consumed by the muscles.
Creatine May Improve Cognition Under Stress or Impairment
Discussion turns to the benefits of creatine on cognitive functions, such as speed and memory, especially under stress or impairment.
10-20 Grams Daily May Boost Brain Creatine
Rhonda Patrick expresses interest in the cognitive benefits of creatine, sharing that higher doses may be needed to enhance brain levels. She mentions that a daily dosage of 10 grams is not rate limited and can increase brain creatine levels. She suggests that individuals may need to double their intake from five grams to 10 grams for it to impact the brain. This is supported by studies where sleep-deprived individuals improved cognitive speed beyond baseline when administered creatine on a per-kilogram body weight basis, amounting to around 20 to 25 grams.
Creatine Enhances Cognitive Speed, Memory, and Function During Sleep Deprivation or Aging
Patrick notes improvements in cognitive processing speed and memory in studies of sleep-deprived subjects and Alzheimer's patients using 20 grams of creatine. She reports experiencing reduced afternoon sleepiness and improved cognitive function during periods of sleep disruption, such as after traveling between time zones.
Cr ...
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Creatine Supplementation For Muscle, Strength, and Cognitive Function
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Counterarguments
- Creatine may not be as effective for everyone, as individual responses to supplementation can vary.
- The recommendation of 5 grams daily to saturate muscle creatine stores is a general guideline, and some individuals may require more or less depending on factors like muscle mass, diet, and activity level.
- While higher doses of creatine may improve brain creatine levels, there is still ongoing research needed to fully understand the long-term effects of high-dose creatine supplementation on cognitive function.
- The benefits of creatine on cognitive function during sleep deprivation or aging may not be as significant for individuals who are not experiencing these conditions.
- The safety profile of creatine is well-established, but there may be rare cases or specific conditions where creatine supplementation could be contraindicated.
- The assertion that vegetarians, older adults, and young athletes might need at least 10 grams of c ...
Actionables
- You can track your cognitive and physical performance before and after starting creatine supplementation to see the effects firsthand. Start by establishing a baseline of your current cognitive abilities and physical performance through tests like online brain games, memory quizzes, and time trials in your preferred sport. After a month of consistent creatine intake, retake the tests to compare results and assess any improvements in speed, memory, and endurance.
- Incorporate creatine into your pre-sleep routine if you frequently experience sleep deprivation. Prepare a small, easy-to-consume snack or beverage that includes your creatine dose and take it shortly before bedtime. Over several weeks, note any changes in your cognitive function upon waking, such as feeling more alert or having improved recall of your dreams, which can be indicative of better sleep quality.
- If you're a vegetarian or older adult, consider pairing creatine with other supplements or ...
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Sauna Use: Cardiovascular and Neuroprotective Benefits
Peter Attia explores the nuances of sauna use with Rhonda Patrick, touching on the potential cardiovascular and neuroprotective benefits. Their discussion highlights physiological mechanisms similar to moderate-intensity exercise and the activation of protective proteins.
Sauna Elicits Cardiovascular Adaptations Similar to Moderate Exercise
Rhonda Patrick explains how deliberate heat exposure from a sauna can mimic some aspects of moderate cardiovascular exercise. Intervention studies show that VO2 max improvements are greater in individuals who include sauna sessions after endurance training on a stationary cycle. In addition to enhanced fitness, sauna use is associated with reduced risks of dementia and cardiovascular disease.
Sauna Use: Boosted Heart Rate and Fitness
Using a sauna boosts the heart rate, similar to moderate exercise, which can contribute to overall cardiovascular fitness. The persistent rise in heart rate during a sauna session may contribute to the cardiovascular benefits seen in sauna users.
Sauna May Lower Cardiovascular and Dementia Risk
Sauna use may lower the risk of cardiovascular disease and especially dementia, Peter Attia emphasizes. Regular sauna users have been shown to have a lower incidence of these health issues compared to non-users.
Sauna-Induced Heat Stress Activates Protective Heat Shock Proteins
Sauna-induced heat stress initiates a response in the body that activates protective heat shock proteins, which are essential in preventing protein misfolding and aggregation—an underlying mechanism in several neurodegenerative diseases.
Heat Shock Proteins Prevent Misfolding In Neurodegenerative Diseases
Rhonda Patrick describes how heat shock proteins are vital for maintaining proper protein structure and function, thereby providing a line of defense against neurodegenerative diseases like Alzheimer's. Animal studies support this, demonstrating these proteins' ability to prevent amyloid-beta aggregation and associated muscle paralysis.
Neuroprotective Effects of Sauna Persist Post-Exposure
The neuroprotective effects of sauna use continue even after the sauna session has ended. Heat shock proteins remain elevated, improving overall protein folding and extending the benefits beyond the time of heat exposure.
Infrared Saunas May Take Longer For Benefits Than Traditional Saunas
Infrared saunas, while beneficial, may require longer sessions to achieve the same level of core temperature increase and ca ...
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Sauna Use: Cardiovascular and Neuroprotective Benefits
Additional Materials
Counterarguments
- Sauna use may not be suitable for everyone, especially those with certain cardiovascular conditions, and may not be a safe alternative to exercise for these individuals.
- The improvements in VO2 max from sauna use may not translate to improved performance in all types of physical activities or sports.
- The association between sauna use and reduced risks of dementia and cardiovascular disease may be confounded by other lifestyle factors common among sauna users.
- The cardiovascular adaptations from sauna use may not be as comprehensive as those from dynamic exercise, which involves multiple muscle groups and joint movements.
- The evidence for sauna use lowering dementia risk is primarily observational, and causation cannot be established without randomized controlled trials.
- The role of heat shock proteins in human neurodegenerative diseases is complex, and sauna use alone may not significantly alter the course of these diseases.
- The long-term effects of regular sauna use on cardiovascular health and neuroprotection are not fully understood, and more research is needed.
- Infrared saunas may not provide the same level of cardiovascul ...
Actionables
- You can integrate sauna sessions into your workout routine by scheduling them immediately after your exercise to enhance cardiovascular benefits. Think of it as a cool-down phase that continues to work your heart in a different way. For example, after a 30-minute jog, spend 15 minutes in a sauna to keep your heart rate elevated in a controlled environment.
- Create a sauna schedule that avoids extreme temperatures by limiting your sauna use to environments below 200°F. Use a simple thermometer to ensure the sauna you're using is within a safe temperature range. This way, you're reaping the benefits without increasing your risk for dementia.
- Combine ...
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