Recently an article got everyone's knickers in a twist about protein and CVD. Here's an easy to read summary of the paper with my pictorial essay medicalnewstoday.com/articles/eatin… Note: this is a conclusion from mice only... it's translation to humans... 🧐

Metformin blunts muscle hypertrophy in response to progressive resistance exercise training in older adults

Just about everything is worse with metformin ncbi.nlm.nih.gov/pmc/articles/P…
This was the original stated purpose "there are several innovative features of the proposed experiments that are expected to significantly advance the field and improve muscle regrowth and mobility, with the overall goal of reducing risk of disability among older adults.

What makes you big and strong? @MACleod_JC & @brad_currier

A 🧵

Free paper, free download...



But complicated I'll admit, so what does it mean?bjsm.bmj.com/content/57/18/… Pairwise meta-analyses compare one condition with another to determine which variable is best/better for an outcome. But what if you have multiple variables to manipulate? Like resistance exercise!

What is the ‘best’ prescription for resistance training (RT) a 🧵

Some folks think we’ve figured it all out, but have we? Others would say there are an infinite number of combinations, kind of like toppings and combinations, at a famous sandwich shop! Does all or any of this really matter when it comes to developing strength and muscle growth (hypertrophy)?

In our recent work (), we attempted to define a prescription for resistance training (RT) instead of what’s done in abjsm.bmj.com/content/early/…

Protein... a 🧵

A key point that it seems even those that 'study' in this area is to recognize is that a requirement for a nutrient may not be a level at which optimal function is achieved. The processes of adaptation and accommodation pubmed.ncbi.nlm.nih.gov/3958814/ seem to have been forgotten or not taught at all. There is a fascination with the ‘elegance’ of balance studies with little-to-no appreciation of all the flaws. pubmed.ncbi.nlm.nih.gov/2750699/ Flaws that in other areas would render the data next to useless!

@Theresa_Furey @maxlugavere @McgrawRhiannon No evidence that higher protein causes declines in renal function pubmed.ncbi.nlm.nih.gov/30383278/ pubmed.ncbi.nlm.nih.gov/30032227/ @Theresa_Furey @maxlugavere @McgrawRhiannon Or if you’d prefer a Mendelian randomization study pubmed.ncbi.nlm.nih.gov/33564816/. A desirable macronutrient composition, including high relative protein intake and low relative fat intake, may causally reduce the risk of CKD in the general population.

How much brotein do I need? A 🧵

Per meal protein doses to 'optimize' anabolism? Aka, "how much protein should I eat?" I think it's pretty clear that 20g does the job (1). The incremental rise in MPS from 20-40g was 14% (using egg protein in young men after an intense leg workout). Witard et al. (2), once again, 20g gets the job done (whey protein and leg exercises only). In that study going from 20-40g gets you an extra 16% in MPS. MacNaughton et al. (3) say 40g > 20g for whole-body resistance exercise; the difference between MPS

Recently, I had the pleasure of speaking in Frankfurt with @BradSchoenfeld and Keith Baar (@MuscleScience). Aside from the great science, an interesting theme emerged for nutritional support of muscle gains and connective tissue 'repair' or remodelling.

Both I and Keith stated that the main, by far, driver of gains in muscle mass is lifting weights or providing isometric tension/loading in the case of the tendon/ligament/cartilage.

This is why I can't understand the preoccupation with overly nuanced variables beyond a total daily protein intake of

@theproof @GardnerPhD If nitrogen balance related to a physiological outcome, I could believe that it was a meaningful outcome. The main flaw in using the RDA is as if it’s a target 🎯 It’s not! The flaws in Nbal are many, well known, and painstakingly documented. It’s been shown, numerous times 1/n @theproof @GardnerPhD To reflect adaptive, and at the EAR accommodative, processes. Thus, it’s not optimal but rather a reflection of a economy of N use. These are old points made by many. So, in answer to your question Simon, it it likely that a number of people can stay in N balance, through 2/n

Lifting light(er) weights, a 🧵

After posting something about light(er) weights in promoting muscle mass and strength gains, it's always interesting to read the emails I get. They range from, thank you, this is so liberating to read, it hurts when I lift heavy, and I never knew lifting lighter had the same effects. Then I get emails excoriating "my" paradigm (as if it's mine) and that lifting light(er) weights is a waste of time. Most of the latter types of emails talk about the "fear" of people prescribing exercise that clients will see no benefit

Systematic review and meta-analysis of protein intake to support muscle mass and function in healthy adults pubmed.ncbi.nlm.nih.gov/35187864/

Bench press strength is slightly increased by ingesting more protein in <65 years old subjects during RE training (SMD = 0.18, 95% CI 0.03:0.33, P = 0.01, 32 studies, low level of evidence). The effects of ingesting more protein are unclear when assessing handgrip strength and only marginal for performance in physical function tests. In conclusion, increasing daily protein ingestion results

Many arguments around protein requirements and adequacy are based on a foundation that the RDA is correct, is a target intake at which we should aim, and represents a level beyond which no further health benefit would result.

Hot take: None of these assumptions are true and it has been shown time and again, using various methods, that optimal levels of protein intake are high(er) than the RDA. How much higher? Well, there I can agree we have room for discussion!

As for the 'downsides' of consuming 'too much' protein, it's probably prudent

Stop saying that higher protein intakes cause renal failure, you are wrong. From the WHO/FAO:
“…the suggestion that the decline of glomerular filtration rate that occurs with advancing age in healthy subjects can be attenuated by reducing the protein content in the diet has no foundation.”
From the IOM in setting the last DRI:
“…protein content of diet is not related to progressive decline in kidney function with age.”

A causal link? No evidence:
Changes in Kidney Function Do Not Differ between Healthy Adults Consuming

So it's playing out like this. Build up your muscle, stay fit; it's our reserve against a catabolic episode (1). When you relax and put your feet up, things go south (fast) and take, it appears, a long-time to recover (2). Now this pandemic has provided a blanket catabolic episode for lots of people, and the age demographics and poor metabolic health of folks don't bode well (3). People can say it 'only' kills older people and those with pre-existing conditions, but who in NA is healthy anymore?

From the @ThePhySoc 2016 Biomedical Basis of Elite Performance conference 25min to pass some time: muscle protein turnover and hypertrophy. Some reading that is now almost 4 years ahead to support the points made:
1) Protein helps to augment hypertrophy but its influence is quite small pubmed.ncbi.nlm.nih.gov/28698222 - @RobMorton23 as the main protagonist.

2) High loads are not required for hypertrophy, or for a large part strength gains (especially if one 'practices' lifting heavy loads) pubmed.ncbi.nlm.nih.gov/28834797 - @BradSchoenfeld