Understanding a Metaboliq LifestyleDr. Donald K. Layman

Health Benefits with Increased ProteinHealth Benefits with Increased Protein

For Treatment or Prevention of:• obesity• Metabolic Syndrome• type 2 diabetes• sarcopenia• osteoporosis• heart disease

Layman et al. AJCN 87: 1571S, 2008Heaney & Layman AJCN: 1567S, 2008

Current nutrition “beliefs” and guidelines

•- avoid fat•- limit animal products (cholesterol and SFA)•- increase fiber (using whole grains)•- eat small meals•- use fat-free foods•- use snacks with low calorie density•- express food as % of energy (% kcals) total daily nutrition

Belief: high Carb, low fat, low protein diets are best

fatsfats

milkmilkcheesecheese

meatmeatfish, eggsfish, eggs

vegetablesvegetables fruitsfruits

bread, cereal, rice & pastabread, cereal, rice & pasta 6-11 servings6-11 servings

USDA FoodUSDA FoodGuide PyramidGuide Pyramid

2-3 servings2-3 servings

3-5 servings3-5 servings 2-4 servings2-4 servings

2-3 servings2-3 servings

Changes in U.S. diet (1970 – 2000)Changes in U.S. diet (1970 – 2000)

red meat (25%) dairy (30%) eggs (40%)

grains (decreased vegetables) fruit juices (decreased fruits) sodas snack foods (refined carbohydrates)

Energy Sources for Women and Children*Energy Sources for Women and Children*

top six: 1. grain-based desserts and snacks 2. yeast breads 3. pasta 4. pizza 5. chicken, chicken products 6. soda, sport drinks

* Source: Dietary Guidelines Advisory Committee, 2010

G. Bray; J Am Med Assoc. (2012) Effect of dietary protein content on weight gain, energy expenditure, and body composition during overeating

Compared diets with 5%, 15%, and 25% proteinOverfed subjects by ~1000 kcal/day (8 weeks)

Headline: “low protein diet blunted energy storage and weight gain”

Protein intakes: 46 g, 140 g, 230 g/day

Problems with PercentagesProblems with Percentages

--USDA Food Guide Pyramid: (55% : 15% : 30%)--

kcal/day Carbs (g/d) protein (g/d) lipids (g/d)

3500 481 131 117

2300 316 86 77

1500 208 56 50

RDA for protein: 81 kg x 0.8 g/kg = 65 g/d

Understanding Calories…Understanding Calories…

Calories are not an exact science counting calories seldom works…

% of calories is misleading

• portion control• satiety• thermogenesis• balance

Understanding Protein…Understanding Protein…

Myth:“Adults eat more protein than they need!”

adults eat more protein than the minimum to prevent deficiencies

minimum needs vs. optimum health

IOM Protein Guidelines: DRIsIOM Protein Guidelines: DRIs

Risk ofInadequacy

Risk of AdverseAffects

RDA upperlimit

acceptableintake

Protein: 0.8 g/kg 2.5 g/kg

Metabolic Advantages of Dietary ProteinMetabolic Advantages of Dietary Protein

Advantages: - improves body composition

↓ body fat, ↑ lean tissue

•- increased thermogenesis(increased protein turnover)

•- increased satiety

•- stabilizes blood sugar

Adult Protein Needs: major pointsAdult Protein Needs: major points

1. Adults decrease efficiency of amino acid use

2. Limiting amino acids versus leucine signaling

3. Need for meal distribution of dietary protein

Protein Turnover: Growth vs AgingProtein Turnover: Growth vs Aging

Protein Turnover = synthesis - breakdown

16 y.o. = 253 g/d - 250 g/d growth

60 y.o. = 250 g/d - 250.01 g/d aging

Protein needs for adultsProtein needs for adults

• Aging reduces amino acid efficiency - loss of growth (anabolic drive)

• Need for higher protein quality

Protein needs for adultsProtein needs for adults

Sedentary lifestyle increases protein needs

proteinneeds

physical activity

Muscle

health:

• repair

• rebuild

Athletes understand

Adult Protein Needs: major pointsAdult Protein Needs: major points

1. Adults decrease efficiency of amino acid use

2. Limiting amino acids versus leucine signaling

““minimumminimum”” protein requirement protein requirement

Amino acids are required as … “building blocks” for new proteins

Protein quality = limiting amino acids: (lysine, methionine)

amino acidsignaling

neurotransmitters(mood, appetite)

vascular health(nitric oxide)

GCN2(ER stress)

gut hormones(GLP1, CCK)

Leucine - mTOR(protein synthesis)

muscle health

SIRT-1(mitochondrial biogenesis)

Metabolic requirement: leucine

insulin

GLUT 1GLUT 4

glucose

IRS-1PI3-k

p85p110

PKCGLUT 4vesicle

mTORleucine

Protein Synthesis

Akt

p70s6K

4E-BP1

eIF4E eIF4E eIF4G

4A

eIF4Fcomplex

glucose

Muscle cell

Leucine signal = “meal” requirement

Leucine signal requires about 3.0 grams of dietary leucine

… or 30 grams of protein

Adult Protein Needs: major pointsAdult Protein Needs: major points

1. Adults decrease efficiency of amino acid use

2. Limiting amino acids versus leucine signaling

3. Need for meal distribution of dietary protein

Common Meal Pattern:Common Meal Pattern:

Breakfast

~10 g protein

Lunch

~20 g protein

Dinner

~60 g protein

Unbalanced Protein Distribution

response range for protein synthesis (skeletal muscle)

Meal Patterns:Meal Patterns:

Breakfast

~10 g protein

Lunch

~20 g protein

Dinner

~60 g protein

Unbalanced Protein Distribution

Breakfast

~30 g protein

Lunch

~30 g protein

Dinner

~30 g protein

Balanced Protein Distribution

Optimum Protein Synthesis

Layman Nutr & Metab 6:12, 2009

Satiety: Satiety: breakfast protein vs Carbsbreakfast protein vs Carbs

Metaboliq balance at breakfast ghrelin (hunger), PYY (satiety) calories at lunch

4:00 - MRI - brain “desire” for snacks evening - snacking

Thermogenesis: Thermogenesis: breakfast protein vs Carbsbreakfast protein vs Carbs

Protein burns calories “diet induced thermogenesis”

Protein synthesis: muscle ATP (energy) mitochondria fat burning

Metabolic Flexibility: protein vs CarbsMetabolic Flexibility: protein vs Carbs

Breakfast: WHEAT WHEY

Gastrocnemius weight (g) 2.08 2.20

Abdominal fat weight (g) 2.82 2.38

% body fat 12.7 9.7

Net fat gain (g) 17.1 5.5

Fat energy gain (kcal) 123.2 39.7

Total energy gain (kcal) 204.2 123.1

% total energy deposited to fat 58.5 29.3

% total energy deposited to lean 41.2 70.7

Metabolic Flexibility: protein vs CarbsMetabolic Flexibility: protein vs Carbs

Breakfast: WHEAT WHEY

Gastrocnemius weight (g) 2.08 2.20

Abdominal fat weight (g) 2.82 2.38

% body fat 12.7 9.7

Net fat gain (g) 17.1 5.5

Fat energy gain (kcal) 123.2 39.7

Total energy gain (kcal) 204.2 123.1

% total energy deposited to fat 58.5 29.3

% total energy deposited to lean 41.2 70.7

Metabolic Flexibility: protein vs CarbsMetabolic Flexibility: protein vs Carbs

Breakfast: WHEAT WHEY

Gastrocnemius weight (g) 2.08 2.20

Abdominal fat weight (g) 2.82 2.38

% body fat 12.7 9.7

Net fat gain (g) 17.1 5.5

Fat energy gain (kcal) 123.2 39.7

Total energy gain (kcal) 204.2 123.1

% total energy deposited to fat 58.5 29.3

% total energy deposited to lean 41.2 70.7

Understanding Carbs…Understanding Carbs…

Myth:“Adults need to increase whole grain cereals”

No dietary need for carbohydratesRDA = 130 g/d average American = 350 g/d

Need for - vegetables - fruits

Understanding Carbs…Understanding Carbs…

Carb threshold per meal is less than 40 grams

High Carb diets produce excessive insulin - causes fat storage - causes inflammation - increases LDL-cholesterol

exercise increases use by musclessedentary behavior shifts to fat storage

Understanding Carbs…Understanding Carbs…

Myth: “fructose is bad for you”

Myth: “beans are a good source of protein”

Myth: “bread is better for you than sugar”

Understanding Fats…Understanding Fats…

Myth: “SFA cause heart disease”

Fats are required for every cell in our bodyFats are an efficient energy storeFatty acids are essential nutrients

Excess dietary energy combined with high Carbs causes inflammation and arterial damage

The METABOLIQ approach…The METABOLIQ approach…

• balance high quality protein at meals• reduce carbohydrates (processed grains)• select reduced fat foods (avoid fried foods, snacks, desserts, etc)• increase fiber (vegetables and berries)• breakfast is most important meal Goal: correct individual meals

THANK YOU!