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Speaker 1: Hey, everybody, Just a quick correction from last week. At

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Speaker 1: the end of the episode. In the mailbag, we were

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Speaker 1: talking about colon cancer screening and I said that the

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Speaker 1: colon guard test is done yearly. That's not right, It's

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Speaker 1: done every three years. The fit testing, which is another

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Speaker 1: forum of stool based testing, is the yearly colon cancer

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Speaker 1: screening test. Thanks so much to amazing doctor Clay Ackerley

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Speaker 1: for pointing that out for us. Now onto the episode.

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Speaker 2: Hi, Perry, high, Emily, nice to see you, you too?

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Speaker 2: Which has more protein?

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Speaker 3: Cup of cottage cheese or a cup of Greek yogurt?

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Speaker 1: Oh? Why are you doing this to me? I am

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Speaker 1: going to say a cup of cottage cheese with low confidence.

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Speaker 3: Excellent, one score of one. Okay.

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Speaker 2: Second question, high demand for what product led to weigh

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Speaker 2: protein being primarily the source of protein for protein shakes,

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Speaker 2: cheese generally cheese is the correct?

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Speaker 1: Okay?

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Speaker 3: Cancer?

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Speaker 1: All right of two?

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Speaker 3: Okay, very hard. Last question.

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Speaker 2: There is a new protein product called a David protein bar.

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Speaker 2: It has a lot of protein. The company that makes

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Speaker 2: it introduced a second product to expand their line. What

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Speaker 2: is that second product?

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Speaker 1: It's gotta be Goliath.

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Speaker 3: No, And that's on the table. They left that on

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Speaker 3: the table.

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Speaker 2: The new product is frozen cod Oh, and that's all

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Speaker 2: you need to know about protein.

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Speaker 1: Wow. So, I, in anticipation of this episode, for the

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Speaker 1: first time really ever, tracked everything I put into my body,

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Speaker 1: everything I ate for a few days because I had

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Speaker 1: no idea how much protein I was taking it. And

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Speaker 1: I will tell you two things. Number One, I don't

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Speaker 1: like writing down everything that I eat. It's annoying, it's

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Speaker 1: hard to search for I don't know what portion sizes

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Speaker 1: are and it makes me feel guilty. And two, the

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Speaker 1: amount of protein I intake from day to day varies

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Speaker 1: wildly and depends almost entirely on whether my kids are

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Speaker 1: having pasta for dinner or not.

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Speaker 3: What was your protein number?

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Speaker 1: So the highest day I had was one hundred and

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Speaker 1: fifty grams and the lowest day I had was sixty grams.

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Speaker 3: Wow, that is a lot of variation.

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Speaker 2: Yeah, I eat exactly the same amount of protein every

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Speaker 2: single day.

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Speaker 1: I think that may say everything anyone needs to know

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Speaker 1: about the two of us. Should we dig into this?

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Speaker 3: We should.

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Speaker 2: I'm Emily Aster, I'm an economist and a data expert.

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Speaker 1: And I'm Perry Wilson. I'm a medical doctor.

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Speaker 2: It's Thursday, April ninth, twenty twenty six, and this is wellness.

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Speaker 1: Actually, because you're getting a staggering amount of health and

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Speaker 1: wellness information nowadays from every source imaginable, and some of

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Speaker 1: it is awesome.

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Speaker 2: And some of it is well actually both Fortunately we

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Speaker 2: are both people who know how to read studies, how

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Speaker 2: to parse the data, and can tell you what's worth

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Speaker 2: thinking about and what you can safely ignore.

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Speaker 1: But before we dig in, a note that this podcast

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Speaker 1: is for educational purposes and should not be construed as

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Speaker 1: medical advice. We don't know your unique situation, so talk

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Speaker 1: to your doctor for personal health decisions.

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Speaker 3: This week we're asking what's the deal with protein?

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Speaker 2: Perry and I will give the official smash her pass

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Speaker 2: and then we'll get to your question of the week.

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Speaker 2: But first let's do the health news roundup after the break.

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Speaker 2: And now for the health news of the week, Perry,

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Speaker 2: there was a lot of GLP one news this week.

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Speaker 2: New GLP one drugs approved, some new research on dosing.

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Speaker 2: What is your favorite piece of GLP one news for

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Speaker 2: the week.

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Speaker 1: I mean, I think it's got to be the approval

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Speaker 1: of the new oral GLP one pill. It is the

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Speaker 1: hardest thing to pronounce the generic name or for glepron

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Speaker 1: terrible or forglepron. The brand name is FOUNDEO, which is

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Speaker 1: a little bit easier from Lily, is now FDA approved

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Speaker 1: for people with obesity or overweight with at least one

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Speaker 1: comorbid condition. This is a GLP one drug interacts with

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Speaker 1: a GLP one receptor, but it's not a peptide. Go

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Speaker 1: back to the peptide episodes to hear about how what

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Speaker 1: is a peptide. FOUNDEO is a small molecule that does

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Speaker 1: interact with the receptor, but not the way the peptide does,

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Speaker 1: so it's its own new thing.

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Speaker 2: And the weight loss on this oral is a little

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Speaker 2: bit less than in the studies than we've seen with

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Speaker 2: something like zep bound, so maybe more like thirteen percent

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Speaker 2: rather than about twenty which is what you're seeing with

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Speaker 2: zep bound. But obviously or dosing far far easier for

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Speaker 2: many people than injection based dosing.

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Speaker 1: Yeah, I think this lowers the barrier so much. I

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Speaker 1: anticipate this will be used pretty broadly. Right now for

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Speaker 1: cash pay patients, they're pricing this at like three hundred

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Speaker 1: and fifty dollars a month, that's still pretty pricey, but

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Speaker 1: you know, most insurance plans will cover this if you have,

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Speaker 1: you know, an appropriate condition.

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Speaker 3: Where do they come up with these names? Is my

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Speaker 3: main question?

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Speaker 2: Like who thought or or flogged leaparon was a good

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Speaker 2: even as a generic I don't love it.

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Speaker 1: There are actually weird rules like for generic names, like

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Speaker 1: they have to have certain combinations of letters depending on

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Speaker 1: what type of drug they are, So I suspect the

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Speaker 1: like g l ip in there like has to be

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Speaker 1: in there for some reason, and then things get kind

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Speaker 1: of thrown together.

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Speaker 3: But can't just be like skinny pill, skinny.

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Speaker 1: Pill, skinny riz or something skinny ris that could be

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Speaker 1: a brand name trademark, don't take it.

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Speaker 2: Second piece of GLP one news, which I think was

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Speaker 2: not very surprising, but there is a retrospective case series

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Speaker 2: that suggested that people can keep weight off in a

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Speaker 2: maintenance phase with reduced frequency dosing of GLP ones. In

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Speaker 2: the case of this case series, they were talking about

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Speaker 2: dosing every other week rather than every week. This isn't

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Speaker 2: very surprising since everyone is already doing this anyway, sometimes

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Speaker 2: with the permission of their doctor and sometimes not. But

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Speaker 2: I think it is the first of what's likely to

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Speaker 2: be a more rigorous set of studies looking at what

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Speaker 2: is the long term maintenance approach to GLP ones, since

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Speaker 2: we know people go totally off them, they regain a

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Speaker 2: lot of weight, but most people don't want to stay

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Speaker 2: on the higher dose forever. So I think we'll see

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Speaker 2: we'll see more of that as this becomes just a

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Speaker 2: more mature market and a more mature set of science.

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Speaker 1: Yeah, couldn't agree more. I could see a little bit

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Speaker 1: of data coming through, but I agree. Not not super newsy,

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Speaker 1: but it's to know at least that there weren't, you know,

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Speaker 1: crazy adverse effects and that people kept the weight off

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Speaker 1: with that reduced dozing.

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Speaker 3: All right.

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Speaker 2: Two other small things that I want to get your

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Speaker 2: thoughts on. One is that benzyl alcohol has been named

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Speaker 2: the Allergen of the Year by the American Contact Dermatitis Society.

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Speaker 1: Congratulations benzyl alcohol.

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Speaker 2: Until all the nomination, wondering who were the other who

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Speaker 2: are the other nominees?

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Speaker 1: Uh?

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Speaker 3: Well, who are the other nominees for Allergen of the year? Uh?

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Speaker 3: What is this? Why do people do this?

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Speaker 1: I think it's I have this like passion for very small,

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Speaker 1: insular groups of people. That care a lot about their

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Speaker 1: very small, insular thing. Like I love like niche conventions

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Speaker 1: where they're talking about like you know, new shoelace design

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Speaker 1: or something, and people are having these heated arguments. But

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Speaker 1: so contact dermatitis this is important. I don't mean to

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Speaker 1: make fun, but having an allergen of the Year is

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Speaker 1: kind of funny. Contact dermatitis is a rash you get

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Speaker 1: on your skin from it being in contact with a

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Speaker 1: potential allergen. And what the Contact Dermatitis Society is trying

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Speaker 1: to get us all to talk about by labeling benzyl

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Speaker 1: alcohol as their Allergen of the Year is that this

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Speaker 1: is not a widely recognized allergen, although it is quite common.

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Speaker 1: So this is an alcohol that's kind of like a floral,

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Speaker 1: pleasant flowery smell, and so it's added to a lot

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Speaker 1: of like fragrances and beauty products, particularly to give that

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Speaker 1: kind of like floral fragrance. And it's not tested for

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Speaker 1: in the standard skin testing for dermatitis. And so if

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Speaker 1: you know you're one of the people that gets like

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Speaker 1: weird reactions on their skin to something, and even if

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Speaker 1: you've been to a doctor and maybe gotten some patch

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Speaker 1: testing that hasn't revealed a particular allergen. You know, think

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Speaker 1: about benzyl alcohol.

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Speaker 3: Think about ben'syl alcohol. It's it's having a moment.

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Speaker 2: I also love niche societies as an economist. You know,

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Speaker 2: we have our own niche societies here and it's a delight.

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Speaker 1: Absolutely. Another niche thing that is, I guess getting quite

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Speaker 1: a bit less niche right now is is kratom. And

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Speaker 1: I might not be pronouncing that correctly. Kratom KRATM is

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Speaker 1: a substance that you can buy at like gas stations

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Speaker 1: and stuff like that. It's not illegal as of yet,

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Speaker 1: but calls to poison control have gone up by about

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Speaker 1: twentyfold over the past fifteen years or so. From the substance.

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Speaker 1: What it is is a chemical that is a partial

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Speaker 1: agonist of the MEW opioid receptors, and that means that

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Speaker 1: it binds to the same receptors as things like heroin

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Speaker 1: and morphine. It's a partial agonist, so it's not quite

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Speaker 1: as strong, which is I think why it hasn't risen

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Speaker 1: to the level of like a national crisis yet. It

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Speaker 1: has some weird dosing effects where like low doses cause

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Speaker 1: sedation but higher doses cause agitation. Bit of a strange drug,

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Speaker 1: but want to call it out there, you probably just

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Speaker 1: in general, should not be taking anything that you buy

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Speaker 1: at the gas station.

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Speaker 2: I don't disagree with that, I will say, you know,

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Speaker 2: I saw this in the CDC's MMWR, which is a

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Speaker 2: great publication that I enjoy, and they are tracking changes

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Speaker 2: in exposure from twenty fifteen to twenty twenty five and

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Speaker 2: looking at the increase in exposure and they have this number.

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Speaker 2: There's a twelve hundred percent increase in exposure reports, which

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Speaker 2: of course over this ten year period, which of course

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Speaker 2: is a lot, but it does start at two hundred

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Speaker 2: and fifty eight and goes up to three thousand and

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Speaker 2: five hundred, so it's worth remembering. You know, there are

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Speaker 2: three hundred and thirty million people in America now, not

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Speaker 2: all of them are purchasing this kratum kreatum item at

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Speaker 2: the gas station, but this is still a fairly small number,

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Speaker 2: although the percent increase is very large.

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Speaker 1: So, yeah, getting more popular, don't take.

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Speaker 3: It getting more popular.

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Speaker 2: And I agree, purchasing psychoactive substances at the gas station

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Speaker 2: to take is probably just like not something that you

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Speaker 2: need to be doing, So don't do that.

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Speaker 1: Pass on, let's forget.

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Speaker 3: You can buy gum.

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Speaker 2: If you need anything, purchase some gum, sure free gum.

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Speaker 2: All right, So that's it for the health news of

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Speaker 2: the week. When we come back, we will talk about protein.

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Speaker 1: So Emily, I'm old enough to have lived through like

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Speaker 1: multiple macronutrient fads. I remember the low fat craze and

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Speaker 1: then the low.

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Speaker 3: Carb phrase bacon only, bacon only.

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Speaker 1: Keto, bacon only. These were the happiest days of my life.

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Speaker 1: You know, it was good. But like, clearly we are

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Speaker 1: in the protein phase right now, right this is this

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Speaker 1: is protein's time.

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Speaker 3: It's protein's moment, at least one of its moments.

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Speaker 2: You know, I could be drinking protein coffee right now

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Speaker 2: that I could make with protein water, and I could

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Speaker 2: have protein popcorn on the side.

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Speaker 3: And that seems notable because in the past.

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Speaker 2: You've really only been able to get protein out of

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Speaker 2: regular protein sources and not out of your water. But

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Speaker 2: now you can get it in your water. And the

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Speaker 2: question is is that good?

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Speaker 3: Is that good?

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Speaker 1: Is that good? Let's let's figure it out, am my

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Speaker 1: personal scale protein and water. I like that metric. I like,

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Speaker 1: if it is in your water, then it is having

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Speaker 1: in a moment caffeine maybe had its moment too. Now

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Speaker 1: that can get calculated water. My metric is Costco. So

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Speaker 1: I don't know if you've been in Costco, but that

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Speaker 1: like snacky aisle that you walk down to get the

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Speaker 1: bulk snacks for your kids lunches and stuff. Or you

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Speaker 1: probably don't because you're a good mother, and but I do,

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Speaker 1: and I don't have a Costco.

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Speaker 3: Near here unfortunately, which is very sad.

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Speaker 1: Well, in my Costco, the entire aisle is protein. Like

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Speaker 1: it says protein on every single snack thing, and they

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Speaker 1: know what they're doing, so yes, it is the protein.

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Speaker 1: Era is that good?

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Speaker 3: Is that good? So let's before we get into is

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Speaker 3: that good? Or how much?

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Speaker 2: And I think people have some pretty basic questions like

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Speaker 2: do I actually need as much as people say? And

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Speaker 2: could I have an infinite amount of protein? But let's

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Speaker 2: like start at the beginning, because I think at all

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Speaker 2: of these conversations there is a moment when you almost

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Speaker 2: don't want to ask like what is this? You know,

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Speaker 2: when you're like snacking on your protein powder. You got

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Speaker 2: to start at the top.

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Speaker 3: So let me start by asking you just what is protein?

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Speaker 1: Yeah? Such an important question? What is protein? Okay? We

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Speaker 1: often talk of the three macro nutrients, so carbohydrates, which

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Speaker 1: is sugars and starches, fats, fats and oils and things

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Speaker 1: like that, and then this protein thing. And protein is

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Speaker 1: far and away the most interesting of the macro nutrients

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Speaker 1: for a number of reasons.

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Speaker 3: It seems so like judgment. That seems so judgement.

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Speaker 2: All right, convince me, convince me. I love carbonydrate, so

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Speaker 2: I'm not really sure that I believe you.

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Speaker 1: That's why they're interesting. Carbohydrates are really simple. You know,

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Speaker 1: they're sugars, or they're sugars that are stuck to other sugars.

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Speaker 1: It's like building a tower of lego blocks with the

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Speaker 1: same shape, you know, all the way up. That's all

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Speaker 1: you can do. Fats are somewhat similar. Carbohydrates and fats

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Speaker 1: both stores of energy get broken down into energy which

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Speaker 1: your body can use, and only two things water and

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Speaker 1: carbon dioxide. So you completely excrete all the product of

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Speaker 1: fat metabolism and carbohydrate metabolism by breathing and I guess

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Speaker 1: peeing if you want to get rid of the excess water. Now,

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Speaker 1: proteins are really complicated, So you go back to high

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Speaker 1: school biology, you'll remember that proteins are comprised of these

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Speaker 1: different amino acids, and there are really kind of twenty

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Speaker 1: common amino acids that humans use. There are twenty two total.

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Speaker 1: If you really search, you can find an extra two

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Speaker 1: amino acids, but they're basically twenty amino acids, which are

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Speaker 1: the different lego pieces that you can put together in

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Speaker 1: any different combination you want to make any different protein

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Speaker 1: you want, which is why proteins make up all of

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Speaker 1: the stuff of our body. You know, your skin is protein,

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Speaker 1: and your muscle is protein, and your hair is protein

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Speaker 1: or products of protein, and it's incredibly complicated. And when

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Speaker 1: you break down protein, you don't just get water and

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Speaker 1: carbon dioxide. You get water, carbon dioxide and other stuff

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Speaker 1: amino acids and ammonia, which is highly toxic, and that's

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Speaker 1: something that we might have to come around to now.

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Speaker 1: Of course, your body has ways to deal with that

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Speaker 1: toxic stuff. We can metabolize protein, but it's pretty interesting.

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Speaker 1: The other interesting thing about all these amino acids is

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Speaker 1: that nine of them are what are called essential, and

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Speaker 1: essential amino acids are amino acids that you cannot synthesize

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Speaker 1: in your own body from any chemicals that exist naturally

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Speaker 1: in your body or from other amino ass acids that

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Speaker 1: you take in. In other words, these are amino acids

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Speaker 1: that if you don't get them into your body, you

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Speaker 1: will die. Nine of them are like that. So nine

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Speaker 1: amino acids. Nine components of protein act similarly to vitamins,

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Speaker 1: such that if you didn't have enough, and you don't

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Speaker 1: need a ton, but if you didn't have enough, it

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Speaker 1: would be fatal. And that's not the case for carbohydrates

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Speaker 1: or fats. In general. You need some carbohydrate and some

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Speaker 1: fat to sustain life, but it doesn't particularly matter which

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Speaker 1: one or which source. That's why they're so interesting, all right.

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Speaker 3: So fine, they seem interesting.

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Speaker 2: Another way to say this is that I could in

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Speaker 2: principle live on carbohydrates and protein with almost no fat

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Speaker 2: or very little fat. And I could also live on

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Speaker 2: fat and protein with very little or no carbohydrates. But

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Speaker 2: I could not live on carbohydrates and fat without some protein.

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Speaker 1: That's absolutely right, And there is a condition pure protein malnutrition.

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Speaker 1: So these are people who have adequate caloric intake from

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Speaker 1: carbohydrates and potentially fats, but not enough protein. It's called

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Speaker 1: quashy or core. But where you have seen it are

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Speaker 1: those if you remember those old advertisements of this, like

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Speaker 1: quote unquote starving kids in Africa with the big bellies.

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Speaker 1: So that big belly is filled with a fluid leaking

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Speaker 1: from the liver because there's no protein in the body

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Speaker 1: to retain that fluid. It's called ascid's And that is

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Speaker 1: not starvation, not pure starvation. It is protein specific starvation.

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Speaker 1: So there is a disease syndrome associated with pure protein malnutrition.

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Speaker 1: I will say that you also die if you only

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Speaker 1: eat protein, and there are cases of this. You go

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Speaker 1: into keto acidosis if you don't have any sugar or

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Speaker 1: fat at some point, and this has been reported in

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Speaker 1: some very rare people who have been living like exclusively

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Speaker 1: on highly lean mind like rabbit meat. So there are

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Speaker 1: people living in the wilderness who like only eate rabbits

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Speaker 1: for thirty days or something, and you can actually die

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Speaker 1: of that as well.

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Speaker 3: Don't you think at that point you'd also have scurvy?

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Speaker 1: You would almost certainly have scurvy, But I think it

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Speaker 1: takes a bit longer.

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Speaker 2: To get scurvy. Yeah, okay, we can do another episode

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Speaker 2: on scurvy.

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Speaker 1: Yeah, a lot of our time, certainly, not a lot.

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Speaker 2: Of people have it, but if you have it, it's

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Speaker 2: not good. Okay, So back to the product. Protein is

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Speaker 2: a thing that we need. We need a good solid

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Speaker 2: amount of because of these amino acids, particularly the nine

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Speaker 2: amino acids. Is any type of protein going to give

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Speaker 2: us the nine essential amino acids?

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Speaker 1: Short answer is yes, we don't have to worry about

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Speaker 1: this too too much, And I think this can transit

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Speaker 1: provided you eat an adequate total amount of protein. Most

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Speaker 1: stuff you're going to get out there is comprised of

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Speaker 1: enough variation in amino acids that you'll cover your bases.

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Speaker 1: But this leads to the I think central question that

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Speaker 1: we're all asking ourselves. Certainly I am since I started

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Speaker 1: writing down what I'm actually eating from day to day,

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Speaker 1: which is, wait a second, how much protein am I

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Speaker 1: supposed to have? So Emily, I want to turn this

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Speaker 1: to you. How much protein does the government say we

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Speaker 1: need to have? And then I want to know how

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Speaker 1: much protein you have?

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Speaker 2: Okay, So I will tell you that I hate this

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Speaker 2: question and I feel like it is the first question

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Speaker 2: people are like, how much protein.

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Speaker 3: Should I have?

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Speaker 2: And I think that that question is like fundamentally really

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Speaker 2: really flawed.

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Speaker 3: So I will tell you what the government says.

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Speaker 2: The government has a like recommended daily allowance, and it

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Speaker 2: is zero point eight grams per kilogram per day.

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Speaker 3: So that's about a.

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Speaker 2: Third of a gram of protein per pound. So if

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Speaker 2: you're a person who weighs like one hundred and eighty pounds,

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Speaker 2: that would say you should have about sixty five grams

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Speaker 2: of protein a day. That is actually not that much,

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Speaker 2: and most people in the U get that amount. So

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Speaker 2: I looked in preparation for this discussion, I looked at

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Speaker 2: the en Haines data, which is a national longitudinal representative study,

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Speaker 2: and they ask people about their diet and they calculate

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Speaker 2: their protein. And the average woman has studies getting about

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Speaker 2: seventy five grams of protein to day. The average man's

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Speaker 2: getting a little over one hundred. So that is actually

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Speaker 2: plenty of protein based on the government recommendations.

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Speaker 1: And that recommendation, correct me if I'm wrong, is essentially

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Speaker 1: based on these calculations of like, if you fall below

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Speaker 1: this for a sustained period of time, you will actually

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Speaker 1: like get into worse health or potentially have malnutrition.

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Speaker 2: Yeah, so this comes out of the recommended daily allowance,

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Speaker 2: which is a number that the government has designed in

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Speaker 2: order to tell basically an institutional like if you had

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Speaker 2: an institutional population, you know, you were like feeding people

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Speaker 2: at a jail, and you were controlling like how many

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Speaker 2: calories you would have available, and how much protein and

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Speaker 2: how many micronutrients they have, these numbers of which you know,

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Speaker 2: this is like this is one of them. And the

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Speaker 2: idea is that this is going to like this would

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Speaker 2: be enough for people to be healthy and like lead

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Speaker 2: a healthy institutional lifestyle.

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Speaker 3: That's the basic idea.

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Speaker 1: Let's say I want to do a little bit more

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Speaker 1: than be a healthy a healthy member of some institution.

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Speaker 2: All right, let's sort of say like sixty five grams

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Speaker 2: if you're a person in one hundred and eight pounds,

399
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Speaker 2: like sixty five sixty grams of protein to day is

400
00:21:31,160 --> 00:21:36,000
Speaker 2: actually not that much. So a cup of Greek yogurt

401
00:21:36,119 --> 00:21:39,240
Speaker 2: has like twelve grams of protein. Chicken breast, a sort

402
00:21:39,240 --> 00:21:42,880
Speaker 2: of standard sized chicken brass, has probably thirty grams of protein.

403
00:21:43,000 --> 00:21:45,240
Speaker 2: So this is like, you know, you could get to

404
00:21:45,280 --> 00:21:48,119
Speaker 2: sixty grams of protein pretty easily, which is not surprising

405
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Speaker 2: that most people are there.

406
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Speaker 3: The question then is like is that enough?

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Speaker 2: And this is the discussion, like sort of out in

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Speaker 2: the world where people are telling you look or people influencers,

409
00:22:00,720 --> 00:22:04,000
Speaker 2: you know, fitness enthusiasts will say, you know, point a

410
00:22:04,040 --> 00:22:06,840
Speaker 2: grams per kilogram is nowhere near enough. A number that

411
00:22:06,920 --> 00:22:10,159
Speaker 2: often gets thrown around is like one gram per pound

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Speaker 2: of body weight. So that would mean for someone of

413
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Speaker 2: one hundred and eighty pounds, rather than take having sixty

414
00:22:14,880 --> 00:22:16,480
Speaker 2: five grams a day, you should have one hundred and

415
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Speaker 2: eighty grams a day. And that's a lot more than sixty. Obviously,

416
00:22:20,800 --> 00:22:23,320
Speaker 2: that is a ton ton of protein. Yeah, it's a

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Speaker 2: ton of protein.

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Speaker 3: And I think the core question for people is, like,

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Speaker 3: is that something I need to be prioritizing in part

420
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Speaker 3: because like, that's work. Like to particularly to get.

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Speaker 2: One hundred and eighty grams of protein while also not

422
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Speaker 2: consuming like four hundred billion calories is challenging. Right, When

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Speaker 2: people say get all this protein, they don't mean like

424
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Speaker 2: and also get an equivalently larger number of carbohydrates in fat.

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Speaker 2: They mean like, prioritize protein relative to those and that

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Speaker 2: takes effort.

427
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Speaker 1: Right, So if we are pursuing that kind of goal,

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Speaker 1: and I tried it a little bit, I tried to

429
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Speaker 1: think to myself and it does take planning. It's like, okay, wait,

430
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Speaker 1: what am I going to have for lunch? And how

431
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Speaker 1: am I going to get all this protein in? And

432
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Speaker 1: you're looking for foods that are, you know, how per

433
00:23:06,800 --> 00:23:09,400
Speaker 1: calorie have a lot of protein in them. And one

434
00:23:09,520 --> 00:23:12,119
Speaker 1: rule I sort of saw that does work out fairly

435
00:23:12,240 --> 00:23:14,440
Speaker 1: nicely is that if you take the grams of protein

436
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Speaker 1: in a food and you multiply it by ten and

437
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Speaker 1: that's more than the calories in the food, then it's

438
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Speaker 1: like a high protein food. So for example, if you

439
00:23:23,280 --> 00:23:25,760
Speaker 1: know there's ten grams of protein in a one hundred

440
00:23:25,920 --> 00:23:30,439
Speaker 1: calorie portion, then that's a high protein food. And that

441
00:23:30,520 --> 00:23:34,360
Speaker 1: works out to about forty percent protein per calorie, which

442
00:23:34,400 --> 00:23:37,160
Speaker 1: is like that seems about right to me, But it's

443
00:23:37,160 --> 00:23:40,760
Speaker 1: actually quite hard to even all those protein bars and

444
00:23:40,760 --> 00:23:45,280
Speaker 1: stuff at costco like don't necessarily get to that level.

445
00:23:46,000 --> 00:23:47,600
Speaker 3: Yeah, I think so, I think we should talk about

446
00:23:47,600 --> 00:23:48,480
Speaker 3: how to get to that level.

447
00:23:48,480 --> 00:23:50,320
Speaker 2: But I think we should also we should start by

448
00:23:50,320 --> 00:23:53,359
Speaker 2: talking about, like what are the scenarios in which you

449
00:23:53,400 --> 00:23:56,399
Speaker 2: would want to get to a higher level of protein. So,

450
00:23:56,800 --> 00:23:58,960
Speaker 2: because I think again getting back like the question of

451
00:24:00,119 --> 00:24:02,440
Speaker 2: than asking what is the right amount of protein, I

452
00:24:02,480 --> 00:24:04,320
Speaker 2: think the first question people should say is like what

453
00:24:04,400 --> 00:24:04,840
Speaker 2: is their goal?

454
00:24:05,000 --> 00:24:05,680
Speaker 1: What is your goal?

455
00:24:06,280 --> 00:24:08,560
Speaker 3: And I think there's a few different goals people have.

456
00:24:08,880 --> 00:24:11,280
Speaker 1: Let me give you my goal. I want to know

457
00:24:11,320 --> 00:24:15,440
Speaker 1: about building muscle. I want to I'm in my forties

458
00:24:15,720 --> 00:24:17,920
Speaker 1: and I'm looking to get a little.

459
00:24:17,760 --> 00:24:21,600
Speaker 2: Bit mid mint to late forties, Perry, you.

460
00:24:21,560 --> 00:24:25,440
Speaker 1: Know who's counting. I'm in my mental late forties and

461
00:24:26,160 --> 00:24:29,280
Speaker 1: I'm hitting the gym, and the guys there are I

462
00:24:29,320 --> 00:24:35,280
Speaker 1: will say, very into protein. So what's the evidence there

463
00:24:35,320 --> 00:24:37,840
Speaker 1: is protein supplementation good for muscle? It makes sense, right,

464
00:24:37,840 --> 00:24:40,560
Speaker 1: Protein blocks supplement is the building block of muscle. That's

465
00:24:40,560 --> 00:24:42,800
Speaker 1: what I learned in biology.

466
00:24:43,000 --> 00:24:44,440
Speaker 2: This is the place where I think the evidence the

467
00:24:44,520 --> 00:24:48,560
Speaker 2: sort of most clear that protein is key to building muscle.

468
00:24:49,160 --> 00:24:52,120
Speaker 2: And if you are either a person in your mid

469
00:24:52,160 --> 00:24:54,000
Speaker 2: to late forties who is looking to build some muscle,

470
00:24:54,160 --> 00:24:55,840
Speaker 2: or and I think this is important if you're an

471
00:24:55,880 --> 00:24:59,560
Speaker 2: older person who is trying to maintain muscle mass. Hard

472
00:24:59,600 --> 00:25:01,119
Speaker 2: to build my muscle when you're you know, in your

473
00:25:01,119 --> 00:25:03,800
Speaker 2: sixties and seventies, but you can maintain muscle. It's really

474
00:25:03,840 --> 00:25:06,959
Speaker 2: important for like not falling down. And we have a

475
00:25:07,000 --> 00:25:10,320
Speaker 2: fair amount of good evidence, particularly in these older populations

476
00:25:10,480 --> 00:25:15,040
Speaker 2: that having a higher amount of protein relative to these

477
00:25:15,640 --> 00:25:20,320
Speaker 2: you know, recommendations. But having more protein can maintain muscle

478
00:25:20,359 --> 00:25:23,600
Speaker 2: mass and can improve people's health.

479
00:25:24,080 --> 00:25:25,160
Speaker 3: But and this is I.

480
00:25:25,080 --> 00:25:28,679
Speaker 2: Think like the most important thing. It is not just

481
00:25:28,840 --> 00:25:32,520
Speaker 2: eating the protein. You also have to exercise. Right, Like

482
00:25:32,560 --> 00:25:34,800
Speaker 2: we talk about the protein, like you eat the protein

483
00:25:34,800 --> 00:25:36,720
Speaker 2: and then it like magically turns into muscle.

484
00:25:37,040 --> 00:25:37,919
Speaker 3: That's not how it works.

485
00:25:38,240 --> 00:25:40,960
Speaker 2: You eat the protein and you do resistance training some

486
00:25:41,160 --> 00:25:44,720
Speaker 2: kind of exercise, and those together make more muscle. So

487
00:25:44,760 --> 00:25:46,399
Speaker 2: if you're gonna you perry, you are going to go

488
00:25:46,440 --> 00:25:48,840
Speaker 2: to the gym and stand there and watch the other

489
00:25:48,880 --> 00:25:52,359
Speaker 2: guys while you eat a protein bar. Nothing will happen

490
00:25:52,480 --> 00:25:54,639
Speaker 2: except you will just be a person who's eating a

491
00:25:54,640 --> 00:25:55,240
Speaker 2: protein bar.

492
00:25:55,480 --> 00:25:59,399
Speaker 1: It's such a good point. And I will say that biologically,

493
00:26:00,160 --> 00:26:02,840
Speaker 1: when your body breaks down that protein into its constituent

494
00:26:02,880 --> 00:26:06,000
Speaker 1: amino acids, there are two pathways that those amino acids

495
00:26:06,040 --> 00:26:08,840
Speaker 1: can go down. One pathway is those amino acids get

496
00:26:08,840 --> 00:26:11,960
Speaker 1: incorporated into a new protein like a muscle fiber. The

497
00:26:12,000 --> 00:26:14,920
Speaker 1: other pathways that those amino acids gets further broken down

498
00:26:15,080 --> 00:26:18,640
Speaker 1: into sugar and you get calories out of it, and

499
00:26:18,840 --> 00:26:21,160
Speaker 1: your body is more than willing to get calories out

500
00:26:21,200 --> 00:26:23,440
Speaker 1: of anything you put into it if you're not using

501
00:26:23,480 --> 00:26:26,280
Speaker 1: it for some other purpose, So absolutely you got to

502
00:26:26,280 --> 00:26:28,600
Speaker 1: actually use it. Do you have any opinion about this,

503
00:26:28,880 --> 00:26:33,360
Speaker 1: like should I be doing protein supplementation before workout after workout?

504
00:26:33,440 --> 00:26:34,320
Speaker 1: Is that superstition?

505
00:26:35,359 --> 00:26:37,880
Speaker 3: I have a lot of feelings about that.

506
00:26:38,240 --> 00:26:43,240
Speaker 2: In general, it doesn't matter so most people, it actually

507
00:26:43,240 --> 00:26:46,440
Speaker 2: doesn't matter much in the data. This is a place

508
00:26:46,440 --> 00:26:48,639
Speaker 2: where we have pretty good data because it's actually very

509
00:26:48,680 --> 00:26:51,840
Speaker 2: easy to study people who are doing endurance sports or

510
00:26:51,840 --> 00:26:54,000
Speaker 2: any kind of sports, because they love to be studied,

511
00:26:54,000 --> 00:26:56,320
Speaker 2: and they're looking to optimize their protein intake in various

512
00:26:56,359 --> 00:27:02,359
Speaker 2: ways because they're lunatics. When you look at that those populations,

513
00:27:02,880 --> 00:27:05,560
Speaker 2: it doesn't matter what time of what. When you had

514
00:27:05,600 --> 00:27:07,360
Speaker 2: people tell you have to have your protein shape within

515
00:27:07,440 --> 00:27:09,680
Speaker 2: like thirty minutes after a workout is just not supported

516
00:27:09,720 --> 00:27:10,640
Speaker 2: by the evidence.

517
00:27:10,680 --> 00:27:12,280
Speaker 3: You want to kind of have it within a day.

518
00:27:12,600 --> 00:27:14,760
Speaker 2: But if we're thinking about over the course of a day,

519
00:27:15,720 --> 00:27:18,400
Speaker 2: it doesn't that whether you get all your protein, even

520
00:27:18,480 --> 00:27:21,920
Speaker 2: like all at once versus in multiple chunks, doesn't seem

521
00:27:21,920 --> 00:27:23,919
Speaker 2: to impact the performance.

522
00:27:24,200 --> 00:27:26,000
Speaker 1: That's been something people have been worried about for a

523
00:27:26,000 --> 00:27:29,680
Speaker 1: long time. Was this idea that there's like protein overflow,

524
00:27:29,760 --> 00:27:32,359
Speaker 1: like if you took too much in at once, you

525
00:27:32,359 --> 00:27:35,080
Speaker 1: wouldn't use it and the excess wouldn't get used appropriately.

526
00:27:35,680 --> 00:27:36,919
Speaker 1: Not much evidence for that.

527
00:27:37,000 --> 00:27:39,119
Speaker 2: Not much evidence for that, certainly over a course of

528
00:27:39,160 --> 00:27:40,800
Speaker 2: like a twenty four hour period.

529
00:27:41,560 --> 00:27:43,040
Speaker 1: I want to move on from muscle because there's some

530
00:27:43,119 --> 00:27:45,639
Speaker 1: other interesting protein stuff out there, But before we do,

531
00:27:45,760 --> 00:27:49,520
Speaker 1: we should probably talk about the specialist of the amino acids,

532
00:27:49,600 --> 00:27:55,440
Speaker 1: which is leucine. So leucine is this amino acid that,

533
00:27:55,880 --> 00:28:00,880
Speaker 1: unlike all of its nineteen brethren that found in protein,

534
00:28:01,240 --> 00:28:04,960
Speaker 1: has a signaling effect in muscle. So in your body,

535
00:28:04,960 --> 00:28:07,280
Speaker 1: there are all sorts of signals that your body reads

536
00:28:07,280 --> 00:28:09,320
Speaker 1: to know how to grow and how to change, And

537
00:28:09,560 --> 00:28:13,920
Speaker 1: muscle has a signaling receptor for leucine. And it seems

538
00:28:13,960 --> 00:28:17,879
Speaker 1: like lucine may be the thing that muscle uses to

539
00:28:18,000 --> 00:28:20,040
Speaker 1: know that there's a lot of protein around, right, Like,

540
00:28:20,200 --> 00:28:22,119
Speaker 1: how does your muscle know it's safe to sort of

541
00:28:22,119 --> 00:28:26,560
Speaker 1: build more muscle? And there's some evidence that the signaling

542
00:28:26,600 --> 00:28:30,280
Speaker 1: molecule for muscle reading your nutritional status from a protein

543
00:28:30,320 --> 00:28:34,920
Speaker 1: perspective is this particularly meino acid, leucine because of that,

544
00:28:35,160 --> 00:28:39,560
Speaker 1: you see leucine supplement supplements out there. We've started to

545
00:28:39,560 --> 00:28:43,120
Speaker 1: see a few loucine supplement studies in terms of muscle

546
00:28:43,120 --> 00:28:47,160
Speaker 1: building with mixed results. But I wanted to bring it up.

547
00:28:47,480 --> 00:28:51,240
Speaker 1: There's not a good natural source of lucine beyond anything

548
00:28:51,240 --> 00:28:53,400
Speaker 1: else that has a lot of protein. So like chicken

549
00:28:53,440 --> 00:28:56,920
Speaker 1: breast has plenty of leucine in it, beans have lucine,

550
00:28:57,440 --> 00:29:00,040
Speaker 1: cottage she has lucine. Wherever you're getting your protein and

551
00:29:00,040 --> 00:29:02,840
Speaker 1: you're getting your lucine. But supplementation is always different, right

552
00:29:02,880 --> 00:29:05,760
Speaker 1: because now we're talking about something that's processed. You're getting

553
00:29:05,800 --> 00:29:09,320
Speaker 1: super physiologic doses, and we're starting to see that. Have

554
00:29:09,440 --> 00:29:11,280
Speaker 1: you had people coming to you talking to you about

555
00:29:11,320 --> 00:29:13,080
Speaker 1: lucine yet or is this still on the edge.

556
00:29:13,480 --> 00:29:15,000
Speaker 2: I think this is still on the edge, and people

557
00:29:15,040 --> 00:29:16,840
Speaker 2: ask me a lot about protein in general.

558
00:29:16,920 --> 00:29:18,640
Speaker 3: But even it's interesting.

559
00:29:18,680 --> 00:29:21,480
Speaker 2: So I consume, as people will learn if they listen

560
00:29:21,640 --> 00:29:24,800
Speaker 2: to this podcast more. I consume a lot of endurance

561
00:29:24,840 --> 00:29:29,200
Speaker 2: sports content and even there you will see some discussions

562
00:29:29,240 --> 00:29:33,000
Speaker 2: of sort of lucine supplementation, but I think not as

563
00:29:33,080 --> 00:29:35,000
Speaker 2: much as you would get it. Like body, My guess

564
00:29:35,000 --> 00:29:37,680
Speaker 2: is in the body building space. This gets a lot

565
00:29:37,720 --> 00:29:40,800
Speaker 2: of discussion because the core there is muscle building.

566
00:29:41,160 --> 00:29:43,920
Speaker 1: Yeah, yeah, so keep an eye out for that. We

567
00:29:44,400 --> 00:29:48,160
Speaker 1: might end up talking about lucine again in the future

568
00:29:48,200 --> 00:29:51,640
Speaker 1: if we ever get to wrap a micin and aging.

569
00:29:51,760 --> 00:29:56,240
Speaker 1: But speaking of aging the aging brain, so I'm willing

570
00:29:56,280 --> 00:29:59,160
Speaker 1: to concede that to build muscle you probably need to

571
00:29:59,200 --> 00:30:03,280
Speaker 1: have adequate prote ten intake. You probably need to have

572
00:30:04,160 --> 00:30:06,680
Speaker 1: are there recommended? Before we move on? Sorry, can you

573
00:30:06,680 --> 00:30:09,880
Speaker 1: give me a number like I is my one hundred

574
00:30:09,880 --> 00:30:12,600
Speaker 1: and fifty that I had that day? Is that a

575
00:30:12,640 --> 00:30:15,160
Speaker 1: good target for me? Clearly more than the sixty I

576
00:30:15,160 --> 00:30:16,520
Speaker 1: had when I just state mac and cheese.

577
00:30:16,640 --> 00:30:18,880
Speaker 2: Yeah, I mean, I think a lot of a number

578
00:30:18,920 --> 00:30:21,200
Speaker 2: that a lot of people talk about is two grams

579
00:30:21,200 --> 00:30:23,880
Speaker 2: per kilogram or one point six grams per kilograms, So

580
00:30:23,920 --> 00:30:27,400
Speaker 2: that would put people in more like you know, somebody

581
00:30:27,800 --> 00:30:28,720
Speaker 2: like you, more like one.

582
00:30:28,680 --> 00:30:30,760
Speaker 1: Hundred little less than a gram per pound.

583
00:30:30,680 --> 00:30:32,560
Speaker 2: Little less than a graand per pound. A grad per

584
00:30:32,560 --> 00:30:34,800
Speaker 2: pound is a lot of protein. I think many of

585
00:30:34,840 --> 00:30:36,440
Speaker 2: these things go for one point six.

586
00:30:36,480 --> 00:30:39,200
Speaker 1: All right, So I need to find some good ways

587
00:30:39,200 --> 00:30:42,400
Speaker 1: to get me today. Yeah, all right, So let's talk

588
00:30:42,400 --> 00:30:46,800
Speaker 1: about brains a lot of studies of protein supplementation have

589
00:30:46,960 --> 00:30:51,120
Speaker 1: focused on more older people, elderly people, particularly the frail elderly,

590
00:30:51,840 --> 00:30:55,920
Speaker 1: with some interesting results. One I pulled out of the

591
00:30:55,960 --> 00:30:57,600
Speaker 1: ether here a little bit was a trial called the

592
00:30:57,640 --> 00:31:02,480
Speaker 1: pro Muscle Trial smallest set sixty five frail elderly people

593
00:31:02,840 --> 00:31:07,960
Speaker 1: who were randomized to get supplementation with milk protein. Not

594
00:31:08,000 --> 00:31:11,400
Speaker 1: sure if milk protein is different than just way protein,

595
00:31:11,440 --> 00:31:14,520
Speaker 1: but it was described as milk protein thirty grams a

596
00:31:14,600 --> 00:31:18,360
Speaker 1: day in two doses versus just a placebo Emily, you'll

597
00:31:18,360 --> 00:31:21,200
Speaker 1: be happy to hear they both groups got resistance training.

598
00:31:21,520 --> 00:31:23,360
Speaker 3: You have to do resistant Okay, of.

599
00:31:23,280 --> 00:31:27,640
Speaker 1: Course, yes they they both got resistance training. But the

600
00:31:27,960 --> 00:31:31,240
Speaker 1: group randomized to the protein supplements at the end of

601
00:31:31,320 --> 00:31:34,640
Speaker 1: the trial, which was a couple months, had one point

602
00:31:34,640 --> 00:31:38,960
Speaker 1: three kilograms additional lean body mass and had a one

603
00:31:39,040 --> 00:31:42,160
Speaker 1: point improvement on the short physical performance battery, which is

604
00:31:42,200 --> 00:31:45,240
Speaker 1: sort of a variety of exercise based tests. So not

605
00:31:45,400 --> 00:31:48,960
Speaker 1: like amazing, but you know, a nice randomized trial we

606
00:31:49,080 --> 00:31:53,400
Speaker 1: like to see that seem to work. No particular difference

607
00:31:54,160 --> 00:31:56,920
Speaker 1: in their cognition or.

608
00:31:56,880 --> 00:31:59,680
Speaker 2: Memory that would be consistent with the rest of my

609
00:31:59,720 --> 00:32:03,520
Speaker 2: reading of this, which is that the impacts on dementia

610
00:32:03,600 --> 00:32:06,560
Speaker 2: and so on are small or zero. I think what

611
00:32:07,160 --> 00:32:11,959
Speaker 2: sort of interesting and nuanced about that? Is my sense

612
00:32:12,280 --> 00:32:16,360
Speaker 2: from other pieces of data, is it staying like active

613
00:32:16,440 --> 00:32:20,080
Speaker 2: and engaged with the world is very good for your cognition.

614
00:32:20,520 --> 00:32:24,320
Speaker 2: So if consuming more protein and doing some resistance training

615
00:32:24,320 --> 00:32:27,200
Speaker 2: makes you able to walk around more and you know,

616
00:32:27,240 --> 00:32:29,360
Speaker 2: pick up your grandkids and not be bed ridden, that

617
00:32:29,400 --> 00:32:32,880
Speaker 2: could actually be good for your cognition, just because it

618
00:32:32,960 --> 00:32:36,560
Speaker 2: enables activities which are themselves good for cognition. So is

619
00:32:36,560 --> 00:32:39,720
Speaker 2: there a mechanistic effect through the protein affecting your brain.

620
00:32:39,800 --> 00:32:42,320
Speaker 3: Maybe not. Is there a causal effect because it goes

621
00:32:42,320 --> 00:32:43,640
Speaker 3: through these other pathways.

622
00:32:43,360 --> 00:32:45,880
Speaker 1: Maybe there is, I like the off target effects, the

623
00:32:45,920 --> 00:32:49,760
Speaker 1: knockout effects. Let's move on to the third scenario that

624
00:32:49,840 --> 00:32:53,000
Speaker 1: I like to think about when I'm thinking about protein intake,

625
00:32:53,200 --> 00:32:58,360
Speaker 1: which is can of helping lose weight. So protein I

626
00:32:58,440 --> 00:33:02,600
Speaker 1: have been told is good for satiety. It's a little

627
00:33:02,680 --> 00:33:05,600
Speaker 1: harder to break down, certainly than like a simple carbohydrate

628
00:33:05,600 --> 00:33:07,680
Speaker 1: which is going to give you that boost of energy

629
00:33:07,680 --> 00:33:09,880
Speaker 1: and then begone and then you're hungry five minutes later.

630
00:33:10,400 --> 00:33:15,200
Speaker 1: So I can make a biologic plausibility argument that proteins

631
00:33:15,240 --> 00:33:17,680
Speaker 1: will help you lose weight. Do you think they really

632
00:33:17,960 --> 00:33:20,000
Speaker 1: does A higher protein diet, I should say, really help

633
00:33:20,000 --> 00:33:22,480
Speaker 1: you lose weight, all else being equal, calorically.

634
00:33:22,040 --> 00:33:27,240
Speaker 2: Speaking, look, maybe a little bit in the short term.

635
00:33:27,600 --> 00:33:32,320
Speaker 2: In a very core fact about diets is that they

636
00:33:32,320 --> 00:33:36,160
Speaker 2: mostly don't work in the long term. Most dietary changes

637
00:33:36,200 --> 00:33:38,160
Speaker 2: can cause people to lose some weight in the short term,

638
00:33:38,240 --> 00:33:40,600
Speaker 2: and then mostly they gain it back in the slightly

639
00:33:41,160 --> 00:33:46,400
Speaker 2: longer term. To the extent that protein causes you to

640
00:33:46,400 --> 00:33:48,080
Speaker 2: feel more full and makes it easier for you to

641
00:33:48,120 --> 00:33:52,160
Speaker 2: stick to the diet, then okay, that could make it

642
00:33:52,160 --> 00:33:54,160
Speaker 2: more effective, but this is not a game changer.

643
00:33:54,200 --> 00:33:54,440
Speaker 1: I mean.

644
00:33:54,440 --> 00:33:58,080
Speaker 2: And I also find this discussion at this point like

645
00:33:58,240 --> 00:34:00,840
Speaker 2: if people want to lose significt get amount of weight,

646
00:34:01,200 --> 00:34:04,479
Speaker 2: they should go on a GLP one And that's just

647
00:34:04,520 --> 00:34:05,000
Speaker 2: what it is.

648
00:34:06,160 --> 00:34:09,000
Speaker 1: I tend to agree with you. I think all the

649
00:34:09,040 --> 00:34:13,239
Speaker 1: successful diets tend to be transient, and they all share

650
00:34:13,280 --> 00:34:15,440
Speaker 1: one thing in common, which is that it makes it

651
00:34:15,480 --> 00:34:18,520
Speaker 1: harder to eat food. And so you know, if you

652
00:34:18,520 --> 00:34:20,960
Speaker 1: look at Atkins or something, you know these keto diets,

653
00:34:21,040 --> 00:34:23,399
Speaker 1: like it just is harder. You have to think more

654
00:34:23,440 --> 00:34:25,680
Speaker 1: about what you eat. You have to plan a little

655
00:34:25,680 --> 00:34:29,520
Speaker 1: bit more, and I think high protein diets. My personal

656
00:34:29,560 --> 00:34:32,160
Speaker 1: experience as I've started to look around and like get

657
00:34:32,200 --> 00:34:34,200
Speaker 1: more protein into the food I eat is the same thing.

658
00:34:34,239 --> 00:34:35,839
Speaker 1: I'm like, oh no, I can't eat that. You know

659
00:34:35,920 --> 00:34:39,400
Speaker 1: that those chips are not you know, there's no protein

660
00:34:39,440 --> 00:34:40,759
Speaker 1: in there, and I need to find a source that

661
00:34:40,800 --> 00:34:42,440
Speaker 1: gets my protein. So I think whenever you make it

662
00:34:42,480 --> 00:34:46,719
Speaker 1: difficult for people to eat, yeah, protein chips would be

663
00:34:46,920 --> 00:34:48,960
Speaker 1: you know, but if you make it difficult for people

664
00:34:49,000 --> 00:34:51,000
Speaker 1: to eat, you're always going to lose some weight. I mean,

665
00:34:51,040 --> 00:34:53,719
Speaker 1: I will say there was a just to pull out

666
00:34:53,760 --> 00:34:56,480
Speaker 1: a randomized trial, you know, there is some evidence of

667
00:34:56,480 --> 00:34:59,279
Speaker 1: weight loss. There is a twenty ten study which randomized

668
00:34:59,560 --> 00:35:02,800
Speaker 1: and men with diabetes to a thirty five percent protein

669
00:35:02,880 --> 00:35:07,120
Speaker 1: diet to it versus a fifteen percent protein diet. They

670
00:35:07,120 --> 00:35:10,400
Speaker 1: were both calorie restricted. So that's that's another thing you

671
00:35:10,440 --> 00:35:12,560
Speaker 1: have to account for. Like, as you said, Emily, if

672
00:35:12,600 --> 00:35:15,759
Speaker 1: you eat more protein, but by eating more protein, you're

673
00:35:15,800 --> 00:35:19,440
Speaker 1: eating thirty percent more calories, You're you're definitely not going

674
00:35:19,520 --> 00:35:23,640
Speaker 1: to lose weight, right. But in this calorie equalized environment,

675
00:35:24,200 --> 00:35:27,120
Speaker 1: the men who randomized to the protein that had about

676
00:35:27,120 --> 00:35:31,400
Speaker 1: a three kilogram extra weight loss after four months. This

677
00:35:31,600 --> 00:35:34,759
Speaker 1: is not impressive in a world that has GLP ones,

678
00:35:34,800 --> 00:35:37,080
Speaker 1: I understand, but as we said, not everyone has access

679
00:35:37,120 --> 00:35:39,520
Speaker 1: to GLP ones. Everyone has access to protein.

680
00:35:39,560 --> 00:35:40,400
Speaker 3: We hope agreed.

681
00:35:40,560 --> 00:35:43,040
Speaker 2: I will say there is an addendum here in the

682
00:35:43,080 --> 00:35:45,360
Speaker 2: GLP one space, which is to the extent that people

683
00:35:45,400 --> 00:35:47,839
Speaker 2: are on a GLP one, you know, that makes you

684
00:35:47,920 --> 00:35:53,480
Speaker 2: eat less. And as we said at the top, protein continues.

685
00:35:52,920 --> 00:35:54,400
Speaker 3: To be very important.

686
00:35:54,960 --> 00:35:57,759
Speaker 2: And so to the extent that you are on a

687
00:35:57,800 --> 00:35:59,719
Speaker 2: GLP one and trying to lose weight and do.

688
00:35:59,680 --> 00:36:02,240
Speaker 3: Not want to lose muscle mass, you.

689
00:36:02,120 --> 00:36:05,920
Speaker 2: Do need to prioritize getting a larger share of your

690
00:36:05,920 --> 00:36:08,360
Speaker 2: calories from protein, because you basically want to keep your

691
00:36:08,400 --> 00:36:11,760
Speaker 2: protein more similar to where it was and drop other things.

692
00:36:11,760 --> 00:36:13,879
Speaker 2: And I think that can be a challenge for people

693
00:36:13,960 --> 00:36:16,680
Speaker 2: when they're sort of not hungry and they just kind

694
00:36:16,719 --> 00:36:19,319
Speaker 2: of don't want to eat anything. It's not just eating less,

695
00:36:19,320 --> 00:36:21,759
Speaker 2: it's changing the balances of food.

696
00:36:22,120 --> 00:36:23,560
Speaker 1: This is what I want to hear from you as

697
00:36:23,560 --> 00:36:28,080
Speaker 1: we as we wrap this up. My wife has terminator

698
00:36:28,160 --> 00:36:30,520
Speaker 1: vision for food, Like she can look at a plate

699
00:36:30,880 --> 00:36:33,279
Speaker 1: of food and tell you, like, how many calories, how

700
00:36:33,280 --> 00:36:35,320
Speaker 1: many grams are fat? How many grams of protein? I

701
00:36:35,320 --> 00:36:37,400
Speaker 1: don't know if all women have this. I'm not sure

702
00:36:37,520 --> 00:36:38,279
Speaker 1: if it's built in.

703
00:36:38,480 --> 00:36:39,160
Speaker 3: We developed it.

704
00:36:39,280 --> 00:36:41,399
Speaker 2: We've developed it all women in our in our mid

705
00:36:41,440 --> 00:36:43,480
Speaker 2: to late forties. We developed this a long time ago,

706
00:36:43,520 --> 00:36:47,000
Speaker 2: and we're retaining that skilled ye accurating a bike.

707
00:36:46,960 --> 00:36:49,200
Speaker 1: Like I will, I will take a package that has

708
00:36:49,239 --> 00:36:51,840
Speaker 1: the nutritional information and she will be able to do

709
00:36:51,880 --> 00:36:55,920
Speaker 1: it. It's very impressive. I cannot do that. I know that. Intellectually.

710
00:36:55,960 --> 00:36:59,160
Speaker 1: I'm like, oh, yeah, chicken, that's good. But let's say

711
00:36:59,320 --> 00:37:01,279
Speaker 1: I decide, you know what I'm going to go for it.

712
00:37:01,320 --> 00:37:04,560
Speaker 1: I'm going a gram per pound a lot of protein.

713
00:37:04,600 --> 00:37:06,640
Speaker 1: I don't think I can make it. What are your

714
00:37:06,719 --> 00:37:11,400
Speaker 1: tips for me? And maybe I'll make it even simpler?

715
00:37:11,520 --> 00:37:13,200
Speaker 1: Is there any way to do this short of me

716
00:37:13,480 --> 00:37:16,080
Speaker 1: buying in bulk some can of protein powder, whether it's

717
00:37:16,120 --> 00:37:19,760
Speaker 1: weigh powder or soy powder or you know, wheature, whatever

718
00:37:19,800 --> 00:37:22,720
Speaker 1: it is, and adding it to things and making shakes?

719
00:37:22,840 --> 00:37:26,000
Speaker 1: Or can I do this with food as it exists

720
00:37:26,160 --> 00:37:26,880
Speaker 1: in reality?

721
00:37:27,960 --> 00:37:30,440
Speaker 3: So we term doesn't have a lot of protein, So don't.

722
00:37:30,440 --> 00:37:33,080
Speaker 1: Vi weat gluten? Sorry weak gluten?

723
00:37:33,400 --> 00:37:35,200
Speaker 3: Oh good lord? Okay?

724
00:37:34,920 --> 00:37:41,000
Speaker 2: So uh So I will say I think for most people,

725
00:37:41,239 --> 00:37:44,839
Speaker 2: if you are attempting to get something like a gram

726
00:37:44,880 --> 00:37:47,640
Speaker 2: per pound of body weight, which again is a lot

727
00:37:48,280 --> 00:37:51,319
Speaker 2: even for a pretty small person, is a lot, you

728
00:37:51,400 --> 00:37:56,280
Speaker 2: will need to use some kind of protein powder, something

729
00:37:57,120 --> 00:38:01,640
Speaker 2: some kind of thoughtful of pro coach, which probably involves

730
00:38:01,800 --> 00:38:05,360
Speaker 2: supplementation with not real food. You know, think about like

731
00:38:05,360 --> 00:38:08,600
Speaker 2: a protein shake, you know why. Protein shake probably has

732
00:38:08,920 --> 00:38:11,760
Speaker 2: can you know, can have twenty five grams of protein.

733
00:38:12,160 --> 00:38:14,839
Speaker 2: That's like a whole chicken breast pretty much. And it's

734
00:38:14,880 --> 00:38:18,520
Speaker 2: just hard for people to consume enough whole foods to

735
00:38:18,600 --> 00:38:21,600
Speaker 2: get that kind of protein without also adding a lot

736
00:38:21,600 --> 00:38:24,279
Speaker 2: of fat and carbohydrates. So I will say, you asked

737
00:38:24,280 --> 00:38:25,719
Speaker 2: me at the top, how much protein do you eat

738
00:38:25,760 --> 00:38:28,800
Speaker 2: in a day? I do eat about a gram of

739
00:38:28,880 --> 00:38:31,040
Speaker 2: protein per pound of body weights. That's about one hundred

740
00:38:31,040 --> 00:38:33,719
Speaker 2: and thirty ish grams of protein a day. And the

741
00:38:33,760 --> 00:38:36,360
Speaker 2: only way that I can achieve that is by consuming

742
00:38:37,080 --> 00:38:39,040
Speaker 2: like a large protein shake in the morning.

743
00:38:39,239 --> 00:38:41,000
Speaker 1: And what is the protein? Is it way protein?

744
00:38:41,040 --> 00:38:44,240
Speaker 2: Typically that it's just way breakenth yeah, just way protein.

745
00:38:45,040 --> 00:38:47,719
Speaker 2: All right, all right, So now here's my question for you.

746
00:38:48,000 --> 00:38:50,280
Speaker 2: We have revealed that I'm a crazy person who drinks,

747
00:38:50,320 --> 00:38:52,720
Speaker 2: who eat, consumes a lot of protein, and I should

748
00:38:52,760 --> 00:38:54,719
Speaker 2: say I just I want to say. The reason that

749
00:38:54,800 --> 00:38:56,719
Speaker 2: I consume a lot of protein, getting back to these

750
00:38:56,800 --> 00:38:58,640
Speaker 2: questions of like why are you doing this, is that

751
00:38:58,719 --> 00:39:02,440
Speaker 2: I take myself infinitely too seriously with sports. I'm like

752
00:39:02,440 --> 00:39:05,680
Speaker 2: a pretend elite athlete, a person who pretends to be

753
00:39:05,680 --> 00:39:08,239
Speaker 2: an athlete, and I so I run a lot and

754
00:39:08,280 --> 00:39:10,880
Speaker 2: I consume a lot of protein in service of that.

755
00:39:11,000 --> 00:39:12,960
Speaker 3: So that is my that is my reasoning.

756
00:39:13,040 --> 00:39:16,640
Speaker 1: So not for everyone, but not for people.

757
00:39:16,440 --> 00:39:20,960
Speaker 2: Like you people crazy people. So here's my question. Can

758
00:39:21,000 --> 00:39:23,840
Speaker 2: you have too much protein? And what would happen?

759
00:39:24,320 --> 00:39:29,040
Speaker 1: So yes, as a medical doctor, yes you can. So

760
00:39:29,080 --> 00:39:29,920
Speaker 1: a couple of things.

761
00:39:30,719 --> 00:39:34,160
Speaker 3: You're a kidney doctor, I'm a kidney doctor, specifically good.

762
00:39:34,120 --> 00:39:36,880
Speaker 1: Particular yes, yes, no, this is this is certainly right

763
00:39:37,000 --> 00:39:39,319
Speaker 1: up my alley. So so yeah, I mean, first of all,

764
00:39:39,360 --> 00:39:41,680
Speaker 1: if you only had protein to the exclusion of all

765
00:39:41,719 --> 00:39:44,239
Speaker 1: other macro nutrients, you die. We talked about this, very

766
00:39:44,320 --> 00:39:47,880
Speaker 1: difficult to do unless you're only eating rabbit meat, so

767
00:39:47,880 --> 00:39:50,879
Speaker 1: I'm not too worried about that. But from a kidney standpoint,

768
00:39:50,920 --> 00:39:55,640
Speaker 1: the data is quite compelling that more protein intake puts

769
00:39:56,360 --> 00:40:00,680
Speaker 1: more stress on the kidneys. And I'm pausing on the

770
00:40:00,719 --> 00:40:03,880
Speaker 1: word stress, because what exactly do I mean by that.

771
00:40:04,320 --> 00:40:07,120
Speaker 1: We measure kidneys filter the blood, and we can measure

772
00:40:07,160 --> 00:40:10,160
Speaker 1: the rate at which they filter the blood in milli

773
00:40:10,239 --> 00:40:12,520
Speaker 1: liters per minute, and for a healthy person it's about

774
00:40:12,520 --> 00:40:15,480
Speaker 1: one hundred millimeters per minute, which means that you're cycling

775
00:40:15,520 --> 00:40:19,080
Speaker 1: through your entire blood volume dozens and dozens of times

776
00:40:19,080 --> 00:40:21,640
Speaker 1: a day with your kidneys cleaning that, which is great.

777
00:40:22,560 --> 00:40:27,680
Speaker 1: Acute protein intake increases that filtration rate so from one

778
00:40:27,760 --> 00:40:30,280
Speaker 1: hundred to one hundred and ten one hundred and twenty

779
00:40:30,360 --> 00:40:33,759
Speaker 1: mili liters per minute, and you might think great, you know,

780
00:40:33,880 --> 00:40:36,680
Speaker 1: like that's more filtration now. Of course, the reason your

781
00:40:36,760 --> 00:40:40,080
Speaker 1: kidneys are doing that is because, unlike carbohydrates and fat,

782
00:40:40,640 --> 00:40:45,280
Speaker 1: proteins are metabolized into ammonia, and ammonia needs to be excreted.

783
00:40:45,320 --> 00:40:47,879
Speaker 1: It's excreted as this thing called urea, which is where

784
00:40:48,000 --> 00:40:50,839
Speaker 1: urine gets its name. But urea is the way that

785
00:40:51,040 --> 00:40:54,520
Speaker 1: urine excretes ammonia. You have to increase filtration to get

786
00:40:54,600 --> 00:40:58,320
Speaker 1: rid of the ammonia load. There is data in people

787
00:40:58,360 --> 00:41:03,400
Speaker 1: with kidney disease that low protein diets protect the kidneys

788
00:41:03,400 --> 00:41:07,600
Speaker 1: in the long term. That's been well established. In fact,

789
00:41:08,440 --> 00:41:11,440
Speaker 1: up until about ten years ago, we would routinely recommend

790
00:41:11,440 --> 00:41:14,480
Speaker 1: people with kidney disease to decrease their protein intake for

791
00:41:14,600 --> 00:41:19,279
Speaker 1: just this reason. Nowadays I don't do that, in part

792
00:41:19,320 --> 00:41:22,040
Speaker 1: because of what we've talked about. I'm also worried about

793
00:41:22,040 --> 00:41:25,080
Speaker 1: their muscle mass and their health and their ability to

794
00:41:25,480 --> 00:41:27,720
Speaker 1: move around and get exercise, and I don't like telling

795
00:41:27,719 --> 00:41:30,600
Speaker 1: people to restrict, but I certainly don't tell my patients

796
00:41:30,600 --> 00:41:34,520
Speaker 1: with kidney disease to like supplement protein. And the reason

797
00:41:35,320 --> 00:41:39,400
Speaker 1: it seems that your kidneys are better off when they're

798
00:41:39,440 --> 00:41:42,759
Speaker 1: not stressed like this, when they're not forced to increase filtration,

799
00:41:43,480 --> 00:41:46,720
Speaker 1: is that there's a finite amount of tread on the tire,

800
00:41:47,280 --> 00:41:51,480
Speaker 1: and at least for people with underlying kidney disease, forcing

801
00:41:51,520 --> 00:41:53,759
Speaker 1: them to run at one hundred and ten percent one

802
00:41:53,840 --> 00:41:57,360
Speaker 1: hundred and twenty percent capacity just stresses them out more

803
00:41:57,440 --> 00:42:01,080
Speaker 1: and you lose kidney function faster. What I don't know

804
00:42:01,120 --> 00:42:04,400
Speaker 1: if is that's true for people without any kidney disease.

805
00:42:04,760 --> 00:42:07,560
Speaker 1: We don't have long term data a very high protein

806
00:42:07,600 --> 00:42:10,560
Speaker 1: intake to suggest if that alone in the absence of

807
00:42:10,600 --> 00:42:13,040
Speaker 1: other diseases is going to affect kidney function, but it

808
00:42:13,080 --> 00:42:15,240
Speaker 1: clearly does in people with underlying kidney disease.

809
00:42:15,600 --> 00:42:18,560
Speaker 2: I think the other piece of the we will never

810
00:42:18,640 --> 00:42:20,640
Speaker 2: know the answer to your last question, I think because

811
00:42:20,680 --> 00:42:23,320
Speaker 2: the kind of people who are consuming very high amounts

812
00:42:23,320 --> 00:42:26,920
Speaker 2: of protein are also very different, correct, mostly healthier, but

813
00:42:27,080 --> 00:42:29,600
Speaker 2: just very different in other ways. So we would never

814
00:42:29,680 --> 00:42:32,040
Speaker 2: really be able to compare you know, the people who

815
00:42:32,080 --> 00:42:34,880
Speaker 2: having two and a half grams of protein per kilog

816
00:42:35,320 --> 00:42:38,160
Speaker 2: like these very high levels to lower levels, because you're

817
00:42:38,160 --> 00:42:38,480
Speaker 2: just going to.

818
00:42:38,480 --> 00:42:40,399
Speaker 3: Find they're different in all kinds of other all kinds

819
00:42:40,440 --> 00:42:40,879
Speaker 3: of other ways.

820
00:42:40,960 --> 00:42:44,759
Speaker 1: Yeah, there's a very hypothetical other risk which I will

821
00:42:44,840 --> 00:42:49,840
Speaker 1: just say that protein does have signaling effects, including that

822
00:42:49,920 --> 00:42:53,440
Speaker 1: lucine thing that signals muscles to grow. In the context

823
00:42:53,440 --> 00:42:55,760
Speaker 1: of muscle, we like growth, but there are other parts

824
00:42:55,760 --> 00:42:59,120
Speaker 1: of the body that we don't want to grow. And

825
00:42:59,200 --> 00:43:01,920
Speaker 1: so yourself in your body are kind of constantly under

826
00:43:02,360 --> 00:43:06,560
Speaker 1: balanced signals saying grow, divide like fill in this space,

827
00:43:06,600 --> 00:43:08,920
Speaker 1: you got to cut like heel at that kind of stuff.

828
00:43:09,000 --> 00:43:12,040
Speaker 1: Muscles get bigger, you know, fat cells grow like all

829
00:43:12,080 --> 00:43:14,839
Speaker 1: those kind of things, and signals that say no no, no,

830
00:43:15,120 --> 00:43:18,120
Speaker 1: stay quiet, stay where you are. We know when those

831
00:43:18,120 --> 00:43:21,360
Speaker 1: signals get out of hand and excessive growth signaling occurs

832
00:43:21,480 --> 00:43:25,520
Speaker 1: that that is a step towards cancer development and lucine.

833
00:43:25,520 --> 00:43:31,160
Speaker 1: This particular amino acid stimulates a molecule called m tour,

834
00:43:31,320 --> 00:43:37,000
Speaker 1: a million target of wrapamycin, which is a known cancer

835
00:43:37,840 --> 00:43:42,680
Speaker 1: promoting chemical in the blood. Now it also promotes muscle growth.

836
00:43:43,040 --> 00:43:46,680
Speaker 1: So and there are usually there are many steps to

837
00:43:46,719 --> 00:43:49,120
Speaker 1: getting cancer beyond just like, oh, your level of M

838
00:43:49,200 --> 00:43:51,319
Speaker 1: tour might be a little bit too high. So I'm

839
00:43:51,320 --> 00:43:53,280
Speaker 1: not as worried about this as I am about kidney

840
00:43:53,320 --> 00:43:55,719
Speaker 1: function and very high protein intake. But you know, for

841
00:43:55,840 --> 00:43:59,080
Speaker 1: interest of completeness, we should say that growth in and

842
00:43:59,120 --> 00:44:02,920
Speaker 1: of itself is not universally a good thing. Okay, that

843
00:44:03,080 --> 00:44:06,520
Speaker 1: is a ton of information about protein. Let's let's wrap

844
00:44:06,560 --> 00:44:10,520
Speaker 1: this up, Emily, protein smash or pass?

845
00:44:12,000 --> 00:44:13,440
Speaker 3: I think this question is unfair.

846
00:44:13,680 --> 00:44:16,640
Speaker 2: You need protein for life, so in that sense, I

847
00:44:16,640 --> 00:44:20,120
Speaker 2: would say I'm going to smash it as an essential

848
00:44:20,160 --> 00:44:23,200
Speaker 2: element of not being did I will say if the

849
00:44:23,640 --> 00:44:28,239
Speaker 2: if the question is do I smash getting even more

850
00:44:28,320 --> 00:44:30,480
Speaker 2: protein than you're getting now, I think.

851
00:44:30,280 --> 00:44:33,200
Speaker 3: For most people I'm a pass on that. How about you.

852
00:44:35,040 --> 00:44:38,799
Speaker 1: I'm I think a soft smash on this question of

853
00:44:38,920 --> 00:44:42,280
Speaker 1: getting extra protein. You know, I think probably we should

854
00:44:42,320 --> 00:44:45,920
Speaker 1: be more cognizant of the protein we take in. If

855
00:44:45,920 --> 00:44:48,400
Speaker 1: we can get some extra protein, especially if we're replacing

856
00:44:48,440 --> 00:44:53,000
Speaker 1: carbs in our diet, I'm down for that certainly. I

857
00:44:53,040 --> 00:44:56,400
Speaker 1: think my one concern actually is that we really should

858
00:44:56,400 --> 00:44:58,799
Speaker 1: be getting as much protein as possible from plant based

859
00:44:58,840 --> 00:45:02,360
Speaker 1: sources so we don't tank our fiber intake, which is

860
00:45:02,400 --> 00:45:05,520
Speaker 1: something we'll talk about in future episodes, especially when we

861
00:45:05,600 --> 00:45:09,000
Speaker 1: look at the arising incidents of colon cancer. So cautious smash,

862
00:45:09,040 --> 00:45:10,319
Speaker 1: but you don't have to go crazy about it.

863
00:45:11,680 --> 00:45:15,280
Speaker 2: I feel like you're putting too many caveats into your smashes.

864
00:45:15,320 --> 00:45:18,600
Speaker 2: We have to be a committed Perry in future episodes.

865
00:45:19,080 --> 00:45:24,120
Speaker 2: Commit to smash your pass. There's a soft smash. All right, Fine,

866
00:45:24,480 --> 00:45:27,040
Speaker 2: that's it for protein your mail bag Question of the

867
00:45:27,080 --> 00:45:28,080
Speaker 2: week after the Break.

868
00:45:33,560 --> 00:45:35,839
Speaker 4: Hi, Emile and Perry. My name is Natalie and I'm

869
00:45:35,840 --> 00:45:38,680
Speaker 4: from Boston. Have been listening to the podcast and I

870
00:45:38,719 --> 00:45:40,560
Speaker 4: heard you say that there's a lack of evidence on

871
00:45:40,640 --> 00:45:43,880
Speaker 4: the efficacy of shockwave therapy. I've received this treatment a

872
00:45:43,920 --> 00:45:47,279
Speaker 4: couple of times. For instances of tendonosis, and I was

873
00:45:47,360 --> 00:45:50,719
Speaker 4: really pleasantly surprised. Of course, I'm willing to accept the

874
00:45:50,760 --> 00:45:53,799
Speaker 4: possibility of the placebo effect, but my curse research of

875
00:45:53,840 --> 00:45:56,359
Speaker 4: the literature did turn up a few studies that seem

876
00:45:56,480 --> 00:45:59,239
Speaker 4: to support shockwave treatment. I would love to hear your

877
00:45:59,280 --> 00:46:02,080
Speaker 4: thoughts on this. Thank you so much. Hi.

878
00:46:03,080 --> 00:46:04,040
Speaker 3: Shockwave therapy.

879
00:46:04,440 --> 00:46:08,040
Speaker 2: Yes, so, I have spent a lot of personal time, Perry,

880
00:46:08,239 --> 00:46:14,000
Speaker 2: looking into this because I had a hamstring injury, hamstring tendinopathy,

881
00:46:14,040 --> 00:46:16,359
Speaker 2: and I was told that shockwave therapy would help for

882
00:46:16,440 --> 00:46:18,480
Speaker 2: those of you who are not you know, deep in

883
00:46:18,520 --> 00:46:22,600
Speaker 2: the well of this activity. What this involves, at least

884
00:46:22,600 --> 00:46:26,880
Speaker 2: in the sports context, is somebody taking a probe and

885
00:46:26,920 --> 00:46:31,200
Speaker 2: some gel and delivering like acoustic waves into your tissue.

886
00:46:31,280 --> 00:46:35,000
Speaker 2: It's quite uncomfortable, and the idea is that it like

887
00:46:35,200 --> 00:46:40,040
Speaker 2: boosts your cell metabolism and generates better repair. I will

888
00:46:40,080 --> 00:46:43,040
Speaker 2: say I did look into the data before I did this,

889
00:46:43,239 --> 00:46:48,080
Speaker 2: and there is some reasonable randomized data suggesting that this

890
00:46:48,280 --> 00:46:54,400
Speaker 2: improves healing speed in some tendonopathy related injuries, things like

891
00:46:54,480 --> 00:47:00,480
Speaker 2: achilles tennis elbow rotator, actually your rotator cuff, Perry, it

892
00:47:00,560 --> 00:47:03,560
Speaker 2: might help with that and I will say really helped

893
00:47:03,560 --> 00:47:06,319
Speaker 2: with my hamstring, although it's very painful. Like there's a

894
00:47:06,320 --> 00:47:08,239
Speaker 2: person doing this and they're like, what's your pain level.

895
00:47:08,320 --> 00:47:09,239
Speaker 3: I was like, oh, it's like a four.

896
00:47:09,320 --> 00:47:11,160
Speaker 2: He's like great, we're going for a seven, and then

897
00:47:11,160 --> 00:47:16,000
Speaker 2: they just like turn it up until you're like, ah.

898
00:47:15,080 --> 00:47:17,360
Speaker 1: Just compared to that, my hamstring feels great.

899
00:47:18,000 --> 00:47:21,040
Speaker 2: Exactly afterwards, you're like, oh, thank god it's over. So

900
00:47:21,239 --> 00:47:23,440
Speaker 2: a little bit of positive evidence on this.

901
00:47:24,000 --> 00:47:26,400
Speaker 1: Yeah, we use it for kidney stones. Actually, I mean

902
00:47:26,440 --> 00:47:29,080
Speaker 1: this is sort of different, but you know, for small

903
00:47:29,200 --> 00:47:31,160
Speaker 1: enough kidney stones, you can send the shock weaves in

904
00:47:31,200 --> 00:47:34,800
Speaker 1: and they kind of break up like an opera singer

905
00:47:34,880 --> 00:47:37,040
Speaker 1: shattering a glass with her voice, and then you pass

906
00:47:37,120 --> 00:47:40,799
Speaker 1: the little pieces out, which is I guess better than

907
00:47:40,880 --> 00:47:43,200
Speaker 1: going up and retrieving them yourselves. Do you want to

908
00:47:43,239 --> 00:47:44,440
Speaker 1: know a little interesting physics?

909
00:47:45,440 --> 00:47:47,400
Speaker 3: Yes, always so.

910
00:47:48,080 --> 00:47:51,000
Speaker 1: An ellipse has two fox si. That's like how you

911
00:47:51,000 --> 00:47:54,000
Speaker 1: define the ellipse, Like two focuses two points inside the ellipse,

912
00:47:54,000 --> 00:47:56,320
Speaker 1: and every point along the outer edge of the ellipse

913
00:47:56,400 --> 00:48:00,000
Speaker 1: is equidistant from like the sum to the distance between

914
00:48:00,120 --> 00:48:02,520
Speaker 1: those focia is constant. That's what defines an ellipse. Okay, wait,

915
00:48:03,600 --> 00:48:08,200
Speaker 1: any time anything that goes through one focus bounces off

916
00:48:08,239 --> 00:48:10,520
Speaker 1: the edge of the ellipse and will go through the

917
00:48:10,560 --> 00:48:15,399
Speaker 1: other focus. And so for extra corporeal shockwave lithotripsy, they

918
00:48:15,440 --> 00:48:18,759
Speaker 1: put the sound emitting device, the ultrasound device, at one

919
00:48:19,440 --> 00:48:23,880
Speaker 1: focus of the ellipse, and then they curve the ellipse

920
00:48:24,160 --> 00:48:26,319
Speaker 1: that it's in. It's like a half ellipse, a shell,

921
00:48:26,520 --> 00:48:30,160
Speaker 1: so that's that sound bounces off and all of it

922
00:48:30,200 --> 00:48:33,600
Speaker 1: gets focused into the other focus of the ellipse, which

923
00:48:33,600 --> 00:48:35,560
Speaker 1: is somewhere inside your body. Isn't that kind of neat?

924
00:48:36,239 --> 00:48:42,400
Speaker 2: That is incredibly interesting and physics is very neat, I

925
00:48:42,440 --> 00:48:44,720
Speaker 2: think no. Okay, So one question I think maybe people

926
00:48:44,719 --> 00:48:47,120
Speaker 2: have about the shockwave therapy is like, is this just

927
00:48:47,200 --> 00:48:50,760
Speaker 2: place ebo? Because of course we know the placebo effect

928
00:48:50,800 --> 00:48:52,960
Speaker 2: is one of the best effects, and it's hard to

929
00:48:53,120 --> 00:48:57,080
Speaker 2: know if something is real or sham. But actually, in

930
00:48:57,120 --> 00:48:59,319
Speaker 2: a lot of these studies of shockwave therapy they do

931
00:48:59,440 --> 00:49:04,879
Speaker 2: placebo sham shockwave therapy on people. I'm not really sure

932
00:49:04,880 --> 00:49:07,240
Speaker 2: how that would be involved and is it less painful?

933
00:49:07,280 --> 00:49:09,920
Speaker 2: So we always have to be careful about placibo effects.

934
00:49:09,960 --> 00:49:11,879
Speaker 2: On the other hand, my hamstring feels much better, So

935
00:49:12,000 --> 00:49:12,960
Speaker 2: I guess I don't care.

936
00:49:13,000 --> 00:49:17,200
Speaker 3: Why is my fundamental answer? All right, that's it for

937
00:49:17,239 --> 00:49:17,640
Speaker 3: this week.

938
00:49:17,920 --> 00:49:20,319
Speaker 2: Join us next week when we'll ask what's the deal

939
00:49:20,400 --> 00:49:25,759
Speaker 2: with continuous glucose monitors? Wellness Actually is produced in association

940
00:49:25,880 --> 00:49:26,960
Speaker 2: with iHeartMedia.

941
00:49:27,360 --> 00:49:29,280
Speaker 3: Our senior producer is Tamar Avishai.

942
00:49:29,719 --> 00:49:33,359
Speaker 2: Our executive producer at iHeart is Jennifer Bassett. Our theme

943
00:49:33,440 --> 00:49:36,080
Speaker 2: music is by Eric Deutsch, and our content is for

944
00:49:36,200 --> 00:49:37,399
Speaker 2: educational purposes only.

945
00:49:38,120 --> 00:49:40,359
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946
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947
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948
00:49:46,320 --> 00:49:49,360
Speaker 1: the show. You can follow us on Instagram at Wellness

949
00:49:49,400 --> 00:49:52,600
Speaker 1: Actually pod and don't forget We want to hear from you.

950
00:49:53,000 --> 00:49:55,520
Speaker 1: Head over to Wellness Actually dot fm and leave us

951
00:49:55,560 --> 00:49:58,160
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952
00:49:58,160 --> 00:49:58,839
Speaker 1: a future show.

953
00:49:59,560 --> 00:50:01,439
Speaker 3: We'll let the influencers have the last word.

954
00:50:02,040 --> 00:50:05,760
Speaker 5: This is why I'm jacked and you're not. It's because

955
00:50:05,840 --> 00:50:09,760
Speaker 5: I eat meals like this round beef and whole eggs,

956
00:50:10,040 --> 00:50:15,440
Speaker 5: pure protein and healthy fats, zero carbohydrates. This is what

957
00:50:15,560 --> 00:50:18,520
Speaker 5: I wish fat people understood if they just cut out

958
00:50:18,560 --> 00:50:22,959
Speaker 5: carbohydrates for two weeks. I'm talking zero grams to twenty

959
00:50:22,960 --> 00:50:27,520
Speaker 5: grams of carbs per day. They would lose ten pounds instantly.

960
00:50:27,920 --> 00:50:38,760
Speaker 1: It's that easy.