Protein, muscle, aging, and longevity

Two references I've recently ran across seem to say two completely opposite things about aging, or rather managing and reducing the rate of aging.  Both relate to one particular input, to adjusting protein consumption and amount of bodily muscle tissue.  Offsetting aging is an aggressive goal, but whether that's practical or not it can be interesting to hear about potential approaches, or even uncertain background.

One set of statements and claims by Leo (Laith) of the Leo and Longevity YouTube channel claims that reduced calorie intake, and specifically reduced protein intake, increases lifespan. Another article connects lack of muscle with aging issues, and claims that substantial protein intake is necessary to maintain higher levels of muscle tissue, which increases both longevity and health in later life. I think we can unpack both and resolve this apparent contradiction, to some limited extent. 

A lot of this will be my own speculation, to be clear, and I'm not some sort of medical professional.  I will mention some unusual personal exposure along the way, but that's not intended as clearly defined evidence, just extra anecdotal input.

Let's start with the pro-muscle development article, Muscle Is the Cornerstone of Longevity:

Pumping iron, weight-lifting, strength training—call it what you want, but it is key to living longer, according to Dr. Gabrielle Lyon...

  

“The more muscle mass, the more survivability against diseases,” Dr. Lyon explained. But muscle mass must be maintained to have these effects. It’s a use-it-or-lose-it part of our biology due to sarcopenia. Sarcopenia, as defined by the National Institute on Aging, is “a decline in muscle mass, strength, and function...” ...Weight training is essential to mitigate these effects as we age. When you “stimulate skeletal muscle,” stated Dr. Lyon, “ [you] maintain mobility, mental clarity, hormonal balance, and improve mood.” 

The National Institute on Aging explains that “a big culprit for losing our physical abilities as we grow older is the age-related loss of muscle mass and strength…in addition to making everyday tasks difficult, mobility limitations are also linked to higher rates of falls, chronic disease, nursing home admission, and mortality.” Dr. Lyon emphasized that we should be “focusing on building muscles rather than losing fat. [Muscle] will help you build your body armor to protect you throughout life.” 

...Adiposity [being overweight] is the result of a health problem, not the starting point. It is the same with other chronic diseases “such as type 2 diabetes, heart disease, and fatty liver.” According to Dr. Howard J. Luks, an orthopedic sports medicine surgeon, in his article, Muscle Mass, Strength, and Longevity, he writes “losing active [muscle] tissue can have dramatic consequences. Muscles help us control our glucose levels, use glucose as fuel, and have a role in insulin resistance.” So, instead of thinking of fat as the root cause of health problems, we must understand that it’s no more than the middleman. The actual chain of command is unhealthy muscle tissue, adiposity, then disease. 

But to build healthy muscle tissue, you need protein. “Protein is necessary for nearly every function in the body and every structure,” explained Lyon. “There are 20 different amino acids. We need the nine essentials—histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine—to support many processes that happen within our body. Each amino acid has more than one role; they function as a metabolic signal and are necessary building blocks.” 

So there we have it; per this longer set of conclusions losing core strength and functional muscle tissue causes lots of other health problems, which can all be avoided by weight training and eating enough protein.  The part about core strength limiting risk from falls is familiar enough, but the rest not so much.  I don't want to include too many tangents but this reminds me of an interesting Instagram channel, that relates to how to control glucose spikes in the body, the Glucose Goddess channel:

You probably get the idea; you can adjust what you eat together to prevent blood sugar spikes.  Which are obviously a bad thing, right?  Sort of, or probably, but part of what I'm interpreting that last long cited passage to mean is that with substantial muscle tissue in your body you can store that glucose better, to use it throughout the day, while if you have very little muscle tissue it's going to potentially be more impactful having that sudden digestion input fall a bit out of balance.  

It could've been clearer that muscle tissue actually helps with storing glucose, since one read is that muscles burn more energy, in the statement "muscles help us control our glucose levels, use glucose as fuel, and have a role in insulin resistance."  I think I've drawn that from other background, like this statement by the Cleveland Clinic:

Glycogen is a form of glucose, a main source of energy that your body stores primarily in your liver and muscles...  Your body mainly stores glycogen in your liver and skeletal muscles (the muscles attached to your bones and tendons), with small amounts in your brain.

So with very little muscle tissue your body will either need to work through a blood sugar spike or else convert that energy to fat to do something with it, but muscle lets you store more for medium term use.  Moving on, Leo asserts something else, in the video Protein:  the Key to Longevity, and related to two other follow-up videos in a three part set.

Based on different starting points and evidence, Leo rejects the common "building blocks" model of analyzing dietary inputs, that your body uses proteins, carbohydrates, and fats as energy sources and tissue building inputs (which is certainly correct, but it's only one part of what's going on).  He claims that this model is one partly accurate and descriptive construct, but not the only valid frame of reference. 

At a finer level of internal body process review signaling models apply, that what you ingest triggers specific physiological processes that can be active or inactive, or partially active, not all relating to only energy use or storing fat energy.  Even his complete video, that I'm summarizing here, clearly states he isn't unpacking a large proportion of this background, and narrowing related body processes down to two examples, versus treating how a larger range of them interrelate and apply.

Leo is citing a lot of well known references to low calorie intake being associated with longer lifespan, with links in that video--that part is already familiar to many.  It's very problematic for people to restrict their calorie intake for extended periods of time, for years, so attempts at "dietary restriction" take other practical forms today, including intermittent fasting.  

Leo goes further, claiming that lower protein intake alone can have the same effect, lengthening lifespan, especially related to limiting high levels of specific amino acids (protein building blocks), most specifically two related to red meat consumption, present at far lower levels in vegetarian proteins.  This isn't a guess based on his own reasoning; he is citing the same kind of documented, peer-reviewed animal studies that initiated these earlier conclusions related to calorie restrictions, in studies conducted on fish and rodents.

If the two references are saying opposite things, and the first is based on direct input from a longevity research professional, and the second is based on many seemingly sound research sources, who can we trust? Can both be right? Maybe. I'll not fully unpack or resolve this, but it's possible that the contradiction is only apparent. I'll get to that part, but first I wanted to raise one more anecdotal input, about not personally experiencing aging as much as I expected.  It does connect, and some works as a good framework of ideas for how this might play out in actual application.

A personal account of atypical aging experience

I'm 54 and in pretty good shape. Good diet and some exercise can account for that, or good genetics and luck. But my hair isn't greying much more than in my 20s, my skin isn't wrinkling much, I'm retaining more muscle mass than I think I need, but then maybe that is useful after all, given some of this input. 

I suspect that staying active accounts for a lot of it (I run), but it also seems possible that spending 17 years as a vegetarian helped by keeping my body weight moderate, or even low.  For early adulthood, teens out to close to 40, I weighed about 145 pounds (65 kg) at 5' 8" (170 cm), and I've only recently increased that to 165 pounds / 74 kg.  I wasn't trying to be thin, or to not eat much, it just worked out that way.  

That diet may have led to moderate protein intake over a long time period, and the distribution of amino acids from vegetarian sources would be slightly different (something Leo addressed specifically, best reviewed by watching that video). Even now I eat a lot of fruits and vegetables, and a generally clean diet, and need to work on it to include enough protein to support exercise recovery, from the running.

Genetics is surely a main input; my mother aged somewhat slowly, and my sister also does.  It's probably not a coincidence that both maintained low body weights for their entire lives.  I suspect that eating a very good diet comes into play, along with getting some exercise, or other activity, moderating input of drugs and alcohol, getting enough sleep, and so on, general healthy living.

That first article seems to waive off body weight and fat level as most relevant (or more clearly seeing that as an outcome, not a cause). Maybe it's all relevant, activity level, muscle development, amount of body weight, and positive diet inputs, nutrient levels and on from there.  The modern reductionist tendency for people to look for one key cause is probably misguided, one independent "life-hack" to adjust complex inputs towards a different result by making one or two simple adjustments.

  

It's even more indirect and hearsay based, but it's a commonly expressed theme in bodybuilding circles that maintaining high body weight from either fat or muscle tissue adds stress to the body, and could impact longevity and long term health.  Of course that's not to be wrongly regarded as directly opposing the initial point that maintaining healthy muscle tissue levels contradicts this view, that carrying excess muscle tissue is a problem.  Higher level male bodybuilders can maintain moderate body fat levels while weighing between 250 and 300 pounds, with female bodybuilders typically not matching that atypical body size, which would be stressful for bodily systems.  Of course intake of drugs enabling that form of growth is a secondary risk factor; no one is "naturally" gaining that kind of muscle tissue weight, and steroids and growth hormone use pose other risks.

All this isn't to speculate that we should just be healthy; that would be an oversimplification.  Retaining a typical younger-life, high activity level of both fitness and muscle tissue probably are healthy.  Leo wasn't claiming that carrying any level of muscle tissue is a problem; he was pointing out that internal physiological processes are "turned on or turned off" when signaled by protein intake, and other factors.  He was seeing an indirect outcome from higher protein intake as a problem.  Let's consider further one such process, the main one he was discussing, from a Google search results reference, on MTOR:

Mammalian target of rapamycin (mTOR) regulates cell proliferation, autophagy, and apoptosis by participating in multiple signaling pathways in the body. Studies have shown that the mTOR signaling pathway is also associated with cancer, arthritis, insulin resistance, osteoporosis, and other diseases. The mTOR signaling pathway, which is often activated in tumors, not only regulates gene transcription and protein synthesis to regulate cell proliferation and immune cell differentiation but also plays an important role in tumor metabolism. Therefore, the mTOR signaling pathway is a hot target in anti-tumor therapy research. In recent years, a variety of newly discovered mTOR inhibitors have entered clinical studies, and a variety of drugs have been proven to have high activity in combination with mTOR inhibitors.

It sounds like this MTOR is a bad thing, and we should stop doing that, but it's not nearly that simple.  It's a key bodily function (internal process), that is required, so the concern here is how often or how long it is "turned on" or active, and the positive and negative effects of maintaining a greater frequency or duration of that internal process (or set of those; it's all not completely clear).  Let's simplify that down a little from a Wikipedia reference:

mTOR integrates the input from upstream pathways, including insulin, growth factors (such as IGF-1 and IGF-2), and amino acids.[11] mTOR also senses cellular nutrient, oxygen, and energy levels.[30] The mTOR pathway is a central regulator of mammalian metabolism and physiology, with important roles in the function of tissues including liver, muscle, white and brown adipose tissue,[31] and the brain, and is dysregulated in human diseases, such as diabetes, obesity, depression, and certain cancers.  

Sounds more positive there, but none of this lends itself to simple interpretation.  As Leo summarized it you can't prevent the mTOR signaling pathway (if I'm using that term correctly), but as he frames it you can help your body regulate how often and to what degree this is active.  He feels that it would be a good thing to do so, and consistently eating a lot of protein throughout the day could actually be very unhealthy.  It's my impression that he's linking general and broad studies that claim that, that higher protein intake levels in animals (fish and rodents, I think it was) correlate with reduced lifespans, and then he's trying to work back to why that would be, even though maybe this isn't a clear and singular cause.  Personally it's hard for me to completely accept any simple conclusions distilled from complex inputs; it's back to this being more interesting to consider than relating to obviously correct conclusions.

Potential resolution

Per my impression of that first long cited passage they are discussing problems with loss of normal levels of muscle tissue, not necessarily related to people being on a spectrum of having more or less.  Exercise inputs, genetics, and those dietary inputs (eating enough or a surplus of protein) would relate to gaining and retaining muscle mass, instead of there being one main input.

Per a common sense interpretation if someone spent a period of years weightlifting to build strength, and muscle mass, and coupled that with a higher than average and high protein diet, this wouldn't be as impactful as spending a much longer time on a primarily carnivorous diet, or even an all-meat diet (a recent health trend, an offshoot of the "keto" fad).  Of course maintaining normal but significant amounts of muscle tissue on a moderate protein intake diet is possible.

This reminded me of how an athlete like Alex Honnold might see this issue, a vegetarian rock climber famous for free soloing El Capitan.  His take:

Humans definitely need protein to maintain muscle mass and be healthy, and athletes certainly need more than sedentary people. But I think that protein is wildly over-emphasized. The average person, in the U.S. anyway, eats far more than they need.

There's evidence that humans have optimum health with a diet around 10-percent protein - that's easily met by just eating greens like spinach. So, it's not like a typical American needs to be seeking out more protein. That said, proteins and fats do help me feel fuller so I do think about the macronutrient breakdown of what I'm eating. 

The part about getting enough protein from spinach is a bit striking, isn't it?  In a GQ article his typical daily diet does sound like something no normal person could live on, never mind a high level athlete, with nothing in it including a substantial amount of protein:

Breakfast:  Muesli with flax meal, banana, hemp milk.

On-the-wall snacks:  Apples, nuts, avocado sandwich (fresh avocado on bread)

Dinner:  Macaroni and cheese with spinach, red peppers and yellow squash, topped with pumpkin seeds.

An average person living on fruit, nuts, vegetables, and granola wouldn't be that impressive, but his feat of athleticism, skill, and mental focus in that one free solo feat is all but unmatched across all of sports, pulled off on a diet most people think couldn't sustain them, whether they exercise or not.

One thing I didn't mention about my own experiences (with a very limited protein-input vegetarian diet) was that I was snowboarding and hiking a lot back then, living in a ski resort, and working long hours in demanding jobs as a restaurant server.  I even rock climbed a little.  I wasn't giving it much thought but in retrospect it's odd how it all worked out, even though none of that is impressive at all compared to high level rock climbing, or any competitive professional sports.

sometime in the 90s, out doing 15+ mile daily desert hikes for fun

last week; I am aging, just not so quickly for mid-50s

It makes you wonder how hormone replacement might factor in, but that's too complicated and involved to pair with these other completely separate concerns.  I suspect that maintaining a high activity level sustains adequate hormone balance, even into advanced age, but what do I know.  

I've known plenty of earlier generation family members who were very active and healthy, some into their 90s, but isolated cases like that aren't necessarily helpful for establishing generalities.  Those old-school, rural-life family members ate from gardens more than markets or grocery stores, and my family hunted as much meat as they bought, but again I'm not reducing that to claims here.  I think that eating a diverse and balanced diet is important, for me ideally including plenty of fresh fruits and vegetables, and then we can place input like these two sets of claims however we like within or beyond that.

Post script:  Leo Rex of Leo and Longevity died not so long ago (Laith really; Leo is an adopted name), and it seems appropriate to mention that here.  It's quite sad, to me, because in one sense it wasn't his time yet, as someone so young, bright, charismatic, and eager to help others.  

Related to his sharing of information online critiques sometimes came up, that he was too eager to experiment with risky "bio-hacking" themes, and offer information that others might base their own unsafe practices on.  This summarized topic example isn't that; eating a lot of protein, or very little of it, surely wouldn't pose or reduce health risks much in comparison with adjusting sleep cycles, using nootropics (mental enhancement drugs), steroids, or using other experimental exercise recovery support drugs.

I have greatly valued Leo's content and input, and wish to honor his contributions by remembering him positively here.  He was a fellow seeker, that many would recognize aspects of in themselves.  Sometimes even the parts that could be negative in some ways, the intensity and focus on shifting topics, and good intentions at times extended towards obsession, or pursuing a search for truth on to involving personal conflict.  Rest in peace, friend.

What fasting is like when it doesn't work out

 

Day one:

This is my fourth trial of fasting, moving on to a habit or accepted regular practice.  It made perfect sense to try it out as an experiment, but I could be clearer on what I expect from this.

It's not losing weight; I didn't weigh myself before or after the last five days, less than a month ago, but at a recent health check I'm 1 kg over my normal weight last year, up to 75 (165 pounds).  My blood pressure was up too, so general health isn't looking better, instead worse.  I've been running a lot lately and wonder if I'm not stressing my body a bit much, if recovery isn't a burden for it.  Of course I ran today, on the first day of the fast too, so it's not as if I'm acting on that as a concern.  

The theory behind that was from online discussion input that if you can burn up some available glycogen reserves on the first day that can speed up switching to ketosis, use of stored fat as energy (mostly that, at least; your body can use your own protein based tissue too, muscle, per my very limited understanding).  Supposedly even hunger might seem less an issue.  It is strange how I keep forgetting I'm fasting today, when in the past days 1 through 3 have always been rough.

There are a list of supposed, somewhat mysterious health benefits attributed to fasting (especially autophagy), and maybe it really is all that, the appeal of something wonderful being possible, just not clearly defined.  I'm also curious if the experience keeps changing, if it gets easier and easier, and some degree of benefit emerges with more exposure.  I may be slightly clearer mentally; something like that.  

I've been eating a continually healthier diet since I've started fasting some months ago, but it seems like the "diet reset" function is largely finished, that I'm as "switched over" in terms of clean diet as I'm probably going to get.  Most sugar and processed food is already out, and I eat a bit like those people who go on and on about it on social media, the streams of ultra healthy meal photos, I just don't mention it.

Day 2

Done already; I woke up in the night and couldn't go back to sleep, and felt an odd and disturbing sensation in my chest, and eventually called it.  I woke to drink water, with some extra electrolytes, but then over an hour later it wasn't resolving, so I ate a snack.

Maybe an electrolyte imbalance?  Seems most likely.  I was very careful about measuring out recommended amounts of sodium and potassium, and took a mid-level supplement range of magnesium, in pill form, in a multi-vitamin, and in a dissolving tablet, about 500 mg worth in total, but it still may have been that.

Two variable conditions came into play, which could've worked together.  I ran yesterday, thinking that it might help switch me over to ketosis to clear glycogen stores.  Since it was a short run (2.1 miles) I bumped intensity, to see how that would go, running that as 4 fast half-mile (800-900 meter) sections.  Of course that went badly; I don't train exactly like that, even though adding a fast 800 meter section at the end is normal for me.  Making a change in form might've been a bad idea.  I hadn't eaten for 15 hours or so at that point but I was expecting reserve energy level to hold over from the day before.  It kind of did, just not completely.

That step definitely seemed to help to smooth transition; I wasn't hungry at all yesterday, and an hour could go by without me thinking of being on a fast.  When I did walk by a snack food I'd often not notice, or the inclination to eat seemed muted.

A second variable was going to a health check-up a week or so ago and registering higher blood pressure than I've ever experienced (150 / 85).  I don't know why that happened.  My mother said that high blood pressure runs in our family, that she switched to experiencing it quite suddenly in middle age, in "spells," and there is probably a trigger I'm not clear on causing it.  

I've been increasing running distance, frequency, and intensity over the past 3 weeks, and that breaks a golden rule of running training, exceeding something like 10% weekly increase in any one or set of those.  That alone could be it, that my body is shocked by the change, experiencing higher recovery demands causing stress.  Or I suppose it's easy to see how working with a standard electrolyte supplementation input may not apply at all coupled with increasing running training.  

I checked total weekly running distance while editing this and I covered about 27 miles in a week, 43 km, when my past total never amounted to half that, at the same time I've been dropping pace down to around or under 6 min / km, around 9 1/2 minute miles, across run distances up to 10k.  Stopping eating without stopping running was foolish, even if it was the plan to take a couple days off for the fast.  It was surely too much recovery demand to put on my body even if all the running occurred just prior to the fast, with the last run in the first half day.

I'll move to Hawaii in two weeks so there's a lot that I wanted to get in (running, fasting, and of course packing), and compressing it together is probably not a good idea.  My kids are there now, and have been there, and I spent last Sept. and October there, so it's an odd staged move.  

I've "trained up" to a point where a lot of new running options are open to me, I'll just have to not rush to try too many at once.  I really should start tracking my heart rate, and just eating a good diet may not be enough, I may need to check into a few extra key supplements.  I switched over to running 6+ miles in distance back in Honolulu last year, including hills there, so it's not really sudden, but checking timing and pace recently probably caused me to increase that.

my longer running route there goes around this, Diamondhead

we live in that background shown there, with my heart and soul in the foreground

I want to distill this to what I take to be a lesson, to advice, but to be clear I'm no authority on any of it, and the main thing I would recommend is caution (so don't do what I do).  Fasting seems like it can be quite safe, interesting to experience, and probably healthy, but dialing in electrolyte supplementation, drinking enough water, and eliminating other variables seems helpful.  Going into it with concern over a health condition is probably always going to raise level of doubts, and with or without that activating a significant risk it could be quite uncomfortable.  Stepping up to longer time-frames seems much better, which I didn't do earlier, but then I pulled the plug on my first fasting trial after three days as a result.

Then there is an odd balance theme that comes up, how keeping busy enough to not focus on not eating seems critical, but being over-taxed by physical and mental demands won't work either.  Something like watching a movie can provide enough distraction, or cleaning the house.  I packed for the move yesterday, or started to, and I suppose it's conceivable that embracing the stress of wondering what I'm going to need, and what's going to happen, could've added mental burden.  During fasting would be a fantastic time to get out and experience a bit of nature, which luckily is all around me where I live now, even though I'm in Bangkok.

papaya in the yard; that squirrel just ate another one, long before it was ready

I don't feel bad about this test not working out.  Of course I'm more concerned about my general health; I keep saying that I'm going to moderate running intensity but I'm addicted.  Maybe I'll test how slowly I can run this evening, or taking a day off would make more sense.  [later edit:  of course I ran, and tried to keep it slow, but did drop below that 6 min / km pace on a light 4 mile run, which seems moderate because it's normal now].

More on electrolytes

It sounds like it should be simple to dial this part in, right?  There's an RDA for minerals like potassium and magnesium, and surely some normal range for sodium, and ingesting that should keep you in the clear.  One problem is that people claim you go through more of those in ketosis, and if you end up drinking a lot of water (which is recommended, to support different body function using different internal energy source), and add in exercise, then who knows what the actual suitable input level is.  

Let's take a look at what I'm working around, that Reddit fasting sub reference, cited in high level of detail here to talk around (but there is more to check out; the rest is worth a look):

So potassium deficiency can cause irregular heartbeat and low magnesium levels insomnia; sounds about right.  Fasting is no joke; I get it why people often recommend consulting a doctor before trying it, which of course I didn't do.  Then you would have the problem that if you talked to 10 different doctors you would probably hear a range of advice, from some seeing it as a great idea with low risk and others saying not to do it, with advice in the middle varying.

Checking RDA is pretty easy, since you just need to look at the back of a multivitamin bottle and multiply out the percentage value (in the US; the same approach could give slightly varying results elsewhere, but it would be similar).  Magnesium (on mine) lists 50 mg as 12%, so that's just over 400 mg per day.  Then it's a bit complicated sorting out bio-availability concerns and amount of a compound in a salt form.

I had read through all this, made simpler for taking a 300 mg magnesium supplement capsule that first morning.  As best I could I sorted out using a variation of what they referred to as "Lite Salt," filling a container of water full of the sodium and potassium mixture for a day (the "chloride" version of both; I had tried mixing baking soda as an input before, as they recommended in one place, but it's disgusting).  It should've been fine.  Maybe especially the magnesium input, since I ended up taking around 500 mg, versus that 300 - 400.  Mixing a day's worth in advance like seems best because you can not worry about tracking amounts, and can mix that solution with water or an herb tea as you like.

Adding running is a variable though; it has been cool out, for us, so level of demand seems to be not as much an input as when I'm running in the mid 90s F (mid 30s C), but I should've tried out a slow, easy run.  I was still undergoing muscle recovery from a run the day before too; it's hard to factor that in, but I guess that process may or may not also utilize electrolytes (why wouldn't it?).

Related to taking it easy, or not, I ran another "short" 4 mile / 6 km outing the evening after bailing the night before, and 10k the next day, and as I finish final editing I'm forcing myself to take a day off.

I discussed in a recent post how getting new running shoes is part of wanting to get out more

I think if people had to wait until conditions were perfect to try out fasting, or extend duration of trials, that they never would get to it.  Work is always going to enter in, or exercise, family demands, or other external stresses.  Some degree of moderation must be required though, which of course I didn't factor in.  Naps are perfect for adjusting energy level imbalances, more of an issue in early fasting trials, but that's not a standard practice most people could include, outside of during weekends.  Days 1 through 3 seem the hardest, so starting on a Saturday could include the first two then.

I was awake in the night some last night, not related to fasting, and it's obvious then that if I had been fasting I might see that as a potentially significant side effect, when really it just varies how long it takes to fall back to sleep.  A lot of it is psychological, that if you expect it all to go well and see minor issues as minor then it's not so bad, but with the opposite negative expectations little issues could add up.  I think that I really did screw it all up for not moderating exercise, as described, that it wasn't mostly about expectations this time.