Most people do not consume enough protein. As I discussed in episode #202, protein consumption is a variable I’ve become increasingly attuned to with my patients.
The more I research this topic, the more I find that the RDA (recommended daily allowance) of 0.8 grams per kilogram of body weight is simply not sufficient to build and maintain muscle mass as we age — a critical component of my 4-part exercise framework for longevity. Instead, in our practice, we recommend patients aim to consume 2 grams of protein per kilogram of body weight (or about 1 gram per pound).
I have found that this level of protein consumption can often be difficult for patients if they are also fasting or engaging in time-restricted feeding (TRF). Although fasting and TRF can be useful tools in some cases, particularly in combating insulin resistance, for others they can be problematic due to the heightened risk of protein deficiency and subsequent loss of muscle mass.
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No_stone_unturned
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This is a fantastic and very timely for me NSU. Over the last couple of months I have been doing some research on how much protein I need. I think I was protein starved.My background: I'm almost 68, on triplet therapy and doing well now coming up to my second anniversary of diagnosis of high volume metastatic prostate cancer with mets to the spine etc etc.
Having read about the value of exercise not only for the quality of life but also for life extension I have been doing a large amount of exercise over the past year. Also learned there's a lot to know about how to exercise correctly. I didn't get this right for a while.
For example the balance between aerobic and resistance. And because of the research on myokines and how these byproducts of vigorous exercise can help fight against cancer I've been working on increasing the volume and intensity of my exercise. My original goal was 10 hours of exercise a week. And maybe 40 MET hours.
I got to a point best fall where I was hitting 9 hours of exercise a week and maybe 35 MET hours. Pleased to report a significant increase in fitness and maintenance of strength! And the delight of walking up a flight of stairs with a spring in my step.
Until it all came crashing down. Physically consumed by exhaustion and mentally gone. Fools jump in where angels fear to tread! I started learning about exerciserecovery. And then I learned about proteinrequirements!
My sense is I was probably only eating about half the amount of protein I needed given the amount of exercise I was doing.
It's my impression, based on a lot of reading and great high quality research, that men with metastatic prostate cancer and on ADT really can benefit from exercise. Including some high intensity and high volume exercise. Skeleton permitting. And this needs the right diet to support.
Learning how to do all this is not easy because finding an exercise coach that knows what they're doing seems difficult. They all have strong opinions. And so far I have not found one that mentioned protein. And it's more complicated if one is fasting (I do 136 hour fast per week).
With all this discussion about exercise and diet where are we? What label can we give this? We have prostate cancer and we have drug therapies and surgery and radiation. And we have eating well and supplements and exercise. And I suppose you could add in "having a good attitude" too. You could call this cancer rehab. In the world of prostate cancer specifically this is not a commonly found term, in my experience. This is beyond palliative and relief of symptoms while you slowly die. This is about living longer.
My sense is there's a huge opportunity here that is not well served. Palliative care receives millions in funding. But cancer rehab? What's that?
Your comments today were a trigger for my long note. Your focus on protein consumption is integral to a program of exercise that could be so important for everyone with prostate cancer and probably breast cancer too. Super thanks for your share from Peter Attia
Hey John thank you for the validation and the valuable dialogue you’ve brought to the conversation. I’m a true believer that the body has the ability to heal itself if given the right environment. I mean in most cases, the wrong environment is what got most of us here. I used to work out mostly for modest vanity reasons, now I work out to thrive and stay alive. I’m NOT a gym rat, and as a matter of fact I’m about doing the least most effective amount of exercise as possible. Ironically, I’m in the best shape of my life with less effort than before. Like you mentioned; I’ve learned the most efficient way to exercise for maximum results and the least time in the gym.
We hear a lot about exercise, fasting and diet on this forum which is why I love this group. I feel like the patients and care givers on this site are the 1%ers who give the most shits and are not afraid to lean into this horrible disease, think outside the box and challenge the status quo’s. That’s where break throughs happen. A decade or so ago, anyone who brought up immunotherapy or checkpoint inhibitors would have been laughed out of the room. Because of patient driven conversations, we are changing the game and forcing the trillion dollar industry to pay attention. Because of all this, I promote this site every chance I get.
I recently learned that exercise tricks the body into autophagy. Even more effectively than fasting which I’m now taking a different look at. Before learning this new information I was eating one to two meals a day within an 8 hour period. However, it is thought now that autophagy does not take place until 3-5 days in strictly a water fast. And that’s a guess because there is no biomarker for it.
More importantly is it is very difficult to get (150-180g) of protein in that small of a window and reap the benefits I am looking for. Therefore, I’m now pivoting to 30-40g of protein 4x a day in a 10 hour window. I will still restrict my calories because the evidence still suggests benefit but I have shifted the priority weight of exercise above fasting. Atleast for now.
I disagree. Most people in the US consume too much protein. It should increase with muscle-building exercise, and decrease with age and ADT. Men get fat as we age because metabolism slows and we do not adjust caloric consumption. Calories come from carbs, fats and proteins. Your body converts excess protein as glycogen, so it is wasted to simply consume more.
yup, most people seem to think that the amount of proteins that you cannot absorb (basically if you eat too many calories in protein or even if you eat more than 40-50 grams of proteins at once) somehow disappear. But our body does not waste calories, we are made for survival and we store for the bad times. 😀
Not sure what you think about Peter Attia’s work but his book outlive is pretty outstanding. Here’s an interview with him on the Protein subject. Who knows maybe you change your mind…
Youtube videos will never change my mind, and you do yourself a disservice in informing yourself with them (but I understand how desperation can cause one to grasp at straws). They sound "sciency" but have nothing to do with medical science.
This is a bit unfair to No_Stone_Unturned. He referenced a book. Written by a doctor. With a lot of science in it. To dismiss it out of hand because there’s also a video is prejudicial.
If there has been no peer-review, it is not science. If this doctor has anything useful to add to the conversation, it will be peer-reviewed and published in a journal that upholds basic scientific standards. Of course, anyone can consult Dr Google and believe any nonsense they pull off of the Internet, but it isn't science.
This is a video on youtube, not a "youtube" video in the way you mean it. Last I checked there's nothing controversial about either one of these guys. If there is, it's the first I'm hearing of it and would want to know if you know something I don't. Last I checked Peter Attia is a respected expert in longevity.
"Dr. Attia received his medical degree from the Stanford University School of Medicine and trained for five years at the Johns Hopkins Hospital in general surgery, where he was the recipient of several prestigious awards, including resident of the year.
He spent two years at the National Institutes of Health as a surgical oncology fellow at the National Cancer Institute, where his research focused on immune-based therapies for melanoma."
I find Tom Billyeu (Owner of Quest Nutrition) does some of the best interviews and his impact theory content is some of the best out there. TA, I'm not desperate or naive. I've already made peace with dying and I don't try anything dangerous or potentially toxic. I am however well read, resourceful, open minded and only share things that are legitimate.
As much as I respect the wise and sometimes callous truths you bring to this group, it's insulting to suggest that no-one else has useful things to share here because it doesn't pass your litmus test. What I appreciate the most about your contributions is the fact that you DO push back on some of the fringe science. The last thing we need in this world is another echo chamber. However, your push back would garner more credibility If you read or listen to things before passing judgement no matter how ridiculous your instincts tell you you they are.
With that said; we do need your voice on this forum, so I hope anything I said here doesn't discourage that. I don't think they would, but I just want to say that. Thanks TA.
Science is never settled , Let history be your guide. Imagine a world in the present and future if science was settled in the past. Flat earth - Peer review by the queen's best or Galieo, at the end of the day we know that was about her control over the people , Happy Columbus day, lol many more on you Cheerio
I agree science is not truth and putting trust and faith in anything other for me is worrysome. But in order for any science to be positive proven, it must demonstrate itself to be repeatable and accurate ( safe and effective comes to mind )
Yes, I agree that science, though fallible, is the best process we have at getting us closer to truths about the material world. We depart from it at our peril. (There are many truths, arguably the most important ones, that are not scientifically decidable.)
Scientists take the problem of reproducibility seriously. You may be interested in this, which begins with "Patients are often confused by seemingly conflicting findings of studies, or equally good doctors recommending different treatment plans. How are we to decide?"
I utilize a multi disciplined approuch to all information , and through gods gift of discernment sort it out. I am thankfull a few years back I was able to make the right decisions as to what was considered safe and effective for me. Best
You brought up good talking point, Nothing wrong with information . I am kinda new to this site , I am getting a feel for individuals and their concerns and topics and reply backs . Keep posting good stuff. I am listening ! Best
Spirulina is a source of veg protein with many other benefits, told to cut out dairy, eggs and limit red meat and chicken what can one expect, screw eating your wheaties, lol I guess soy milk or tofu and sardines, salmon. Maybe drive by burger king at noon and breath in that flame broiled whopper smoke. lol
every recommendation I’ve heard still says that grass fed beef is still better for you than lab burgers. I was doing the vegan burger until I kept hearing this.
I try to consume between 70 - 90 grams a day. I've settled in on this range after several months of experimenting. I feel best when protein consumption is in this range and crappy when outside this range.
I workout nearly every day for 90 minutes and do a mixture of reps and heavy weights.
I came across this article that has just been published on Medscape "Retaining Lean Body Mass While Taking Weight Loss Drugs": medscape.com/viewarticle/99...
On the 3rd page it gives figures from a systematic review and meta-analysis which indicate that for those NOT trying to lose weight and who took part in strength training experienced a peak strength benefit at a protein intake of 1.5 g/kg/d.
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Albumin protein in urine 
C-Reactive Protein levels
We will fight through this, DAD!
Is ADT and radiation enough?
ADT and daily carb intake for weight training 
