#369 ‒ Rethinking protein needs for performance, muscle preservation, and longevity, and the mental and physical benefits of creatine supplementation and sauna use | Rhonda Patrick, Ph.D.
Rhonda Patrick, scientist and host of FoundMyFitness, discusses protein's insufficient RDA, optimal intake for muscle/aging, creatine's benefits for performance and cognition, and sauna's cardiovascular and brain health effects, including practical guidance.
Deep Dive Analysis
16 Topic Outline
Protein RDA: Underestimation and Flaws in Nitrogen Balance Studies
Consequences of Insufficient Protein Intake: Muscle Catabolism
Optimal Protein Intake vs. RDA: Isotope Tracer Studies
Anabolic Resistance: Inactivity vs. Aging
Frailty and Sarcopenia: Quality of Life Implications
Optimal Protein Dosing for Active Individuals
Protein Needs During Caloric Deficit and GLP-1 Use
Calculating Protein Needs for Overweight/Obese Individuals
Reconciling Protein Intake, mTOR, and Longevity Research
Creatine: Introduction and Performance Benefits
Creatine for Brain Health: Dosing and Cognitive Effects
Practical Guidelines for Creatine Supplementation
Sauna Use: Cardiovascular and Brain Health Benefits
Heat Shock Proteins and Dementia Risk
Infrared vs. Traditional Saunas and Temperature Considerations
Rhonda's Podcast Journey and Future Excitement
5 Key Concepts
RDA for Protein
The Recommended Daily Allowance (RDA) for protein (0.8 grams per kilogram body weight per day) is a minimal intake to prevent deficiency, not an optimal amount. It is widely considered underestimated due to flaws in the historical nitrogen balance studies used to determine it.
Nitrogen Balance Studies
These are flawed studies historically used to determine protein RDA, which measure nitrogen excretion in urine. Flaws include varying nitrogen-to-protein ratios in foods, incomplete urine collection, and nitrogen loss through other means, leading to an underestimation of actual protein needs.
Stable Isotope Studies
These are more accurate studies for determining protein needs, using isotope tracers like L13 carbon-labeled phenylalanine. The tracer's oxidation is measured through breath, providing a more precise quantification of protein steady state and turnover.
Anabolic Resistance
This is a condition where muscle tissue becomes less sensitive to amino acids, particularly leucine, reducing muscle protein synthesis. It is primarily driven by physical inactivity, more so than aging itself, and can be largely overcome by resistance training.
Heat Shock Proteins
These are proteins activated by heat stress (e.g., sauna use) that prevent other proteins from misfolding and forming aggregates. They are part of a stress response that helps with proper protein folding, which can have protective effects against conditions like dementia.
15 Questions Answered
The current protein RDA is 0.8 grams per kilogram body weight per day, but it's considered a minimal allowance, not optimal. It's problematic because it was determined by flawed nitrogen balance studies and is insufficient to maintain a positive protein balance in most adults.
Multiple stable isotope studies suggest that at least 1.2 grams of protein per kilogram body weight per day is needed to prevent adults from being in a negative protein balance, which is 50% more than the current RDA.
Anabolic resistance, where muscle tissue becomes less sensitive to amino acids, is primarily driven by physical inactivity rather than aging itself. It can be overcome by engaging in resistance training, which restores muscle sensitivity to amino acids.
Maintaining muscle mass is crucial because its loss (sarcopenia) leads to frailty, significantly impacting mobility and increasing the risk of falls and disability, which severely diminishes quality of life in later decades.
For active individuals, 1.6 grams of protein per kilogram body weight per day provides significant benefits in lean body mass and strength. Higher levels, up to 2-2.2 g/kg/day, may offer marginal additional benefits, especially for elite athletes or those in a caloric deficit.
Overweight or obese individuals should calculate their protein needs based on their target body weight or lean body mass, rather than their actual weight, to avoid excessively high and unnecessary protein intake.
While caloric restriction and rapamycin, which downregulate mTOR, are linked to longevity in animal models, exercise also activates mTOR in skeletal muscle. The consensus is that mTOR activation is beneficial in muscle (especially with physical activity) but not necessarily systemically, and human data on protein restriction for longevity is complex and often misconstrued from animal studies.
Creatine supplementation primarily enhances physical performance by rapidly recycling ATP in skeletal muscle, allowing for one to two more repetitions during high-intensity exercise, increasing training volume, and improving recovery time, which leads to gains in muscle mass and strength.
Yes, creatine can benefit brain health and cognition, particularly under conditions of stress such as sleep deprivation, psychological stress, aging, or neurodegenerative disease, by helping the brain recycle energy quicker and improving cognitive functions like processing speed.
While 5 grams per day saturates muscle tissue, studies suggest that 10 grams per day is necessary to significantly increase creatine levels in the brain and observe cognitive benefits, especially under stress.
It is most important to look for creatine monohydrate, preferably with NSF certification to ensure purity and absence of contaminants like heavy metals. Creatine gummies should generally be avoided as third-party tests often show negligible active ingredient, and capsules require consuming too many to reach effective doses.
Sauna use can improve cardiovascular health by mimicking aspects of moderate-intensity exercise and can benefit brain health through improved cardiovascular fitness and the activation of heat shock proteins, which protect against protein misfolding linked to neurodegenerative diseases.
Heat shock proteins, activated by heat stress from saunas, prevent other proteins from misfolding and forming aggregates. They remain active for a long time after sauna use, generally improving protein folding and offering protective effects against conditions like dementia.
Infrared saunas can be effective, but most comparative studies show that for similar cardiovascular benefits, one might need to double the duration in an infrared sauna compared to a traditional dry sauna due to lower operating temperatures.
No, hotter is not always better. While sauna use is beneficial, a study showed that consistently going above 200 degrees Fahrenheit (e.g., 212°F) was associated with an increased risk of dementia, suggesting a hormetic sweet spot for temperature.
36 Actionable Insights
1. Prioritize Exercise
Recognize and prioritize exercise as the most important ‘drug’ for overall health, as its benefits are multifaceted and cannot be fully replicated by pills or other interventions.
2. Resistance Train to Counter Anabolic Resistance
Engage in resistance training to restore muscle sensitivity to amino acids and overcome anabolic resistance, allowing older adults to achieve the same anabolic response to protein as younger adults.
3. Build Physiologic Headroom Early
Actively build up as much muscle mass, strength, and cardiovascular fitness as possible in your 40s, 50s, and 60s to create physiologic headroom and prepare for inevitable age-related decline and catabolic events.
4. Increase Protein Intake Minimum
Aim for a minimum protein intake of at least 1.2 grams per kilogram body weight per day, which is 50% more than the current RDA, to avoid negative protein balance and prevent muscle catabolism.
5. Aim Higher Protein Intake
To ensure consistent adequate protein intake and avoid falling below critical thresholds on ‘bad days,’ aim for a daily intake closer to 2 grams of protein per kilogram body weight, with a range of 1.6 to 2.2 grams per kilogram.
6. Protein for Older Adults
Older adults should aim for at least 1.2 grams of protein per kilogram body weight per day, as this intake has been shown to nearly eliminate age-related muscle loss and reduce frailty risk by 30% in older women.
7. Utilize Sauna for Health
Incorporate regular sauna use for cardiovascular adaptations, heat shock protein activation, and reduction in dementia and cardiovascular disease risk, aiming for specific temperatures and durations.
8. Optimal Dry Sauna Temperature
Aim for a dry sauna temperature between 180-190 degrees Fahrenheit for optimal benefits, as there is no added advantage to going hotter and potential risks above 200 degrees Fahrenheit.
9. Avoid Extreme Sauna Heat
Avoid using dry saunas at extremely high temperatures (e.g., above 200-212 degrees Fahrenheit), as one study suggested an increased dementia risk at such temperatures, with particular concern for head exposure.
10. Disregard mTOR Protein Concerns
Do not be overly concerned about the controversy surrounding protein intake, mTOR activation, and cancer risk, especially if you are physically active, as the benefits of adequate protein for muscle health and longevity outweigh these theoretical concerns in humans.
11. No Harm from High Protein
Do not be concerned about consuming up to 2.5 grams of protein per kilogram body weight per day, as there is currently no human clinical or epidemiological evidence to suggest it is harmful in healthy adults.
12. Tailor Nutrition to Activity
Recognize that optimal nutrition strategies, including protein intake, differ significantly between active and sedentary individuals; do not apply the same dietary advice to both groups.
13. Protein Calculation for Obesity
If you are overweight or obese, calculate your protein intake based on your target body weight or lean body mass, rather than your actual weight, to avoid excessively high protein recommendations.
14. High Protein for Body Recomposition
For body recomposition (losing fat and gaining muscle), prioritize a high protein intake, potentially up to 2.2 grams per kilogram body weight per day, to prevent muscle catabolism during caloric deficit and support muscle protein synthesis.
15. Liquid Protein on GLP-1s
Individuals using GLP-1 receptor agonists (e.g., tirzepatide) should prioritize easy-to-digest liquid protein sources like shakes to ensure adequate protein intake (e.g., 1.6 g/kg/day) despite reduced appetite and slowed digestion.
16. Maintain Steady GLP-1 Dose
When using GLP-1 receptor agonists, aim for a slow and steady approach with a lower, consistent dose (e.g., 2.5 mg tirzepatide) rather than rapid dose escalation or cycling on and off the drug, to minimize muscle loss and other potential downsides.
17. Consider Creatine Supplementation
Consider supplementing with creatine monohydrate, a safe and well-studied supplement, to enhance strength, endurance performance, and support cognitive function, especially under stress or for brain health.
18. Creatine Dose for Brain
To increase creatine levels in the brain and potentially enhance cognitive function, consider increasing your daily creatine monohydrate intake to 10 grams, as 5 grams may be primarily consumed by muscles.
19. Creatine for Cognitive Stress
Utilize creatine supplementation, particularly at higher doses (e.g., 10 grams/day), to support cognitive function and mitigate deficits during periods of stress such as sleep deprivation, psychological stress, or brain aging.
20. Choose Certified Creatine
When purchasing creatine, ensure it is creatine monohydrate and ideally look for NSF certification to guarantee purity and absence of contaminants like heavy metals.
21. Use Cystatin C for GFR
When monitoring kidney function, especially in individuals supplementing with creatine, ask your physician to use Cystatin C as it provides a more accurate estimate of GFR and is not confounded by creatine intake.
22. Optimal Protein for Training
For individuals engaged in resistance training, aim for an optimal protein intake of at least 1.6 grams per kilogram body weight per day to significantly increase lean body mass and muscle strength.
23. Creatine Needs Exercise
Understand that creatine supplementation enhances muscle mass and strength gains by allowing you to perform more work during exercise; it is not a substitute for physical training.
24. Protein for Adolescents
Adolescents, especially those who are physically active, should aim for a protein intake of at least 1.2 to 1.6 grams per kilogram body weight per day to support growth and activity levels.
25. Liquid Protein During Fasting
If practicing intermittent fasting or time-restricted eating for body recomposition, consume liquid protein shakes outside of your main eating window to maintain an amino acid excess and hit protein targets while in a caloric deficit.
26. Sedentary Minimum Protein
Even if sedentary and with unhealthy lifestyle factors, ensure you consume at least the minimal recommended protein intake (1.2 g/kg/day) to avoid a deficit, but avoid excessive protein if not supporting physical activity.
27. Creatine Dosing for Muscle
To saturate muscle tissue, take 5 grams of creatine monohydrate per day; it typically takes about three weeks to a month to reach full saturation without a loading phase, which is generally unnecessary.
28. Split High Creatine Doses
If taking higher doses of creatine (e.g., 10-20 grams/day for jet lag or intense cognitive stress), split the intake into multiple 5-gram doses throughout the day to minimize potential gastrointestinal distress.
29. Prefer Creatine Powder
Opt for creatine powder over capsules, as achieving effective doses (e.g., 5-10 grams) with capsules would require consuming an impractically large number of pills.
30. Avoid Creatine Gummies
Avoid creatine gummy products, as third-party testing has shown that most contain negligible or no active creatine monohydrate due to manufacturing challenges and heat degradation.
31. Creatine for Active Youth
Consider creatine supplementation for active children (e.g., 2.5 grams/day for a son) and adolescents (e.g., 5-10 grams/day for a tall, active daughter) to improve agility, speed, and cognitive function, especially during periods of intense study.
32. Hot Bath for Heat Shock
To induce a heat shock protein response, take a hot bath at approximately 104 degrees Fahrenheit for 20 minutes with your shoulders submerged.
33. Sauna for Heat Shock
To significantly increase heat shock proteins, use a dry sauna at around 163 degrees Fahrenheit for 30 minutes.
34. Infrared Sauna Duration
If using an infrared sauna, be prepared to double the duration compared to a traditional dry sauna to achieve similar cardiovascular and heat stress benefits, as the temperature is typically lower.
35. Optimize mTOR Activation
Aim for a balanced approach to mTOR activation, promoting it when it serves a purpose (e.g., during and after exercise to build muscle) and allowing it to be relatively silent otherwise, rather than constantly activating or suppressing it.
36. Consider Sauna Hat
If experiencing discomfort in the head during hot sauna sessions, consider wearing a sauna hat, as it seems to help, although the exact mechanism is unclear.
5 Key Quotes
The only place that an amino acid sits in residence in our body is in the muscle.
Peter Attia
If you have like a wet washcloth, you squeeze it to get all the water out. Most of that water is coming out at 1.6 grams per kilogram body weight.
Rhonda Patrick
Exercise is the most important drug.
Peter Attia
The muscles are greedy as hell.
Rhonda Patrick
Mice usually lie. Monkeys sometimes lie. It's humans we care about.
Rhonda Patrick