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082723-LBM-DrSears-Q&A-Blog

Lean Body Mass Q&A with Dr. Sears

Most of us are familiar with the advantages of lean body mass from a physical perspective; the more you have, the more fat you burn. It turns out that this topic is a bit more complex than burn fat faster. In this Q&A, Dr. Sears answers your questions about the science of lean body mass, how to gain it, and what makes you lose it. 

Question: What is the difference between lean body mass and muscle mass?

Lean body mass is your total weight minus your total body fat. Lean body mass includes muscle, organs, bones, skin, and water. Although your muscle mass is the main part of the “lean body mass” component that can grow, the other components of lean body mass require incoming protein to maintain themselves too. This is because you are losing about one million damaged cells per second and must replace those removed damaged cells. Without adequate incoming protein, that cellular replacement process slows down.

Question: What are some possible reasons why you may be losing muscle?

Answer: It impossible to measure muscle mass directly because nearly 80 percent of muscle weight is composed of water. The best way to determine if your muscle mass is increasing or decreasing is your strength. If you are losing strength, you might be losing muscle mass for several reasons, but the primary one is not consuming enough protein to maintain your lean body mass. Emotional stress is another factor that can lead to muscle mass loss as it causes increased insulin resistance. This is because insulin is required to activate the building of muscle. Insulin resistance makes it difficult for insulin to activate the appropriate receptors to stimulate new muscle synthesis. Finally, you only build muscle by stressing it by exercise. This means you not only have to have adequate protein but also be doing resistant exercise to maintain and hopefully increase your existing muscle mass.

Question: What part of my lean body mass gets access to incoming dietary protein?

Your body’s primary concern is protecting your organs. Therefore, they get the first crack at incoming dietary protein. The goal for those trying to lose weight is to lose fat and maintain lean body mass. The classic way is to reduce calorie intake, but you must ensure that you take in adequate protein to preserve your lean body mass. This ensures that weight loss is primarily fat loss, not lean body mass. For example, the current generation of injectable weight loss drugs stops hunger, which often leads to decreased protein intake. As a result, nearly 40 percent of the weight loss using these injectable drugs comes from losing lean body mass.

(Read more about injectable weight loss drugs here.)

Question: How much protein do you recommend daily to maintain lean body mass?

Answer: The average person requires about 30 grams of protein at each meal to maintain lean body mass. This is about 90 grams of protein per day for most individuals. Very active individuals may need up to 40 grams of protein at each meal or about 120 grams of protein per day. The first 30 grams of dietary protein go for maintaining existing lean body mass. Any amount over that can be used to build new muscle, but only if the muscle is being stressed by exercise. Beyond 40 grams of protein at a meal, you start to develop insulin resistance, and there are no further benefits in building new muscle.

Question: What are your recommendations for individuals looking to gain weight healthfully or gain muscle mass?

Answer: The key is to have adequate, but not excessive, protein at each meal balanced with enough carbohydrates to maintain satiety between meals. That will be about 30 grams of protein and 40 grams of low-glycemic load carbohydrates consisting of primarily non-starchy vegetables and a dash of fat. That is about 400 calories per meal. This will allow you to maintain lean body mass without increasing stored body fat. To increase muscle mass, you need to increase your protein intake to no more than 40 grams of protein coupled with about 50 grams of low glycemic carbohydrates, plus exercise your muscles to stimulate their growth.  The best exercise to induce muscle formation is high-intensity interval training (HIIT).  The following best method is standard resistance training to fatigue.

Question: What foods would you recommend using for weight gain?

Answer: Getting adequate protein at dinner is usually no problem, but it is more difficult to do at breakfast and lunch. Once you get the desired protein amount (about 30 grams per meal), balance it with moderate amounts of low-glycemic carbohydrates (non-starchy vegetables being the best), followed by a dash of fat.  That could be a vegetable omelet with eight egg whites in the morning, a lunch salad with four ounces of chicken breast with extra non-starchy vegetables, and six ounces of fish with more non-starchy vegetables at dinner.

Question: Is there a way to tell if you are gaining weight correctly?

Answer: Gaining new muscle requires effort, but it is worth it.  You know when you taking in too many calories if your waist-to-height ratio exceeds 0.5.

Question: When should you see a healthcare provider about losing muscle? Are there any specific signs and symptoms to look for?

Answer: The underlying cause of loss of muscle mass is increased insulin resistance coupled with decreased physical activity. The primary consequence of loss of muscle mass is increased frailty. This is most frequently seen in older demographics. It is difficult to maintain muscle mass as one ages. Therefore, reducing insulin resistance, consuming adequate protein, and increasing physical activity are critical at every age.

Question: Why do we lose muscle mass as we age?

Answer:  There are three reasons that muscle mass is lost with aging. Insulin resistance (i.e., metabolic inefficiency) is the primary one, as insulin is anabolic hormone that activates mTOR.  If you have insulin resistance, the simulating effect of insulin is reduced.  Another is the reduction of growth hormone secretion that causes production of IGF-1 that uses the same pathway for mTOR activation as insulin. The third is decreased stress on the muscle that is needed to work in combination with mTOR for skeletal muscle synthesis. Finally, it becomes increasingly difficult to consume adequate protein with age to provide the necessary building blocks (e.g. the amino acid leucine) which is a direct stimulator of mTOR. I spoke about many of these concepts in The Anti-Aging Zone published in 1999.

 


Have more questions for Dr. Sears? Let us know in the comments below!

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062524---Keto-Blog

Ketogenic Diets and Aging

Chances are, you or someone you know has tried the keto diet at some point in time. This high-fat, very low-carbohydrate eating plan appeals to many due to its promise of rapid weight loss. In this blog, Dr. Sears explores some of the latest scientific findings on ketogenic diets and provides caution before hopping on this trend. What is a Ketogenic Diet? The ketogenic diet is a high-fat, very low-carbohydrate eating plan. This significant reduction in carbohydrates to induce a metabolic state is called ketosis. This only occurs when there is not enough carbohydrates in your liver to completely convert fatty acids to carbon dioxide and water. The normal conversion generates the chemical energy (ATP) that keeps us alive. In the absence of ketosis, each fatty acid generates 108 molecules of ATP when oxidized in the mitochondria. Ketone bodies make less ATP when they are metabolized by mitochondria. How much less? About five times less. This is like switching the gasoline in your car from high-octane fuel to low octane fuel as ketone bodies increase in the blood. Furthermore, contrary to popular belief, ketones are not an ideal energy source for the brain, as glucose remains the preferred fuel for ATP production in brain cells. Lack of blood glucose is a highly stressful situation for the brain. This is why the body secretes the stress hormone cortisol from the adrenal glands during ketosis to breakdown protein and convert the amino acids into glucose for the brain. This explains why even under complete starvation for 38 days, the blood glucose levels never dropped below 68 mg/dL. This is still considered as a normal blood sugar level. Where did this blood glucose come from if there was none in the diet for 38 days? The answer is neo-glucogenesis primarily using lean body mass. Ketogenic Diets Pros and Cons Interest in ketogenic diets rises and falls about every 20 years. They’re very low-carbohydrate diets that claim that carbohydrates make you fat and keep you fat. This is simply not true. It is not carbohydrates per se but a disrupted metabolism that makes you fat. To be more specific, it is the inhibition of AMPK, the master regulator of your metabolism that makes you fat. Why? As AMPK activity increases, you burn stored fat faster. Frankly, I’ve always been amazed by the re-emergence of ketogenic diets. Eighteen years ago, I published the premier clinical study demonstrating that, under equal calorie intake in which all the food was provided to the subjects for six weeks, the Zone Diet was better than a ketogenic diet in reducing total weight, excess body fat, and inflammation. Now, a recent study revealed some more very concerning findings about the long-term effects of ketogenic diets. This new study indicated that following a keto diet causes a rise in senescent cells, popularly known as “zombie cells.” Zombie Cells are damaged cells that no longer divide but don't die. That’s bad enough, but zombie cells continue spreading inflammation throughout the body. As the number of zombie cells increases in your body, they become a living nightmare. Why? Zombie cells accelerate aging because they cause the earlier development of many chronic diseases. In this study they found that zombie cells in the animals began to appear while they were on a ketogenic diet. The zombie cells then disappeared when researchers changed the diet to a “non-ketogenic diet” (i.e., the Zone diet). And when the animals were given a Keto diet again, the zombie cells reappeared. Notice a trend? If you want to hear more about this study you can listen to our recent podcast at Dr.Sears.com. Based on earlier blogs, this adds to the list of downsides for following a ketogenic diet versus the Zone Diet. PROS Rapid initial weight loss: This is primarily due to the loss of retained water from the glycogen stores in the liver, which is rapidly used up to maintain blood sugar levels. Since these glycogen stores in the liver contain significant levels of retained water, much of the initial weight loss is water rather than stored body fat. If your main goal is loss retained water, this can be seen as a benefit. Of course, going to a sauna would also work. Reduced hunger: Ketogenic diets are rich in protein. Any increase in protein intake can help reduce hunger. CONS Production of acetone: One of the ketone bodies produced during ketosis is acetone, which is also the main chemical in nail polish. Increased calcium loss: A ketogenic diet can lead to higher calcium loss from bones. Limited fat utilization: High levels of dietary fat reduce the likelihood of using stored body fat for energy unless you also significantly restrict calories. Reduced energy levels: The lack of ATP production on a ketogenic diet can lead to easier fatigue during mild exercise. Damage from cheat meals: After seven days on a keto diet, a single high-carb cheat meal can damage blood vessels. Lack of polyphenols: This makes it difficult to activate genes that optimize metabolism by improving mitochondrial efficiency in converting fat into ATP. No long-term weight loss advantage: Long-term studies show no difference in weight loss between a ketogenic diet and a low-fat, high-carb diet. No short-term metabolic advantage: Careful studies demonstrate that fat loss on a ketogenic diet is the same as on a low-fat, high-carb diet with the same caloric intake. Compromised gut health: A lack of fermentable fiber from carbohydrates can lead to poor gut health and an increased risk of developing a leaky gut, which can cause significant inflammation. Furthermore, short-chain fatty acids (SCFA) are the metabolic product of fermentable fiber. These SCFA are powerful epigenetic signaling agents that enhance gene transcription. Ketosis generates a different type of hydroxylated short fatty acid (3-hydroxyl butyrate, that has no effect on gene transcription. In addition, the lack of SCFA has significant negative consequences on the gut-brain axis. Cortisol build-up: To produce glucose for the brain, cortisol levels increase to breakdown protein to make sufficient glucose via neoglucogenesis. Excess cortisol can lead to insulin resistance that cause regain of some of initially loss body fat. In addition, increased cortisol levels cause a depressed immune system as well as destruction of memory cells in the hippocampus. The initial benefits of following the ketogenic diet result in some initial weight loss (primarily water weight rather than fat loss), long-term studies show no significant differences in overall weight loss. Now new findings show a ketogenic diet may lead to significant adverse health consequences by accelerating the formation of zombie cells. Call me crazy, but I feel the key to longevity and wellness comes down to better metabolic control instead of living in a constant state of ketosis. Following Metabolic Engineering® for a lifetime provides that pathway of losing body fat without ketosis. References 1. Johnston CS, Tjonn SL, Swan PD, White A, Hutchins H, and Sears B. “Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets.” Am J Clin Nutr 2006 83:1055-61. 2. White AM, Johnston CS, Swan PD, Tjonn SL, and Sears B. “Blood ketones are directly related to fatigue and perceived effort during exercise in overweight adults adhering to low-carbohydrate diets for weight loss: a pilot study.” J Am Diet Assoc. 2007 107:1792-1796. 3. Sung-Jen Wei, Joseph R Schell, E Sandra Chocron, Mahboubeh Varmazyad, Guogang Xu, Wan Hsi Chen, Gloria M Martinez, Felix F Dong, Prethish Sreenivas, Rolando Trevino Jr , Haiyan Jiang, Yan Du, Afaf Saliba, Wei Qian, Brandon Lorenzana, Alia Nazarullah, Jenny Chang, Kumar Sharma, Erin Munkácsy, Nobuo Horikoshi, David Gius. Ketogenic diet induces p53-dependent cellular senescence in multiple organs. Sci Adv. 2024 May 17;10(20):eado1463. doi: 10.1126/sciadv.ado1463. 4. Owen OE, Felig P, Morgan AP, Wahren J, Cahill GF Jr. Liver and kidney metabolism during prolonged starvation. J Clin Invest. 1969 Mar;48(3):574-83. doi: 10.1172/JCI106016. 5. Chriett, S., Dąbek, A., Wojtala, M. et al. Prominent action of butyrate over β-hydroxybutyrate as histone deacetylase inhibitor, transcriptional modulator and anti-inflammatory molecule. Sci Rep 9, 742 (2019). https://doi.org/10.1038/s41598-018-36941-9. 6. Silva YP, Bernardi A, Frozza RL. The Role of Short-Chain Fatty Acids From Gut Microbiota in Gut-Brain Communication. Front Endocrinol (Lausanne). 2020 Jan 31;11:25. doi: 10.3389/fendo.2020.00025. 

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050824---Tofu-Blog

Tofu: Tips and Recipes Ideas

I have been eating tofu for a very long time, much longer than the 30 or so years I have been following the Zone Diet. Back then many of my favorite recipes came from the Tassajara cookbooks by Edward Espe Brown, the celebrated chef from the kitchen at California’s famous Zen Mountain Center, and cookbooks by Louise Hagler, a.k.a. Wendy Louise, a well-known authority on vegetarian cooking who is associated with a community in Tennessee known as The Farm. Those books are still among the best resources for tofu recipes. My mantra has always been if you don’t like something, don’t eat it. Keep this in mind if you’re new to tofu, start slowly by combining it with flavors and foods you like.    Tips and Suggestions    Firm-sprouted tofu is my preference for the Zone Diet. Unlike traditional tofu, which contains significant amounts of both protein and carbohydrate, sprouted has almost no carbohydrates. It’s lighter tasting, refreshing, and very filling.   Freezing tofu results in a chewy, sponge-like texture. I don’t recommend freezing, but some people prefer it when using tofu to substitute for meat in a recipe.    Baked tofu comes in a variety of flavors and makes an excellent quick meal with some vegetables and fruit added. It’s also great in salads.     Tofu made it into the book “The Top 100 Zone Foods” by Barry Sears.    Some recipes call for draining the tofu first. I find that usually isn’t necessary.   Tofu takes on the flavor of whatever is added to it.    Add nutritional yeast flakes to give a cheesy flavor to vegan tofu scrambles and dips. It’s also rich in protein and vitamin B12.   Cherry Vanilla Tofu “Ice Cream”   Tip: This doesn’t freeze or store well, so prepare only the amount you plan to serve immediately.   Using an immersion blender or a food processor blend equal parts of frozen dark cherries and firm tofu, plus some vanilla extract (preferably alcohol-free for best flavor). Serve immediately.  Tofu Scramble  This is great for breakfast, lunch, or dinner, and we’ve even brought it on long day hikes for a snack.   Crumble some firm tofu and stir in a generous amount of seasonings, taking care not to overdo it with the salt. Heat in a well-seasoned or nonstick skillet with a little Zone-friendly oil to the desired doneness.    Optional: If time allows, sauté some chopped onion in the skillet before adding the tofu and seasonings.    My favorite seasoning combination for this dish at my house is onion powder, garlic powder, turmeric, paprika, some oregano or thyme, nutritional yeast flakes, salt, and ground black pepper. The yellow color of the turmeric makes it somewhat like scrambled eggs.   Tofu Veggie Almond Pasta Salad   Dressing: Thin some smooth almond butter by stirring in some water, a little vinegar, and either soy sauce or Bragg’s Liquid Aminos (an unfermented soy sauce found in the health food section of most grocery stores).    Toss together cooked Dr. Sears’ Zone PastaRx Fusilli, tofu cut into cubes, matchstick cut red bell pepper, chopped green parts of scallions (a.k.a. green onions), and the almond butter dressing. Serve immediately or chill to serve later. It will keep well in the fridge for two or three days.   Use your imagination and see what you can come up with.  Experiment and have fun with it. Try using tofu to make cheesecakes, whipped desserts, tofu chocolate pudding, tofu “cream” based soups, tofu pot pie (think chicken pot pie), tofu burgers, tofu burritos, Buffalo tofu (like Buffalo wings), layered Mediterranean dips, tofu “meatballs”, grilled tofu, and more.    Enjoy! 

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