1. Understanding a Metaboliq Lifestyle Dr. Donald K. Layman

2. Health Benefits with Increased Protein For Treatment or Prevention of: obesity Metabolic Syndrome type 2 diabetes sarcopenia osteoporosis heart disease Layman et al. AJCN 87: 1571S, 2008 Heaney & Layman AJCN: 1567S, 2008

3. Current nutrition “beliefs” and guidelines - avoid fat - limit animal products (cholesterol and SFA) - increase fiber (using whole grains) - eat small meals - use fat-free foods - use snacks with low calorie density - express food as % of energy (% kcals) total daily nutrition Belief: high Carb, low fat, low protein diets are best

4. fats milk milkcheesemeat fish, eggs vegetables vegetablesfruits bread, cereal, rice & pasta 6-11 servings 6-11 servings USDA Food Guide Pyramid 2-3 servings 3-5 servings 2-4 servings 2-3 servings

5. Changes in U.S. diet (1970 – 2000)  red meat (25%)  dairy (30%)  eggs (40%)  grains (decreased vegetables)  fruit juices (decreased fruits)  sodas  snack foods (refined carbohydrates)

6. Energy Sources for Women and Children* top six: 1. grain-based desserts and snacks 2. yeast breads 3. pasta 4. pizza 5. chicken, chicken products 6. soda, sport drinks * Source: Dietary Guidelines Advisory Committee, 2010

7. G. Bray; J Am Med Assoc. (2012) Effect of dietary protein content on weight gain, energy expenditure, and body composition during overeating Compared diets with 5%, 15%, and 25% protein Overfed subjects by ~1000 kcal/day (8 weeks) Headline: “low protein diet blunted energy storage and weight gain” Protein intakes: 46 g, 140 g, 230 g/day

8. Problems with Percentages --USDA Food Guide Pyramid: (55% : 15% : 30%)-- kcal/dayCarbs (g/d) protein (g/d)lipids (g/d) 3500 481131 117 2300 316 86 77 1500 208 56 50 RDA for protein: 81 kg x 0.8 g/kg = 65 g/d

9. Understanding Calories… Calories are not an exact science counting calories seldom works… % of calories is misleading portion control satiety thermogenesis balance

10. Understanding Protein… Myth: “Adults eat more protein than they need!” adults eat more protein than the minimum to prevent deficiencies minimum needs vs. optimum health

11. IOM Protein Guidelines: DRIs Risk of Inadequacy Risk of Adverse Affects RDA upper limit acceptable intake Protein: 0.8 g/kg 2.5 g/kg

12. Metabolic Advantages of Dietary Protein Advantages: - improves body composition ↓ body fat, ↑ lean tissue - increased thermogenesis (increased protein turnover) - increased satiety - stabilizes blood sugar

13. Adult Protein Needs: major points 1. Adults decrease efficiency of amino acid use 2. Limiting amino acids versus leucine signaling 3. Need for meal distribution of dietary protein

14. Protein Turnover: Growth vs Aging Protein Turnover = synthesis - breakdown 16 y.o. = 253 g/d - 250 g/d growth 60 y.o. = 250 g/d - 250.01 g/d aging

15. Protein needs for adults Aging reduces amino acid efficiency - loss of growth (anabolic drive) Need for higher protein quality

16. Protein needs for adults Sedentary lifestyle increases protein needs protein needs physical activity

17. Muscle health: repair rebuild Athletes understand

18. Adult Protein Needs: major points 1. Adults decrease efficiency of amino acid use 2. Limiting amino acids versus leucine signaling

19. “minimum” protein requirement Amino acids are required as … “building blocks” for new proteins Protein quality = limiting amino acids: (lysine, methionine)

20. amino acid signaling neurotransmitters (mood, appetite) vascular health (nitric oxide) GCN2 (ER stress) gut hormones (GLP1, CCK) Leucine - mTOR (protein synthesis) muscle health SIRT-1 (mitochondrial biogenesis) Metabolic requirement: leucine

21. insulin GLUT 1 GLUT 4 glucose IRS-1 PI3-k p85 p110 PKC GLUT 4 vesicle mTOR leucine Protein Synthesis Akt p70s6K 4E-BP1 eIF4E eIF4G 4A eIF4F complex glucose Muscle cell

22. Leucine signal = “meal” requirement Leucine signal requires about 3.0 grams of dietary leucine … or 30 grams of protein

23. Adult Protein Needs: major points 1. Adults decrease efficiency of amino acid use 2. Limiting amino acids versus leucine signaling 3. Need for meal distribution of dietary protein

24. Common Meal Pattern: Breakfast ~10 g protein Lunch ~20 g protein Dinner ~60 g protein Unbalanced Protein Distribution response range for protein synthesis (skeletal muscle)

25. Meal Patterns: Breakfast ~10 g protein Lunch ~20 g protein Dinner ~60 g protein Unbalanced Protein Distribution Breakfast ~30 g protein Lunch ~30 g protein Dinner ~30 g protein Balanced Protein Distribution Optimum Protein Synthesis Layman Nutr & Metab 6:12, 2009

26. Satiety: breakfast protein vs Carbs Metaboliq balance at breakfast  ghrelin (hunger),  PYY (satiety)  calories at lunch 4:00 - MRI -  brain “desire” for snacks evening -  snacking

27. Thermogenesis: breakfast protein vs Carbs Protein burns calories “diet induced thermogenesis” Protein synthesis:  muscle ATP (energy)  mitochondria  fat burning

28. Metabolic Flexibility: protein vs Carbs Breakfast: WHEATWHEY Gastrocnemius weight (g)2.082.20 Abdominal fat weight (g)2.822.38 % body fat12.79.7 Net fat gain (g)17.15.5 Fat energy gain (kcal)123.239.7 Total energy gain (kcal)204.2123.1 % total energy deposited to fat58.529.3 % total energy deposited to lean41.270.7

29. Metabolic Flexibility: protein vs Carbs Breakfast: WHEATWHEY Gastrocnemius weight (g)2.082.20 Abdominal fat weight (g)2.822.38 % body fat12.79.7 Net fat gain (g)17.15.5 Fat energy gain (kcal)123.239.7 Total energy gain (kcal)204.2123.1 % total energy deposited to fat58.529.3 % total energy deposited to lean41.270.7

30. Metabolic Flexibility: protein vs Carbs Breakfast: WHEATWHEY Gastrocnemius weight (g)2.082.20 Abdominal fat weight (g)2.822.38 % body fat12.79.7 Net fat gain (g)17.15.5 Fat energy gain (kcal)123.239.7 Total energy gain (kcal)204.2123.1 % total energy deposited to fat58.529.3 % total energy deposited to lean41.270.7

31. Understanding Carbs… Myth: “Adults need to increase whole grain cereals” No dietary need for carbohydrates RDA = 130 g/d average American = 350 g/d Need for - vegetables - fruits

32. Understanding Carbs… Carb threshold per meal is less than 40 grams High Carb diets produce excessive insulin - causes fat storage - causes inflammation - increases LDL-cholesterol exercise increases use by muscles sedentary behavior shifts to fat storage

33. Understanding Carbs… Myth: “fructose is bad for you” Myth: “beans are a good source of protein” Myth: “bread is better for you than sugar”

34. Understanding Fats… Myth: “SFA cause heart disease” Fats are required for every cell in our body Fats are an efficient energy store Fatty acids are essential nutrients Excess dietary energy combined with high Carbs causes inflammation and arterial damage

35. The METABOLIQ approach… balance high quality protein at meals reduce carbohydrates (processed grains) select reduced fat foods (avoid fried foods, snacks, desserts, etc ) increase fiber (vegetables and berries) breakfast is most important meal Goal: correct individual meals

36. THANK YOU!