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If you're a longtime listener, you know that I HATE crazy food dogmas. I will say it OVER and OVER again! So, with this conversation, one of the important pieces that I want people to walk away from today is that this is not black and white- are certain foods good or bad for you, should you only eat Organic, you need to eat only after a certain time of day, etc. Food restrictions or diets are not a one size fits all.
Today's guest, Dr. Gabrielle Lyon, is a Washington University fellowship-trained physician in Nutritional Science and Geriatrics and is board certified in Family Medicine. Dr. Lyon is the founder of the Institute for Muscle Centric-Medicine™. She services the leaders, innovators, mavericks, and executives in their prospective fields. In addition, Gabrielle works closely with the Special Operations Military and has a private practice that services patients worldwide.
If you've increased your protein intake and it helped your skin health, what are your favorite ways to do so? Share with me in the comments below!
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In this episode:
- Why the argument against protein tends to be incorrect
- The importance of muscle in terms of longevity
- How does muscle act as a metabolic regulator?
- If you're dealing with a compromised skin barrier, what types of intake numbers might you consider?
- The BIG animal vs. plant question
- What happens inside the body when you exercise and why it's CRUCIAL for health
- Dr. Lyon's big announcement on the working title of her new book!
Quotes
“Everyone talks about insulin resistance, diabetes, cardiovascular disease, Alzheimer's. Much of these metabolic diseases begin in skeletal muscle first.” [5:32]
“For protein turnover, your body goes through about 250 grams, depending on your size, of protein turnover a day. That's a lot of protein turnover!” [6:32]
Links
Find Dr. Lyon online and download her free LYON PROTOCOL for a food guide here (scroll down halfway on homepage)
Follow Dr. Lyon on Facebook | Instagram | Twitter
Preorder Dr. Lyon's book Forever Strong: A New, Science-Based Strategy for Aging Well coming out this Fall!
Try these brands for some supportive products to help get your protein intake up: Quell's Protein Powders | PaleoValley
Healthy Skin Show ep. 065: Why Protein Is Good For Your Skin (And Solving Skin Rashes)
Healthy Skin Show ep. 268: Plant-based Vs Carnivore Diet: What’s Best For Chronic Skin Issues?
281: Why Protein Intake Is So Important For Skin Health w/ Dr. Gabrielle Lyon FULL TRANSCRIPT
Jennifer Fugo: Dr. Lyon, thank you so much for being here. I really appreciate it and I'm excited to have you here today. We're going to talk all about protein.
Dr. Gabrielle Lyon: I am so thrilled to be here, especially talking about protein because I know that your audience is really interested in skin. They always say that skin is the largest organ in the body, it's not. Quite frankly, it's actually muscle. And the way you support muscle also has a potentially direct effect on how your skin looks.
Jennifer: Yeah. And I think one of the important pieces that I want people to walk away from today is that this conversation is not so black and white because it is portrayed as black and white on social media about should we consume more protein? Is it bad for you? Are certain sources more toxic or inflammatory than others? And I want people to have a more… I love having nuanced conversations like this. So can you kick us off with the information that you think is most important in terms of is protein really that big of a deal in terms of overall health? And obviously if you want to touch on how it could possibly be helpful for skin issues, that's great too.
Dr. Lyon: Yeah. You are very wise to focus on protein and when we think about protein, it's really actually a very complex topic because it's made up of 20 amino acids. A dietary protein typically is 20 different amino acids, nine of which in terms of what make up our body are essential, meaning we must get them from the diet. Those nine essential amino acids are available in various amounts from food that we eat. Right now we're hearing a lot of narrative talking about how protein can shorten longevity. Protein is creating the issue of cancer, of anything in the environment, you name it's probably protein's fault.
Jennifer: Unfortunately, it's so sad.
Dr. Lyon: When you hear arguments like that, they're typically not correct. We have an essential need for dietary protein. We don't have an essential need for carbohydrates. The amount of essential fatty acids that we need are much lower than that would be compared to dietary protein. Protein is arguably the most important macronutrient and it's responsible for really everything. Every turnover in the body, it's responsible for your gut turnover in terms of being able to support it, organ turnover, liver, brain, everything, hormones, skin. And most importantly from my perspective, muscle. Muscle is the organ of longevity. And when muscle mass decreases your survivability for all things goes down.
Jennifer: Can you just extrapolate upon that a little bit about importance of muscle in terms of longevity? Because for some individuals with very longstanding chronic health issues, especially when you can't exercise, you start to… Some individuals become bedridden based on how severe their symptoms are. Why are muscles so important?
Dr. Lyon: Well, muscles are important really, I think about it in two major categories. I think about it from the physical domain, exactly what you said. When an individual goes into bedrest, your lower body becomes weaker, of course your upper body becomes weaker. But typically people don't walk on their hands. And when an individual falls and breaks a hip or they are unstable on their feet, that is really the kiss of death. We've all seen not necessarily our parents, but perhaps our parents older individuals fall, break a hip and never make it out of the hospital.
So from a physical perspective, and I'm not talking about fitness performance, which is arguably where the focus on muscle has always been, really is about physical and athleticism. I'm much more interested in as a health biomarker. When you think about muscle, you must think about strength, stability, being able to carry out activities of daily living, being able to pick up your computer or go get groceries, do fundamental things, brush your teeth. When that decreases, when someone has a chronic health condition, your body really depends on muscle to be able to support increasing metabolic processes.
For example, if you have an infection. If you have an infection, if you have cancer, anything that creates a very high metabolic load. And that's a catchall term in terms of what I'm talking about, but really a stressor. Any stressor is going to rely on muscle or the foods that you're eating, but really the reserve of amino acids are in muscle. So that's one aspect. So strength, body armor.
The other aspect and really important perception of muscle, which I think that we're seeing more of is muscle. As a metabolic regulator. We hear about diabetes, insulin resistance, obesity. I would say that obesity and insulin resistance, those things in my opinion, begin in skeletal muscle. And insulin resistance is really at the core and foundation of subsequent problems. Everyone talks about insulin resistance, diabetes, cardiovascular disease, Alzheimer's. Much of these metabolic diseases begin in skeletal muscle first.
Jennifer: And you also mentioned something that I definitely want to question about is you said that the muscles had these amino acid reserves to them, but I worry sometimes that in saying that someone may take that as well, great. Then I have reserves. I can tap into them. It doesn't matter if I go low protein all week and maybe I have just a higher protein meal once in a while. Is it okay to tap into your muscles for those?
Dr. Lyon: It's not ideal. It would be considered more of a stress situation. It's not ideal. The body actually goes through constant protein turnover. Your gut is always undergoing turnover, your liver, your heart. There's organs that are constantly… Your muscle, it's always going through turnover, getting rid of old cells, making new cells. You don't want to tap into reserve. For protein turnover, your body goes through about 250 grams depending on your size of protein turnover a day. That's a lot of protein turnover.
The idea of purposely restricting dietary protein I think is a huge mistake to do for a long period of time because when you think about longevity, health and aging, we must relate it to muscle mass. We have to relate it to muscle mass and strength, even metabolic health. When I really sit down and I am working on articulating a new model of obesity, I was working with a very good friend of mine yesterday, in fact, she's a PhD that went to Princeton. And we're working on a new model of obesity that's really related to skeletal muscle as the core as opposed to there's the calories in, calories out model and then there's the carbohydrate insulin model. The reality is I think both are valuable and both lacking. We are working to create a new model of obesity.
And the reason I say that is because it or it originates in skeletal muscle and you cannot have healthy skeletal muscle without dietary protein. If our end goal is to live a healthy life, is it to live longer? I'm a trained geriatrician and which means I have been at the bedside of many individuals at the end of life, including working at a nursing home. And part of my fellowship and responsibility was to run a brain clinic. That's just what the fellows do. And I will say that it's not about lifespan per se and the end of life, those last five to 10 years, you want to have a full cognitive capacity in full physical capacity.
Jennifer: Yeah. I agree with that. My dad, who is an ophthalmologist, most people who go to the ophthalmologist are elderly individuals and that was the majority of his patients, 65 and up. And they would tell me repeatedly that the golden years is one of the biggest lies, that it is a horrible state of being constantly sick in and out of the hospital on a ton of medications, feeling awful. And basically your life becomes what TV show, are you watching? Do you don't want to miss your shows? And it was very staggering for me to hear that because and over and over again from people who didn't know one another. And that's something that while someone right now maybe not in the best of health or who is, and you're just interested in this topic, might not realize the importance of skeletal muscle and protein as much because the quality of life does… I mean it drastically drops off as people age unfortunately in the United States, which is a reality that we need.
And I guess for someone who is dealing with pretty damaged skin, so there's people who listen to the show, who have psoriasis head to toe, there are people who have eczema and really, really almost full body damage to their skin. An extremely compromised skin barrier. The research has shown in someone who say like a burn victim, and obviously it's not exactly apples to apples, but someone who has a really compromised skin situation does generally require a higher protein need. Do you feel like this would qualify for someone who has pretty damaged skin? Obviously, there's a need for skin turnover and whatnot, but does that, in your opinion, qualify as a need for more protein in the diet?
Dr. Lyon: That is a wonderful question. You mentioned burn victims and when you think about burn victims, there's a percentage in which the burn would cover the body is how they grade the burn victim. And what we do know is one of the very critical treatments of a burn victim, aside from skin flaps, aside from really caring for that external wound, is dietary protein. And that's easily above and beyond. I've seen numbers up to 3.3 grams per kilogram. I've seen numbers up that high in terms of treatment.
What you are asking is in terms of skin turnover and really that inflammatory skin state, would protein be beneficial? I absolutely believe that it would. And if we were to think about what those numbers would be, I mean obviously I haven't seen any clinical research regarding what specifically for a full body eczema or psoriasis patient would need. But easily above, I would argue at the minimum one gram per pound ideal body weight, at the minimum.
Jennifer: And I think then the question is, and I think you're the best person to answer this, does it matter where the protein comes from? Because we have some…
Dr. Lyon: And also for skin turnover we're talking about… So what you're really asking is that animal versus plant question. So I've been doing this for 20 years and when I was in my undergraduate where when I first met my mentor who is a world leading protein expert, Dr. Donald Layman, there wasn't these conversations. They were not nearly as prevalent or pervasive as they are now. Should you eat plant protein, should you eat animal protein? And I'm going to tell you why. The reason is the quality of protein is purely in numbers. It's a hard, fast biological value that doesn't change.
I said in the beginning of this interview that there are roughly 20 amino acids that make up humans that we need, that we eat. Of those 20 amino acids, nine of which are essential. Of those essential amino acids and that's really what determines protein quality because it's a need. Of those nine essential amino acids, there's a handful of amino acids called branch chain amino acids. Branch chain amino acids simply refers to the structure. It has a branched chain, a structure of that amino acid. That is one of the groups. So it's leucine, isoleucine, and valine. Out of those amino acids. Leucine is the primary driver for a muscle protein synthesis for the overall health of the muscle. I hate to oversimplify it. The body needs all these proteins and the muscle needs a full spectrum of these proteins.
And the reality is animal-based proteins are more bioavailable and have more of the essential amino acids. This is a numbers game. So no, plant and animal protein are not equal. But could you go plant-based and get the amount of protein that you need, if we are strictly speaking about protein? Yes you can but I think that's a very limited view, especially for someone with skin issues. You're going to need zinc, iron, selenium. You're going to need the components within the food matrix of the entire product to help, especially with healing. And we know that the bioavailability of these nutrients in plants is just lower.
Jennifer: If for whatever reason someone decides that they're going to shift their protein powder over to a vegan protein powder and they're going to start shifting their meals over to more plant-based options in terms of protein intake. With time, do we start to see the depletions of these key amino acids in their system?
Dr. Lyon: Great question. It depends on what is making up the rest of their food. And also if they're willing to supplement and they're very diligent on supplementing with creatine, very diligent on supplementing with iron and zinc, are they going to be able to supplement with all the other things like ancelin and carnitine? Probably not. So over a period of time, do I think that it can be problematic? I do. I do think over a period of time it can be problematic if we are thinking about long-term.
And also what about bone health? Bone is made of protein and in order to eat whole foods, if you're talking about a whole foods plant-based diet, you're talking about a lot of carbohydrates. And if your muscle mass is already limited because another primary aspect about muscle, which I touched on was the metabolic aspect. One role is the site of glucose disposal simply meaning the carbohydrates that you eat. How I like to think about muscle is really muscle as a suitcase and the storage capacity of muscle is where you're going to stuff your glucose in. If you are bedridden, if you are in a chronic catabolic state, if you are not resistance training, eating dietary protein, your suitcase goes from being a large suitcase to a carryon.
So if it goes from going to a large suitcase to a carryon, then there's only so much you can fit in that carry on. All the rest of the glucose is going to stay into the bloodstream. So now you are limiting your storage space, your body's protective armor and likely decreasing strength. And over a period of time this muscle tissue begins to look like a marbled steak.
Jennifer: I like that analogy. I like visuals. I'm a very visual-driven person and I think that'll be helpful for people who are listening to this to imagine that type of situation. The other question that I had for you, because I noticed it in your notes, and I had never really thought of this before. With these skin issues, we know that they are associated a lot of times with certain cytokines and that's why we have biologic drugs being produced and JAK inhibitors for eczema, psoriasis, they're now using them for vitiligo and all these different skin issues. So we know that there is a very distinct immune component to what can drive these issues beyond like, “I have an allergy to my laundry detergent or something like that.” So how does muscle play a role or even just protein, how is that associated with immune function?
Dr. Lyon: I think this is a very important topic and this is really about exercise immunology. The topic you're now moving into for the listener is exercise immunology muscle is an endocrine organ and an endocrine organ is simply an organ that secretes something, a protein or a hormone. And it has impact systemically, locally to the tissue and on itself. When you contract skeletal muscle through exercise, whether it's resistance exercise or aerobic exercise, skeletal muscle tissue, which is the muscle that you have voluntary control over secretes myokines, and they are also known as cytokines. And I'll give you an example because your listener is likely very savvy to skin cytokines, which would be say interleukin 6 or interleukin 15. A very interesting phenomenon happens in the exercise effect. Contracting skeletal muscle secretes multiple myokines, there's many, there's hundreds. Hundreds if not thousands of myokines that are still being identified.
The big one that we know that's in the literature, and this is largely spearheaded by a woman named Henderson out of Copenhagen is interleukin 6 and interleukin 15. When you contract skeletal muscle, you see 100 fold increase in, for example, interleukin 6. And for the skin person they're thinking, “Well, that's not good. You're increasing the cytokine of interleukin 6. What about this cytokine storm?” Interleukin 6 secreted from skeletal muscle has a different effect on the body than interleukin 6 secreted from cells of the immune system. And in fact it actually interplays and lowers systemic inflammation. Obviously exercise in itself is an inflammatory process, but subsequently there is a lowering of interleukin 6 and counterbalancing things like TNF alpha which are also highly inflammatory.
Jennifer: Yes. A lot of people have psoriasis and IBD, they are familiar because Humira and Enbrel are two drugs used to block tumor necrosis factor alpha.
Dr. Lyon: Yeah. This is one way, again, while we're not talking directly to skin, we are talking about likely if there's an inflammatory process, it's not just skin related, it is systemic. And certainly with skin issues, especially at the magnitude of which you are speaking about are likely systemic. Number one, arguably there's no downside to exercise. It's going to improve nearly every function and every domain of life, end of story. Also every illness else. Can you say? That the fitter you are, the more likely you are going to do better in any capacity in medicine, nearly 100% of the time? I can't even think of a time where you wouldn't.
That's really important to understand individuals who are suffering from these inflammatory states, I think that it's worthwhile to increase physical activity for exactly this reason. And I certainly don't want to overstate it saying, okay, so now if you train, you're going to reduce your inflammation. However, there is good data for safe rheumatoid arthritis that these kinds of processes through exercise may work as well as medication. So the question then becomes could that possibly impact skin?
Jennifer: Well, we also have psoriatic arthritis can be associated with the joint inflammation and there's connections obviously to psoriasis and Hashimoto thyroiditis and all sort. A lot of these autoimmune conditions on that side of things tend to be linked. And when you get diagnosed with one, you have a propensity to add more on, unfortunately. So if someone was to consider increasing… They've heard me… I feel bad you see this word, but harp on this about increase your protein, increase your protein, you need more protein and they're worried about it being inflammatory. Do you agree? Because that's another word. That's another one of these inflammatory words that's thrown around to make people afraid to increase protein or that they're going to harm their kidneys if they increase protein too much. What would be the final thought that you'd like to leave people around this? Is it inflammatory? Is it going to damage their kidneys? Because I think obviously you've made a good case for why protein is important.
Dr. Lyon: I want to really take a step back and people must understand that there's a totality of evidence. It's not one person's opinion over another person's opinion or one scientist over another scientist. We have to look at the totality of evidence in human-based trials, not rodents, mechanistic data, but truly what does the evidence support over decades of work? What we do know, again, not my opinion, is that higher protein diets for nearly everything, and we would have to define higher protein diets. You're talking about diets above the RDA. So the RDA is pointed grams per kilogram. Evidence supports that diets 1.2 grams per kilogram a day, so more than the RDA will always have better outcomes than the RDA. They will have better body composition. And of course you have to look at the quality of study, better body composition, better glucose regulation, able to retain more lean muscle mass.
So the totality of evidence is there. In addition, there's been multiple meta-analysis about kidney function, kidney function and dietary protein. In fact, if an individual has healthy kidney function, it does nothing but increase its filtration rate, improve its function. So then the bigger question becomes why such controversy over dietary protein? The next logical question after that question is who stands to profit with these narratives? And I don't have that answer. I only can make suggestions on who I think stands to profit and what are the real motives behind these things.
And I believe that animal-based dietary protein sources are the most important inclusion that we can have in our diet. I also believe when you hear longevity experts talk about further reducing protein, we have to ask ourselves how does that make logical sense, and where's the clinical outcomes, and where's the human trial? Not mechanistic, not epidemiology, but really human trials. What does that look like? So if we are talking about optimizing muscle mass in midlife, I think that dietary protein is key. Animal-based products are a privilege. In other countries they aren't having these conversations. They think we are crazy that we are so privileged and we are choosing to eat a lower quality diet. That's not to say I have any ethical issue, whether someone wants to eat animals or plants. This is purely what I believe to be a science-based logical conversations. This is not based on emotion or religious belief or any of those things.
The other part about that is we have to understand that for example, climate change. Climate change is not driven largely by agriculture. It's a smoke smokescreen for fossil fuels. It's a smokescreen for big industries. It's a smokescreen for potentially is it processed food companies that are using large buildings to produce this stuff. So I think we have to be really careful on being very clear about the health outcomes that we're looking for.
Jennifer: And I would agree with that. One thing that I have learned is a lot about regenerative farming over the past couple of years, which I definitely am hoping to have someone come on and talk more about that because whenever a client is like, “Well, I'm really concerned about animal welfare and the quality of animal products and are they loaded with antibiotics and all this stuff.” I'm like you need to understand that there is another farming system out there that deserves our attention that is actually getting this right. And if you're worried about helping the planet, this is actually in balance with the planet. So there are other answers out there. I think when we get caught in that black and white narrative, if it's this side or that side, we lose sense of the nuance. This is a much bigger, more complicated conversation than who's right.
Dr. Lyon: And we have to feed a planet. The longevity experts, the conversations that we're having, it's a luxury conversation. We have to figure out how do we feed an entire planet? How do we do it well? How do we do it without completely destroying ourselves? And it's not just about, it's so complex. It's not just about the food, it's about the transportation, it's about all this other stuff. And we have to understand that our actions have significant impacts to our own health.
For example, if you are going to remove animal-based products, what are you going to fill it with? Probably carbohydrates or fat. Okay. Then how are you going to actually get those amino acids? How are you going to protect yourself in the future 10 to 20 years later when you've now decided to not eat dietary protein in your prime muscle building years? What are you going to do? How do these decisions that one is making early with good intention, what are the unintended consequences of this? We have to be really, really thoughtful about is the conversation that we're having, really the conversation that needs to be discussed. Which thank you so much for allowing me a platform to be able to talk and speak about this. I think it's critical. These conversations are critical.
Jennifer: They are. And I appreciate you making the time to be here. This has been months in the making and I hope that we can have you back sometime because I know that you have various projects and things coming out that-
Dr. Lyon: Well, I have a book. I'm going to share it publicly for the first time ever right now, the working title is, and this title might change so you guys have to look me up if you're interested is Forever Strong. It's called Forever Strong. And it really is about the revolutionary science of muscle and nutrition for longevity and extraordinary health at any age.
Jennifer: Well, I think it's going to be an amazing book. I'm very excited for it and we'll have to have you come on also, maybe to talk more about the book again. But thank you so much for being here. It's just been an honor and I appreciate you also coming at this from an approach that's not loaded full of fear and emotion based. I think that's where we start. The conversation goes sideways. We just have to talk about the facts and also that this is nuanced and I want to help people make a better decision that's right for them. And we're all well meaning. We're all well-meaning well-intentioned. We want to do what's best for the animals and the planet and all of this stuff. But you're right, we have to ask the question, who benefits from this?
Dr. Lyon: Who stands to benefit?
Jennifer: Who stands to benefit? And ultimately we have to worry about our health, our longevity because it is more than just skin. It is a whole body. This is about whole body health at the end of the day.
Dr. Lyon: And nothing exists in isolation. It just doesn't exist in isolation. Skin health doesn't exist in isolation. Muscle health doesn't exist. It's all, we are a complex homeostatic mechanism. We are the human weapon. And how do you optimize for that, and what are the truths and the things that need to be addressed and what are fundamental perspectives that are valuable? For me, it is muscle as the organ of longevity, truly muscle. And besides your skin's going to look better, it's going to be tighter the more muscle you have arguably. And then the other aspect is nutrition and understanding that there's multiple different ways an individual can eat, but there are so some core fundamental principles that I believe that we were designed to have.
Jennifer: Yeah. Well, thank you so much for being here. I really appreciate it.
Dr. Lyon: Of course. And I have a podcast myself, The Dr. Gabrielle Lyon Show.
Jennifer: That's true. And we're going to link up to all of your information in the show notes because I want to make sure that not only people can find you, but they can check out your podcast. And I love that you have guessed on your podcasts that are talking about not just the topics like this that you love to talk about, but I love that there's also a lot of mindset to that as well that I don't think… It's not like the woo-woo. This is very practical. Things that you can implement.
Dr. Lyon: My guests that are talking about mindset are world world class warriors. They were not talking about crystals. There's nothing wrong with crystals. But these are warriors and we can learn a few things from them.
Jennifer: Absolutely. So we'll make sure to link up so everyone can find you. They can find the link to your book coming out and pre-order.
Dr. Lyon: Thank you so much.
Jennifer: And we'll have you back sometime.
Dr. Lyon: I appreciate you so much. Thank you.
