Optimal Protein Quality and Consumption for Healthy Living: Beyond the RDA. No disclosures. What I am going to talk about today

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1 Optimal Protein Quality and Consumption for Healthy Living: Beyond the RDA No disclosures Chris McGlory Protein Metabolism Research Group McMaster University Chris McGlory PhD, ILSI SEA, Bangkok 3 rd May 2017 Chris McGlory PhD, ILSI SEA, Bangkok 3 rd May 2017 What I am going to talk about today 1 Regulation of muscle mass and the role of protein ingestion and exercise 2 Dose, timing, and quality of protein intake to enhance muscle health and quality 3 Purported negative impacts of increased protein intake Credit: Heather Chris Griffin McGlory PhD, ILSI SEA, Bangkok 3 rd May 2017 Chris McGlory PhD, ILSI SEA, Bangkok 3 rd May 2017

2 Time course of age-related muscle loss Muscle mass 1%/yr Regulation of muscle mass by protein and exercise Muscle strength 3%/yr 50 Age (years) Chris McGlory PhD, ILSI SEA, Bangkok 3rd May English and Paddon-Jones (2010) Curr. Opin. Nutr. Metab. Care;13,34-39 Feeding and contraction regulate skeletal muscle mass Balance Rest AA RE RE + AA Biolo et al. (1995); Biolo et al. (1997) Am. J. Physiol. Endocrinol. Metab. MPS MPB

3 Imbalance RDA: 0.83g. kg -1. d -1 Exercise + Rand et al. (2003) Am J Clin Nutr; 77, Chris McGlory PhD, ILSI SEA, Bangkok 3 rd May 2017 MPS MPB Chris McGlory PhD, ILSI SEA, Bangkok 3 rd May 2017 Chris McGlory PhD, ILSI SEA, Bangkok 3 rd May 2017 Chris McGlory PhD, ILSI SEA, Bangkok 3 rd May 2017

4 Older adults require more protein to maximally stimulate MPS # Older adults require more protein to maximally stimulate MPS in a single meal Young g/kg ( ) Protein (g/kg) Older g/kg ( ) Protein (g/kg) 0.7 Moore et al. (2015) J Gerontol A Biol Sci Med Sci; 70, Witard et al. (2014) Am J Clin Nutr: ; Yang et al. (2012) Br J Nutr: 108, Older adults display a reduced MPS response to resistance exercise More protein than the Recommended Dietary allowance in older persons Young Older -88% -50% g/kg 0.8g/kg RDA (19+yrs) Exercise intensity (% 1RM) Current1 Acute or chronic disease2,3 Severe illness or injury, or marked malnutrition2 New Recommendations >65 years2,3 increase above current Protein RDA1 Kumar et al. (2009) J Physiol; 1, Minimum protein intake for healthy people2, g/kg Up to 2.0g/kg 1. DRIs for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). (2005) National Academy of Sciences. Institute of Medicine. 2. Bauer J et al. Evidence-based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group. JAMDA. 2013;14: Deutz NEP et al. Protein intake and exercise for optimal muscle function with aging: Recommendations for the ESPEN Expert Group. Clinical Nutrition (2014) In Press;

5 Take home points (Part 1) increases in MPS dictate the size 1 Feeding-induced of human muscle mass 2 Daily protein distribution Protein ingestion is a potent stimulator of MPS 3 Age and acute exercise alter protein requirements for maximal MPS response Protein intake in older adults is skewed But what if it was balanced (and increased) Maximal MPS Breakfast 0.0 Lunch Adapted from Murphy, Oikawa, & Phillips (2016) J. Frailty. Aging; 5, Dinner Maximal MPS 0.6 Breakfast Lunch Adapted from Paddon-Jones & Rasmussen (2009) Curr. Opin. Clin. Nutr. Metab. Care; 12, Dinner Snack

6 Balanced protein intake enhances 24h MPS in middle aged adults Metabolic ward research 90g (1.2g.kg.d-1) of protein in a mixed macronutrient meal 0.10 Day 1 Day 7 Balanced 30/30/30g Skewed 10/15/65g vs Day1 Day7 Mamerow et al. (2014) J. Nutr; 144, Skewed Mamerow et al. (2014) J. Nutr; 144, Balanced protein intake does not alter skeletal MPS in older adults Metabolic ward research 2 RDA 1.5g/kg/d 1 RDA 0.8g/kg/d Skewed 15/20/65% 2 RDA 1 RDA Balanced 33/33/33% Skewed 15/20/65% vs = %/h or 0.408%/d Kim et al. (2015). Am. J. Physiol. Endocrinol. Metab; 308,E21-E vs. Balanced 33/33/33% Even Uneven Even Kim et al. (2015). Am. J. Physiol. Endocrinol. Metab; 308,E21-E28. ~14.3g muscle/d

7 Balanced protein intake is effective during energy restriction Murphy et al. (2015). Am. J. Physiol. Endocrinol. Metab; 308, E734-E743. Whey protein is superior for stimulating MPS 0.20 Rest Exercise 0.15 Whey protein is superior for stimulating MPS Casein Whey Whey Casein Soy Rest Tang et al. (2009) J. Appl. Physiol; 107(3), Exercise Burd et al. (2012) Br. J. Nutr; 108,

8 Wheat protein stimulates MPS Biopsy timing matters Whey Casein Gorissen et al. (2016) J. Nutr.; 146, No evidence that higher protein intake is detrimental towards renal function in healthy adults Average Joe Joe: 80kg, 55 years old, Sedentary Calculation New Calculation 80 x 0.8 = 64g 3 meals: Breakfast 9g Lunch 18g Dinner 37g Daily requirement N/A Requires 2700 kcal 260/2700 = 9.5% Boirie et al. (1997) Proc. Natl. Acad. Sci; 94, meals x 0.4g/kg/meal Breakfast 32g Lunch 32g Dinner 32g Requires 2700 kcal 384/2700 = 14% There are no data that causatively link higher protein diets to renal disease: the FAO/WHO report says this as does the current IOM document that sets the DRI for North Americans. In the most recent round of discussions in setting the new DRI, the IOM concluded, content of diet is not related to progressive decline in kidney function with age the suggestion that the decline of glomerular filtration rate that occurs with advancing age in healthy subjects can be attenuated by reducing the protein in the diet has no foundation.

9 What I have told you this morning 1 Age-related loss in muscle mass is associated with Feeding-induced declines in MPS 2 Increased and balanced protein intake may be a way to combat sarcopenia 3 There is little evidence that higher protein intakes cause renal failure Jack LaLanne Protein Metabolism Research Group Thank You! Principal Scientist Prof. Stuart Phillips Laboratory Manager Mr. Todd Prior Post Doctoral Researchers Dr. Stefan Gorissen Dr. Martin MacInnis Dr. Tanya Holloway Dr. Dan Traylor Dr. Caoileann Murphy R.D Ph.D., Trainees Ms. Amy Hector Mrs. Kirsten Bell Ms. Sara Oikawa Mr. Rob Morton Mr. Tanner Stokes Ms. Josie Vescio

10 Increased protein intake results in less loss of lean mass over a 3 year period Imbalance 0.7g/kg/d (11.2%) 0.7g/kg/d (12.7%) 0.8g/kg/d (14.1%) 0.9g/kg/d 1.1g/kg/d (15.8%) (18.2%) Inactivity Inactivity+ Inactivity+ Houston et al. (2008) Am J Clin Nutr ;87: MPS Impact of protein intake on MPS during energy restriction MPB? Balanced protein intake is effective during energy restriction Murphy et al. (2015). Am. J. Physiol. Endocrinol. Metab; 308, E734-E743.