Here’s a bit on protein based on the views of Dr. Rhonda Patrick as she appeared with Dr. Peter Attia. There’s been a lot of discussion about protein in recent years because it’s now obvious we’re not eating nearly enough. Personally, I think that’s the intention from policy makers, but Attia and Patrick don’t go there.
UPDATE: Before we start, though, please note that I utterly despise Attia. I stopped listening to him around 2018 when he refused to evolve on the LDL cholesterol issue, but on protein he seems largely in line with current trends. I can’t explain that but it’s consistent with what I’ve experienced with other powerful people who may have hidden interests, hold inconsistent views, and over time become closed minded when presented with new data. That’s Attia. And then there’s his overt love affair with Jeffrey Epstein, which came as a surprise to everyone and is obviously unforgivable. Hopefully, he gets what’s coming to him. When I listened to this podcast on protein with Rhonda Patrick last year I didn’t notice Attia being his usual obnoxious self so I thought I’d go with it. I’ve been following Patrick for years too. I don’t agree with everything she says, but she’s largely open minded and she qualifies her statements regularly. Plus, I really only care about protein at this point and I’ve learned to not accept everything everyone says just because I agree with part of what they say.
So, here’s my bit on the Patrick/Attia discussion.
Everyone knows that the current dietary guidelines in the United States is trash and should be ignored entirely if you want to be healthy. The protein reference range is dangerously inadequate for maintaining muscle mass, preventing frailty, and supporting long-term health. And it’s a shame that even in innovative conversations like this with Attia and Patrick they still have to refer back to the official guidelines to compare what they are recommending. I’d much prefer that they and others just delete the guidelines completely and start fresh with their own assertions based on their own research. Hopefully, RFK, JR will help move that needle. But back to Attia and Patrick on their latest findings on protein.
The Foundation Is Flawed
The current U.S. Recommended Daily Allowance for protein is a pathetic 0.8 grams per kilogram of body weight per day. This number has guided nutritional advice for decades. The number appears on food labels and in dietary guidelines worldwide, as well, because many countries blindly follow the American scientific establishment. But according to Dr. Rhonda Patrick, a scientist whose work explores nutrition, aging, and disease prevention, this recommendation rests on fundamentally flawed research. Honestly, listening to Patrick on protein, I can’t help think that this foundation of “flawed research” sounds just like the history of fat and sugar as we’ve discovered in recent years.
“What you will learn is that a lot of the studies that were done to determine this RDA were flawed,” Patrick says. “They were called nitrogen balance studies, and for many reasons they’re flawed.”
The nitrogen balance method attempted to measure protein needs by tracking nitrogen excretion in urine after protein metabolism. The logic may have seemed sound on its face. Measure what goes in, measure what comes out, and calculate what the body needs. But the execution was problematic.
Different protein sources have varying nitrogen to protein ratios. Urine collection was incomplete. And critically, we lose nitrogen through pathways other than urine. So, the signal to noise ratio in these studies was simply too low to produce reliable results. The whole process today just looks sophomoric now.
“Ultimately, what countless experts have now agreed upon is that the protein for the RDA has been underestimated because of those reasons,” Patrick says. I’d go further. Those early studies were silly.
The New Science Tells a Different Story
Modern research using stable isotope studies has provided far more accurate measurements. These studies use L-1,13-carbon labeled phenylalanine as a tracer, allowing researchers to measure protein metabolism through breath rather than relying on incomplete urine collection. The results are striking.
Multiple isotope tracer studies now show that adults need between 1.2 and 1.6 grams of protein per kilogram of body weight daily to prevent negative protein balance. This represents a 50% increase over the current RDA. It is a massive difference with serious implications for public health.
Attia emphasizes the critical importance of this finding by explaining what makes protein unique among macronutrients.
“We can store fat in unlimited quantities,” Attia says. “We can store carbohydrates. Now, we can’t store them quite as much because we only have so much glycogen we can store in the muscle and in the liver. But when we break down fat, we keep making the substrate to actually make glucose. The only place that an amino acid sits in residence in our body is in the muscle.”
This distinction is critical. When we fall short on protein intake, we have no buffer zone. We have no reserve tank to draw from. We immediately begin breaking down muscle tissue to access the amino acids our bodies need for countless essential functions.
“There is not really a single scenario I can think of that is clinically relevant where it would be desirable to give up muscle mass,” Attia says emphatically. “Giving up muscle mass because we are falling short on our protein intake would be a strategic error and an unforced error.”
The Reality on the Ground
The gap between what people need and what they actually consume is alarming. Nutritional surveys reveal that most adults consume approximately 0.9 grams of protein per kilogram of body weight daily. Men average about 0.9 grams per kilogram, while women consume even less at 0.8 grams per kilogram. They are barely meeting the inadequate RDA.
This means the majority of adults are walking around in a state of negative protein balance, slowly losing muscle mass year after year. For short term and long term health, this creates a compounding problem that becomes increasingly difficult to reverse with age. Don’t believe it? Ask any 60 year old who easy it is to build muscle. Then ask a 20 year old. It’s a distinction with a very big difference.
The Anabolic Resistance Factor
The protein problem intensifies as we age, but not necessarily for the reasons we might think. Patrick says that a phenomenon called anabolic resistance makes muscle tissue less responsive to amino acids. When researchers give the same protein dose to younger adults and older adults, younger people show twice as much muscle protein synthesis. For older adults to achieve the same benefit, they need to double their protein intake. Double!
But here is where the research gets interesting. Attia shares findings from Dr. Luc van Loon demonstrating that inactivity, more than aging itself, drives anabolic resistance.
In one experiment, researchers placed casts on one leg of young subjects while leaving the other leg free to exercise. After the cast period ended, stable isotope studies revealed significant anabolic resistance in the immobilized leg compared to the active leg. This was in the same young person.
“That’s the clearest demonstration that inactivity is the main culprit,” Attia says. “There’s probably an all things equal age related component as well, but I suspect that inactivity is playing a larger role than aging per se.”
Patrick agrees completely and adds that older adults who engage in resistance training show the same anabolic response to protein as younger adults. The activity itself makes up for age related changes.
“If there’s a public health message in this episode, it really is you should be training,” Patrick says. “That’s the most important thing.” She’s obviously advocating training at adequate levels while also eating sufficient levels of protein.
The Frailty Timeline
The consequences of inadequate protein intake combined with inactivity follow a predictable but often overlooked pattern. Patrick describes how muscle loss typically occurs not as a smooth decline but through discrete events.
“Maybe there’s a fall or maybe there’s just a surgery, a planned surgery or a hip replacement or a knee replacement, and your parents or your grandparents are inactive for many weeks and they lose a lot of muscle mass,” she says. “When this is a younger person, it’s much easier to gain back that muscle mass. It’s not the same with an older adult. Even if you’re engaging in resistance training after, you’re not going to get the same amount of muscle mass back as you’ve lost.” I’ve experienced this personally multiple times based on multiple long hospital stays throughout my lifetime. It’s amazing how fast your body simply digests itself and you shrink. It’s shocking, actually.
These events compound over time. A surgery here, a bout with the flu there, another fall, another period of immobility. Eventually, people reach what Patrick calls a “disability threshold” where mobility becomes severely compromised.
“I think people kind of just don’t follow the timeline where it’s like they see what’s leading up to it and before this sort of catabolic crisis occurs where then they reach this point now where they’ve just lost so much muscle mass from these several events that have occurred where they’re just not mobile,” Patrick says.
Attia connects this to quality of life in powerful terms. While frailty and sarcopenia may not be the leading causes of death compared to cardiovascular disease, cancer, and neurodegenerative diseases, they profoundly impact the quality of our final years. Yet, it’s still considered “normal” aging. It’s not.
“When you think about quality of life, which most people care about at least as much, if not slightly more than length of life, I think frailty just kind of wins the day,” Attia says. “Along with cognitive health, frailty is the thing that seems to determine the quality of your final decade on this earth.”
Despite witnessing frailty in parents and grandparents, people somehow fail to prepare for what is essentially inevitable and preventable. “We’ve been to the movie over and over and over again. We see how it goes. And yet somehow we either don’t think it’s going to happen to us or it somehow still seems abstract because it’s so many years off,” Attia says with frustration. Why? Decades of pervasive and ignorant propaganda coming from our so-called official health and medical authorities who control the funding of science worldwide. Think that’s an overstatement? Right. Visit Okinawa and talk to the 100 year old apple farmer who climbs trees every day to get the apples. Ask him if he watches CNN all day long. Ask him what he eats. Ask him how active he is all day every day.
Finding the Optimal Dose
Moving beyond the inadequate 0.8 grams per kilogram minimum, the question becomes what’s optimal?
Patrick points to a meta-analysis by Dr. Stuart Phillips, who examined 49 controlled trials of adults undergoing resistance training with and without supplemental protein. The findings were striking. People consuming 1.6 grams of protein per kilogram of body weight gained 27% more lean body mass and 10% more muscle strength compared to training alone with lower protein intake.
“That’s supply and demand,” Patrick says. “When you’re training, you’re breaking down muscle. You need protein to support the repair of that muscle and the rebuilding of it.”
Above 1.6 grams per kilogram, benefits continue but at a diminishing rate. Patrick uses an analogy from Phillips: “If you have like a wet washcloth and you squeeze it to get all the water out, most of that water is coming out at 1.6 grams per kilogram body weight. But you can keep squeezing a little and you’re still getting some water out. It’s just sort of marginal.”
For most people training regularly, 1.6 grams per kilogram represents the sweet spot. For high level athletes or those banking muscle mass aggressively, doses up to 2.2 grams per kilogram may provide additional marginal benefits.
The Real World Target: Aim Higher
This is where Attia makes a critical practical point that separates clinical medicine from theoretical guidelines. He recommends his patients target 2 grams of protein per kilogram of body weight daily, but he acknowledges that 1.6 grams is probably sufficient for most people training regularly.
His reasoning is brilliant for its simplicity — real life is messy.
“My patients unfortunately don’t live in labs,” Attia says. “My patients live in this place. It’s called the real world. And in the real world, you can’t always hit your targets. Some days you do, some days you don’t. Some days you’re traveling, some days you’re not.”
If someone aims for 1.6 grams and hits it some days but falls short to 1.2 grams on others, they will average around 1.6 grams. But half their days will be below the optimal threshold. The downside of those low days is asymmetric compared to the upside of high days. You cannot make up for insufficient protein intake the previous day by eating more protein today.
“What I’d really like to do is shift the range so that your low day is 1.6 and your high day is maybe 2.2,” Attia says. “And then guess what? You don’t have days where you are ever amino acid restricted.”
Patrick strongly agrees, adding from personal experience: “I have a hard time hitting my goals too. I’m busy. I miss meals. Sometimes we just have a low protein meal. It’s very difficult if you don’t have a chef preparing your every meal to hit these targets every day.”
The recommendation stands: aim for 2 grams per kilogram daily, knowing that on the inevitable days you fall short, you will still meet the minimum threshold for muscle protein synthesis.
Special Populations
Protein needs vary across different life stages and conditions. During pregnancy and adolescence, requirements increase to support growth. Patrick says that essential amino acids activate IGF-1 and growth hormone, which are both critical for development. Studies in infants and toddlers show that protein sources with more essential amino acids support better growth outcomes.
For adolescents approaching adult body size who are physically active, Patrick says that at least 1.2 to 1.6 grams per kilogram, though she acknowledges the data is less specific for this age group. Attia says that given typical activity levels in kids, they should probably aim toward the higher end of that range.
For people trying to lose fat while maintaining or gaining muscle (an increasingly common goal) protein needs climb even higher, potentially to 2.2 grams per kilogram or more. In an energy deficit, the body is constantly battling the pull toward catabolism, making adequate protein intake crucial for preserving muscle mass.
Attia shares his own experience with body recomposition, describing how he consumed protein shakes outside his eating window during a period of intermittent fasting. He was in a caloric deficit but maintained an amino acid excess, which enabled him to lose fat while preserving muscle. “You can actually do that with liquid protein pretty easily because basically all you’re getting is relatively few calories because you’re just consuming whey protein,” he explains. Weight lifters have know this for decades.
This approach becomes especially important for people using GLP-1 receptor agonists like tirzepatide for weight loss. These medications induce significant appetite suppression, which makes it challenging to consume adequate protein. Patrick and Attia discuss how easy to digest protein sources, particularly liquid shakes, become essential for these patients to prevent the muscle loss that plagued early users of these drugs. The very last thing you want is to lose too much lean mass while trying to lose overall body weight. When finally lose the weight, too many people are left with a rail thin body. That’s not the goal of oftentimes that’s the result from using these drugs.
One critical calculation is that for people who are overweight or obese, protein needs should be calculated based on target body weight, not current weight. Otherwise, the numbers become unrealistically high and are driven by fat mass rather than metabolic needs. It’s important to understand this and to give some time for the body to adjust to the new diet.
Addressing the mTOR Controversy
No discussion of protein would be complete without addressing the elephant in the room — concerns about mTOR activation and its relationship to aging and disease.
Patrick acknowledges this stems partly from aging research showing benefits from protein restriction in laboratory animals. But she is quick to point out the profound differences between lab mice and humans. Humans aren’t mice and that’s important to realize because so much drug research is done on mice and then applied to humans.
“These mice are in a small cage. They are not physically active. They’re not under threat. They’re being fed ad libitum. They’re in a perfectly thermoregulated environment. They’re not being exposed to influenza or COVID or whatever viruses, anything that’s going to take them out for a period of a couple of weeks,” Patrick says. “People are not mice. As we get older, we’re being exposed to infectious diseases, things are going to make us immobile for a period of weeks and that is devastating to us.”
The critical distinction is where mTOR activation occurs. When you exercise and consume protein, leucine and other branched chain amino acids are preferentially taken up by skeletal muscle, where mTOR activation drives muscle protein synthesis. This is exactly what you want.
“You want mTOR active in your skeletal muscle,” Patrick says. “You don’t necessarily always want it active systemically.”
Attia draws a parallel with inflammation. “A constant on state of the inflammatory system would be bad. But of course if you had no inflammatory response that would be also bad. So the ideal state is inflammation when you need it otherwise off.”
The same principle applies to mTOR. “We want mTOR on when it has a job to do and we want it relatively silent when we don’t,” Attia says.
Patrick points to compelling human data that contradicts concerns about protein intake, such as in elite athletes, including Olympic athletes and professional athletes in major sports leagues, where they consume at least 2 grams of protein per kilogram daily. They live on average five years longer than the general population.
“Clearly protein isn’t killing them,” Patrick says. “In fact, they’re living longer than the general population. It comes down to supporting exercise. Exercise is the king. Exercise is the most important thing, but you need protein to support that physical activity.”
Creatine: Supplement for Brain and Muscle
Aside from total protein and getting all the essential amino acids in their proper rations, Attia and Patrick also discussed at length the need for creatine. Patrick’s journey with creatine began not in a laboratory, but in her own training regimen. After realizing she had neglected resistance training in favor of endurance work, she hired a personal trainer and increased her strength training from 30 minutes per week to three hours. That’s when creatine entered the picture.
“I finally realized that I wasn’t doing enough training, resistance training,” Patrick says. “And so I got a trainer. I have a personal trainer now. I’m doing resistance type training. I do like a CrossFit type training for at least three hours a week.”
What makes creatine particularly interesting is its research pedigree. Attia says from his own experience, creatine has been studied extensively for decades. He recalls that even 35 to 40 years ago, teenage athletes were consuming creatine based on advice from bodybuilding magazines and supplement store employees. The difference today is that we have a much more sophisticated understanding of how it works and what doses are actually effective.
How Creatine Works in Muscle
Most people know creatine is stored in skeletal muscle as creatine phosphate, where it serves a critical function to rapidly recycle ATP, the major energy currency in cells. This allows for quicker energy production, which becomes relevant during high intensity interval training, resistance training, and even endurance training because it decreases recovery time. And that’s critical as we age because recovery time skyrockets over time after workouts. Remember when you were 20 and you recovered in a day or so from a stressful workout? Try that at 60. You may need a week.
We make creatine endogenously. Our livers produce about one to two grams per day. We can also obtain it from diet, primarily from meat, with beef being the richest source. Vegetarians rely entirely on their endogenous production of one to two grams daily, which is why they tend to be the population that benefits most from creatine supplementation.
The traditional recommendation has been five grams per day, which is enough to saturate muscle tissue over about three to four weeks even for large body builders. This is where the old “loading phase” recommendations came from. Athletes wanting immediate saturation would take much higher doses (like the 30 grams Attia recalls from his youth), but Patrick says this is unnecessary unless you’re competing imminently.
“Most people don’t have to do that,” Patrick says. “The problem is unless you’re doing some competition and you need it right then and there, generally speaking, it’s just not necessary and you really just increase the risk of GI distress.” Thirty grams a day can be a challenge unless the doses are spread out substantially. Otherwise, you’ll get gas and gut pain.
The Exercise Performance Evidence
The data on creatine for exercise performance is extensive and consistent. Patrick explains that creatine essentially improves your exercise performance by allowing you to do one to two more reps or increase your training volume because you’re recycling energy quicker.
“It’s not like the creatine itself is acting like protein,” Patrick says. “It’s not increasing muscle protein synthesis if you’re just a couch potato. You have to do the work.” Again back to exercise, which is the basis of so many recommendations. The human body was designed to move. So, move. A lot.
The reason people increase muscle mass and strength when supplementing with creatine is because they’re able to do more work. For Patrick’s CrossFit training, with its explosive leg movements and high intensity intervals, the effect was noticeable. She acknowledges there’s probably some placebo effect mixed in, but the research is clear enough that she’s confident in the real benefits. It’ll be interesting to see as this research matures whether it’ll be acknowledged by the medical authorities. I predict it wont. Not for a very, very long time. I’m not waiting. Are you?
Creatine for the Brain: The Emerging Frontier
While the muscle benefits are well established, Patrick recently has become increasingly fascinated with creatine’s effects on the brain. This represents a newer area of research, and it’s where the dosing recommendations change significantly.
The brain makes a small amount of creatine on its own, somewhere between one to three grams daily. But here’s the challenge: muscles are very greedy. When you consume creatine, your muscles consume it immediately, especially if you’re training. A German study using isotope labeling found that you need to double the standard dose to get creatine into the brain effectively.
“The 10 grams was where creatine was now not rate limited,” Patrick says.
This finding fundamentally changes the supplementation strategy for cognitive benefits. At five grams per day, you might saturate your muscles, but you’re not getting meaningful amounts into your brain. At 10 grams per day, you cross that threshold.
When Creatine Shines for Cognition
Patrick emphasizes a critical point: creatine for the brain works best in the background of stress. And who doesn’t have stress! This isn’t about taking creatine and suddenly becoming smarter. It’s about resilience under challenging conditions, which for most people is pretty much normal life.
“What I mean by stress is sleep deprivation, psychological stress, like you have an exam, marital stress, emotional stress, sleep deprivation is a big one, neurodegenerative disease or anything that’s compromising brain function,” she says. “That’s where creatine really shines in terms of cognitive function.”
The brain consumes 20% of our total caloric intake despite weighing less than 2% of body weight. It’s one energy hungry organ! Giving your brain extra creatine, which can recycle energy quicker, makes sense particularly when you’re using more of that energy under stress conditions.
Studies on creatine and cognitive function typically look at processing speed and memory, using standard batteries of tests. The results show benefits, but almost always in the context of some form of stress. Sleep deprivation studies are particularly compelling.
“There’s been a few studies that have shown people that are sleep deprived, if you give them (this was on a per kilogram body weight basis, so I think total it was like 20 to 25 grams of creatine) if they were sleep deprived and given that creatine, not only did the cognitive deficits that usually occur when you’re sleep deprived not occur, but their cognitive processing speed was improved more than baseline,” Patrick says.
She’s quick to acknowledge these are small studies and we can’t hang our hats on them alone so more research is needed. But the pattern is consistent across multiple studies. Older adults seem to benefit from creatine supplementation, with aging itself representing a form of stress on the brain.
Even preliminary research in Alzheimer’s disease patients shows promise. A pilot study gave patients with Alzheimer’s 20 grams of creatine and found improvements in cognitive function compared to placebo. When those same patients exercised, they also improved strength and lean body mass.
Attia frames the most interesting question perfectly. It’s prevention. While helping people who already have Alzheimer’s is valuable, the real opportunity lies in using creatine consistently 10 or 20 years earlier in people susceptible to metabolic pathways that may lead toward dementia.
“When you take that individual who is most susceptible to the metabolic path towards dementia and 10 years earlier or 20 years earlier, you’re giving them a substrate that is augmenting ATP creation, I get it,” Attia observes. “That’s the hardest thing to study. That’s also the single most important question in my mind.”
Patrick’s Personal Protocol
Patrick’s current regimen reflects her confidence in the brain benefits. She takes 10 grams per day, split into two five gram doses, mostly before noon. She’s noticed that she no longer experiences afternoon sleepiness when she maintains this dose. When she only gets five grams, the sleepiness returns. She recognizes that this is anecdotal so more research is needed.
“Now again it could be complete bias and who cares if it’s not, because it’s physiologic,” she says. “It’s a biological mechanism that’s working for me.”
When dealing with extreme stress like jet lag from international travel, she increases to 15 to 20 grams per day. She takes the doses in water or tea, finding this easier on her digestive system than taking larger amounts at once. I’ve taken 20 grams and found it difficult on my gut, so it’s makes sense to spread out the doses and increase slowly to find out if you body is able to digest these higher amounts. Attia agrees with the practical approach of splitting doses, noting that 10 to 20 grams in one sitting would probably cause GI issues for many people.
Dosing for Different Populations
For adults training regularly and interested in both muscle and cognitive benefits, Patrick recommends 10 grams per day as the baseline. This ensures muscle saturation while also getting creatine into the brain across the blood brain barrier.
For children and adolescents, the research shows benefits for agility and speed. Patrick gives her sons approximately 2.5 grams daily, based on a recommendation of about 0.1 grams per kilogram of body weight for younger individuals.
When Attia asks about his 17 year old daughter who trains hard with cross country, track, and weight room work, Patrick doesn’t hesitate. “If it were me, I would do 10,” she says. The combination of intense studying and athletic training creates exactly the kind of stress conditions where creatine provides benefits.
Choosing Quality Products
Patrick’s primary concern when selecting creatine is NSF certification, which involves rigorous testing to ensure there’s no lead contamination or heavy metals that can hitchhike on supplements. While Creapure (a particularly pure form of creatine monohydrate) is good, NSF certification provides additional assurance.
The form matters too. Stick with creatine monohydrate, which has the most research behind it. And avoid gummies entirely. A member of Attia’s team discovered through third party testing that 95% of creatine gummy products contained essentially no creatine monohydrate despite label claims.
“Gummies, yeah, unless you can find a third party tested gummy that actually has the amount of creatine monohydrate in it that’s labeled that says on the nutrition facts label I would avoid a gummy,” Patrick says.
And capsules present a different problem. You’ll need to take so many capsules to reach 10 grams. The powder form remains the most practical option.
Debunking the Kidney Myth
One persistent concern about creatine has been kidney health. This stems from confusion between creatine supplementation and creatinine levels in blood tests. When you supplement with creatine, creatinine levels can increase, which some physicians interpret as kidney problems.
Attia provides a simple solution for physicians: use cystatin C instead of creatinine to estimate glomerular filtration rate (GFR). “Cystatin C is a far more accurate way to measure and estimate GFR and you don’t have this problem of getting the confounded creatine levels increased,” he says.
Patrick agrees, noting that the claimed kidney problems from creatine are unfounded. You just need to inform your physician that you’re supplementing so they can interpret lab results correctly or use the more appropriate test. A personal note: Good luck educating your physician on any of this. Unless they are schooled on this research, they’ll balk every time because most doctors just follow the government’s guidelines. Give it a try, though. It’s fun to argue with doctors. Most of them get pissed jet quick when you show up with some expertise. This is especially true in the United States given their education.
The Bottom Line on Creatine
Patrick summarizes her position clearly: “I think that there’s really no downside to doing 10 grams a day.”
The evidence for muscle benefits is solid after decades of research. The evidence for brain benefits is emerging and compelling, particularly for resilience under stress, sleep deprivation, and aging. The safety profile is excellent. And the cost is minimal.
“I’m all in on the creatine,” Patrick says. “My creatine budget literally the household creatine budget just went up 4x,” Attia says, after deciding to give it to his entire family.
For a supplement that has been studied for 40 years with consistent benefits and no identified harms, creatine represents one of the rare cases where the science actually supports the hype, yet the authorities remain silent about these benefits. The key is understanding the proper dosing. Five grams daily for muscle saturation, but 10 grams daily if you want the cognitive benefits as well.
As Patrick experienced firsthand in her training and Attia witnessed in decades of research, sometimes the old supplements really do work. We just understand them better now.
Finally
The evidence is clear and converging from multiple lines of research. The current protein recommendations are too low for maintaining muscle mass, preventing frailty, and supporting optimal health across the lifespan.
For total protein, Attia and Patrick recommend that the minimum should be raised from 0.8 to 1.2 grams per kilogram of body weight. For people who are training regularly (and everyone should be training regularly) the target should be bumped to 1.6 grams per kilogram. And for practical purposes in the real world where consistency is challenging, aiming for 2 grams per kilogram provides a buffer that ensures you never fall below the threshold where muscle protein synthesis is compromised.
As Attia says, “If new data emerge, I’m always happy to change my mind. I’ve changed my mind about so many things over the past 10 years. But I’m going to stand by my recommendation. Two grams per kilogram per day.” That’s more than people think. You really have to pay attention to every meal to make sure you’re getting enough.
Beyond total protein, consider adding creatine to your regimen as well. The science here is equally compelling. Five grams daily will saturate your muscles and improve training performance. Ten grams daily appears necessary to get meaningful amounts into your brain for cognitive benefits, particularly under conditions of stress, sleep deprivation, or aging. After 40 years of research, creatine remains one of the safest and most effective supplements available. Patrick’s conclusion is simple: “I think that there’s really no downside to doing 10 grams a day.”
This entire discussion on protein is serious. Muscle mass is not just about aesthetics or athletic performance. It’s about being strong, maintaining independence, preventing disability, preserving cognitive function, and ensuring the quality of your final decades. Building and maintaining muscle is one of the most important investments you can make in your future self. Say it again: “Building and maintaining muscle is one of the most important investments you can make.” If you dispute this, visit any elderly person in any hospital in any country in the world. What you will see isn’t “normal” aging. It’s sarcopenia. And it’s largely preventable.
“You must steal yourself for what is coming,” Attia says. “You must build up as much muscle mass and strength and cardiovascular fitness as you can muster because the longer you can ride it out, the better you’re going to be.” He’s directly commenting about your elderly years here.
This is really simple. Train consistently, eat optimal levels of protein at every meal, add creatine supplementation for both physical and cognitive benefits, build your physiological reserve of muscle immediately and consciously, and don’t stop. The rainy day is coming. The only question is whether you’ll be prepared. And finally, always question “the science” that says otherwise. Do your own research. Prove yourself right or wrong. Science isn’t something to be followed. It’s to be questioned. To not know this simple principle is to not have a functioning brain.