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Make Protein the Priority

Dr. Donald Layman on Building Muscle, Losing Fat, and Reducing the Metabolic Decline of Aging

Dr. Donald Layman has spent decades studying protein and amino acids. He’s a Professor Emeritus at the University of Illinois, and he’s published more than 120 peer-reviewed papers. His work has transformed how we think about dietary protein. And unlike many scientific experts promoting their views online, Layman’s research cuts cleanly through the confusion about how much protein we need, when to eat it, and why quality matters more than most people realize. 

This post is based on eight interviews with Layman in the last few years, and it’s focused exclusively on his insights and recommendations about protein metabolism, muscle health, and optimal nutrition. All quotes are Layman’s. See the resource list below.

The Muscle-Centric Philosophy

Layman developed what he calls a muscle-centric approach to nutrition. He explains that nutrition comes down to two critical tissues: the brain and skeletal muscle. Everything else in the body adapts and regulates, but these two tissues must be supported well because they determine our quality of life. Layman says, “If you keep muscle healthy, you’ve got a good shot at avoiding obesity, avoiding diabetes, avoiding cancer as you age.”

This focus makes sense when you understand what muscle does. It serves as our largest reservoir for glucose, holding about 75 to 80 percent of our total glucose storage capacity. When muscle health declines, however, we lose this metabolic buffer. Then fat droplets accumulate in muscle cells, and over time this creates insulin resistance and makes it harder for muscles to accept carbohydrates. This cascade leads to hyperglycemia in the blood and eventually diabetes.

But muscle does more than manage glucose. Layman says, “Whether you’re 16 or whether you’re 65, you have to build 250 to 300 grams of new protein [every day] just to replace and repair what you already have.” This constant daily turnover happens regardless of age. The difference is efficiency. Young people enjoy hormonal protection that makes protein synthesis easier. But older people must work harder on both diet and exercise to maintain the same results. The difference is significant. 

The body operates in a constant state of protein flux. Every protein in your body gets broken down and rebuilt in a continuous cycle. Layman says that we replace the equivalent of every protein in our bodies about four times per year. This metabolic demand never stops. The liver must produce proteins 24 hours a day to maintain blood protein levels, manufacture enzymes, and support immune function. When dietary protein falls short, the body simply pulls amino acids from muscle tissue to keep these essential processes running. If dietary protein continues to decline over many years, people loose a significant amount of muscle mass. Sometimes this loss is hidden when people gain weight, but when they lost that weight the muscle loss becomes obvious. 

Children require only about five grams of net new protein per day for growth. Adults need none for growth, but they require vastly more protein for maintenance and repair. The adult body must synthesize 250 to 300 grams of protein daily just to stay even. This remarkable fact challenges the common assumption that children need more protein than adults. The opposite is true. In reality, adults face a more demanding protein requirement because the efficiency of their protein metabolism declines as they age. Also, adults are not as active as children and so their muscles don’t receive the signal from exercise to grow. 

The RDA Problem

The Recommended Dietary Allowance for protein in the United State sits at 0.8 grams per kilogram of body weight. Layman has spent years explaining why this number falls way short. The history is important. The RDA came from nitrogen balance studies conducted decades ago using conscientious objectors during World War II. Researchers put these men in special suits to collect nitrogen leaving their bodies. They lowered protein intake to zero, then gradually increased it until nitrogen inputs matched outputs. This became the basis for protein requirements.

There are big problems with this early research, however. “The RDA is the average requirement. By definition, that’s only the average. Half of the people are above average.” The RDA represents a minimum for survival, not optimal health. Also, nitrogen balance studies carry inherent flaws. All amino acids contain different amounts of nitrogen and plant proteins have more non-essential amino acids than animal proteins. When researchers use nitrogen analysis, they consistently overestimate the actual protein content.

Layman now argues for a fundamental shift in how we think about dietary requirements. He says we should stop talking about protein as a requirement and start talking about essential amino acid requirements. Layman says, “We actually don’t need protein in the diet. We need nutrients and the nutrients are essential amino acids.”

Based on dietary surveys, about 45 percent of Americans consume protein below recommended amounts. That’s an incredible statistic given that RDA is the minimum requirement. Women face particular challenges, especially those over 60 and between 18 and 22. Older women prefer carbohydrates to protein in their diets during a time when their bodies are aging and require fewer total calories to function. Their resting metabolism literally drops about 100 calories per decade naturally. However, younger women often intentionally restrict protein for appearance or moral reasons when many of them adopt extreme diets like veganism. Only women in the middle age range are getting the minimum amount of protein.

How Much Protein Do We Actually Need?

Remember that the American RDA for protein is  0.8 grams per kilogram of body weight. However, Layman recommends that most adults should consume between 1.2 and 1.8 grams of protein per kilogram of body weight. For practical purposes, this translates to roughly 0.5 to 0.8 grams per pound. The exact amount depends on several factors including age, activity level, and metabolic health. Layman’s recommendation isn’t unreasonable, although it may sound shocking to some people since it’s substantially higher than what the U.S. government has been saying for decades. Many others in the protein field go even higher to 1.0 – 1.2 grams of protein per kilogram of body weight just to account for those days when it’s impossible to get the minimum. Life is variable so people have to account for things like travel, schedules, emergencies, etc. 

When determining your dietary protein target, Layman says that you should use your ideal body weight rather than your current weight if you carry excess fat, which is at this point most Americans. He explains that adipose (fat) tissue does not require protein maintenance the way muscle does. For someone who weighs 200 pounds but should weigh 170, calculate protein needs based on 170.

The upper limit matters less than most people think, and Layman is actually somewhat conservative in his recommendations. He says that his research supports a protein intake of up to 1.8 grams per kilogram without concerns. “I don’t think the data really supports going above 1.8 g per kg,” but he emphasizes this comes from lack of research rather than evidence of harm. Studies on protein intake from 0.8 grams per kilogram up to 3 grams per kilogram show that protein appears totally safe across this entire range. Note that most professional and amateur athletes who are knowledgable about protein exceed Layman’s recommendations. Yet Layman sticks to his levels because that’s what his data demonstrates. Actually, Layman rarely talks about professional athletes. Instead, his focus and expertise is on the biochemistry and health of the general population through their entire lifespan. 

Protein Quality Makes the Difference

Not all protein delivers equal benefits. Layman focuses on three key amino acids: leucine, lysine, and methionine. Leucine especially triggers muscle protein synthesis through the mTOR pathway. Animal protein foods deliver about 8 to 10 percent leucine, while plant proteins typically contain only 6 to 7 percent. This presents a problem for vegans as they age. Smart vegans supplement. But if people who have adopted vegan diets don’t supplement, they generally find that over time they lose muscle mass and overall lean tissue as they age. You can clearly see this with the naked eye in vegan populations that aren’t overweight. 

This difference compounds when you consider digestibility. Animal proteins offer about 95 percent digestibility. Plant proteins drop to 60 to 75 percent, and that varies also with different cooking techniques. When you eat beans, for example, your body cannot access nearly half the protein on the label. “The idea that beans are a substitute for beef is a really dumb idea,” Layman says. Strong language like that is rare from Layman, yet he has decades of research to back up his claims. 

The distinction matters most as we age. “Under 30 it doesn’t matter when you eat your protein. It doesn’t matter very much the quality of the protein. But once you cross 30, now the efficiency of how you put it all together makes a big difference in how you’re going to repair or remodel your protein for healthy aging.”

Americans who shift toward plant-based diets, with the extreme being pure veganism, typically increase their grain consumption substantially rather than eating more beans, chickpeas, and almonds. “Americans get 80% of their plant-based protein from wheat. And wheat is a very poor quality protein.” When people eat primarily grains at the RDA level, they become deficient in two or three essential amino acids.

The wheat problem is deeper than most people realize. About 60 percent of American protein comes from animal sources such as fish, eggs, milk, and meats. The remaining 40 percent, though, comes from plants, and 80 percent of that plant protein comes from wheat. That’s a problem because it makes it challenging to get all the required amino acids in their proper proportions. Wheat is deficient in lysine, tryptophan, threonine, and leucine. When people shift toward more plant-based eating by simply consuming more wheat products, they create multiple amino acid deficiencies. These shortfalls affect everything from metabolic signaling to fat burning to brain function through tryptophan and serotonin production. Remember that the body must have all the essential amino acids in specific ratios, so if you don’t consume them the body will simply take them from storage — the muscles. 

Layman emphasizes that although relatively few Americans are vegans the general population is already largely eating a plant-based diet. Over 70 percent of our calories come from plants, but more than 80 percent of those plant calories come from added sugars, oils, hydrogenated fats, and highly refined carbohydrates. Junk food, basically. The number one plant in the American diet is french fries, followed by tomato sauce on pizza and lettuce. “We don’t need a more plant-based diet. We need a better one.” Here Layman distinguishes himself from the current carnivore trend. He’s perfectly ok with an omnivore diet as long as the non-meat portions are based on healthy, properly prepared, food. 

The body requires 20 different amino acids to build protein tissue. Nine of these amino acids are essential, which means that the body cannot manufacture them and must obtain them from food. The remaining 11 are non-essential. But that term can be misleading because the body still needs them. The difference is production capability, not importance. When you lack essential amino acids, protein synthesis stops completely. The body cannot substitute one amino acid for another or skip amino acids in a protein chain. So the body has no choice but to tap the stocks and get those amino acids. Where does it go to find those amino acids? To the muscles. 

Leucine stands out among essential amino acids for its unique signaling role. Beyond serving as a building block, leucine activates the mTOR pathway that initiates muscle protein synthesis. You need approximately 2.5 to 3 grams of leucine per meal to trigger this response. Animal proteins deliver this amount in modest portions, while plant proteins require much larger servings to reach the same threshold. This is one reason why people on plant-based diets must consume more total calories because the body is always hungry and looking for those required amino acids. 

Lysine becomes particularly important when evaluating plant proteins. Grains contain very little lysine, which creates a major limitation in grain-based diets. This shortage explains the traditional practice of combining beans with rice or corn in cultures relying heavily on plant foods. The combination provides complementary amino acid profiles that neither food delivers alone. Experienced vegetarians and vegans know this issue well and monitor it carefully when they eat. It’s not a full proof method to acquire all the essential amino acids, but at least it’s an attempt to recognize the issue.

Methionine supports glutathione production, one of the body’s master antioxidants. Layman’s research shows that when protein intake drops toward the RDA level, glutathione levels decline. To maximize glutathione levels in older adults, protein intake needs to reach at least 1.2 grams per kilogram. This requirement is 50 percent higher than the RDA, revealing how the minimum standard fails to support optimal metabolic function. There is more than enough research on protein now. One wonders why the RDA remains so low. 

Timing and Distribution

The first meal after waking is most importance. Layman consistently emphasizes getting at least 30 to 35 grams of high-quality protein within an hour of rising. This first protein bolus stops the catabolic overnight fasting state that builds during sleep and triggers muscle protein synthesis. 

After that initial meal, distribution throughout the day becomes more flexible. In weight loss studies, Layman found success with 35 grams of protein at breakfast, 35 at lunch, and about 50 at dinner. But he allows variation based on individual preference. “The reality is we have really good data about the protein at breakfast. We have pretty good data about protein at dinner and we have zero data about protein at lunch.”

Layman’s own diet reflects this understanding. He typically consumes 40 to 45 grams at breakfast, 15 to 20 at lunch, and 50 to 60 at dinner. He finds that large midday meals make him sleepy and less alert. Everyone’s different. People just have to experiment to see what fits them best as long as they are getting what they need in any given day. But it’s important to hit that minimum effective dose per meal of around 30 grams of high-quality protein. This amount provides about 2.5 to 3 grams of leucine, enough to trigger muscle protein synthesis. Younger people need less. But older people need higher amounts and sometimes require 40 to 50 grams to achieve the same anabolic response.

The Fasting Dilemma

Time-restricted eating has grown in popularity recently, but Layman urges caution for anyone over 40. In fact, he’s emphatic on the issue. “I don’t think anybody over the age of 50 should ever fast.” The muscle mass lost during extended fasting becomes permanent without aggressive resistance training during the recovery period, and very few people realize this until they directly experience the process themselves. I certainly have. And it’s shocking.

But Layman distinguishes between proper time-restricted feeding and true fasting. Eating within an eight or ten hour window can work if you maintain adequate protein intake. But going 36 hours or longer without food creates a catabolic crisis that strips away lean tissue. Remember, the body must absolutely have all 9 essential amino acids at all times not only to build and maintain muscle but also for hundreds of regular biochemical processes just to maintain health. 

The problem intensifies with some popular one-meal-a-day approaches advocated by some people online. Protein synthesis can process only so much protein at once, typically maxing out around 40 to 50 grams. When you try to consume 100 or more grams in a single meal, your body cannot use all the amino acids for building tissue. You miss opportunities to stimulate synthesis multiple times throughout the day. You see these people online. Their bodies transform quickly. They tend to look shredded but also gaunt. They don’t look healthy at all. 

Research on protein synthesis shows effects lasting four to five hours after a protein-rich meal. This window suggests that we should space our protein intake every four to five hours to optimize results. Cramming all protein into one meal wastes the stimulatory potential of well-timed protein distribution throughout the day. 

Protein and Weight Loss

Layman conducted extensive weight loss research demonstrating protein’s protective effects on lean tissue. He found that typical weight loss results in about 50 percent muscle loss and 50 percent fat loss. This composition change proves devastating, especially for older people who clearly struggle to rebuild lost muscle. But a higher protein intake can change this situation dramatically. “We can make the weight loss 95% fat 5% muscle,” Layman says. The key lies in maintaining at least 100 grams of protein per day for women during caloric restriction combined with resistance exercise. Men need proportionally more protein based on their larger size.

Layman taught his research subjects a simple a visual method to make implementation much easier than counting grams. He says that protein and carbohydrates should look equal in size on the plate. Four ounces of meat appears roughly equivalent to half a cup of rice. This one-to-one visual balance creates roughly the right macronutrient ratio for a meal. 

Higher protein intake during weight loss provides additional advantages beyond muscle preservation. Protein carries a higher thermogenic effect than carbohydrates or fat, which means you burn more calories digesting and processing protein. Protein also provides superior satiety, reduces hunger, and makes caloric restriction more tolerable.

The metabolic advantage of protein extends beyond the thermic effect of food. When you maintain muscle mass during weight loss, you preserve your metabolic rate. Each pound of muscle burns more calories at rest than a pound of fat. But losing muscle during dieting creates a vicious cycle where your metabolism slows down and makes further weight loss harder and weight regain more likely.

Layman’s research reveals that people using skim milk during weight reduction lost the advantage of both protein quality and satiety. The fat naturally present in dairy products serves important functions. He recommends reduced fat products rather than fat-free versions, allowing people to control total fat intake while maintaining the benefits of naturally occurring dairy fat.

The body’s overall composition during weight loss matters far more than the number on the scale. A 60-year-old who loses 30 pounds but half of that comes from muscle ends up metabolically similar to an unhealthy 80-year-old. And visually, these people look obviously gaunt. The muscle loss accelerates the aging process and reduces functional capacity. In contrast, losing mostly fat while preserving muscle keeps you metabolically younger and maintains strength and mobility, both of which are critical to maintaining health as you age. If you think that strength isn’t a factor over time, just observe any elderly person after a few falls and hospital stays. Their bodies dramatically reduce in size as their health rapidly declines. 

GLP-1 medications also present particular challenges during this time. Sure, people lose weight rapidly on these drugs. But without adequate protein and resistance exercise, about 50 percent of the weight loss comes from lean tissue. Layman warns — strongly — that this muscle loss becomes especially problematic because these people often struggle to rebuild what they lost after they discontinue the medication. 

Exercise and Protein Work Together

Resistance training and protein operate synergistically. Layman estimates that building muscle comes down to about 75 percent resistance training and 25 percent protein intake. That may seem anti intuitive given his research on the biochemistry of protein synthesis. However, you cannot compensate for lack of exercise with more protein. The protein intake is the foundational requirement to enable people to maximizes the benefits of training. 

But as you age you don’t have to go crazy in the gym. The definition of resistance training is broader than most people assume. Layman says that gradual stretching and low impact workouts represent a major part of resistance exercise. His weight loss studies with middle-aged women used Nautilus machines without adding weights. The women simply moved through the full range of motion, which emphasizes the eccentric or stretching process. This protocol produced significant improvements in body composition and demonstrates that even a minimal level of moment is beneficial. 

For people intimidated by gyms, Layman recommends yoga, Pilates, or rubber band stretches and movements at home. He says, “The best exercise is the one you’ll do consistently!” The critical factor lies in creating mechanical stimulus that tells muscles they need to maintain or grow their mass. And while muscles are moving under even mild stress they signal other lean tissue to grow, such as bones, ligaments, and tendons. Movement is critical to health. 

Timing protein around exercise matters less than most people think. Layman’s research shows that resistance exercise in a fasted state can trigger protein synthesis mechanisms. But without adequate amino acids available, the signal cannot translate into actual tissue building. Layman says you can “trigger those processes” with exercise or leucine alone, “but you need the complete amino acid mix.” Here Layman emphasizes the interdependence of proper nutrition and proper exercise. 

The Kidney Myth

Concerns about protein harming kidney function persist despite evidence to the contrary. Layman explains that higher protein intake actually increases kidney size and improves the body’s glomerular filtration rate. The kidney adapts to increased protein load by becoming more efficient at clearing urea and creatinine from blood.

Research comparing 0.8 grams per kilogram of protein with 1.6 grams per kilogram shows accelerated clearance rates at higher intake levels. Layman says that “the rate of creatinine clearance, the rate of urea clearance, actually accelerates. GFR becomes more efficient.”

But protein restriction produces the opposite effect. When people consume low protein diets below or even at the RDA level, their kidneys actually shrink and clearance capacity decreases. For healthy people, protein intake up to one gram per pound appears completely safe for the kidneys. Some markers of kidney function improve simply with better hydration because protein requires more water for processing.

Practical Protein Sources

Eggs, dairy, fish, and meat provide the most complete amino acid profiles with the highest digestibility. Whey protein stands out as particularly effective due to its rapid digestion and high leucine content. Layman himself often mixes whey protein powder with Greek yogurt to combine the fast-acting whey with the slower-digesting casein found in yogurt.

For budget-constrained people, eggs and ground beef offer an excellent value. Layman says that when people shift from junk food and quick-service meals to protein-focused diets, they often actually spend less money despite buying better quality food. Various cuts of meat, fish, chicken, ham, cheese, and milk all qualify as functional protein sources since you don’t have to worry about getting all nine essential amino acids. Milk provides one of the easiest ways to fine-tune protein intake. Layman says, “Milk is one gram per ounce. I like milk. So if I need nine more grams at my meal, I just have nine ounces of milk.”

For plant-based eaters, though, the protein challenge intensifies. Beans have to be combined with grains to provide complete amino acid profiles, but even then, digestibility problems persist. Layman suggests that vegetarians and vegans should consider supplementing with essential amino acids to ensure adequate an intake of leucine, lysine, and methionine.

The dairy industry transformed itself based on Layman’s research. In 2003, he addressed 250 research and development professionals from dairy companies. He told them their yogurts contained nothing but sugar and urged them to develop Greek yogurt with higher protein content. Chobani launched within a year, and the entire yogurt market shifted toward protein-rich products. The proliferation of protein shakes and high-protein foods in stores today traces back to this research that shows the importance of protein quality and quantity. Or you could just eat a a traditional diet based on whatever culture you are from since they all generally contain enough protein without having to always think about reading labels and supplementing. 

Greek yogurt also offers advantages over regular yogurt because the straining process concentrates protein while removing excess liquid and sugar. However, Greek yogurt contains more casein than whey. Layman addresses this by adding whey protein powder to Greek yogurt, which creates an ideal blend of fast and slow-digesting proteins.

Whey digests rapidly and floods the bloodstream with amino acids within an hour. This quick availability makes whey excellent for stimulating muscle protein synthesis. Casein, however, digests more slowly and provides a steady release of amino acids over several hours. The combination delivers both immediate stimulus and sustained amino acid availability.

Cheaper protein sources work perfectly well for most people too. Ground beef provides complete protein at lower cost than premium steaks. Chicken thighs cost less than breasts and often taste better due to higher fat content over breasts. Whole eggs deliver superior nutrition compared to egg whites despite containing fat and cholesterol. The key lies in choosing real animal foods rather than processed protein products that promise convenience but deliver inferior amino acid profiles.

Layman conducted weight loss studies specifically examining low-income populations. These studies revealed that shifting to a protein-focused diet actually costs less than the typical American diet heavy in processed foods, chips, candy, and fast service restaurant meals. The perception that healthy eating costs more often reflects comparison of premium organic products with budget processed foods rather than realistic and simple alternatives. Learn to cook. And don’t forget to consider the cost of disease that results from decades of eating poor quality food.

The Carbohydrate Question

Layman takes a balanced approach to carbohydrates that focuses on individual needs and activity levels. He says that the brain and red blood cells require at least 100 grams of carbohydrates per day. If you fail to eat this minimum, your body converts protein into glucose through gluconeogenesis. This process wastes dietary protein that could otherwise build and repair tissues, which is critical as we age. 

Also, exercise intensity determines carbohydrate needs above this baseline. Activities below 65 percent of maximum heart rate primarily burn fat for fuel. Walking, cycling, and low-intensity exercise fall into this category and require minimal carbohydrates beyond the 100-gram minimum. Once intensity crosses the 65 percent threshold into moderate and high-intensity work, the body shifts toward carbohydrate metabolism. Resistance training, running, competitive sports, and high-intensity interval training all demand immediate carbohydrate fuel.

Layman practices what he preaches. He plays tennis and exercises intensely, so he includes carbohydrates in his diet. He says he needs adequate carbs to feel good and compete well during exercise. Without sufficient carbohydrates, he says his performance suffers because he operates above the threshold where fat alone can meet energy demands.

Layman’s one-to-one visual ratio of protein to carbohydrates on the plate creates an effective and visual framework for most people. This approach naturally limits carbohydrate intake while ensuring adequate protein. For someone eating 30 to 40 grams of protein per meal, the equal volume of carbohydrates translates to roughly 30 to 40 grams of carbs, creating a moderate overall carbohydrate intake. The key is to focus on real food carbs, not junk food. That may sound obvious, but in modern society most people have lost the knowledge of basic nutrition to the point that they don’t even know how to search out and prepare real food. 

Also, individual carbohydrate tolerance varies significantly based on genetics, activity level, and metabolic health. Someone with insulin resistance needs to restrict carbohydrates more than a metabolically healthy athlete. The key here lies in matching carbohydrate intake to actual metabolic demand rather than following arbitrary rules about high-carb or low-carb diets.

Protein as an Absolute Number

One of Layman’s most important insights concerns how we think about protein intake. Layman says that protein should be treated as an absolute number, not as a percentage of total calories. “Protein’s an absolute number. I want 150 grams per day or 120. You pick that and then you pick carbohydrates and fat relative to your energy needs.” In other words, he’s advocating that we optimize for protein first, which makes a complex issue much easier to understand. 

This approach changes everything. Most diet plans express protein as a percentage of calories, typically 15 to 30 percent. But that method creates problems. For example, if someone reduces total calories while keeping protein at a fixed percentage, their absolute protein intake will drop too low. During weight loss or caloric restriction, this percentage-based approach guarantees muscle loss.

Instead, Layman recommends choosing your protein target first based on your body weight and activity level. Lock in that absolute number as your top priority. Then adjust carbohydrates and fats based on your individual needs, preferences, and metabolic health. Someone who loves carbohydrates and exercises intensely can probably eat 300 grams per day. Someone managing diabetes may need to restrict carbohydrates significantly. A person following a ketogenic approach can increase dietary fat. The critical factor lies in maintaining adequate protein regardless of how you adjust the other macronutrients. There are only three macronutrients (fat, protein, carbohydrates) and the ratio between the three matters. 

This framework supports personalized nutrition. Layman says the future of nutrition must be personal with people having a clear understanding of protein as the foundation. “It’s the single most important nutrition decision we make. Everything else revolves around it, and if you make the wrong decision there you’re really behind the eight ball to make everything else work.”

The Future of Protein Research

Layman advocates for putting amino acid profiles on nutrition labels. Current labeling tells people how many grams of protein a food contains but provides no information about which amino acids those grams contain. This oversight leaves people unable to make informed decisions about protein quality, which is the most important aspect of protein nutrition. Food labels really should just list the amino acids along with the other nutrients. 

Testing technology exists to analyze amino acids quickly and affordably. For example, mass spectrometry with fluorescence detection can process 400 foods in a day. With 15,000 new food products released in the United States annually, consumers need better tools to evaluate their choices. Looking at eight protein bars on a shelf, you cannot determine which provides superior amino acid composition without detailed analysis.

The resistance to implementing this change comes not from technical barriers but from political and economic forces, which are substantial in the nutrition industry and throughout the scientific community. Adding amino acid profiles to labels would reveal the inferior quality of many plant-based products currently marketed as protein sources. Layman has worked with various organizations and government agencies to push for these changes, but unfortunately progress is coming very slowly.

A Message for Healthy Aging

Layman returns repeatedly to the idea that protein requirements actually increase with age because the human body’s efficiency decreases. The transition begins between 30 and 40 and accelerates dramatically after age 50. Hormonal changes, particularly in women during perimenopause and menopause, make adequate protein intake even more critical.

Beyond muscle, protein affects bone health, immune function, and metabolic regulation. Layman says, “Bone is first and foremost a protein matrix.” Osteoporosis reflects not just calcium deficiency but inadequate protein to maintain the structural foundation of bone tissue. Sarcopenia, the age-related loss of muscle mass and function, threatens independence and quality of life more than most people realize until it’s too late. This wasting process is difficult to see when you are overweight. But lose the fat and it becomes obvious. 

Falls and fractures represent one of the major health problems for people over 65. Layman notes that 300,000 hip fractures occur annually in the United States, which is an utterly massive number of injuries that are not necessary. And it gets worse because one-third of those people never leave the hospital! So, maintaining muscle strength and bone density through adequate protein intake and resistance training provides one of the most effective strategies for preventing these catastrophic medical events.

But this protein issue goes beyond muscle development. The amino acids in protein are necessary for neurotransmitter synthesis and affect mood and cognitive function. Methionine supports glutathione production, one of the body’s primary antioxidant systems. Threonine maintains gut health through mucin production. Tryptophan influences serotonin levels and sleep quality. These metabolic roles require amino acid intake significantly above the RDA. Protein is everywhere in the body, and no substance comes close to protein in terms of overall nutritional requirements. 

The Bottom Line

Layman summarizes his philosophy simply — start all dietary decisions with protein first. Whether you choose to eat vegetarian or carnivore, high-fat or high-carb, everything else should follow from first ensuring adequate high-quality protein first. “Your first choice about what you should eat should always be about a protein decision.”

The science supports consuming significantly more protein than the RDA suggests. Most adults benefit from 1.2 to 1.8 grams per kilogram of body weight, with the first meal of the day containing at least 30 to 35 grams. Animal sources provide superior quality and digestibility compared to plant sources. Resistance training amplifies protein’s benefits but cannot compensate for inadequate protein intake. As a practical matter, the sequence he’s suggesting is pretty simple. 

After decades of research and hundreds of publications, Layman has shown that protein affects nearly every aspect of health from muscle and bone to metabolism and disease prevention. His work has helped reshape the food industry, promoting the development of Greek yogurt and other high-protein products. But Layman’s his most important contribution lies in teaching people that the RDA represents a minimum for survival rather than a target for thriving. Note the use of the term survival. Too few people realize how important protein is to their health. 

And finally, as we age, protein becomes more important and essential for maintaining independence, mobility, and quality of life. “Every year you replace the equivalent of every protein in your body about four times and how well you do that determines a lot about how you age.”

References

More Protein, Please

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. However, 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.

#369 ‒ Rethinking protein needs for performance, muscle preservation, and longevity, and the mental and physical benefits of creatine supplementation and sauna use | Rhonda Patrick, Ph.D.

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.